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Monitoring lung injury with particle flow rate in LPS- and COVID-19-induced ARDS.
Stenlo, Martin; Silva, Iran A N; Hyllén, Snejana; Bölükbas, Deniz A; Niroomand, Anna; Grins, Edgars; Ederoth, Per; Hallgren, Oskar; Pierre, Leif; Wagner, Darcy E; Lindstedt, Sandra.
Afiliación
  • Stenlo M; Department of Cardiothoracic Anaesthesia and Intensive Care and Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund University, Sweden.
  • Silva IAN; Wallenberg Center for Molecular Medicine, Lund University, Sweden.
  • Hyllén S; Department of Clinical Sciences, Lund University, Sweden.
  • Bölükbas DA; Department of Experimental Medical Sciences, Lung Bioengineering and Regeneration, Lund University, Sweden.
  • Niroomand A; Wallenberg Center for Molecular Medicine, Lund University, Sweden.
  • Grins E; Lund Stem Cell Center, Lund University, Sweden.
  • Ederoth P; Department of Cardiothoracic Anaesthesia and Intensive Care and Cardiothoracic Surgery and Transplantation, Skåne University Hospital, Lund University, Sweden.
  • Hallgren O; Department of Clinical Sciences, Lund University, Sweden.
  • Pierre L; Department of Experimental Medical Sciences, Lung Bioengineering and Regeneration, Lund University, Sweden.
  • Wagner DE; Wallenberg Center for Molecular Medicine, Lund University, Sweden.
  • Lindstedt S; Lund Stem Cell Center, Lund University, Sweden.
Physiol Rep ; 9(13): e14802, 2021 07.
Article en En | MEDLINE | ID: mdl-34250766
In severe acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) is a life-prolonging treatment, especially among COVID-19 patients. Evaluation of lung injury progression is challenging with current techniques. Diagnostic imaging or invasive diagnostics are risky given the difficulties of intra-hospital transportation, contraindication of biopsies, and the potential for the spread of infections, such as in COVID-19 patients. We have recently shown that particle flow rate (PFR) from exhaled breath could be a noninvasive, early detection method for ARDS during mechanical ventilation. We hypothesized that PFR could also measure the progress of lung injury during ECMO treatment. Lipopolysaccharide (LPS) was thus used to induce ARDS in pigs under mechanical ventilation. Eight were connected to ECMO, whereas seven animals were not. In addition, six animals received sham treatment with saline. Four human patients with ECMO and ARDS were also monitored. In the pigs, as lung injury ensued, the PFR dramatically increased and a particular spike followed the establishment of ECMO in the LPS-treated animals. PFR remained elevated in all animals with no signs of lung recovery. In the human patients, in the two that recovered, PFR decreased. In the two whose lung function deteriorated while on ECMO, there was increased PFR with no sign of recovery in lung function. The present results indicate that real-time monitoring of PFR may be a new, complementary approach in the clinic for measurement of the extent of lung injury and recovery over time in ECMO patients with ARDS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Lipopolisacáridos / Material Particulado / Lesión Pulmonar / COVID-19 / Pulmón Tipo de estudio: Screening_studies Límite: Animals Idioma: En Revista: Physiol Rep Año: 2021 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome de Dificultad Respiratoria / Lipopolisacáridos / Material Particulado / Lesión Pulmonar / COVID-19 / Pulmón Tipo de estudio: Screening_studies Límite: Animals Idioma: En Revista: Physiol Rep Año: 2021 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos