Markers of poor outcome in patients with acute hypoxemic respiratory failure

“…Hypoxic respiratory failure is a common condtion in ICU patients, with an incidence of 22-33% 102,103 , depending on the definition (usually the need for mechanical ventilation and/or a PaO 2 /FiO 2 ratio of <300 mmHg 102–104 ), and is associated with a mortality of 31–52% 102–104 . A subcategory of hypoxic respiratory failure is Acute Respiratory Distress Syndrome (ARDS), comprising 3–70% of patients with respiratory failure 102–104 .…”

Section: Hypoxia In Critically Ill Patientsmentioning

confidence: 99%

“…A subcategory of hypoxic respiratory failure is Acute Respiratory Distress Syndrome (ARDS), comprising 3–70% of patients with respiratory failure 102–104 . ARDS severity can be classified according to the Berlin definitions as either mild (200-300 mmHg), moderate (100-200 mmHg), or severe (<100 mmHg), with mortality ranging from 32 to 65% 104–110 . It is important to differentiate between the diagnosis of hypoxic respiratory failure (i.e.…”

Section: Hypoxia In Critically Ill Patientsmentioning

confidence: 99%

Immunologic Consequences of Hypoxia during Critical Illness

et al. 2016

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Hypoxia and immunity are highly intertwined at clinical, cellular, and molecular levels. The prevention of tissue hypoxia and modulation of systemic inflammation are cornerstones of daily practice in the intensive care unit. Potentially, immunologic effects of hypoxia may contribute to outcome and represent possible therapeutic targets. Hypoxia and activation of downstream signaling pathways result in enhanced innate immune responses, aimed to augment pathogen clearance. On the other hand, hypoxia also exerts antiinflammatory and tissue-protective effects in lymphocytes and other tissues. Although human data on the net immunologic effects of hypoxia and pharmacologic modulation of downstream pathways are limited, preclinical data support the concept of tailoring the immune response through modulation of the oxygen status or pharmacologic modulation of hypoxia-signaling pathways in critically ill patients.

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“…Even with modern medical treatment, recent studies have shown that patients suffering from respiratory failure experience a mortality rate of 31-45% [1]- [4], with some reports of morality rates as high as 75% [3], [5]. Mechanical ventilation may be inadequate due to limited mass transfer in the damaged lung, and may even exacerbate the condition by causing overinflation, barotrauma, and cyclic closing and reopening of the alveoli, which can trigger an inflammatory response and multiple system organ failure [6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Peritoneal Microbubble Oxygenation Therapy in a Rabbit Model of Hypoxemia

Legband

Feshitan²,

Borden

et al. 2015

IEEE Trans. Biomed. Eng.

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Abstract-Alternative extrapulmonary oxygenation technologies are needed to treat patients suffering from severe hypoxemia refractory to mechanical ventilation. We previously demonstrated that peritoneal microbubble oxygenation (PMO), in which phospholipid-coated oxygen microbubbles (OMBs) are delivered into the peritoneal cavity, can successfully oxygenate rats suffering from a right pneumothorax. This study addressed the need to scale up the procedure to a larger animal with a splanchnic cardiac output similar to humans. Our results show that PMO therapy can double the survival time of rabbits experiencing complete tracheal occlusion from 6.6 ± 0.6 min for the saline controls to 12.2 ± 3.0 min for the bolus PMO-treated cohort. Additionally, we designed and tested a new peritoneal delivery system to circulate OMBs through the peritoneal cavity. Circulation achieved a similar survival benefit to bolus delivery under these conditions. Overall, these results support the feasibility of the PMO technology to provide extrapulmonary ventilation for rescue of severely hypoxic patients.Index Terms-Acute lung injury (ALI), acute respiratory distress syndrome (ARDS), airway obstruction, extrapulmonary ventilation, oxygen delivery.

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Markers of poor outcome in patients with acute hypoxemic respiratory failure

Cited by 27 publications

References 27 publications

Effects of Sigh on Regional Lung Strain and Ventilation Heterogeneity in Acute Respiratory Failure Patients Undergoing Assisted Mechanical Ventilation*

Effects of Sigh on Regional Lung Strain and Ventilation Heterogeneity in Acute Respiratory Failure Patients Undergoing Assisted Mechanical Ventilation*

Immunologic Consequences of Hypoxia during Critical Illness

Evaluation of Peritoneal Microbubble Oxygenation Therapy in a Rabbit Model of Hypoxemia

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