Veno–veno–arterial extracorporeal membrane oxygenation for acute respiratory distress syndrome with septic-induced cardiomyopathy due to severe pulmonary tuberculosis

Lee, Seok In; Hwang, Hyun Joong; Lee, So Young; Choi, Chang Hyu; Park, Chul-Hyun; Park, Kook Yang; Kim, Yu Jin

doi:10.1007/s10047-017-0982-5

Cited by 13 publications

(12 citation statements)

References 15 publications

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“…Both are common and highly lethal and have significant negative effects on survivors [20]. Sepsis-induced ARDS has an estimated incidence of over 40% and is the leading cause of ARDS death [21]. ARDS is a life-threatening complication featured by diffuse alveolar damage [22].…”

Section: Discussionmentioning

confidence: 99%

“…As a complex pathological process, ARDS is regulated by transcription factors as well as miRNA. A miRNA is a small endogenous non-coding RNA molecule that includes approximately [18][19][20][21][22][23][24] nucleotides. It usually complements sites in the 3' untranslated region of the target messenger RNA for inhibiting the expression of post-transcriptional gene [8].…”

Section: Introductionmentioning

confidence: 99%

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miR-146b-3p regulates PI3K/AKT signaling pathway in septic mice with acute respiratory distress syndrome

Liu¹,

Zhu²,

Jin³

et al. 2020

Preprint

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Background: This study aimed to explore the effect of miR-146b-3p on acute respiratory distress syndrome in septic mice by regulating PI3K/AKT signaling pathway. Methods: Seventy C57BL/6 mice were divided into normal group ( n = 10) and modeling group ( n = 60, mice for constructing septic mice models with acute respiratory distress syndrome). Model mice were subdivided into model group (without any treatment), negative control (NC) mimic group (injection with miRNA NC), miR-146b-3p mimic group (injection with miR-146b-3p mimic), si-NC group (injection with PI3Kγ siRNA NC), si-PI3Kγ group (injection with PI3Kγ interference sequence), and miR-146b-3p mimic + oe-PI3Kγ group (injection with miR-146b-3p mimic + PI3Kγ overexpression plasmid). Dual-luciferase reporter assay was conducted to determine the target relationship between miR-146b-3p and PI3Kγ. Wet weight/dry weight (W/D) ratio of the left lung was measured. Hematoxylin and eosin stain was used to detect the pathological change of mouse lung. ELISA was employed to measure serum interleukin (IL) -1β and IL-18 levels. miR-146b-3p and PI3Kγ expressions were detected by qRT-PCR. PI3Kγ, AKT, NLRP3, apoptosis-associated speck-like protein caspase recruitment domain (ASC) and Caspase-1 protein expressions were detected by Western blotting. Results: miR-146b-3p negatively regulated PI3Kγ. The lung tissues in other groups compared with normal group had down-regulated miR-146b-3p, up-regulated PI3Kγ, p-AKT, ASC, NLRP3 and Caspase-1 proteins, higher W/D ratio, and more serum IL-1β and IL-18 (all P < 0.05). All indicators in miR-146b-3p mimic group and si-PI3Kγ group were significantly improved as compared to model group (all P < 0.05). Up-regulated PI3Kγ, p-AKT, ASC, NLRP3 and Caspase-1 proteins and higher W/D ratio and IL-1β and IL-18 levels in serum existed in miR-146b-3p mimic + oe-PI3Kγ group compared with miR-146b-3p mimic group (all P < 0.05). Conclusions: Up-regulation of miR-146b-3p can restrain PI3K/AKT signaling pathway, thereby improving acute respiratory distress syndrome in septic mice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

miR-146b-3p regulates PI3K/AKT signaling pathway in septic mice with acute respiratory distress syndrome

