Definitions, Epidemiology, Clinical Risk Factors, and Health Disparities in Acute Respiratory Distress Syndrome

2019 ◽  
Vol 40 (01) ◽  
pp. 003-011 ◽  
Author(s):  
Mohleen Kang ◽  
Jordan Kempker
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Temporal Trends ◽  
Epidemiologic Study ◽  
Case Fatality ◽  
Rapid Onset ◽  
Case Definition ◽  
Lung Damage

AbstractAcute respiratory distress syndrome (ARDS) is a syndrome of inflammatory lung injury currently defined as the rapid onset of hypoxemia and radiographic opacities from a recent direct or indirect insult that is not explained by other causes. While the diagnostic criteria used to define ARDS are helpful in the clinical setting, they are not entirely specific for the characteristic pathophysiology of diffuse alveolar lung damage. This case definition introduces challenges to the reliable and accurate epidemiologic study of the condition. Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.

Nitric oxide and interval hypoxic training in COVID-19 rehabilitation— new research direction

2021 ◽  
pp. 30-41
Author(s):  
Tatyana Nikolaevna Tsyganova ◽  
Egor Egorov ◽  
Tamara Nikolaevna Voronina
Keyword(s):  
Nitric Oxide ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Viral Infection ◽  
Distress Syndrome ◽  
The Body ◽  
Lung Damage ◽  
Specific Method ◽  
Hypoxic Training

COVID-19, a disease caused by the novel coronavirus SARS-CoV-2, primarily affects lung tissue and disrupts gas exchange, leading to acute respiratory distress syndrome, systemic hypoxia, and lung damage. The search for methods of prevention and rehabilitation, especially after suffering from pneumonia caused by COVID-19, is on the agenda. This article discusses the possibilities of the interval hypoxic training (IHT) method for preventing infections by initiating nitric oxide production in the body. One of the main effects of IHT is the balanced stimulation of nitric oxide (NO) secretion. Over the past two decades, there has been an increasing interest in the function of nitric oxide (NO) in the human body. Nitric oxide plays a key role in maintaining normal vascular function and regulating inflammatory processes, including those leading to lung damage and the development of acute respiratory distress syndrome (ARDS). Our immune system destroys bacteria and viruses by oxidative burst, i.e. when oxygen accumulates inside the cell. This process also involves nitric oxide, a signaling molecule that has an antibacterial and antiviral effect, as well as regulates vascular tone and affects the permeability of the cell wall. Interval hypoxytherapy enhances endogenous oxidative protection and increases the amount of nitric oxide, thus allowing the body’s cells to resist infection more effectively. Mitochondrial NOS induction and mitochondrial NO synthesis increase under the action of pathogenic factors on the cell. By modulating the activity of mtNOS and the synthesis of mitochondrial NO, it is possible to increase the resistance to hypoxic effects. Interval hypo-hyperoxic training as an effective non-specific method of increasing the body’s defenses is indispensable not only in the prevention of viral infection, but also in rehabilitation after viral pneumonia, as well as as a method that reduces the severity of viral infection in the event of infection.

scholarly journals COVID19 Acute respiratory distress syndrome and extra-corporeal membrane oxygenation; A mere option or ultimate necessity

Perfusion ◽  
2020 ◽  
pp. 026765912096150
Author(s):  
Taha Ahmed ◽  
Talha Ahmed ◽  
Hussain Karimi ◽  
Leslie Tolle ◽  
Muhammad Nouman Iqbal
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Potential Role ◽  
Distress Syndrome ◽  
Case Fatality ◽  
Lung Protective Ventilation ◽  
Membrane Oxygenation ◽  
Exponential Increase ◽  
Refractory Hypoxemia

Extracorporeal membrane oxygenation (ECMO) is considered a salvage therapy in patients with acute respiratory distress syndrome (ARDS) and refractory hypoxemia (hypoxemia persisting despite lung-protective ventilation). One aspect of ECMO is whether there would be an application of the technology related to the Coronavirus pandemic. The number of people diagnosed with Coronavirus disease (COVID19) has crossed the five million mark on 9 August 2020, with a case fatality rate of 5.2%. Due to this exponential increase in the number of coronavirus disease (COVID19) cases particularly the ones associated with ARDS, experts are evaluating the need for ECMO in intensive care units. Herein, we chronicle a review encompassing the available evidence on ECMO and its potential role in COVID19 ARDS, as we aim for optimal patient care with appropriate resource utilization and conservation.

Sevoflurane, Compared With Isoflurane, Minimizes Lung Damage in Pulmonary but Not in Extrapulmonary Acute Respiratory Distress Syndrome in Rats

2017 ◽  
Vol 125 (2) ◽  
pp. 491-498 ◽  
Author(s):  
Mariana N. Araújo ◽  
Cíntia L. Santos ◽  
Cynthia S. Samary ◽  
Luciana B. B. Heil ◽  
Vinicius C. M. Cavalcanti ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Damage

scholarly journals Protective - ventilation strategy in the acute respiratory distress syndrome

2004 ◽  
Vol 51 (3) ◽  
pp. 45-49 ◽  
Author(s):  
Vladimir Bumbasirevic ◽  
V. Bukumirovic ◽  
Nada Popovic ◽  
V. Nikolic ◽  
Nevena Kalezic ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Pulmonary Ventilation ◽  
Lung Damage ◽  
Ventilatory Strategy ◽  
Protective Ventilation Strategy

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) contribute to progressive hypoxemia in critically ill patients. It has been proved that conventional mechanical ventilation with physiological respiratory volume contributes to further lung damage. In this respect, application of protective ventilatory strategy - pulmonary ventilation with limited volume and pressure can avoid mentioned consequences. The aim of this paper is to discuss mechanims by which elements contained in protective mechanical ventilation of patients with ALI/ARDS prevent further progrssive lung injury, to argue the effects of positive end - expiratory pressure and present insturctions for its application.

