Search results for "Respiratory Distress"
showing 10 items of 137 documents
Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review
2020
Abstract Background Tocilizumab is an IL-6 receptor-blocking agent proposed for the treatment of severe COVID-19. The aim of this systematic review was to describe the rationale for the use of tocilizumab for the treatment of COVID-19 and to summarize the available evidence regarding its efficacy and safety. Methods MEDLINE, PubMed, EMBASE, pre-print repositories (bioRxiv and medRxiv) and two trial Registries were searched for studies on the use of tocilizumab in COVID-19 or SARS-CoV-2 infection, viral pneumonia, and/or sepsis until 20th June 2020. Results We identified 3 indirect pre-clinical studies and 28 clinical studies including 5776 patients with COVID-19 (13 with a comparison group,…
Sepsis and Coronavirus Disease 2019: Common Features and Anti-Inflammatory Therapeutic Approaches
2020
Great efforts are being made worldwide to identify the specific clinical characteristics of infected critically ill patients that mediate the associated pathogenesis, including vascular dysfunction, thrombosis, dysregulated inflammation, and respiratory complications. Recently, coronavirus disease 2019 has been closely related to sepsis, which suggests that most deaths in ICUs in infected patients are produced by viral sepsis. Understanding the physiopathology of the disease that lead to sepsis after severe acute respiratory syndrome coronavirus 2 infection is a current clinical need to improve intensive care-applied therapies applied to critically ill patients. Although the whole represent…
Novel technologies to detect atelectotrauma in the injured lung
2010
ABSTRACTCyclical recruitment and derecruitment of lung parenchyma (R/D) remains a serious problem in ALI/ARDS patients, defined as atelectotrauma. Detection of cyclical R/D to titrate the optimal respiratory settings is of high clinical importance. Image-based technologies that are capable of detecting changes of lung ventilation within a respiratory cycle include dynamic computed tomography (dCT), synchrotron radiation computed tomography (SRCT), and electrical impedance tomography (EIT). Time-dependent intra-arterial oxygen tension monitoring represents an alternative approach to detect cyclical R/D, as cyclical R/D can result in oscillations of PaO2 within a respiratory cycle. Continuous…
Nanomedicine: A Diagnostic and Therapeutic Approach to COVID-19
2021
The SARS-CoV-2 virus is causing devastating morbidity and mortality worldwide. Nanomedicine approaches have a high potential to enhance conventional diagnostics, drugs and vaccines. In fact, lipid nanoparticle/mRNA vaccines are already widely used to protect from COVID-19. In this review, we present an overview of the taxonomy, structure, variants of concern, epidemiology, pathophysiology and detection methods of SARS-CoV-2. The efforts of repurposing, tailoring, and adapting pre-existing medications to battle COVID-19 and the state of vaccine developments are presented. Next, we discuss the broad concepts and limitations of how nanomedicine could address the COVID-19 threat. Nanomaterials …
Akutes Lungenversagen bei Malaria tropica in der Schwangerschaft: Erfolgreiche Behandlung durch extrakorporale CO2-Elimination
2008
Eine 32jahrige Schwangere (26. Schwangerschaftswoche) erkrankte am 6. Tag nach der Ruckkehr von einem Indonesienaufenthalt mit Fieber bis 42°C, hamolytischer Anamie (Hamoglobin 7,6 g/dl) und Thrombozytopenie (7000/µl). Es wurde eine Malaria diagnostiziert; eine Prophylaxe hatte sie nicht durchgefuhrt. Unter antiparasitarer Chemotherapie mit Chloroquin, Chinin und Pyrimethamin kam es zur Elimination der Parasiten (Makrogametozyten von Plasmodium falciparum) aus dem peripheren Blut. Im weiteren Verlauf entwickelte sich jedoch ein progredientes Lungenversagen und eine therapierefraktare Pneumonie, die zu einem »adult respiratory distress syndrome« (ARDS; Morel-Stadium 4) fuhrten. Bei drohendem…
Bronchoalveolar Lavage and Oleic Acid-Injection in Pigs as a Double-Hit Model for Acute Respiratory Distress Syndrome (ARDS).
2020
The treatment of ARDS continues to pose major challenges for intensive care physicians in the 21st century with mortality rates still reaching up to 50% in severe cases. Further research efforts are needed to better understand the complex pathophysiology of this disease. There are different well-established animal models to induce acute lung injury but none has been able to adequately mimic the complex pathomechanisms of ARDS. The most crucial factor for the development of this condition is the damage to the alveolar capillary unit. The combination of two well-established lung injury models allow us to mimic in more detail the underlying pathomechanism. Bronchoalveolar lavage (BAL) leads to…
Treatment of bilateral vocal cord paralysis following permanent recurrent laryngeal nerve injury.
2012
Bilateral vocal cord paralysis is a serious illness requiring emergency intervention to resolve the potentially life-threatening respiratory distress. Several surgical procedures were proposed to help improve the airway and to eliminate the tracheostoma in those patients with permanent paralysis. All the procedures have their own advantages and disadvantages. We conducted a retrospective study of 30 patients affected by bilateral vocal cord paralysis following total thyroidectomy. All the patients underwent total thyroidectomy for benign thyroid pathology. In 26 patients (86.6%), cord paralysis occurred during the perioperative stage; and in the remaining 4 cases (13.3%), it occurred within…
Targeted fibre-optical intrabronchial lipopolysaccharide administration in pigs – a methodical refinement for improved accuracy in respiratory resear…
2019
To establish and evaluate a standardized method of targeted, intrabronchial drug delivery in pigs.Randomized controlled trial.A total of 16 German Landrace pigs (Sus scrofa), age range 12‒16 weeks, and weighing 28‒35 kg.The animals were anaesthetized, intubated, and instrumented with extended cardiovascular monitoring. Lung injury was induced by administering via a flexible fibre-optic endoscope using 100 mL saline solution containing either 20 mg of Escherichia coli lipopolysaccharide (E. coli LPS) (n = 8) or no additive (sham, n = 8) into the two distal mainstem bronchi. The animals were monitored for 8 hours and arterial oxygenation, inspiratory pressure and arterial blood pressure were …
Responses of retinal arterioles and ciliary arteries in pigs with acute respiratory distress syndrome (ARDS)
2019
Abstract Acute respiratory distress syndrome (ARDS) is a clinical syndrome of acute lung failure in critically sick patients, which severely compromises the function of multiple organs, including the brain. Although, the optic nerve and the retina are a part of the central nervous system, the effects of ARDS on these ocular structures are completely unknown. Thus, the major goal of this study was to test the hypothesis that ARDS affects vascular function in the eye. ARDS was induced in anesthetized pigs by intratracheal injection of lipopolysaccharide (LPS). Sham-treated animals served as controls. Pigs were monitored for 8 h and then sacrificed. Subsequently, retinal arterioles and short p…
Overview of the pathology of three widely used animal models of acute lung injury
2007
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are syndromes of acute diffuse damage to the pulmonary parenchyma by a variety of local or systemic insults. Increased alveolar capillary membrane permeability was recognized as the common end organ injury and a central feature in all forms of ALI/ARDS. Although great strides have been made in understanding the pathogenesis of ALI/ARDS and in intensive care medicine, the treatment approach to ARDS is still relying on ventilatory and cardiovascular support based on the recognition of the clinical picture. In the course of evaluating novel treatment approaches to ARDS, 3 models of ALI induced in different species, i.e. the…