Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2188
M. Lavae-Mokhtari, Omar Alshintiry, J. Fichter, G. May, V. Vieth, N. Dickgreber
{"title":"Quantitative CT based selective Lung-Volume Reduction by prolonged Weaning in COPD GOLD D Patients with massive Emphysema","authors":"M. Lavae-Mokhtari, Omar Alshintiry, J. Fichter, G. May, V. Vieth, N. Dickgreber","doi":"10.1183/13993003.congress-2019.pa2188","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2188","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76728589","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2271
Lunxian Tang
The function of histone methyltransferase enhancer of zeste homolog 2 (EZH2) in sepsis remains unknown. We reported here that the expression of EZH2 and H3K27me3 was significantly upregulated in the circulation of septic patients, whereas patients who survived presented downregulated the expression of EZH2 on CD14+ monocytes/macrophages. We further identified increased expression of EZH2 in the circulation, peritoneal fluid, and septic lungs from CLP mice. 3-DZNeP treated CLP mice improved mortality and protected from organ injury. EZH2 inhibition not only suppressed the activation of inflammatory cells and release of cytokines in the circulation and infectious sites, but also promoted bacteria clearance and replenished the circulating monocyte and neutrophil pool from bone marrow. Blockage of EZH2 also suppressed the progression of lung injury and alleviated inflammation by decreasing the pulmonary cell apoptosis, reducing inflammatory cells infiltration and cytokines release through inhibition of the STAT3 signaling pathway and recovery of PPARγ activation. In addition, EZH2 inhibitor blunted macrophage M1 polarization by SOCS3/STAT1 pathway. Overall, these data suggest that EZH2 could be a potential biomarker predicting clinical outcome and a new target for therapeutic interference in sepsis.
{"title":"Novel pharmacological inhibition of EZH2 attenuates septic shock by altering innate inflammatory responses to sepsis","authors":"Lunxian Tang","doi":"10.1183/13993003.congress-2019.pa2271","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2271","url":null,"abstract":"The function of histone methyltransferase enhancer of zeste homolog 2 (EZH2) in sepsis remains unknown. We reported here that the expression of EZH2 and H3K27me3 was significantly upregulated in the circulation of septic patients, whereas patients who survived presented downregulated the expression of EZH2 on CD14+ monocytes/macrophages. We further identified increased expression of EZH2 in the circulation, peritoneal fluid, and septic lungs from CLP mice. 3-DZNeP treated CLP mice improved mortality and protected from organ injury. EZH2 inhibition not only suppressed the activation of inflammatory cells and release of cytokines in the circulation and infectious sites, but also promoted bacteria clearance and replenished the circulating monocyte and neutrophil pool from bone marrow. Blockage of EZH2 also suppressed the progression of lung injury and alleviated inflammation by decreasing the pulmonary cell apoptosis, reducing inflammatory cells infiltration and cytokines release through inhibition of the STAT3 signaling pathway and recovery of PPARγ activation. In addition, EZH2 inhibitor blunted macrophage M1 polarization by SOCS3/STAT1 pathway. Overall, these data suggest that EZH2 could be a potential biomarker predicting clinical outcome and a new target for therapeutic interference in sepsis.","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81307916","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4018
A. Vianello, S. Ferrarese, B. Molena, G. Arcaro, F. Braccioni, L. Paladini, F. Gallan
Background: Some patients with Idiopathic Pulmonary Fibrosis (IPF) develop acute exacerbation (AE-IPF) leading to severe Acute Respiratory Failure (ARF); despite conventional supportive therapy, the mortality rate remains extremely high. Aims and Objectives: To assess how a treatment algorithm incorporating High Flow Nasal Cannula (HNFC) oxygen therapy and Extracorporeal CO2 Removal (ECCO2R) may affect the short-term mortality of patients with AE-IPF who develop ARF. Methods: Seventeen AE-IPF patients admitted to a Respiratory Intensive Care Unit (RICU) for ARF were managed using a treatment algorithm incorporating HFNC and ECCO2R. Mortality rate during their stay in the RICU and short-term survival rates were recorded. Results: The implementation of the treatment algorithm led to a successful outcome in 9 patients (52.9%). 8 patients (47.1%) died within 39 days of being admitted to the RICU. The survival rate was 70.6% (±0.1 %) at 15 days, 52.9% (±0.1%) at 30 days, 35.3% (±0.1%) at 90 days, and 15.6% (±9.73 %) at 365 days. Four/10 patients who did not respond to conventional oxygen therapy showed a satisfactory response to HFNC. Conclusions: Short-term mortality fell to below 50 per cent when a treatment algorithm incorporating HFNC and ECCO2R was implemented in a group of AE-IPF patients admitted to a RICU for ARF. Subjects not responding to conventional oxygen therapy seemed to benefit from HFNC.
