scholarly journals The changes in biomarkers for necrotising enterocolitis in premature calves with respiratory distress syndrome

2019 ◽  
Vol 64 (No. 10) ◽  
pp. 440-447
Author(s):  
R Yildiz ◽  
M Ok ◽  
M Ider ◽  
A Akar ◽  
A Naseri ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Plasma Concentrations ◽  
Necrotising Enterocolitis ◽  
Control Group ◽  
Intestinal Damage ◽  
Fatty Acid Binding ◽  
Group A ◽  
Novel Biomarkers

The aim of this study was to determine the changes of the biomarkers used for the diagnosis of necrotising enterocolitis of human neonates in premature calves with respiratory distress syndrome (RDS). Novel biomarkers including the intestinal fatty acid binding protein (IFABP), the liver-type FABP (LFABP), trefoil factor-3 (TFF3), actin gamma 2 smooth muscle (ACTG2), and Claudin-3 were investigated using bovine specific ELISA kits. Thirty premature calves with respiratory distress syndrome (the RDS group), seven premature calves without RDS (the non-RDS group), and seven healthy calves (control) were included in the study. Blood samples from all the groups were taken at 0 and 48 h for the blood gas and biomarker measurement. It was determined that IFABP (P < 0.05), LFABP (P < 0.05), TFF3 (P < 0.05), ACTG2 (P < 0.05), and Claudin-3 (P < 0.05) in the control group were significantly higher than those in the RDS and non-RDS groups at 0 hour. The LFABP and Claudin-3 concentrations in the control group were statistically higher (P < 0.05) than those in the RDS and non-RDS groups at 48 h, whereas the ACTG2 and TFF3 contents were significantly higher (P < 0.05) than the non-RDS group. A significant increase in the contents of IFABP (P ≤ 0.01), LFABP (P < 0.05), TFF3 (P < 0.05), ACTG2 (P < 0.05) at 48 h was detected in the RDS group only. In conclusion, the changes in the biomarkers support the suspicion of intestinal damage such as necrotising enterocolitis (NEC) after enteral feeding in premature calves with RDS. Intestinal damage biomarkers such as IFABP, LFABP, TFF3, and ACTG2 may be useful in the diagnosis of intestinal damage in premature calves. These results also indicate that the plasma concentrations of the intestinal biomarkers change in new born calves with their gestational age.

scholarly journals Early individualized positive end-expiratory pressure guided by electrical impedance tomography in acute respiratory distress syndrome: a randomized controlled clinical trial

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Huaiwu He ◽  
Yi Chi ◽  
Yingying Yang ◽  
Siyi Yuan ◽  
Yun Long ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Electrical Impedance ◽  
Distress Syndrome ◽  
Control Group ◽  
Positive End Expiratory Pressure ◽  
Ventilation Distribution ◽  
Impedance Tomography ◽  
Group A

Abstract Background Individualized positive end-expiratory pressure (PEEP) by electrical impedance tomography (EIT) has potential interest in the optimization of ventilation distribution in acute respiratory distress syndrome (ARDS). The aim of the study was to determine whether early individualized titration of PEEP with EIT improved outcomes in patients with ARDS. Methods A total of 117 ARDS patients receiving mechanical ventilation were randomly assigned to EIT group (n = 61, PEEP adjusted based on ventilation distribution) or control group (n = 56, low PEEP/FiO2 table). The primary outcome was 28-day mortality. Secondary and exploratory outcomes were ventilator-free days, length of ICU stay, incidence of pneumothorax and barotrauma, and difference in Sequential Organ Failure Assessment (SOFA) score at day 1 (ΔD1-SOFA) and day 2 (ΔD2-SOFA) compared with baseline. Measurements and main results There was no statistical difference in the value of PEEP between the EIT group and control group, but the combination of PEEP and FiO2 was different between groups. In the control group, a significantly positive correlation was found between the PEEP value and the corresponding FiO2 (r = 0.47, p < 0.00001) since a given matched table was used for PEEP settings. Diverse combinations of PEEP and FiO2 were found in the EIT group (r = 0.05, p = 0.68). There was no significant difference in mortality rate (21% vs. 27%, EIT vs. control, p = 0.63), ICU length of stay (13.0 (7.0, 25.0) vs 10.0 (7.0, 14.8), median (25th–75th percentile); p = 0.17), and ventilator-free days at day 28 (14.0 (2.0, 23.0) vs 19.0 (0.0, 24.0), p = 0.55) between the two groups. The incidence of new barotrauma was zero. Compared with control group, significantly lower ΔD1-SOFA and ΔD2-SOFA were found in the EIT group (p < 0.001) in a post hoc comparison. Moreover, the EIT group exhibited a significant decrease of SOFA at day 2 compared with baseline (paired t-test, difference by − 1 (− 3.5, 0), p = 0.001). However, the control group did show a similar decrease (difference by 1 (− 2, 2), p = 0.131). Conclusion Our study showed a 6% absolute decrease in mortality in the EIT group: a statistically non-significant, but clinically non-negligible result. This result along with the showed improvement in organ function might justify further reserach to validate the beneficial effect of individualized EIT-guided PEEP setting on clinical outcomes of patients with ARDS. Trial registration: ClinicalTrials, NCT02361398. Registered 11 February 2015—prospectively registered, https://clinicaltrials.gov/show/NCT02361398.

scholarly journals Inhalationally Administered Semifluorinated Alkanes (SFAs) as Drug Carriers in an Experimental Model of Acute Respiratory Distress Syndrome

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 431
Author(s):  
Matthias Otto ◽  
Jörg Krebs ◽  
Peter Welker ◽  
René Holm ◽  
Manfred Thiel ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Lung Mechanics ◽  
Systemic Absorption ◽  
Control Group ◽  
Pharmacokinetic Data ◽  
Tnf Α ◽  
Semifluorinated Alkanes

Aerosol therapy in patients suffering from acute respiratory distress syndrome (ARDS) has so far failed in improving patients’ outcomes. This might be because dependent lung areas cannot be reached by conventional aerosols. Due to their physicochemical properties, semifluorinated alkanes (SFAs) could address this problem. After induction of ARDS, 26 pigs were randomized into three groups: (1) control (Sham), (2) perfluorohexyloctane (F6H8), and (3) F6H8-ibuprofen. Using a nebulization catheter, (2) received 1 mL/kg F6H8 while (3) received 1 mL/kg F6H8 with 6 mg/mL ibuprofen. Ibuprofen plasma and lung tissue concentration, bronchoalveolar lavage (BAL) fluid concentration of TNF-α, IL-8, and IL-6, and lung mechanics were measured. The ibuprofen concentration was equally distributed to the dependent parts of the right lungs. Pharmacokinetic data demonstrated systemic absorption of ibuprofen proofing a transport across the alveolo-capillary membrane. A significantly lower TNF-α concentration was observed in (2) and (3) when compared to the control group (1). There were no significant differences in IL-8 and IL-6 concentrations and lung mechanics. F6H8 aerosol seemed to be a suitable carrier for pulmonary drug delivery to dependent ARDS lung regions without having negative effects on lung mechanics.

BODY WATER COMPARTMENTS IN THE PREMATURE INFANT, WITH SPECIAL REFERENCE TO THE EFFECTS OF THE RESPIRATORY DISTRESS SYNDROME AND OF MATERNAL DIABETES AND TOXEMIA

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 883-889
Author(s):  
Wesley M. Clapp ◽  
L. Joseph Butterfield ◽  
Donough O'Brien
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Total Body Water ◽  
Distress Syndrome ◽  
Body Water ◽  
Control Group ◽  
Extracellular Water ◽  
Water Compartments ◽  
Significant Difference ◽  
Total Body

Normal values for both total body water and extracellular water have been determined in 86 premature infants aged 1 to 90 days and weighing 940 to 2,435 gm, with use of the techniques of deuterium oxide and bromide dilution. Nine full-term infants aged 1 to 6 days and weighing 2,590 to 4,985 gm were similarly studied. Nine infants with the respiratory distress syndrome and eight infants of toxemic mothers studied in the first 24 hours of life showed no significant difference in their body water compartments in comparison to a control group of normal infants matched for age and weight. Seven infants of diabetic mothers studied in the first 24 hours of life showed a significant decrease in total body water, expressed as percentage of body weight, with a normal intracellular to extracellular water ratio. These data indirectly support other evidence that there is an increase in body fat in these infants at birth. See Table in the PDF file

Corticosteroids as Primary Therapeutic Agents in Respiratory Distress Syndrome (RDS)

PEDIATRICS ◽  
1973 ◽  
Vol 51 (5) ◽  
pp. 952-954
Author(s):  
Philip M. Farrell ◽  
Richard D. Zachman
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Therapeutic Agents ◽  
Control Group ◽  
Prophylactic Therapy ◽  
Supportive Management ◽  
First Time

The long awaited article by Liggins and Howie1 was received with great enthusiasm. Although one must remain cautiously optimistic, it would appear that for the first time an agent is available which transcends the previous methods of supportive management and provides at least a primary approach to prophylactic therapy for RDS. Their data for steroid-treated infants of 26 to 32 weeks' gestation are impressive statistically and the incidence of RDS in the control group (69.6%) is a credible figure based on current estimates.2

scholarly journals Effect of low-dose exogenous surfactant on infants with acute respiratory distress syndrome after cardiac surgery: A retrospective analysis

2020 ◽  
Author(s):  
Rongyuan Zhang ◽  
Xu Wang ◽  
Shoujun Li ◽  
Jun Yan
Keyword(s):  
Cardiac Surgery ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Standard Therapy ◽  
Low Dose ◽  
Distress Syndrome ◽  
Exogenous Surfactant ◽  
Control Group ◽  
Surfactant Treatment

Abstract Background: To evaluate the effect of low-dose exogenous surfactant therapy on infants suffering acute respiratory distress syndrome (ARDS) after cardiac surgery. Methods: We conducted a retrospective case-control study of infants diagnosed with moderate-severe ARDS after cardiac surgery. A case was defined as a patient that received surfactant and standard therapy, while a control was defined as a patient that underwent standard therapy. The primary endpoint was the improvement in oxygenation index (OI) after 24-hour of surfactant treatment; and secondary endpoints were the ventilator time and PICU time. Results: 22 infants treated with surfactant were matched with 22 controls. Early low-dose (20mg/kg) surfactant treatment was associated with improved outcomes. After surfactant administration for 24-hour, the surfactant group was much better compared with the control group at the 24-hour in OI (difference in average change from baseline, -6.7 [95% CI, -9.3 to -4.1]) (P < 0.01) and VI (mean difference, -11.9 [95% CI, -18.1 to -5.7]) (P < 0.01). Ventilation time and PICU time were significantly shorter in the surfactant group compared with the control group (133.6h±27.2 vs 218.4h±28.7, P < 0.01 ; 10.7d±5.1 vs 17.5d±6.8, P < 0.01). Infants in the surfactant group under 3 months benefit more from OI and VI than the infants over 3 months in a preliminary exploratory analysis.Conclusions: In infants with moderate-severe ARDS after cardiac surgery, early low-dose exogenous surfactant treatment could prominently improve oxygenation and reduce mechanical ventilation time and PICU time. Infants younger than 3 months may get more benefit of oxygenation than the older ones.

Double-Blind, Randomized Trial of a Calf Lung Surfactant Extract Administered at Birth to Very Premature Infants for Prevention of Respiratory Distress Syndrome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 593-599 ◽  
Author(s):  
Donald L. Shapiro ◽  
Robert H. Notter ◽  
Frederick C. Morin ◽  
Karl S. Deluga ◽  
Leonard M. Golub ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Distress Syndrome ◽  
Lung Surfactant ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Severe Respiratory Distress

Organic solvent extraction of surfactant obtained by lavage of calf lungs yields a highly surfaceactive material. A double blind, randomized clinical trial to determine the effect of this material on respiratory distress syndrome in premature infants was initiated in the Neonatal Intensive Care Unit at the University of Rochester in December 1983. Infants 25 to 29 weeks gestational age were eligible for entry into the trial. At the time of this interim analysis 32 patients had been randomly selected and entered into the trial, 16 surfactant-treated patients and 16 in a control group who received only saline. At birth, intrapulmonary instillation of the calf lung surfactant extract dispersed in saline or saline alone occurred in the delivery room immediately after intubation and prior to ventilation; infants were then ventilated and treated as usual. At 6, 12, 24, 48, and 72 hours after birth, the severity of respiratory distress was categorized as either minimal, intermediate, or severe based on oxygen and mean airway pressure requirements. Differences observed at six hours after birth were of marginal significance, but at 12 and 24 hours the surfactant-treated group had significantly (P &lt; .01) less severe respiratory distress compared with the control group. Differences between treated and control infants were not statistically significant at 48 and 72 hours after birth. In four surfactant-treated infants the severity of respiratory distress worsened between 24 and 48 hours after birth, suggesting that one dose of surfactant at birth may not be sufficient for some infants.

scholarly journals Mesenchymal Stromal Cells Attenuate Infection-Induced Acute Respiratory Distress Syndrome in Animal Experiments: A Meta-Analysis

2020 ◽  
Vol 29 ◽  
pp. 096368972096918
Author(s):  
Wang Fengyun ◽  
Zhou LiXin ◽  
Qiang Xinhua ◽  
Fang Bin
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Weight Ratio ◽  
Lung Injury Score ◽  
Control Group ◽  
Inflammatory Factor

Mesenchymal stromal cell (MSC) therapy is a potential therapy for treating acute lung injury (ALI) or acute respiratory distress syndrome (ARDS), which was widely studied in the last decade. The purpose of our meta-analysis was to investigate the efficacy of MSCs for simulated infection-induced ALI/ARDS in animal trials. PubMed and EMBASE were searched to screen relevant preclinical trials with a prespecified search strategy. 57 studies met the inclusion criteria and were included in our study. Our meta-analysis showed that MSCs can reduce the lung injury score of ALI caused by lipopolysaccharide or bacteria (standardized mean difference (SMD) = −2.97, 95% CI [−3.64 to −2.30], P < 0.00001) and improve the animals’ survival (odds ratio = 3.64, 95% CI [2.55 to 5.19], P < 0.00001). Our study discovered that MSCs can reduce the wet weight to dry weight ratio of the lung (SMD = −2.58, 95% CI [−3.24 to −1.91], P < 0.00001). The proportion of the alveolar sac in the MSC group was higher than that in the control group (SMD = 1.68, 95% CI [1.22 to 2.13], P < 0.00001). Moreover, our study detected that MSCs can downregulate the levels of proinflammatory factors such as interleukin (IL)-1β, IL-6, and tumor necrosis factor-α in the lung and it can upregulate the level of anti-inflammatory factor IL-10. MSCs were also found to reduce the level of neutrophils and total protein in bronchoalveolar lavage fluid, decrease myeloperoxidase (MPO) activity in the lung, and improve lung compliance. MSC therapy may be a promising treatment for ALI/ARDS since it may mitigate the severity of lung injury, modulate the immune balance, and ameliorate the permeability of lung vessels in ALI/ARDS, thus facilitating lung regeneration and repair.

Changes in fatty acids in phospholipids of the bronchoalveolar fluid in bacterial pneumonia and in adult respiratory distress syndrome.

1984 ◽  
Vol 30 (4) ◽  
pp. 521-523 ◽  
Author(s):  
R P Baughman ◽  
E Stein ◽  
J MacGee ◽  
M Rashkin ◽  
H Sahebjami
Keyword(s):  
Fatty Acids ◽  
Oleic Acid ◽  
Fatty Acid ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Adult Respiratory Distress Syndrome ◽  
Bacterial Pneumonia ◽  
Distress Syndrome ◽  
Lavage Fluid ◽  
Control Group

Abstract Fatty acids of the phospholipid fraction of bronchoalveolar lavage fluid from patients with bacterial pneumonia or with the adult respiratory distress syndrome were chromatographed and the patterns compared with those for a control group. In the control group, palmitic acid (16:0) was the predominant fatty acid, accounting for 58.0% (SD 8.25%) of the total fatty acid, a proportion significantly higher (p less than 0.001) than in the distress-syndrome group (42.1%, SD 4.88%) or the acute pneumonia group (32.1%, SD 1.73%). There was a greater proportion of oleic acid (18:1) in the disease groups; thus the ratio of palmitic to oleic acid was useful in distinguishing these three groups. No patient with a palmitic/oleic acid ratio greater than 2.45 had evidence of parenchymal inflammation. Of those with a ratio less than 1.3, 89% had acute bacterial pneumonia.

