Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management

Gorman, Ellen; O’Kane, Cecilia; McAuley, Daniel F.

doi:10.1016/s0140-6736(22)01439-8

Cited by 154 publications

(106 citation statements)

References 162 publications

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“…However, the literature well-describes how to assess the severity of lung injury in patients with COVID-19 AHRF to identify those who may require intubation and invasive mechanical ventilation. These vary from gas exchange to lung images, scores of organ severity, and more recently also the adoption of biological markers ( Gorman et al, 2022 ). COVID-19 pneumonia often meets the Berlin criteria of ARDS but manifests with peculiar features, which may need different treatment strategy according to radiological phenotype ( Gattinoni et al, 2020 , Robba et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

High flow nasal oxygen and awake prone positioning – Two allies against COVID-19: A systematic review

Godoy¹,

Longhitano

Fazzini

et al. 2023

Respiratory Physiology & Neurobiology

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Section: Discussionmentioning

confidence: 99%

High flow nasal oxygen and awake prone positioning – Two allies against COVID-19: A systematic review

Godoy¹,

Longhitano

Fazzini

et al. 2023

Respiratory Physiology & Neurobiology

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“…According to the American-European Consensus Conference, if the concentration of arterial oxygen in the blood divided by the inspired fraction of oxygen (i.e. a PaO2/FiO2) is less than 200 mm Hg a diagnosis of ARDS is made with the Berlin definition stratifying the severity of disease into 3 groups: mild (≤ 300 mm Hg), moderate (≤ 200 mm Hg), and severe (≤ 100 mm Hg) [ 28 , 142 , 143 ]. ARDS during severe pneumonia can be described as occurring in stages associated with direct damage to the lung parenchyma along with indirect damage incurred from systemic inflammation [ 28 , 144 ].…”

Section: Organ Damage Occurs During Acute Infection With Lasting Cons...mentioning

confidence: 99%

“…The edema and acute inflammation of ARDS is gradually resolved in many patients without fibrosis occurring [ 28 ]. The presence of ARDS increases the likelihood of non-pulmonary organ failure including cardiovascular failure, renal failure, abnormal liver function, and hematologic abnormalities such as anemia and thrombocytopenia [ 28 , 142 ]. These are discussed in more detail below.…”

Section: Organ Damage Occurs During Acute Infection With Lasting Cons...mentioning

confidence: 99%

Acute organ injury and long-term sequelae of severe pneumococcal infections

et al. 2023

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Streptococcus pneumoniae (Spn) is a major public health problem, as it is a main cause of otitis media, community-acquired pneumonia, bacteremia, sepsis, and meningitis. Acute episodes of pneumococcal disease have been demonstrated to cause organ damage with lingering negative consequences. Cytotoxic products released by the bacterium, biomechanical and physiological stress resulting from infection, and the corresponding inflammatory response together contribute to organ damage accrued during infection. The collective result of this damage can be acutely life-threatening, but among survivors, it also contributes to the long-lasting sequelae of pneumococcal disease. These include the development of new morbidities or exacerbation of pre-existing conditions such as COPD, heart disease, and neurological impairments. Currently, pneumonia is ranked as the 9th leading cause of death, but this estimate only considers short-term mortality and likely underestimates the true long-term impact of disease. Herein, we review the data that indicates damage incurred during acute pneumococcal infection can result in long-term sequelae which reduces quality of life and life expectancy among pneumococcal disease survivors.

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“…Acute respiratory distress syndrome (ARDS) is a common critical illness characterized by acute hypoxic respiratory insufficiency or failure, often requiring hospitalisation in an intensive care unit (1). The life-threatening illness can be caused by a variety of non-cardiogenic factors, including pneumonia, sepsis, and trauma (2).…”

Section: Introductionmentioning

confidence: 99%

α1-adrenoceptor stimulation ameliorates lipopolysaccharide-induced lung injury by inhibiting alveolar macrophage inflammatory responses through NF-κB and ERK1/2 pathway in ARDS

Cong

Yang²,

Zeng³

et al. 2023

Front. Immunol.

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IntroductionCatecholamines such as norepinephrine or epinephrine have been reported to participate in the development of acute respiratory distress syndrome (ARDS) by activating adrenergic receptors (ARs). But the role of α1-AR in this process has yet to be elucidated.MethodsIn this study, ARDS mouse model was induced by intratracheal instillation of lipopolysaccharide. After treatment with α1-AR agonist phenylephrine or antagonist prazosin, lung pathological injury, alveolar barrier disruption and inflammation, and haemodynamic changes were evaluated. Cytokine levels and cell viability of alveolar macrophages were measured in vitro. Nuclear factor κB (NF-κB), mitogen-activated protein kinase, and Akt signalling pathways were analysed by western blot.ResultsIt showed that α1-AR activation alleviated lung injuries, including reduced histopathological damage, cytokine expression, and inflammatory cell infiltration, and improved alveolar capillary barrier integrity of ARDS mice without influencing cardiovascular haemodynamics. In vitro experiments suggested that α1-AR stimulation inhibited secretion of TNF-α, IL-6, CXCL2/MIP-2, and promoted IL-10 secretion, but did not affect cell viability. Moreover, α1-AR stimulation inhibited NF-κB and enhanced ERK1/2 activation without significantly influencing p38, JNK, or Akt activation.DiscussionOur studies reveal that α1-AR stimulation could ameliorate lipopolysaccharide-induced lung injury by inhibiting NF-κB and promoting ERK1/2 to suppress excessive inflammatory responses of alveolar macrophages.

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Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management

Cited by 154 publications

References 162 publications

High flow nasal oxygen and awake prone positioning – Two allies against COVID-19: A systematic review

High flow nasal oxygen and awake prone positioning – Two allies against COVID-19: A systematic review

Acute organ injury and long-term sequelae of severe pneumococcal infections

α1-adrenoceptor stimulation ameliorates lipopolysaccharide-induced lung injury by inhibiting alveolar macrophage inflammatory responses through NF-κB and ERK1/2 pathway in ARDS

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