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    Reclassifying Acute Respiratory Distress Syndrome.
    Am J Respir Crit Care Med 2018 Jan 18. Epub 2018 Jan 18.
    University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany ;
    Rationale: The ratio of PaO2 to FiO2 (P/F) defines ARDS severity and suggests appropriate therapies.

    Objectives: We investigated 1) whether a 150 mmHg P/F threshold within the range of moderate ARDS (100-200 mmHg) would define two, more homogeneous subgroups, 2) which criteria led the clinicians to apply ECMO in severe ARDS. Methods & Measurements: At 150 mmHg P/F threshold, moderate patients were split in mild-moderate (n=50) and moderate-severe (n=55). Read More

    Surfactant Protein C dampens inflammation by decreasing JAK/STAT activation during lung repair.
    Am J Physiol Lung Cell Mol Physiol 2018 Jan 18. Epub 2018 Jan 18.
    Yale University, United States.
    Surfactant Protein C (SPC), a key component of pulmonary surfactant, also plays a role in regulating inflammation. SPC deficiency in patients and mouse models is associated with increased inflammation and delayed repair, but the key drivers of SPC-regulated inflammation in response to injury are largely unknown. This study focuses on a new mechanism of SPC as an anti-inflammatory molecule using SPC-TK/SPC-KO (surfactant protein C-thymidine kinase/surfactant protein C knockout) mice, which represent a novel sterile injury model that mimics clinical acute respiratory distress syndrome (ARDS). Read More

    Protease activated-receptor 2 is necessary for neutrophil chemorepulsion induced by trypsin, tryptase, or dipeptidyl peptidase IV.
    J Leukoc Biol 2018 Jan 11;103(1):119-128. Epub 2017 Dec 11.
    Department of Biology, Texas A&M University, College Station, Texas, USA.
    Compared to neutrophil chemoattractants, relatively little is known about the mechanism neutrophils use to respond to chemorepellents. We previously found that the soluble extracellular protein dipeptidyl peptidase IV (DPPIV) is a neutrophil chemorepellent. In this report, we show that an inhibitor of the protease activated receptor 2 (PAR2) blocks DPPIV-induced human neutrophil chemorepulsion, and that PAR2 agonists such as trypsin, tryptase, 2f-LIGRL, SLIGKV, and AC55541 induce human neutrophil chemorepulsion. Read More

    Prognosis of Acute Respiratory Distress Syndrome in Patients With Hematological Malignancies.
    J Intensive Care Med 2018 Jan 1:885066617753566. Epub 2018 Jan 1.
    2 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
    Introduction: The intensive care unit (ICU) admission of patients with hematologic malignancies is gradually increasing. Life-threatening events are common, and acute respiratory distress syndrome (ARDS) is one of the most critical conditions. The aim of this study was to investigate the clinical characteristics and outcomes of ARDS in patients with hematological malignancies admitted to the ICU. Read More

    Increased serum concentrations of soluble ST2 are associated with pulmonary complications and mortality in polytraumatized patients.
    Clin Chem Lab Med 2018 Jan 17. Epub 2018 Jan 17.
    Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
    Background: We sought to evaluate the role of soluble ST2 (suppression of tumorigenicity) serum concentrations in polytraumatized patients and its potential role as biomarker for pulmonary complications.

    Methods: We included severely injured patients (injury severity score≥16) admitted to our level I trauma center and analyzed serum samples obtained on the day of admission and on day 2. Furthermore, patients with isolated thoracic injury and healthy probands were included and served as control groups. Read More

    Acute kidney injury due to multiple Hymenoptera stings-a clinicopathological study.
    Clin Kidney J 2017 Aug 28;10(4):532-538. Epub 2017 Mar 28.
    Community Medicine, Indira Gandhi Medial College, Shimla, Himachal Pradesh, India.
    Background: Acute kidney injury (AKI) after multiple Hymenoptera stings is well known but still a rare phenomenon.

    Methods: We conducted a retrospective study of the clinicopathological spectrum of AKI due to multiple Hymenoptera stings over 13 years (July 2003-June 2016).

    Results: A total of 35 patients were diagnosed with AKI due to multiple Hymenoptera stings. Read More

    The Association Between Ventilator Dyssynchrony, Delivered Tidal Volume, and Sedation Using a Novel Automated Ventilator Dyssynchrony Detection Algorithm.
    Crit Care Med 2018 Feb;46(2):e151-e157
    Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO.
    Objective: Ventilator dyssynchrony is potentially harmful to patients with or at risk for the acute respiratory distress syndrome. Automated detection of ventilator dyssynchrony from ventilator waveforms has been difficult. It is unclear if certain types of ventilator dyssynchrony deliver large tidal volumes and whether levels of sedation alter the frequency of ventilator dyssynchrony. Read More

    Multicohort Analysis of Whole-Blood Gene Expression Data Does Not Form a Robust Diagnostic for Acute Respiratory Distress Syndrome.
    Crit Care Med 2018 Feb;46(2):244-251
    Stanford Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA.
    Objectives: To identify a novel, generalizable diagnostic for acute respiratory distress syndrome using whole-blood gene expression arrays from multiple acute respiratory distress syndrome cohorts of varying etiologies.

    Data Sources: We performed a systematic search for human whole-blood gene expression arrays of acute respiratory distress syndrome in National Institutes of Health Gene Expression Omnibus and ArrayExpress. We also included the Glue Grant gene expression cohorts. Read More

    Evaluation of Almitrine Infusion During Veno-Venous Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome in Adults.
    Anesth Analg 2018 Jan 15. Epub 2018 Jan 15.
    This single-center case series investigated the effect of almitrine infusion on PaO2/fraction of inspired oxygen (FIO2) in 25 patients on veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. A positive trial was defined as an increase of PaO2/FIO2 ratio ≥20%. Thirty-two trials were performed. Read More

    Novel Mechanism for Nicotinamide Phosphoribosyltransferase Inhibition of TNF-α-Mediated Apoptosis in Human Lung Endothelial Cells.
    Am J Respir Cell Mol Biol 2018 Jan 16. Epub 2018 Jan 16.
    University of Arizona, Arizona Health Sciences Center, Tucson, Arizona, United States ;
    Nicotinamide phosphoribosyltransferase (NAMPT) exists as both intracellular (iNAMPT) and extracellular (eNAMPT) proteins. eNAMPT is secreted into the blood and functions as a cytokine/enzyme (cytozyme) that activates NFκB signaling via ligation of the TLR4 receptor, further serving as a biomarker for inflammatory lung disorders such as the acute respiratory distress syndrome (ARDS). In contrast, iNAMPT is involved in nicotinamide mononucleotide (NMN) synthesis and has been implicated in the regulation of cellular apoptosis, although the exact mechanisms for this regulation are poorly understood. Read More

    Acute lung injury induced by intestinal ischemia and reperfusion is altered in obese female mice.
    Pulm Pharmacol Ther 2018 Jan 11. Epub 2018 Jan 11.
    Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, Brazil. Electronic address:
    Rational: Acute lung injury (ALI) is a common complication after intestinal ischemia and reperfusion (I/R) injury that can lead to acute respiratory distress syndrome (ARDS). We have previously demonstrated that females are protected against lung damage induced by intestinal I/R through an estrogen mediated mechanism.

