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    Maternal and neonatal outcomes of respiratory failure during pregnancy.
    J Formos Med Assoc 2017 May 17. Epub 2017 May 17.
    Department of Thoracic Medicine, Chang Gung University College of Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan. Electronic address:
    Background: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy.

    Methods: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. Read More

    Keratinocyte growth factor for the treatment of the acute respiratory distress syndrome (KARE): a randomised, double-blind, placebo-controlled phase 2 trial.
    Lancet Respir Med 2017 May 16. Epub 2017 May 16.
    Centre for Experimental Medicine, The Wellcome Wolfson Building, The Queen's University Belfast, Belfast, UK.
    Background: Data from in-vitro, animal, and human lung injury models suggest that keratinocyte growth factor (KGF) might be beneficial in acute respiratory distress syndrome (ARDS). The objective of this trial was to investigate the effect of KGF in patients with ARDS.

    Methods: We did a double-blind, allocation concealed, randomised, placebo-controlled phase 2 trial in two intensive care units in the UK, involving patients fulfilling the American-European Consensus Conference Definition of ARDS. Read More

    Is There a Preinterventional Mechanical Ventilation Time Limit for Candidates of Adult Respiratory Extracorporeal Membrane Oxygenation.
    ASAIO J 2017 May 18. Epub 2017 May 18.
    From the *Department of Cardiovascular Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; †Department of Thoracic Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; ‡Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; and §Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
    Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality. Read More

    [Efficacy of 20% albumin infusion on coagulation and pulmonary fibrosis in rabbits with ARDS].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 May;29(5):407-412
    Department of Critical Care Medicine, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou, China (Yao L, Liu B, Shen F); Department of Critical Care Medicine, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, China (Yao L). Corresponding author: Shen Feng, Email:
    Objective: To observe the efficacy of 20% albumin infusion on coagulation and pulmonary fibrosis in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hit of intravenous infusion of oleid acid (OA) and lipopolysaccharide (LPS).

    Methods: Forty healthy adult male rabbits were randomly divided into five groups, namely sham group, model group, albumin group (20% albumin), saline group (0.9% sodium chloride injection) and Ringer group (lactate Ringer solution), with 8 rabbits in each group. Read More

    The Role of Transient Receptor Potential Vanilloid 4 in Pulmonary Inflammatory Diseases.
    Front Immunol 2017 4;8:503. Epub 2017 May 4.
    Cleveland Clinic, Department of Pathobiology, Lerner Research Institute, Cleveland, OH, USA.
    Ion channels/pumps are essential regulators of organ homeostasis and disease. In the present review, we discuss the role of the mechanosensitive cation channel, transient receptor potential vanilloid 4 (TRPV4), in cytokine secretion and pulmonary inflammatory diseases such as asthma, cystic fibrosis (CF), and acute lung injury/acute respiratory distress syndrome (ARDS). TRPV4 has been shown to play a role in lung diseases associated with lung parenchymal stretch or stiffness. Read More

    Protective Effects of Hydrogen-Rich Saline Against Lipopolysaccharide-Induced Alveolar Epithelial-to-Mesenchymal Transition and Pulmonary Fibrosis.
    Med Sci Monit 2017 May 19;23:2357-2364. Epub 2017 May 19.
    Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).
    BACKGROUND Fibrotic change is one of the important reasons for the poor prognosis of patients with acute respiratory distress syndrome (ARDS). The present study investigated the effects of hydrogen-rich saline, a selective hydroxyl radical scavenger, on lipopolysaccharide (LPS)-induced pulmonary fibrosis. MATERIAL AND METHODS Male ICR mice were divided randomly into 5 groups: Control, LPS-treated plus vehicle treatment, and LPS-treated plus hydrogen-rich saline (2. Read More

    Immune plasma for the treatment of severe influenza: an open-label, multicentre, phase 2 randomised study.
    Lancet Respir Med 2017 May 15. Epub 2017 May 15.
    National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
    Background: Influenza causes substantial morbidity and mortality despite available treatments. Anecdotal reports suggest that plasma with high antibody titres to influenza might be of benefit in the treatment of severe influenza.

