Daily Ards Research Analysis

OBJECTIVE: To investigate the effects of continuous blood purification (CBP) combined with antibiotics on pulmonary surfactant protein D (SP-D), Clara cell protein-16 (CC-16), and prognosis in patients with severe acute pancreatitis (SAP) complicated by acute respiratory distress syndrome (ARDS). METHODS: A total of 128 patients with SAP and ARDS treated at Fudan University Shanghai Cancer Center from June 2021 to June 2023 were enrolled. Patients were divided into two groups: a control group (n=64) receiving routine treatment (gastrointestinal decompression, somatostatin administration, nutritional support, correction of water-electrolyte imbalance, and microcirculation improvement) and an observation group (n=64) treated with CBP combined with antibiotics. Clinical data, including the pancreatic edema resolution time, ventilator weaning time, and hospital stay, were compared between groups. Additional comparisons included intra-abdominal pressure (IAP), blood amylase (AMS), urinary amylase (UAMY), inflammatory markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β)], respiratory mechanics indices [airway peak pressure (Peak), airway plateau pressure (Plat), respiratory rate (F)], and blood oxygen levels [partial pressure of arterial oxygen (PaO RESULTS: The observation group demonstrated significantly better outcomes compared to the control group in terms of pancreatic edema resolution time, ventilator weaning time, hospital stay, and other indicators (all P<0.05). The 28-day mortality rate in the observation group was significantly lower than in the control group (P<0.05). Post-treatment levels of CC-16, SP-D, Peak, Plat, and other indicators improved significantly in both groups compared to baseline (all P<0.05). The observation group exhibited significantly greater improvements in PaO CONCLUSION: CBP combined with antibiotics significantly improves clinical symptoms, reduces inflammatory markers, enhances prognosis, and lowers mortality rates in patients with SAP complicated by ARDS.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection spread rapidly from China around the world, causing the worst pandemic since the beginning of the 21st century. Although the disease named coronavirus disease 2019 (COVID-19) has multiple organ symptoms, the main pathological lesions occur in the lung, causing respiratory failure, pulmonary embolism, secondary bacterial pneumonia and pulmonary fibrosis. Despite the best efforts of researchers, the pathogenesis of SARS-CoV-2-induced cellular and tissue damage in organs and systems is poorly understood. Therefore, in our study, we aimed to highlight the pulmonary lesions and their extent, which could explain the complex symptomatology presented by patients who died with acute respiratory distress syndrome (ARDS). The study was performed on a number of 36 patients diagnosed with COVID-19 who died under legally suspicious conditions, requiring autopsy within the Romanian Forensic Medicine Institutes. All patients presented a local inflammatory reaction of pneumonic type, with exudative and proliferative phenomena, with intra-alveolar and interstitial inflammatory infiltrates formed by lymphocytes, macrophages and neutrophilic granulocytes, with congested or ruptured blood vessels with intra-alveolar or interstitial hemorrhages, with multiple thrombosis, with proliferation of local fibroblasts transformed into myofibroblasts and presence of granulation tissue that remodeled the entire lung parenchyma.

BACKGROUND: The recent outbreak of Coronavirus 2019 (COVID-19) is a respiratory disorder caused by the Acute Respiratory Syndrome Coronavirus 2. At the start of the epidemic, early intubation was the optimal strategy for managing ARDS caused by COVID-19. Several non-invasive methods for respiratory support in patients with moderate to severe COVID-19 may reduce intubation, disease severity, ventilator use, and hospitalization in the intensive care unit (ICU). In this study, the characteristics of COVID-19 patients who failed NIV therapy were compared with those who had successful NIV. MATERIALS AND METHODS: The present descriptive-analytical study was conducted at the COVID-19 center of KHORSHID University Hospital. Patients were aged > 18 years with confirmed COVID-19 and hospitalized in the ICU from the beginning of January to the end of March 2021. They had an oxygen level of < 88% despite receiving 15 L of oxygen with reserve masks and were undergoing non-invasive ventilation (NIV) treatment. Data collection included patients' demographic information, vital signs, and test results upon hospital admission, and assessed disease severity using APACHE, SAPS, and SOFA scores. Patients were categorized into responders (R) and non-responders (NR) to determine predictors of non-invasive ventilation (NIV) success, with follow-up based on device tolerance and changes in vital signs. RESULTS: 71 Individuals were candidates for NIV. Twenty patients were excluded from the study, and 51 patients were included in the study. Of these, 35 patients underwent NIV treatment failure (NR). On the other hand, 16 (31.4%) patients completely recovered after receiving NIV (R) and they were discharged from the ICU. CONCLUSION: Serum Albumin and BMI levels of COVID-19 patients undergoing NIV therapy seem to affect their responses to treatment. Hence, it is recommended to evaluate the nutritional status of patients before the start of NIV .