Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 427
Filtrar
2.
Respirology ; 23(2): 130-137, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29052924

RESUMO

Human coronaviruses (HCoVs) have been considered to be relatively harmless respiratory pathogens in the past. However, after the outbreak of the severe acute respiratory syndrome (SARS) and emergence of the Middle East respiratory syndrome (MERS), HCoVs have received worldwide attention as important pathogens in respiratory tract infection. This review focuses on the epidemiology, pathogenesis and clinical characteristics among SARS-coronaviruses (CoV), MERS-CoV and other HCoV infections.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Humanos , Coronavírus da Síndrome Respiratória do Oriente Médio , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Vírus da SARS , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia
4.
Med. intensiva (Madr., Ed. impr.) ; 41(8): 491-496, nov. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-168428

RESUMO

La ventilación mecánica (VM) es clave en el manejo del síndrome de distrés respiratorio del adulto (SDRA) ya que existe un alto nivel de evidencia de que la ventilación con volúmenes tidales de 6ml/kg (ventilación protectora) mejora la supervivencia. La oxigenación con membrana extracorpórea (ECMO) veno-venosa es una terapia de rescate en el tratamiento de la insuficiencia respiratoria refractaria que mejora la oxigenación, reduce el CO2 y facilita la aplicación de VM protectora, reduciendo potencialmente la lesión pulmonar asociada a VM. Aunque las estrategias ventilatorias en pacientes con SDRA han sido analizadas en numerosos estudios, no existe consenso respecto a cómo ventilar a pacientes con ECMO veno-venosa. El concepto de «lung rest», introducido hace años, carece aún de evidencias para recomendar su uso pero podría promover la recuperación pulmonar y facilitar el destete de la VM. El objetivo de esta revisión es describir las diferentes estrategias de ventilación en pacientes tratados con ECMO veno-venosa (AU)


Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Although numerous trials have investigated different ventilation strategies in patients with ARDS, consensus is lacking on the optimal MV settings during venovenous ECMO. Although the concept of 'lung rest' was introduced years ago, there are no evidence-based guidelines on its use in application to MV in patients supported by ECMO. How MV in ECMO patients can promote lung recovery and weaning from ventilation is not clear. The purpose of this review is to describe the ventilation strategies used during venovenous ECMO in clinical practice (AU)


Assuntos
Humanos , Oxigenação por Membrana Extracorpórea/métodos , Oxigenação por Membrana Extracorpórea , Respiração Artificial/métodos , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/terapia , Lesão Pulmonar/complicações , Ácido Carbônico/uso terapêutico
5.
J Crit Care ; 42: 109-115, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28711861

RESUMO

PURPOSE: This study investigated the availability of relevant structural and human resources needed for the clinical management of patients with severe acute respiratory infections and sepsis in critical care units in Vietnam. MATERIAL AND METHODS: A questionnaire survey was conducted by purposive sampling of 128 hospitals (36% of total hospitals in surveyed provinces), including 25 provincial and 103 district level hospitals, from 20 provinces in Vietnam. Data on availability of hospital characteristics, structural resources and health care workers was then analyzed. RESULTS: Most hospitals (>80%) reported having 60% of the relevant structural resources. Significant differences were observed between provincial hospitals when compared to district hospitals in regards to availability of central oxygen piping system (78.3% vs 38.7%, p=0.001) mechanical ventilation (100.0% vs 73.6%, p=0.003), mobile x-rays (80.0% vs 29.8%, p<0.001), carbapenem antibiotic (73.9% vs 17.4%, p<0.001) and norepinephrine (95.8% vs 56.3%, p<0.001). There was a limited availability of arterial blood gas analyzers (13.7%), oseltamivir (42.2%) and N95 respirators (54.6%) across all hospitals surveyed. CONCLUSIONS: The limited availability of relevant structural and human resources in critical care units around Vietnam makes the implementation of quality critical care to patients with SARI and sepsis, according international guidelines, not universally possible.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Recursos em Saúde/provisão & distribução , Acesso aos Serviços de Saúde/estatística & dados numéricos , Infecções Respiratórias/terapia , Sepse/terapia , Cuidados Críticos/normas , Feminino , Pessoal de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pobreza , Respiração Artificial/estatística & dados numéricos , Síndrome Respiratória Aguda Grave/terapia , Ventiladores Mecânicos/provisão & distribução , Vietnã
7.
Ann Hematol ; 96(5): 879-880, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28213751

Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Imunossupressores/efeitos adversos , Infecções Meningocócicas/fisiopatologia , Neisseria meningitidis Sorogrupo W-135/imunologia , Infecções Oportunistas/fisiopatologia , Microangiopatias Trombóticas/complicações , Síndrome de Waterhouse-Friderichsen/etiologia , Lesão Renal Aguda/complicações , Lesão Renal Aguda/etiologia , Lesão Renal Aguda/imunologia , Lesão Renal Aguda/terapia , Adulto , Antibacterianos/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Ciprofloxacino/uso terapêutico , Terapia Combinada , Coagulação Intravascular Disseminada/complicações , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/terapia , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , Unidades de Terapia Intensiva , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Infecções Meningocócicas/complicações , Infecções Meningocócicas/tratamento farmacológico , Infecções Meningocócicas/microbiologia , Neisseria meningitidis Sorogrupo W-135/efeitos dos fármacos , Neisseria meningitidis Sorogrupo W-135/isolamento & purificação , Infecções Oportunistas/complicações , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/microbiologia , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/etiologia , Síndrome Respiratória Aguda Grave/imunologia , Síndrome Respiratória Aguda Grave/terapia , Choque Séptico/complicações , Choque Séptico/etiologia , Choque Séptico/imunologia , Choque Séptico/terapia , Microangiopatias Trombóticas/etiologia , Microangiopatias Trombóticas/imunologia , Microangiopatias Trombóticas/prevenção & controle , Resultado do Tratamento , Síndrome de Waterhouse-Friderichsen/imunologia , Síndrome de Waterhouse-Friderichsen/microbiologia , Síndrome de Waterhouse-Friderichsen/prevenção & controle , Adulto Jovem
8.
Curr Opin Crit Care ; 23(2): 175-179, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28157820

RESUMO

PURPOSE OF REVIEW: In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. This review provides an overview of these new clinical data and also explores new areas of investigation for HFOV in adults. RECENT FINDINGS: While prior meta-analyses suggested benefit for HFOV, updated systematic reviews published this year, which include two large recent clinical trials, now show no statistically significant impact of HFOV on mortality in adults with ARDS. It is possible that HFOV would be safer and more effective with a more individualized approach to setting mean airway pressure (mPaw). Possible techniques to achieve this include titrating mPaw in response to oxygenation or hemodynamic changes after HFOV initiation, by measuring respiratory system impedance, or by following echocardiographic changes. SUMMARY: Although not first-line, HFOV remains a tool in the armamentarium of the intensivist managing the patient with severe ARDS and refractory hypoxemia. A refinement in the approach to delivering HFOV is warranted, with more attention paid to its adverse hemodynamic consequences.


Assuntos
Ventilação de Alta Frequência , Síndrome Respiratória Aguda Grave/terapia , Hemodinâmica , Humanos , Resultado do Tratamento
9.
Neumol. pediátr. (En línea) ; 12(1): 23-27, ene. 2017.
Artigo em Espanhol | LILACS | ID: biblio-869152

RESUMO

Mechanical ventilation (MV) is a usual therapy for the management of critically ill children. However its inappropriate use can produce lung injury. Today, the evidence recommends protective ventilation such as strategie low tidal volumes (VT) that minimize injury and thus, high frequency oscillatory ventilation (HFOV) would have a theoretical role. HFOV allows gas exchange using low tidal volumes (1 – 2 ml/kg) and supraphysiologic respiratory frequencies. In pediatrics it comprises 3 – 30 percent of mechanically ventilated patients, most of the time as a rescue therapy in refractory respiratory failure cases where conventional mechanical ventilation fails. Many aspects of HFVO in children remain unclear, theoretical benefits has no solid clinical basis, when is the best time to initiate (early vs rescue mode), which are the optimal settings, and how to monitor lung mechanics. This review examines HFVO theoretical bases, suggest recommendations for its use and considers the available evidence to understand the aspects that are still unclear.


La ventilación mecánica (VM) constituye un apoyo frecuente en el manejo de niños críticamente enfermos, quienes pueden requerirla por diferentes etiologías, entre ellas el síndrome de dificultad respiratoria aguda (SDRA). Sabemos que a pesar de ser un soporte vital, su uso inapropiado puede producir daño inducido por ventilación mecánica (DIVM). En la actualidad, la evidencia recomienda las estrategias de “ventilación protectora”, bajos volúmenes corrientes, que minimicen este daño y es ahí donde la ventilación de alta frecuencia oscilatoria (VAFO) tendría un rol teórico. La VAFO permite el intercambio gaseoso usando pequeños volúmenes corrientes (VT) 1-2 ml /kg y frecuencias respiratorias supra fisiológicas, con la consiguiente disminución del riesgo de atelectrauma, manteniendo el “pulmón abierto” y en la zona de seguridad de la curva presión-volumen. Su uso en pediatría oscila entre el 3 y el 30 por ciento de los pacientes ventilados, la mayoría de las veces como terapia de rescate frente a la falla de la ventilación convencional (VMC) en insuficiencia respiratoria refractaria. Muchos aspectos de la VAFO en pediatría no han sido totalmente esclarecidos; su efecto protector teórico permanece aún sin bases sólidas en el escenario clínico, quienes se benefician de su uso, cuál es el mejor momento para iniciarla (temprana o rescate), cuales son los valores óptimos del oscilador y como monitorear la mecánica pulmonar en VAFO. La presente revisión pretende repasar los conceptos teóricos de la VAFO, formular recomendaciones para su uso y considerar la evidencia disponible que nos permitan dilucidar las interrogantes antes mencionadas.


Assuntos
Humanos , Criança , Síndrome Respiratória Aguda Grave/terapia , Ventilação de Alta Frequência/métodos , Lesão Pulmonar Induzida por Ventilação Mecânica/etiologia , Monitorização Fisiológica , Seleção de Pacientes , Ventilação de Alta Frequência/efeitos adversos
10.
Perfusion ; 32(2): 168-170, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27511946

RESUMO

Haemolysis, thrombosis and haemorrhage are well-documented complications of extracorporeal membrane oxygenation. This case report outlines an unusual case of haemolysis, thought secondary to a large mobile thrombus in the inferior vena cava.


Assuntos
Oxigenação por Membrana Extracorpórea/efeitos adversos , Hemólise , Trombose/etiologia , Veia Cava Inferior/patologia , Adulto , Oxigenação por Membrana Extracorpórea/métodos , Hemoglobinas/análise , Humanos , Masculino , Síndrome Respiratória Aguda Grave/sangue , Síndrome Respiratória Aguda Grave/complicações , Síndrome Respiratória Aguda Grave/patologia , Síndrome Respiratória Aguda Grave/terapia , Trombose/sangue , Trombose/patologia
12.
Euro Surveill ; 21(48)2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27934581

RESUMO

In October 2016, a severe infection with swine influenza A(H1N1) virus of the Eurasian avian lineage occurred in a child with a previous history of eczema in the Netherlands, following contact to pigs. The patient's condition deteriorated rapidly and required life support through extracorporeal membrane oxygenation. After start of oseltamivir treatment and removal of mucus plugs, the patient fully recovered. Monitoring of more than 80 close unprotected contacts revealed no secondary cases.


Assuntos
Oxigenação por Membrana Extracorpórea , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/diagnóstico , Infecções Respiratórias/virologia , Síndrome Respiratória Aguda Grave/terapia , Animais , Antivirais/uso terapêutico , Humanos , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Unidades de Terapia Intensiva Pediátrica , Países Baixos , Infecções por Orthomyxoviridae/transmissão , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/virologia , Oseltamivir/uso terapêutico , Reação em Cadeia da Polimerase em Tempo Real , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/tratamento farmacológico , Síndrome Respiratória Aguda Grave/complicações , Suínos , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologia , Resultado do Tratamento
13.
Int J Artif Organs ; 39(5): 249-52, 2016 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-27338282

RESUMO

INTRODUCTION: Data on prolonged extracorporeal membrane oxygenation (ECMO) usage in influenza associated acute respiratory distress syndrome (ARDS) are lacking. Furthermore, no consensus exists on when to terminate ECMO treatment in refractory cases. This report highlights additional treatment measures and complications in prolonged ECMO therapy and discusses associated ethical burdens. CASE REPORT: We report on a 64-year-old man with confirmed H1N1 influenza virus infection who was successfully weaned from 65-day ECMO treatment with an excellent outcome. CONCLUSIONS: Our experience suggests that prolonged ECMO therapy may be provided as long as only 1-organ failure exists and no lung fibrosis occurs. Active physical therapy, facilitated by ECMO treatment, is crucial and should be performed as early as possible.