    Methods: In this randomised, open-label, multicentre, phase 2 trial, 29 academic medical centres in the USA assessed the safety and efficacy of anti-influenza plasma with haemagglutination inhibition antibody titres of 1:80 or more to the infecting strain. Read More

    Use of High-Frequency Percussive Ventilation to Expand Organ Donor Pool.
    J Intensive Care Med 2017 Jan 1:885066617709969. Epub 2017 Jan 1.
    2 Department of Cardiothoracic Surgery, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA.
    A 34-year-old woman was brought in to the emergency department after a motor vehicle accident. She had signs of traumatic head injury with Glasgow Coma Scale score of 3, and her neurological examination was consistent with brain death. She was persistently hypoxic on conventional mechanical ventilation and high-frequency percussive ventilation was initiated. Read More

    Simvastatin for patients with acute respiratory distress syndrome: long-term outcomes and cost-effectiveness from a randomised controlled trial.
    Crit Care 2017 May 17;21(1):108. Epub 2017 May 17.
    Northern Ireland Clinical Trials Unit, Elliot Dynes Building, The Royal Hospitals, Grosvenor Road, Belfast, BT12 6BA, UK.
    Background: Simvastatin therapy for patients with acute respiratory distress syndrome (ARDS) has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at 12 months.

    Methods: This was a cost-utility analysis alongside a multicentre, double-blind, randomised controlled trial carried out in the UK and Ireland. Read More

    Clinical Profile and Outcome of Newborns with Acute Kidney Injury in a Level 3 Neonatal Unit in Western India.
    J Clin Diagn Res 2017 Mar 1;11(3):SC01-SC04. Epub 2017 Mar 1.
    Professor, Department of Paediatrics, Pramukhswami Medical College, Karamsad, Gujarat, India.
    Introduction: Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications.

    Aim: To evaluate clinical profile, identify associated and prog-nostic factors in newborns with AKI. Read More

    Mechanical ventilation in the acute respiratory distress syndrome.
    Hosp Pract (1995) 2017 May 23:1-11. Epub 2017 May 23.
    b Division of Cardiology , Westchester Medical Center, New York Medical College , Valhalla , NY , USA.
    The management of the acute respiratory distress syndrome (ARDS) patient is fundamental to the field of intensive care medicine, and it presents unique challenges owing to the specialized mechanical ventilation techniques that such patients require. ARDS is a highly lethal disease, and there is compelling evidence that mechanical ventilation itself, if applied in an injurious fashion, can be a contributor to ARDS mortality. Therefore, it is imperative for any clinician central to the care of ARDS patients to understand the fundamental framework that underpins the approach to mechanical ventilation in this special scenario. Read More

    Surfactants in Acute Respiratory Distress Syndrome in Infants and Children: Past, Present and Future.
    Clin Drug Investig 2017 May 16. Epub 2017 May 16.
    Chiesi Farmaceutici Spa, Parma, Italy.
    There is a lack of definitive data on the effective management of acute respiratory distress syndrome (ARDS) in infants and children. The development and validation of the Berlin definition (BD) for ARDS and the Pediatric Acute Lung Injury Consensus Conference (PALICC) recommendations in children represented a major advance in optimizing research and treatment, mainly due to the introduction of a severe ARDS category. Proposed reasons for the lack of consistent results with surfactants in children and infants compared with neonates include different causes, type of lung damage (direct or indirect), timing and mode of administration as well as the type of surfactant used. Read More

    Can glypican-3 be a disease-specific biomarker?
    Clin Transl Med 2017 Dec 16;6(1):18. Epub 2017 May 16.
    Department of Pulmonary Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
    Background: Glypican-3 (GPC3) is a cell surface-bound proteoglycan which has been identified as a potential biomarker candidate in hepatocellular carcinoma, lung carcinoma, severe pneumonia, and acute respiratory distress syndrome (ARDS). The aim of our review is to evaluate whether GPC3 has utility as a disease-specific biomarker, to discuss the potential involvement of GPC3 in cell biology, and to consider the changes of GPC3 gene and protein expression and regulation in hepatocellular carcinoma, lung cancer, severe pneumonia, and ARDS.

