Article
Respiratory System
Evdokia Gavrielatou, Katerina Vaporidi, Vasiliki Tsolaki, Nikos Tserlikakis, George E. Zakynthinos, Eleni Papoutsi, Aikaterini Maragkuti, Athina G. Mantelou, Dimitrios Karayiannis, Zafeiria Mastora, Dimitris Georgopoulos, Epaminondas Zakynthinos, Christina Routsi, Spyros G. Zakynthinos, Edward J. Schenck, Anastasia Kotanidou, Ilias I. Siempos
Summary: Rapidly improving ARDS is not prevalent and is not associated with good prognosis among patients with COVID-19. Persistent severe ARDS has a higher prevalence and mortality rate.
RESPIRATORY RESEARCH
(2022)
Article
Respiratory System
Sheng-Yuan Ruan, Chun-Ta Huang, Ying-Chun Chien, Chun-Kai Huang, Jung-Yien Chien, Lu-Cheng Kuo, Ping-Hung Kuo, Shih-Chi Ku, Huey-Dong Wu
Summary: This study demonstrated significant etiology-associated heterogeneity in ARDS, with differences observed in gas exchange abnormality, hemodynamic instability, non-pulmonary organ dysfunction, inflammation and coagulation biomarkers, and mortality rates. It also highlighted variations within pneumonia-associated ARDS, especially between bacterial and non-bacterial pneumonia cases, suggesting the need for further exploration into etiology-specific effects in ARDS research.
BMC PULMONARY MEDICINE
(2021)
Article
Critical Care Medicine
Ellen A. Gorman, Jennifer Rynne, Hannah J. Gardiner, Anthony J. Rostron, Jonathan Bannard-Smith, Andrew M. Bentley, David Brealey, Christina Campbell, Gerard Curley, Mike Clarke, Ahilanadan Dushianthan, Phillip Hopkins, Colette Jackson, Kallirroi Kefela, Anna Krasnodembskaya, John G. Laffey, Cliona McDowell, Margaret McFarland, Jamie McFerran, Peter McGuigan, Gavin D. Perkins, Jonathan Silversides, Jon Smythe, Jacqui Thompson, William S. Tunnicliffe, Ingeborg D. M. Welters, Laura Amado-Rodriguez, Guillermo Albaiceta, Barry Williams, Manu Shankar-Hari, Daniel F. McAuley, Cecilia M. O'Kane
Summary: This study investigated the safety and efficacy of ORBCEL-C (CD362-enriched, umbilical cord-derived MSCs) in COVID-19-related ARDS. The results showed that ORBCEL-C did not improve surrogate outcomes of pulmonary organ dysfunction. Evaluation: 7/10.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Cell & Tissue Engineering
Kazuya Ichikado, Toru Kotani, Yasuhiro Kondoh, Hideaki Imanaka, Takeshi Johkoh, Kiminori Fujimoto, Shin Nunomiya, Tomotaka Kawayama, Masanori Sawada, Eric Jenkins, Sadatomo Tasaka, Satoru Hashimoto
Summary: This study evaluated the efficacy and safety of invimestrocel, a bone marrow-derived, allogeneic, multipotent adult progenitor cell, combined with standard treatment in patients with ARDS caused by pneumonia. The results showed that the addition of invimestrocel to standard treatment resulted in a non-significant improvement in ventilator-free days and an improved survival rate at 28 days compared to standard treatment alone. The addition of invimestrocel was well tolerated without any allergic or serious adverse reactions.
STEM CELL RESEARCH & THERAPY
(2023)
Article
Multidisciplinary Sciences
Yin Chen, Dong Wei, Jin Zhao, Xiangnan Xu, Jingyu Chen
Summary: Formononetin pretreatment significantly attenuates hyperoxia-induced ALI by increasing HO-1 expression and suppressing inflammation, dependent on the Nrf2/HO-1 signaling pathway.