Assuntos
Oxigenação por Membrana Extracorpórea , Influenza Humana/complicações , Síndrome Respiratória Aguda Grave/terapia , Expiração , Humanos , Vírus da Influenza A Subtipo H1N1 , Masculino , Pessoa de Meia-Idade , Síndrome Respiratória Aguda Grave/etiologia , Resultado do Tratamento
14.
Ann Biol Clin (Paris) ; 74(1): 117-20, 2016 Jan-Feb.
Artigo em Francês | MEDLINE | ID: mdl-26878616

RESUMO

Corynebacterium ulcerans is a bacterium able to infect humans by inducing a disease close to diphtheria. We describe the case of a 83-year-old patient hospitalized as a matter of urgency in intensive care for which C. ulcerans was isolated in pure culture in its bronchial samples. Even if the isolate was not secreting toxin in vitro, it possesses the tox gene which motivated the use of specific antitoxin serum. After two months of intensive care the patient went out of the service. It is about a remarkable case of clinicobiologic collaboration.


Assuntos
Infecções por Corynebacterium/complicações , Corynebacterium/isolamento & purificação , Atelectasia Pulmonar/microbiologia , Infecções Respiratórias/microbiologia , Síndrome Respiratória Aguda Grave/microbiologia , Idoso de 80 Anos ou mais , Cuidados Críticos , Feminino , Humanos , Atelectasia Pulmonar/terapia , Infecções Respiratórias/terapia , Síndrome Respiratória Aguda Grave/terapia
15.
Intensive Care Med ; 42(5): 817-828, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26880091

RESUMO

PURPOSE: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). METHODS: All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. RESULTS: Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk. CONCLUSIONS: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.


Assuntos
Síndrome Respiratória Aguda Grave/terapia , Fatores Etários , Idoso , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/microbiologia , Síndrome Respiratória Aguda Grave/mortalidade , Índice de Gravidade de Doença
16.
Mycopathologia ; 181(3-4): 267-71, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26455910

RESUMO

Pseudallescheria boydii is a fungal organism known to affect immunocompromised patients. This organism is known to cause, in severe cases, invasive infection of various organs such as the central nervous, cardiovascular, and respiratory systems. We report an unusual case of pulmonary P. boydii pneumonia in an immunocompromised critically ill patient with a co-infection of Aspergillus fumigatus and Aspergillus terreus with ARDS. This case highlights the importance of a high index of suspicion for superimposed fungal infections in patients who are critically ill and immunocompromised. Uncommon fungal pathogens should be considered in the differential diagnosis of respiratory failure, especially if diagnostic markers such as galactomannan (from BAL and serum) or 1,3-beta-D-glucan are elevated. Further diagnostic interventions are warranted when insufficient clinical improvement is observed to prevent treatment failure and adverse outcomes.


Assuntos
Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergillus fumigatus/isolamento & purificação , Coinfecção/tratamento farmacológico , Hospedeiro Imunocomprometido , Pneumonia/tratamento farmacológico , Pseudallescheria/isolamento & purificação , Transplantados , Idoso , Anfotericina B/uso terapêutico , Aspergilose/diagnóstico , Claritromicina/uso terapêutico , Coinfecção/microbiologia , Estado Terminal/terapia , Oxigenação por Membrana Extracorpórea , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Linezolida/uso terapêutico , Masculino , Mananas/sangue , Meropeném , Pneumonia/microbiologia , Pseudallescheria/efeitos dos fármacos , Síndrome Respiratória Aguda Grave/mortalidade , Síndrome Respiratória Aguda Grave/terapia , Tienamicinas/uso terapêutico , Voriconazol/uso terapêutico , beta-Glucanas/sangue
17.
Health Expect ; 19(3): 762-72, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-25220505

