28,011 results match your criteria Acute Respiratory Distress Syndrome


Explore potential plasma biomarkers of acute respiratory distress syndrome (ARDS) using GC-MS metabolomics analysis.

Clin Biochem 2019 Feb 16. Epub 2019 Feb 16.

Departmen of Emergency and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, China. Electronic address:

Objectives: The aim of this study was to analyse the metabolomics of patients with acute respiratory distress syndrome (ARDS) for the identification of metabolic markers with potential diagnostic and prognostic value.

Methods: The enrolled subjects included adult patients with ARDS that met the Berlin definition and healthy controls matched based on age, gender, and body mass index (BMI). Plasma samples were collected from 37 patients with ARDS and 28 healthy controls. Read More

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http://dx.doi.org/10.1016/j.clinbiochem.2019.02.009DOI Listing
February 2019

The Cost-Effectiveness of Interventions to Increase Utilization of Prone Positioning for Severe Acute Respiratory Distress Syndrome.

Crit Care Med 2019 Mar;47(3):e198-e205

Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Objectives: Despite strong evidence supporting proning in acute respiratory distress syndrome, few eligible patients receive it. This study determines the cost-effectiveness of interventions to increase utilization of proning for severe acute respiratory distress syndrome.

Design: We created decision trees to model severe acute respiratory distress syndrome from ICU admission through death (societal perspective) and hospital discharge (hospital perspective). Read More

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http://dx.doi.org/10.1097/CCM.0000000000003617DOI Listing

Declining Mortality in Patients With Acute Respiratory Distress Syndrome: An Analysis of the Acute Respiratory Distress Syndrome Network Trials.

Crit Care Med 2019 Mar;47(3):315-323

Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Objectives: There has been multiple advances in the management of acute respiratory distress syndrome, but the temporal trends in acute respiratory distress syndrome-related mortality are not well known. This study aimed to investigate the trends in mortality in acute respiratory distress syndrome patients over time and to explore the roles of daily fluid balance and ventilation variables in those patients.

Design: Secondary analysis of randomized controlled trials conducted by the Acute Respiratory Distress Syndrome Network from 1996 to 2013. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003499DOI Listing

IL-33-mediated IL-13 secretion by ST2+ Treg controls inflammation after lung injury.

JCI Insight 2019 Feb 19. Epub 2019 Feb 19.

Acute respiratory distress syndrome is an often fatal disease that develops after acute lung injury and trauma. How released tissue damage signals, or alarmins, orchestrate early inflammatory events is poorly understood. Herein we reveal that IL-33, an alarmin sequestered in the lung epithelium, is required to limit inflammation after injury due to an unappreciated capacity to mediate Foxp3+ Treg control of local cytokines and myeloid populations. Read More

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http://dx.doi.org/10.1172/jci.insight.123919DOI Listing
February 2019

Acute Respiratory Failure in Renal Transplant Recipients: A Single Center Experience.

Exp Clin Transplant 2019 Jan;17(Suppl 1):172-174

From the Pulmonary Medicine, Baskent University, Adana, Turkey.

Objectives: We evaluated the frequency and cause of acute respiratory failure in renal transplant recipients.

Materials And Methods: Our single-center retrospective observational study included consecutive renal transplant recipients who were admitted to an intensive care unit for acute respiratory failure between 2011 and 2017. Acute respiratory failure was defined as oxygen saturation < 92% or partial pressure of oxygen in arterial blood < 60 mm Hg on room air and/or requirement of noninvasive or invasive mechanical ventilation. Read More

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http://dx.doi.org/10.6002/ect.MESOT2018.P49DOI Listing
January 2019

Acute Respiratory Distress Syndrome Secondary to Histoplasmosis-induced Hemophagocytic Lymphohistiocytosis.

Arch Bronconeumol 2019 Feb 15. Epub 2019 Feb 15.

Division of Pulmonary and Critical Care Medicine, Medstar Georgetown University Hospital, Washington, DC, United States.

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http://dx.doi.org/10.1016/j.arbres.2018.12.011DOI Listing
February 2019

Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure-Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.

JAMA 2019 Feb 18. Epub 2019 Feb 18.

Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Importance: Adjusting positive end-expiratory pressure (PEEP) to offset pleural pressure might attenuate lung injury and improve patient outcomes in acute respiratory distress syndrome (ARDS).

Objective: To determine whether PEEP titration guided by esophageal pressure (PES), an estimate of pleural pressure, was more effective than empirical high PEEP-fraction of inspired oxygen (Fio2) in moderate to severe ARDS.