Article
Critical Care Medicine
Julien Lopinto, Romain Arrestier, Bastien Peiffer, Antoine Gaillet, Guillaume Voiriot, Tomas Urbina, Charles-Edouard Luyt, Raphael Bellaiche, Tai Pham, Zakaria Ait-Hamou, Damien Roux, Raphael Clere-Jehl, Elie Azoulay, Stephane Gaudry, Julien Mayaux, Armand Mekontso Dessap, Florence Canoui-Poitrine, Nicolas de Prost
Summary: High doses of corticosteroids (HDCT) in critically ill COVID-19 patients with nonresolving acute respiratory distress syndrome (ARDS) leads to an increased 90-day mortality.
CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Faraaz Ali Shah, Nuala J. Meyer, Derek C. Angus, Rana Awdish, Elie Azoulay, Carolyn S. Calfee, Gilles Clermont, Anthony C. Gordon, Arthur Kwizera, Aleksandra Leligdowicz, John C. Marshall, Carmen Mikacenic, Pratik Sinha, Balasubramanian Venkatesh, Hector R. Wong, Fernando G. Zampieri, Sachin Yende
Summary: Precision medicine focuses on identifying effective treatment strategies for groups of patients based on similar characteristics, and similar advances are possible in sepsis and ARDS with further research and investment. By creating knowledge networks, implementing novel trial designs, and continuing to innovate methods, precision medicine may offer better individualized therapies for patients.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Review
Critical Care Medicine
Fernando Jose da Silva Ramos, Flavio Geraldo Rezende de Freitas, Flavia Ribeiro Machado
Summary: Severe COVID-19 should be considered sepsis due to both viral toxicity and dysregulated host response. Co-infection and secondary infection aggravate the condition, particularly in resource-poor settings. Mortality rates are influenced by factors such as hospital strain, HAI incidence, and organizational aspects.
CURRENT OPINION IN CRITICAL CARE
(2021)
Article
Multidisciplinary Sciences
Pierre Bost, Francesco De Sanctis, Stefania Cane, Stefano Ugel, Katia Donadello, Monica Castellucci, David Eyal, Alessandra Fiore, Cristina Anselmi, Roza Maria Barouni, Rosalinda Trovato, Simone Caligola, Alessia Lamolinara, Manuela Iezzi, Federica Facciotti, Annarita Mazzariol, Davide Gibellini, Pasquale De Nardo, Evelina Tacconelli, Leonardo Gottin, Enrico Polati, Benno Schwikowski, Ido Amit, Vincenzo Bronte
Summary: COVID-19 patients show unique immune features, including lung accumulation of naive lymphoid cells, systemic expansion and activation of myeloid cells, and immune suppression. Loss of monocyte-driven and neutrophil-driven immune suppression may lead to fatal outcomes in severe patients. On the other hand, a lung CXCR6(+) effector memory T cell subset may be associated with better prognosis in severe COVID-19 patients.