    Results: Immunohistochemical studies have suggested that over-expression of GPC3 is associated with a poorer prognosis for hepatocellular carcinoma patients. Read More

    Matrix stiffness regulates migration of human lung fibroblasts.
    Physiol Rep 2017 May 14;5(9). Epub 2017 May 14.
    Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
    In patients with pulmonary diseases such as idiopathic pulmonary fibrosis and severe acute respiratory distress syndrome, progressive pulmonary fibrosis is caused by dysregulated wound healing via activation of fibroblasts after lung inflammation or severe damage. Migration of fibroblasts toward the fibrotic lesions plays an important role in pulmonary fibrosis. Fibrotic tissue in the lung is much stiffer than normal lung tissue. Read More

    [The role of extracorporeal removal of CO2 (ECCO2R) in the management of respiratory diseases].
    Rev Mal Respir 2017 May 12. Epub 2017 May 12.
    Service de réanimation médicale, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France.
    Introduction: The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows.

    State Of The Art: For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications. Read More

    Design of Surfactant Protein B Peptide Mimics Based on the Saposin Fold for Synthetic Lung Surfactants.
    Biomed Hub 2016 Sep-Dec;1(3). Epub 2016 Nov 16.
    Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
    Surfactant protein (SP)-B is a 79-residue polypeptide crucial for the biophysical and physiological function of endogenous lung surfactant. SP-B is a member of the Saposin or Saposin-like proteins (SAPLIP) family of proteins that share an overall three-dimensional folding pattern based on secondary structures and disulfide connectivity and exhibit a wide diversity of biological functions. Here we review the synthesis, molecular biophysics and activity of synthetic analogs of Saposin proteins designed to mimic those interactions of the parent proteins with lipids that enhance interfacial activity. Read More

    [Extracorporeal life support in thoracic surgery: What are the indications and the pertinence?]
    Rev Mal Respir 2017 May 12. Epub 2017 May 12.
    Service de chirurgie thoracique, groupe de transplantation pulmonaire de Strasbourg, nouvel hôpital civil, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France. Electronic address:
    Introduction: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine.

    State Of The Art: ECLS technologies should only be undertaken in expert centers. Read More

    Impact of hernia volume on pulmonary complications following complex hernia repair.
    J Surg Res 2017 May 7;211:8-13. Epub 2016 Dec 7.
    Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
    Background: Despite a multitude of evidence-based prediction models and risk factors for postoperative complications after ventral hernia repair, estimating a patient's risk of postoperative complications after ventral hernia repair remains challenging. In an attempt to improve the preoperative assessment of complex hernia patients, some studies have examined pulmonary changes after hernia repair hypothesizing that large hernias lead to pulmonary changes and increased pulmonary complication rates. Some studies have described a correlation between hernia volume and pulmonary changes, although none provided compelling evidence to identify hernia volume as a risk factor for pulmonary complications. Read More

    Systematic review and meta-analysis of complications and mortality of veno-venous extracorporeal membrane oxygenation for refractory acute respiratory distress syndrome.
    Ann Intensive Care 2017 Dec 12;7(1):51. Epub 2017 May 12.
    Critical Care Center, CIBER de Enfermedades Respiratorias, Corporació Sanitària Universitària Parc Taulí, Autonomous University of Barcelona, Parc Taulí 1, 08208, Sabadell, Spain.
    Veno-venous extracorporeal membrane oxygenation (ECMO) for refractory acute respiratory distress syndrome (ARDS) is a rapidly expanding technique. We performed a systematic review and meta-analysis of the most recent literature to analyse complications and hospital mortality associated with this technique. Using the PRISMA guidelines for systematic reviews and meta-analysis, MEDLINE and EMBASE were systematically searched for studies reporting complications and hospital mortality of adult patients receiving veno-venous ECMO for severe and refractory ARDS. Read More

    Molecular aspects of MERS-CoV.
    Front Med 2017 May 13. Epub 2017 May 13.
    Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, 31311, Saudi Arabia.
    Middle East respiratory syndrome coronavirus (MERS-CoV) is a betacoronavirus which can cause acute respiratory distress in humans and is associated with a relatively high mortality rate. Since it was first identified in a patient who died in a Jeddah hospital in 2012, the World Health Organization has been notified of 1735 laboratory-confirmed cases from 27 countries, including 628 deaths. Most cases have occurred in Saudi Arabia. Read More