scholarly journals Recovery of COVID-19 acute respiratory distress syndrome with tocilizumab: successful outcome in two critically ill patients

Immunotherapy ◽  
2020 ◽  
Vol 12 (15) ◽  
pp. 1127-1132 ◽  
Author(s):  
Juan David Cala-García ◽  
Juan David Sierra-Bretón ◽  
Jorge Eduardo Cavelier-Baiz ◽  
Álvaro A Faccini-Martínez ◽  
Carlos Eduardo Pérez-Díaz
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Severe Pneumonia ◽  
Lung Damage ◽  
Successful Outcome ◽  
Cytokine Storm ◽  
Principal Mechanism ◽  
Prior Administration

Background: Severe pneumonia and acute respiratory distress syndrome (ARDS) due to COVID-19 is a challenge for nowadays medical practice. Although there is no clarity in the principal mechanism of lung damage and ARDS development, it has been suggested that one of the main reasons of this pathology is the hyperactivation of the immune system, better known as cytokine storm syndrome. Tocilizumab has been proposed to treat COVID-19 severe cases associated to ARDS. Results & methodology: Here we present two successful cases of tocilizumab administration in two COVID-19 patients with prior administration of antiviral therapy (hydroxychloroquine, azithromycin, lopinavir and ritonavir) with adequate response and resolution of ARDS, septic shock and severe pneumonia within the first 72 h. Discussion & conclusion: This case supports the usage of tocilizumab as an effective therapy in COVID-19 associated cytokine storm syndrome. Further studies should be done in order to assess its effectiveness and security.

scholarly journals Clinical characteristics and prognosis of drug-associated acute respiratory distress syndrome compared with non-drug-associated acute respiratory distress syndrome: a single-centre retrospective study in Japan

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015330 ◽  
Author(s):  
Keisuke Anan ◽  
Kazuya Ichikado ◽  
Kodai Kawamura ◽  
Takeshi Johkoh ◽  
Kiminori Fujimoto ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Arterial Oxygen Tension ◽  
Ventilator Weaning ◽  
Serum Lactate ◽  
Lung Damage ◽  
Arterial Oxygen ◽  
Serum Lactate Dehydrogenase

ObjectivesTo report the clinical features and prognosis of drug-associatedacute respiratory distress syndrome (ARDS).DesignA retrospective analysis of data collected during a prospective cohort study.SettingIntensive care unit in a teaching hospital.ParticipantsA total of 197 Japanese patients with ARDS diagnosed by the Berlin definition who were admitted to the Division of Respiratory Medicine from October 2004 to December 2015 were enrolled in the study and were classified as two groups according to their causes: a drug-associated ARDS group (n=27) and a non-drug-associated ARDS group (n=170). Primary outcome measure is 28-day mortality, and the secondaryoutcome measure is ventilator-free days.ResultsThe Acute Physiology and Chronic Health Evaluation II scores were significantly lower in the drug-associated ARDS group than in the non-drug-associated ARDS group (median (IQR): 18.0 (16.5–21.0) vs 23.0 (18.0–26.0), p<0.001), and the arterial oxygen tension/fractional inspired oxygen ratio was higher (148.0 (114.1–177.5) vs 101.0 (71.5–134.0), p=0.003). In the drug-associated ARDS group, although high-resolution CT scores indicative of the extent of fibroproliferation (301.6 (244.1–339.8) vs 208.3 (183.4–271.6), p<0.001), serum lactate dehydrogenase levels (477 (365–585) vs 322 (246–434), p=0.003) and the McCabe scores (score 1/2/3, n (%): 20 (74)/4 (15)/3 (11)vs154 (91)/7 (4)/9 (5), p=0.04) were significantly higher, ventilator weaning was earlier (p<0.001) and 28-day mortality was better (p=0.043). After adjusting for potentially confounding covariates, drug-associated ARDS group was associated with lower 28-day mortality (adjusted HR (HR) 0.275; 95% CI 0.106 to 0.711; p=0.008).ConclusionsAlthough more severe lung damage with fibroproliferation was observed in patients with drug-associated ARDS, ventilator weaning was earlier, and their prognosis was better than the others. Further well-designed prospective studies are needed.

scholarly journals Rapid-Onset Acute Respiratory Distress Syndrome (ARDS) in a Patient Undergoing Metastatic Liver Resection: A Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Thorsten Brenner ◽  
Johann Motsch ◽  
Jens Werner ◽  
Lars Grenacher ◽  
Eike Martin ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Liver Resection ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Surgical Procedure ◽  
Distress Syndrome ◽  
Rapid Onset ◽  
Pulmonary Complications ◽  
Life Threatening ◽  
Metastatic Liver

Metastatic liver resection following cytoreductive chemotherapy is an accepted treatment for oligometastatic tumor diseases. Although pulmonary complications are frequently reported in patients undergoing liver surgery including liver transplantation, life-threatening acute respiratory failures in the absence of aspiration, embolism, transfusion-related acute lung injury (TRALI), pulmonary infection, or an obvious source of systemic sepsis are rare. We performed an extensive clinical review of a patient undergoing metastatic liver resection who had a clinical course compatible to an acute respiratory distress syndrome (ARDS) without an obvious cause except for the surgical procedure and multiple preoperative chemotherapies. We hypothesize that either the surgical procedure mediated by cytokines and tumor necrosis factor or possible toxic effects of oxygen applied during general anesthesia were associated with life-threatening respiratory failure in the patient. Discrete and subclinical inflammated alveoli (probably due to multiple preoperative chemotherapies with substances at potential risk for interstitial pneumonitis as well as chest radiation) might therefore be considered as risk factors.

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