heart lung interactions in sepsis and acute respiratory distress syndrome

... early-stage patients with acute respiratory distress syndrome • In patients with early-stage acute respiratory distress syndrome of suspected non-infectious origin, open lung biopsy may have a high ... yield rate • The role of open lung biopsy in patients with acute respiratory distress syndrome needs to be investigated in prospective, randomized and controlled clinical trials Authors' contributions ... HRCT findings, or on a chest X-ray when HRCT was unavailable BAL was performed by introducing 200 ml of sterile warm (37°C) saline solution into a lung subsegment and aspirating it back in four...

Ngày tải lên: 13/08/2014, 01:20

... of a clear algorithm and indication strategy Since 2004, we have worked to change the use of iLA in terms of defining indications, refining insertion technique and optimising the management of ... and clinical monitoring of the pumpless interventional lung assist (iLA) in patients with acute respiratory distress syndrome (ARDS) Evaluation and preparation Insertion Monitoring Echocardiography: ... Guérin C: Ventilation in the prone position in patients with acute lung injury /acute respiratory distress syndrome Curr Opin Crit Care 2006, 12:50-54 Staudinger T, Kofler J, Müllner M, Locker GJ,...

Ngày tải lên: 13/08/2014, 11:23

... [54], and stressed cell systems [63] induced acute respiratory distress syndrome (ARDS) Apoptosis of neutrophils in a healthy donor and in a patient with sepsisinduced acute respiratory distress syndrome ... volumes for acute lung injury and the acute respiratory distress syndrome N Engl J Med 2000, 342:1301-1308 Ware LB, Matthay MA: Clinical progress: the acute respiratory distress syndrome N Engl ... of acute lung injury and acute respiratory distress syndrome trials testing low tidal volumes Am J Respir Crit Care Med 2002, 166:1510-1514 Lee WL, Downey GP: Neutrophil activation and acute lung...

Ngày tải lên: 13/08/2014, 03:20

... ventilator-induced lung injury (VILI) [1] To prevent alveolar cycling and derecruitment in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), high levels of positive end-expiratory ... findings underscore the need to ensure an adequate intravascular volume status before attempting RMs Although venous return was maintained, the RMs, by inducing lung inflation, most probably increased ... (Express) Study Group: Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial JAMA 2008, 299:646-655 Eisner...

Ngày tải lên: 13/08/2014, 16:20

... two indicators: ice-cold water and indocyanin green (ICG) Cold distributes to both intravascular and extravascular volumes, whereas ICG remains intravascular Both indicators are injected into ... Trauma/aspiration Aspiration 48 55 35 34 42 20 382 301 Dobutamine Dobutamine 20, Norepinephrine 0.3 Norepinephrine 0.7 Dobutamine 5, Norepinephrine 0.08 Dobutamine K S S S NS NS 337 504 181 225 327 22 28 19 ... arterial and mixed venous concentrations of cGMP increased significantly during NO inhalation EVLWI did not change either during ANP infusion or during NO inhalation In patients who responded to NO inhalation...

Ngày tải lên: 12/08/2014, 18:21

... useful in diagnosing lung infections in the context of acute respiratory distress syndrome • Peritoneal sTREM-1 is capable of identifying an abdominal infection, including those developed in the ... abdominal infection), had abdominal infection (without lung infection), and had both infections The patients with lung infection had a higher CPIS and a greater alveolar sTREM-1 (P = 0.019 and ... in 29% of cases, acute enteritis in 19%, acute pancreatitis in 14%, digestive tract hemorrhage in 14%, and acute hepatitis in 10%, and case each (5%) had cholecystitis, hepatic abscess, and intestinal...

Ngày tải lên: 14/08/2014, 07:21

... Fang X, Martin TR, Matthay MA, 22 23 24 25 26 27 28 29 Hashimoto S: Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndrome ... assessing the degree of alveolar epithelial damage and predicting overall clinical outcome Another interesting finding was that in the nonsurvivors, the significantly elevated levels of KL-6 in ... (ELF) In the normal lung, this glycoprotein can be predominantly found on alveolar type II epithelial cells, and its expression is greatly increased in proliferating, regenerating, or injured...