    Extracorporeal membrane oxygenation (ECMO) as a treatment strategy for severe acute respiratory distress syndrome (ARDS) in the low tidal volume era: A systematic review.
    J Crit Care 2017 Apr 27;41:64-71. Epub 2017 Apr 27.
    Division of Critical Care Medicine, Department of Medicine, Western University, Canada; Department of Surgery, Western University, Canada.
    Objective: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone.

    Methods: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included. Read More

    PPAR-α improves the recovery of lung function following acute respiratory distress syndrome by suppressing the level of TGF-β1.
    Mol Med Rep 2017 May 10. Epub 2017 May 10.
    Intensive Care Unit, Zigong First People's Hospital, Zigong, Sichuan 643000, P.R. China.
    Although peroxisome proliferator-activated receptor (PPAR)-α has been reported to be involved in preventing acute lung injury (ALI), the molecular regulation of post‑ALI lung recovery remains to be fully elucidated. The aim of the present study was to characterize the mechanism by which PPAR‑α prevents ALI and examine the role of PPAR‑α in the recovery of lung function following acute respiratory distress syndrome (ARDS). Reverse transcription‑quantitative‑polymerase chain reaction and western blot analyses suggested that PPAR‑α was effective in suppressing transforming growth factor (TGF)‑β1 in HLF cells and RAW 264. Read More

    The role of high airway pressure and dynamic strain on ventilator-induced lung injury in a heterogeneous acute lung injury model.
    Intensive Care Med Exp 2017 Dec 12;5(1):25. Epub 2017 May 12.
    Department of Surgery, SUNY Upstate Medical University, 750 E Adams Street, Syracuse, NY, 13210, USA.
    Background: Acute respiratory distress syndrome causes a heterogeneous lung injury with normal and acutely injured lung tissue in the same lung. Improperly adjusted mechanical ventilation can exacerbate ARDS causing a secondary ventilator-induced lung injury (VILI). We hypothesized that a peak airway pressure of 40 cmH2O (static strain) alone would not cause additional injury in either the normal or acutely injured lung tissue unless combined with high tidal volume (dynamic strain). Read More

    Intrapulmonary Percussive Ventilation as an Airway Clearance Technique during Venoarterial Extracorporeal Life Support in an Infant with Pertussis.
    Front Pediatr 2017 27;5:99. Epub 2017 Apr 27.
    Department of Pediatrics, Division of Pediatric Critical Care Medicine, Penn State University College of Medicine, Hershey, PA, USA.
    Initiation of extracorporeal life support (ECLS) is often followed by complete opacification of pulmonary parenchyma and volume loss. The optimal mechanical ventilator management and lung recruitment strategy of a pediatric patient requiring extracorporeal membrane oxygenation is not known. We present a case of a 4-week old infant who developed a severe pertussis infection requiring ECLS. Read More

    Role of heparin in pulmonary cell populations in an in-vitro model of acute lung injury.
    Respir Res 2017 May 10;18(1):89. Epub 2017 May 10.
    Institut d' Investigació i Innovació Parc Taulí (I3PT), Sabadell, Spain.
    Background: In the early stages of acute respiratory distress syndrome (ARDS), pro-inflammatory mediators inhibit natural anticoagulant factors and initiate an increase in procoagulant activity. Previous studies proved the beneficial effects of heparin in pulmonary coagulopathy, which derive from its anticoagulant and anti-inflammatory activities, although it is uncertain whether heparin works. Understanding the specific effect of unfractioned heparin on cell lung populations would be of interest to increase our knowledge about heparin pathways and to treat ARDS. Read More

    The Predictive Value of Coefficient of PCT × BG for Anastomotic Leak in Esophageal Carcinoma Patients With ARDS After Esophagectomy.
    J Intensive Care Med 2017 Jan 1:885066617705108. Epub 2017 Jan 1.
    1 Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
    Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Read More

    A Novel Porcine Model of Septic Shock Induced by Acute Respiratory Distress Syndrome due to Methicillin-resistant Staphylococcus aureus.
    Chin Med J (Engl) 2017 May;130(10):1226-1235
    Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing 100020, China.
    Background: Sepsis is one of the main causes of mortality in critically ill patients following progression to septic shock. To investigate the pathophysiologic changes of sepsis, we developed a novel porcine model of septic shock induced by acute respiratory distress syndrome (ARDS) due to methicillin-resistant Staphylococcus aureus(MRSA) pneumonia.

