Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 227 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 9526 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 44 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 227 ARDS 57 patient 50 COVID-19 31 ICU 25 SARS 18 study 17 ECMO 15 acute 14 lung 14 day 13 ALI 12 result 12 peep 12 group 11 method 11 cell 11 Fig 11 Care 10 respiratory 10 mortality 10 LPS 9 Intensive 9 Hospital 8 sofa 8 high 8 VAP 8 APACHE 8 AKI 7 covid-19 7 conclusion 6 pulmonary 6 introduction 5 level 5 increase 5 figure 5 RSV 5 NIV 5 IL-6 4 blood 4 MSC 4 January 4 H1N1 3 ventilation 3 trauma 3 surfactant 3 prone 3 mean 3 injury 3 hour 3 gene Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 27610 patient 16960 % 9605 study 7184 lung 6347 group 5655 cell 5313 day 4909 mortality 4534 result 4524 p 4195 level 4017 injury 3974 ventilation 3676 infection 3592 treatment 3577 care 3410 syndrome 3409 pressure 3319 analysis 3291 method 3281 blood 3219 effect 3178 disease 3176 datum 3111 case 3090 outcome 3027 time 2886 factor 2813 sepsis 2784 failure 2766 therapy 2697 hospital 2678 risk 2617 rate 2468 score 2427 conclusion 2373 admission 2367 distress 2305 year 2212 response 1977 pneumonia 1953 use 1942 trial 1917 protein 1917 age 1906 hour 1905 shock 1892 control 1857 system 1845 model Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 7609 ARDS 6069 ICU 2010 COVID-19 1316 ECMO 1261 SARS 1221 LPS 1178 al 1148 II 1093 . 977 et 977 Fig 916 Care 899 ALI 887 mg 832 TNF 814 IL-6 802 ± 760 CI 722 kg 668 CoV-2 662 C 645 Hospital 625 M. 611 CT 603 Intensive 557 APACHE 542 A 533 AKI 524 T 519 VAP 494 L 456 J. 443 S. 428 der 427 Group 422 Table 420 NIV 419 MV 398 January 398 C. 395 China 390 University 368 B 347 H1N1 329 E. 318 D 309 IV 299 PEEP 288 CO 287 IQR Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 6634 we 3304 it 1135 they 832 i 547 them 304 he 140 us 122 she 71 itself 54 themselves 43 you 40 one 19 him 11 himself 10 me 6 her 5 s 4 peli2 4 em 3 rrt 3 imagej 2 theirs 2 thee 2 pi-3-kinase 2 ourselves 2 ours 2 oneself 2 mrnas 2 herself 2 cxcl10 1 wi~ 1 upar 1 upa 1 u2gm3kyh 1 tv/ 1 tnf~ 1 tnfrt 1 ta 1 t 1 p~ 1 peep 1 pdcs 1 pav20 1 p.dligh]cine 1 p-450 1 otud1 1 olhf).the 1 ol!guria 1 oct 1 mrs Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 72765 be 10978 have 5882 use 3889 associate 3825 increase 3743 include 3315 show 2805 compare 2613 induce 2376 follow 2351 do 2226 perform 1874 reduce 1811 find 1791 receive 1683 require 1608 improve 1553 report 1550 assess 1542 evaluate 1541 treat 1541 measure 1502 base 1490 decrease 1465 suggest 1430 admit 1419 identify 1406 relate 1370 observe 1367 develop 1296 determine 1221 lead 1168 consider 1159 die 1138 cause 1091 demonstrate 1087 remain 1084 study 1078 provide 1060 accord 1035 present 1033 obtain 1025 define 1014 occur 991 describe 963 ventilate 963 result 932 investigate 922 control 892 predict Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 6173 not 6095 respiratory 5768 acute 5251 high 4619 - 4159 severe 4111 clinical 3173 pulmonary 2946 low 2777 also 2693 more 2243 significant 2162 mechanical 2146 other 2024 however 2001 well 2001 early 1995 inflammatory 1959 significantly 1871 first 1795 only 1771 intensive 1756 septic 1726 cardiac 1661 non 1658 most 1600 ill 1584 critically 1488 different 1485 such 1449 mean 1274 as 1221 positive 1198 respectively 1193 endothelial 1177 critical 1131 arterial 1095 medical 1050 human 1045 further 1037 vascular 1032 immune 1025 specific 996 therapeutic 991 less 986 long 973 normal 973 important 957 renal 957 common Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 395 most 291 least 273 good 191 high 170 Most 95 low 68 large 40 bad 33 great 29 late 27 common 23 early 22 strong 10 long 8 near 6 small 6 short 6 old 6 close 5 young 5 sick 5 big 3 severe 3 -ch 2 weak 2 steep 2 simple 2 dense 2 Least 1 ~trointesfimd 1 ~I 1 x2-t 1 slight 1 postsurgery 1 poor 1 palienl 1 p=0.016 1 organized.in 1 oflNO 1 nfthe 1 new 1 lfigh 1 healthy 1 hard 1 fast 1 easy 1 dry 1 deadly 1 d2-t 1 cruel Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 1263 most 245 least 33 well 4 highest 1 worst 1 themost 1 long 1 ifn)-alpha 1 fast 1 farthest 1 -rigorous 1 -not Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- 46 doi.org 6 ccforum.com 3 www.networkanalyst.ca 3 www.jgc301.com 3 orcid.org 2 www.researchprotection.org 2 www.nhc.gov.cn 2 www.frontiersin.org 2 www.anzctr.org.au 2 github.com 2 dx.doi.org 2 creativecommons.org 2 clinicaltrials.gov 1 www.who 1 www.shef.ac.uk 1 www.r-project.org 1 www.polio-vaccine.com 1 www.ncbi.nlm.nih.gov 1 www.metaboanalyst.ca 1 www.medsci.org 1 www.ismpp.org 1 www.hmdb.ca 1 www.gnomixx.com 1 www.genome.jp 1 www.geneontology.org 1 www.ctmm.nl 1 www.chictr.org.cn 1 www.bytefish.de 1 www.bundles.com.br 1 www.biorxiv.org 1 www.biomedcentral.com 1 www.r-project.org 1 www 1 wjw.wuhan.gov.cn 1 links.lww.com 1 coronavirus.jhu.edu Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- 10 http://doi.org/10.1101/2020.06.24.20139303 9 http://doi.org/10 6 http://doi.org/10.1101/2020.10.05.20207217 6 http://doi.org/10.1101/2020.09.16.20195958 6 http://ccforum.com/supplements/17/S2 4 http://doi.org/10.1101/2020.07.22.20154542 3 http://www.networkanalyst.ca 3 http://www.jgc301.com 3 http://doi.org/10.1101/2020.06 2 http://www.nhc.gov.cn/ 2 http://dx.doi.org/10.1007/s00134-007-0661-8 2 http://doi.org/10.1101/2020.06.23.20134072 2 http://doi.org/10.1101/2020.04.02.20051565 2 http://creativecommons.org/licenses/by/4.0/ 1 http://www.who 1 http://www.shef.ac.uk/FRAX 1 http://www.researchprotection.org/InformedConsent/InformedConsent.html 1 http://www.researchprotection.org 1 http://www.r-project.org 1 http://www.polio-vaccine.com/fr/ 1 http://www.ncbi.nlm.nih.gov/geo 1 http://www.metaboanalyst.ca 1 http://www.medsci.org/v17p1773s1.pdf 1 http://www.ismpp.org/gpp3 1 http://www.hmdb.ca/ 1 http://www.gnomixx.com/ 1 http://www.genome.jp/kegg/ 1 http://www.geneontology.org/ 1 http://www.frontiersin.org/articles/10.3389/fmed 1 http://www.frontiersin.org/articles/10.3389/fimmu.2020 1 http://www.ctmm.nl 1 http://www.chictr.org.cn/edit.aspx?pid=25609&htm=4 1 http://www.bytefish.de/blog/pca_lda_with_gnu_octave/ 1 http://www.bundles.com.br 1 http://www.biorxiv.org/content/10.1101/2020.02.29 1 http://www.biomedcentral.com/1471-2334/5/26/prepub 1 http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366838&isReview=true 1 http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=36683 1 http://www.R-project.org/ 1 http://www 1 http://wjw.wuhan.gov.cn/ 1 http://orcid.org/0000-0002-9401-7684 1 http://orcid.org/0000-0002-8885-9025 1 http://orcid.org/0000-0002-4843-6837 1 http://links.lww.com/ALN/C348 1 http://github.com/najoshi/sickle 1 http://github.com/jstjohn/SeqPrep 1 http://doi.org/10.1186/s40635-020-00348-6 1 http://doi.org/10.1093/nar/gks1004. 1 http://doi.org/10.1038/s41598-020-59732-7.Correspondence Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- 3 jgc@mail.sciencep.com 2 yacine001@yahoo.fr 2 oussamajaoued@gmail.com 2 benhamzasabah5@gmail.com 1 toshiiba@juntendo.ac.jp 1 tommaso.mauri@unimi.it 1 sophie.jacquier@chr-orleans.fr 1 samia.ayed@yahoo.fr 1 sadatsouhila@hotmail.fr 1 paul.jaubert@gmail.com 1 painvinbe@gmail.com 1 nicolas.garbez@umontpellier.fr 1 nabilghomari@hotmail.fr 1 mzkxlz@126.com 1 mel.fromentin@wanadoo.fr 1 marin002@umn.edu 1 mariem241090@gmail.com 1 marielemerle@yahoo.fr 1 lisaleon1307@gmail.com 1 lea.savary@hotmail.com 1 khaoula87@hotmail.fr 1 kais.regaieg@gmail.com 1 julien.goutay@gmail.com 1 jean-luc.diehl@aphp.fr 1 jean-luc.baudel@aphp.fr 1 jabirachid@gmail.com 1 hgheerbrant@chu-grenoble.fr 1 guillaume.geri@aphp.fr 1 geoffroyhariri@hotmail.com 1 gautier.nitel@gmail.com 1 fanny.ardisson@gmail.com 1 esmaeiliem@yahoo.com 1 erwan.begot@chu-bordeaux.fr 1 dr.amira.jamoussi@gmail.com 1 claravigneron@hotmail.fr 1 chiche@aphp.fr 1 cguetteche@gmail.com 1 armin.flinspach@kgu.de 1 alex.lepage-farrell@umontreal.ca 1 alain.combes@aphp.fr 1 adnanejanati@gmail.com 1 picu@its.mew.edu 1 nicu-net@u.washington.edu 1 dr.maythem84@yahoo.com 1 -zakaria.riad@icloud.com 1 -titeca.dimitri@chu-amiens.fr 1 -tardif.elsa@gmail.com 1 -sahar.habacha@gmail.com 1 -mickaelandais@gmail.com 1 -maud.loiselle@outlook.fr Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 43 patients did not 35 levels were significantly 27 mortality was higher 25 data are available 25 mortality was significantly 21 patients receiving mechanical 21 patients requiring mechanical 20 patients were not 19 % were male 19 levels were higher 17 groups were similar 16 patients were male 15 patients were randomly 15 study are available 14 mortality was not 14 study was not 13 patients were eligible 13 patients were prospectively 12 ards is not 12 case report form 12 levels were not 12 patients required mechanical 12 patients were mechanically 12 patients were more 11 % were males 11 cells were then 11 groups were comparable 11 mortality is high 11 studies are necessary 11 study did not 10 ards did not 10 groups did not 10 patients had more 10 patients had severe 9 data do not 9 effect was not 9 levels were lower 9 mortality was similar 9 patients had ards 9 patients is not 9 pressure was significantly 9 studies did not 9 study does not 8 analysis did not 8 data were available 8 group was significantly 8 patients are not 8 patients had normal 8 patients has not 8 patients receiving ecmo Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 4 levels were not different 4 results were not statistically 3 % had no effect 3 mortality was not different 3 results have not yet 2 ards is not fully 2 injury are not well 2 levels were not significant 2 levels were not significantly 2 lungs are not as 2 mortality did not significantly 2 mortality was not significantly 2 mortality was not statistically 2 outcome was not different 2 patient is not verbally 2 patients are not always 2 patients had no significant 2 patients is not clear 2 result showed no statistically 2 study found no significant 2 study is not publicly 2 study was not statistically 2 study was not sufficiently 2 syndrome has not yet 1 % had no history 1 % had no recovery 1 % were no longer 1 analyses are not applicable 1 analysis is not exhaustive 1 analysis showed no difference 1 analysis showed no statistically 1 analysis was not feasible 1 analysis was not significant 1 ards are not entirely 1 ards are not well 1 ards do not fully 1 ards had no elevated 1 ards had no long 1 ards has not yet 1 ards is not due 1 ards is not helpful 1 ards is not invariably 1 ards is not novel 1 ards is not universally 1 ards is not yet 1 ards showed no difference 1 ards was not different 1 blood was not able 1 care did not statistically 1 care is no longer A rudimentary bibliography -------------------------- id = cord-005572-zdzeqc19 author = Agarwal, Ritesh title = Experience with ARDS caused by tuberculosis in a respiratory intensive care unit date = 2005-07-09 keywords = ARDS summary = OBJECTIVE: Acute respiratory distress syndrome (ARDS) is an important cause of morbidity and mortality in intensive care units. Abstract Objective: Acute respiratory distress syndrome (ARDS) is an important cause of morbidity and mortality in intensive care units. Conclusions: Tuberculosis is an uncommon but definite cause of ARDS, and in patients with ARDS of obscure aetiology where the cliniAcute respiratory distress syndrome (ARDS) is a common disorder in the intensive care unit (ICU) and is associated with high mortality and morbidity [1] . At admission to the RICU, diagnosis of ARDS was established on the basis of acute onset respiratory distress, bilateral infiltrates on chest radiograph, PaO/FiO 2 ratio <200, and no clinical or radiological evidence of left atrial hypertension [9] . Tuberculosis (TB) is an uncommon cause of acute respiratory distress syndrome (ARDS) associated with a very high mortality [3, 4, 5, 6, 7] . Acute respiratory distress syndrome (ARDS) in miliary tuberculosis: a twelve-year experience doi = 10.1007/s00134-005-2721-2 id = cord-352196-rpyoeg9n author = Alberici, Federico title = A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection. date = 2020-05-08 keywords = ARDS; SARS summary = title: A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection. The main clinical characteristics of the overall MHD population with SARS-CoV2 infection and the subgroups managed as outpatient or in hospital are shown in Table 2 . In our cohort including four centers of the "Brescia Renal COVID task force", we have identified 94 patients with SARS-CoV-2 infection. The finding of worse outcome of hemodialysis patients with SARS-CoV-2 infection may be explained by high prevalence of comorbidities as well as other risk factors related to end stage renal disease per se (2). Management of Patients on Dialysis and With Kidney Transplantation During the SARS-CoV-2 (COVID-19) Pandemic in Brescia A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia doi = 10.1016/j.kint.2020.04.030 id = cord-004532-flo9139j author = Andrews, Peter title = Year in review in intensive care medicine, 2004. I. Respiratory failure, infection, and sepsis date = 2004-12-18 keywords = ARDS; CVC; ICU; VAP; patient summary = The authors concluded that their findings are important for trial design because of the observed differences in outcome, and proposed the use of standardized ventilator settings for patient enrollment. As indicated by Yu and Singh [46] , "over 300 studies have been published in peer-review journals in the past 8 years dealing with management of ventilator-associated pneumonia (VAP)." However, no consensus exists to date on the best way for identifying patients with true lung infection, for selecting early appropriate antimicrobial therapy, or for avoiding unnecessary use of antibiotics. [52] designed a study in 108 patients with 171 VAPs to assess the impact on the duration of MV and the use of antibiotic treatment of the results of a diagnostic technique: the percentage