Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Search

Page Path
HOME > Search
35 "respiratory distress"
Filter
Filter
Article category
Keywords
Publication year
Authors
Funded articles
Original Articles
Pulmonary
Awake prone positioning for COVID-19 acute hypoxemic respiratory failure in Tunisia
Khaoula Ben Ismail, Fatma Essafi, Imen Talik, Najla Ben Slimene, Ines Sdiri, Boudour Ben Dhia, Takoua Merhbene
Acute Crit Care. 2023;38(3):271-277.   Published online August 21, 2023
DOI: https://doi.org/10.4266/acc.2023.00591
  • 1,713 View
  • 116 Download
AbstractAbstract PDF
Background
In this study, we explored whether awake prone position (PP) can impact prognosis of severe hypoxemia coronavirus disease 2019 (COVID-19) patients.
Methods
This was a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. Patients were divided into two groups: group G1, patients who benefited from a vigilant and effective PP (>4 hours minimum/24) and group G2, control group. We compared demographic, clinical, paraclinical and evolutionary data.
Results
Three hundred forty-nine patients were hospitalized during the study period, 273 met the inclusion criteria. PP was performed in 192 patients (70.3%). The two groups were comparable in terms of demographic characteristics, clinical severity and modalities of oxygenation at intensive care unit (ICU) admission. The mean PaO2/ FIO2 ratios were 141 and 128 mm Hg, respectively (P=0.07). The computed tomography scan was comparable with a critical >75% in 48.5% (G1) versus 54.2% (G2). The median duration of the daily PP session was 13±7 hours per day. The average duration of spontaneous PP days was 7 days (4–19). Use of invasive ventilation was lower in the G1 group (27% vs. 56%, P=0.002). Healthcare-associated infections were significantly lower in G1 (42.1% vs. 82%, P=0.01). Duration of total mechanical ventilation and length of ICU stay were comparable between the two groups. Mortality was significantly higher in G2 (64% vs. 28%, P=0.02).
Conclusions
Our study confirmed that awake PP can improve prognosis in COVID-19 patients. Randomized controlled trials are needed to confirm this result.
Pulmonary
Extravascular lung water index, pulmonary vascular permeability index, and global end-diastolic volume index in mechanically ventilated COVID-19 patients requiring prone position ventilation: a preliminary retrospective study
Rosanna Carmela De Rosa, Antonio Romanelli, Michele Gallifuoco, Giovanni Messina, Marianne Di Costanzo, Antonio Corcione
Acute Crit Care. 2022;37(4):571-579.   Published online November 10, 2022
DOI: https://doi.org/10.4266/acc.2022.00423
  • 2,171 View
  • 102 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
There is a lack of data on extravascular lung water index (EVLWi), pulmonary vascular permeability index (PVPi), and global end-diastolic volume index (GEDVi) during prone position ventilation (PPV) in coronavirus disease 2019 (COVID-19) patients. The objectives of this study were to analyze trends in EVLWi, PVPi, and GEDVi during PPV and the relationships between these parameters and PaO2/FiO2. Methods: In this preliminary retrospective observational study, we performed transpulmonary thermodilution (TPTD) in seven mechanically ventilated COVID-19 patients without cardiac and pulmonary comorbidities requiring PPV for 18 hours, at specific times (30 minutes pre-PPV, 18 hours after PPV, and 3 hours after supination). EVLWi, PVPi and GEDVi were measured. The relationships between PaO2/FiO2 and EVLWi, and PVPi and GEDVi values, in the supine position were analyzed by linear regression. Correlation and determination coefficients were calculated. Results: EVLWi was significantly different between three time points (analysis of variance, P=0.004). After 18 hours in PPV, EVLWi was lower compared with values before PPV (12.7±0.9 ml/kg vs. 15.3±1.5 ml/kg, P=0.002). Linear regression showed that only EVLWi was correlated with PaO2/FiO2 (β =–5.757; 95% confidence interval, –10.835 to –0.679; r=–0.58; R2 =0.34; F-test P=0.029). Conclusions: EVLWi was significantly reduced after 18 hours in PPV and values measured in supine positions were correlated with PaO2/FiO2. This relationship can help clinicians discriminate whether deterioration in gas exchange is related to fluid overload or disease progression. Further clinical research should evaluate the role of TPTD parameters as markers to stratify disease severity and guide clinical management.