NATURE COMMUNICATIONS
(2021)
Article
Medicine, General & Internal
Niklas Kronibus, Frederik Seiler, Guy Danziger, Ralf M. Muellenbach, Christian Reyher, Andre P. Becker, Maren Kamphorst, Torben M. Rixecker, Carlos Metz, Robert Bals, Philipp M. Lepper, Sebastian Mang
Summary: This study analyzed and compared the ventilation of critically ill patients with COVID-19 and Influenza A or B, and questioned whether acute lung failure due to COVID-19 requires different intensive care management compared to conventional ARDS. The findings showed that COVID-19 patients had higher ventilatory system compliance, higher ventilatory ratio, and higher minute ventilation at the time of intubation compared to Influenza patients.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Respiratory System
Cecilia Lopez-Martinez, Paula Martin-Vicente, Juan Gomez de Ona, Ines Lopez-Alonso, Helena Gil-Pena, Elias Cuesta-Llavona, Margarita Fernandez-Rodriguez, Irene Crespo, Estefania Salgado del Riego, Raquel Rodriguez-Garcia, Diego Parra, Javier Fernandez, Javier Rodriguez-Carrio, Francisco Jose Jimeno-Demuth, Alberto Davalos, Luis A. Chapado, Eliecer Coto, Guillermo M. Albaiceta, Laura Amado-Rodriguez
Summary: In this study, researchers identified two transcriptomic clusters in critically ill COVID-19 patients based on peripheral blood transcriptomes. One cluster was characterized by interferon-related expression and the other promoted B-cell activation. These clusters had different ICU outcomes, suggesting different pathogenetic mechanisms. The findings demonstrate the potential of transcriptomics in identifying patient endotypes for personalized therapies in severe COVID-19.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Review
Critical Care Medicine
Eleni Papoutsi, Vassilis G. Giannakoulis, Eleni Xourgia, Christina Routsi, Anastasia Kotanidou, Ilias I. Siempos
Summary: This study suggests that the timing of intubation may not affect the mortality and morbidity of critically ill patients with COVID-19, supporting a wait-and-see approach which might lead to fewer intubations. Relevant guidelines may therefore need to be updated.
Article
Immunology
Ren-Qi Yao, Zong Shen, Qi-Min Ma, Ping Ling, Chen-Ru Wei, Li-Yu Zheng, Yu Duan, Wei Li, Feng Zhu, Yu Sun, Guo-Sheng Wu
Summary: This study aimed to develop a model that combines transcriptional biomarkers and clinical parameters to predict the development of acute respiratory distress syndrome (ARDS) in septic patients. Six differentially expressed genes were identified as risk factors, and a prediction model based on these genes was established, showing good performance in predicting ARDS occurrence.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Cell & Tissue Engineering
Yuling Luo, Shanhui Ge, Qingui Chen, Shan Lin, Wanmei He, Mian Zeng
Summary: This study explored whether overexpression of FoxM1 promotes the therapeutic effect of BMSCs on ARDS. The results showed that FoxM1 overexpression significantly decreased pathological variations, protein concentration, oxidative stress, and cytokine levels. Furthermore, FoxM1 enhanced the protective effect of BMSCs on endothelial cell injury through the activation of the Wnt/beta-catenin signaling pathway.
STEM CELL RESEARCH & THERAPY
(2023)
Article
Medicine, Research & Experimental
Weixin Guo, Zhonghua Wang, Shouhong Wang, Xiaolong Liao, Tiehe Qin
Summary: This study collected lung tissues from sepsis induced ARDS patients and brain dead patients without ARDS for genome-wide sequencing analysis, revealing that certain circRNAs were simultaneously up-regulated or down-regulated in both plasma and lung tissues, possibly involving in the regulation of pathways such as ECM-receptor interaction and adherens junction. The data suggests that circRNAs may be involved in the progression of sepsis induced ARDS.
Article
Anesthesiology
Alice Marguerite Conrad, Gregor Loosen, Christoph Boesing, Manfred Thiel, Thomas Luecke, Patricia R. M. Rocco, Paolo Pelosi, Joerg Krebs
Summary: In patients with severe ARDS managed with V-V ECMO, increasing extracorporeal blood flow alters the calculation of lung water index (EVLWI) and intrathoracic blood volume index (ITBVI), resulting in unreliable measurements.
JOURNAL OF CLINICAL MONITORING AND COMPUTING
(2023)
Article
Respiratory System
Hugo Goulart de Oliveira, Amarilio Macedo-Neto, Mauricio Saueressig, Paulo Sanches, Lea Fialkow, Edino Parolo, Fabiano Nagel, Tiago Garcia, Patricia Rieken Macedo Rocco
Summary: This study aimed to demonstrate whether a new prototype implantable artificial bronchus (IAB) can release trapped air from the lungs of recently deceased patients with emphysema. By mechanically ventilating seven deceased patients and measuring ventilation parameters and fraction of inspired oxygen before and after IAB placement, it was found that IAB implantation significantly reduced respiratory system plateau pressure and intrinsic positive end-expiratory pressure in most patients with emphysema. These findings provide a basis for further clinical studies on the safety and efficacy of IAB in patients with emphysema and its short- and long-term effects.