    Methods: Twenty-six male Landraces (Lvyuanweiye, Beijing, China) weighing 30 ± 2 kg were divided into four groups: sham group (SH; n = 5); cotton smoke inhalation group (SM; n = 6); MRSA pneumonia group (MR; n = 6); and septic shock group with cotton smoke inhalation + MRSA pneumonia (SS; n = 9). Read More

    Assessment of 1-year Outcomes in Survivors of Severe Acute Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation or Mechanical Ventilation: A Prospective Observational Study.
    Chin Med J (Engl) 2017 May;130(10):1161-1168
    Department of Critical Care Medicine, Tianjin Third Central Hospital, Artificial Cells Key Laboratory of Tianjin, Tianjin 300170, China.
    Background: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population.

    Methods: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled. Read More

    Heart-Shaped Bilateral Medullary Pyramidal Infarction as a Pathognomonic Finding of Anterior Spinal Artery Occlusion.
    Neurocrit Care 2017 May 8. Epub 2017 May 8.
    Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
    Background: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction.

    Methods: Case reports and literature review. Read More

    Xenogeneic human umbilical cord-derived mesenchymal stem cells reduce mortality in rats with acute respiratory distress syndrome complicated by sepsis.
    Oncotarget 2017 Apr 21. Epub 2017 Apr 21.
    Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
    This study tested the hypothesis that xenogeneic human umbilical cord-derived mesenchymal stem cell (HUCDMSC) therapy would improve survival rates in rats with acute respiratory distress-syndrome (ARDS, induction by 48 h inhalation of 100% oxygen) and sepsis-syndrome (SS, induction by cecal-ligation and puncture) (ARDS-SS). Adult-male Sprague-Dawley rats were categorized into group 1 (sham-controls), group 2 (ARDS-SS), group 3 [ARDS-SS+HUCDMSC (1.2 x106 cells administered 1 h after SS-induction)], and group 4 [ARDS-SS+HUCDMSC (1. Read More

    Losartan, a selective antagonist of AT1 receptor, attenuates seawater inhalation induced lung injury via modulating JAK2/STATs and apoptosis in rat.
    Pulm Pharmacol Ther 2017 May 5. Epub 2017 May 5.
    Department of Respiration, Tangdu Hospital, Fourth Military Medical University, 710038, PR China. Electronic address:
    Losartan is a selective antagonist of AngⅠ type (AT1) receptor of Angiotensin Ⅱ (Ang Ⅱ), which is widely used as a clinical medicine for the hypertension. Recent studies have shown that losartan was shown to protect from acute lung injury (ALI). However, the underlying mechanism remains unclear. Read More

    Fifty Years of Research in ARDS. Genomic Contributions and Opportunities.
    Am J Respir Crit Care Med 2017 May 8. Epub 2017 May 8.
    University of Pennsylvania, Pulmonary, Allergy and Critical Care, Philadelphia, Pennsylvania, United States ;
    Clinical factors alone poorly explain ARDS risk and ARDS outcome. In the search for individual factors that may influence ARDS risk, the past 20 years have witnessed the identification of numerous genes and genetic variants that are associated with ARDS. The field of ARDS genomics has cycled from candidate gene association studies to bias-free approaches that identify new candidates, and increasing effort is made to understand the functional consequences that may underlie significant associations. Read More