of infected cells in liquid obtained with BAL, i.e., the value of direct examination. doi = 10.1007/s00134-004-2529-5 id = cord-005577-uk5wzk6m author = Bachmann, D. C. G. title = Respiratory syncytial virus triggered adult respiratory distress syndrome in infants: A report of two cases date = 1994 keywords = ARDS; RSV summary = Two infants with severe respiratory syncytial virus infection which resulted eventually in classical adult respiratory distress syndrome (ARDS) are presented. The first patient recovered with residual restrictive changes determined during a follow-up 2.5 months later, whereas the second infant died because of ARDS, pulmonary interstitial emphysema and hypoxemic hypoxia. Respiratory syncytial virus (RSV) is the single most frequent cause of acute viral infections of the lower respiratory tract in infants and young children [1] . During the winter 1990/91 we treated two infants in whom RSV infection triggered severe adult respiratory distress syndrome (ARDS). Only two cases of RSV triggered acute hypoxemic failure ("ARDS") have been described in the literature [8] , we report two additional cases with particular emphasis on respiratory system mechanics. Our two patients with clearly documented RSV infection fulfilled the classical criteria of severe ARDS for infants and children as reported by Pfenninger et al. doi = 10.1007/bf02425060 id = cord-256385-g1wcfrfi author = Badraoui, Riadh title = Acute respiratory distress syndrome: a life threatening associated complication of SARS-CoV-2 infection inducing COVID-19 date = 2020-08-05 keywords = ACE2; ARDS; COVID-19; SARS summary = title: Acute respiratory distress syndrome: a life threatening associated complication of SARS-CoV-2 infection inducing COVID-19 A better understood of ARDS key features and the pathophysiological injuries of the pulmonary parenchyma are linked to lessons learned from previous severe diseases associated previous coronaviruses outbreaks (especially SARS-CoV and MERS-CoV) and more the ongoing SARS-CoV-2. The novel coronavirus, finally named as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses, and it''s inducing Coronavirus Disease 2019 (COVID-19) (Gorbalenya et al., 2020; Khailany et al., 2020) . While SARS-CoV-2 induces mild symptoms in several infected patients (low pathogenic), it can also be associated with a fast onset of widespread infection in the lungs worsened in an acute respiratory distress syndrome (ARDS) . Lessons learned from previous severe diseases caused by coronaviruses outbreaks (SARS-CoV and MERS-CoV) and more recently SARS-CoV-2 lead to a better understood of ARDS key features associated COVID-19. doi = 10.1080/07391102.2020.1803139 id = cord-333856-ujnhjy0s author = Baer, Brandon title = Exogenous Surfactant as a Pulmonary Delivery Vehicle for Budesonide In Vivo date = 2020-10-26 keywords = ARDS; BLES; HKB summary = RESULTS: Although budesonide exhibited anti-inflammatory effects when administered alone, delivery with BLES enhanced those effects by lowering the lavage neutrophil counts and myeloperoxidase activity in lung tissue. Similarly, in vivo studies, including those modeling ARDS, have observed improved drug distribution and anti-inflammatory effects for glucocorticoids delivered by a surfactant vehicle [12] [13] [14] . This study tested the hypothesis that fortifying an exogenous surfactant preparation, BLES, with budesonide would enhance the efficacy for treating pulmonary inflammation in vivo. Specifically, it uses outcomes such as MPO activity, neutrophil counts, and chemokine concentrations to focus on neutrophilic inflammation, which have been suggested to be a critical aspect of disease progression for ARDS [28] When combined with this previous data, our study further supports the use of exogenous surfactant as a delivery vehicle for budesonide in the treatment of pulmonary inflammation. doi = 10.1007/s00408-020-00399-2 id = cord-328569-1lx3fkv3 author = Bagate, François title = Rescue therapy with inhaled nitric oxide and almitrine in COVID-19 patients with severe acute respiratory distress syndrome date = 2020-11-04 keywords = ARDS; COVID-19; patient summary = title: Rescue therapy with inhaled nitric oxide and almitrine in COVID-19 patients with severe acute respiratory distress syndrome BACKGROUND: In COVID-19 patients with severe acute respiratory distress syndrome (ARDS), the relatively preserved respiratory system compliance despite severe hypoxemia, with specific pulmonary vascular dysfunction, suggests a possible hemodynamic mechanism for VA/Q mismatch, as hypoxic vasoconstriction alteration. Some authors have hypothesized that potential relatively preserved respiratory system compliance (Crs) despite severe hypoxemia in COVID-19 patients suggests a possible hemodynamic mechanism for ventilation/perfusion (VA/Q) mismatch as hypoxic vasoconstriction alteration [5] . Individual values of the ratio of oxygen partial pressure to inspired oxygen fraction in arterial blood in patients with severe acute respiratory distress syndrome secondary to coronavirus disease 2019, according to position (prone or supine) and administration of inhaled nitric oxide with or without almitrine. Correlations between respiratory mechanics and oxygenation response to the combination of inhaled nitric oxide and almitrine in ten patients with severe acute respiratory distress syndrome secondary to coronavirus disease 2019. doi = 10.1186/s13613-020-00769-2 id = cord-282151-mai4eggf author = Bai, Lu title = Clinical Features of Pneumonia Caused by 2009 Influenza A(H1N1) Virus in Beijing, China date = 2015-12-16 keywords = A(H1N1; ARDS; patient summary = METHODS: During October 26, 2009, and January 23, 2010, adult patients with pneumonia with laboratory-confirmed or clinically suspected A(H1N1) infections were observed for clinical characteristics, high-resolution chest CT scan, and lung function test changes during acute and 3-month convalescent phases. Multivariate Cox regression identified two independent risk factors for death: progressive dyspnea after resolution of fever (relative risk, 5.852; 95% CI, 1.395-24.541; P = .016) and a higher APACHE (Acute Physiology and Chronic Health Evaluation) II score on presentation (relative risk for each point, 1.312; 95% CI, 1.140-1.511; P < .001). 6 Many studies have been published on the clinical manifestations of A(H1N1) pneumonia during the acute phase of illness, [7] [8] [9] [10] [11] [12] [13] [14] [15] but no information has been reported on symptoms and radiographic and lung function changes in convalescence. Information recorded included demographic data, underlying medical conditions, symptoms, signs, laboratory and chest radiograph fi ndings before therapy and during follow-up, and the clinical course, treatment, and adverse events during hospital stay. doi = 10.1378/chest.10-1036 id = cord-348823-u2gm3kyh author = Baksh, Mizba title = A Systematic Review of Cases of Acute Respiratory Distress Syndrome in the Coronavirus Disease 2019 Pandemic date = 2020-05-18 keywords = ARDS; COVID-19; SARS summary = About 80% of COVID-19 infections are mild or asymptomatic and never require hospitalization but about 5% of patients become critically ill and develop acute respiratory distress syndrome (ARDS). The widely used management for ARDS in COVID-19 has been in line with the standard approach, but the need to adjust the treatment protocols has been questioned based on the reports of higher mortality risk among those requiring mechanical ventilation. Although some antimalarial and antiviral drugs may prove effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), their safety and efficacy are still under clinical trials. We conducted a systematic review of case reports on ARDS in SARS-CoV-2 infection to summarize the clinical presentation, laboratory and chest imaging findings, management protocols, and outcome of ARDS in COVID-19-positive patients. Tissue plasminogen activator (tPA) treatment for COVID-19 associated acute respiratory distress syndrome (ARDS): a case series doi = 10.7759/cureus.8188 id = cord-276927-rxudwp2v author = Barbas, Carmen Sílvia Valente title = Goal-Oriented Respiratory Management for Critically Ill Patients with Acute Respiratory Distress Syndrome date = 2012-08-23 keywords = ARDS; acute; lung; patient; peep; respiratory summary = Rapid administration of antibiotics and resuscitative measures in case of sepsis and septic shock associated with protective ventilatory strategies and early short-term paralysis associated with differential ventilatory techniques (recruitment maneuvers with adequate positive end-expiratory pressure titration, prone position, and new extracorporeal membrane oxygenation techniques) in severe ARDS can help improve its prognosis. Incorporation of modified risk factors such as acute increase of respiratory rate, presence of tachypnea, detection of pulse oximeter desaturation, increased necessity of oxygen supplementation, presence of low pH, acidosis, or hypoxemia in an arterial blood gas sample in clinical practice can improve the clinicians'' ability to perform early diagnosis and prompt therapeutic intervention in ARDS [17] . doi = 10.1155/2012/952168 id = cord-308402-37i62atc author = Barnes, Betsy J. title = Targeting potential drivers of COVID-19: Neutrophil extracellular traps date = 2020-04-16 keywords = ARDS; COVID-19; net summary = In this Perspective, autopsy results and literature are presented supporting the hypothesis that a little known yet powerful function of neutrophils—the ability to form neutrophil extracellular traps (NETs)—may contribute to organ damage and mortality in COVID-19. Furthermore, neutrophils from patients with pneumonia-associated ARDS appear "primed" to form NETs, and both the extent of priming and the level of NETs in blood correlate with disease severity and mortality (Adrover et al., 2020; Bendib et al., 2019; Ebrahimi et al., 2018; Lefrançais et al., 2018; Mikacenic et al., 2018) . NETs and excessive thrombosis Acute cardiac and kidney injuries are common in patients with severe COVID-19 and contribute to the mortality of this disease (Bonow et al., 2020) . Neutrophil extracellular traps (NETs) are increased in the alveolar spaces of patients with ventilator-associated pneumonia doi = 10.1084/jem.20200652 id = cord-328996-3sf2i45r author = Barthélémy, Romain title = Efficacy of Almitrine in The Treatment of Hypoxemia in Sars-Cov-2 Acute Respiratory Distress Syndrome date = 2020-06-06 keywords = ARDS; Cov-2 summary = title: Efficacy of Almitrine in The Treatment of Hypoxemia in Sars-Cov-2 Acute Respiratory Distress Syndrome This monocenter retrospective study aimed to evaluate the association between almitrine 19 introduction and improvement of oxygenation in Sars-Cov-2 ARDS. Inclusion criteria in the study were: admission for respiratory failure, a diagnosis of ARDS 24 according to Berlin criteria 8 , laboratory confirmed Sars-Cov-2 infection, almitrine infusion in 25 ICU. In our 73 observational study, almitrine was associated with an increase in PaO 2 /FiO 2 ratio after 74 treatment. Furthermore, despite an associated improvement in PaO 2 /FiO 2 ratio, the majority 76 of patients receiving almitrine went on to needing additional rescue interventions or died. 77 This may be explained by the fact that, in our study, almitrine has been used as a rescue 78 therapy in severe patients with worsening hypoxemia and very low PaO 2 /FiO 2 ratio. doi = 10.1016/j.chest.2020.05.573 id = cord-006181-fkh2fzbr author = Bednarczyk, Joseph M. title = Extracorporeal membrane oxygenation for blastomycosis-related acute respiratory distress syndrome: a case series date = 2015-04-08 keywords = ARDS; ECMO; patient summary = This report describes the clinical course of four consecutive patients with blastomycosis-related ARDS treated with venovenous extracorporeal membrane oxygenation (ECMO) during 2009-2014. 3 Venovenous extracorporeal membrane oxygenation (ECMO) has been utilized for the management of severe ARDS to facilitate gas exchange, allow lung rest by deescalation of ventilatory support, and provide time for resolution of the underlying disease. 