    Objectives: to investigate the effect of obesity on ALI induced by intestinal I/R in female mice. Read More

    Quality of inter-hospital transportation in 431 transport survivor patients suffering from acute respiratory distress syndrome referred to specialist centers.
    Ann Intensive Care 2018 Jan 15;8(1). Epub 2018 Jan 15.
    Department of Anaesthesiology, University Medical Centre Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
    Background: The acute respiratory distress syndrome (ARDS) is a life-threatening condition. In special situations, these critically ill patients must be transferred to specialized centers for escalating treatment. The aim of this study was to evaluate the quality of inter-hospital transport (IHT) of ARDS patients. Read More

    [Recurrent multiple lung lesions synchronizing with the disease activity of multiple myeloma].
    Rinsho Ketsueki 2017 ;58(12):2406-2410
    Department of Hematology and Oncology, University of Fukui.
    A 68-year-old male patient, who was diagnosed with MGUS (IgG-λ) 11 years ago, was referred to our hospital because of a progressing pancytopenia. He was diagnosed with multiple myeloma (MM) and was hospitalized because of fever and pneumonia. Although empiric antibiotic and antifungal therapies were promptly initiated, his pneumonia worsened. Read More

    Single-Center Experience With Venovenous ECMO for Influenza-Related ARDS.
    J Cardiothorac Vasc Anesth 2017 Sep 22. Epub 2017 Sep 22.
    Shock Trauma Critical Care, University of Maryland School of Medicine, Baltimore, MD.
    Objectives: This study was designed to determine whether venovenous extracorporeal membrane oxygenation (VV ECMO) reduced mortality in patients with influenza-related acute respiratory distress syndrome (ARDS).

    Design: A retrospective cohort study was performed. Baseline characteristics of participants were compared and Kaplan-Meier survival analysis was used to compare survival at last medical center follow-up. Read More

    High frequency percussive ventilation increases alveolar recruitment in early acute respiratory distress syndrome: an experimental, physiological and CT scan study.
    Crit Care 2018 Jan 11;22(1). Epub 2018 Jan 11.
    Departement de Médecine Périopératoire (MPO), Hôpital Estaing, Centre Hospitalier Universitaire (CHU) Clermont-Ferrand, 1 place Lucie Aubrac, Clermont-Ferrand, F-63003, France.
    Background: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). Read More

    High Level of Neutrophil Extracellular Traps Correlates With Poor Prognosis of Severe Influenza A Infection.
    J Infect Dis 2018 Jan 9. Epub 2018 Jan 9.
    Institute of Infectious Diseases, Capital Medical University, China.
    Background: Most patients with severe infection with influenza A virus (IAV) progress to acute respiratory distress syndrome and even multiple organ dysfunction syndrome (MODS). Neutrophil extracellular traps (NETs) can be induced by pathogens and are responsible for immune tissue damage. We conducted a prospective study on the production and effects of NETs in H7N9 and H1N1 patients. Read More

    Ulinastatin Protects Against LPS-Induced Acute Lung Injury by Attenuating TLR4/NF-κB Pathway Activation and Reducing Inflammatory Mediators.
    Shock 2018 Jan 10. Epub 2018 Jan 10.
    Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin, China.
    Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity. Read More

    Effects of pressure support ventilation on ventilator-induced lung injury in mild acute respiratory distress syndrome depend on level of positive end-expiratory pressure.
    Eur J Anaesthesiol 2018 Jan 10. Epub 2018 Jan 10.
    From the Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro (PAFM, GAP, LM, CLS, LAM, CLB, PRMR, PLS), Graduate Program in Maternal and Child Health, Professor Fernando Figueira Institute of Comprehensive Medicine, Recife, Pernambuco (PAFM, MCMBD, LBA), Faculty of Medicine, Laboratory of Experimental Surgery, Federal University of Rio de Janeiro, Rio de Janeiro (CLS, AS), Department of Pathology, School of Medicine, University of São Paulo, São Paulo, Brazil (VLC), Department of Anesthesiology and Intensive Care Therapy, Pulmonary Engineering Group, University Hospital Carl Gustav Carus (RH, MGA), Dresden University of Technology, Dresden, Germany (RH, MGA) and Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy (PP).
    Background: Harmful effects of spontaneous breathing have been shown in experimental severe acute respiratory distress syndrome (ARDS). However, in the clinical setting, spontaneous respiration has been indicated only in mild ARDS. To date, no study has compared the effects of spontaneous assisted breathing with those of fully controlled mechanical ventilation at different levels of positive end-expiratory pressure (PEEP) on lung injury in ARDS. Read More