Article
Critical Care Medicine
Tai Pham, Leo Heunks, Giacomo Bellani, Fabiana Madotto, Irene Aragao, Gaetan Beduneau, Ewan C. Goligher, Giacomo Grasselli, Jon Henrik Laake, Jordi Mancebo, Oscar Penuelas, Lise Piquilloud, Antonio Pesenti, Hannah Wunsch, Frank van Haren, Laurent Brochard, John G. Laffey
Summary: This study investigated the management and outcomes of weaning from invasive mechanical ventilation in patients requiring at least 2 days of ventilation. The results showed that only 65% of patients were successfully weaned at 90 days. Factors such as delayed initiation of weaning and excessive sedation levels were associated with weaning failure. Understanding these factors could improve the success rate of weaning.
LANCET RESPIRATORY MEDICINE
(2023)
Article
Chemistry, Medicinal
Declan Byrnes, Claire H. Masterson, Jack Brady, Senthilkumar Alagesan, Hector E. Gonzalez, Sean D. McCarthy, Juan Fandino, Daniel P. O'Toole, John G. Laffey
Summary: This study investigates the potential of mesenchymal stromal cells (MSCs) for treating pulmonary sepsis caused by antimicrobial-resistant bacterial strains. The results show that pre-conditioning MSCs enhances their therapeutic potential by promoting wound healing, reducing inflammation, preserving metabolic activity, and enhancing bacterial killing. Additionally, the study demonstrates that MSCs pre-activated with cytokines are more effective in attenuating pneumosepsis and improving lung function compared to naive and hypoxia-exposed MSCs.
Article
Critical Care Medicine
Giacomo Grasselli, Carolyn S. Calfee, Luigi Camporota, Daniele Poole, Marcelo B. P. Amato, Massimo Antonelli, Yaseen M. Arabi, Francesca Baroncelli, Jeremy R. Beitler, Giacomo Bellani, Geoff Bellingan, Bronagh Blackwood, Lieuwe D. J. Bos, Laurent Brochard, Daniel Brodie, Karen E. A. Burns, Alain Combes, Sonia D'Arrigo, Daniel De Backer, Alexandre Demoule, Sharon Einav, Eddy Fan, Niall D. Ferguson, Jean-Pierre Frat, Luciano Gattinoni, Claude Guerin, Margaret S. Herridge, Carol Hodgson, Catherine L. Hough, Samir Jaber, Nicole P. Juffermans, Christian Karagiannidis, Jozef Kesecioglu, Arthur Kwizera, John G. Laffey, Jordi Mancebo, Michael A. Matthay, Daniel F. McAuley, Alain Mercat, Nuala J. Meyer, Marc Moss, Laveena Munshi, Sheila N. Myatra, Michelle Ng Gong, Laurent Papazian, Bhakti K. Patel, Mariangela Pellegrini, Anders Perner, Antonio Pesenti, Lise Piquilloud, Haibo Qiu, Marco Ranieri, Elisabeth Riviello, Arthur S. Slutsky, Renee D. Stapleton, Charlotte Summers, Taylor B. Thompson, Carmen Valente Barbas, Jesus Villar, Lorraine B. Ware, Bjoern Weiss, Fernando G. Zampieri, Elie Azoulay, Maurizio Cecconi
Summary: The aim of these guidelines is to update the 2017 clinical practice guideline (CPG) of the European Society of Intensive Care Medicine (ESICM). The scope of this CPG is limited to adult patients and to non-pharmacological respiratory support strategies across different aspects of acute respiratory distress syndrome (ARDS), including ARDS due to coronavirus disease 2019 (COVID-19). These guidelines were formulated by an international panel of clinical experts, one methodologist and patients' representatives on behalf of the ESICM.
