Comments on “Stressing the Brain...Acute Respiratory Distress Syndrome”

2018 ◽  
Vol 15 (1) ◽  
pp. 113-114 ◽  
Author(s):  
Mickey C. Harrison ◽  
Richard B. Dunn ◽  
Jody Kear
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
The Brain

scholarly journals Medical Image of the Month: Severe Acute Respiratory Distress Syndrome and Embolic Strokes from Polymethylmethacrylate (PMMA) Embolization

2021 ◽  
Vol 22 (4) ◽  
pp. 86-87
Author(s):  
Sooraj Kumar ◽  
Sharanyah Srinivasan ◽  
Tammer El-Aini
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Emergency Room ◽  
Medical Image ◽  
Distress Syndrome ◽  
Depression And Anxiety ◽  
History Of ◽  
The Brain ◽  
History Of Depression

No abstract available. Article truncated after 150 words. A 35-year-old lady with a history of depression and anxiety presented to the emergency room with worsening shortness of breath after receiving polymethylmethacrylate (PMMA) injections in her buttock for cosmetic purposes in Mexico. Immediately after the injection in the outpatient office, she became acutely short of breath, tachypneic, and tachycardic. She was brought to the emergency room where she was hypoxic with oxygen saturations in the low 80s on a non-rebreather, tachypneic with a respiratory rate in the 40s, and tachycardic with heart rates in 140s. She was emergently intubated. A CTA of the chest demonstrated bilateral ground glass opacities throughout, most pronounced in the upper lobes which progressed to significant bilateral airspace disease consistent with acute respiratory distress syndrome (Figure 1). Her neurological examination declined over the course of her hospitalization. An MRI of the brain with contrast demonstrated bilateral foci of susceptibility artifact throughout the entirety of the …

scholarly journals Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome. Prevention of venous thromboembolism in patients with COVID-19

2020 ◽  
Vol 3-4 (213-214) ◽  
pp. 2-7
Author(s):  
Akhmetzhan Sugraliyev ◽  
◽  
Рlinio Cirillo ◽  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Venous Thrombosis ◽  
Distress Syndrome ◽  
Ultrasound Examination ◽  
Multiple Organ ◽  
Autopsy Study ◽  
Lung Vessels ◽  
The Brain

In this review, the authors describe the new concept of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) - proposed by Italian multidisciplinary team headed by Ciceri F, et al. as the cause of atypical acute respiratory distress syndrome. Ciceri F, etal. hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. In addition, patients with COVID-19 often develop macrovascular venous thrombosis as a result of the activation of the Virchow triad. Microvascular and macrovascular thrombosis development in patients with COVID-19 is confirmed by ultrasound examination of the veins of the lower extremities and complete autopsy study. The data obtained indicate the importance of the prevention of venous thrombosis with LMWH (nadroparin, enoxaparin) and Fondaparinux sodium in all hospitalized patients with COVID-19. Keywords: COVID-19, аtypical acute respiratory distress syndrome, MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome), thrombosis, hemostasis.

Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis

2020 ◽  
Vol 22 (2) ◽  
pp. 95-97
Author(s):  
Fabio Ciceri ◽  
◽  
Luigi Beretta ◽  
Anna Mara Scandroglio ◽  
Sergio Colombo ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Multiple Organ Failure ◽  
Inflammatory Reaction ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
Sequence Of Events ◽  
Lung Vessels ◽  
The Brain

We suggest the use of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) as a new name for severe pulmonary coronavirus disease 2019 (COVID-19). We hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. Future steps in the understanding of the disease and in the identification of treatments may benefit from this definition and hypothesised sequence of events.

COVID-19 – eine vaskuläre Systemerkrankung

2020 ◽  
Vol 49 (10) ◽  
pp. 418-421
Author(s):  
Christopher Werlein ◽  
Peter Braubach ◽  
Vincent Schmidt ◽  
Nicolas J. Dickgreber ◽  
Bruno Märkl ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome

ZUSAMMENFASSUNGDie aktuelle COVID-19-Pandemie verzeichnet mittlerweile über 18 Millionen Erkrankte und 680 000 Todesfälle weltweit. Für die hohe Variabilität sowohl der Schweregrade des klinischen Verlaufs als auch der Organmanifestationen fanden sich zunächst keine pathophysiologisch zufriedenstellenden Erklärungen. Bei schweren Krankheitsverläufen steht in der Regel eine pulmonale Symptomatik im Vordergrund, meist unter dem Bild eines „acute respiratory distress syndrome“ (ARDS). Darüber hinaus zeigen sich jedoch in unterschiedlicher Häufigkeit Organmanifestationen in Haut, Herz, Nieren, Gehirn und anderen viszeralen Organen, die v. a. durch eine Perfusionsstörung durch direkte oder indirekte Gefäßwandschädigung zu erklären sind. Daher wird COVID-19 als vaskuläre Multisystemerkrankung aufgefasst. Vor dem Hintergrund der multiplen Organmanifestationen sind klinisch-pathologische Obduktionen eine wichtige Grundlage der Entschlüsselung der Pathomechanismen von COVID-19 und auch ein Instrument zur Generierung und Hinterfragung innovativer Therapieansätze.

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