    Acute Cor Pulmonale in Veno-Venous Extracorporeal Membrane Oxygenation: Three Case Reports.
    ASAIO J 2018 Jan 10. Epub 2018 Jan 10.
    A retrospective review of three patients with acute respiratory distress syndrome (ARDS) and normal baseline right ventricular function admitted to the Cardiac Surgery Intensive Care Unit whom developed acute cor pulmonale while on veno-venous extracorporeal membrane oxygenation. These patients were diagnosed with ARDS using Berlin Criteria definitions and cannulated with a dual lumen (Avalon) cannula. Despite variations in history, presentation, and course, findings of acute cor pulmonale were encountered 4 to 6 weeks after extracorporeal membrane oxygenation cannulation. Read More

    Inhibitory Effect of Circulating Fibrocytes on Injury Repair in Acute Lung Injury/Acute Respiratory Distress Syndrome Mice Model.
    J Cell Biochem 2018 Jan 11. Epub 2018 Jan 11.
    Department of Respiratory, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China.
    The study was aimed to explore the functions of circulating fibrocytes (CFs) on injury repair in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) mice model and its clinical value as a biomarker for ALI/ARDS. ALI/ARDS mice model was established by intratracheal instillation of lipopolysaccharide (LPS). Mononuclear cells were isolated from peripheral blood of ALI/ARDS model and flow cytometry was used to measure CFs defined as cells positive for CD45 and collagen-1. Read More

    Extracorporeal Membrane Oxygenation for Refractory Severe Respiratory Failure in Acute Interstitial Pneumonia.
    Artif Organs 2018 Jan 11. Epub 2018 Jan 11.
    Department of Emergency and Intensive Care Medicine, Centro Hospitalar S. João, Porto, Portugal.
    Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial lung disease with rapid progressive respiratory failure and high mortality. In the present report, three cases of AIP complicated by refractory respiratory failure supported with extracorporeal membrane oxygenation (ECMO) are presented. One male and two female patients (ages 27-59) were included. Read More

    Accidental hypothermia as an independent risk factor of poor neurological outcome in older multiply injured patients with severe traumatic brain injury: a matched pair analysis.
    Eur J Trauma Emerg Surg 2018 Jan 9. Epub 2018 Jan 9.
    Trauma Department, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hanover, Germany.
    Purpose: Patients with multiple injuries are particularly susceptible to accidental hypothermia which is correlated with an increased risk of post-traumatic complications and mortality; however, its impact on neurological outcome in cases where there is concomitant traumatic brain injury is underexplored.

    Methods: We analyzed severely injured patients (ISS ≥ 16) including a moderate-to-severe traumatic brain injury (AISHead ≥ 3). The primary endpoint was objective neurological recovery, expressed as Glasgow Outcome Scale (GOS) score at time of discharge. Read More

    Differential induction of malaria liver pathology in mice infected with Plasmodium chabaudi AS or Plasmodium berghei NK65.
    Malar J 2018 Jan 9;17(1):18. Epub 2018 Jan 9.
    Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy.
    Background: Cerebral malaria and severe anaemia are the most common deadly complications of malaria, and are often associated, both in paediatric and adult patients, with hepatopathy, whose pathogenesis is not well characterized, and sometimes also with acute respiratory distress syndrome (ARDS). Here, two species of murine malaria, the lethal Plasmodium berghei strain NK65 and self-healing Plasmodium chabaudi strain AS which differ in their ability to cause hepatopathy and/or ARDS were used to investigate the lipid alterations, oxidative damage and host immune response during the infection in relation to parasite load and accumulation of parasite products, such as haemozoin.

    Methods: Plasma and livers of C57BL/6J mice injected with PbNK65 or PcAS infected erythrocytes were collected at different times and tested for parasitaemia, content of haemozoin and expression of tumour necrosis factor (TNF). Read More

    [Effects of baicalin on the changes in hemorheology of acute respiratory distress syndrome in rats].
    Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017 Nov;35(11):807-811
    Department of Occupational Disease, Peking University Third Hospital, Beijing 100191, China.
    Objective: To investigate the effect of baicalin on the changes in hemorheology and its mechanism during the development of Acute Respiratory Distress Syndrome(ARDS) induced by oleic acid (OA) in rats. Methods: Rats were randomized into 3 groups: control, ARDS (OA induction, 0.12 mg/kg) and ba-icalin-treated group (300 mg/kg). Read More

    [Noninvasive ventilation in acute respiratory insufficiency].
    Med Klin Intensivmed Notfmed 2018 Jan 8. Epub 2018 Jan 8.
    Medizinische Klinik I - Sektion Pneumologie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
    The use of noninvasive ventilation reduces ventilator-associated complications. Thus, the outcome of patients suffering from acute hypercapnic respiratory insufficiency as well as cardiogenic lung edema can be improved. For the use of noninvasive ventilation to be successful and safe, its correct application is pivotal. Read More

    Acute respiratory distress syndrome in traumatic brain injury: how do we manage it?
    J Thorac Dis 2017 Dec;9(12):5368-5381
    Neurocritical Care Unit, Addenbrooke's Hospital, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.
    Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Read More

    Hemorrhage under veno-venous extracorporeal membrane oxygenation in acute respiratory distress syndrome patients: a retrospective data analysis.
    J Thorac Dis 2017 Dec;9(12):5017-5029
    Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
    Background: Despite being still invasive and challenging, technical improvement has resulted in broader and more frequent application of extracorporeal membrane oxygenation (ECMO), to prevent hypoxemia and to reduce invasiveness of mechanical ventilation (MV). Heparin-coated ECMO-circuits are currently standard of care, in addition to heparin based anticoagulation (AC) regimen guided by activated clotting time (ACT) or activated partial thromboplastin time (aPTT). Despite these advances, a reliable prediction of hemorrhage is difficult and the risk of hemorrhagic complication remains unfortunately high. Read More

    Application of extracorporeal membrane oxygenation in patients with severe acute respiratory distress syndrome induced by avian influenza A (H7N9) viral pneumonia: national data from the Chinese multicentre collaboration.
    BMC Infect Dis 2018 Jan 8;18(1):23. Epub 2018 Jan 8.
    Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, China-Japan Friendship Hospital, No. 2 Yinghua East Road, Chaoyang District, Beijing, 100029, People's Republic of China.

    [Effect mechanism of α-adrenoceptor on sepsis-induced acute respiratory distress syndrome].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Jan;30(1):83-87
    Department of Intensive Care Unit, Peking University Third Hospital, Beijing 100191, China (Lyu XP, Cong ZK, Li D, Zhu X); Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China (Tao YF). Corresponding author: Zhu Xi, Email:
    Objective: Acute respiratory distress syndrome (ARDS), characterized by acute hypoxic respiratory dysfunction or failure, is a manifestation of multiple organ failure (MOF) in the lung, which often caused by various non-cardiac reasons, included severe trauma, infection, shock; and the most common risk factor is sepsis which would cause uncontrolled host response to infecting factors. As a strong stressor during sepsis, the severe infectious state of the body triggers serious stress reaction. The hypothalamus-pituitary-adrenal cortical (HPA) axis and sympathetic-adrenal medulla axis were activated and participated the initiation and progression of the stress response through the production of adrenocorticotropic hormone (ACTH), glucocorticoid (GC), epinephrine and norepinephrine (NE). Read More

    [Establishment of multiple organ dysfunction syndrome early warning score in patients with severe trauma and its clinical significance: a multicenter study].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Jan;30(1):41-46
    Department of Intensive Care Unit, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, Guizhou, China (Huang WJ, Qin S, Huang Q, Chen T); First Department, Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China (Sun Y, Yin SQ, Fan X, Liang HP). Corresponding author: Liang Huaping, Email:
    Objective: To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients.