Recruitment Maneuvers after a Positive End-expiratory Pressure Trial Do Not Induce Sustained Effects in Early Adult Respiratory Distress Syndrome

2004 ◽  
Vol 101 (3) ◽  
pp. 620-625 ◽  
Author(s):  
Wolfgang Oczenski ◽  
Christoph Hörmann ◽  
Christian Keller ◽  
Norbert Lorenzl ◽  
Anton Kepka ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Adult Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Recruitment Maneuver ◽  
Arterial Oxygen ◽  
Control Group ◽  
Venous Admixture ◽  
Positive End Expiratory Pressure ◽  
Recruitment Maneuvers

Background Recruitment maneuvers performed in early adult respiratory distress syndrome remain a matter of dispute in patients ventilated with low tidal volumes and high levels of positive end-expiratory pressure (PEEP). In this prospective, randomized controlled study the authors evaluated the impact of recruitment maneuvers after a PEEP trial on oxygenation and venous admixture (Qs/Qt) in patients with early extrapulmonary adult respiratory distress syndrome. Methods After a PEEP trial 30 consecutive patients ventilated with low tidal volumes and high levels of PEEP were randomly assigned to either undergo a recruitment maneuver or not. Data were recorded at baseline, 3 min after the recruitment maneuver, and 30 min after baseline. Recruitment maneuvers were performed with a sustained inflation of 50 cm H2O maintained for 30 s. Results Compared with baseline the ratio of the arterial oxygen partial pressure to the fraction of inspired oxygen (Pao2/Fio2) and Qs/Qt improved significantly at 3 min after the recruitment maneuver (Pao2/Fio2, 139 +/- 46 mm Hg versus 246 +/- 111 mm Hg, P &lt; 0.001; Qs/Qt, 30.8 +/- 5.8% versus 21.5 +/- 9.7%, P &lt; 0.005), but baseline values were reached again within 30 min. No significant differences in Pao2/Fio2 and Qs/Qt were detected between the recruitment maneuver group and the control group at baseline and after 30 min (recruitment maneuver group [n = 15]: Pao2/Fio2, 139 +/- 46 mm Hg versus 138 +/- 39 mm Hg; Qs/Qt, 30.8 +/- 5.8% versus 29.2 +/- 7.4%; control group: [n = 15]: Pao2/Fio2, 145 +/- 33 mm Hg versus 155 +/- 52 mm Hg; Qs/Qt, 30.2 +/- 8.5% versus 28.1 +/- 5.4%). Conclusion In patients with early extrapulmonary adult respiratory distress syndrome who underwent a PEEP trial, recruitment maneuvers failed to induce a sustained improvement of oxygenation and venous admixture.

scholarly journals Acute respiratory distress syndrome

2017 ◽  
Vol 26 (144) ◽  
pp. 160116 ◽  
Author(s):  
Marco Confalonieri ◽  
Francesco Salton ◽  
Francesco Fabiano
Keyword(s):  
Risk Factors ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Low Income ◽  
Distress Syndrome ◽  
Plasma Concentrations ◽  
Outcome Data ◽  
Low Income Countries ◽  
Resource Setting

Since its first description, the acute respiratory distress syndrome (ARDS) has been acknowledged to be a major clinical problem in respiratory medicine. From July 2015 to July 2016 almost 300 indexed articles were published on ARDS. This review summarises only eight of them as an arbitrary overview of clinical relevance: definition and epidemiology, risk factors, prevention and treatment. A strict application of definition criteria is crucial, but the diverse resource-setting scenarios foster geographic variability and contrasting outcome data. A large international multicentre prospective cohort study including 50 countries across five continents reported that ARDS is underdiagnosed, and there is potential for improvement in its management. Furthermore, epidemiological data from low-income countries suggest that a revision of the current definition of ARDS is needed in order to improve its recognition and global clinical outcome. In addition to the well-known risk-factors for ARDS, exposure to high ozone levels and low vitamin D plasma concentrations were found to be predisposing circumstances. Drug-based preventive strategies remain a major challenge, since two recent trials on aspirin and statins failed to reduce the incidence in at-risk patients. A new disease-modifying therapy is awaited: some recent studies promised to improve the prognosis of ARDS, but mortality and disabling complications are still high in survivors in intensive care.

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