Design, Setting, And Participants: Phase 2 randomized clinical trial conducted at 14 hospitals in North America. Read More

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http://dx.doi.org/10.1001/jama.2019.0555DOI Listing
February 2019

Unfractionated Heparin Alleviates Sepsis-Induced Acute Lung Injury by Protecting Tight Junctions.

J Surg Res 2019 Feb 13;238:175-185. Epub 2019 Feb 13.

Department of Critical Care Medicine, The First Affiliated Hospital, China Medical University, Shenyang, People's Republic of China. Electronic address:

Background: Unfractionated heparin (UFH) has been shown to ameliorate lung edema and lung vascular leakage in lipopolysaccharide-induced lung injury. Impaired tight junction (TJ) function is a sign of sepsis-induced acute respiratory distress syndrome (ARDS) and acute lung injury (ALI), which is closely related to the downregulated expression of TJ-specific proteins or the upregulated expression of inflammatory cytokines. Because UFH has been intensively studied in modulating inflammation, we hypothesize that UFH may play a positive role in treating sepsis-induced ARDS/ALI by protecting TJs. Read More

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http://dx.doi.org/10.1016/j.jss.2019.01.020DOI Listing
February 2019

Alveolar-Capillary Membrane-Related Pulmonary Cells as a Target in Endotoxin-Induced Acute Lung Injury.

Int J Mol Sci 2019 Feb 15;20(4). Epub 2019 Feb 15.

Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia.

The main function of the lungs is oxygen transport from the atmosphere into the blood circulation, while it is necessary to keep the pulmonary tissue relatively free of pathogens. This is a difficult task because the respiratory system is constantly exposed to harmful substances entering the lungs by inhalation or via the blood stream. Individual types of lung cells are equipped with the mechanisms that maintain pulmonary homeostasis. Read More

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http://dx.doi.org/10.3390/ijms20040831DOI Listing
February 2019

Kaempferol reduces K63-linked polyubiquitination to inhibit nuclear factor-κB and inflammatory responses in acute lung injury in mice.

Toxicol Lett 2019 Feb 12. Epub 2019 Feb 12.

Chemical Biology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China; The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China. Electronic address:

Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), pose a major clinical challenge. The major driving force in this syndrome is pulmonary inflammation. Recent studies have shown that the naturally occurring flavonoid kaempferol (KPF) reduces endotoxin-induced inflammatory responses in mice. Read More

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http://dx.doi.org/10.1016/j.toxlet.2019.02.005DOI Listing
February 2019

Organ Failure Modifies the Relationship Between Calorie Exposure and ICU Outcome in Acute Respiratory Distress Syndrome Patients: Further Analysis Is Required.

Crit Care Med 2019 Mar;47(3):e272-e273

Department of Emergency Medicine, The Affiliated Hospital of Ningbo University Medical College, Ningbo 315200, China Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

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http://dx.doi.org/10.1097/CCM.0000000000003570DOI Listing

Respiratory complications following mini-invasive laparoscopic and thoracoscopic esophagectomy for esophageal cancer. Experience in 215 patients.

Wideochir Inne Tech Maloinwazyjne 2019 Jan 24;14(1):52-59. Epub 2018 Jul 24.

Department of Surgery I, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic.

Introduction: Respiratory complications (RC) including respiratory failure and adult respiratory distress syndrome (ARDS) affect the outcomes of esophagectomy substantially. In order to decrease their incidence, identification of important features of RC is necessary.

Aim: To evaluate the incidence and risk factors of postoperative RC following hybrid esophagectomy. Read More

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http://dx.doi.org/10.5114/wiitm.2018.77276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372868PMC
January 2019

Distinct Metabolic Endotype Mirroring Acute Respiratory Distress Syndrome (ARDS) Subphenotype and its Heterogeneous Biology.

Sci Rep 2019 Feb 14;9(1):2108. Epub 2019 Feb 14.

Centre of Biomedical Research, SGPGIMS Campus, Raebarelly Road, Lucknow, 226014, India.

Predisposing aetiologies in Acute Respiratory Distress Syndrome (ARDS), perpetuates to heterogeneous clinical course hampering therapeutic response. Therefore, physiological variables need to be identified by stratifying ARDS subphenotypes and endotype, to target ARDS heterogeneity. The present study is stimulated by the fact that the ARDS heterogeneity arises from diverse pathophysiological changes leading to distinct ARDS endotypes characterized by perturbed biological mechanism which can be exploited in terms of metabolic profile by metabolomics. Read More

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http://dx.doi.org/10.1038/s41598-019-39017-4DOI Listing
February 2019

Retrospective study of pneumonia due to Panton-Valentine leukocidin-producing Staphylococcus aureus in Reunion.