    ROS feedback regulates the microRNA-19-targeted inhibition of the p47phox-mediated LPS-induced inflammatory response.
    Biochem Biophys Res Commun 2017 May 4. Epub 2017 May 4.
    Department of Geratology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'An, ShaanXi, CHN 710068, China. Electronic address:
    In acute lung injury/acute respiratory distress syndrome (ALI/ARDS), pathogenesis is associated with the regulation of macrophage-generated oxidative stress, and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX)-derived reactive oxygen species(ROS) are key to regulating oxidative stress. In the present study, we found that miR-19 inhibited the expression of p47phox in macrophages, resulting in the alleviation of the lipopolysaccharides(LPS)-induced inflammatory response. In a mouse LPS-induced model of lung injury, miR-19-deficient murine lung tissue was more susceptible to inflammatory responses and exhibited a higher infiltration rate, a higher number of inflammatory cells in the lungs, a higher level of inflammatory cytokines in the Bronchoalveolar lavage fluid (BALF), and more severe pathological damage in lung tissues. Read More

    Early Onset Noninfectious Pulmonary Syndromes after Hematopoietic Cell Transplantation.
    Clin Chest Med 2017 Jun;38(2):233-248
    Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Mailstop D5-360, Seattle, WA 98109, USA.
    This article reviews the noninfectious pulmonary syndromes that cause morbidity and mortality early after hematopoietic cell transplantation with an emphasis on risk factors, clinical manifestations, treatment, and outcomes. The first section covers idiopathic pneumonia syndrome and its subtypes: peri-engraftment respiratory distress syndrome, diffuse alveolar hemorrhage, delayed pulmonary toxicity syndrome, and cryptogenic organizing pneumonia. The second section covers pulmonary toxicities of chemotherapies and immunosuppressive agents used in this setting. Read More

    A Multi-institutional Analysis of Trimodality Therapy for Esophageal Cancer in Elderly Patients.
    Int J Radiat Oncol Biol Phys 2017 Feb 20. Epub 2017 Feb 20.
    Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota. Electronic address:
    Purpose: The therapeutic gains of neoadjuvant chemoradiation therapy (nCRT) followed by esophagectomy may be offset by increased incidences of morbidity and mortality in elderly patients. This study aimed to determine the impact of age on the risks and benefits of trimodality therapy for esophageal cancer.

    Methods And Materials: We evaluated 571 patients treated with trimodality therapy at 3 high-volume tertiary cancer centers in the United States from 2007 to 2013. Read More

    Scrub typhus in Uttarakhand & adjoining Uttar Pradesh: Seasonality, clinical presentations & predictors of mortality.
    Indian J Med Res 2016 Dec;144(6):901-909
    Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India.
    Background & Objectives: Scrub typhus is a re-emerging mite-borne rickettsiosis, which continues to be underdiagnosed, with lethal consequences. The present study was conducted to determine the seasonality, clinical presentation and predictors of mortality in patients with scrub typhus at a tertiary care teaching hospital in northern India.

    Methods: Scrub typhus was suspected in patients attending the hospital as per the standard case definition and serological evidence was obtained by performing an IgM ELISA. Read More

    Therapeutic blockade of CD54 attenuates pulmonary barrier damage in T cell-induced acute lung injury.
    Am J Physiol Lung Cell Mol Physiol 2017 May 4:ajplung.00050.2017. Epub 2017 May 4.
    University of Connecticut Health
    Acute respiratory distress syndrome (ARDS) is a serious, often fatal condition without available pharmacotherapy. While the role of innate cells in ARDS has been studied extensively, emerging evidence suggests that T cells may be involved in disease etiology. Staphylococcus aureus enterotoxins are potent T cell mitogens capable of triggering life-threatening shock. Read More

    CGRP 8-37 enhances lipopolysaccharide-induced acute lung injury and regulating aquaporin 1 and 5 expressions in rats.
    J Physiol Biochem 2017 May 4. Epub 2017 May 4.
    Department of Pediatrics, The first people's hospital of Yunnan province, Kunming, China.
    Calcitonin gene-related peptide (CGRP) has been shown to play important roles in biological functions. However, there is very little evidence on the value of CGRP in lipopolysaccharide (LPS)-induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Therefore, this study aimed to investigate the role of CGRP in LPS-induced ALI in rats. Read More

    The ICM research agenda on extracorporeal life support.
    Intensive Care Med 2017 May 3. Epub 2017 May 3.
    Réanimation des Détresses Respiratoires et Infections Sévères, CHU Nord, UMR CNRS 7278, Aix-Marseille Université, Marseille, France.
    Purpose: This study aimed to concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be performed over the next decade and their expected outcomes with regard to extracorporeal membrane oxygenation (ECMO).