Citations

Citations to this article as recorded by  
  • Determining Extracellular Water Effects in Mild and Severe COVID-19 Pneumonia Clinical Course by using the Bioimpedance Method
    Zuhal Cavus, Ayse Vahaboglu, Ulku Aygen Turkmen, Habibe Vural, Dondu Genc Moralar
    Medical Bulletin of Haseki.2023; 61(2): 81.     CrossRef
Pulmonary
Effect of prone positioning on gas exchange according to lung morphology in patients with acute respiratory distress syndrome
Na Young Kim, Si Mong Yoon, Jimyung Park, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
Acute Crit Care. 2022;37(3):322-331.   Published online July 29, 2022
DOI: https://doi.org/10.4266/acc.2022.00367
  • 3,160 View
  • 227 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
There are limited data on the clinical effects of prone positioning according to lung morphology. We aimed to determine whether the gas exchange response to prone positioning differs according to lung morphology.
Methods
This retrospective study included adult patients with moderate-to-severe acute respiratory distress syndrome (ARDS). The lung morphology of ARDS was assessed by chest computed tomography scan and classified as “diffuse” or “focal.” The primary outcome was change in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio after the first prone positioning session: first, using the entire cohort, and second, using subgroups of patients with diffuse ARDS matched 2 to 1 with patients with focal ARDS at baseline.
Results
Ninety-five patients were included (focal ARDS group, 23; diffuse ARDS group, 72). Before prone positioning, the focal ARDS group showed worse oxygenation than the diffuse ARDS group (median PaO2/FiO2 ratio, 79.9 mm Hg [interquartile range (IQR)], 67.7–112.6 vs. 104.0 mm Hg [IQR, 77.6–135.7]; P=0.042). During prone positioning, the focal ARDS group showed a greater improvement in the PaO2/FiO2 ratio than the diffuse ARDS group (median, 55.8 mm Hg [IQR, 11.1–109.2] vs. 42.8 mm Hg [IQR, 11.6–83.2]); however, the difference was not significant (P=0.705). Among the PaO2/FiO2-matched cohort, there was no significant difference in change in PaO2/FiO2 ratio after prone positioning between the groups (P=0.904).
Conclusions
In patients with moderate-to-severe ARDS, changes in PaO2/FiO2 ratio after prone positioning did not differ according to lung morphology. Therefore, prone positioning can be considered as soon as indicated, regardless of ARDS lung morphology.

Citations

Citations to this article as recorded by  
  • Subphenotypes of Acute Respiratory Distress Syndrome: Advancing Towards Precision Medicine
    Andrea R. Levine, Carolyn S. Calfee
    Tuberculosis and Respiratory Diseases.2024; 87(1): 1.     CrossRef
Nephrology
Clinical efficacy of blood purification using a polymethylmethacrylate hemofilter for the treatment of severe acute pancreatitis
Kiyohiko Kinjoh, Ryoji Nagamura, Yutaka Sakuda, Shoki Yamauchi, Hideta Takushi, Tadashi Iraha, Koji Idomari
Acute Crit Care. 2022;37(3):398-406.   Published online July 5, 2022
DOI: https://doi.org/10.4266/acc.2022.00192
  • 3,292 View
  • 187 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Severe acute pancreatitis (SAP) is a systemic inflammatory disease, and it can often complicate into acute kidney injury (AKI) and acute lung injury/acute respiratory distress syndrome (ALI/ARDS). This study aimed to evaluate the clinical effectiveness of blood purification using a polymethylmethacrylate (PMMA) hemofilter.
Methods
We retrospectively examined 54 patients, who were diagnosed with SAP according to the Japanese criteria from January 2011 to December 2019.
Results
Of a total of 54 SAP patients, 26 patients progressively developed AKI and required continuous hemodialysis with a PMMA membrane hemofilter (PMMA-CHD). Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score were significantly higher in patients requiring PMMA-CHD than in patients not requiring hemodialysis. The lung injury scores were also significantly higher in patients requiring PMMA-CHD. Of the 26 patients, 16 patients developed ALI/ARDS and required mechanical ventilation. A total of seven patients developed severe ALI/ARDS and received additional intermittent hemodiafiltration using a PMMA hemofilter (PMMA-HDF). Although the length of intensive care unit stay was significantly longer in patients with severe ALI/ARDS, blood purification therapy was discontinued in all the patients. The survival rates at the time of discharge were 92.3% and 92.9% in patients with and without PMMA-CHD, respectively. These real mortality ratios were obviously lower than the estimated mortality ratios predicted by APACHE II scores.
Conclusions
These finding suggest that the blood purification using a PMMA hemofilter would be effective for the treatment of AKI and ALI/ARDS in SAP patients.

