Acute Respiratory Distress Syndrome in Children

Sakai, Lígia; Gaspar, Heloisa Amaral; Ferranti, Juliana Ferreira; Carvalho, Werther Brunow de; Delgado, Artur Figueiredo

doi:10.1097/pcc.0000000000000026

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Treatment of respiratory distress in neonates proceeds by a combination of surfactant replacement therapy (SRT) [5,6], where exogenous surfactant is injected into the lungs to reduce the surface tension, and mechanical ventilation, where air is forced into the lung to recruit airways and promote gas exchange [7,8]. However, this process can exert significant stresses on the airway wall, which can in turn lead to ventilator-induced lung injury (VILI) [9].…”

Section: Introductionmentioning

confidence: 99%

Patterns of recruitment and injury in a heterogeneous airway network model

Stewart

Jensen

2015

J. R. Soc. Interface.

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In respiratory distress, lung airways become flooded with liquid and may collapse due to surface-tension forces acting on air–liquid interfaces, inhibiting gas exchange. This paper proposes a mathematical multiscale model for the mechanical ventilation of a network of occluded airways, where air is forced into the network at a fixed tidal volume, allowing investigation of optimal recruitment strategies. The temporal response is derived from mechanistic models of individual airway reopening, incorporating feedback on the airway pressure due to recruitment. The model accounts for stochastic variability in airway diameter and stiffness across and between generations. For weak heterogeneity, the network is completely ventilated via one or more avalanches of recruitment (with airways recruited in quick succession), each characterized by a transient decrease in the airway pressure; avalanches become more erratic for airways that are initially more flooded. However, the time taken for complete ventilation of the network increases significantly as the network becomes more heterogeneous, leading to increased stresses on airway walls. The model predicts that the most peripheral airways are most at risk of ventilation-induced damage. A positive-end-expiratory pressure reduces the total recruitment time but at the cost of larger stresses exerted on airway walls.

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Section: Introductionmentioning

confidence: 99%

Patterns of recruitment and injury in a heterogeneous airway network model

Stewart

Jensen

2015

J. R. Soc. Interface.

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The Alleviation of LPS-Induced Murine Acute Lung Injury by GSH-Mediated PEGylated Artesunate Prodrugs

et al. 2022

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Acute lung injury (ALI) or its aggravated stage acute respiratory distress syndrome (ARDS) is a common severe clinical syndrome in intensive care unit, may lead to a life-threatening form of respiratory failure, resulting in high mortality up to 30–40% in most studies. Nanotechnology-mediated anti-inflammatory therapy is an emerging novel strategy for the treatment of ALI, has been demonstrated with unique advantages in solving the dilemma of ALI drug therapy. Artesunate (ART), a derivative of artemisinin, has been reported to have anti-inflammatory effects. Therefore, in the present study, we designed and synthesized PEGylated ART prodrugs and assessed whether ART prodrugs could attenuate lipopolysaccharide (LPS) induced ALI in vitro and in vivo. All treatment groups were conditioned with ART prodrugs 1 h before challenge with LPS. Significant increased inflammatory cytokines production and decreased GSH levels were observed in the LPS stimulated mouse macrophage cell line RAW264.7. Lung histopathological changes, lung W/D ratio, MPO activity and total neutrophil counts were increased in the LPS-induced murine model of ALI via nasal administration. However, these results can be reversed to some extent by treatment of ART prodrugs. The effectiveness of mPEG2k-SS-ART in inhibition of ALI induced by LPS was confirmed. In conclusion, our results demonstrated that the ART prodrugs could attenuate LPS-induced ALI effectively, and mPEG2k-SS-ART may serve as a novel strategy for treatment of inflammation induced lung injury.

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Acute Respiratory Distress Syndrome in Children

Cited by 2 publications

References 9 publications

Patterns of recruitment and injury in a heterogeneous airway network model

Patterns of recruitment and injury in a heterogeneous airway network model

The Alleviation of LPS-Induced Murine Acute Lung Injury by GSH-Mediated PEGylated Artesunate Prodrugs

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