Mihkel Pindus, H. Orru, M. Maasikmets, M. Kaasik, R. Jõgi
{"title":"Association Between Health Symptoms and Particulate Matter from Traffic and Residential Heating − Results from RHINE III in Tartu","authors":"Mihkel Pindus, H. Orru, M. Maasikmets, M. Kaasik, R. Jõgi","doi":"10.2174/1874306401610010058","DOIUrl":"https://doi.org/10.2174/1874306401610010058","url":null,"abstract":"Background: Traffic and residential heating are the main sources of particulate matter (PM) in Northern Europe. Wood is widely used for residential heating and vehicle numbers are increasing. Besides traffic exhaust, studded tires produce road dust that is the main source of traffic-related PM10. Several studies have associated total PM mass with health symptoms; however there has been little research on the effects of PM from specific sources. Objective: To study the health effects resulting from traffic and local heating PM. Methods: Data on respiratory and cardiac diseases were collected within the framework of RHINE III (2011/2012) in Tartu, Estonia. Respondents’ geocoded home addresses were mapped in ArcGIS and linked with local heating-related PM2.5, traffic-related PM10 and total PM2.5 concentrations. Association between self-reported health and PM was assessed using multiple logistic regression analysis. Results: The annual mean modelled exposure for local heating PM2.5 was 2.3 μg/m3, for traffic PM10 3.3 μg/m3 and for all sources PM2.5 5.6 μg/m3. We found relationship between traffic induced PM10 as well as all sources induced PM2.5 with cardiac disease, OR=1.45 (95% CI 1.06−1.93) and 1.42 (95% CI 1.02−1.95), respectively. However, we did not find any significant association between residential heating induced particles and self-reported health symptoms. People with longer and better confirmed exposure period were also significantly associated with traffic induced PM10, all sources induced PM2.5 and cardiac diseases. Conclusion: Traffic-related PM10 and all sources induced PM2.5 associated with cardiac disease; whereas residential heating induced particles did not.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 1","pages":"58 - 69"},"PeriodicalIF":0.0,"publicationDate":"2016-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lung Function Monitoring; A Randomized Agreement Study.","authors":"Sveinung Berntsen, Solvor B Stølevik, Petter Mowinckel, Wenche Nystad, Trine Stensrud","doi":"10.2174/1874306401610010051","DOIUrl":"https://doi.org/10.2174/1874306401610010051","url":null,"abstract":"Objective: To determine the agreement between devices and repeatability within devices of the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and forced expiratory flow at 50% of FVC (FEF50) values measured using the four spirometers included in the study. Methods: 50 (24 women) participants (20-64 years of age) completed maximum forced expiratory flow manoeuvres and measurements were performed using the following devices: MasterScreen, SensorMedics, Oxycon Pro and SpiroUSB. The order of the instruments tested was randomized and blinded for both the participants and the technicians. Re-testing was conducted on a following day within 72 hours at the same time of the day. Results: The devices which obtained the most comparable values for all lung function variables were SensorMedics and Oxycon Pro, and MasterScreen and SpiroUSB. For FEV1, mean difference was 0.04 L (95% confidence interval; -0.05, 0.14) and 0.00 L (-0.06, 0.06), respectively. When using the criterion of FVC and FEV1 ≤ 0.150 L for acceptable repeatability, 67% of the comparisons of the measured lung function values obtained by the four devices were acceptable. Overall, Oxycon Pro obtained most frequently values of the lung function variables with highest precision as indicated by the coefficients of repeatability (CR), followed by MasterScreen, SensorMedics and SpiroUSB (e.g. min-max CR for FEV1; 0.27-0.46). Conclusion: The present study confirms that measurements obtained by the same device at different times can be compared; however, measured lung function values may differ depending on spirometers used.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 ","pages":"51-7"},"PeriodicalIF":0.0,"publicationDate":"2016-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/e3/TORMJ-10-51.PMC4981697.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34408015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pilot Study of a New Adjustable Thermoplastic Mandibular Advancement Device for the Management of Obstructive Sleep Apnoea-Hypopnoea Syndrome: A Brief Research Letter.","authors":"Mohammed El Ibrahimi, Mounir Laabouri","doi":"10.2174/1874306401610010046","DOIUrl":"https://doi.org/10.2174/1874306401610010046","url":null,"abstract":"<p><strong>Background: </strong>Prefabricated adjustable thermoplastic mandibular advancement devices (PAT-MADs) are a practical short-term treatment for obstructive sleep apnoea-hypopnoea syndrome (OSAHS) in patients who have failed or refused continuous positive airway pressure (CPAP) therapy.</p><p><strong>Objective: </strong>To assess the effectiveness of a new professionally-fitted PAT-MAD in patients with OSAHS in Morocco.</p><p><strong>Method: </strong>Twenty-four adults with mild, moderate or severe OSAHS were fitted with the PAT-MAD (BluePro(®); BlueSom, France). Respiratory parameters (apnoea-hypopnoea index (AHI), oxygen desaturation index (ODI)) and daytime sleepiness using the Epworth Sleepiness scale (ESS) were assessed before and after treatment. Adverse events were recorded.</p><p><strong>Results: </strong>Mean treatment duration was 106.3 ± 73.4 days. Mean AHI score decreased from 21.4 ± 7.4 to 9.3 ± 4.1 after treatment (p<0.0001) (mean reduction of 57.0 ± 12.3%). Mean ESS and ODI also decreased at EOS (from 10.4 ± 2.8 to 7.3 ± 2.3, mean reduction 30.3 ± 12.2%, p=0.0001; and 7.0 ± 6.9 to 4.7 ± 4.0, mean reduction 30.5 ± 25.0%, p=0.2, respectively). Treatment was considered to have been successful in 22 patients (91.7%) who had mild OSAHS or an AHI score of ≤5 at the end of the study. The device was well-tolerated.</p><p><strong>Conclusion: </strong>This new PAT-MAD appears to be effective at reducing respiratory parameters and improving daytime alertness in patients with OSAHS. Long term studies in a larger number of patients are warranted to assess the long-term efficacy, retention and side-effects of this device.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 ","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2016-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401610010046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34738152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leyla Sahebi, Khalil Ansarin, Parviz Mohajeri, Majid Khalili, Amir Monfaredan, Safar Farajnia, Simin Khayyat Zadeh
{"title":"Patterns of Drug Resistance Among Tuberculosis Patients in West and Northwestern Iran.","authors":"Leyla Sahebi, Khalil Ansarin, Parviz Mohajeri, Majid Khalili, Amir Monfaredan, Safar Farajnia, Simin Khayyat Zadeh","doi":"10.2174/1874306401610010029","DOIUrl":"https://doi.org/10.2174/1874306401610010029","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is the leading cause of morbidity and mortality among chronic infectious diseases.</p><p><strong>Objective: </strong>The goal of this cross-sectional study (2011-2013;2013) was to examine the patterns of TB drug resistance among HIV-negative pulmonary TB patients in regions near the Iranian border.</p><p><strong>Method: </strong>To this end, MTB isolates were harvested from 300 HIV-negative, pulmonary smear-positive TB patients from the northwest and west Iranian border provinces. Isolates were subjected to first and second-line drug susceptibility testing by the 1% proportion method. Demographic and clinical data were provided using a questionnaire and information from patient records. Results were analyzed using SPSS-18.</p><p><strong>Results: </strong>The mean age of the patients was 52.03 years and 54.3% were male. The prevalence of resistance to any TB drug was 13.6% (38 cases). Eleven percent of the new treatment TB group (28 patients) and 40.7% of the retreatment TB group (11 patients) were resistant to all TB drugs. Twelve (4.3%) patients had multidrug-resistant tuberculosis (MDR-TB) (2.38% in the new TB treatment group and 23.1% in the retreatment group). One patient had extensively drug-resistant tuberculosis (XDR-TB). There was a statistically significant relationship between TB drug resistance and smoking (p=0.02) and a history of migration from village to city (p=0.04), also between TB drug resistance and recurrence of TB in patients that had previously received treatment (p<0.001).</p><p><strong>Conclusion: </strong>Knowledge of drug resistance patterns for new and previously treated cases is critical for effective control of MDR-TB in different regions of the country. The burden of MDR-TB in retreatment cases was high. Previous TB treatment was one of the most important mokers and those who had a history of rural to urban migration were at high risk for the occurrence of TB drug resistance.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 ","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/bf/TORMJ-10-29.PMC4992749.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34408014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seo W Kim, Hunam Kim, Yon J Ryu, Jin H Lee, Sung S Shim, Yoo K Kim, Jung H Chang