Citations

Citations to this article as recorded by  
  • A Retrospective Study on the Start and End of Continuous Hemodialysis using a Polymethylmethacrylate Hemofilter for Severe Acute Pancreatitis
    Kiyohiko Kinjoh, Ryoji Nagamura, Yutaka Sakuda
    Internal Medicine.2024;[Epub]     CrossRef
  • Evaluation of the therapeutic efficiency and efficacy of blood purification in the treatment of severe acute pancreatitis
    Hongwei Huang, Zhongshi Huang, Menghua Chen, Ken Okamoto, Chiara Lazzeri
    PLOS ONE.2024; 19(1): e0296641.     CrossRef
  • Enhancing Immune Protection in Hemodialysis Patients: Role of the Polymethyl Methacrylate Membrane
    Rossana Franzin, Alessandra Stasi, Gianvito Caggiano, Elena Squiccimarro, Vincenzo Losappio, Marco Fiorentino, Carlo Alfieri, Giovanni Stallone, Loreto Gesualdo, Giuseppe Castellano
    Blood Purification.2023; : 27.     CrossRef
Pulmonary
Association of pulmonary arterial pressure with volume status in patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation
Tae Hwa Hong, Hyoung Soo Kim, Sunghoon Park
Acute Crit Care. 2022;37(2):159-167.   Published online March 11, 2022
DOI: https://doi.org/10.4266/acc.2021.00927
  • 4,385 View
  • 214 Download
AbstractAbstract PDFSupplementary Material
Background
Data on pulmonary hemodynamic parameters in patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) are scarce.
Methods
The associations between pulmonary artery catheter parameters for the first 7 days of ECMO, fluid balance, and hospital mortality were investigated in adult patients (aged ≥19 years) who received venovenous ECMO for refractory ARDS between 2015 and 2017.
Results
Twenty patients were finally included in the analysis (median age, 56.0 years; interquartile range, 45.5–68.0 years; female, n=10). A total of 140 values were collected for each parameter (i.e., 7 days×20 patients). Net fluid balance was weakly but significantly correlated with systolic and diastolic pulmonary arterial pressures (PAPs; r=0.233 and P=0.011; r=0.376 and P<0.001, respectively). Among the mechanical ventilation parameters, above positive end-expiratory pressure was correlated with systolic PAP (r=0.191 and P=0.025), and static compliance was negatively correlated with diastolic PAP (r=−0.169 and P=0.048). Non-survivors had significantly higher systolic PAPs than in survivors. However, in multivariate analysis, there was no significant association between mean systolic PAP and hospital mortality (odds ratio, 1.500; 95% confidence interval, 0.937–2.404; P=0.091).
Conclusions
Systolic PAP was weakly but significantly correlated with net fluid balance during the early ECMO period in patients with refractory ARDS receiving ECMO.
Infection
Comparison of critically ill COVID-19 and influenza patients with acute respiratory failure
Mehmet Yildirim, Burcin Halacli, Mehmet Yasir Pektezel, Berrin Er, Ismail Tuna Geldigitti, Gulay Tok, Ebru Ortac Ersoy, Arzu Topeli
Acute Crit Care. 2022;37(2):168-176.   Published online March 11, 2022
DOI: https://doi.org/10.4266/acc.2021.00920
  • 5,910 View
  • 235 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
Coronavirus disease 2019 (COVID-19) is one of the biggest pandemic causing acute respiratory failure (ARF) in the last century. Seasonal influenza carries high mortality, as well. The aim of this study was to compare features and outcomes of critically-ill COVID-19 and influenza patients with ARF.
Methods
Patients with COVID-19 and influenza admitted to intensive care unit with ARF were retrospectively analyzed.
Results
Fifty-four COVID-19 and 55 influenza patients with ARF were studied. Patients with COVID-19 had 32% of hospital mortality, while those with influenza had 47% (P=0.09). Patients with influenza had higher Eastern Cooperative Oncology Group, Clinical Frailty Scale, Acute Physiology and Chronic Health Evaluation II and admission Sequential Organ Failure Assessment (SOFA) scores than COVID-19 patients (P<0.01). Secondary bacterial infection, admission acute kidney injury, procalcitonin level above 0.2 ng/ml were the independent factors distinguishing influenza from COVID-19 while prone positioning differentiated COVID-19 from influenza. Invasive mechanical ventilation (odds ratio [OR], 42.16; 95% confidence interval [CI], 9.45–187.97), admission SOFA score more than 4 (OR, 5.92; 95% CI, 1.85–18.92), malignancy (OR, 4.95; 95% CI, 1.13–21.60), and age more than 65 years (OR, 3.31; 95% CI, 0.99–11.03) were found to be independent risk factors for hospital mortality.
Conclusions
There were few differences in clinical features of critically-ill COVID-19 and influenza patients. Influenza cases had worse performance status and disease severity. There was no significant difference in hospital mortality rates between COVID-19 and influenza patients.

Citations

Citations to this article as recorded by  
  • Comparison of Clinical Characteristics and Outcomes in Intensive Care Units Between Patients with Coronavirus Disease 2019 (COVID-19) and Patients with Influenza: A Systematic Review and Meta-Analysis
    Zhuan Zhong, Xin Wang, Jia Guo, Xingzhao Li, Yingying Han
    Journal of Intensive Care Medicine.2024;[Epub]     CrossRef
  • Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis
    Chiu-Ying Hsiao, Heng-Chih Pan, Vin-Cent Wu, Ching-Chun Su, Tzu-Hsuan Yeh, Min-Hsiang Chuang, Kuan-Chieh Tu, Hsien-Yi Wang, Wei-Chih Kan, Chun-Chi Yang, Jui-Yi Chen
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Comparison of Clinical Features and Outcomes between SARS-CoV-2 and Non-SARS-CoV-2 Respiratory Viruses Associated Acute Respiratory Distress Syndrome: Retrospective Analysis
    Manbong Heo, Jong Hwan Jeong, Sunmi Ju, Seung Jun Lee, Yi Yeong Jeong, Jong Deog Lee, Jung-Wan Yoo
    Journal of Clinical Medicine.2022; 11(8): 2246.     CrossRef
Case Report
Basic science and research
COVID-19–related acute respiratory distress syndrome treated with veno-venous extracorporeal membrane oxygenation and programmed multi-level ventilation: a case report
Filip Depta, Anton Turčan, Pavol Török, Petra Kapraľová, Michael A. Gentile
Acute Crit Care. 2022;37(3):470-473.   Published online January 21, 2022
DOI: https://doi.org/10.4266/acc.2021.01109
  • 3,804 View
  • 173 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a patient with severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) treated with veno-venous extracorporeal membrane oxygenation (VV ECMO) and programmed multi-level ventilation (PMLV). VV ECMO as a treatment modality for severe ARDS has been described multiple times as a rescue therapy for refractory hypoxemia. It is well known that conventional ventilation can cause ventilator-induced lung injury. Protective ventilation during VV ECMO seems to be beneficial, translating to using low tidal volumes, prone positioning with general concept of open lung approach. However, mechanical ventilation is still required as ECMO per se is usually not sufficient to maintain adequate gas exchange due to hyperdynamic state of the patient and limitation of blood flow via VV ECMO. This report describes ventilation strategy using PMLV during “resting” period of the lung. In short, PMLV is a strategy for ventilating non-homogenous lungs that incorporates expiratory time constants and multiple levels of positive end-expiratory pressure. Using this approach, most affected acute lung injury/ARDS areas can be recruited, while preventing overdistension in healthy areas. To our knowledge, case report using such ventilation strategy for lung resting period has not been previously published.

Citations

Citations to this article as recorded by  
  • Treatment of acute respiratory failure: extracorporeal membrane oxygenation
    Jin-Young Kim, Sang-Bum Hong
    Journal of the Korean Medical Association.2022; 65(3): 157.     CrossRef
Original Articles
Infection
Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia
Mabrouk Bahloul, Sana Kharrat, Kamilia Chtara, Malek Hafdhi, Olfa Turki, Najeh Baccouche, Rania Ammar, Nozha Kallel, Majdi Hsairi, Olfa Chakroun-Walha, Chokri Ben Hamida, Hedi Chelly, Khaiereddine Ben Mahfoudh, Abelhamid Karoui, Hela Karray, Noureddine Rekik, Mounir Bouaziz
Acute Crit Care. 2022;37(1):84-93.   Published online November 16, 2021
DOI: https://doi.org/10.4266/acc.2021.00129
  • 14,420 View
  • 313 Download
  • 5 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods: We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection— admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results: A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions: In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.

Citations

Citations to this article as recorded by  
  • Cost Effectiveness of Strategies for Caring for Critically Ill Patients with COVID-19 in Tanzania
    Hiral Anil Shah, Tim Baker, Carl Otto Schell, August Kuwawenaruwa, Khamis Awadh, Karima Khalid, Angela Kairu, Vincent Were, Edwine Barasa, Peter Baker, Lorna Guinness
    PharmacoEconomics - Open.2023; 7(4): 537.     CrossRef
  • Prognostic Value of Serum Cholinesterase Activity in Severe SARS-CoV-2–Infected Patients Requiring Intensive Care Unit Admission
    Mabrouk Bahloul, Sana Kharrat, Saba Makni, Najeh Baccouche, Rania Ammar, Aida Eleuch, Lamia Berrajah, Amel Chtourou, Olfa Turki, Chokri Ben Hamida, Hedi Chelly, Kamilia Chtara, Fatma Ayedi, Mounir Bouaziz
    The American Journal of Tropical Medicine and Hygiene.2022; 107(3): 534.     CrossRef
Pulmonary
Impact of prone position on outcomes of COVID-19 patients with spontaneous breathing
Mabrouk Bahloul, Sana Kharrat, Malek Hafdhi, Anis Maalla, Olfa Turki, Kamilia Chtara, Rania Ammar, Basma Suissi, Chokri Ben Hamida, Hedi Chelly, Khaiereddine Ben Mahfoudh, Mounir Bouaziz
Acute Crit Care. 2021;36(3):208-214.   Published online August 12, 2021
DOI: https://doi.org/10.4266/acc.2021.00500
  • 5,606 View
  • 209 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Background
In this study, we explored whether early application of the prone position (PP) can improve severe hypoxemia and respiratory failure in coronavirus disease 2019 (COVID-19) patients with spontaneous breathing.
Methods
This is a prospective observational study of severe, critically ill adult COVID-19 patients admitted to the intensive care unit. All vital parameters were recorded in real time for all patients. Moreover, the results of chest computed tomography (CT), when available, were analyzed.
Results
PP was applied in 21 patients who were breathing spontaneously. The application of PP was associated with a significant increase in oxygen saturation measured by pulse oximetry (SpO2) from 82%±12% to 96%±3% (P<0.001) 1 hour later. Moreover, PP was associated with a significant reduction in respiratory rate from 31±10 to 21±4 breaths/min (P<0.001). Furthermore, the number of patients who exhibited signs of respiratory distress after PP was reduced from 10 (47%) to 3 (14%) (P=0.04). Early PP application also led to a clear improvement on CT imaging. It was not, however, associated with a reduction in mortality rate or in the use of invasive mechanical ventilation (P>0.05 for both).
Conclusions
Our study confirmed that the early application of PP can improve hypoxemia and tachypnea in COVID-19 patients with spontaneous breathing. Randomized controlled trials are needed to confirm the beneficial effects of PP in COVID-19 patients with spontaneous breathing.