7 Extracorporeal membrane oxygenation is generally considered in ARDS patients with refractory hypoxemia or hypercapnia despite a lung protective ventilation strategy or in those where the maintenance of adequate gas exchange requires potentially injurious applied volumes or pressures. Extracorporeal membrane oxygenation may be an effective treatment modality for patients with blastomycosis-related ARDS and refractory hypoxemia despite optimal mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) in fulminant blastomycosis in Germany doi = 10.1007/s12630-015-0378-z id = cord-339128-npfoircv author = Blair, Robert V. title = Acute Respiratory Distress in Aged, SARS-CoV-2 Infected African Green Monkeys but not Rhesus Macaques date = 2020-11-07 keywords = ARDS; COVID-19; SARS summary = Here we report ARDS in two aged African green monkeys (AGMs) infected with SARS-CoV-2 that demonstrated pathological lesions and disease similar to severe COVID-19 in humans. Here we report ARDS in two aged African green monkeys (AGMs) infected with SARS-CoV-2 that demonstrated pathological lesions and disease similar to severe COVID-19 in humans. We also report a comparatively mild COVID-19 phenotype characterized by minor clinical, radiographic and histopathologic changes in the two surviving, aged AGMs and four rhesus macaques (RMs) infected with SARS-CoV-2. We also report a comparatively mild COVID-19 phenotype characterized by minor clinical, radiographic and histopathologic changes in the two surviving, aged AGMs and four rhesus macaques (RMs) infected with SARS-CoV-2. This study demonstrates that following exposure to SARS-CoV-2 aged AGMs develop a spectrum of disease, from mild to severe COVID-19, which in some cases progress to ARDS. doi = 10.1016/j.ajpath.2020.10.016 id = cord-278249-vvhq9vgp author = Blot, Mathieu title = CXCL10 could drive longer duration of mechanical ventilation during COVID-19 ARDS date = 2020-11-02 keywords = ARDS; CXCL10; ELF; SARS; covid-19; dna summary = In addition, since most patients need to undergo mechanical ventilation in this context, ventilator-induced lung injury (VILI) could exacerbate tissue damage as well as local and systemic inflammation, thus acting as a "second hit." Our team has previously shown that mitochondrial alarmins (i.e., mitochondrial DNA) are released by human epithelial cells submitted to cyclic stretch, and these alarmins are also recovered from bronchoalveolar lavage (BAL) fluid obtained from either ventilated rabbits or ARDS patients. This comprehensive evaluation of systemic and pulmonary immune response showed that the higher CXCL10 concentrations in both the systemic and alveolar compartments of patients with COVID-19 ARDS were associated with a longer duration of mechanical ventilation. Finally, in both COVID-19 and non-COVID-19 patients, higher mitochondrial DNA concentrations in the plasma and ELF compartment were highly correlated with alveolar inflammation, as assessed by BALF cell count and ELF IL-8 and IL-1β concentrations. doi = 10.1186/s13054-020-03328-0 id = cord-261370-jp5sqqwc author = Bollag, Wendy B. title = Phosphatidylglycerol and Surfactant: A Potential Treatment for COVID-19? date = 2020-09-16 keywords = ARDS; COVID-19; surfactant summary = It is thought that surfactant, which is already approved by the Food and Drug Administration for intratracheal administration to treat neonatal respiratory distress syndrome in infants, could benefit COVID-19-infected individuals by: (1) restoring surfactant damaged by lung infection and/or decreased due to the virus-induced death of the type II pneumocytes that produce it and (2) reducing surface tension to decrease the work of breathing and limit pulmonary edema. In addition, a constituent of surfactant, phosphatidylglycerol, could mitigate COVID-19-induced lung pathology by: (3) decreasing excessive innate immune system activation via its inhibition of toll-like receptor-2 and -4 activation by microbial components and cellular proteins released by damaged cells, thereby limiting inflammation and the resultant pulmonary edema, and (4) possibly blocking spread of the viral infection to non-infected cells in the lung. doi = 10.1016/j.mehy.2020.110277 id = cord-291481-ov1gkgpc author = Bonizzoli, Manuela title = Human herpesviruses respiratory infections in patients with acute respiratory distress (ARDS) date = 2016-05-02 keywords = ARDS; EBV; ICU summary = In patients requiring mechanical ventilation, herpesviruses, mainly HSV1 and hCMV, may be frequently detected from either upper or lower respiratory tract Abstract Acute respiratory distress syndrome (ARDS) is today a leading cause of hospitalization in intensive care unit (ICU). A higher ICU mortality was significantly related to the presence of herpesvirus infection in the lower respiratory tract as well as to impaired immunophenotype, as patients with poor outcome showed severe lymphopenia, affecting in particular T (CD3+) cells, since the first days of ICU hospitalization. One hundred and eight clinical samples from upper and lower respiratory tract from the 54 ICU patients were analyzed to detect influenza and other respiratory viruses and a group of herpesviruses (EBV, hCMV and HSV1). This report concerns a group of 54 patients admitted to ICU because of ARDS with unknown causative agent; 19 of them were infected by influenza virus, as demonstrated by the detection of viral RNA in both upper and lower respiratory tract samples. doi = 10.1007/s00430-016-0456-z id = cord-012587-h3c9novk author = Bos, Lieuwe D. J. title = Subphenotyping Acute Respiratory Distress Syndrome in Patients with COVID-19: Consequences for Ventilator Management date = 2020-09-17 keywords = ARDS; COVID-19 summary = title: Subphenotyping Acute Respiratory Distress Syndrome in Patients with COVID-19: Consequences for Ventilator Management Most patients in the intensive care unit (ICU) with severe COVID-19 meet the criteria for acute respiratory distress syndrome (ARDS), and proven therapies for ARDS not related to COVID-19 are likely effective in these patients as well. Based on these preliminary data, we conclude that compliance and an estimation of lung weight do not correlate in patients with COVID-19-related ARDS. ARDS = acute respiratory distress syndrome; COVID-19 = coronavirus disease. Personalised mechanical ventilation tailored to lung morphology versus low positive endexpiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial Lung recruitment in patients with the acute respiratory distress syndrome Lung morphology predicts response to recruitment maneuver in patients with acute respiratory distress syndrome doi = 10.1513/annalsats.202004-376rl id = cord-012010-5h2ox3hu author = Bos, Lieuwe D.J. title = Response to “COVID-19 conundrum: Clinical phenotyping based on pathophysiology as a promising approach to guide therapy in a novel illness” and “Strengthening the foundation of the house of CARDS by phenotyping on the fly” and “COVID-19 phenotypes: leading or misleading?” date = 2020-08-03 keywords = ARDS; COVID-19 summary = take issue with our interpretation of the respiratory physiology of COVID-19, arguing that it is based merely on "small cohort studies," instead arguing that "a high proportion of mechanically ventilated COVID-19 patients exhibit near-normal lung compliance." [1] Yet the low respiratory compliance of COVID19 patients has now been extensively demonstrated by studies totaling more than 800 COVID-19 patients [2] [3] [4] [5] [6] [7] [8] , including a direct comparison with non-COVID ARDS patients that revealed no difference in respiratory compliance. In his response to our Editorial, Dr. Rajendram reveals a curious misinterpretation of our Editorial: "Thus, whilst the net effect of the ARDSNet protocol is beneficial at the level of the study population, theoretically, it may harm select patients… contrary to the opinions of the Surviving Sepsis Campaign, and Bos and colleagues, the ARDSNet protocol is not a panacea." Putting aside the wishful thinking of a supportive intervention functioning as a "panacea" for a condition with persistent mortality of 30-40%, the correspondent (along with Drs. Cherian et al.) seems to think that we dispute the heterogeneity of ARDS, and advocate for a "one-size-fits-all" approach to its clinical management. doi = 10.1183/13993003.02756-2020 id = cord-284332-p4c1fneh author = Bosma, Karen J. title = Pharmacotherapy for Prevention and Treatment of Acute Respiratory Distress Syndrome: Current and Experimental Approaches date = 2012-09-19 keywords = ALI; ARDS; acute; lung; mortality; patient; respiratory; study summary = [47] Although both of these studies were conducted prior to the 1994 AECC definition, ARDS was strictly defined in the aforementioned studies, including a PaO 2 /FiO 2 ratio <150 or intrapulmonary shunt >20% in patients requiring mechanical ventilation and who had diffuse infiltrates on chest radiograph without clinical evidence of heart failure as pulmonary arterial occlusion pressures were <18 mmHg. Building on the results of these two studies, Sinuff and colleagues [48] developed practice guidelines for prophylactic ketoconazole use, and tested the implementation and efficacy of these guidelines in two ICUs (one control and one active comparator). [119] A phase II study enrolling 98 patients with ALI compared an antioxidant enteral feeding formula containing eicosapentaenoic acid, g-linolenic acid and antioxidant vitamins with placebo, and observed improved oxygenation, reduced pulmonary inflammation, fewer days of mechanical ventilation and fewer non-pulmonary organ failures in the treatment arm, although there was no difference in mortality between this approach and the control group. doi = 10.2165/10898570-000000000-00000 id = cord-349329-f0pbd968 author = Bosteels, Cedric title = Sargramostim to treat patients with acute hypoxic respiratory failure due to COVID-19 (SARPAC): A structured summary of a study protocol for a randomised controlled trial date = 2020-06-05 keywords = ARDS; COVID-19; CSF; Leukine; day; patient summary = -Presence of acute hypoxic respiratory failure defined as (either or both)  saturation below 93% on minimal 2 l/min O2  PaO2/FiO2 below 350 -Admitted to specialized COVID-19 ward -Age 18-80 -Male or Female -Willing to provide informed consent Exclusion criteria -Patients with known history of serious allergic reactions, including anaphylaxis, to human granulocyte-macrophage colony stimulating factor such as sargramostim, yeast-derived products, or any component of the product. Study Interventions Confirmed or highly suspect COVID-19 patients with acute hypoxic respiratory failure (saturation below 93% on minimal 2 l/min O2 or PaO2/FiO2 <350) will be randomized to receive sargramostim 125mcg twice daily for 5 days as a nebulized inhalation on top of standard of care (active group), or to receive standard of care treatment (control group). doi = 10.1186/s13063-020-04451-7 id = cord-017854-ff3gm50j author = Bromberg, Z. title = Heat Shock Proteins in Inflammation date = 2007 keywords = ARDS; HSP70 summary = Most HSPs are constitutively and ubiquitously expressed molecular chaperones that guide the normal folding, intracellular disposition, and proteolytic turnover of many of the key regulators of cell growth and survival [14] . Thus, the protective process involves the interaction of many different HSPs. For example, HSP90, which comprises 1-2% of total cellular protein in non-stress conditions [15] , supports meta-stable protein conformations and expresses a high affinity binding state to hormone receptors. Several in vitro models have proven that heat shock or elevated levels of HSP70 suppresses NF-κB activity and that this inhibition of NF-κB results in a general reduction in the inflammatory response [44, 46, 71, 73] . Major heat shock protein hsp70 protects tumor cells from tumor necrosis factor cytotoxicity Anti-inflammatory effect of heat shock protein induction is related to stabilization of I kappa B alpha through preventing I kappa B kinase activation in respiratory epithelial cells doi = 10.1007/3-540-30328-6_8 id = cord-018685-i7s04fh5 author = Bromberg, Z. title = Cell Regeneration in Lung Injury date = 2007 keywords = ARDS; ATII; cell summary = Following injury, regeneration of alveolar epithelial cells proceeds via an organized paradigm where ATII cells and other specific stem cells appear to function as progenitor cells for ATI cells [16 -17] (Fig. 1 ). Cyclin A/cdk2 accumulates during S phase and its activation triggers the transition to G2, a phase characterized by the accumulation of cyclin B/cdc2, which results in the inhibition of DNA replication, cell growth and new protein synthesis [26, 27] The Wnt/␤catenin Cell Signaling Pathway An activated form of q -catenin was expressed in respiratory epithelial cells of the developing lung. Activation of q -catenin caused ectopic differentiation of ATII-like cells in conducting airways, goblet cell hyperplasia, and airspace enlargement, demonstrating a critical role for the Wnt/ q -catenin signal transduction pathway in the differentiation of the respiratory epithelium in the postnatal lung [31] . Pulmonary edema fluid from patients with acute lung injury augments in vitro alveolar epithelial repair by an IL-1beta-dependent mechanism doi = 10.1007/978-3-540-49433-1_28 id = cord-346230-39oo7vnq author = Byrne, J. D. title = Prophylaxis with tetracyclines in ARDS: Potential therapy for COVID-19-induced ARDS? date = 2020-07-28 keywords = ARDS summary = Here, we present a retrospective multi-institutional cohort study evaluating ventilatory status in patients who had taken a tetracycline antibiotic within a year prior to diagnosis of acute respiratory distress syndrome (ARDS). Minocycline or doxycycline treatment within a year prior to ARDS diagnosis was associated with a 75% reduced likelihood for mechanical ventilation during hospital stay. In this retrospective multi-institutional cohort study, we aimed to assess whether prophylactic use of either minocycline, doxycycline, or tetracycline could reduce the concomitant requirement for ventilatory support and duration of ICU stay among ARDS patients. Minocycline (p = 0.037) or doxycycline (p = 0.035) treatment within a year prior to ARDS diagnosis was associated with a 75% reduced likelihood for mechanical ventilation during hospital stay (Figure 1, A) . Similarly, treatment effects regression modeling indicated that minocycline (p = 0.004), doxycycline (p = 0.04), and tetracycline (p < 0.001) therapy corresponded to significant reductions in duration of mechanical ventilation in ARDS patients. doi = 10.1101/2020.07.22.20154542 id = cord-322887-md446f9p author = Carver, Catherine title = Cardiac injury and ARDS meta-analysis validity – Correspondence in response to Santoso et al. date = 2020-06-27 keywords = ARDS summary = This paper was of note to us because it included a meta-analysis on acute respiratory distress syndrome (ARDS) and cardiac injury, based on two papers -one by Shi (2) and another by Wu (3). On reading the paper by Wu, we have significant concerns about the inclusion of this study in Santoso''s meta-analysis as we believe it currently underpins an inaccurate conclusion that cardiac injury is not significantly associated with increased risk of ARDS in COVID-19 by Santoso. However, from what we currently have access to, it seems most likely that Santoso''s meta-analysis for ARDS has been based on composite endpoint data. Moreover, the conclusion of Santoso runs counter to Shi''s JAMA Cardiology paper, which was the other paper included in Santoso''s meta-analysis, which did report on purely ARDS cases and cardiac injury and did find a statistically significant association. Cardiac injury is