{"title":"Efficacy and Safety of Modified Pranlukast (Prakanon(®)) Compared with Pranlukast (Onon(®)): A Randomized, Open-Label, Crossover Study.","authors":"Seo W Kim, Hunam Kim, Yon J Ryu, Jin H Lee, Sung S Shim, Yoo K Kim, Jung H Chang","doi":"10.2174/1874306401610010036","DOIUrl":"https://doi.org/10.2174/1874306401610010036","url":null,"abstract":"<p><strong>Introduction: </strong>Pranlukast is a leukotriene receptor antagonist (LTRA) that is used as an additional controller of mild to moderate asthma. This study compared the efficacy and side effects of two bioequivalent preparations of pranlukast: original pranlukast (Onon(®); Ono Pharmaceutical, Japan) and a modified formulation of pranlukast (Prakanon(®); Yuhan Co, Korea) in patients with mild to moderate asthma.</p><p><strong>Methods: </strong>Of the 34 subjects screened, 30 patients who were using standard medication to control asthma and scored less than 20 points on the Asthma Control Test(™) (ACT) were assigned randomly to one of the two groups in a prospective, open label, crossover study: group 1 received Prakanon(®) (150 mg/day) and group 2 received Onon(®) (450 mg/day) for 8 weeks each; after a 1-week rest period, the groups were switched to the alternative medication for further 8 weeks and monitored for 2 more weeks without study medication. Evaluation parameters included the ACT, quality of life questionnaire adult Korean asthmatics (QLQAKA), pulmonary function tests, peripheral blood tests, vital signs, and adverse events.</p><p><strong>Results: </strong>Thirty patients were enrolled and 21 completed the trial: 10 in group 1 and 11 in group 2. The baseline data of the two groups did not differ. No statistical significant differences were observed in efficacy and lung function at each time and in changes from baseline value between the two kinds of pranlukast. The final asthma control rate was 81% with Prakanon(®) and 76% with Onon(®). There were no differences in vital signs and laboratory data at each time and in changes from baseline value between the two drugs. There were no differences in adverse events between the two drugs. The most common side effect was abdominal pain. Drug compliance was high, without differences between the two drugs.</p><p><strong>Conclusion: </strong>These findings suggest that Prakanon(®) which is an improved formulation of pranlukast at a lower dose than the original formulation, Onon(®), has a similar efficacy and side effect profile in the control of persistent asthma.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 ","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/fb/TORMJ-10-36.PMC4951783.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34738151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship Between Lung Cancer and Mycobacterium Avium Complex Isolated Using Bronchoscopy.","authors":"Atsuhisa Tamura, Akira Hebisawa, Kei Kusaka, Takashi Hirose, Junko Suzuki, Akira Yamane, Hideaki Nagai, Takeshi Fukami, Ken Ohta, Fumiaki Takahashi","doi":"10.2174/1874306401610010020","DOIUrl":"https://doi.org/10.2174/1874306401610010020","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of Mycobacterium avium complex (MAC)-positive respiratory specimen cultures and MAC lung disease (MACLD) is increasing worldwide. This retrospective study aimed to assess the association between MAC culture-positive bronchoscopy specimens and lung cancer.</p><p><strong>Materials and methods: </strong>The medical records of 1382 untreated lung cancer patients between 2003 and 2011 were collected using our hospital database. Of them, records for 1258 that had undergone bronchoscopy together with sampling for mycobacterial culture were reviewed. Patient characteristics were compared between those with MAC-positive/other nontuberculous mycobacteria (NTM)-negative bronchial washings and those with MAC-negative/other NTM-negative bronchial washings. Patients with MAC-positive lung cancer were cross-sectionally divided into MACLD and non-MACLD groups, and their features were assessed. Follow-up data for patients with lung cancer but without MACLD were reviewed for subsequent development of MACLD.