Citations

Citations to this article as recorded by  
  • Awake prone positioning for patients with COVID-19-related respiratory failure: a systematic review and meta-analysis
    Mara Graziani, Andrea Galeazzo Rigutini, Diletta Bartolini, Laura Traballi, Lorenzo Luzi, Rossana Regina, Francesco Bossi, Carla Caponi, Cecilia Becattini
    Internal and Emergency Medicine.2024; 19(1): 147.     CrossRef
  • Conscious prone positioning in nonintubated COVID-19 patients with acute respiratory distress syndrome: systematic review and meta-analysis
    Gustavo Adolfo Vásquez-Tirado, Edinson Dante Meregildo-Rodríguez, Martha Genara Asmat-Rubio, María José Salazar-Castillo, Claudia Vanessa Quispe-Castañeda, María del Carmen Cuadra-Campos
    Critical Care Science.2024;[Epub]     CrossRef
  • Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis
    Raíssa S. Freire, Camila M. S. S. Barros, Jefferson Valente, Cássia da Luz Goulart, Anna G. R. Santos, Fernando H. Fonseca, Sabrina T. Saenz, Andiana S. Dias, Maria G. A. Rodrigues, Bernardo Maia Silva, Eduardo Fernandes, Nadia Cubas-Vega, Vanderson Sampa
    Expert Review of Respiratory Medicine.2024; : 1.     CrossRef
  • Awake prone positioning for COVID-19 acute hypoxemic respiratory failure in Tunisia
    Khaoula Ben Ismail, Fatma Essafi, Imen Talik, Najla Ben Slimene, Ines Sdiri, Boudour Ben Dhia, Takoua Merhbene
    Acute and Critical Care.2023; 38(3): 271.     CrossRef
  • Gravity-induced ischemia in the brain-and prone positioning for COVID-19 patients breathing spontaneously
    J. Howard Jaster, Giulia Ottaviani
    Acute and Critical Care.2022; 37(1): 131.     CrossRef
  • Gravity-induced ischemia in the brain and prone positioning for COVID-19 patients breathing spontaneously: still far from the truth!
    Mabrouk Bahloul, Sana Kharrat, Kamilia Chtara, Hedi Chelly, Chokri Ben Hamida, Mounir Bouaziz
    Acute and Critical Care.2022; 37(1): 134.     CrossRef
  • A Case of COVID-19 with Acute Exacerbation after Anti-Inflammatory Treatment
    Yugo Ashino, Yoichi Shirato, Masahiro Yaegashiwa, Satoshi Yamanouchi, Noriko Miyakawa, Kokichi Ando, Yumiko Sakurada, Haorile Chagan Yasutan, Toshio Hattori
    Reports.2022; 5(2): 24.     CrossRef
  • Efficacy and safety of prone position in COVID-19 patients with respiratory failure: a systematic review and meta-analysis
    Hyeon-Jeong Lee, Junghyun Kim, Miyoung Choi, Won-Il Choi, Joonsung Joh, Jungeun Park, Joohae Kim
    European Journal of Medical Research.2022;[Epub]     CrossRef
Pulmonary
Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
Acute Crit Care. 2021;36(3):223-231.   Published online July 30, 2021
DOI: https://doi.org/10.4266/acc.2021.00388
  • 4,102 View
  • 104 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Both coronavirus disease 2019 (COVID-19) and Middle East respiratory syndrome (MERS) can cause acute respiratory distress syndrome (ARDS); however, their ARDS course and characteristics have not been compared, which we evaluate in our study.
Methods
MERS patients with ARDS seen during the 2014 outbreak and COVID-19 patients with ARDS admitted between March and December 2020 in our hospital were included, and their clinical characteristics, ventilatory course, and outcomes were compared.
Results
Forty-nine and 14 patients met the inclusion criteria for ARDS in the COVID-19 and MERS groups, respectively. Both groups had a median of four comorbidities with high Charlson comorbidity index value of 5 points (P>0.22). COVID-19 patients were older, obese, had significantly higher initial C-reactive protein (CRP), more likely to get trial of high-flow oxygen, and had delayed intubation (P≤0.04). The postintubation course was similar between the groups. Patients in both groups experienced a prolonged duration of mechanical ventilation, and majority received paralytics, dialysis, and vasopressor agents (P>0.28). The respiratory and ventilatory parameters after intubation (including tidal volume, fraction of inspired oxygen, peak and plateau pressures) and their progression over 3 weeks were similar (P>0.05). Rates of mortality in the ICU (53% vs. 64%) and hospital (59% vs. 64%) among COVID-19 and MERS patients (P≥0.54) were very high.
Conclusions
Despite some distinctive differences between COVID-19 and MERS patients prior to intubation, the respiratory and ventilatory parameters postintubation were not different. The higher initial CRP level in COVID-19 patients may explain the steroid responsiveness in this population.

Citations

Citations to this article as recorded by  
  • Does COVID-19 Vaccine Impact the Soul? A Pre-post Vaccination Comparison of Health Care Workers’ Infection Control Practices and Perspectives
    Imran Khalid, Muhammad Ali Akhtar, Manahil Imran, Maryam Imran, Musaab Ahmed Mujalli, Moayad Sami Qashqari, Abeer N Alshukairi, Amina Nisar, Tabindeh Jabeen Khalid
    Infectious Diseases in Clinical Practice.2023;[Epub]     CrossRef
  • Advances in mRNA and other vaccines against MERS-CoV
    Wanbo Tai, Xiujuan Zhang, Yang Yang, Jiang Zhu, Lanying Du
    Translational Research.2022; 242: 20.     CrossRef
Pediatric
Oxygenation Index in the First 24 Hours after the Diagnosis of Acute Respiratory Distress Syndrome as a Surrogate Metric for Risk Stratification in Children
Soo Yeon Kim, Byuhree Kim, Sun Ha Choi, Jong Deok Kim, In Suk Sol, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Sohn, Kyu-Earn Kim
Acute Crit Care. 2018;33(4):222-229.   Published online November 29, 2018
DOI: https://doi.org/10.4266/acc.2018.00136
  • 6,115 View
  • 182 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS.
Methods
Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality.
Results
PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001).
Conclusions
Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

Citations

Citations to this article as recorded by  
  • A single‐center PICU present status survey of pediatric sepsis‐related acute respiratory distress syndrome
    Liang Zhou, Shaojun Li, Tian Tang, Xiu Yuan, Liping Tan
    Pediatric Pulmonology.2022; 57(9): 2003.     CrossRef
Infection
A Retrospective Study Investigating Risks of Acute Respiratory Distress Syndrome and Mortality Following Human Metapneumovirus Infection in Hospitalized Adults
Hyunjung Hwang, Yujin Kim, Jeong-Woong Park, Sung Hwan Jeong, Sun Young Kyung
Korean J Crit Care Med. 2017;32(2):182-189.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00038
  • 6,361 View
  • 85 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Background
Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported.
Methods
We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group.
Results
In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment.
Conclusions
These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.