RESUMO

BACKGROUND: Although SARS had been with a controversial topic for a decade at the time of this study, numerous SARS survivors had not yet physically, psychologically or socially recovered from the aftermath of SARS. Among chronically ill patients, the use of complementary and alternative medicine (CAM) is reported to be widespread. However, extremely little is known about the use of CAM by SARS survivors in the post-SARS period and even less is known about how the use of CAM is related to the unpleasant social and medical-treatment experiences of SARS survivors, their eagerness to re-establish social networks, and their awareness to prepare for future epidemics. OBJECTIVE: To investigate the motivations for practising tai chi among SARS survivors in post-SARS Hong Kong. DESIGN, SETTING AND PARTICIPANTS: Using a qualitative approach, I conducted individual semi-structured interviews with 35 SARS survivors, who were purposively sampled from a tai chi class of a SARS-patient self-help group in Hong Kong. RESULTS: Health concerns and social experiences motivated the participants to practise tai chi in post-SARS Hong Kong. Experiencing health deterioration in relation to SARS-associated sequelae, coping with unpleasant experiences during follow-up biomedical treatments, a desire to regain an active role in recovery and rehabilitation, overcoming SARS-associated stigmas by establishing a new social network and preparing for potential future stigmatization and discrimination were the key motivators for them. CONCLUSION: The participants practised tai chi not only because they sought to improve their health but also because it provided a crucial social function and meaning to them.


Assuntos
Motivação , Síndrome Respiratória Aguda Grave/psicologia , Síndrome Respiratória Aguda Grave/terapia , Sobreviventes/psicologia , Tai Ji/psicologia , Adaptação Psicológica , Adulto , Atitude Frente a Saúde , Comorbidade , Epidemias , Feminino , Hong Kong , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Relações Profissional-Paciente , Recuperação de Função Fisiológica , Estigma Social , Tai Ji/métodos , Adulto Jovem
19.
Stem Cells Transl Med ; 4(10): 1199-213, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26285659

RESUMO

UNLABELLED: Mesenchymal stromal cells (MSCs) have been investigated as a treatment for various inflammatory diseases because of their immunomodulatory and reparative properties. However, many basic questions concerning their mechanisms of action after systemic infusion remain unanswered. We performed a detailed analysis of the immunomodulatory properties and proteomic profile of MSCs systemically administered to two patients with severe refractory acute respiratory distress syndrome (ARDS) on a compassionate use basis and attempted to correlate these with in vivo anti-inflammatory actions. Both patients received 2×10(6) cells per kilogram, and each subsequently improved with resolution of respiratory, hemodynamic, and multiorgan failure. In parallel, a decrease was seen in multiple pulmonary and systemic markers of inflammation, including epithelial apoptosis, alveolar-capillary fluid leakage, and proinflammatory cytokines, microRNAs, and chemokines. In vitro studies of the MSCs demonstrated a broad anti-inflammatory capacity, including suppression of T-cell responses and induction of regulatory phenotypes in T cells, monocytes, and neutrophils. Some of these in vitro potency assessments correlated with, and were relevant to, the observed in vivo actions. These experiences highlight both the mechanistic information that can be gained from clinical experience and the value of correlating in vitro potency assessments with clinical effects. The findings also suggest, but do not prove, a beneficial effect of lung protective strategies using adoptively transferred MSCs in ARDS. Appropriate randomized clinical trials are required to further assess any potential clinical efficacy and investigate the effects on in vivo inflammation. SIGNIFICANCE: This article describes the cases of two patients with severe refractory adult respiratory syndrome (ARDS) who failed to improve after both standard life support measures, including mechanical ventilation, and additional measures, including extracorporeal ventilation (i.e., in a heart-lung machine). Unlike acute forms of ARDS (such in the current NIH-sponsored study of mesenchymal stromal cells in ARDS), recovery does not generally occur in such patients.


Assuntos
Transplante de Células-Tronco Mesenquimais , Síndrome Respiratória Aguda Grave/terapia , Adulto , Aloenxertos , Cateterismo Venoso Central , Células Cultivadas , Terapia Combinada , Ensaios de Uso Compassivo , Epitélio/patologia , Vesículas Extracelulares , Oxigenação por Membrana Extracorpórea , Histocompatibilidade , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/terapia , Doadores Vivos , Pulmão/patologia , Teste de Cultura Mista de Linfócitos , Masculino , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/química , MicroRNAs/sangue , Pessoa de Meia-Idade , Células Mieloides/imunologia , Proteoma , Terapia de Salvação , Síndrome Respiratória Aguda Grave/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA