Acute Respiratory Failure

Methods to label, image, and analyze the complex structural architectures of microvascular networks

“…Indeed, the importance of the microvasculature has long been appreciated in diseases such as small vessel disease, coronary microvascular disease, and the abundance of complications associated with diabetes . However, recent research has indicated that the microvasculature also plays key roles in the top eight causes of death in the United States (Figure ) and many others, including (1) heart disease: impaired infarct wound healing, reduced oxygenation, pulmonary hypertension in pre‐capillary and post‐capillary vessels; (2) cancer: pathological angiogenesis, enriched microvessel permeability, significant route for metastasis; (3) lower respiratory disease: capillary dropout, reduced muscle oxygenation, airway rigidity from vasodilation; (4) stroke: impaired microvascular flow patterns and reduced oxygenation, pericyte constriction of capillaries, dropout of functioning capillaries; (5) unintentional injuries: angiogenesis, clot formation, immune cell recruitment; (6) Alzheimer's: attenuated vasodilation response, amyloid angiopathy, and tissue hypoxia; (7) diabetes mellitus: capillary permeability, pericyte dropout, capillary dropout; and (8) pneumonia and influenzas: capillary permability, immune cell recruitment, and impaired lung oxygen transport . Additionally, the microvasculature is recognized as one of the most promising routes of drug delivery by enabling direct targeting of microvascular endothelial cells with intravascularly injected drugs to exert profound therapeutic effects in disease conditions .…”

COVID-19 pathology and therapeutics

“…The clinical presentation and histopathological studies of COVID-19 patients are consistent with those observed in ARDS. This includes persistent hypoxemia that requires assisted oxygenation and unilateral or bilateral pulmonary consolidation (ground glass opacity) on chest CT scans (Gurka and Balk 2008) (Tian, Hu et al 2020). Evidence for alveolar and endothelial dysfunction is also noted.…”

“…Evidence for alveolar and endothelial dysfunction is also noted. Macroscopic findings revealed heavy and wet lungs secondary to pulmonary edema, hyaline membrane disposition combined with profound inflammation and pulmonary infiltration by PMNL (Luca Carsana, Aurelio Sonzogni et al 2020) (Gurka and Balk 2008) (Fox, Akmatbekov et al 2020). Diffuse alveolar damage (DAD) is the most abundant manifestation observed in deceased COVID-19 patients (Fox, Akmatbekov et al 2020, Luca Carsana, Aurelio Sonzogni et al 2020, Wichmann, Sperhake et al 2020.…”

“…Moreover, the highly noted difference in outcomes reflects that individuals could react uniquely in response to infection. Previous studies showed that the pathophysiology of ARDS is typically a consequence of the dysregulation between anti-inflammatory and pro-inflammatory mediators leading to both immunosuppression and more predisposition to infections (excessive CARS) or organ dysfunction (excessive SIRS) (Gurka and Balk 2008). Critical COVID-19 cases demonstrated high circulating levels of inflammatory cytokines most specifically TNF-alpha, IL-6 and IL-1 (Tufan, Avanoglu Guler et al 2020).…”

“…Several trials have been conducted to test the efficacy of some therapies for the management of ARDS. Despite an initial improvement, the effects on mortality rate were mild (Gurka and Balk 2008). That's why, it appears that a combination therapy and close monitoring of pre-existing conditions and vital parameters such as serum electrolytes, blood glucose, renal and cardiac functions as well as the adoption of a healthy diet that's rich in antioxidants and immunomodulatory agents are necessary for COVID-19 patients to efficiently reverse these devastating effects.…”