{"title":"A new treatment algorithm for acute exacerbation of IPF: a retrospective cohort study","authors":"A. Vianello, S. Ferrarese, B. Molena, G. Arcaro, F. Braccioni, L. Paladini, F. Gallan","doi":"10.1183/13993003.congress-2019.pa4018","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4018","url":null,"abstract":"Background: Some patients with Idiopathic Pulmonary Fibrosis (IPF) develop acute exacerbation (AE-IPF) leading to severe Acute Respiratory Failure (ARF); despite conventional supportive therapy, the mortality rate remains extremely high. Aims and Objectives: To assess how a treatment algorithm incorporating High Flow Nasal Cannula (HNFC) oxygen therapy and Extracorporeal CO2 Removal (ECCO2R) may affect the short-term mortality of patients with AE-IPF who develop ARF. Methods: Seventeen AE-IPF patients admitted to a Respiratory Intensive Care Unit (RICU) for ARF were managed using a treatment algorithm incorporating HFNC and ECCO2R. Mortality rate during their stay in the RICU and short-term survival rates were recorded. Results: The implementation of the treatment algorithm led to a successful outcome in 9 patients (52.9%). 8 patients (47.1%) died within 39 days of being admitted to the RICU. The survival rate was 70.6% (±0.1 %) at 15 days, 52.9% (±0.1%) at 30 days, 35.3% (±0.1%) at 90 days, and 15.6% (±9.73 %) at 365 days. Four/10 patients who did not respond to conventional oxygen therapy showed a satisfactory response to HFNC. Conclusions: Short-term mortality fell to below 50 per cent when a treatment algorithm incorporating HFNC and ECCO2R was implemented in a group of AE-IPF patients admitted to a RICU for ARF. Subjects not responding to conventional oxygen therapy seemed to benefit from HFNC.","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88111640","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2259
I. Karampela, Evangelia Kandri, E. Chrysanthopoulou, G. Skyllas, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga
{"title":"Free leptin index in critically ill septic patients: a prospective case-control study","authors":"I. Karampela, Evangelia Kandri, E. Chrysanthopoulou, G. Skyllas, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga","doi":"10.1183/13993003.congress-2019.pa2259","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2259","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90225356","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4020
F. Yıldırım, S. Ocal, Ebru Ortaç, Ömer Zühtü Yöndem, B. Yüksel, T. Akbaş, O. Balbay, E. Aydın, F. Aydın, Nilgün Mendil, S. Turan, H. Dal, Y. Dikmen, E. Erdoğan, Serdar Akpınar, G. Aygencel, M. Turkoglu, Nur Karaaslan, S. Izdes, H. Demir, N. Şenoğlu, Burcu Sayan, C. Kıraklı, R. Kayali, Pervin Korkmaz, F. Bacakoğlu, F. Koşar
Aim: High flow nasal oxygen (HFNO) is widely used all over the world as oxygen support therapy. In our study, we aimed to evaluate the clinical characteristics of the patients treated with HFNO therapy, indications and results of HFNO therapy in adult ICUs of Turkey. Method: This multicenter, prospective, observational was conducted between 15 January 2018 and 15 January 2019 and included 14 centers. Results: The study included 298 patients with a mean age of 65.8±17.1 years, 172 (57.7%) of the patients were male. APACHE II and SOFA scores were 22.5±7.8 and 5.8±3.4 respectively. The mean respiratory rate of the patients at the onset of HFNO was 26.2±7.6 breaths/min, SpO2 89.3±8.2% and median Dyspnea score was 7. Most common indication for the use of HFNO was respiratory failure in 220 (73.8%) patients. Other indications were the risk of post-operative respiratory failure in 57 (29.8%) patients, palliative purposes in 17 (5.7%) patients. Type 1 hypoxemic respiratory failure was most common reason for respiratory failure (70.8%). Median HFNO administration time 4 [1-21] days, median initial flow rate was 54 L/min, and median initiation FiO2 was 60%. Initial respiratory rate (p