    Methods: Narrative review based on a systematic analysis of the medical literature, national and international guidelines, and expert opinion.

    Results: The use of venovenous ECMO (VV-ECMO) is increasing in the most severe forms of acute lung injury. Read More

    Novel role for endogenous mitochondrial formylated peptide-driven formyl peptide receptor 1 signalling in acute respiratory distress syndrome.
    Thorax 2017 May 3. Epub 2017 May 3.
    The MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
    Background: Acute respiratory distress syndrome (ARDS) is an often fatal neutrophil-dominant lung disease. Although influenced by multiple proinflammatory mediators, identification of suitable therapeutic candidates remains elusive. We aimed to delineate the presence of mitochondrial formylated peptides in ARDS and characterise the functional importance of formyl peptide receptor 1 (FPR1) signalling in sterile lung inflammation. Read More

    Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology.
    Semin Immunopathol 2017 May 2. Epub 2017 May 2.
    Department of Microbiology, University of Iowa, BSB 3-712, Iowa City, IA, 52242, USA.
    Human coronaviruses (hCoVs) can be divided into low pathogenic and highly pathogenic coronaviruses. The low pathogenic CoVs infect the upper respiratory tract and cause mild, cold-like respiratory illness. In contrast, highly pathogenic hCoVs such as severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV) predominantly infect lower airways and cause fatal pneumonia. Read More

    Pulmonary strongyloidiasis: assessment between manifestation and radiological findings in 16 severe strongyloidiasis cases.
    BMC Infect Dis 2017 May 2;17(1):320. Epub 2017 May 2.
    Department of Infectious Diseases, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
    Background: Strongyloidiasis is a chronic parasitic infection caused by Strongyloides stercoralis. Severe cases such as, hyperinfection syndrome (HS) and disseminated strongyloidiasis (DS), can involve pulmonary manifestations. These manifestations frequently aid the diagnosis of strongyloidiasis. Read More

    Risk Factors and Outcomes Related to Pediatric Intensive Care Unit Admission after Hematopoietic Stem Cell Transplantation: a Single Centre Experience.
    Biol Blood Marrow Transplant 2017 Apr 28. Epub 2017 Apr 28.
    Pediatric Hematology and Oncology, Department of Woman's and Child's Health, University-Hospital of Padua.
    To describe incidence, causes and outcomes related to pediatric intensive care unit (PICU) admission for patients undergoing hematopoietic stem cell transplantation (HSCT). To investigate risk factors predisposing to PICU admission and prognostic factors in terms of patient survival. From October 1998 to April 2015, 496 children and young adults (0-23 years) underwent transplantation in the HSCT Unit. Read More

    Anticoagulation and Transfusions Management in Veno-Venous Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: Assessment of Factors Associated With Transfusion Requirements and Mortality.
    J Intensive Care Med 2017 Jan 1:885066617706339. Epub 2017 Jan 1.
    1 Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
    Purpose: We describe an approach for anticoagulation and transfusions in veno-venous-extracorporeal membrane oxygenation (VV-ECMO), evaluating factors associated with higher transfusion requirements, and their impact on mortality.

    Methods: Observational study on consecutive adults supported with VV-ECMO for acute respiratory distress syndrome (ARDS). We targeted an activated partial thromboplastin time of 40 to 50 seconds and a hematocrit of 24% to 30%. Read More

    Mortality in Pediatric Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.
    J Intensive Care Med 2017 Jan 1:885066617705109. Epub 2017 Jan 1.
    2 Duke-NUS Medical School, Singapore, Singapore.
    Objective: Sparse and conflicting evidence exists regarding mortality risk from pediatric acute respiratory distress syndrome (ARDS). We aimed to determine the pooled mortality in pediatric ARDS and to describe its trend over time.

    Data Sources And Study Selection: MEDLINE, EMBASE, and Web of Science were searched from 1960 to August 2015. Read More

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