Optimal Method for Selecting Peep Level in Ali/Ards Patients under Mechanical Ventilation

Masry, Ashraf Al; Boules, Maged Labib; Boules, Nermin S.

doi:10.12816/0006323

Cited by 7 publications

(7 citation statements)

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“…Excessive and uncontrolled inflammatory reaction in the lungs is the root cause of ALI. Fundamentally, the main cause of lung function loss is inflammatory injury to pulmonary vascular endothelial cells and alveolar epithelial cells [27,28]. Inflammatory factors such as IL-1, IL-6, and TNF-α are crucial in the human body.…”

Section: Discussionmentioning

confidence: 99%

[Retracted] The Protective Effect of Sulodexide on Acute Lung Injury Induced by a Murine Model of Obstructive Jaundice

Yue

et al. 2022

BioMed Research International

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Introduction. The effect of sulodexide (SLX) on obstructive jaundice- (OJ-) induced acute lung injury (ALI) in rats was examined in this study. Methods. In this study, 48 rats were randomly assigned to one of six groups: sham, OJ, OJ+saline, OJ+SLX (0.5 mg/ml/d), OJ+SLX (1 mg/ml/d), and OJ+SLX (2 mg/ml/d). The pathological lung injury was assessed by histological analysis and lung injury grading. ELISA kits were used to evaluate the expression of IL-6, IL-1, TNF-α, and syndecan-1 (SDC-1) in bronchoalveolar lavage fluids (BALFs). Commercial assay kits were performed to evaluate malondialdehyde (MDA) production and catalase (CAT) activity in lung tissues. The apoptosis was assessed by TUNEL assay. The lung microvascular permeability was investigated using Evans blue leakage, lung wet/dry weight (W/D) ratio, and lung permeability index (LPI). SDC-1, claudin-5, ZO-1, and VE cadherin expression levels in lung tissues were measured using Western blot. Results. The OJ-induced ALI rats showed severe lung injury. The value of IL-6, IL-1β, TNF-α, and SDC-1 in BALFs was remarkedly increased in the OJ group. MDA content, apoptotic area, apoptotic molecules, and SDC-1 level were all higher in the OJ group’s lung tissues than in the sham group. CAT activity, Evans blue leakage, W/D ratio, LPI, and expression of claudin-5, ZO-1, and VE cadherin were all lower in the OJ group compared to the sham group. The degenerative alterations in lung tissue improved after 7 days of treatment with 2 mg/ml SLX. The BALFs had lower amounts of IL-6, IL-1, TNF-α, and SDC-1. The SLX therapy reduced MDA levels while restoring CAT activity. In lung tissues, SLX reduced apoptotic area and SDC-1 expression. SLX reduced lung microvascular permeability by raising the expression of Claudin-5, ZO-1, and VE-cadherin in lung tissue when compared to the OJ group. Conclusion. The results suggested that SLX attenuates OJ-induced ALI in rats by protecting the pulmonary microvascular endothelial barrier.

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Section: Discussionmentioning

confidence: 99%

[Retracted] The Protective Effect of Sulodexide on Acute Lung Injury Induced by a Murine Model of Obstructive Jaundice

Yue

et al. 2022

BioMed Research International

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“…The most commonly reported P : F ratio inclusion thresholds, below which patients were included in the RCT, were ≤26.6 kPa (63/146; 43.2%) and ≤39.9 kPa (64/146; 43.8%) ( Table 1 ). The P : F ratio maximum threshold was concordant with the Berlin definition in 26/29 (89.7%) RCTs 134 , 135 , 136 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 151 , 152 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 compared with 101/117 (86.3%) RCTs 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , ...…”

Section: Resultsmentioning

confidence: 52%

“…Bilateral chest infiltrates on the chest radiograph (CXR) were used in 118/146 (80.8%) RCTs. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , ...…”

Section: Resultsmentioning

confidence: 99%

“… 134 , 135 , 136 , 140 , 141 , 142 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 In accordance with the Berlin definition, a minimum PEEP of 5 cm H 2 O was specified in all 29 RCTs using this definition. The AECC definition does not specify a minimum PEEP value, and 96/117 (82.1%) RCTs 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 39 , 40 , 41 , 42 , 43 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68...…”

Section: Resultsmentioning

confidence: 99%

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Impact of differences in acute respiratory distress syndrome randomised controlled trial inclusion and exclusion criteria: systematic review and meta-analysis