Liu¹,

Zhu²,

Jin³

et al. 2020

Preprint

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“…In the present case, the pathophysiology of TB may be disseminated, since the onset of clinical symptoms, including dyspnea, was acute, and CT images of disease onset showed diffuse consolidation shadows in both lungs without focal signs at the initial stage. In addition, a report of patient with ARDS and septic-induced cardiomyopathy secondary to pulmonary TB with the veno-veno-arterial (VVA) ECMO indicated that blood gas exchange was recovered slowly, while cardiac function was recovered within 10 days from the initiation of VVA-ECMO and the patient weaned ECMO at 28 days [16]. This result inferred the difficulty of recovering the respiratory function for patient with TB if the lung destruction has been occurred [16].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a report of patient with ARDS and septic-induced cardiomyopathy secondary to pulmonary TB with the veno-veno-arterial (VVA) ECMO indicated that blood gas exchange was recovered slowly, while cardiac function was recovered within 10 days from the initiation of VVA-ECMO and the patient weaned ECMO at 28 days [16]. This result inferred the difficulty of recovering the respiratory function for patient with TB if the lung destruction has been occurred [16]. However, the present case had the less lung destruction.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis-induced acute respiratory distress syndrome treated with veno-venous extracorporeal membrane oxygenation

Binh

Manabe

et al. 2019

Respiratory Medicine Case Reports

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Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS) with a high mortality. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be an alternative option for treating TB-induced ARDS. However, the literature on TB-induced ARDS treated with VV-ECMO is limited and the most of them were prolonged therapy. We report on a-48-year-old man with TB-induced ARDS who was successfully treated by short-term use of VV-ECMO (5 days). He was developed symptoms and hospitalized with severe dyspnea in a local hospital for 3 days before admission to our hospital. At the time when he was transferred to our hospital, his chest computed tomography showed bilateral, diffuse and consolidative shadows all over the lungs, the ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO 2 /FiO 2 ) was 50 mmHg, and respiratory system compliance was 12.5 mL/cmH 2 O. Two days after admission, Mycobacterium tuberculosis was detected by a sputum smear examination and he was diagnosed with TB-induced ARDS. VV-ECMO support was then initiated with administration of anti-TB drugs and systemic corticosteroid treatment. On the 4 th day of ECMO support, his PaO 2 /FiO 2 increased to 400 mmHg and lung compliance increased to 45 mL/cmH 2 O. He was weaned from ECMO on the 5th day of ECMO support and was extubated at the 8th day. He was discharged from hospital on the 47th hospitalized day and continued anti-TB medication at home. VV-ECMO is effective for TB-induced ARDS even in short-term administration if progression of ARDS is rapid.

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“…It is reported that the survival was better when supported by ECPELLA system than ECMO support alone in 30-day mortality in patients with refractory cardiogenic shock [34]. In cases with advanced pulmonary congestion and pulmonary oxygenation disorders, the Veno-veno-arterial ECMO system is preferable to VA-ECMO to prevent hypoxic blood perfusion to the brain through Impella [35].…”

Section: Ecpella (Ecmo Plus Impella)mentioning

confidence: 99%

Current indication and practical management of percutaneous left ventricular assist device support therapy in Japan

Imamura

Ueno

Kinugawa

2020

Journal of Cardiology

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Impella (Abiomed, Danvers, MA, USA) is a recently-innovated (commercially available from 2017 in Japan) percutaneous left ventricular assist device which is inserted percutaneously and transfers blood from the left ventricle to the ascending aorta, improving systemic circulation and end-organ dysfunction as well as unloading left ventricle in patients with cardiogenic shock. Impella has not yet shown a significant survival benefit in patients with cardiogenic shock compared to intra-aortic balloon pump in randomized control trials, but gives powerful circulatory support immediately with minimally invasive manner when used in appropriate patients at optimal timing with adequate management. In this review article, we will introduce and discuss optimal and practical management of Impella therapy in Japan.

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Veno–veno–arterial extracorporeal membrane oxygenation for acute respiratory distress syndrome with septic-induced cardiomyopathy due to severe pulmonary tuberculosis

Cited by 13 publications

References 15 publications

miR-146b-3p regulates PI3K/AKT signaling pathway in septic mice with acute respiratory distress syndrome

miR-146b-3p regulates PI3K/AKT signaling pathway in septic mice with acute respiratory distress syndrome

Tuberculosis-induced acute respiratory distress syndrome treated with veno-venous extracorporeal membrane oxygenation

Current indication and practical management of percutaneous left ventricular assist device support therapy in Japan

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