{"title":"High Flow Nasal Oxygen Therapy Usage in the Adult Intensive Care Units in Turkey: Multi-center, Prospective Study","authors":"F. Yıldırım, S. Ocal, Ebru Ortaç, Ömer Zühtü Yöndem, B. Yüksel, T. Akbaş, O. Balbay, E. Aydın, F. Aydın, Nilgün Mendil, S. Turan, H. Dal, Y. Dikmen, E. Erdoğan, Serdar Akpınar, G. Aygencel, M. Turkoglu, Nur Karaaslan, S. Izdes, H. Demir, N. Şenoğlu, Burcu Sayan, C. Kıraklı, R. Kayali, Pervin Korkmaz, F. Bacakoğlu, F. Koşar","doi":"10.1183/13993003.congress-2019.pa4020","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4020","url":null,"abstract":"Aim: High flow nasal oxygen (HFNO) is widely used all over the world as oxygen support therapy. In our study, we aimed to evaluate the clinical characteristics of the patients treated with HFNO therapy, indications and results of HFNO therapy in adult ICUs of Turkey. Method: This multicenter, prospective, observational was conducted between 15 January 2018 and 15 January 2019 and included 14 centers. Results: The study included 298 patients with a mean age of 65.8±17.1 years, 172 (57.7%) of the patients were male. APACHE II and SOFA scores were 22.5±7.8 and 5.8±3.4 respectively. The mean respiratory rate of the patients at the onset of HFNO was 26.2±7.6 breaths/min, SpO2 89.3±8.2% and median Dyspnea score was 7. Most common indication for the use of HFNO was respiratory failure in 220 (73.8%) patients. Other indications were the risk of post-operative respiratory failure in 57 (29.8%) patients, palliative purposes in 17 (5.7%) patients. Type 1 hypoxemic respiratory failure was most common reason for respiratory failure (70.8%). Median HFNO administration time 4 [1-21] days, median initial flow rate was 54 L/min, and median initiation FiO2 was 60%. Initial respiratory rate (p","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79205381","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2283
B. Khassawneh, Ali M Ibnian, Ahmed Yassin, Abdel-Hameed W. Al-Mistarehi, Islam E’Leimat, Musaab K. Ali, Ahmad Shannaq, K. El-Salem
{"title":"The outcome of patients with acute stroke requiring intensive care unit admission","authors":"B. Khassawneh, Ali M Ibnian, Ahmed Yassin, Abdel-Hameed W. Al-Mistarehi, Islam E’Leimat, Musaab K. Ali, Ahmad Shannaq, K. El-Salem","doi":"10.1183/13993003.congress-2019.pa2283","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2283","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88778805","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2267
Erum Umer, Z. Ahmed, Syed Ali Arsalan
{"title":"Macrolides resitance to streptococcus pneumonia","authors":"Erum Umer, Z. Ahmed, Syed Ali Arsalan","doi":"10.1183/13993003.congress-2019.pa2267","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2267","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88159718","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}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa2260
I. Karampela, Evangelia Kandri, G. Skyllas, E. Chrysanthopoulou, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga
{"title":"Serum kinetics of total leptin and soluble leptin receptor as prognostic tools in sepsis","authors":"I. Karampela, Evangelia Kandri, G. Skyllas, E. Chrysanthopoulou, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga","doi":"10.1183/13993003.congress-2019.pa2260","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2260","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78298497","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}
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