</p><p><strong>Results: </strong>Of the 1258 patients with lung cancer, 25 (2.0%) had MAC-positive/other NTM-negative bronchial washings. The proportion of women (52% vs 30%; P = 0.0274) and patient age (72 years vs 69 years; P = 0.0380) were significantly higher in the MAC-positive/other NTM-negative lung cancer group (n = 25) than in the MAC-negative/other NTM-negative lung cancer group (n = 1223). There were 10 patients with lung cancer and MACLD and 15 without MACLD; significant differences in patient characteristics were not found between the two groups, and none of the 15 patients without MACLD subsequently developed MACLD.</p><p><strong>Conclusion: </strong>MAC culture-positive bronchial washing is positively associated with lung cancer. Female sex and advanced age, but not lung cancer characteristics, were found to be associated with MAC infection in patients with lung cancer.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 ","pages":"20-8"},"PeriodicalIF":0.0,"publicationDate":"2016-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401610010020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34604482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guilherme Medeiros de Alvarenga, H. Gamba, Lilian Elisa Hellman, Vanusa Ganzert Ferrari, R. Macedo
{"title":"Physiotherapy Intervention During Level I of Pulmonary Rehabilitation on Chronic Obstructive Pulmonary Disease: A Systematic Review","authors":"Guilherme Medeiros de Alvarenga, H. Gamba, Lilian Elisa Hellman, Vanusa Ganzert Ferrari, R. Macedo","doi":"10.2174/1874306401610010012","DOIUrl":"https://doi.org/10.2174/1874306401610010012","url":null,"abstract":"Background: \u0000The progressive and chronic course of COPD, characterized by difficulty in breathing, can be aggravated by periods of increased symptoms (exacerbation). The treatment often involves in-hospital care and among the interventions applied in COPD patients, physical therapy prompts good results. However the most used techniques are not properly pinpointed and there is no consensus in the literature regarding its effectiveness.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 1","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2016-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401610010012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Varga, A. Pálinkás, Imre Lajkó, I. Horváth, K. Boda, A. Somfay
{"title":"Pulmonary Arterial Pressure Response During Exercise in COPD: A Correlation with C-Reactive Protein (hsCRP)","authors":"J. Varga, A. Pálinkás, Imre Lajkó, I. Horváth, K. Boda, A. Somfay","doi":"10.2174/1874306401610010001","DOIUrl":"https://doi.org/10.2174/1874306401610010001","url":null,"abstract":"Background: The non-invasive assessment of pulmonary haemodynamics during exercise provides complementary data for the evaluation of exercise tolerance in patients with COPD. Methods: Exercise echocardiography in the semi-supine position was performed in 27 patients with COPD (C) with a forced expiratory volume in one second (FEV1) of 36±12% predicted and 13 age and gender-matched non-COPD subjects (NC). COPD patients also underwent cardiopulmonary exercise testing with gas exchange detection (CPET). Furthermore, serum high sensitive C-reactive protein (hsCRP), a marker of systemic inflammation, was also measured. Results: The maximal work rate (WRmax) and aerobic capacity (VO2peak) were significantly reduced (WRmax: 77±33 Watt, VO2peak: 50±14 %pred) in COPD. Pulmonary arterial systolic pressure (PAPs) was higher in COPD versus controls both at rest (39±5 vs. 31±2 mmHg, p<0.001), and at peak exercise (72±12 vs. 52±8 mmHg, p<0.001). In 19 (70%) COPD patients, the increase in PAPs was above 22 mmHg. The change in pressure (dPAPs) correlated with hsCRP (r2=0.53, p<0.0001) and forced vital capacity (FVC) (r2=0.18, p<0.001). Conclusion: PAPs at rest and during exercise were significantly higher in COPD patients and correlated with higher hsCRP. This may indicate a role for systemic inflammation and hyperinflation in the pulmonary vasculature in COPD. The study was registered at ClinicalTrials.gov webpage with NCT00949195 registration number.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"10 1","pages":"1 - 11"},"PeriodicalIF":0.0,"publicationDate":"2016-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ventura Rabell-Santacana, Rafael Panadès-Valls, Rosa Vila-Rigat, Enric HernÁndez-Huet, Joan Sivecas-Maristany, Xavier Blanché-Prat, Gemma Prieto, L. Muñoz, Pere Torán