    Methods: Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed. The patients were divided into MODS groups (n = 251) and non-MODS group (n = 91) according to clinical outcomes. Read More

    [Design and application of bundle treatment plan in the early stage for severe human infection by avian influenza H7N9].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Jan;30(1):24-28
    Department of Intensive Care Unit, the People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili 556000, Guizhou, China. Corresponding author: Wang Ling, Email:
    Objective: To design bundle treatment plan in the early stage for severe human infection by avian influenza H7N9, and explore its clinical efficacy and application value.

    Methods: Fifteen patients with severe human infection by avian influenza H7N9 in Guizhou Province from December 29th, 2016 to June 7th, 2017 were enrolled. Patients admitted from March 6th, 2017 to June 7th, 2017 served as a prospective observation period (bundle treatment group), and those from December 29th, 2016 to March 5th, 2017 were selected as a historical control period (conventional treatment group). Read More

    [2017 clinical breakthroughs in critical care medicine].
    Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2018 Jan;30(1):1-7
    Department of Intensive Care Unit, First Affiliated Hospital of Dalian Medical University, Dalian 116012, Liaoning, China. Corresponding author: Huang Wei, Email:
    Objective: New achievements in critical care medicine 2017 may include updating of "Surviving Sepsis Campaign" international guideline. Comparing evaluation of sequential (sepsis-related) organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA), combination therapies with steroid, vitamin B1 and vitamin C in patients with sepsis, identification of endophenotype of sepsis, as well phenotype of acute respiratory distress syndrome (ARDS). However, it is also need to mention some of negative trials, such as levosimendan in patients undergoing cardiac surgery, low-dose immunoglobulin G and polymyxin B hemoperfusion for patient with septic shock, and enteral versus parenteral early nutrition in ventilated adults with shock. Read More

    Hypercapnia induces IL-1β overproduction via activation of NLRP3 inflammasome: implication in cognitive impairment in hypoxemic adult rats.
    J Neuroinflammation 2018 Jan 5;15(1). Epub 2018 Jan 5.
    Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
    Background: Cognitive impairment is one of common complications of acute respiratory distress syndrome (ARDS). Increasing evidence suggests that interleukin-1 beta (IL-1β) plays a role in inducing neuronal apoptosis in cognitive dysfunction. The lung protective ventilatory strategies, which serve to reduce pulmonary morbidity for ARDS patients, almost always lead to hypercapnia. Read More

    Six-month Outcome of Immunocompromised Severe ARDS Patients Rescued by ECMO. An International Multicenter Retrospective Study.
    Am J Respir Crit Care Med 2018 Jan 3. Epub 2018 Jan 3.
    Groupe Hospitalier Pitié-Salpêtrière, Service de réanimation médicale, Paris, France ;
    Objectives: To report outcomes of immunocompromised patients treated with extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) and to identify their pre-ECMO predictors of 6-month mortality and main ECMO-related complications.

    Methods: Retrospective multicenter study in 10 international intensive care units (ICUs) with high ECMO-case volumes. Immunocompromised patients, defined as having hematological malignancies, active solid tumor, solid-organ transplant, acquired immunodeficiency syndrome, or long-term or high-dose corticosteroid or immunosuppressant use, and severe ECMO-treated ARDS from 2008 to 2015 were included Measurements and Main Results: We collected demographics, clinical, ECMO-related complications, ICU- and 6-month-outcome data for 203 patients (median APACHE II 28 [25th ;75th percentile, 20;33]; age 51 [38;59] years, PaO2/FiO2 60 [50;82] mmHg before ECMO) who fulfilled our inclusion criteria. Read More