Med Mal Infect 2019 Feb 11. Epub 2019 Feb 11.

Centre René Labusquière, (Institut de Médecine tropicale), Université Victor Segalen, 33000 Bordeaux, France; Service de réanimation polyvalente, centre hospitalier universitaire, site Felix Guyon, allée des Topazes, CS11021, 97400 Saint-Denis, Reunion.

Objective: Panton-Valentine leukocidin-producing Staphylococcus aureus necrotizing pneumonia is an unusual cause of community-acquired pneumonia, although associated with a high case fatality. This infection mainly affects young individuals, without any history, and is most often preceded by flu-like symptoms.

Method: We focused on patients presenting with Staphylococcus aureus necrotizing pneumonia in Reunion (Indian Ocean) admitted to the emergency department. Read More

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http://dx.doi.org/10.1016/j.medmal.2019.01.010DOI Listing
February 2019

The triad of diabetes ketoacidosis, hypertriglyceridemia and acute pancreatitis. How does it affect mortality and morbidity?: A 10-year analysis of the National Inpatient Sample.

Medicine (Baltimore) 2019 Feb;98(7):e14378

Gastroenterology and Hepatology Department, Digestive Disease Institute.

The triad of acute pancreatitis (AP) coexisting with diabetes ketoacidosis (DKA) and hypertriglyceridemia (HTG) has been reported, but no impact on mortality has been found to date. We aim to assess if patients with this triad are at a higher inpatient mortality compared to patients with acute pancreatitis only.Retrospective cohort. Read More

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http://dx.doi.org/10.1097/MD.0000000000014378DOI Listing
February 2019
3 Reads

Minimal Change in Cardiac Index With Increasing PEEP in Pediatric Acute Respiratory Distress Syndrome.

Front Pediatr 2019 29;7. Epub 2019 Jan 29.

Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States.

To determine if increasing positive end expiratory pressure (PEEP) leads to a change in cardiac index in children with Pediatric Acute Respiratory Distress Syndrome ranging from mild to severe. Prospective interventional study. Multidisciplinary Pediatric Intensive Care Unit in a University teaching hospital. Read More

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https://www.frontiersin.org/article/10.3389/fped.2019.00009/
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http://dx.doi.org/10.3389/fped.2019.00009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361833PMC
January 2019
1 Read

Lipopolysaccharide promotes lung fibroblast proliferation through autophagy inhibition via activation of the PI3K-Akt-mTOR pathway.

Lab Invest 2019 Feb 13. Epub 2019 Feb 13.

Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Pulmonary fibrosis is a major cause of death in patients with acute respiratory distress syndrome (ARDS). Our previous study revealed that lipopolysaccharide (LPS) challenge could lead to mouse lung fibroblast proliferation. Additionally, inhibition of autophagy in lung fibroblasts was also reported to be crucial during the process of pulmonary fibrosis. Read More

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http://www.nature.com/articles/s41374-018-0160-2
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http://dx.doi.org/10.1038/s41374-018-0160-2DOI Listing
February 2019
3 Reads

Exosomes from endothelial progenitor cells improve outcomes of the lipopolysaccharide-induced acute lung injury.

Crit Care 2019 Feb 13;23(1):44. Epub 2019 Feb 13.

Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 173 Ashley Ave., MSC 908, CRI Room 610, Charleston, SC, 29425, USA.

Background: The acute respiratory distress syndrome (ARDS) is characterized by disruption of the alveolar-capillary barrier resulting in accumulation of proteinaceous edema and increased inflammatory cells in the alveolar space. We previously found that endothelial progenitor cell (EPC) exosomes prevent endothelial dysfunction and lung injury in sepsis in part due to their encapsulation of miRNA-126. However, the effects of EPC exosomes in acute lung injury (ALI) remain unknown. Read More

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http://dx.doi.org/10.1186/s13054-019-2339-3DOI Listing
February 2019
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PES Pathogens in Severe Community-Acquired Pneumonia.

Microorganisms 2019 Feb 12;7(2). Epub 2019 Feb 12.

Department of Pneumology, Hospital Clinic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB)-SGR 911-Ciber de Enfermedades Respiratorias (Ciberes), 08036 Barcelona, Spain.

Worldwide, there is growing concern about the burden of pneumonia. Severe community-acquired pneumonia (CAP) is frequently complicated by pulmonary and extra-pulmonary complications, including sepsis, septic shock, acute respiratory distress syndrome, and acute cardiac events, resulting in significantly increased intensive care admission rates and mortality rates. (Pneumococcus) remains the most common causative pathogen in CAP. Read More

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http://www.mdpi.com/2076-2607/7/2/49
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http://dx.doi.org/10.3390/microorganisms7020049DOI Listing
February 2019
3 Reads

Mechanosensitive Rap1 activation promotes barrier function of lung vascular endothelium under cyclic stretch.