Ngày tải lên: 12/08/2014, 13:22

... the potential sustained effects of PV measurement on gas exchange and haemodynamic parameters have not been investigated in patients presenting with acute respiratory distress syndrome (ARDS) This ... constructed to determinate the lower inflection point (LIP) [9] and the upper inflection point (UIP) [10] The Chord compliance of the respiratory system (Crs) was defined as the slope of the linear part ... single PV measurement that is not followed by a change in PEEP level This finding is important because many clinical and experimental studies report early evaluation findings for therapeutic interventions...

Ngày tải lên: 12/08/2014, 23:23

... surface and becomes distributed in pulmonary epithelial lining fluid This glycoprotein is predominantly expressed on alveolar type II cells in the lung, with expression increasing in proliferating, ... mode of lung injury Previous studies have indicated that the mode of lung injury can influence the inflammatory milieu and pulmonary mechanics of the lung in ARDS [14] To address this indication ... u/ml in patients with direct lung injury and was 329 u/ml in those with indirect lung injury (P = 0.48) (data not shown) Discussion Injury Score Correlation between Kerbs von Lungren antigen and...

Ngày tải lên: 13/08/2014, 10:20

... rapidly in ventilator-treated patients with acute respiratory distress syndrome (ARDS) [1] Endotracheal suctioning (ETS), which is a common procedure in patients with acute lung injury (ALI) and ... Dynamics of lung collapse and recruitment during prolonged breathing in porcine lung injury J Appl Physiol 1998, 85:1533-1543 Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S: Warning! Suctioning ... routines in our intensive care unit, the Figure Timeline of the study in minutes The order of the two suctioning procedures α and β was randomized The vertical lines above the timeline indicate blood...

Ngày tải lên: 12/08/2014, 19:21

... [1] (b) CT scan of acute respiratory distress syndrome patients before and after a recruitment maneuver with 60 cmH2O maximal inspiratory pressure maintaining PEEP values of 20 and 25 cmH2O without ... issues involved in improving the prognosis of this still life-threatening clinical problem More intriguing are the recent results showing that dead space fractions were elevated early in the ... previous breaths and the applied PEEP level strongly determine the working envelope in the present breath and the chances of promoting intratidal recruitment during mechanical ventilation in ARDS patients...

Ngày tải lên: 12/08/2014, 22:22

... Fr cannula was inserted into the artery and a 15 Fr cannula into the vein using Seldinger's technique The ILA device (Novalung, Hechingen, Germany) was filled with saline solution and connected ... delay and continued for 30 minutes In six animals, the ILA system was clamped immediately; in the other group of six animals it remained open Adrenaline was administered as a continuous infusion ... venous pressure and CVP were monitored using the S/5 anaesthesia monitoring system (Datex Ohmeda, Helsinki, Finland) The iliac artery and vein were cannulated with ultrasound guidance and a 13 Fr...

Ngày tải lên: 13/08/2014, 15:21

... abdominal contents and heart [22], yielding a redistribution of ventilation; (b) increased endexpiratory lung volume resulting in a reduction in stress and strain [25]; and (c) changes in regional ... The Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome ... maneuver in acute lung injury and acute respiratory distress syndrome Respir Care 2008 53:1441–1449 34 Constantin JM, Cayot-Constantin S, Roszyk L, et al.: Response to recruitment maneuver influenc.es...

Ngày tải lên: 13/08/2014, 20:21

... tracer to lung structures not pertaining to the surfactant system (i.e infiltrating inflammatory cells), or to a combination of these ARDS = acute respiratory distress syndrome k21 and k12 = ... mg/kg/d Figure Main kinetic results Main kinetic results Disaturated-phosphatidylcholine-palmitate kinetics in ARDS (left) and controls (right) Unique values are estimated only for M1 and F12 Other ... disaturated-phosphatidylcholine, phosphatidylglycerol and surfactant-specific proteins and fail to reduce surface tension both in vitro and in vivo [4,5] Surfactant organization in the alveoli is also altered, since...

Ngày tải lên: 12/08/2014, 15:20

... injury and the acute respiratory distress syndrome The Acute Respiratory Distress Syndrome Network N Engl J Med 2000, 342:1301-1308 Tasaka S, Hasegawa N, Ishizaka A: Pharmacology of acute lung injury ... resuspended in saline solution, counted and subjected to a cyto spin maneuver [27] Staining was performed according to the Papenheim method (2 in Table 1: Clinical and basic BALF data and cell counts§ ... Conaway MR, Egan EA, the Pediatric Acute Lung Injury and Sepsis Investigators: Effect of exogenous surfactant (calfactant) in pediatric acute lung injury: a randomized controlled trial JAMA 2005,...

Ngày tải lên: 12/08/2014, 15:21

... http://ccforum.com/content/1/1/25 Figure Individual changes in MPAP and PaO2/FiO2 induced by increasing inspiratory intratracheal concentrations of inhaled NO (Insp IT NO) in eight patients with ARDS and without septic ... decrease in MPAP and an increase in PaO2/FiO2 in the range of 0.15 to 150 ppm inhaled NO Toxic effects of increasing concentrations of inhaled NO As shown in Table 3, methemoglobin and NO2 significantly ... vasodilating mediators such as prostaglandins and endogenous NO, and hence result in disproportionately high shunting and hypoxemia [26–32] In addition, exogenous catecholamines, used to maintain arterial...

Ngày tải lên: 12/08/2014, 18:20

... wafers in nondependent lung regions, in middle lung regions and in dependent lung regions in the supine position, in both healthy lungs and in edematous lungs, we found that esophageal pressure ... The Acute Respiratory Distress Syndrome Network: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome ... pulmonary and extrapulmonary acute respiratory distress syndrome Intensive Care Med 2001, 27:477-485 Gattinoni L, Pelosi P, Valenza F, Mascheroni D: Patient positioning in acute respiratory failure In...

Ngày tải lên: 12/08/2014, 20:20

... pressures recorded in four healthy subjects in the supine and in the prone position with and without supports are summarized in Figure As shown, in shifting the subjects from the supine to the prone ... participated in the study design and coordination and performed the measurements MR participated in the study design and coordination and performed the measurements LL participated in the study design and ... aeration, and perfusion in experimental acute lung injury Am J Respir Crit Care Med 2005, 172:480-487 10 Gattinoni L, Pelosi P, Valenza F, Mascheroni D: Patient positioning in acute respiratory...

Ngày tải lên: 12/08/2014, 23:23

... support during the ICU stay and during the rehabilitation period was associated with a decrease in PTSD symptoms In addition, 'high-scoring patients', indicating an increased risk of developing PTSD, ... and 'high-scoring patients' and 'lowscoring patients' suffering from ARDS as well as in the subdimensions physical function, physical role function, bodily pain and general health (Table 4) In ... function, bodily pain, general health, vitality, social function, emotional function and mental health), comparing between patients with acute respiratory distress syndrome and age- and gender-matched...

Ngày tải lên: 13/08/2014, 03:20

... ‘protective’ against VILI In oleic-acid-induced and endotoxin-induced lung injuries, distal lung units are expanded, are filled with haemorrhagic or proteinaceous oedema, and are infiltrated by inflammatory ... Menaldo E, Davini O, Gandini G, Herrmann P, Mascia L, Quintel M, Slutsky AS, Gattinoni L, Ranieri VM: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome ... Ventilator-induced lung injury Curr Opin Crit Care 2002, 8:12-20 Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress...

Ngày tải lên: 13/08/2014, 10:20