Incidence and short-term outcome of acute lung injury in mechanically ventilated children

Dahlem, Peter; Aalderen, W. M. C. van; Hamaker, Marije E.; Dijkgraaf, M.G.W.; Bos, Albert P.

doi:10.1183/09031936.03.00003303

Cited by 114 publications

(92 citation statements)

References 39 publications

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“…Some of these findings, such as bronchiolitis involving alveolar hypoventilation by obstructive atelectasis and air trapping, may be explained by structural features of the infant lung, such as relatively small airway caliber and poor collateral ventilation. hRSV-infected infants are at risk for respiratory failure, a feature that results from the development of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), which are acute-onset inflammatory conditions characterized by severe hypoxemia (Pa O 2 /FI O 2 ratio Ͻ300 mmHg for ALI; Ͻ200 mmHg for ARDS) and bilateral lung infiltrates in the setting of a normal cardiac preload (30,50,106). In addition to these acute symptoms, young children may also experience delayed sequelae of hRSV disease, specifically, recurrent wheezing with airway hyperreactivity in later childhood (88).…”

Section: Human Rsv Disease: What To Model?mentioning

confidence: 99%

Animal models of human respiratory syncytial virus disease

Reinout

Domachowske

Rosenberg

2011

American Journal of Physiology-Lung Cellular and Molecular Phys

173

228

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Bem RA, Domachowske JB, Rosenberg HF. Animal models of human respiratory syncytial virus disease. Am J Physiol Lung Cell Mol Physiol 301: L148 -L156, 2011. First published May 13, 2011; doi:10.1152/ajplung.00065.2011.-Infection with the human pneumovirus pathogen, respiratory syncytial virus (hRSV), causes a wide spectrum of respiratory disease, notably among infants and the elderly. Laboratory animal studies permit detailed experimental modeling of hRSV disease and are therefore indispensable in the search for novel therapies and preventative strategies. Present animal models include several target species for hRSV, including chimpanzees, cattle, sheep, cotton rats, and mice, as well as alternative animal pneumovirus models, such as bovine RSV and pneumonia virus of mice. These diverse animal models reproduce different features of hRSV disease, and their utilization should therefore be based on the scientific hypothesis under investigation. The purpose of this review is to summarize the strengths and limitations of each of these animal models. Our intent is to provide a resource for investigators and an impetus for future research. respiratory virus; pneumovirus; rodent; inflammation Human RSV Disease: Why Model?Human respiratory syncytial virus (hRSV) is among the most important respiratory pathogens in young children worldwide. hRSV infection and transmission result in community outbreaks with peak activity during the winter months in areas with temperate climates, whereas hRSV disease activity is observed on a more continuous basis throughout the year in tropical regions (119). In a recent evaluation of the global burden of hRSV-associated acute lower respiratory tract disease (LRTD), Nair and colleagues (82) noted that, each year, over 33 million children under the age of 5 yr are affected by this disease, leading to over 3 million hospitalizations and almost 200,000 deaths. The annual costs of health care associated with hRSV infection among children in the US alone are over $600 million (86). In addition, a growing body of evidence suggests that hRSV infection results in substantial morbidity among the elderly and in adults with underlying chronic illnesses, further highlighting both the healthcare-related and economic burden of hRSV disease (44).At this writing, there is no licensed vaccine for hRSV, and there are no specific treatment options for severe disease. There is presently no clear evidence supporting the routine use of the antiviral ribavirin (114), inhaled or systemic corticosteroids (12, 87), or bronchodilators (47) as mainstays of acute therapy in nonimmunosuppressed infants and children. The humanized monoclonal anti-RSV F protein, palivizumab, is approved for prophylactic use in high-risk infants only (41, 72), and thus this modality does not presently address the burden of disease among those with no apparent risk factors (55).Modeling human hRSV disease in vivo is an indispensable step in the search for novel therapies and preventive measures for hRSV disease. Animal models provide for t...

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Section: Human Rsv Disease: What To Model?mentioning

confidence: 99%

Animal models of human respiratory syncytial virus disease

Reinout

Domachowske

Rosenberg

2011

American Journal of Physiology-Lung Cellular and Molecular Phys

173

228

View full text Add to dashboard Cite

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“…Published ARDS attributable mortality in children is lower than in adults (18-27%); however, Australian data suggested that PARDS attributable mortality may be similar to adults (35%) 12,[15][16][17][18] .…”

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confidence: 99%

High frequency oscillatory ventilation versus conventional mechanical ventilation in pediatric acute respiratory distress syndrome: A randomized controlled study

et al. 2017

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Although the HFO mode appeared to be a safe mode with a significant better oxygenation improvement (after the first 24 hours) and fewer crossover rates, it failed to show differences as regards mortality or LOS when compared to the CMV adopting protective lung strategy. In PARDS, HFO had a superior advantage in improving oxygenation, yet with no significant mortality improvement, as multi-organ dysfunction syndrome (MODS) was the most common cause of death in our study and not refractory hypoxemia which is the main problem in PARDS; highlighting that mortality in PARDS is multi-factorial and may not depend only on how fast oxygenation improves.

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“…1 Mechanical ventilation strategies are continuously evolving but never more so than following the American-European Consensus Conference, ARDSNet lung protective recommendations. 2 These lung protective ventilation strategies (LPVS) were developed post large, multi-site randomised trials in adults.…”

Section: Introductionmentioning

confidence: 99%

“…4 Ultimately, irrespective of how gently we treat the paediatric lung, iatrogenic harm still occurs. 1 Lung recruitment is considered an adjunct to LPVS and in part addresses the chronic derecruitment that occurs secondary to low tidal volume ventilation. 5,6 This chronic derecruitment coupled with the acute derecruitment that occurs with each circuit disconnection contributes to the incidence of VILI.…”

Section: Introductionmentioning

confidence: 99%