Mol Biol Cell 2019 Feb 13:mbcE18070422. Epub 2019 Feb 13.

Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201.

Mechanical ventilation remains an imperative treatment for the patients with acute respiratory distress syndrome, but can also exacerbate lung injury. We have previously described a key role of RhoA GTPase in high cyclic stretch (CS)-induced endothelial (EC) barrier dysfunction. However, cellular mechanotransduction complexes remain to be characterized. Read More

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https://www.molbiolcell.org/doi/10.1091/mbc.E18-07-0422
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http://dx.doi.org/10.1091/mbc.E18-07-0422DOI Listing
February 2019
2 Reads

The Clinical Significance of a 'Crazy-Paving' Pattern on Chest Radiology.

Eur J Case Rep Intern Med 2018 27;5(12):000978. Epub 2018 Dec 27.

Pulmonary Department, Loewenstein Lung Center, Löwenstein, Germany.

A crazy-paving pattern is a non-specific radiological sign which is characterized by the presence of diffuse ground-glass attenuation associated with interlobular septal thickening and intralobular lines. It was initially described as a pathognomonic sign of pulmonary alveolar proteinosis. However, it can be also found in many other diffuse acute and chronic lung diseases including diffuse alveolar haemorrhage (DAH), a rare and life-threatening clinical syndrome which can be caused by many conditions, the most frequent of these being capillaritis associated with systemic autoimmune diseases. Read More

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http://dx.doi.org/10.12890/2018_000978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346976PMC
December 2018
6 Reads

Lung fluid biomarkers for acute respiratory distress syndrome: a systematic review and meta-analysis.

Crit Care 2019 Feb 12;23(1):43. Epub 2019 Feb 12.

Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center of Respiratory and Critical Care Medicine, Capital Medical University, NO. 8, Gong Ti South Road, Chao-Yang District, Beijing, 100020, China.

Background: With the development of new techniques to easily obtain lower respiratory tract specimens, bronchoalveolar lavage fluid and other lung fluids are gaining importance in pulmonary disease diagnosis. We aimed to review and summarize lung fluid biomarkers associated with acute respiratory distress syndrome diagnosis and mortality.

Methods: After searching PubMed, Embase, Web of Science, and the Cochrane Library for articles published prior to January 11, 2018, we performed a meta-analysis on biomarkers for acute respiratory distress syndrome diagnosis in at-risk patients and those related to disease mortality. Read More

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https://ccforum.biomedcentral.com/articles/10.1186/s13054-01
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http://dx.doi.org/10.1186/s13054-019-2336-6DOI Listing
February 2019
4 Reads

MicroRNA‑223 attenuates LPS‑induced inflammation in an acute lung injury model via the NLRP3 inflammasome and TLR4/NF‑κB signaling pathway via RHOB.

Int J Mol Med 2019 Mar 23;43(3):1467-1477. Epub 2019 Jan 23.

Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China.

Acute lung injury (ALI) and the more severe acute respiratory distress syndrome are common and complex inflammatory lung diseases. MicroRNAs (miRs) have emerged as novel gene regulatory molecules, serving a crucial role in a variety of complex diseases, including ALI. In the present study, the anti‑inflammatory action of miR‑223 on inflammation in ALI was demonstrated and the possible mechanism was further examined. Read More

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http://www.spandidos-publications.com/10.3892/ijmm.2019.4075
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http://dx.doi.org/10.3892/ijmm.2019.4075DOI Listing
March 2019
2 Reads

What links ventilator driving pressure with survival in the acute respiratory distress syndrome? A computational study.

Respir Res 2019 Feb 11;20(1):29. Epub 2019 Feb 11.

School of Engineering, University of Warwick, Coventry, UK.

Background: Recent analyses of patient data in acute respiratory distress syndrome (ARDS) showed that a lower ventilator driving pressure was associated with reduced relative risk of mortality. These findings await full validation in prospective clinical trials.

Methods: To investigate the association between driving pressures and ventilator induced lung injury (VILI), we calibrated a high fidelity computational simulator of cardiopulmonary pathophysiology against a clinical dataset, capturing the responses to changes in mechanical ventilation of 25 adult ARDS patients. Read More

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http://dx.doi.org/10.1186/s12931-019-0990-5DOI Listing
February 2019
1 Read

Prognostic values of the Berlin definition criteria, blood lactate level, and fibroproliferative changes on high-resolution computed tomography in ARDS patients.

BMC Pulm Med 2019 Feb 11;19(1):37. Epub 2019 Feb 11.

Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 160-8582, Japan.

Background: In the Berlin definition, acute respiratory distress syndrome (ARDS) is stratified into three stages according to oxygenation severity at the onset. The relevance between ARDS severity and prognosis varies among published reports and has not been verified, especially in Asian patients.

Methods: In this study, we examined the associations between the Berlin definition criteria and prognosis and clinical parameters, including high-resolution computed tomography (HRCT) scores of fibroproliferative changes of the lungs. Read More

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http://dx.doi.org/10.1186/s12890-019-0803-0DOI Listing
February 2019

Long term veno-venous extracorporeal life support without intravenous anticoagulation for diffuse alveolar hemorrhage.

Perfusion 2019 Feb 11:267659119826828. Epub 2019 Feb 11.

1 University of Maryland School of Medicine, Baltimore, MD, USA.

Introduction:: Diffuse alveolar damage is the histologic hallmark for the acute phase of acute respiratory distress syndrome and can occasionally present as diffuse alveolar hemorrhage.

Case Report:: We report a patient with diffuse alveolar hemorrhage and acute respiratory distress syndrome requiring veno-venous extracorporeal life support for 210 days, who was successfully treated for a period of 130 consecutive days without intravenous anticoagulation.

Discussion:: Although there are a few brief reports detailing long extracorporeal life support runs, the literature is largely devoid of data regarding long-term extracorporeal life support without full systemic anticoagulation. Read More

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http://dx.doi.org/10.1177/0267659119826828DOI Listing
February 2019
2 Reads

Bronchoalveolar Fluid and Plasma Inflammatory Biomarkers in Contemporary ARDS Patients.

Biomarkers 2019 Feb 12:1-25. Epub 2019 Feb 12.

a Department of Medicine, Division of Pulmonary and Critical Care Medicine , University of Vermont College of Medicine , Burlington , Vermont , USA.

Purpose: Bronchoalveolar fluid (BALF) and plasma biomarkers are often endpoints in early phase randomized trials (RCTs) in acute respiratory distress syndrome (ARDS). With ARDS mortality decreasing, we analyzed baseline biomarkers in samples from contemporary ARDS patients participating in a prior RCT and compared these to historical controls.

Materials And Methods: Ninety ARDS adult patients enrolled in the parent trial. Read More

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https://www.tandfonline.com/doi/full/10.1080/1354750X.2019.1
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http://dx.doi.org/10.1080/1354750X.2019.1581840DOI Listing
February 2019
2 Reads

Effects of Stepwise Lung Recruitment Maneuvers in Patients with Early Acute Respiratory Distress Syndrome: A Prospective, Randomized, Controlled Trial.

J Clin Med 2019 Feb 10;8(2). Epub 2019 Feb 10.

School of Medicine, College of Medicine, Fu Jen Catholic University, Xinzhuang Dist., New Taipei City 24205, Taiwan (R.O.C).

Since the clinical benefit of lung recruitment maneuvers (LRMs) is still conflicting, we performed this prospective, randomized, controlled study to investigate whether LRMs should be used in the routine management of acute respiratory distress syndrome (ARDS). This trial was conducted in four intensive care units (ICUs) to compare application of a modified stepwise LRMs with solely lung-protective ventilation in patients with moderate to severe ARDS within 72 h from the onset. The primary outcome was 28-day mortality, and the secondary outcomes were ventilator-free days and ICU-free days. Read More

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http://www.mdpi.com/2077-0383/8/2/231
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http://dx.doi.org/10.3390/jcm8020231DOI Listing
February 2019
3 Reads

Life-Threatening Complications among Women with Severe Ovarian Hyperstimulation Syndrome.

Am J Obstet Gynecol 2019 Feb 8. Epub 2019 Feb 8.

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Columbia University Medical Center, 5 Columbus Circle, PH, New York, NY 10019.

Background: Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening clinical condition.

Objective: The objective of this study was to evaluate risk factors for life-threatening complications for patients with severe OHSS in a United States nationwide sample.

Materials And Methods: OHSS admissions from 2002-2011 from the Nationwide Inpatient Sample (NIS) were included in this study. Read More

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http://dx.doi.org/10.1016/j.ajog.2019.02.009DOI Listing
February 2019
1 Read

Volume Capnography in the Intensive Care Unit: Potential Clinical Applications.

Authors:
John W Kreit

Ann Am Thorac Soc 2019 Feb 11. Epub 2019 Feb 11.