associated with mortality and critically ill pneumonia in COVID-19: A meta-analysis doi = 10.1016/j.ajem.2020.06.028 id = cord-315866-6vcts4w3 author = Chan, KC Allen title = Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome: a case control study date = 2005-04-09 keywords = ARDS; SARS summary = title: Absence of association between angiotensin converting enzyme polymorphism and development of adult respiratory distress syndrome in patients with severe acute respiratory syndrome: a case control study Thus, we have investigated the association between ACE insertion/deletion (I/D) polymorphism and the progression to ARDS or requirement of intensive care in SARS patients. RESULTS: There is no significant difference in the genotypic distributions and the allelic frequencies of the ACE I/D polymorphism between the SARS patients and the healthy control subjects. Therefore, in this study, we investigated the association of the ACE insertion/deletion (I/D) polymorphism of the 287 bp Alu repeat to the susceptibility to SARS and the development of adult respiratory distress syndrome (ARDS) with a larger population. The genotypic distributions and allelic frequencies of ACE I/D polymorphism in the SARS patients and control subjects are shown in table 2. doi = 10.1186/1471-2334-5-26 id = cord-282547-ehr9aaix author = Chang, Jae C. title = Acute Respiratory Distress Syndrome as an Organ Phenotype of Vascular Microthrombotic Disease: Based on Hemostatic Theory and Endothelial Molecular Pathogenesis date = 2019-11-28 keywords = ARDS; DIC; ULVWF; VMTD summary = 7 Recently, two proposed hemostatic mechanisms have opened the door in the understanding of ARDS from molecular pathogenesis associated with endotheliopathy that promotes inflammation and coagulation disorder in sepsis and other critical illnesses [8] [9] [10] [11] ; one is "two-activation theory of the endothelium" in which endothelial pathogenesis activates inflammatory pathway and microthrombotic pathway and the other is a novel "two-path unifying theory" of hemostasis in which hemostasis initiates thrombogenesis and promotes microthrombogenesis, leading to vascular microthrombotic disease (VMTD). ARDS indicates acute respiratory distress syndrome; DIT, disseminated intravascular thrombosis; EA-VMTD, endotheliopathy-associated vascular microthrombotic disease; ECs, endothelial cells; HC, hepatic coagulopathy; MAHA/aMAHA, microangiopathic hemolytic anemia/atypical microangiopathic hemolytic anemia; MODS: multi-organ dysfunction syndrome; MOF, multi-organ failure; TMA, thrombotic microangiopathy; SIRS, systemic inflammatory response syndrome; TTP, thrombotic thrombocytopenic purpura; ULVWF, unusually large von Willebrand factor multimers activates ULVWF path, but TF path is not activated if subendothelial tissue (SET)/extravascular tissue (EVT) illustrated in Figure 2 is not compromised. doi = 10.1177/1076029619887437 id = cord-343743-6k3soh1l author = Chaudhary, Sachin title = Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused date = 2020-09-09 keywords = ARDS; COVID-19; patient summary = Among the many excellent ongoing studies with good preclinical data in appropriate animal models, some arising directly from recent clinical observations, we were surprised to see studies proposing to use the FDA-approved anti-fibrotic therapies (nintedanib NCT04338802 and pirfenidone NCT04282902) for idiopathic pulmonary fibrosis (IPF) in COVID-19 patients. In this review, we posit that, unlike patients with IPF, the COVID-19 survivors will follow a familiar course of intense pulmonary inflammation, leading to mild scarring and near-normal lung function recovery over time. Fewer studies are available for outcomes in MERS, but similar to other causes of viral-induced lung injury, MERS survivors have a reduced quality of life (21) , and the pulmonary sequelae from MERS are mild. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge doi = 10.3389/fmed.2020.00539 id = cord-002540-hgx0bfbz author = Chen, Chaolei title = Can glypican-3 be a disease-specific biomarker? date = 2017-05-16 keywords = ARDS; GPC3; Wnt summary = BACKGROUND: Glypican-3 (GPC3) is a cell surface-bound proteoglycan which has been identified as a potential biomarker candidate in hepatocellular carcinoma, lung carcinoma, severe pneumonia, and acute respiratory distress syndrome (ARDS). The aim of our review is to evaluate whether GPC3 has utility as a disease-specific biomarker, to discuss the potential involvement of GPC3 in cell biology, and to consider the changes of GPC3 gene and protein expression and regulation in hepatocellular carcinoma, lung cancer, severe pneumonia, and ARDS. Specific role of GPC3 in cancer and inflammatory disease at different times seems to have a clear and reasonable disease control, e.g., severe pneumonia with or without ARDS, or virus-infected patients with hepatocellular carcinoma compared with other liver diseases [3, 4] . doi = 10.1186/s40169-017-0146-5 id = cord-334528-xenq90xj author = Chen, Hsing I title = Acute lung injury and acute respiratory distress syndrome: experimental and clinical investigations date = 2011-03-17 keywords = ALI; ARDS; acute; lung; pulmonary summary = This literature review includes a brief historical retrospective of ALI/ARDS, the neurogenic pulmonary edema due to head injury, the long-term experimental studies and clinical investigations from our laboratory, the detrimental role of NO, the risk factors, and the possible pathogenetic mechanisms as well as therapeutic regimen for ALI/ARDS. [33, 34] In addition to the aforementioned animal experimentations and clinical observations that NO production through the iNOS may be involved in the lung injury due to various causes, our research team demonstrated that endotoxemia produced in anesthetized rats by intravenous administration of lipopolysaccharide (LPS, endotoxin) provoked systemic hypotension, endothelial damage and ALI accompanied by increased plasma nitrate/nitrite and expression of iNOS mRNA, TNF α and IL-1 β . The detrimental role of inducible nitric oxide synthase in the pulmonary edema caused by hypercalcemia in conscious rats and isolated lungs doi = 10.3724/sp.j.1263.2011.00044 id = cord-002782-mena480g author = Chen, Jiajia title = Long term outcomes in survivors of epidemic Influenza A (H7N9) virus infection date = 2017-12-08 keywords = ARDS; H7N9; patient summary = Our findings suggest that pulmonary function and imaging findings improved during the first 6 months especially for those with ARDS, however long-term lung disability and psychological impairment in H7N9 survivors persisted at 2 years after discharge from the hospital. In survivors of H5N1 virus infection, radiologic abnormalities including ground-glass opacities with a reticular pattern remained evident at the 12-month follow-up visit 10 . A study of the long-term outcomes of survivors with ARDS reported a mild restrictive pattern on lung-function testing, with a mild-to-moderate reduction in carbon monoxide diffusion capacity at 3 months; The median DLCO improved by 9% of the predicted value from 3 to 12 months 13 . A meta-analysis showed that recovery in the HRQoL of ARDS survivors occurred during the first 6 months after discharge 20 , but no significant improvement was evident at the 2-year follow-up in our study. Follow-up study on pulmonary function and lung radiographic changes in rehabilitating severe acute respiratory syndrome patients after discharge doi = 10.1038/s41598-017-17497-6 id = cord-336159-w646qkjz author = Chen, Wei title = Incidence and Outcomes of Acute Respiratory Distress Syndrome: A Nationwide Registry-Based Study in Taiwan, 1997 to 2011 date = 2015-10-30 keywords = ARDS; acute summary = title: Incidence and Outcomes of Acute Respiratory Distress Syndrome: A Nationwide Registry-Based Study in Taiwan, 1997 to 2011 A total of 40,876 ARDS patients (68% male; mean age 66 years) were identified by International Classification of Diseases, 9th edition coding and further analyzed for clinical characteristics, medical costs, and mortality. An abrupt decrease in the in-hospital mortality rate in 2003 was coincident with an outbreak of severe acute respiratory syndrome that year. 42, [44] [45] [46] Interestingly, in the current study, there was an abrupt decrease in mortality in 2003, which coincided with the outbreak of severe acute respiratory syndrome in Asia 22 and an increase in incidence of ARDS (Fig. 1A) . Clinical epidemiology of acute lung injury and acute respiratory distress syndrome: incidence, diagnosis, and outcomes Acute respiratory distress syndrome: estimated incidence and mortality rate in a 5 millionperson population base doi = 10.1097/md.0000000000001849 id = cord-344978-m672rnze author = Chen, Yuntian title = A Quantitative and Radiomics approach to monitoring ARDS in COVID-19 patients based on chest CT: a retrospective cohort study date = 2020-07-06 keywords = ARDS; COVID-19 summary = title: A Quantitative and Radiomics approach to monitoring ARDS in COVID-19 patients based on chest CT: a retrospective cohort study Three different models were constructed by using the traditional quantitative imaging metrics, radiomics features and their combinations, respectively. In this study, we use quantitative data analysis of chest CT images to detect the existence of ARDS during the COVID-19 treatment. Our results showed that used radiomics or quantitative metrics to monitor the ARDS existence was feasible, which had expanded the effectiveness of CT scans during the COVID-19 treatment, although it is still in controversy for reasons of availability, cost, and increased risk of cross-infection and radiation dosage [23] . Our results showed that radiomics or traditional quantitative post-analysis on a CT image could add extra information of disease condition in COVID-19 patients. A noninvasive ARDS existence monitoring model was constructed by using quantitative and radiomics analysis of chest CT images for COVDI-19 patients. doi = 10.7150/ijms.48432 id = cord-323566-jck799zq author = Cheung, Oi-Yee title = Acute Lung Injury date = 2017-11-05 keywords = ARDS; DAD; Fig; acute; lung; pulmonary summary = Acute fibrinous and organizing pneumonia (AFOP) is a histologic pattern of acute lung injury with a clinical presentation similar to that of classic DAD, in terms of both potential etiologic disorders and outcome. 104 Histologically, the disease is characterized by acute and organizing lung injury showing classic features (Fig. 6.34 ) of (1) alveolar septal edema, (2) eosinophilic airspace macrophages, (3) tissue and airspace eosinophils in variable numbers, and (4) marked reactive atypia of alveolar type II cells (eSlide 6.5). Considerations in the differential diagnosis include infection, connective tissue disease, acute exacerbation of idiopathic pulmonary fibrosis (IPF), drug effect, and other causes of DAD. doi = 10.1016/b978-0-323-44284-8.00006-5 id = cord-304201-fziv9a9k author = Chiang, Chi-Huei title = Eight-Month Prospective Study of 14 Patients With Hospital-Acquired Severe Acute Respiratory Syndrome date = 2004-11-30 keywords = ARDS; LDH; SARS summary = CONCLUSION The clinical picture of our patients presenting with hospital-acquired SARS revealed atypical pneumonia associated with lymphopenia, elevated serum levels of LDH, rapid clinical deterioration, and lack of response to empirical antibiotic therapy. The need for mechanical ventilation was associated with bilateral lung involvement on the initial chest radiograph and higher peak levels of LDH and CRP. The need for mechanical ventilation was associated with bilateral lung involvement on the initial chest radiograph and higher peak levels of LDH and CRP. The clinical picture of our patients presenting with hospital-acquired SARS revealed atypical pneumonia associated with lymphopenia, elevated serum levels of LDH, rapid clinical deterioration, and lack of response to empirical antibiotic therapy. Although several case series of SARS have been reported, 7-9 to our knowledge, a prospective clinical study including long-term follow-up assessment by chest radiography, chest high-resolution computed tomography (HRCT), and pulmonary function testing has not been reported, particularly for hospital-acquired cases. doi = 10.4065/79.11.1372 id = cord-016142-7j5cdt1b author = Chiang, Eddie T. title = Acute Lung Injury: The Injured Lung Endothelium, Therapeutic Strategies for Barrier Protection, and Vascular Biomarkers date = 2010-06-28 keywords = ALI; ARDS; MLC; PBEF; barrier; s1p summary = In this chapter, we will (1) address the role of cytoskeletal rearrangement in mechanistic regulation of pulmonary vascular barrier function and permeability, (2) define current strategies designed to enhance the integrity of the lung vascular endothelium, and (3) identify vascular biomarkers and potential prognostic determinants of acute inflammation. Phosphorylation of the substrate myosin light chain (MLC) by nmMLCK is central to paracellular gap formation and increased permeability by many edemagenic agents, including thrombin [18] and vascular endothelial growth factor (VEGF) [19] , both in vitro and in preclinical models of inflammatory lung injury. Protein kinase C (PKC)-mediated pathways exert a prominent effect on barrier regulation in a time-and speciesspecific manner without significantly increasing MLC phosphorylation and without inducing formation of actin stress fibers, but with alterations in other components of the endothelial cytoskeleton [18, 83, 84] . doi = 10.1007/978-0-387-87429-6_12 id = cord-017897-mbwm0ytg author = Chiumello, Davide title = The Acute Respiratory Distress Syndrome: Diagnosis and Management date = 2018-10-01 keywords = ARDS; patient; peep; respiratory summary = In order to guarantee a better patient adaptation to the ventilator, to reduce the oxygen consumption related to the respiratory muscle activity and to guarantee a protective transpulmonary pressure, the use of