Citations

Citations to this article as recorded by  
  • A Case of Metapneumovirus Pneumonia-Related Acute Respiratory Distress Syndrome in a Young Adult Patient
    Tae Wan Kim, Won-Young Kim
    The Korean Journal of Medicine.2024; 99(2): 111.     CrossRef
  • Human Metapneumovirus Pneumonia Precipitating Acute Respiratory Distress Syndrome in an Adult Patient
    Dena H Tran, Muhammad Sameed, Ellen T Marciniak, Avelino C Verceles
    Cureus.2021;[Epub]     CrossRef
  • Outcomes of severe human metapneumovirus-associated community-acquired pneumonia in adults
    Sang-Ho Choi, Sang-Bum Hong, Jin Won Huh, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Heungsup Sung, Hyun Jung Koo, Kyung-Hyun Do, Sang-Oh Lee, Chae-Man Lim, Yang Soo Kim, Jun Hee Woo, Younsuck Koh
    Journal of Clinical Virology.2019; 117: 1.     CrossRef
Pulmonary
Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study
Joohae Kim, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang Hoon Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Sang-Min Lee
Korean J Crit Care Med. 2017;32(2):154-163.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00976
  • 11,302 View
  • 186 Download
  • 29 Web of Science
  • 32 Crossref
AbstractAbstract PDF
Background
Acute respiratory distress syndrome (ARDS) remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE) inhibitor is known to modulate the neurohormonal system to reduce inflammation and to prevent tissue fibrosis. However, the role of ACE inhibitor in the lungs is not well understood. We therefore conducted this study to elucidate the effect of renin-angiotensin system (RAS) blockage on the prognosis of patients with ARDS.
Methods
We analyzed medical records of patients who were admitted to the medical intensive care unit (ICU) at a tertiary care hospital from January 2005 to December 2010. ARDS was determined using the Berlin definition. The primary outcome was the mortality rate of ICU. Survival analysis was performed after adjustment using propensity score matching.
Results
A total of 182 patients were included in the study. Thirty-seven patients (20.3%) took ACE inhibitor or angiotensin receptor blocker (ARB) during ICU admission, and 145 (79.7%) did not; both groups showed similar severity scores. In the ICU, mortality was 45.9% in the RAS inhibitor group and 58.6% in the non-RAS inhibitor group (P = 0.166). The RAS inhibitor group required a longer duration of mechanical ventilation (29.5 vs. 19.5, P = 0.013) and longer ICU stay (32.1 vs. 20.2 days, P < 0.001). In survival analysis, the RAS inhibitor group showed better survival rates than the non-RAS group (P < 0.001).
Conclusions
ACE inhibitor or ARB may have beneficial effect on ARDS patients.