University of Pittsburgh, Pulmonary, Allergy, and Critical Care Medicine, Pittsburgh, Pennsylvania, United States ;

Volume capnography provides a non-invasive, continuous display of the fractional concentration or partial pressure of carbon dioxide versus exhaled volume. Derived measurements and calculations are influenced by changes in both ventilation and perfusion and are therefore useful for assessing both respiratory and cardiovascular function. This article provides an evidence-based review of several potential uses of volume capnography in the ICU: 1) monitoring the effectiveness of ventilation by using end-tidal PCO2 as a surrogate for arterial PCO2; 2) assessing volume-responsiveness; 3) measuring cardiac output; 4) determining prognosis in patients with the acute respiratory distress syndrome; 5) optimizing alveolar recruitment; and 6) excluding pulmonary embolism. Read More

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http://dx.doi.org/10.1513/AnnalsATS.201807-502CMEDOI Listing
February 2019
1 Read

poisoning: a case report of intentional poisoning.

BMJ Case Rep 2019 Feb 9;12(2). Epub 2019 Feb 9.

Neurology, Vinayaka Neuro Multispecialty Clinic, Warangal, India.

We report a case of 50-year-old male patient from tribal area in South Indian state of Telangana, who ingested the liquid extract from crushed leaves of the plant, cleistanthus collinius with the intention of self-harm. Immediate gastric lavage and activated charcoal administration was done and the patient was subsequently admitted into an acute medical care unit. During first 24 hours of monitoring, the patient was clinically stable. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22819
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http://dx.doi.org/10.1136/bcr-2018-228197DOI Listing
February 2019
5 Reads

HIPK1 Interference Attenuates Inflammation and Oxidative Stress of Acute Lung Injury via Autophagy.

Med Sci Monit 2019 Jan 29;25:827-835. Epub 2019 Jan 29.

Department of Obstetrics, Qingdao Municipal Hospital of Shandong Province, Qingdao, Shandong, China (mainland).

BACKGROUND Acute respiratory distress syndrome (ARDS), which is characterized by severe hypoxemia (PaO2/FIO2 ≤300 mmHg), is usually companied by uncontrolled inflammation, oxidative injury, and the damage to the alveolar-capillary barrier. Severe ARDS is usually companied with acute lung injury that worsen the patients' condition. HIPK1 is a modulator of homeodomain-containing transcription factors and regulates multiple cellular biological process associated with inflammation and anti-stress responses. Read More

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http://dx.doi.org/10.12659/MSM.912507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362758PMC
January 2019
2 Reads

Platelets inhibit apoptotic lung epithelial cell death and protect mice against infection-induced lung injury.

Blood Adv 2019 Feb;3(3):432-445

Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.

Thrombocytopenia is associated with worse outcomes in patients with acute respiratory distress syndrome, which is most commonly caused by infection and marked by alveolar-capillary barrier disruption. However, the mechanisms by which platelets protect the lung alveolar-capillary barrier during infectious injury remain unclear. We found that natively thrombocytopenic mice deficient in the thrombopoietin receptor sustain severe lung injury marked by alveolar barrier disruption and hemorrhagic pneumonia with early mortality following acute intrapulmonary (PA) infection; barrier disruption was attenuated by platelet reconstitution. Read More

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http://dx.doi.org/10.1182/bloodadvances.2018026286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373758PMC
February 2019
2 Reads

Successful extracorporeal membrane oxygenation support for severe acute diquat and glyphosate poisoning: A case report.

Medicine (Baltimore) 2019 Feb;98(6):e14414

Department of Critical Care Medicine, Quzhou People's Hospital, Quzhou.

Rationale: Because of the lack of an antidote or effective treatment, patients with severe acute diquat and glyphosate poisoning always died within a few hours. Extracorporeal membrane pulmonary oxygenation (ECMO), as an artificial heart-lung supporting system, can be applied to support lung that is expected to recover from reversible pathological damage. However, to our knowledge, the application of ECMO for patients with diquat and glyphosate poisoning has not been reported. Read More

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http://dx.doi.org/10.1097/MD.0000000000014414DOI Listing
February 2019
1 Read

Role of Nrf2 and Its Activators in Respiratory Diseases.

Oxid Med Cell Longev 2019 8;2019:7090534. Epub 2019 Jan 8.

Institute of Translational Medicine, The First Hospital of Jilin University, Changchun 130001, China.

Transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) is a major regulator of antioxidant response element- (ARE-) driven cytoprotective protein expression. The activation of Nrf2 signaling plays an essential role in preventing cells and tissues from injury induced by oxidative stress. Under the unstressed conditions, natural inhibitor of Nrf2, Kelch-like ECH-associated protein 1 (Keap1), traps Nrf2 in the cytoplasm and promotes the degradation of Nrf2 by the 26S proteasome. Read More

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http://dx.doi.org/10.1155/2019/7090534DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341270PMC
January 2019
1 Read

Severe thoracic trauma caused left pneumonectomy complicated by right traumatic wet lung, reversed by extracorporeal membrane oxygenation support-a case report.

BMC Pulm Med 2019 Feb 6;19(1):30. Epub 2019 Feb 6.

Critical Care Medicine Department of The First People's Hospital of Foshan, Lingnan Avenue North 81, Shiwan, Chancheng, Foshan, 528000, China.

Background: Double lumen intubation and one-lung ventilation should be applied without delay in cases of traumatic main bronchial rupture. In most cases, when the patients' vital signs have been stabilized, the repair can be performed. However, when one-lung ventilation is complicated by traumatic wet lung, the mortality rate is likely to be much higher. Read More

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http://dx.doi.org/10.1186/s12890-019-0790-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366044PMC
February 2019
1 Read

Resolvin D1 attenuates mechanical stretch-induced pulmonary fibrosis via epithelial-mesenchymal transition (EMT).

Am J Physiol Lung Cell Mol Physiol 2019 Feb 6. Epub 2019 Feb 6.

Anesthesiology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.

Mechanical ventilation-induced pulmonary fibrosis plays an important role in the high mortality rate of acute respiratory distress syndrome (ARDS). Resolvin D1 (RvD1) displays potent proresolving activities. Epithelial-mesenchymal transition (EMT) has been proven to be an important pathological feature of lung fibrosis. Read More

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http://dx.doi.org/10.1152/ajplung.00415.2018DOI Listing
February 2019
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Mechanical Ventilation and Extracorporeal Membrane Oxygena tion in Acute Respiratory Insufficiency.

Dtsch Arztebl Int 2018 12;115(50):840-847

Board of directors, Ulm University Hospital

Background: Mechanical ventilation is life-saving for patients with acute respiratory insufficiency. In a German prevalence study, 13.6% of patients in intensive care units received mechanical ventilation for more than 12 hours; 20% of these patients received mechanical ventilation as treatment for acute respiratory distress syndrome (ARDS). Read More

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http://dx.doi.org/10.3238/arztebl.2018.0840DOI Listing
December 2018
2 Reads

Can We Prevent the Progression to Pediatric Acute Respiratory Distress Syndrome? Let's Start With Identifying Those "At Risk".

Pediatr Crit Care Med 2019 Feb;20(2):204-205

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA Department of Pediatrics and Public Health Sciences, Penn State University College of Medicine, Hershey, PA.

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http://dx.doi.org/10.1097/PCC.0000000000001836DOI Listing
February 2019
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Impact of spontaneous breathing during mechanical ventilation in acute respiratory distress syndrome.

Curr Opin Crit Care 2019 Jan 31. Epub 2019 Jan 31.

Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Purpose Of Review: Facilitating spontaneous breathing has been traditionally recommended during mechanical ventilation in acute respiratory distress syndrome (ARDS). However, early, short-term use of neuromuscular blockade appears to improve survival, and spontaneous effort has been shown to potentiate lung injury in animal and clinical studies. The purpose of this review is to describe the beneficial and deleterious effects of spontaneous breathing in ARDS, explain potential mechanisms for harm, and provide contemporary suggestions for clinical management. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000597DOI Listing
January 2019
8 Reads

Gemykibivirus genome in lower respiratory tract of elderly woman with unexplained acute respiratory distress syndrome.

Clin Infect Dis 2019 Feb 2. Epub 2019 Feb 2.

The Joint Center for Infection and Immunity: a. Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China; b. Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China.

We identified, for the first time, the presence of small circular single stranded Gemykibivirus (GkV) genome from the respiratory tract of an elderly woman with severe acute respiratory distress syndrome using metagenomics analysis. Our results suggest that further studies on whether GkVs infect humans and cause respiratory disease are needed. Read More

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http://dx.doi.org/10.1093/cid/ciz072DOI Listing
February 2019
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Cell therapy for ARDS: efficacy of endobronchial versus intravenous administration and biodistribution of MAPCs in a large animal model.

BMJ Open Respir Res 2019 12;6(1):e000308. Epub 2019 Jan 12.

The Dorothy P. and Richard P. Simmons Center for Interstitial Lung Diseases, Pittsburgh, Pennsylvania, USA.

Introduction: Bone marrow-derived multipotent adult progenitor cells (MAPCs) are adult allogeneic adherent stem cells currently investigated clinically for use in acute respiratory distress syndrome (ARDS). To date, there is no agreement on which is the best method for stem cells delivery in ARDS. Here, we compared the efficacy of two different methods of administration and biodistribution of MAPC for the treatment of ARDS in a sheep model. Read More

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http://dx.doi.org/10.1136/bmjresp-2018-000308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339992PMC
January 2019
2 Reads

Does lack of thoracic trauma attenuate the severity of pulmonary failure? An 8-year analysis of critically injured patients.

