scholarly journals Imagining of Acute Respiratory Distress Syndrome: A Review

2021 ◽  
pp. 55-61
Author(s):  
Hossam A. El-Kenawy ◽  
Abdullah Thamer Aldarsouny ◽  
Nouf Mohammed Alaqel ◽  
Noor Anwar S. Alkhamis ◽  
Fatimah Fayez J Aldawood ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Treatment Options ◽  
Low Oxygen ◽  
Life Threatening Illness ◽  
Imaging Results ◽  
Life Threatening ◽  
Bilateral Lung

Acute respiratory distress syndrome (ARDS) is a life-threatening disorder marked by low oxygen levels and rigid or non-compliant lungs. In the absence of any indication of cardiogenic pulmonary edema, ARDS is defined as an acute disease that begins within 7 days of the triggering event and is marked by bilateral lung infiltrates and severe progressive hypoxemia. ARDS has a significant death rate, and there are few effective treatment options for this life-threatening illness. The management of these severely ill patients in the intensive care unit relies heavily on imaging. Chest radiography, bedside lung ultrasonography, and computed tomography scans can all help with patient care and prognostic variables identification. However, imaging results are not always specific, and other diagnosis should be considered.

scholarly journals Acute respiratory distress syndrome in a case of diabetic ketoacidosis requiring ECMO support

2021 ◽  
Vol 2021 ◽  
Author(s):  
Milad Darrat ◽  
Brian Gilmartin ◽  
Carmel Kennedy ◽  
Diarmuid Smith
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Diabetic Ketoacidosis ◽  
Distress Syndrome ◽  
Early Recognition ◽  
Ecmo Support ◽  
List Type ◽  
Life Threatening ◽  
Life Threatening Complication

Summary Acute respiratory distress syndrome (ARDS) is a rare but life-threatening complication of diabetic ketoacidosis (DKA). We present the case of a young female, with no previous diagnosis of diabetes, presenting in DKA complicated by ARDS requiring extra corporeal membrane oxygenation (ECMO) ventilator support. This case report highlights the importance of early recognition of respiratory complications of severe DKA and their appropriate management. Learning points ARDS is a very rare but life-threatening complication in DKA. The incidence of ARDS remains unknown but less frequent than cerebral oedema in DKA. The mechanism of ARDS in DKA has multifactorial aetiology, including genetic predisposition. Early recognition and consideration of rare pulmonary complication of DKA can increase survival rate and provide very satisfactory outcomes. DKA patients who present with refractory ARDS can be successfully rescued by ECMO support.

scholarly journals Rationale for the Use of Radiation-Activated Mesenchymal Stromal/Stem Cells in Acute Respiratory Distress Syndrome

Cells ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 2015 ◽  
Author(s):  
Isabel Tovar ◽  
Rosa Guerrero ◽  
Jesús J. López-Peñalver ◽  
José Expósito ◽  
José Mariano Ruiz de Almodóvar
Keyword(s):  
Stem Cells ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Human Umbilical Cord ◽  
Annexin A1 ◽  
Significant Difference ◽  
Life Threatening ◽  
Stromal Stem Cells

We have previously shown that the combination of radiotherapy with human umbilical-cord-derived mesenchymal stromal/stem cells (MSCs) cell therapy significantly reduces the size of the xenotumors in mice, both in the directly irradiated tumor and in the distant nonirradiated tumor or its metastasis. We have also shown that exosomes secreted from MSCs preirradiated with 2 Gy are quantitatively, functionally and qualitatively different from the exosomes secreted from nonirradiated mesenchymal cells, and also that proteins, exosomes and microvesicles secreted by MSCs suffer a significant change when the cells are activated or nonactivated, with the amount of protein present in the exosomes of the preirradiated cells being 1.5 times greater compared to those from nonirradiated cells. This finding correlates with a dramatic increase in the antitumor activity of the radiotherapy when is combined with MSCs or with preirradiated mesenchymal stromal/stem cells (MSCs*). After the proteomic analysis of the load of the exosomes released from both irradiated and nonirradiated cells, we conclude that annexin A1 is the most important and significant difference between the exosomes released by the cells in either status. Knowing the role of annexin A1 in the control of hypoxia and inflammation that is characteristic of acute respiratory-distress syndrome (ARDS), we designed a hypothetical therapeutic strategy, based on the transplantation of mesenchymal stromal/stem cells stimulated with radiation, to alleviate the symptoms of patients who, due to pneumonia caused by SARS-CoV-2, require to be admitted to an intensive care unit for patients with life-threatening conditions. With this hypothesis, we seek to improve the patients’ respiratory capacity and increase the expectations of their cure.