Citations

Citations to this article as recorded by  
  • Systematic review and meta-analysis of the clinical outcomes of ACEI/ARB in East-Asian patients with COVID-19
    Nancy Xurui Huang, Qi Yuan, Fang Fang, Bryan P. Yan, John E. Sanderson, Masaki Mogi
    PLOS ONE.2023; 18(1): e0280280.     CrossRef
  • Renin-angiotensin system modulators in COVID-19 patients with hypertension: friend or foe?
    Shakhi Shylesh C.M, Arya V S, Kanthlal S. K., Uma Devi P.
    Clinical and Experimental Hypertension.2022; 44(1): 1.     CrossRef
  • A propensity score‐matching analysis of angiotensin‐converting enzyme inhibitor and angiotensin receptor blocker exposure on in‐hospital mortality in patients with acute respiratory failure
    Yi‐Peng Fang, Xin Zhang
    Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2022; 42(5): 387.     CrossRef
  • The Renin-Angiotensin System as a Component of Biotrauma in Acute Respiratory Distress Syndrome
    Katharina Krenn, Verena Tretter, Felix Kraft, Roman Ullrich
    Frontiers in Physiology.2022;[Epub]     CrossRef
  • ACE2-like enzyme B38-CAP suppresses abdominal sepsis and severe acute lung injury
    Takafumi Minato, Tomokazu Yamaguchi, Midori Hoshizaki, Satoru Nirasawa, Jianbo An, Saori Takahashi, Josef M. Penninger, Yumiko Imai, Keiji Kuba, Yu Ru Kou
    PLOS ONE.2022; 17(7): e0270920.     CrossRef
  • Tidal Volume–Dependent Activation of the Renin-Angiotensin System in Experimental Ventilator-Induced Lung Injury*
    Xinjun Mao, Katharina Krenn, Thomas Tripp, Verena Tretter, Roman Reindl-Schwaighofer, Felix Kraft, Bruno K. Podesser, Yi Zhu, Marko Poglitsch, Oliver Domenig, Dietmar Abraham, Roman Ullrich
    Critical Care Medicine.2022; 50(9): e696.     CrossRef
  • The Association of Renin-Angiotensin System Blockades and Mortality in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Acute Respiratory Failure: A Retrospective Cohort Study
    Zhishen Ruan, Dan Li, Yuanlong Hu, Zhanjun Qiu, Xianhai Chen
    International Journal of Chronic Obstructive Pulmonary Disease.2022; Volume 17: 2001.     CrossRef
  • Renin-angiotensin system at the interface of COVID-19 infection
    Rukhsana Gul, Uh-Hyun Kim, Assim A. Alfadda
    European Journal of Pharmacology.2021; 890: 173656.     CrossRef
  • A pharmacological framework for integrating treating the host, drug repurposing and the damage response framework in COVID‐19
    Jennifer H. Martin, Richard Head
    British Journal of Clinical Pharmacology.2021; 87(3): 875.     CrossRef
  • A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor
    Murat Oz, Dietrich Ernst Lorke, Nadine Kabbani
    Pharmacology & Therapeutics.2021; 221: 107750.     CrossRef
  • Renin-angiotensin system blocker and outcomes of COVID-19: a systematic review and meta-analysis
    Hyun Woo Lee, Chang-Hwan Yoon, Eun Jin Jang, Chang-Hoon Lee
    Thorax.2021; 76(5): 479.     CrossRef
  • Evaluation of expression of VDR-associated lncRNAs in COVID-19 patients
    Mohammad Taheri, Lina Moallemi Rad, Bashdar Mahmud Hussen, Fwad Nicknafs, Arezou Sayad, Soudeh Ghafouri-Fard
    BMC Infectious Diseases.2021;[Epub]     CrossRef
  • Mechanisms of Damage to the Cardiovascular System in COVID-19
    Alexandr Y. Fisun, Yuriy V. Lobzin, Dmitry V. Cherkashin, Vadim V. Tyrenko, Konstantin N. Tkachenko, Vasilii A. Kachnov, Gennadiy G. Kutelev, Ignat V. Rudchenko, Alexey D. Sobolev
    Annals of the Russian academy of medical sciences.2021; 76(3): 287.     CrossRef
  • Coronavirus Disease 2019 (COVID-19) Infection and Renin Angiotensin System Blockers
    Chirag Bavishi, Thomas M. Maddox, Franz H. Messerli
    JAMA Cardiology.2020; 5(7): 745.     CrossRef
  • COVID-19, ACE2, and the cardiovascular consequences
    Andrew M. South, Debra I. Diz, Mark C. Chappell
    American Journal of Physiology-Heart and Circulatory Physiology.2020; 318(5): H1084.     CrossRef
  • Understanding the renin–angiotensin–aldosterone–SARS-CoV axis: a comprehensive review
    Nicholas E. Ingraham, Abdo G. Barakat, Ronald Reilkoff, Tamara Bezdicek, Timothy Schacker, Jeffrey G. Chipman, Christopher J. Tignanelli, Michael A. Puskarich
    European Respiratory Journal.2020; 56(1): 2000912.     CrossRef
  • Putative contributions of circadian clock and sleep in the context of SARS-CoV-2 infection
    Miguel Meira e Cruz, Masaaki Miyazawa, David Gozal
    European Respiratory Journal.2020; 55(6): 2001023.     CrossRef
  • COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis?
    Massimo Imazio, Karin Klingel, Ingrid Kindermann, Antonio Brucato, Francesco Giuseppe De Rosa, Yehuda Adler, Gaetano Maria De Ferrari
    Heart.2020; 106(15): 1127.     CrossRef
  • Vitamin D receptor stimulation to reduce acute respiratory distress syndrome (ARDS) in patients with coronavirus SARS-CoV-2 infections
    Jose Manuel Quesada-Gomez, Marta Entrenas-Castillo, Roger Bouillon
    The Journal of Steroid Biochemistry and Molecular Biology.2020; 202: 105719.     CrossRef
  • Bloqueantes del sistema renina-angiotensina e infección por COVID-19
    L.M. Ruilope, J.A. Garcia Donaire, A. de la Sierra
    Hipertensión y Riesgo Vascular.2020; 37(3): 99.     CrossRef
  • COVID-19: The Influence of ACE Genotype and ACE-I and ARBs on the Course of SARS-CoV-2 Infection in Elderly Patients


    Jerzy Sieńko, Maciej Kotowski, Anna Bogacz, Kacper Lechowicz, Sylwester Drożdżal, Jakub Rosik, Marek Sietnicki, Magdalena Sieńko, Katarzyna Kotfis
    Clinical Interventions in Aging.2020; Volume 15: 1231.     CrossRef
  • A dissection of SARS‑CoV2 with clinical implications (Review)
    Felician Stancioiu, Georgios Papadakis, Stelios Kteniadakis, Boris Izotov, Michael Coleman, Demetrios Spandidos, Aristidis Tsatsakis
    International Journal of Molecular Medicine.2020; 46(2): 489.     CrossRef
  • Outcomes Associated with the Use of Renin-Angiotensin-Aldosterone System Blockade in Hospitalized Patients with SARS-CoV-2 Infection
    Imran Chaudhri, Farrukh M. Koraishy, Olena Bolotova, Jeanwoo Yoo, Luis A. Marcos, Erin Taub, Haseena Sahib, Michelle Bloom, Sahar Ahmad, Hal Skopicki, Sandeep K. Mallipattu
    Kidney360.2020; 1(8): 801.     CrossRef
  • Coronavirus Disease 2019 and Hypertension: The Role of Angiotensin-Converting Enzyme 2 and the Renin-Angiotensin System
    Daniel L. Edmonston, Andrew M. South, Matthew A. Sparks, Jordana B. Cohen
    Advances in Chronic Kidney Disease.2020; 27(5): 404.     CrossRef
  • Disequilibrium between the classic renin-angiotensin system and its opposing arm in SARS-CoV-2-related lung injury
    Riccardo Sarzani, Federico Giulietti, Chiara Di Pentima, Piero Giordano, Francesco Spannella
    American Journal of Physiology-Lung Cellular and Molecular Physiology.2020; 319(2): L325.     CrossRef
  • COVID-19 and renin-angiotensin system modulators: what do we know so far?
    Angel de la Cruz, Shoaib Ashraf, Timothy J. Vittorio, Jonathan N. Bella
    Expert Review of Cardiovascular Therapy.2020; 18(11): 743.     CrossRef
  • Mortality and Disease Severity Among COVID-19 Patients Receiving Renin-Angiotensin System Inhibitors: A Systematic Review and Meta-analysis
    Syed Shahzad Hasan, Chia Siang Kow, Muhammad Abdul Hadi, Syed Tabish Razi Zaidi, Hamid A. Merchant
    American Journal of Cardiovascular Drugs.2020; 20(6): 571.     CrossRef
  • Renin-Angiotensin System Inhibitors in COVID-19: Current Concepts
    Kunal Mahajan, Prakash Chand Negi, Neeraj Ganju, Sachin Sondhi, Naresh Gaur, Rao Somendra, Tomohiro Katsuya
    International Journal of Hypertension.2020; 2020: 1.     CrossRef
  • Role of Renin-Angiotensin System in Acute Lung Injury Caused by Viral Infection


    Yan-Lei Gao, Yue Du, Chao Zhang, Cheng Cheng, Hai-Yan Yang, Yue-Fei Jin, Guang-Cai Duan, Shuai-Yin Chen
    Infection and Drug Resistance.2020; Volume 13: 3715.     CrossRef
  • Are losartan and imatinib effective against SARS-CoV2 pathogenesis? A pathophysiologic-based in silico study
    Reza Nejat, Ahmad Shahir Sadr
    In Silico Pharmacology.2020;[Epub]     CrossRef
  • Renin–Angiotensin System: An Important Player in the Pathogenesis of Acute Respiratory Distress Syndrome
    Jaroslav Hrenak, Fedor Simko
    International Journal of Molecular Sciences.2020; 21(21): 8038.     CrossRef
  • COVID-19 pandemic: a glimpse into newly diagnosed hypertensive patients
    Ertan Yetkin, Gökay Taylan, Kenan Yalta
    Cardiovascular Endocrinology & Metabolism.2020; 10(1): 1.     CrossRef
Case Reports
Trauma
Long-term extracorporeal membrane oxygenation after severe blunt traumatic lung injury in a child
Ok Jeong Lee, Yang Hyun Cho, Jinwook Hwang, Inae Yoon, Young-Ho Kim, Joongbum Cho
Acute Crit Care. 2019;34(3):223-227.   Published online February 10, 2017
DOI: https://doi.org/10.4266/acc.2016.00472
  • 27,042 View
  • 183 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Managing acute respiratory distress syndrome (ARDS) after severe blunt traumatic lung injury can be challenging. In cases where patients are refractory to conventional therapy, extracorporeal membrane oxygenation (ECMO) should be considered. In addition, the heparin-coated circuit can reduce hemorrhagic complications in patients with multiple traumas. Although prolonged ECMO may be necessary, excellent outcomes are frequently associated. In this study, we report long-term support with venovenous-ECMO applied in a child with severe blunt trauma in Korea. This 10-year-old and 30-kg male with severe blunt thoracic trauma after a car accident developed severe ARDS a few days later, and ECMO was administered for 33 days. Because of pulmonary hemorrhage during ECMO support, heparin was stopped for 3 days and then restarted. He was weaned from ECMO successfully and has been able to run without difficulty for the 2 years since discharge.

Citations

Citations to this article as recorded by  
  • Traumatic main airway rupture successfully rescued by extracorporeal membrane oxygenation: A case report
    Lijun Cao, Jun Xu, Linfeng Tang, Yuli Zhou, Xianhua Xiang
    Experimental and Therapeutic Medicine.2023;[Epub]     CrossRef
  • Extracorporeal membrane oxygenation in trauma patients: a systematic review
    Changtian Wang, Lei Zhang, Tao Qin, Zhilong Xi, Lei Sun, Haiwei Wu, Demin Li
    World Journal of Emergency Surgery.2020;[Epub]     CrossRef
Pulmonary/Cardiology
Successful Use of Extracorporeal Membrane Oxygenation in Diffuse Alveolar Hemorrhage Secondary to Systemic Lupus Erythematosus
Gyu Ho Choi, Mi Il Kang
Korean J Crit Care Med. 2016;31(4):364-368.   Published online November 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00451
  • 8,113 View
  • 135 Download
AbstractAbstract PDF
Diffuse alveolar hemorrhage (DAH) is an uncommon complication in patients with systemic lupus erythematosus (SLE), and mortality remains high. In recent years, cases of DAH due to SLE treated with extracorporeal membrane oxygenation (ECMO) have rarely been reported. The authors present a case of a 43-year-old woman with SLE who had rapidly aggravating dyspnea and hemoptysis. She was diagnosed as having DAH with refractory respiratory failure and was successfully managed with veno-venous ECMO. We propose ECMO as a useful salvage therapy in patients with alveolar hemorrhage secondary to SLE who are failing conventional ventilatory support.

ACC : Acute and Critical Care