Eur J Trauma Emerg Surg 2019 Feb 2. Epub 2019 Feb 2.

Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave. #225, Memphis, TN, 38163, USA.

Purpose: Patients with thoracic trauma are presumed to be at higher risk for pulmonary dysfunction, but adult respiratory distress syndrome (ARDS) may develop in any patient, regardless of associated chest injury. This study evaluated the impact of thoracic trauma and pulmonary failure on outcomes in trauma patients admitted to the intensive-care unit (ICU).

Methods: All trauma patients admitted to the ICU over an 8-year period were identified. Read More

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http://dx.doi.org/10.1007/s00068-019-01081-wDOI Listing
February 2019
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Carinal surgery: A single-institution experience spanning 2 decades.

J Thorac Cardiovasc Surg 2018 Dec 15. Epub 2018 Dec 15.

Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Mass. Electronic address:

Objectives: Complete resection of neoplasms involving the carina are technically challenging and have high operative morbidity and mortality. This study examines the last 2 decades of clinical experience at our institution.

Methods: Medical records were retrospectively reviewed between 1997 and 2017 to identify all patients who underwent carinal resection. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00225223183330
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http://dx.doi.org/10.1016/j.jtcvs.2018.11.130DOI Listing
December 2018
5 Reads

Acute Respiratory Failure from Cement Exposure: A Case Report and Review of the Literature.

R I Med J (2013) 2019 Feb 1;102(1):55-57. Epub 2019 Feb 1.

Department of Emergency Medicine, and Division of Emergency Toxicology, Brown Emergency Medicine, 55 Claverick Street, Suite 100, Providence, RI.

Cement is widely used in construction. Acute exposures with immediate sequelae have been infrequently described. This case report describes a man who developed multifocal pneumonitis with acute respiratory distress syndrome (ARDs) and respiratory failure one day after cement dust exposure. Read More

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February 2019
3 Reads

[Review and forecast of critical care medicine in 2018].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2019 Jan;31(1):16-22

Department of Critical Care Medicine, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, China. Corresponding author: Huang Wei, Email:

Objective: In 2018, a bunch of considerable positive progresses have been presented, including a revised "hour-1 bundle" introduced by international guideline for management of sepsis and septic shock, trans-pulmonary pressure monitoring via esophageal manometry in acute respiratory distress syndrome (ARDS) models, successful trials for new antibiotics, angiotensin II in patients with vasodilatory shock and renal replacement therapy, advanced airway management in out-of-hospital cardiac arrest (OHCA) patients as well cellular immunotherapy for septic shock. But some of investigational trials did not yield expected results. For example, extracorporeal membrane oxygenation (ECMO) therapy for ARDS patients, the strategy of sequencing weaning with early extubation to noninvasive ventilation, prevention of delirium with haloperidol, surrogate decision supported by interprofessional intensive care unit (ICU) team and prophylaxis for gastrointestinal stress ulceration with pantoprazole in ICU. Read More

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http://dx.doi.org/10.3760/cma.j.issn.2095-4352.2019.01.005DOI Listing
January 2019
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Clear as Mud: Diagnostic Uncertainty in Acute Respiratory Distress Syndrome.

Ann Am Thorac Soc 2019 Feb;16(2):197-199

Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.

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http://dx.doi.org/10.1513/AnnalsATS.201810-697EDDOI Listing
February 2019
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Omega-3 polyunsaturated fatty acids in critically ill patients with acute respiratory distress syndrome: A systematic review and meta-analysis.

Nutrition 2018 Nov 5;61:84-92. Epub 2018 Nov 5.

Department of Critical Care, Intensive Care Unit, University Hospital, Faculty of Medicine, UDELAR, Montevideo, Uruguay.

Objective: Acute respiratory distress syndrome (ARDS) is characterized by an acute inflammatory response in the lung parenchyma leading to severe hypoxemia. Because of its anti-inflammatory and immunomodulatory properties, omega-3 polyunsaturated fatty acids (ω-3 PUFA) have been administered to ARDS patients, mostly by the enteral route, as immune-enhancing diets with eicosapentaenoic acid, γ-linolenic acid, and antioxidants. However, clinical benefits of ω-3 PUFAs in ARDS patients remain unclear because clinical trials have found conflicting results. Read More

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http://dx.doi.org/10.1016/j.nut.2018.10.026DOI Listing
November 2018
1 Read