neuromuscular blockers is accepted in clinical practice [49] . The indications for the prone positioning have changed over time: once it was used to improve arterial oxygenation in the most severe forms of respiratory failure [53, 54] ; while nowadays it aims to achieve a more homogeneous distribution of stress and strain within the lung parenchyma, acting in synergy with the remaining therapies and protecting against the ventilator induced lung injury [55] . Lung recruitability is better estimated according to the Berlin definition of acute respiratory distress syndrome at standard 5 cm H2O rather than higher positive end-expiratory pressure: a retrospective cohort study Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial doi = 10.1007/978-3-319-94189-9_11 id = cord-305758-6twwcp47 author = Combes, Alain title = ECMO for severe ARDS: systematic review and individual patient data meta-analysis date = 2020-10-06 keywords = ARDS; CESAR; ECMO summary = METHODS: We conducted a systematic review and individual patient data meta-analysis of randomised controlled trials (RCTs) performed after Jan 1, 2000 comparing ECMO to conventional management in patients with severe ARDS. In this individual patient data meta-analysis of patients with severe ARDS included in the CESAR [15] and EOLIA [17] randomised trials, there is strong evidence to suggest that early recourse to ECMO leads to a reduction in 90-day mortality and less treatment failure compared with conventional ventilatory support. doi = 10.1007/s00134-020-06248-3 id = cord-324296-a9as72bx author = Combes, Alain title = Extracorporeal life support for adults with acute respiratory distress syndrome date = 2020-11-02 keywords = ARDS; ECCO; ECLS; ECMO; extracorporeal summary = Venovenous extracorporeal membrane oxygenation (ECMO), which uses high blood flow rates to both oxygenate the blood and remove carbon dioxide, may be considered in patients with severe ARDS whose oxygenation or ventilation cannot be maintained adequately with best practice conventional mechanical ventilation and adjunctive therapies, including prone positioning. VCV volumecontrolled ventilation, PEEP positive end-expiratory pressure, VT tidal volume, Pplat plateau pressure, BIPAP/APRV biphasic positive airway pressure/ airway pressure release ventilation, RR respiratory rate, ∆P driving pressure, Fr French, ARDS acute respiratory distress syndrome, ECLS extracorporeal life support, MV mechanical ventilation, FdO 2 fraction on oxygen in the sweep gas, MO, membrane oxygenator, Qecmo (Q E ) ECMO flow in L/min. The strategy of ultraprotective lung ventilation with extracorporeal CO 2 removal (SUPERNOVA) pilot study included 95 patients with moderate-to-severe ARDS in 23 ICUs. ECCO 2 R allowed a significant decrease in mechanical power with reductions of Pplat (27 to 24 cmH 2 O), VT (6 to 4 mL/kg), RR (28 to 24 breaths/min), and minute ventilation (10 to 6 L/min) [51] . doi = 10.1007/s00134-020-06290-1 id = cord-355847-1ru15s5a author = Convertino, Irma title = Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in COVID-19 patients date = 2020-06-11 keywords = ARDS; COVID-19; TNF summary = Several drugs, endowed with modulating activity on cytokine pathways, including anti-IL-6, anti-TNF, and Janus kinase (JAK) inhibitors, currently approved for the treatment of immune-mediated inflammatory diseases, have been suggested or could be yet taken into account for experimental use in COVID-19 patients with ARDS and/or pneumonia ( Fig. 1 ). In addition, a multicenter open-label randomized clinical trial is studying the benefit risk profile of siltuximab, as a single therapeutic option or in combination with anakinra, at a single dose of 11 mg/kg, in comparison with tocilizumab or anakinra, alone or in combination, in ARDS patients with COVID-19 [20] . Based on the results expected with tocilizumab and siltuximab, other anti-IL-6 drugs, currently approved for rheumatoid arthritis, namely sarilumab and sirukumab, could be studied in ARDS and pneumonia patients with COVID-19. Anti-JAK drugs (such as ruxolitinib, tofacitinib, baricitinib, oclacitinib, fedratinib, upadacitinib, and peficitinib) [39] should be considered also among the options for clinical investigations in COVID-19-related ARDS and pneumonia patients. doi = 10.1186/s13054-020-03020-3 id = cord-309089-ex9nh1yi author = Coperchini, Francesca title = The Cytokine storm in COVID-19: An overview of the involvement of the chemokine/chemokine-receptor system date = 2020-05-11 keywords = ARDS; COVID-19; CXCL10; MERS; SARS summary = Since the first reports on COVID-19 disease, it appeared clear that Acute respiratory distress syndrome (ARDS) accounted for a significant number of deaths among infected patients and that ARDS should be regarded as the hallmark immune-mediated clinical consequence in SARS-CoV-2, similarly to what described for SARS-CoV and MERS-CoV infections [11] . As shown by previous data in the literature, increased circulating levels of pro-inflammatory cytokines (eg, Interferon γ, interleukin (IL-) 1B, IL-6, IL-12) and chemokines (CXCL10, and CCL2) are associated with pulmonary inflammation and extensive lung involvement in SARS patients, similarly to what happens in MERS-CoV infection [13] . In mice infected with SARS-CoV, the clinical features of the syndrome showed an age-dependent increase in severity (similarly to what observed in humans), which was related to an increased level of pro-inflammatory cytokines and chemokines, paralleled by a reduction in T-cell responses [78] . doi = 10.1016/j.cytogfr.2020.05.003 id = cord-023890-z346hh2c author = Cotogni, Paolo title = Polyunsaturated Fatty Acids and Cytokines: Their Relationship in Acute Lung Injury date = 2015 keywords = ALI; ARDS; DHA; PUFA summary = However, at present, the issue of lipid therapy in ALI/ARDS is still controversial due, at least in part, to inconclusive or contradicting results in several recent clinical trials using n-3 PUFAs. Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are inflammatory diseases whose clinical severity depends on the grade of inflammatory response. The first RCT showed the ability of an enteral formula with a high n-3/n-6 PUFA ratio (1:1) to reduce pulmonary inflammation and improve clinical outcomes, i.e., better oxygenation, shorter requirement for mechanical ventilation, shorter ICU-LOS, and less incidence of new organ failure; however, no difference in mortality was observed in ARDS patients (Gadek et al. The first RCT analyzed the effect of an enteral n-3 PUFA-enriched diet in septic patients with ALI or ARDS showing that the administration of the study formula, compared to a control formula with less lipids than in the previous three studies, was associated to a shorter ICU-LOS but not to an improvement in gas exchange or in a lower incidence of novel organ failures (Grau-Carmona et al. doi = 10.1007/978-1-4614-7836-2_112 id = cord-286771-77hs34jm author = Cruces, Pablo title = A physiological approach to understand the role of respiratory effort in the progression of lung injury in SARS-CoV-2 infection date = 2020-08-10 keywords = ARDS; SILI; lung summary = Protective lowtidal volume (Vt) mechanical ventilation (MV), including delivering a physiologic low Vt adjusted by ideal body weight, is currently the standard of care for patients requiring invasive respiratory support, like moderate and severe ARDS. Additionally, we found a significant progression of regional Fig. 2 Regional volumetric strain maps in a 3-h murine model of patient self-inflicted lung injury randomized to two groups: Group I: subjects with induced lung injury on low tidal volume mechanical ventilation at the beginning of the experiment (T1) and at the end of the experiment (T3) (upper left and right panels). Ventilation-induced lung injury exists in spontaneously breathing patients with acute respiratory failure: yes Can high-flow nasal cannula reduce the rate of endotracheal intubation in adult patients with acute respiratory failure compared with conventional oxygen therapy and noninvasive positive pressure ventilation?: a systematic review and meta-analysis doi = 10.1186/s13054-020-03197-7 id = cord-341472-29opvzrj author = Curley, Gerard F. title = Future therapies for ARDS date = 2014-12-04 keywords = ARDS; lung summary = authors: Curley, Gerard F.; Laffey, John G. Despite more than 150 randomized clinical trials (RCTs) of multiple potential therapies, the only interventions for acute respiratory distress syndrome (ARDS) that reduce mortality are those that minimize ventilator-induced lung injury [1] . In pre-clinical studies, heparin has been found to reduce alveolar fibrin deposition and exert anti-inflammatory effects. Interferon beta (IFN-b) increases endothelial expression of CD73, the rate-limiting enzyme in the conversion of adenosine monophosphate to adenosine, which in turn binds to pulmonary A2B receptors and exerts multiple protective effects in pre-clinical models. A randomized clinical trial of hydroxymethylglutarylcoenzyme a reductase inhibition for acute lung injury (The HARP Study) The effect of intravenous interferon-beta-1a (FP-1201) on lung CD73 expression and on acute respiratory distress syndrome mortality: an open-label study Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study doi = 10.1007/s00134-014-3578-z id = cord-280965-x5ffw843 author = Damiani, Elisa title = Comment on “Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study” date = 2020-10-23 keywords = ARDS summary = title: Comment on "Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study" on the evaluation of respiratory mechanics and gas exchanges in patients with acute respiratory distress syndrome (ARDS) due to COVID-19 that was recently published in the Annals of Intensive Care [1] . In 22 patients with moderate-to-severe ARDS, the authors observed high physiological dead space (V D /V T ) and ventilatory ratio (VR). In a recent report, we described the sublingual microcirculation of mechanically ventilated patients with severe SARS-COV-2 pneumonia and showed an inverse correlation between perfused vessel density (PVD) and D-dimers [4] . Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study Microcirculatory dysfunction and dead-space ventilation in early ARDS: a hypothesis-generating observational study All authors read and approved the final manuscript. doi = 10.1186/s13613-020-00765-6 id = cord-303292-iheq50ub author = De Jong, Audrey title = How to ventilate obese patients in the ICU date = 2020-10-23 keywords = ARDS; ICU; NIV; peep summary = Regarding mechanical ventilation in patients with and without acute respiratory distress syndrome (ARDS), low tidal volume (6 ml/kg of predicted body weight) and moderate to high positive end-expiratory pressure (PEEP), with careful recruitment maneuver in selected patients, are advised. During invasive mechanical ventilation, patients with obesity are more prone to lung collapse and require higher PEEP to avoid it; low V T is calculated on predicted body weight. In a randomized controlled trial of the same team comparing HFNC to standard oxygen [87] in high-risk non-hypercapnic patients including 22% of patients with obesity, the study was stopped due to low recruitment after 155 patients, without any difference in extubation failure rate found between the two groups. PBW predicted body weight, PEEP positive end-expiratory pressure, ARDS acute respiratory distress syndrome, ECMO extracorporeal membrane oxygenation, CPAP continuous positive airway pressure, NIV noninvasive ventilation, HFNC high-flow nasal cannula oxygen patients. doi = 10.1007/s00134-020-06286-x id = cord-321878-bnjupaik author = Deliwala, Smit S. title = A 29-Year-Old Male with a Fatal Case of COVID-19 Acute Respiratory Distress Syndrome (CARDS) and Ventilator-Induced Lung Injury (VILI) date = 2020-07-23 keywords = ARDS; COVID-19; Type summary = title: A 29-Year-Old Male with a Fatal Case of COVID-19 Acute Respiratory Distress Syndrome (CARDS) and Ventilator-Induced Lung Injury (VILI) Patient: Male, 29-year-old Final Diagnosis: Acute respiratory distress syndrome (ARDS) • COVID-19 •multi organ failure/septic shock • pneumothorax Symptoms: Cough • dyspnea • fatigue • myalgia Medication:— Clinical Procedure: Mechanical ventilation • thoracentesis Specialty: Critical Care Medicine OBJECTIVE: Unknown ethiology BACKGROUND: COVID-19 patients that develop acute respiratory distress syndrome (ARDS) "CARDS" behave differently compared to patients with classic forms of ARDS. In previous cases of SARS patients, pneumothorax was noted at 14-37 days after the initial diagnosis [16] , suggesting that a sustained period of lung inflammation serves as a pre-requisite, a similar time course as our patient Recently a scoring system was proposed to predict the risk of developing critical illness in COVID-19, allowing early interventions and resource allocation to mitigate the high disease burden [17] . doi = 10.12659/ajcr.926136 id = cord-006459-9kizif98 author = Deng, Guangcun title = Acute respiratory distress syndrome induced by H9N2 virus in mice date = 2009-11-28 keywords = ARDS; BALF; H9N2 summary = Clinical signs, pathological changes and viral replication in lungs, arterial blood gas, and cytokines in bronchoalveolar lavage fluid (BALF) were observed at different time points after infection. Our data show that H9N2 viral infection resulted in ARDS in mice, and this may facilitate studies of the pathogenesis of future potential H9N2 disease in humans. Arterial blood gas, white blood cell counts, tumor necrosis factor (TNF)-a and interleukin (IL)-6 levels in bronchoalveolar lavage fluid (BALF), and viral titers in the lungs were measured at different times. In H9N2-virus-infected mice, we observed that circulating leukocytes dramatically decreased in the blood and that a great number of inflammatory cells infiltrated the lungs. Acute respiratory distress syndrome induced by avian influenza A (H5N1) virus