Saha

Assouline

Mason

et al. 2021

British Journal of Anaesthesia

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Background: Control-arm mortality varies between acute respiratory distress syndrome (ARDS) RCTs. Methods: We systematically reviewed ARDS RCTs that commenced recruitment after publication of the AmericaneEuropean Consensus (AECC) definition (MEDLINE, Embase, and Cochrane central register of controlled trials; January 1994 to October 2020). We assessed concordance of RCT inclusion criteria to ARDS consensus definitions and whether exclusion criteria are strongly or poorly justified. We estimated the proportion of between-trial difference in control-arm 28-day mortality explained by the inclusion criteria and RCT design characteristics using meta-regression. Results: A literature search identified 43 709 records. One hundred and fifty ARDS RCTs were included; 146/150 (97.3%) RCTs defined ARDS inclusion criteria using AECC/Berlin definitions. Deviations from consensus definitions, primarily aimed at improving ARDS diagnostic certainty, frequently related to duration of hypoxaemia (117/146; 80.1%). Exclusion criteria could be grouped by rationale for selection into strongly or poorly justified criteria. Common poorly justified exclusions included pregnancy related, age, and comorbidities (infectious/immunosuppression, hepatic, renal, and human immunodeficiency virus/acquired immunodeficiency syndrome). Control-arm 28-day mortality varied between ARDS RCTs (mean: 29.8% [95% confidence interval: 27.0e32.7%; I 2 ¼88.8%; t 2 ¼0.02; P<0.01]), and differed significantly between RCTs with different PaO 2 :FiO 2 ratio inclusion thresholds (26.6e39.9 kPa vs <26.6 kPa; P<0.01). In a metaregression model, inclusion criteria and RCT design characteristics accounted for 30.6% of between-trial difference (P<0.01). Conclusions: In most ARDS RCTs, consensus definitions are modified to use as inclusion criteria. Between-RCT mortality differences are mostly explained by the PaO 2 :FiO 2 ratio threshold within the consensus definitions. An exclusion criteria framework can be applied when designing and reporting exclusion criteria in future ARDS RCTs.

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“…1−4 Over the past few decades, supportive care, such as mechanical ventilation, has been developed to treat ALI. 5,6 Although the survival rate has improved, there is no specific agent for ALI based on the molecular pathophysiology. 7,8 Particularly, previous studies have demonstrated that many specific therapies for ALI have not been proven favorable.…”

Section: Introductionmentioning

confidence: 99%

Development of a Decafluorobiphenyl Cyclized Peptide Targeting the NEMO–IKKα/β Interaction that Enhances Cell Penetration and Attenuates Lipopolysaccharide-Induced Acute Lung Injury

Li,

Song,

Liu

et al. 2024

Bioconjugate Chem.

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Aberrant canonical NF-κB signaling has been implicated in diseases, such as autoimmune disorders and cancer. Direct disruption of the interaction of NEMO and IKKα/β has been developed as a novel way to inhibit the overactivation of NF-κB. Peptides are a potential solution for disrupting protein−protein interactions (PPIs); however, they typically suffer from poor stability in vivo and limited tissue penetration permeability, hampering their widespread use as new chemical biology tools and potential therapeutics. In this work, decafluorobiphenyl-cysteine S N Ar chemistry, molecular modeling, and biological validation allowed the development of peptide PPI inhibitors. The resulting cyclic peptide specifically inhibited canonical NF-κB signaling in vitro and in vivo, and presented positive metabolic stability, anti-inflammatory effects, and low cytotoxicity. Importantly, our results also revealed that cyclic peptides had huge potential in acute lung injury (ALI) treatment, and confirmed the role of the decafluorobiphenyl-based cyclization strategy in enhancing the biological activity of peptide NEMO−IKKα/β inhibitors. Moreover, it provided a promising method for the development of peptide-PPI inhibitors.

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Optimal Method for Selecting Peep Level in Ali/Ards Patients under Mechanical Ventilation

Cited by 7 publications

References 0 publications

[Retracted] The Protective Effect of Sulodexide on Acute Lung Injury Induced by a Murine Model of Obstructive Jaundice

[Retracted] The Protective Effect of Sulodexide on Acute Lung Injury Induced by a Murine Model of Obstructive Jaundice

Impact of differences in acute respiratory distress syndrome randomised controlled trial inclusion and exclusion criteria: systematic review and meta-analysis

Development of a Decafluorobiphenyl Cyclized Peptide Targeting the NEMO–IKKα/β Interaction that Enhances Cell Penetration and Attenuates Lipopolysaccharide-Induced Acute Lung Injury

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