Adult Respiratory Distress Syndrome in Patients with Severe Neutropenia

Ognibene, Frederick P.; Martin, Sue Ellen; Parker, Margaret M.; Schlesinger, Terri; Roach, Patricia; Burch, Cynthia; Shelhamer, James H.; Parrillo, Joseph E.

doi:10.1056/nejm198608283150904

Cited by 351 publications

(68 citation statements)

References 18 publications

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“…In contrast, other authors [10, 19, 20, 21, 22]noted that ARDS was likely to occur during neutropenia. Apart from the complement-neutrophil pathway, they assumed that other mediators of the inflammatory pathway play important roles in the development of ARDS [22, 23]. In our research, the accelerated increase in neutrophil counts induced by administering G-CSF was not the only factor promoting ARDS.…”

Section: Discussionmentioning

confidence: 55%

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Effect of Granulocyte/Colony-Stimulating Factor on the Onset of the Adult Respiratory Distress Syndrome

et al. 1999

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To evaluate the effect of granulocyte/colony-stimulating factor (G-CSF) on the onset of the adult respiratory distress syndrome (ARDS), we investigated whether the incidence of ARDS due to pulmonary infection differed between the G-CSF group which received chemotherapy with G-CSF and historical controls without G-CSF. We evaluated 132 patients with hematological malignancy in complete remission without any main organ dysfunction who had been treated between April 1983 and December 1997. We compared the incidence of ARDS due to pulmonary infection between those who received G-CSF and those who did not. There was no remarkable difference in the number of patients, gender, age, or distribution of primary diseases between the two groups. The intensity of chemotherapy was not considered to significantly differ between the two groups, though the chemotherapy regimens administered differed slightly. In the G-CSF group, the duration of neutropenia was significantly shorter and the frequency of documented infection was significantly decreased. We could not find any relationship between ARDS due to pulmonary infection and any anticancer agent or antibiotics. There was no relationship between the kind of G-CSF and the incidence of ARDS due to pulmonary infection (per chemotherapy session; p > 0.10, per case; p > 0.30, χ² test). The incidence of ARDS due to pulmonary infection per chemotherapy session was 4.21%, and showed a higher tendency in the G-CSF group (p < 0.100, χ² test). The incidence of ARDS due to pulmonary infection per case was 25.4% and was significantly higher in the G-CSF group (p < 0.025, χ² test). The incidence of ARDS due to pulmonary infection was higher in the G-CSF group than in the controls, suggesting that G-CSF promotes the development of ARDS due to pulmonary infection.

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Section: Discussionmentioning

confidence: 55%

“…In a study by Ognibene et al [23], the mortality from ARDS was 40–90%. However, we administered steroid pulse therapy for ARDS, and ARDS mortality was 23.5% in the G-CSF group.…”

Section: Discussionmentioning

confidence: 99%

Effect of Granulocyte/Colony-Stimulating Factor on the Onset of the Adult Respiratory Distress Syndrome

et al. 1999

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“…The occurrence of ALI/ARDS in neutropenic patients [90], along with the existence of both neutrophil-dependent and independent models of ALI, makes this a contributing, but not obligatory step in the development of this syndrome. The mechanisms underlying neutrophil recruitment are beyond the scope of this review, but are well described elsewhere [26].…”

Section: Pathogenesis Of Ardsmentioning

confidence: 99%

Advances in Understanding of the Pathogenesis of Acute Respiratory Distress Syndrome

2015

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The clinical syndrome of acute lung injury (ALI) occurs as a result of an initial acute systemic inflammatory response. This can be consequent to a plethora of insults, either direct to the lung or indirect. The insult results in increased epithelial permeability, leading to alveolar flooding with a protein-rich oedema fluid. The resulting loss of gas exchange leads to acute respiratory failure and typically catastrophic illness, termed acute respiratory distress syndrome (ARDS), requiring ventilatory and critical care support. There remains a significant disease burden, with some estimates showing 200,000 cases each year in the USA with a mortality approaching 50%. In addition, there is a significant burden of morbidity in survivors. There are currently no disease-modifying therapies available, and the most effective advances in caring for these patients have been in changes to ventilator strategy as a result of the ARDS network studies nearly 15 years ago. Here, we will give an overview of more recent advances in the understanding of the cellular biology of ALI and highlight areas that may prove fertile for future disease-modifying therapies.

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“…Das Auftreten von ALI/ARDS bei Patienten mit Neutropenie [90] in Verbindung mit der Existenz von sowohl Neutrophilen-abhängigen als auch -unabhängigen ALI-Modellen macht Neutrophile zu einem beitragenden, aber nicht obligatorischen Faktor bei der Entstehung dieses Syndroms. Die Mechanismen, die der Rekrutierung von Neutrophilen zugrunde liegen, würden den Rahmen der vorliegenden Übersichtsarbeit sprengen, sie sind jedoch an anderer Stelle ausführlich beschrieben [26].…”

Section: Pathogenese Des Ardsunclassified

Neue Erkenntnisse zur Pathogenese des akuten Atemnotsyndroms

Sharp¹,

Millar²,

Medford³

2016

Kompass Pneumol

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Das klinische Syndrom der akuten Lungenschädigung (ALI; acute lung injury) entwickelt sich basierend auf einer vorausgehenden akuten systemischen Entzündungsreaktion. Diese kann auf direktem oder indirektem Wege vielfältige Schäden an der Lunge hervorrufen. Diese Schäden wiederum führen zu einer erhöhten epithelialen Permeabilität und damit zum Einstrom von Ödemflüssigkeit mit hohem Eiweißgehalt in den Alveolarraum. Die daraus resultierende Beeinträchtigung des Gasaustauschs mündet in einer akuten respiratorischen Insuffizienz und einem typischerweise katastrophalen Krankheitsbild, das als akutes Atemnotsyndrom (ARDS; acute respiratory distress syndrome) bezeichnet wird und eine Beatmung sowie Intensivpflege erforderlich macht. Die Krankheitslast ist nach wie vor hoch; Schätzungen zufolge sind es allein in den USA 200 000 Fälle pro Jahr, mit einer Mortalität von nahezu 50%. Zusätzlich leiden die Überlebenden unter signifikanter Morbidität. Derzeit stehen keine krankheitsmodifizierenden Therapien zur Verfügung, und die wirkungsvollsten Fortschritte in der Versorgung betroffener Patienten bestanden in Modifikationen der Beatmungsstrategie auf der Grundlage der Arbeiten des ARDS Network vor knapp 15 Jahren. Der vorliegende Artikel soll einen Überblick über aktuelle Fortschritte zum Verständnis der Zellbiologie der ALI geben und aufzeigen, wo mögliche Ansatzpunkte für künftige krankheitsmodifizierende Therapien liegen könnten.

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Adult Respiratory Distress Syndrome in Patients with Severe Neutropenia

Cited by 351 publications

References 18 publications

Effect of Granulocyte/Colony-Stimulating Factor on the Onset of the Adult Respiratory Distress Syndrome

Effect of Granulocyte/Colony-Stimulating Factor on the Onset of the Adult Respiratory Distress Syndrome

Advances in Understanding of the Pathogenesis of Acute Respiratory Distress Syndrome

Neue Erkenntnisse zur Pathogenese des akuten Atemnotsyndroms

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