    The coming era of precision medicine for intensive care.
    Crit Care 2017 Dec 28;21(Suppl 3):314. Epub 2017 Dec 28.
    Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, route de Lennik 808, 1070, Bruxelles, Belgium.
    Recent advances in technology and better understanding of mechanisms underlying disease are beginning to enable us to better characterize critically ill patients. Instead of using nonspecific syndromic groupings, such as sepsis or acute respiratory distress syndrome, we can now classify individual patients according to various specific characteristics, such as immune status. This "personalized" medicine approach will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses that will influence their need for and responses (both negative and positive) to specific treatments. Read More

    [The correlation between CT score of lung injury and oxygenation index in patients with acute hydrogen sulphide poisoning].
    Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017 Sep;35(9):691-694
    CT department of Wenling First People's Hospital, Taizhou 317500, China.
    Objective: To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference. Methods: The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 (the diagnostic standard of occupational H(2)S acute poisoning) , these patients were divided into 2 grouds including moderate groud and severe groud; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase; The correlation between CT score and oxygenation index were analyzed. Results: The CT score in moderate poisoning group were lower than severe group (2. Read More

    Metabolomic Profile of Ards by Nuclear Magnetic Resonance Spectroscopy in Patients with H1N1 Influenza Virus Pneumonia.
    Shock 2017 Dec 29. Epub 2017 Dec 29.
    CIBER de Enfermedades Respiratorias (CIBERES). Madrid, Spain.
    Purpose: The integrated analysis of changes in the metabolic profile could be critical for the discovery of biomarkers of lung injury, and also for generating new pathophysiological hypotheses and designing novel therapeutic targets for the acute respiratory distress syndrome (ARDS). This study aimed at developing a Nuclear Magnetic Resonance (NMR)-based approach for the identification of the metabolomic profile of ARDS in patients with H1N1 influenza virus pneumonia.

    Methods: Serum samples from 30 patients (derivation set) diagnosed of H1N1 influenza virus pneumonia were analysed by unsupervised Principal Component Analysis (PCA) to identify metabolic differences between patients with and without ARDS by NMR-spectroscopy. Read More

    Risk Stratification Using Oxygenation in the First 24 Hours of Pediatric Acute Respiratory Distress Syndrome.
    Crit Care Med 2018 Jan 2. Epub 2018 Jan 2.
    Department of Anesthesiology and Critical Care Medicine, University of Southern California Keck School of Medicine, Children's Hospital of Los Angeles, Los Angeles, CA.
    Objective: Oxygenation measured 24 hours after acute respiratory distress syndrome onset more accurately stratifies risk, relative to oxygenation at onset, in both children and adults. However, waiting 24 hours is problematic, especially for interventions that are more efficacious early in the disease course. We aimed to delineate whether oxygenation measured at timepoints earlier than 24 hours would retain predictive validity in pediatric acute respiratory distress syndrome. Read More

    Outcomes of Acute Kidney Injury in Patients With Severe ARDS Due to Influenza A(H1N1) pdm09 Virus.
    Am J Crit Care 2018 Jan;27(1):67-73
    Christopher J. Tignanelli is a surgical critical care fellow, University of Michigan Health System, Ann Arbor, Michigan. Arek J. Wiktor is an assistant professor of surgery, University of Colorado, Denver, Colorado. Cory J. Vatsaas is an assistant professor of surgery, Duke University Health System, Durham, North Carolina. Gaurav Sachdev is an assistant professor of surgery, Carolinas Medical Center, Charlotte, North Carolina. Michael Heung is an associate professor of medicine, Division of Nephrology, University of Michigan Health System. Pauline K. Park and Krishnan Raghavendran are professors of surgery, University of Michigan Health System. Lena M. Napolitano is professor of surgery, division chief of acute care surgery, director of trauma and surgical critical care, and associate chair of the Department of Surgery, University of Michigan Health System.
    Background: The incidence and long-term outcomes of acute kidney injury in patients with severe acute respiratory distress syndrome (ARDS) due to influenza A(H1N1) pdm09 virus (pH1N1) have not been examined.

    Objective: To assess long-term renal recovery in patients with acute kidney injury and severe ARDS due to pH1N1.