INTENSIVE CARE MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Christiana Kartsonaki, J. Kenneth Baillie, Noelia Garcia Barrio, Joaquin Baruch, Abigail Beane, Lucille Blumberg, Fernando Bozza, Tessa Broadley, Aidan Burrell, Gail Carson, Barbara Wanjiru Citarella, Andrew Dagens, Emmanuelle A. Dankwa, Christl A. Donnelly, Jake Dunning, Loubna Elotmani, Martina Escher, Nataly Farshait, Jean-Christophe Goffard, Bronner P. Goncalves, Matthew Hall, Madiha Hashmi, Benedict Sim Lim Heng, Antonia Ho, Waasila Jassat, Miguel Pedrera Jimenez, Cedric Laouenan, Samantha Lissauer, Ignacio Martin-Loeches, France Mentre, Laura Merson, Ben Morton, Daniel Munblit, Nikita A. Nekliudov, Alistair D. Nichol, Budha Charan Singh Oinam, David Ong, Prasan Kumar Panda, Michele Petrovic, Mark G. Pritchard, Nagarajan Ramakrishnan, Grazielle Viana Ramos, Claire Roger, Oana Sandulescu, Malcolm G. Semple, Pratima Sharma, Louise Sigfrid, Emily C. Somers, Anca Streinu-Cercel, Fabio Taccone, Pavan Kumar Vecham, Bharath Kumar Tirupakuzhi Vijayaraghavan, Jia Wei, Evert-Jan Wils, Xin Ci Wong, Peter Horby, Amanda Rojek, Piero L. Olliaro, Ali Abbas
Summary: This study analyzed demographic features, treatments, and clinical outcomes of hospitalized COVID-19 patients in 52 countries from January 2020 to January 2022. Age and male sex were associated with a higher risk of death. Symptoms, co-morbidities, and treatments were associated with clinical outcomes. This comprehensive international study provides valuable information for prioritizing treatment for COVID-19 patients at higher risk of death.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Declan Byrnes, Claire H. Masterson, Hector E. Gonzales, Sean D. McCarthy, Daniel P. O'Toole, John G. Laffey
Summary: Antimicrobial-resistant bacteria, such as Klebsiella species, are a common cause of hospital-acquired pneumonia, leading to high mortality and morbidity. Using mesenchymal stem cells (MSCs) to harness the host immune response to these bacteria shows promise in bypassing antimicrobial resistance mechanisms. This study tested the efficacy of repeated doses and preactivated MSCs in attenuating Klebsiella pneumonia-induced pneumonia in rat models. Two doses of MSCs were effective in improving lung function and reducing bacteria and injury, with preactivated MSCs showing superior results. MSC therapy also affected immune cell populations both locally and systemically. Repeated doses of MSCs, particularly preactivated MSCs, enhance their therapeutic potential in treating antimicrobial-resistant Klebsiella pneumonia.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Biochemical Research Methods
Zhuo Zhen Chen, Lloyd Johnson, Uriel Trahtemberg, Andrew Baker, Saaimatul Huq, Jaimie Dufresne, Peter Bowden, Ming Miao, Ja-An Ho, Cheng-Chih Hsu, Claudia C. dos Santos, John G. Marshall
Summary: Proteomic analysis of COVID-19 and ICU-ARDS plasma identified mitochondrial proteins as potential prognostic markers of severe lung damage. PCR confirmed the presence of mitochondrial DNA in the plasma samples. Cytochrome activity assays demonstrated increased activity in COVID-19 and ICU-ARDS plasma.
CLINICAL PROTEOMICS
(2023)
Review
Respiratory System
Monique Martins Melo, Fernanda Ferreira Cruz, Patricia Rieken Macedo Rocco
Summary: Cell therapy has emerged as an alternative option for chronic lung diseases with high morbidity and mortality rates worldwide. This review discusses the definition and properties of mesenchymal stromal cells (MSCs), their mechanisms of action, as well as preclinical and clinical studies in various chronic lung diseases. Ongoing clinical trials are also presented.
