???Best PEEP??? Therapy in the Injured Lung

2005 ◽  
Vol 12 (1) ◽  
pp. 56-57
Author(s):  
Samar Khan ◽  
Terence K. Trow
Keyword(s):  
2016 ◽  
Vol 55 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Sarah M. Haeger ◽  
Yimu Yang ◽  
Eric P. Schmidt
Keyword(s):  

Author(s):  
Kerry A. Danelson ◽  
Joel D. Stitzel

Motor Vehicle Crashes (MVCs) are a public health problem in the United States. In 2009, 33,808 Americans were killed in a MVC and 2.22 million more were injured.4 Pulmonary contusion (PC) is a common injury following MVC with over 38% of the Abbreviated Injury Scale (AIS) 3+ thoracic injuries identified as some form of PC in a recent National Automotive Sampling System (NASS) study.5 Miller et al. correlated the percent injured lung to the possibility of developing Acute Respiratory Distress Syndrome (ARDS). The results indicated that if 20% of the lung was injured, the incidence of ARDS sharply increased with seventy-eight percent of those patients developing ARDS.2 The significance of these findings is that the volumetric measurement of PC can predict possible clinical outcomes.


2002 ◽  
Vol 93 (5) ◽  
pp. 1709-1715 ◽  
Author(s):  
Gilman Allen ◽  
Lennart K. A. Lundblad ◽  
Polly Parsons ◽  
Jason H. T. Bates

The lasting effects of a recruitment maneuver (RM) in the injured lung are not well characterized. We speculated that the reduction in respiratory elastance ( H) after a deep inflation (DI) is transient in nature and should be sustained longer at higher positive end-expiratory pressure (PEEP). Thirteen ventilated mice were given 2 DIs at various levels of PEEP before and after saline lavage. Forced oscillations were used to measure H periodically over 7 min after the DIs. Time constants (τ) were estimated for the post-DI recovery in H. Values for τ before lavage (80–115 s) were reduced after lavage (13–30 s) at all levels of PEEP ( P = 0.0001). PEEP did not significantly influence τ before or after lavage. The plateau level and total recovery in H after a DI were significantly influenced by PEEP and lavage ( P < 0.0001). Our results suggest that for a DI to be beneficial in the injured mouse lung, it may have to be applied several times a minute.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zahid Akhter ◽  
Jagdish Chandra Joshi ◽  
Vijay Avin Balaji Ragunathrao ◽  
Richard L Proia ◽  
Asrar B Malik ◽  
...  

Introduction: Increased endothelial permeability and failure to repair is the hallmark of several vascular diseases including acute lung injury (ALI). However, little is known about the intrinsic pathways that activate the endothelial cell (EC) regenerative programs facilitating thereby tissue repair. Studies have invoked a crucial role of sphingosine-1-phosphate (S1P) in resolving endothelial hyperpermeability through activation of the G-protein coupled receptor, sphingosine-1-phosphate receptor 1 (S1PR1). Hypothesis: We postulate that S1PR1 + EC serve as an endogenous means to prevent endothelial injury. Methods: Studies were made using EC-S1PR1 null mice and S1PR1-GFP reporter mice to trace the generation and characteristics of S1PR1 + EC by exploiting immuno-histochemical analysis and FACS. RNA-seq analysis was performed to identify the genetic signature of S1PR1 + EC. Combination of genetic and pharmacological strategies were included for mechanistic study. Transplantation of S1PR1 + EC and edema measurement was performed in EC-S1PR1 null mice. Results: We observed in a mouse model of endotoxemia that LPS via generation of S1P induced the programming of S1PR1 lo EC to S1PR1 + EC, comprising 80% of lung EC. Their generation preceded the vascular repair phase and these cells were required for reestablishing the endothelial barrier function. Thus, conditional deletion of S1PR1 in EC spontaneously increased lung vascular permeability. RNA-seq analysis of S1PR1 + EC showed enrichment of genes regulating S1P synthesis and transport, sphingosine kinase 1 (SPHK1) and SPNS2, respectively, as well as transcription factors EGR1 and STAT3. EGR1 and STAT3 were essential for transcribing SPHK1 and SPNS2, respectively to increase S1P concentration that served to amplify S1PR1 + EC transition. Transplantation of S1PR1 + EC into injured lung vasculature of EC-S1PR1 -/- mice restored endothelial integrity. Conclusions: Findings illustrate that generation of a specialized S1PR1 + EC population has the potential to activate key endothelial regenerative program mediating vascular endothelial repair raising the possibility of activating this pathway to restore vascular homeostasis in inflammatory lung injury.


2021 ◽  
pp. 685-698
Author(s):  
Takeshi Yoshida ◽  
Lu Chen ◽  
Remi Coudroy ◽  
Laurent J. Brochard

2002 ◽  
Vol 161 (4) ◽  
pp. 1383-1393 ◽  
Author(s):  
Rhonda J. Staversky ◽  
Richard H. Watkins ◽  
Terry W. Wright ◽  
Eric Hernady ◽  
Michael B. LoMonaco ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document