scholarly journals Rituximab Twice Weekly for Refractory Thrombotic Thrombocytopenic Purpura in a Critically Ill Patient with Acute Respiratory Distress Syndrome

2020 ◽  
Vol 13 (1) ◽  
pp. 153-157
Author(s):  
Bahjat Azrieh ◽  
Arwa Alsaud ◽  
Khaldun Obeidat ◽  
Amr Ashour ◽  
Seham Elebbi ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Distress Syndrome ◽  
Standard Of Care ◽  
Critically Ill Patient ◽  
Microangiopathic Hemolytic Anemia ◽  
Thrombocytopenic Purpura ◽  
Life Threatening

Thrombotic thrombocytopenic purpura (TTP) is a rare, serious, life-threatening disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and hypercoagulability. The etiology is a deficiency of ADAMTS13 which is usually caused by acquired antibodies. Plasma exchange and steroids is the standard of care in the treatment of TTP. However, there are refractory cases of TTP which require further management. Rituximab appears to be a safe and effective therapy for refractory and relapsing TTP. Here we report a challenging case of TTP that responded to treatment with rituximab twice weekly. According to our knowledge, rituximab twice weekly has never been used for TTP before.

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.

Ketorolac may control more than pain

2003 ◽  
Vol 105 (5) ◽  
pp. 549-550 ◽  
Author(s):  
Frank ISIK
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Inhalation Injury ◽  
Clinical Science ◽  
Inflammatory Cascade ◽  
Life Threatening

Life-threatening acute respiratory distress syndrome (ARDS) complicates the recovery of patients with burn and inhalation injury. The study by Enkhbaatar and co-workers in this issue of Clinical Science suggests that reducing the early and robust inflammatory cascade may provide patients with protection from developing cardiopulmonary compromise seen early after burn and inhalation injury.

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.

Pathophysiology and Management of Acute Respiratory Distress Syndrome in Obese Patients

2019 ◽  
Vol 40 (01) ◽  
pp. 040-056 ◽  
Author(s):  
Michele Umbrello ◽  
Jacopo Fumagalli ◽  
Antonio Pesenti ◽  
Davide Chiumello
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Public Health Problem ◽  
Optimal Strategies ◽  
Current Evidence ◽  
Important Public Health Problem

AbstractA rising prevalence of obesity is reported over time and throughout the world. At the same time, the acute respiratory distress syndrome (ARDS) remains an important public health problem, accounting for approximately 10% of intensive care unit admissions and leading to significant hospital mortality. Even in the absence of acute illnesses, obesity affects respiratory mechanics and gas exchange in the setting of a restrictive disease. In the presence of ARDS, obesity adds various challenges to a safe and effective management of respiratory support. Difficult airway management, altered lung and chest wall physiology, and positional gas trapping are routinely encountered. The management of such difficult cases is generally empiric, as it is based on small-sized, physiologic studies or on suggestions from the general anesthesia literature. The present review focuses on those cases in which ARDS is coincident with obesity, with the aim of presenting treatment options based on the current evidence. The first part summarizes the epidemiology of obesity and ARDS. Then the diagnostic challenges due to obesity-related artifacts of the different imaging techniques will be presented. A subsequent, detailed description of the altered respiratory anatomy and physiology of obesity will provide help in selecting an optimal, individually tailored strategy of support. Furthermore, we will discuss how esophageal manometry should be used to adjust the settings of positive end-expiratory pressure and tidal volume; the challenges of prone positioning and extracorporeal support; and the optimal strategies for weaning from mechanical ventilation, including when and how to perform a tracheostomy.

Sign in / Sign up

Export Citation Format

Share Document