EXPERT REVIEW OF RESPIRATORY MEDICINE
(2023)
Article
Immunology
Andy Y. An, Arjun Baghela, Peter Zhang, Reza Falsafi, Amy H. Lee, Uriel Trahtemberg, Andrew J. Baker, Claudia C. dos Santos, Robert E. W. Hancock
Summary: This study compared the gene expression trajectories between severe COVID-19 patients and contemporaneous non-COVID-19 severe sepsis patients during hospitalization. COVID-19 patients had 1,215 differentially expressed genes compared to non-COVID-19 sepsis patients at ICU admission, but the number dropped to 9 genes after one week. The findings highlight the importance of early antiviral treatment for COVID-19 and the potential for heme-related therapeutics.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Anesthesiology
Christoph Boesing, Laura Schaefer, Jochen Johannes Schoettler, Alena Quentin, Grietje Beck, Manfred Thiel, Patrick Honeck, Karl-Friedrich Kowalewski, Paolo Pelosi, Patricia R. M. Rocco, Thomas Luecke, Joerg Krebs
Summary: This study compares the effects of different individualized PEEP titration strategies during Trendelenburg position with pneumoperitoneum. The results show that PEEP Delta P strategy can reduce lung stress and strain, and improve gas exchange. However, PEEP Delta P may result in decreased cardiac output.
EUROPEAN JOURNAL OF ANAESTHESIOLOGY
(2023)
Review
Engineering, Biomedical
Denise Battaglini, Ida Giorgia Iavarone, Chiara Robba, Lorenzo Ball, Pedro Leme Silva, Patricia R. M. Rocco
Summary: Despite extensive research, treatment for acute respiratory distress syndrome (ARDS) remains mainly supportive. New ventilatory modes and strategies have been proposed, but their clinical impact is uncertain and not supported by guidelines. This review provides an overview and update on ventilatory management for ARDS patients.
EXPERT REVIEW OF MEDICAL DEVICES
(2023)
Article
Physiology
Jakob Wittenstein, Martin Scharffenberg, Xiuli Yang, Thomas Bluth, Thomas Kiss, Marcus J. Schultz, Patricia R. M. Rocco, Paolo Pelosi, Marcelo Gama de Abreu, Robert Huhle
Summary: Global and regional transpulmonary pressure and driving pressure increase during protective low tidal volume one-lung ventilation compared to two-lung ventilation, and vary with body position. Lung instability is more likely to occur in the lateral and semilateral decubitus positions during one-lung ventilation in pigs after thoracic surgery.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Hematology
Matthew J. Griffee, Patricia T. Bozza, Luis Felipe Reyes, Devin P. Eddington, Dorothea Rosenberger, Laura Merson, Barbara Wanjiru Citarella, Jonathon P. Fanning, Peta M. A. Alexander, John Fraser, Heidi Dalton
Summary: In this study, the frequency of coagulopathy complications in COVID-19 patients from developing countries (LMICs) was compared to those from high-income countries (HICs), and it was found that complications were more frequent in HICs. Complications were more common in patients receiving advanced treatment, and were associated with increased in-hospital mortality. Moreover, the mortality associated with these complications was higher in LMICs. Therefore, further research is needed to explore timely diagnosis and intervention for coagulation derangements in COVID-19, particularly in limited-resource settings.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Critical Care Medicine
Christoph Boesing, Laura Schaefer, Peter T. Graf, Paolo Pelosi, Patricia R. M. Rocco, Thomas Luecke, Joerg Krebs
Summary: In ARDS patients treated with VV ECMO, adjusting PEEP to 10 cmH(2)O can reduce MP, improve hemodynamic parameters, and increase oxygen delivery.
JOURNAL OF CRITICAL CARE
(2024)