scholarly journals Differential Redox State and Iron Regulation in Chronic Obstructive Pulmonary Disease, Acute Respiratory Distress Syndrome and Coronavirus Disease 2019

Antioxidants ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1460
Author(s):  
Lorena Duca ◽  
Sara Ottolenghi ◽  
Silvia Coppola ◽  
Rocco Rinaldo ◽  
Michele Dei Cas ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Redox State ◽  
Distress Syndrome ◽  
Iron Regulation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Hematopoietic Response

In patients affected by Acute Respiratory Distress Syndrome (ARDS), Chronic Obstructive Pulmonary Disease (COPD) and Coronavirus Disease 2019 (COVID-19), unclear mechanisms negatively interfere with the hematopoietic response to hypoxia. Although stimulated by physiological hypoxia, pulmonary hypoxic patients usually develop anemia, which may ultimately complicate the outcome. To characterize this non-adaptive response, we dissected the interplay among the redox state, iron regulation, and inflammation in patients challenged by either acute (ARDS and COVID-19) or chronic (COPD) hypoxia. To this purpose, we evaluated a panel of redox state biomarkers that may integrate the routine iron metabolism assays to monitor the patients’ inflammatory and oxidative state. We measured redox and hematopoietic regulators in 20 ARDS patients, 20 ambulatory COPD patients, 9 COVID-19 ARDS-like patients, and 10 age-matched non-hypoxic healthy volunteers (controls). All the examined pathological conditions induced hypoxia, with ARDS and COVID-19 depressing the hematopoietic response without remarkable effects on erythropoietin. Free iron was higher than the controls in all patients, with higher levels of hepcidin and soluble transferrin receptor in ARDS and COVID-19. All markers of the redox state and antioxidant barrier were overexpressed in ARDS and COVID-19. However, glutathionyl hemoglobin, a candidate marker for the redox imbalance, was especially low in ARDS, despite depressed levels of glutathione being present in all patients. Although iron regulation was dysfunctional in all groups, the depressed antioxidant barrier in ARDS, and to a lesser extent in COVID-19, might induce greater inflammatory responses with consequent anemia.

scholarly journals Intercellular Communication by Vascular Endothelial Cell-Derived Extracellular Vesicles and Their MicroRNAs in Respiratory Diseases

2021 ◽  
Vol 7 ◽  
Author(s):  
Shota Fujimoto ◽  
Yu Fujita ◽  
Tsukasa Kadota ◽  
Jun Araya ◽  
Kazuyoshi Kuwano
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Acute Respiratory Distress Syndrome ◽  
Endothelial Cell ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Respiratory Diseases ◽  
Distress Syndrome ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Respiratory diseases and their comorbidities, such as cardiovascular disease and muscle atrophy, have been increasing in the world. Extracellular vesicles (EVs), which include exosomes and microvesicles, are released from almost all cell types and play crucial roles in intercellular communication, both in the regulation of homeostasis and the pathogenesis of various diseases. Exosomes are of endosomal origin and range in size from 50 to 150 nm in diameter, while microvesicles are generated by the direct outward budding of the plasma membrane in size ranges of 100–2,000 nm in diameter. EVs can contain various proteins, metabolites, and nucleic acids, such as mRNA, non-coding RNA species, and DNA fragments. In addition, these nucleic acids in EVs can be functional in recipient cells through EV cargo. The endothelium is a distributed organ of considerable biological importance, and disrupted endothelial function is involved in the pathogenesis of respiratory diseases such as chronic obstructive pulmonary disease, pulmonary hypertension, and acute respiratory distress syndrome. Endothelial cell-derived EVs (EC-EVs) play crucial roles in both physiological and pathological conditions by traveling to distant sites through systemic circulation. This review summarizes the pathological roles of vascular microRNAs contained in EC-EVs in respiratory diseases, mainly focusing on chronic obstructive pulmonary disease, pulmonary hypertension, and acute respiratory distress syndrome. Furthermore, this review discusses the potential clinical usefulness of EC-EVs as therapeutic agents in respiratory diseases.

Respiratory emergencies

2019 ◽  
pp. 171-226
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir H. Sam
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Acute Severe Asthma ◽  
Pleural Effusions ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Emergencies

This chapter discusses respiratory emergencies, including pneumonia (acute, Mycoplasma, Legionella, viral, Chlamydia), psittacosis, acute asthma, acute severe asthma, mild to moderate asthmatic attacks, acute exacerbation of chronic obstructive pulmonary disease (COPD), respiratory failure, adult respiratory distress syndrome, pneumothorax (acute, tension), haemoptysis, pleural effusions, chronic massive effusion, empyema, and acute upper airway obstruction.