in mice doi = 10.1007/s00705-009-0560-0 id = cord-000492-ec5qzurk author = Devaney, James title = Clinical Review: Gene-based therapies for ALI/ARDS: where are we now? date = 2011-06-20 keywords = ALI; ARDS; gene; lung summary = Plasmid transfer (closed Easily produced at low cost No specifi c cell targeting Electroporation-mediated gene transfer of the dsDNA circles) Very ineffi cient Na + ,K + -ATPase rescues endotoxin-induced lung injury [60] Nonviral DNA complexes Complexes protect DNA Less effi cient than viral vectors Cationic lipid-mediated transfer of the Na + ,K + -(lipoplexes or polyplexes) Modifying transgene DNA to eliminate bacterial motifs [75, 76] Development of high-effi ciency tissue-specifi c promoters [77] [78] [79] [80] Development of promoters that regulate gene expression [83] Enhanced therapeutic targeting Nebulization technologies [9] Strategies to target the pulmonary endothelium [10] Improved cellular uptake of vector Surface active agents to enhance vector spread [84] Reduce ubiquitination of viral capsid proteins [85] Better therapeutic targets Enhancement or restoration of lung epithelial and/or endothelial cell function [86] Strengthening lung defense mechanisms against injury [87] Speeding clearance of infl ammation and infection Enhancement of the repair process following ALI/ARDS [88] . doi = 10.1186/cc10216 id = cord-279440-0mn5b0vv author = Diehl, J-L title = Response to Damiani and colleagues date = 2020-10-14 keywords = ARDS summary = have put our results in perspective with their own published observations of an inverse relationship between sublingual perfused vessel density and D-dimers in mechanically ventilated patients with severe SARS-CoV-2 pneumonia. To explore if COVID-19 ARDS patients could exhibit a lung-specific microvascular response to high PEEP levels, as compared to non-COVID-19 ARDS patients, seems to be an important field of investigation. One important point is that the very vast majority of studies in COVID-19 ARDS patients used, by convenience, ventilatory ratio (VR) as a marker of impaired ventilatory efficacy, as mentioned in Damiani''s comment, rather than dead space measurements. Finally, it will be important to further precisely investigate the relationship between dead space measurements, with a special focus on indicators of alveolar dead space, and markers of endothelial dysfunction, such as bio-markers (such as CECs and D-dimers) and innovative methods such as the video-microscopy methods used by Damiani and colleagues. doi = 10.1186/s13613-020-00757-6 id = cord-025163-iyh0d6mj author = Ding, Lin title = Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers date = 2020-05-24 keywords = ARDS; pneumoniae summary = title: Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers pneumoniae pneumonia induced ARDS in a case series of adults and youth hospitalized with radiographically confirmed CAP prospectively enrolled in an observational cohort study in two university teaching hospitals, from November 2017 to October 2019. pneumoniae induced ARDS were adequately supported with HFNC or NIV, 50% required intubation, RM and prone position were effective in 30% intubated cases, and 20% needed ECMO support; 5) when early anti-mycoplasmal drugs together with sufficient respiratory support are given, the survival rate was high with no need for corticosteroids; and 6) younger patients with lower PaO 2 / FiO 2 and APACHE II scores, and higher PCT and higher neutrophil cell proportion at ICU admission were more likely to require intubation. doi = 10.1186/s12879-020-05085-5 id = cord-034469-ew90eef4 author = Dos Santos Rocha, Andre title = Physiologically variable ventilation reduces regional lung inflammation in a pediatric model of acute respiratory distress syndrome date = 2020-10-31 keywords = ARDS; PVV; lung; ventilation summary = Here, we compare structural, molecular and functional outcomes reflecting regional inflammation between PVV and conventional pressure-controlled ventilation (PCV) in a pediatric model of healthy lungs and acute respiratory distress syndrome (ARDS). CONCLUSIONS: Variable ventilation based on a physiological respiratory pattern, compared to conventional pressure-controlled ventilation, reduced global and regional inflammation in both healthy and injured lungs of juvenile rabbits. Conversely, ventilating the lungs with PVV resulted in a significant decrease in tissue damping in control animals (T1-T5, p < 0.01), whereas no change in respiratory mechanics was detected in the ARDS model. In the present study, a combined approach consisting of lung functional and structural assessment was used to investigate differences in the global and regional effects of PVV and the conventional monotonous pressure-controlled mode in a pediatric model of normal lungs and ARDS. doi = 10.1186/s12931-020-01559-x id = cord-005705-j765ruj1 author = Dreyfuss, Didier title = Is it better to consent to an RCT or to care?: Μηδεν αγαν (“nothing in excess”) date = 2004-12-17 keywords = ARDS; consent; patient; research; trial summary = Another contention of the present paper is this [14] : critical care physicians may still believe that RCTs remain the best tool for improving knowledge and care, and in this case they must accept to use the means needed to achieve the end and therefore to insist on mandatory informed consent from the patient or proxy; or they may realize that the game is not worth the candle and they must then turn to other forms of research that are ranked less highly in the pyramid of evidence-based medicine [15] . Before discussing the problem of informed consent to research a critical appraisal of the scientific and ethical validity of RCTs in critical care medicine is in order. doi = 10.1007/s00134-004-2493-0 id = cord-006237-oxbquzeg author = Dwenger, A. title = Bioluminescence, chemiluminescence date = 1990 keywords = ARDS; PMNL; neutrophil summary = The oxygen radical production was measured by luminol (0.4 mmol/1 test) and/or lucigenin (0.23 retool/1 test) enhanced chemiluminescence response (CL) (Biolumat LB 9505, Berthold) in absence or in presence of different stimuli, N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP, Sigma; 3.5 • 10-6 tool/1 test), zymosan A (Sigma; 3.5 mg/ml test), latex (Unisphere latex 22, 0.8 gin, Serva; 2 gl/ml test), lipopolysaccharide (LPS from E. The aim of the present study was to examine, if PGE 1 might 80 influence injury to EC, caused by LPS-primed neutrophils, and furthermore, if this effect could be explained by a diminished oxygen radical production, measured by chemiluminescence (CL). Addition of 0.1 gg of radical trap (MDTQ-DA) to each zymosan stimulated whole blood sample reduced CL response by 7 0 -90 p.c. Following induction of haemorrhagic-necrotising pancreatitis, high quantities of toxic oxygen metabolites are released from pancreatic tissue, contributing to the development of MOF. doi = 10.1007/bf00325727 id = cord-305389-n5cppi72 author = D’Alonzo, Daniele title = COVID-19 and pneumonia: a role for the uPA/uPAR system date = 2020-06-18 keywords = ARDS; COVID-19; FPR1; UPARANT; receptor summary = Here, we highlight recent findings on the urokinase plasminogen activator (uPA)/uPA receptor (uPAR) system that suggest its potential role as a main orchestrator of fatal progression to pulmonary, kidney, and heart failure in patients with coronavirus. Given its lack of a transmembrane domain, GPI-anchored uPAR has high mobility on the cell surface and can interact with later partners with the ability to communicate with the internal cell compartment to produce downstream intracellular signaling mediated by effector molecules, such as the focal adhesion kinase, Src, and Akt. uPAR binds vitronectin, and multiple cell receptors, such as different types of transmembrane receptor [the formyl peptide receptors (FPRs), integrins, and VEGFR2 [23] ], establishing crosstalk between membrane-bound uPAR and its co-receptors. Serum plasminogen activator urokinase receptor predicts elevated risk of acute respiratory distress syndrome in patients with sepsis and is positively associated with disease severity, inflammation and mortality doi = 10.1016/j.drudis.2020.06.013 id = cord-329585-uyze6dtu author = Earhart, Alexander P. title = Consideration of dornase alfa for the treatment of severe COVID-19 ARDS date = 2020-04-30 keywords = ARDS summary = The cellular and molecular mechanism proposed for dornase alfa activity in severely distressed lungs of CF and many ARDS patients is as follows. Inflammation results in neutrophilia and neutrophil infiltration in the lungs, where these cells produce NETs, largely comprised of sticky, large chromosomal DNA that physically reinforces airway mucus viscosity and accumulation (5, 6) . Dornase alfa facilitates airway clearance by breaking up reinforcement of mucus by NETs, by far the greatest source of extracellular DNA in inflamed lungs (5, 6) . Indeed, lung neutrophilia and NET production have been shown to contribute to the development of ARDS in other severe viral respiratory infections, including H1N1 influenza (11) . We postulate that nebulized dornase alfa may effectively treat a deleterious effect of NETs in the airways and thus promote recovery in patients with COVID-19-related ARDS ( Figure 1 ). Model of how dornase alfa-sensitive NETs from neutrophils may reinforce mucus accumulation, rigidity, and airway occlusion in severe COVID-19. doi = 10.1016/j.nmni.2020.100689 id = cord-025865-jjjr3ymt author = Eastin, Carly title = Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China: Wu C, Chen X, Cai Y, et al. JAMA Intern Med. doi:10.1001/jamainternmed.2020.0994. date = 2020-06-03 keywords = ARDS summary = Additionally the majority of cases were suspected, not confirmed, and some of the children remained hospitalized at the end of the study therefore severity of disease may not be accurate. The authors concluded that COVID-19 caused infection in all ages without obvious gender differences, however younger children appeared to have higher severity of disease. Presenting symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) typically include fever, dyspnea, myalgia, and cough. This study reports characteristics of and potential risk factors for patients who developed acute respiratory distress syndrome (ARDS) or who died as a result of SARS-CoV-2, the virus that causes COVID-19. Patients aged 21 to 83 who had confirmed COVID-19 and were admitted to Jinyintan Hospital in Wuhan, China between December 25, 2019 and January 26, 2020 were included in this retrospective study. doi = 10.1016/j.jemermed.2020.04.007 id = cord-032608-zw540s64 author = Elsayed, Hany Hasan title = Dexamethasone for treatment of severe COVID-19, a surprise? date = 2020-09-24 keywords = ARDS summary = In fact, the Surviving Sepsis Campaign panel recently recommended that "mechanically ventilated patients with COVID-19 related ARDS should be managed similarly to other patients with acute respiratory failure in the ICU" [3] . In fact, Villar and his colleagues have published the largest meta-analysis of using dexamethasone treatment for the acute respiratory distress syndrome few months back and this has shown a mortality benefit [6] . In fact, 1772 patients with severe COVID-19 ARDS requiring mechanical ventilation in the RECOVERY trial did not receive steroids. I believe that most intensivists around the world were using dexamethasone for their patients with severe COVID-19 developing ARDS before the RECOVERY trial results were released based on the evidence they had on how to manage this unique entity from a variety of causes. Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial doi = 10.1186/s43057-020-00032-1 id = cord-329381-uwae8738 author = Evrard, Bruno title = Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome date = 2020-05-18 keywords = ARDS summary = title: Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome COVID-19 patients with ACP tended to have lower respiratory-system compliance than their counterparts, presumably due to distinct ARDS phenotypes [6] . This first study assessing hemodynamically ventilated COVID-19 patients with TEE shows a lower **Calculated as the tidal volume divided by the driving pressure (difference between the inspiratory plateau pressure and positive end-expiratory pressure) ***One patient was diagnosed with a Tako-tsubo syndrome during transesophageal echocardiography examination performed shortly after tracheal intubation, after 6 days of high-flow nasal cannula; full recovery of left ventricular systolic function was documented under mechanical ventilation 10 days later ****Measured using the Doppler method applied at the left ventricular outflow tract *****As per April 24, with still 6 patients hospitalized in the intensive care unit, 5 of them being invasively ventilated prevalence of LV and RV failure than in flu-related ARDS patients. doi = 10.1186/s13054-020-02958-8 id = cord-293740-4c3yemi3 author = Ferrando, Carlos title = Clinical features, ventilatory management, and outcome of ARDS caused by COVID-19 are similar to other causes of ARDS date = 2020-07-29 keywords = ARDS; COVID-19; patient summary = METHODS: This is a multicenter, prospective, observational study in consecutive, mechanically ventilated patients with ARDS (as defined by the Berlin criteria) affected with with COVID-19 (confirmed SARS-CoV-2 infection in nasal or pharyngeal swab specimens), admitted to a network of 36 Spanish and Andorran intensive care units (ICUs) between March 12 and June 1, 2020. [temperature, mean arterial pressure (MAP), heart rate], laboratory parameters (blood test, coagulation, biochemical), ventilatory parameters [tidal volume (VT), inspiratory oxygen fraction (FiO 2 ), respiratory rate (RR), PEEP, plateau pressure (Pplat), driving pressure (DP), respiratory system compliance (Crs)], the use of adjunctive therapies [recruitment maneuvers (RM), prone position, neuromuscular blocking agents (NMBA), extracorporeal membrane oxygenation (ECMO)], pharmacological treatments, disease chronology [time from onset of symptoms and from hospital admission to initiation of mechanical ventilation (MV), ventilator-free days (VFDs) during the first 30 days, ICU length of stay (LOS)]. doi = 10.1007/s00134-020-06192-2 id = cord-033298-4d40yyzu author = Fiedler, M. O. title = Fokus Beatmung, Sauerstofftherapie und Weaning: Intensivmedizinische Studien aus 2019/2020 date = 2020-10-07 keywords = ARDS; Beatmung; Patienten; Studien; der summary = Tab. 1 Die Standardtherapie bei der Beatmung von Patienten mit einem akuten Lungenversagen (ARDS) wird als lungenprotektive Beatmung bezeichnet und beinhaltet die Anwendung von niedrigem Tidalvolumen und eine Begrenzung des oberen Plateaudrucks [9] . Ein erhöhter respiratorischer Antrieb ("respiratory drive") bei Patienten im schweren ARDS ohne tiefe Sedierung und ohne Muskelrelaxierung kann das Risiko einer "ventilatorinduzierten Lungenschädigung" ("ventilator induced lung injury", VILI) erhöhen. Basierend auf den Ergebnissen der ACURASYS-und ROSE-Studie sind Muskelrelaxanzien erst einzusetzen, wenn eine Reihe von lungenprotektiven Maßnahmen zur Beatmung eingehalten wird und diese nicht ausreichend ist, um den Patienten vor einem VILI zu bewahren oder die Oxygenierung darunter nicht besser wird. Beitler JR, Sarge T, Banner-Goodspeed VM et al (2019) Effect of titrating positive endexpiratory pressure (PEEP) with an esophageal pressure-guided strategy vs an empirical high PEEP-FiO2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: a randomized clinical trial. doi = 10.1007/s00101-020-00859-7 id = cord-345028-56hg62be author = Flinspach, Armin Niklas title = Volatile Isoflurane in Critically Ill Coronavirus Disease 2019 Patients—A Case Series and Systematic Review date = 2020-10-21 keywords = ARDS; patient; sedation summary = Although the potential benefits of sedation with volatile anesthetics in coronavirus disease 2019 patients are currently being discussed, the use of isoflurane in patients with coronavirus disease 2019–induced acute respiratory distress syndrome has not yet been reported. Although the potential benefits of sedation with volatile anesthetics in coronavirus disease 2019 patients are currently being discussed, the use of isoflurane in patients with coronavirus disease 2019-induced acute respiratory distress syndrome has not yet been reported. To facilitate ventilator synchrony and prone positioning during critical care treatment of coronavirus disease 2019 (COVID-19) patients, deeper sedation levels are often indispensable. Several studies have demonstrated the safe use of volatile anesthetics in critically ill patients, leading to a decreased duration of mechanical ventilation when treating classical acute respiratory distress syndrome (ARDS) (4) (5) (6) (7) (8) (9) . We included five patients admitted to the ICU who were previously diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or who tested positive for COVID-19 during treatment. doi = 10.1097/cce.0000000000000256 id = cord-258087-93yfs7ve author = Flores, Carlos title = A quality assessment of genetic association studies supporting susceptibility and outcome in acute lung injury date = 2008-10-25 keywords = ALI; ARDS; acute; study summary = CONCLUSIONS: Although the quality of association studies seems to have improved over the years, more and better designed studies, including the replication of previous findings, with larger sample sizes extended to population groups other than those of European descent, are needed for identifying firm genetic modifiers of ALI. This quality assessment of genetic association studies with positive findings in susceptibility or outcome of ALI and ARDS identified a total of 29 articles and 16 genes. ACE, angiotensin-converting enzyme; ALI, acute lung injury; ARDS, acute respiratory distress syndrome; CAP, community-acquired pneumonia; CXCL2, chemokine CXC motif ligand 2; F5, coagulation factor V; IL-6, interleukin-6; IL-10, interleukin-10; MBL2, mannose-binding lectin-2; MIF, macrophage migration inhibitory factor; MV, mechanical ventilation; MYLK, myosin light-chain kinase; NFKB1, nuclear factor kappa light polypeptide gene enhancer in B cells; NFKBIA, nuclear factor kappa light polypeptide gene enhancer in B cells inhibitor alpha; NRF2, nuclear factor erythroid-derived 2 factor; PBEF, pre-B cell-enhancing factor; PLAU, plasminogen activator urokinase; SARS, severe acute respiratory syndrome; SFTPB, surfactant pulmonaryassociated protein B; SIRS, systemic inflammatory response syndrome; SNP, single-nucleotide polymorphism; TNF, tumor necrosis factor; TR, tandem repeat (polymorphism); VEGF, vascular endothelial growth factor. Positive genetic association studies with acute lung injury/acute respiratory distress syndrome susceptibility and/or outcome (by year of publication) doi = 10.1186/cc7098 id = cord-254083-ea94wn3f author = Fowler, Alexander J. title = COVID-19 Phenotypes and Potential Harm of Conventional Treatments: How to Prove the Hypothesis date = 2020-08-15 keywords = ARDS; COVID-19 summary = We appreciate the authors'' clinical observations and their expertise; however, we have several concerns with these two recommendations, which diverge from the best established evidence for acute respiratory distress syndrome (ARDS). For reference, patients enrolled in the PROSEVA (Prone Positioning in Severe ARDS) trial had a mean respiratory system compliance of 35 ml/cm H 2 O (SD, 15) at the time of enrollment (3). Evidence from randomized controlled trials suggests that prone positioning and low VT ventilation are the precise strategies for gentle ventilation that patients with ARDS, "typical" or not, should receive. Importantly, the authors suggest that recommended treatment strategies for severe COVID-19 pneumonia based on ARDS management (3) may lead to disease progression and excess harm (1, 2) . Second, we can use the DAG to determine a minimal adjustment set of variables to reliably estimate the direct effect of our exposure (ARDS ventilation strategy in COVID-19 L-phenotype patients) and outcome (ICU mortality). doi = 10.1164/rccm.202004-1293le id = cord-001493-3yu2di1g author = Fujishima, Seitaro title = Pathophysiology and biomarkers of acute respiratory distress syndrome date = 2014-05-07 keywords = ARDS; acute; patient summary = Acute respiratory distress syndrome (ARDS) is defined as an acute-onset, progressive, hypoxic condition with radiographic bilateral lung infiltration, which develops after several diseases or injuries, and is not derived from hydrostatic pulmonary edema. In parallel with progress in understanding the pathophysiology of ARDS, various humoral factors induced by inflammation and molecules derived from activated cells or injured tissues have been shown as potential biomarkers that may be applied in clinical practice. Numerous proinflammatory cytokines play major roles in acute inflammation and the development of inflammatory lung diseases, including ARDS. Increased levels of soluble receptor for advanced glycation end products (sRAGE) and high mobility group box 1 (HMGB1) are associated with death in patients with acute respiratory distress syndrome Neutrophil elastase and systemic inflammatory response syndrome in the initiation and development of acute lung injury among critically ill patients Acute Respiratory Distress Syndrome Network: Plasma surfactant protein levels and clinical outcomes in patients with acute lung injury doi = 10.1186/2052-0492-2-32 id = cord-277590-u0uf88e7 author = Gage, Ann title = Reacquainting Cardiology With Mechanical Ventilation in Response to the COVID-19 Pandemic date = 2020-03-27 keywords = ARDS summary = As ARDS progresses, lung compliance decreases, hypoxemia ensues, and patients can progress to ventilator dependence (3, 4) . After initial stabilization, it is critical to appropriately titrate settings to minimize ventilator-induced lung injury. One of the most common methods for doing this is careful monitoring of the plateau pressure ( Figure 2) . It is also important to monitor the patient''s driving pressure, or difference between the PEEP and plateau pressure, as increased driving pressures have been associated with higher mortality in ARDS (10). Acute respiratory distress syndrome: the Berlin definition Surviving sepsis campaign: guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19) Prone positioning reduces mortality from acute respiratory distress syndrome in the low tidal volume era: a meta-analysis Care for critically ill patients with COVID-19 Driving pressure and survival in the acute respiratory distress syndrome KEY WORDS acute respiratory distress syndrome, coronavirus, coronavirus disease-2019, mechanical ventilation doi = 10.1016/j.jaccas.2020.03.007 id = cord-353594-z1vxamvp author = Gagiannis, Daniel title = Clinical, Serological, and Histopathological Similarities Between Severe COVID-19 and Acute Exacerbation of Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD) date = 2020-10-02 keywords = ANA; ARDS; COVID-19; SARS; patient summary = Since we observed similarities between COVID-19 and interstitial lung disease in connective tissue disease (CTD-ILD), we investigated features of autoimmunity in SARS-CoV-2-associated respiratory failure. Patients or their relatives had given written informed consent to routine diagnostic procedures (serology, bronchoscopy, radiology) as well as (partial) autopsy in the case of death, respectively, as well as to the scientific use of data and tissue samples in the present study. Our finding that significant ANA titers and/or detection of specific autoantibodies are found in most patients who develop ARDS raises the question if there is a comparable mechanism of lung damage between SARS-CoV-2 infection and exacerbating autoimmune disease. Our observation of CTD-associated autoantibodies together with the CTD-like radiologic and histopathologic lung findings in severe cases of COVID-19 point towards a possible dysregulation of the immune response upon SARS-CoV-2 infection that might fuel organizing pneumonia and trigger interstitial fibrosis, with deleterious effects on the functional outcome in long-term survivors. doi = 10.3389/fimmu.2020.587517 id = cord-333520-v2sb90rc author = Gardin, Chiara title = Could Mesenchymal Stem Cell-Derived Exosomes Be a Therapeutic Option for Critically Ill COVID-19 Patients? date = 2020-08-26 keywords = ALI; ARDS; COVID-19; MSC; Mesenchymal; SARS; cell summary = Exosomes derived from mesenchymal stem cells (MSCs) are being explored for the management of a number of diseases that currently have limited or no therapeutic options, thanks to their anti-inflammatory, immunomodulatory, and pro-angiogenic properties. Next, we describe some of the most significant clinical evidence of the successful use of MSC-derived exosomes in animal models of lung and heart injuries, which might strengthen our hypothesis in terms of their utility for also treating critically ill COVID-19 patients. Recently, MSC-derived exosomes have been demonstrated to have comparable and even greater effects than cells themselves in improving inflammation and injury in a variety of pre-clinical lung disease models, including ALI/ARDS (Table 1) . From the studies discussed above, it emerged that the rationale for using MSC-derived exosomes, MVs, or EVs in ALI/ARDS is based on several processes, many of which are shared with those identified in the parent MSCs. These include immunomodulation and anti-inflammatory properties on host tissue, reduction of the permeability of alveolar epithelium and endothelium, improvement of alveolar fluid clearance, enhancement of macrophage phagocytosis, and tissue repair through direct mitochondrial transfer with host cells (Figure 2 ). doi = 10.3390/jcm9092762 id = cord-286133-h8jgwe4z author = Gattinoni, Luciano title = Reply by Gattinoni et al. to Hedenstierna et al., to Maley et al., to Fowler et al., to Bhatia and Mohammed, to Bos, to Koumbourlis and Motoyama, and to Haouzi et al. date = 2020-08-15 keywords = ARDS; COVID-19 summary = However, as evidenced by this correspondence, our scientific community seems divided into two broad categories: On one side are the believers that coronavirus disease (COVID-19) pneumonia must be defined as acute respiratory distress syndrome (ARDS)-and that is it. Dr. Bos, Dr. Maley and colleagues, and Dr. Haouzi and colleagues in their letters conclude, as do many others in our scientific community, that COVID-19 pneumonia is not atypical but fits the conventional ARDS definition and that higher respiratory system compliance (Crs) may be a normal finding in the syndrome. Actually, we have observed that patients with coronavirus disease (COVID-19)-associated acute respiratory distress syndrome (ARDS) from Wuhan often present "better" compliance and "worse" PA O 2 -Pa O 2 gradient at low PEEP. doi = 10.1164/rccm.202004-1052le id = cord-349440-jxigsdzh author = Gattinoni, Luciano title = COVID-19 phenotypes: leading or misleading? date = 2020-07-02 keywords = ARDS summary = Comment to an Editorial where we invite the authors to express with clarity the risks they are referring to and how their argument is furthering the cause of patients and clinicians. After reading sentences such as "…by needlessly clouding the clinical picture, false phenotypes … upon inspection of patient data, simply do not exist" , It is not clear to us -and without a doubt to most readers -what sort of clear, and self-evident truth we (and other authors) have been trying to cloud. We note also with concern the conclusions of the editorial: "by prematurely phenotyping patients with COVID-19, we expose ourselves and our patients to considerable and preventable risk" and we invite the authors to express with clarity the risks they are referring to and how their argument is furthering the cause of patients and clinicians. doi = 10.1183/13993003.02195-2020 id = cord-349980-x1h5dhn9 author = Ge, Huiqing title = Lung Mechanics of Mechanically Ventilated Patients With COVID-19: Analytics With High-Granularity Ventilator Waveform Data date = 2020-08-21 keywords = ARDS; COVID-19; PVA summary = In order to make this gap end, the purpose of the study were 4-folds: (1) to describe the lung mechanics of COVID-19 patients by analyzing high-granularity ventilator waveform data; (2) to explore whether the lung compliance can be influenced by clinical factors, such as recruitment maneuver (RM) and body positioning; (3) to identify risk factors for PVA during IMV in COVID-19 patients; and (4) To describe post-extubation lung functions for survivors with spirometry test. Abbreviations: AI, asynchrony index; WOB, work of breathing; PEEP, positive end expiratory pressure; DT, delayed triggering; IEE, ineffective effort during expiration; IQR, interquartile range; COVID-19, coronavirus disease 2019; PVA, patient-ventilator asynchrony; ARDS, acute respiratory distress syndrome; IMV, invasive mechanical ventilation. The study integrated high-granularity ventilator waveform data with clinical variables to describe the temporal change of lung mechanics of critically ill patients with COVID-19. doi = 10.3389/fmed.2020.00541 id = cord-104423-fxo36z1s author = Ghelichkhani, Parisa title = Prone Position in Management of COVID-19 Patients; a Commentary date = 2020-04-11 keywords = ARDS summary = This disease exacerbates in a number of patients and causes pulmonary edema, multi-organ failure, and acute respiratory distress syndrome (ARDS). 