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C- Reactive protein Kinetic in the Prognosis of Ventilator-Associated Pneumonia C-反应蛋白动力学与呼吸机相关性肺炎预后的关系
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2264
S. Pothal, Chandan Kumar Shit, Pravati Dutta, Rekha Manjhi, Aurobindo Behera
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引用次数: 1
Quantitative CT based selective Lung-Volume Reduction by prolonged Weaning in COPD GOLD D Patients with massive Emphysema 慢性阻塞性肺病GOLD D伴大量肺气肿患者延长脱机后选择性肺容量减少的定量CT
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2188
M. Lavae-Mokhtari, Omar Alshintiry, J. Fichter, G. May, V. Vieth, N. Dickgreber
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引用次数: 0
Novel pharmacological inhibition of EZH2 attenuates septic shock by altering innate inflammatory responses to sepsis 新型药物抑制EZH2通过改变先天炎症反应来减轻脓毒症休克
Pub Date : 2019-09-28 DOI: 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.
zeste同源物2组蛋白甲基转移酶增强子(EZH2)在脓毒症中的作用尚不清楚。我们在这里报道了脓毒症患者循环中EZH2和H3K27me3的表达显著上调,而存活的患者CD14+单核/巨噬细胞中EZH2的表达下调。我们进一步发现EZH2在CLP小鼠的循环、腹膜液和脓毒性肺中的表达增加。3-DZNeP治疗CLP小鼠可改善死亡率并保护其免受器官损伤。EZH2抑制不仅抑制了循环和感染部位炎症细胞的激活和细胞因子的释放,而且促进了细菌的清除,补充了骨髓循环中的单核细胞和中性粒细胞池。阻断EZH2还可通过抑制STAT3信号通路,恢复PPARγ激活,减少肺细胞凋亡,减少炎症细胞浸润和细胞因子释放,从而抑制肺损伤进展,减轻炎症。此外,EZH2抑制剂通过SOCS3/STAT1通路钝化巨噬细胞M1极化。总之,这些数据表明EZH2可能是预测临床结果的潜在生物标志物和脓毒症治疗干预的新靶点。
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引用次数: 1
A new treatment algorithm for acute exacerbation of IPF: a retrospective cohort study IPF急性加重的新治疗算法:一项回顾性队列研究
Pub Date : 2019-09-28 DOI: 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.
背景:一些特发性肺纤维化(IPF)患者急性加重(AE-IPF)导致严重急性呼吸衰竭(ARF);尽管采用了传统的支持性治疗,但死亡率仍然非常高。目的和目的:评估结合高流量鼻插管(HNFC)氧疗和体外CO2去除(ECCO2R)的治疗算法如何影响发生ARF的AE-IPF患者的短期死亡率。方法:17例因ARF入住呼吸重症监护病房(RICU)的AE-IPF患者采用HFNC和ECCO2R相结合的治疗算法。记录了他们在RICU住院期间的死亡率和短期存活率。结果:9例患者(52.9%)采用该治疗算法治疗成功。8例(47.1%)患者在入住RICU后39天内死亡。15天存活率为70.6%(±0.1%),30天存活率为52.9%(±0.1%),90天存活率为35.3%(±0.1%),365天存活率为15.6%(±9.73%)。4 /10对常规氧疗无反应的患者对HFNC有满意的反应。结论:在一组因ARF入住RICU的AE-IPF患者中,当采用HFNC和ECCO2R相结合的治疗算法时,短期死亡率降至50%以下。对常规氧疗无反应的受试者似乎受益于HFNC。
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引用次数: 0
Free leptin index in critically ill septic patients: a prospective case-control study 危重症脓毒症患者游离瘦素指数:一项前瞻性病例对照研究
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2259
I. Karampela, Evangelia Kandri, E. Chrysanthopoulou, G. Skyllas, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga
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引用次数: 1
High Flow Nasal Oxygen Therapy Usage in the Adult Intensive Care Units in Turkey: Multi-center, Prospective Study 高流量鼻氧治疗在土耳其成人重症监护病房的使用:多中心前瞻性研究
Pub Date : 2019-09-28 DOI: 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
目的:高流量鼻吸氧作为一种氧支持疗法在国内外得到了广泛的应用。在我们的研究中,我们旨在评估土耳其成人icu中接受HFNO治疗的患者的临床特点、适应症和结果。方法:该多中心前瞻性观察研究于2018年1月15日至2019年1月15日进行,包括14个中心。结果:298例患者入组,平均年龄65.8±17.1岁,其中男性172例(57.7%)。APACHE II和SOFA评分分别为22.5±7.8分和5.8±3.4分。患者发病时平均呼吸频率26.2±7.6次/min, SpO2 89.3±8.2%,中位呼吸困难评分为7分。220例(73.8%)患者使用HFNO的最常见适应症是呼吸衰竭。其他适应症为57例(29.8%)患者存在术后呼吸衰竭风险,17例(5.7%)患者存在缓解目的。1型低氧血症性呼吸衰竭是呼吸衰竭最常见的原因(70.8%)。HFNO中位给药时间4[1-21]天,中位初始流量54 L/min,中位起始FiO2为60%。初始呼吸速率(p
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引用次数: 2
The outcome of patients with acute stroke requiring intensive care unit admission 急性脑卒中患者需要重症监护病房入院的结果
Pub Date : 2019-09-28 DOI: 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
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引用次数: 2
Macrolides resitance to streptococcus pneumonia 大环内酯类药物对肺炎链球菌的耐药性
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2267
Erum Umer, Z. Ahmed, Syed Ali Arsalan
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引用次数: 0
Hand Grip Strength Predicts In-hospital Clinical Outcomes in Mechanically Ventilated Patients 手部握力预测机械通气患者的住院临床结果
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4016
Chatkarin Tepwimonpetkun, N. Saiphoklang
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引用次数: 0
Serum kinetics of total leptin and soluble leptin receptor as prognostic tools in sepsis 总瘦素和可溶性瘦素受体的血清动力学作为脓毒症的预后工具
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2260
I. Karampela, Evangelia Kandri, G. Skyllas, E. Chrysanthopoulou, G. Christodoulatos, G. Antonakos, E. Vogiatzakis, A. Armaganidis, M. Dalamaga
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引用次数: 0
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Acute critical care
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