{"title":"Prevalence of Work-Related Asthma in Primary Health Care: Study Rationale and Design","authors":"Ventura Rabell-Santacana, Rafael Panadès-Valls, Rosa Vila-Rigat, Enric HernÁndez-Huet, Joan Sivecas-Maristany, Xavier Blanché-Prat, Gemma Prieto, L. Muñoz, Pere Torán","doi":"10.2174/1874306401509010127","DOIUrl":"https://doi.org/10.2174/1874306401509010127","url":null,"abstract":"Background : Occupational Asthma (OA) is the most frequent origin of occupational respiratory diseases in industrialized countries and accounts for between 5% and 25% of asthmatic patients. The correct and early diagnosis of OA is of great preventive and socio-economic importance. However, few studies exist on OA’s prevalence in Catalonia and in Spain and those affected are mainly treated by the public health services and not by the occupational health services, which are private. Objective : To determine the prevalence of OA in patients diagnosed with asthma in the Primary Healthcare system and to evaluate the socio-economic impact of OA in the Primary Healthcare system. Methods/Design : We will carry out an observational, transversal and multi-center study in the Primary Healthcare Service in the Barcelona region (Catalonia, Spain), with 385 asthmatic workers aged between 16 and 64 who are currently working or have been working in the past. We will confirm the asthma diagnosis in each patient, and those meeting the inclusion criteria will be asked to answer a questionnaire that aims to link asthma to the patient’s past employment history. The resulting diagnosis will be of either occupational asthma, work-aggravated asthma or common asthma. We will also collect socio-demographic information about the patients, about their smoking status, their exposure outside of the workplace, their work situation at the onset of the symptoms, their employment history, their symptoms of asthma, their present and past medical asthma treatment, and, in order to estimate the economic impact in the Primary Healthcare system, where they have been attended to and treated. Prevalence will link OA or work-aggravated asthma to the total of patients participating in the study with a asthma diagnosis. Discussion : The results will show the prevalence of OA and work-aggravated asthma, and shall provide valuable information to set out and apply the necessary personal and technical measures, either in the public or in the occupational health services. No studies evaluating the costs generated by the OA in the Primary Healthcare system have been carried out.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"9 1","pages":"127 - 139"},"PeriodicalIF":0.0,"publicationDate":"2015-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Carrasco Loza, G Villamizar Rodríguez, N Medel Fernández
{"title":"Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects.","authors":"R Carrasco Loza, G Villamizar Rodríguez, N Medel Fernández","doi":"10.2174/1874306401509010112","DOIUrl":"https://doi.org/10.2174/1874306401509010112","url":null,"abstract":"<p><p>Acute Respiratory Distress Syndrome (ARDS) is a clinical condition secondary to a variety of insults leading to a severe acute respiratory failure and high mortality in critically ill patients. Patients with ARDS generally require mechanical ventilation, which is another important factor that may increase the ALI (acute lung injury) by a series of pathophysiological mechanisms, whose common element is the initial volutrauma in the alveolar units, and forming part of an entity known clinically as ventilator-induced lung injury (VILI). Injured lungs can be partially protected by optimal settings and ventilation modes, using low tidal volume (VT) values and high positive-end expiratory pressure (PEEP). The benefits in ARDS outcomes caused by these interventions have been confirmed by several prospective randomized controlled trials (RCTs) and are attributed to reduction in volutrauma. The purpose of this article is to present an approach to VILI pathophysiology focused on the effects of volutrauma that lead to lung injury and the 'mechanotransduction' mechanism. A more complete understanding about the molecular effects that physical forces could have, is essential for a better assessment of existing strategies as well as the development of new therapeutic strategies to reduce the damage resulting from VILI, and thereby contribute to reducing mortality in ARDS. </p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"9 ","pages":"112-9"},"PeriodicalIF":0.0,"publicationDate":"2015-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874306401509010112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33955909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}