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.

Acute respiratory distress syndrome in patients with and without diffuse alveolar damage: an autopsy study

2015 ◽  
Vol 41 (11) ◽  
pp. 1921-1930 ◽  
Author(s):  
José A. Lorente ◽  
Pablo Cardinal-Fernández ◽  
Diego Muñoz ◽  
Fernando Frutos-Vivar ◽  
Arnaud W. Thille ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Autopsy Study

scholarly journals Remote ischemic conditioning for acute respiratory distress syndrome in COVID-19

2021 ◽  
Author(s):  
Anthony V. Incognito ◽  
Philip J. Millar ◽  
W. Glen Pyle
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Cardiovascular Complications ◽  
Multiple Organ ◽  
Organ Injury ◽  
Acute Injury ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning

Acute respiratory distress syndrome and subsequent respiratory failure remains the leading cause of death (>80%) in patients severely impacted by COVID-19. The lack of clinically effective therapies for COVID-19 calls for the consideration of novel adjunct therapeutic approaches. Though novel antiviral treatments and vaccination hold promise in control and prevention of early disease, it is noteworthy that in severe cases of COVID-19, addressing "run-away" inflammatory cascades are likely more relevant for improvement of clinical outcomes. Viral loads may decrease in severe, end-stage coronavirus cases, but a systemically damaging cytokine storm persists and mediates multiple organ injury. Remote ischemic conditioning (RIC) of the limbs has shown potential in recent years to protect the lungs and other organs against pathological conditions similar to that observed in COVID-19. We review the efficacy of RIC in protecting the lungs against acute injury and current points of consideration. The beneficial effects of RIC on lung injury along with other related cardiovascular complications are discussed, as are the limitations presented by sex and ageing. This adjunct therapy is highly feasible, non-invasive, and proven to be safe in clinical conditions. If proven effective in clinical trials for acute respiratory distress syndrome and COVID-19, application in the clinical setting could be immediately implemented to improve outcomes.

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