    Methods: A retrospective observational cohort study of adults with severe pH1N1-associated ARDS admitted to a tertiary referral center. Read More

    Enteral nutrition improves clinical outcome and reduces costs of acute mesenteric ischaemia after recanalisation in the intensive care unit.
    Clin Nutr 2017 Dec 20. Epub 2017 Dec 20.
    Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Pujian Road 160, Shanghai, 200127, PR China. Electronic address:
    Background: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU.

    Methods: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Read More

    The effect of alcohol consumption on the risk of ARDS. A systematic review and meta-analysis.
    Chest 2017 Dec 27. Epub 2017 Dec 27.
    UK Centre for Tobacco and Alcohol Studies, Division of Epidemiology and Public Health, University of Nottingham, Hucknall Road, Nottingham NG5 1PB.
    Background: To conduct a systematic review and meta-analysis evaluating the association between alcohol consumption and the risk of Acute Respiratory Distress Syndrome (ARDS) in adults.

    Methods: Medline, EMBASE and Web of Science were searched to identify observational studies evaluating the association between prior alcohol intake and the occurrence of ARDS among adults, published between 1985 and 2015 and with no language restriction. Reference lists were also screened. Read More

    Omentin-A Novel Adipokine in Respiratory Diseases.
    Int J Mol Sci 2017 Dec 28;19(1). Epub 2017 Dec 28.
    Department of Physiology, Xiangya School of Medicine, Central South University, Changsha 410008, China.
    Adipokines, secreted by the adipose tissue, are extensively involved in the regulation and maintenance of various physiological and pathological processes, including insulin sensitivity, energy expenditure, glucose and lipid metabolism, inflammatory activity, neuroendocrine activity, immunity, cancer, homeostasis, angiogenesis, cardiovascular function, breeding and bone metabolism, and all functions of the endocrine-reproductive system axis. Omentin is a recently identified adipokine, which has become a research hotspot due to its pleiotropic effects on various diseases. However, the specific receptor for omentin has not been identified so far. Read More

    Hemodynamic profile of pulmonary hypertension (PH) in ARDS.
    Pulm Circ 2018 Jan-Mar;8(1):2045893217753415. Epub 2017 Dec 28.
    1 36604 Department of Pulmonology, NHC, University of Strasbourg , France.
    Acute respiratory distress syndrome (ARDS) is a diffuse lung injury that leads to a severe acute respiratory failure. Traditional diagnostic criteria for pulmonary hypertension (PH), in this situation, may be unreliable due to the effects of positive pressure ventilation and vasoactive agents. The aim of this study is to describe the hemodynamic characteristics of PH secondary to ARDS, in relation with respiratory parameters. Read More

    Nasal high flow therapy in very low birth weight infants with mild respiratory distress syndrome: a single center experience.
    Ital J Pediatr 2017 Dec 28;43(1):116. Epub 2017 Dec 28.
    Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Policlinico Hospital - Piazza Giulio Cesare n. 11, 70124, Bari, Italy.
    Background: Pulmonary disorders and respiratory failure represent one of the most common morbidities of preterm newborns admitted to neonatal intensive care units (NICUs). The use of nasal high-flow therapy (nHFT) has been more recently introduced into the NICUs as a non-invasive respiratory (NIV) support.

    Methods: We performed a retrospective study to evaluate safety and effectiveness of nHFT as primary support for infants born < 29 weeks of gestation and/or VLBW presenting with mild Respiratory Distress Syndrome (RDS). Read More

    Case report: atypical presentation of vancomycin induced DRESS syndrome: a case report and review of the literature.
    BMC Pulm Med 2017 Dec 28;17(1):217. Epub 2017 Dec 28.
    Nephrology, Sparrow Medical Group, Lansing, MI, USA.
    Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity drug reaction involving the skin and multiple internal organ systems. The symptoms typically present with fever and skin rash, and rapidly progress to multiple organ failures. Vancomycin is a rare drug to cause DRESS syndrome with 23 cases reported to date. Read More

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