Acute respiratory failure and acute respiratory distress syndrome

2018 ◽  
Author(s):  
Luciano Gattinon ◽  
Eleonora Carlesso
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Partial Pressure ◽  
Distress Syndrome ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Low Oxygen ◽  
Arterial Blood

Respiratory failure (RF) is defined as the acute or chronic impairment of respiratory system function to maintain normal oxygen and CO2 values when breathing room air. ‘Oxygenation failure’ occurs when O2 partial pressure (PaO2) value is lower than the normal predicted values for age and altitude and may be due to ventilation/perfusion mismatch or low oxygen concentration in the inspired air. In contrast, ‘ventilatory failure’ primarily involves CO2 elimination, with arterial CO2 partial pressure (PaCO2) higher than 45 mmHg. The most common causes are exacerbation of chronic obstructive pulmonary disease (COPD), asthma, and neuromuscular fatigue, leading to dyspnoea, tachypnoea, tachycardia, use of accessory muscles of respiration, and altered consciousness. History and arterial blood gas analysis is the easiest way to assess the nature of acute RF and treatment should solve the baseline pathology. In severe cases mechanical ventilation is necessary as a ‘buying time’ therapy. The acute hypoxemic RF arising from widespread diffuse injury to the alveolar-capillary membrane is termed Acute Respiratory Distress Syndrome (ARDS), which is the clinical and radiographic manifestation of acute pulmonary inflammatory states.

Acute respiratory failure and acute respiratory distress syndrome

2015 ◽  
Author(s):  
Luciano Gattinon ◽  
Eleonora Carlesso
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Partial Pressure ◽  
Distress Syndrome ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Low Oxygen ◽  
Arterial Blood

Respiratory failure (RF) is defined as the acute or chronic impairment of respiratory system function to maintain normal oxygen and CO2 values when breathing room air. ‘Oxygenation failure’ occurs when O2 partial pressure (PaO2) value is lower than the normal predicted values for age and altitude and may be due to ventilation/perfusion mismatch or low oxygen concentration in the inspired air. In contrast, ‘ventilatory failure’ primarily involves CO2 elimination, with arterial CO2 partial pressure (PaCO2) higher than 45 mmHg. The most common causes are exacerbation of chronic obstructive pulmonary disease (COPD), asthma, and neuromuscular fatigue, leading to dyspnoea, tachypnoea, tachycardia, use of accessory muscles of respiration, and altered consciousness. History and arterial blood gas analysis is the easiest way to assess the nature of acute RF and treatment should solve the baseline pathology. In severe cases mechanical ventilation is necessary as a ‘buying time’ therapy. The acute hypoxemic RF arising from widespread diffuse injury to the alveolar-capillary membrane is termed Acute Respiratory Distress Syndrome (ARDS), which is the clinical and radiographic manifestation of acute pulmonary inflammatory states.

scholarly journals Features of respiration biomechanics at mechanical pressure-controlled helium-oxygen ventilation

2019 ◽  
Vol 100 (3) ◽  
pp. 445-450
Author(s):  
I N Grachev ◽  
B N Bogomolov ◽  
A V Shchegolev ◽  
E G Makarenko ◽  
E N Ershov
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Inspiratory Pressure ◽  
Oxygen Mixture ◽  
Chronic Obstructive ◽  
Mechanical Pressure ◽  
Obstructive Pulmonary Disease ◽  
Pressure Controlled ◽  
Healthy Lung

Aim. To study the dynamics of inspiratory pressure and volume in two versions of the experiment - mechanical pressure-controlled air-oxygen and helium-oxygen ventilation in the models of «healthy lung», «chronic obstructive pulmonary disease», «acute respiratory distress syndrome». Methods. Inspiratory pressure and tidal volume were recorded during 10 respiratory cycles at each predetermined level from 5 to 20 cm H2O with a step of 5 cm H2O. TestСhest® was used as a model of the lungs which allows simulating normal function and some pathological states of the lungs sucj as COPD and ARDS. Results. In the model of «healthy lung» inspiratory pressure in the application of air-oxygen mixture and helium-oxygen mixture was: at level 5 cm H2O - 6.4 (6.26; 6.50) and 7.17 (6.94; 7.17) cm H2O; 10 cm H2O - 11.31 (11.2; 11.43) and 12.11 (12.11; 12.27) cm H2O; 15 cm H2O - 16.8 (16.8; 17.03) and 15.24 (15.07; 15.24) cm H2O and at the level of 20 cm H2O - 18.83 (18.65; 19.04) and 21.52 (21.34; 21.67) cm H2O. At this, the respiratory volumes were 262.1 ml and 280.3 ml at the level 5 cm H2O; 541.8 ml and 577.9 ml at 10 cm H2O, 836.9 ml and 925.9 ml at 15 cm H2O; 1109 ml and 1265 ml at 20 cm H2O. In other studied models the inspiratory pressure and respiratory volume were also determined. Comparison of indicators revealed a statistically significant increase of the studied parameters in the simulated pathological conditions. Conclusion. Pressure-controlled use of helium-oxygen mixture in the simulation of normal breathing mechanics, acute respiratory distress syndrome and chronic obstructive pulmonary disease is accompanied by a statistically significant increase in inspiratory pressure in the airways and inspiratory volume.

