Acute respiratory distress syndrome and acute lung injury

Dushianthan, Ahilanandan; Grocott, Michael P.W.; Postle, Anthony D.; Cusack, Rebecca

doi:10.1136/pgmj.2011.118398

Cited by 263 publications

(204 citation statements)

References 110 publications

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“…1,2 There are many etiological factors contributing to ARDS. However, only a few account for majority of the cases like sepsis from both pulmonary and non-pulmonary origin.…”

Section: Introductionmentioning

confidence: 99%

“…6 The diagnosis of ARDS is done based on three main criteria's: the presence of acute severe hypoxemia, bilateral infiltrates on chest radiography (CXR), and absence of raised pulmonary artery wedge pressure. 1 The pathophysiology of ARDS, the most important feature is increased capillary permeability. This is due to damage of the capillary endothelium and alveolar epithelium lining causing accumulation of protein rich fluid inside the alveoli.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Corticosteroids in Acute Respiratory Distress Syndrome: An Observational Study

A¹,

Awasthi²,

Rithu³

et al. 2017

JYP

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Background: Deficits in the treatment options makes Acute Respiratory Distress Syndrome (ARDS) management more challenging. With Involvement of inflammatory pathways, corticosteroid remains a vital choice for ARDS treatment. However lack of studies and presence of ambiguity in results with use of glucocorticoids makes it imperative to carry out more research. The aim of the study was to assess the efficacy of glucocorticoids in the treatment of ARDS and to identify the treatment pattern of ARDS. Methods: Retrospective observational study, involving 150 patients with confirmed diagnosis of ARDS admitted during January 2011 to December 2011 in a tertiary care hospital. Demographics, social habits, and association between glucocorticoid initiation and respective onset and outcomes like mortality and free ventilator days, were analysed by Chi square test and p<0.05 was considered to be statistically significant. Data analysis was done by using SPSS version 16. Results: Mean age of our study population was 43.37 ± 16.15 with male 60.7% and 39.3% female. The study found reduced mortality (41.7%) in the glucocorticoid treatment group compared to the non-glucocorticoid group (56.4%) (p < 0.022). Among the glucocorticoid treated subgroups, in the early start subgroup there was a statistically significant reduction of mean ventilator days (4.61 ± 2.81 vs 6.44 ± 4.47) and mortality (30.9% vs 80%, p <0.001). Conclusions: The use of glucocorticoids in ARDS showed benefits, especially when started early in the course of treatment with reduced mortality and decreased ventilator days. However small sample size precluded the power of detection of important outcome such as mortality and more research is necessary to establish the role of glucocorticoid therapy in ARDS.Key words: ARDS, Glucocorticoids, Mortality. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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“…1,2 There are many etiological factors contributing to ARDS. However, only a few account for majority of the cases like sepsis from both pulmonary and non-pulmonary origin.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Corticosteroids in Acute Respiratory Distress Syndrome: An Observational Study

A¹,

Awasthi²,

Rithu³

et al. 2017

JYP

View full text Add to dashboard Cite

show abstract

“…Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threatening diseases that present with progressive dyspnea, refractory hypoxemia and a marked increase in difficulties breathing (1,2). Since the initial description of ARDS in 1967 (3), there have been advances in the pathogenesis and treatment of this disease, however, challenges remain.…”

Section: Introductionmentioning

confidence: 99%

“…Epidemiological investigations suggest that ARDS remains a significant health burden with substantial morbidity and mortality (4). The majority of patients require endotracheal intubation and positive pressure ventilation (1,2) and account for millions of days spent in intensive care units (5). In recent years, treatments of ALI/ARDS with improved efficacy have been sought, and studies have indicated that liquid ventilation with perfluorocarbon (PFC) compounds is a promising therapeutic approach (6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

The effects of perfluorocarbon on ICAM-1 expression in LPS-induced A549 cells and the potential mechanism

Cao

Chang

et al. 2016

Mol Med Report

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Abstract. Acute lung injury (ALI)/ARDS is a critical clinical syndrome with high mortality, and the effective therapeutic methods for the treatment remain limited. Previous studies have indicated that liquid ventilation with perfluorocarbon (PFC) may be advantageous over conventional mechanical ventilation in the treatment of ALI/ARDS. Additionally, PFC inhibits the inflammatory response caused by ALI/ARDS. However, the anti-inflammatory mechanism remains to be completely elucidated. In the present study, the aim was to determine the anti-inflammatory mechanism of PFC and the association with microRNA (miR). PFC was used to modulate LPS-induced A549 cells, with the cells divided into four groups: Untreated control group; LPS group, treated with 10 µg/ml LPS; LPS+PFC group, treated with 10 µg/ml LPS and PFC; and PFC group, treated with PFC alone. The intercellular adhesion molecule-1 (ICAM-1) mRNA and protein expression levels of each group were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting, respectively. A549 cells were transfected with miR-17-3p mimics, miR-17-3p inhibitors or negative controls to observe the alterations in the anti-inflammatory effects of PFC. A dual luciferase reporter gene assay was used to determine whether ICAM-1 is a target gene of miR-17-3p. PFC was observed to attenuate the mRNA and protein expression levels of ICAM-1 in LPS-induced A549 cells, with no significant effect on the untreated A549 cells. miR-17-3p was demonstrated to be regulated by PFC. Transfection with miR-17-3p mimics enhanced the anti-inflammatory effects of PFC, whereas the miR-17-3p inhibitor weakened the anti-inflammatory effects of PFC at early time points. To conclude, the current study indicates that ICAM-1 was a target gene of miR-17-3p, and PFC has anti-inflammatory effects. Additionally, the present study is the first report, to the best of our knowledge, that PFC is able to attenuate ICAM-1 expression in LPS-induced A549 cells by increasing miR-17-3p expression.

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“…Acute lung injury (ALI), characterized by unbalanced inflammatory responses, is a leading cause of acute respiratory failure and multiple organ dysfunctions (Dushianthan et al, 2011). In experimental models, ALI can be triggered by either infectious or noninfectious stimuli, such as lipopolysaccharide (LPS) (Favarin et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Impact of Mesenchymal Stem Cells on Lipopolysaccharide-Induced Apoptosis in Acute Lung Injury Rat Model

Mansour¹,

Soliman²,

Hasan³

et al. 2018

Int.J.Curr.Microbiol.App.Sci

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Acute respiratory distress syndrome and acute lung injury

Cited by 263 publications

References 110 publications

Efficacy of Corticosteroids in Acute Respiratory Distress Syndrome: An Observational Study

Efficacy of Corticosteroids in Acute Respiratory Distress Syndrome: An Observational Study

The effects of perfluorocarbon on ICAM-1 expression in LPS-induced A549 cells and the potential mechanism

Impact of Mesenchymal Stem Cells on Lipopolysaccharide-Induced Apoptosis in Acute Lung Injury Rat Model

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