scholarly journals Developing the nomogram for the prediction of in-hospital incidence of acute respiratory distress syndrome in patients with COVID-19

2020 ◽  
Author(s):  
Ning Ding ◽  
Yang Zhou ◽  
Guifang Yang ◽  
Cuirong Guo ◽  
Fengning Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Treatment Plan ◽  
Health Centre ◽  
White Blood Count ◽  
Chronic Obstructive ◽  
Public Health Centre

Abstract Background: Acute respiratory distress syndrome (ARDS) was the most common complication of coronavirus disease-2019(COVID-19), leading to poor clinical outcomes. However, the model to predict the in-hospital incidence of ARDS in patients with COVID-19 is limited. Therefore, we aimed to develop a predictive nomogram for the in-hospital incidence of ARDS in COVID-19 patients.Methods: Patients with COVID-19 admitted to Changsha Public Health Centre between Jan 30, 2020, and Feb 22, 2020, were enrolled. Clinical characteristics and laboratory variables were analyzed in patients with ARDS. Risk factors for ARDS were selected by LASSO binary logistic regression. Nomogram was established based on risk factors and validated by the dataset.Results: A total of 113 patients, involving 99 in the non-ARDS group and 14 in the ARDS group were included in the study. 8 variables including hypertension, chronic obstructive pulmonary disease (COPD), cough, lactate dehydrogenase (LDH), creatine kinase (CK), white blood count (WBC), body temperature, and heart rate were identified to be included in the model. The specificity, sensitivity, and accuracy of the full model were 100%, 85.7%, and 87.5% respectively. The calibration curve also showed good agreement between the predicted and observed values in the model.Conclusions: The nomogram can predict the in-hospital incidence of ARDS in COVID-19 patients. It helps physicians to make an individualized treatment plan for each patient.

The Prevalence and Impact of Mortality of the Acute Respiratory Distress Syndrome on Admissions of Patients With Ischemic Stroke in the United States

2013 ◽  
Vol 29 (6) ◽  
pp. 357-364 ◽  
Author(s):  
Fred Rincon ◽  
Mitchell Maltenfort ◽  
Saugat Dey ◽  
Sayantani Ghosh ◽  
Matthew Vibbert ◽  
...  
Keyword(s):  
United States ◽  
Acute Respiratory Distress Syndrome ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
The United States ◽  
Chronic Obstructive ◽  
Risk Of Death

Purpose: To determine the epidemiology of the acute respiratory distress syndrome (ARDS) and impact on in-hospital mortality in admissions of patients with acute ischemic stroke (AIS) in the United States. Methods: Retrospective cohort study of admissions with a diagnosis of AIS and ARDS from 1994 to 2008 identified through the Nationwide Inpatient Sample. Results: During the 15-year study period, we found 55 58 091 admissions of patients with AIS. The prevalence of ARDS in admissions of patients with AIS increased from 3% in 1994 to 4% in 2008 ( P < .001). The ARDS was more common among younger men, nonwhites, and associated with history of congestive heart failure, hypertension, chronic obstructive pulmonary disease, renal failure, chronic liver disease, systemic tissue plasminogen activator, craniotomy, angioplasty or stent, sepsis, and multiorgan failures. Mortality due to AIS and ARDS decreased from 8% in 1994 to 6% in 2008 ( P < .001) and 55% in 1994 to 45% in 2008 ( P < .001), respectively. The ARDS in AIS increased in-hospital mortality (odds ratio, 14; 95% confidence interval, 13.5-14.3). A significantly higher length of stay was seen in admissions of patients with AIS having ARDS. Conclusion: Our analysis demonstrates that ARDS is rare after AIS. Despite an overall significant reduction in mortality after AIS, ARDS carries a higher risk of death in this patient population.

Sign in / Sign up

Export Citation Format

Share Document