10% of patients who are admitted to the intensive care unit (ICU) develop ARDS (3) and despite all the treatment advances made, the rate of mortality is still high among these patients and has been reported to be between * Corresponding Author: Maryam Esmaeili; School of Nursing and Midwifery, Tehran University of Medical Sciences, Nosrat St., Tohid Sq.,Tehran, Iran. Additionally, in another meta-analysis it was revealed that prone position can only reduce mortality due to ARDS when patients are ventilated with low tidal volume, the treatment is started within the initial 48 hours of initiation of the disease, and patients have severe hypoxia. Available meta-analyses show that prone position can decrease mortality in ARDS patients when performed in the initial hours of disease manifestation, in patients with severe impaired oxygenation and for a long time (8) . doi = nan id = cord-332592-bfqsyiyf author = Goette, Andreas title = COVID-19-Induced Cytokine Release Syndrome Associated with Pulmonary Vein Thromboses, Atrial Cardiomyopathy, and Arterial Intima Inflammation date = 2020-09-26 keywords = ARDS; COVID-19; SARS summary = title: COVID-19-Induced Cytokine Release Syndrome Associated with Pulmonary Vein Thromboses, Atrial Cardiomyopathy, and Arterial Intima Inflammation Coronavirus disease 2019 (COVID-19) is a viral disease induced by severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2), which may cause an acute respiratory distress syndrome (ARDS). Here, we can present a case of cytokine release syndrome induced by SARS-CoV-2 causing multiorgan failure and death. In summary, the present case shows that severe COVID-19 induces CRS associated with ARDS, acute kidney failure, liver pathologies, vascular intimal inflammation, pulmonary arterial, and venous thromboses and an inflammatory atrial cardiomyopathy. In the present case, we can show that COVID-19 can induce the occurrences of ARDS, which was associated with pulmonary embolism, as well as thrombogenesis, in pulmonary veins and the right atrial appendage. In addition to COVID-19-induced ARDS, CRS might be associated with pulmonary artery, as well as vein thromboses, atrial fibrillation, sinus node dysfunction, right atrial clot formation, and inflammatory invasion of autonomic atrial nerve ganglia. doi = 10.1055/s-0040-1716717 id = cord-259204-27t269pd author = Grimaldi, D. title = Characteristics and outcomes of Acute Respiratory Distress Syndrome related to COVID-19 in Belgian and French Intensive Care Units according to antiviral strategies. The COVADIS multicenter observational study. date = 2020-07-07 keywords = AKI; ARDS; VFD; patient summary = Background Limited data are available for antiviral therapy efficacy especially for the most severe patients under mechanical ventilation suffering from Covid-19 related Acute Respiratory Distress Syndrome (ARDS). Methods Observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, comparing antiviral strategies (none, hydroxychloroquine (HCQ), lopinavir/ritonavir (L/R), others (combination or remdesivir). Limited data are available for antiviral therapy efficacy especially for the most severe patients under mechanical ventilation suffering from Covid-19 related Acute Respiratory Distress Syndrome (ARDS). Observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, comparing antiviral strategies (none, hydroxychloroquine (HCQ), lopinavir/ritonavir (L/R), others (combination or remdesivir). In moderate to severe ARDS COVID-19 patients, we did not observe an association between treatment with hydroxychloroquine or lopinavir/ritonavir and ventilatory free days as compared to no antiviral treatment. doi = 10.1101/2020.06.28.20141911 id = cord-330640-6ityxc64 author = Gupta, Ashim title = Mesenchymal stem cells and exosome therapy for COVID-19: current status and future perspective date = 2020-08-11 keywords = ARDS; COVID-19; MSC; cell summary = In the case of pneumonia, acute lung injury (ALI) [12] , acute respiratory distress syndrome (ARDS) [13, 14] and sepsis studies investigating therapy using mesenchymal stem cells (MSCs) have demonstrated safety and some positive effects on these conditions [11] . Another study demonstrated that the efficacy of MSC-based therapy is enhanced with lipid conjugated heparin coating; and the human adipose derived stem cells (hADSCs) delivered to the damaged liver resulted in significantly improved recovery from ALF in a mouse model. Majority of the studies focusing on MSC-derived exosomes have demonstrated regenerative potential, immune-modulatory functions, anti-inflammatory effects, similar to their parents, i.e. Mesenchymal stem cells [44, 45] . In preclinical set up, MSC-derived exosomes have demonstrated aptitude as an acellular alternative to cell-based therapy, against Acute Respiratory Distress Syndrome (ARDS) [46] . Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic Inluenza A (H7N9) infection: A hint for COVID-19 treatment. doi = 10.1007/s13577-020-00407-w id = cord-029646-oujgcciq author = Gupta, Ena title = Don’t Drive Blind: Driving Pressure to Optimize Ventilator Management in ECMO date = 2020-07-23 keywords = ARDS; ECMO summary = Higher driving pressure after initiation of ECMO is associated with increased adjusted 30-day mortality. Initial mechanical ventilator setting protocol after ECMO support was as follows: tidal volume 4-5 ml/ kg PBW; PEEP 5-10 cm H2O; peak inspiratory pressure 25-30 cm H 2 O; respiratory rate 10-12 breaths per minute; and FiO2 adjusted to maintain arterial oxygen saturation above 90%. The increase in driving pressure after ECMO is likely related to a protocolized application of ventilator settings including lower PEEP after initiation of ECMO. A recent study showed that near apneic ventilation in a pig model of acute lung injury supported by ECMO when compared to conventional protective ventilation decreased driving pressure by 40% and reduced mechanical power 10 times [5] . Elevated driving pressure after ECMO initiation was associated with increased adjusted 30-day mortality among both VA-and VV-ECMO. Association of driving pressure with mortality among ventilated patients with acute respiratory distress syndrome: a systematic review and meta-analysis doi = 10.1007/s00408-020-00381-y id = cord-004450-daxz9yhp author = Haeberle, Helene title = Therapeutic iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo trial): a prospective, randomized, multicenter phase II study date = 2020-03-04 keywords = ARDS; ICU; iloprost; patient summary = Several preclinical studies have revealed a beneficial effect of iloprost on the control of pulmonary inflammation, and in a small number of patients with ARDS, iloprost treatment resulted in improved oxygenation. For safety reasons, after treatment of 100 patients (day 28 after last dose investigational medicinal product [IMP] Patient 100) within the study, an interim analysis for an increased risk for pulmonary hemorrhage ≥ grade III according to Common Terminology (Toxicity) Criteria for Adverse Events (CTCAE) Version 5.0 in the treatment (iloprost) arm will be performed and the results discussed with the Data and Safety Monitoring Board (DSMB). When possible, however, the patient or his legal representative is to be informed both in writing and verbally by the investigator before any study-specific procedure is Iloprost or NaCl 0.9% (control) X X X X X Clinical assessment including outcome X X X X X X X X X Laboratory testing X X X X X X X X Adverse/serious adverse event monitoring X X X X X X X Plasma biomarkers X X X X X X Barthel Index X X X X SOFA score X X X X X X X X Health-related questionnaire X VES X performed. doi = 10.1186/s13063-020-4163-0 id = cord-000498-absjerdt author = Hagau, Natalia title = Clinical aspects and cytokine response in severe H1N1 influenza A virus infection date = 2010-11-09 keywords = ARDS; IL-6; IL-8 summary = To and colleagues found higher plasma levels of proinflammatory cytokines and chemokine in the group of patients with acute respiratory distress syndrome (ARDS) caused by viral A(H1N1) influenza, throughout the initial 10 days after symptom onset [8] . The aim of our study was to further investigate the profile of Th1 and Th17 mediators and interferoninductible protein-10 (IP-10), an innate-immunity mediator, as early host response in a group of critical and noncritical hospitalized patients with nvA(H1N1) from Cluj-Napoca, Romania, and to correlate them with the clinical aspects. IL-15 is significantly higher at admission (P1) and 3 days later (P2) in the nvA(H1N1)-ARDS group for nonsurvivors versus survivors, so it might be pathogenic in lung injury influenza A virus infection. An increased level of IP-10 was found in the Spanish group as early response to nvA(H1N1) infection in both hospitalized and mild patient disease, as in the present study, while in the Hong Kong group IP-10 was significantly higher in critical patients only. doi = 10.1186/cc9324 id = cord-005941-e4fvj54l author = Hamm, H. title = The surfactant system of the adult lung: physiology and clinical perspectives date = 1992 keywords = ARDS; alveolar; lung; pulmonary; surfactant summary = Further clinical studies will be necessary to investigate the potential therapeutic benefits of surfactant substitution and the usefulness of pharmacologic manipulation of the secretory activity of alveolar type II cells in pulmonary medicine. The fate of secreted surfactant material seems to be determined by five mechanisms: -Intraalveolar catabolism -Phagocytosis and degradation by alveolar macrophages [110, 118] -Removal by the mucociliary escalator -Recycling into the alveolar type II cell -Redistribution into other surrounding tissue Clearance studies in rabbits [140] have shown that approximately 7% of radiolabeled phosphatidylcholine is removed via the upper airways in 24 h, suggesting that this pathway is only of minor importance. These studies may indicate that the acute effect of nitrogen dioxide on alveolar type II cells is enhanced surfactant lipid synthesis, while chronic low-dose exposure leads to a decrease in surfactant synthesis capacity. Effects of ozone on phospholipid synthesis by alveolar type II cells isolated from adult rat lung doi = 10.1007/bf00180279 id = cord-015384-bz7ui5a0 author = Hans-Peter, Kapfhammer title = Posttraumatic stress disorder in survivors of acute respiratory distress syndrome (ARDS) and septic shock date = 2008-11-27 keywords = ALI; ARDS; PTSD; acute summary = From a perspective of C/L psychiatry persisting cognitive dysfunctions, anxiety and mood disorders, posttraumatic stress disorders (PTSD) in their negative impact on healthIn the etiopathogenesis of PTSD associated with ALI/ ARDS, many influences have to be discussed, e.g., increases in CO 2 triggering panic affects, a mismatch of norepinephric overstimulation and cortisol insufficiency, negative effects of high doses of benzodiazepines resulting in oversedation, prolonged phases of weaning and more frequent states of delirium. Social support during intensive care unit stay might improve mental impairment and consequently health-related quality of life in survivors of severe acute respiratory distress syndrome Risk factors for post-traumatic stress disorder symptoms following critical illness requiring mechanical ventilation: A prospective cohort study Post-traumatic stress disorder and posttraumatic stress symptoms following critical illness in medical intensive care unit patients: Assessing the magnitude of the problem Health-related quality of life and posttrauamtic stress disorder in survivors of the acute respiratory distress syndrome doi = 10.1007/s11800-008-0129-x id = cord-005686-k6t1q7q6 author = Hassett, Patrick title = Overexpression of pulmonary extracellular superoxide dismutase attenuates endotoxin-induced acute lung injury date = 2011-07-14 keywords = AAV; ARDS; SOD summary = title: Overexpression of pulmonary extracellular superoxide dismutase attenuates endotoxin-induced acute lung injury PURPOSE: Superoxide is produced by activated neutrophils during the inflammatory response to stimuli such as endotoxin, can directly or indirectly injure host cells, and has been implicated in the pathogenesis of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). We wished to determine the potential for pulmonary overexpression of the extracellular isoform of superoxide dismutase (EC-SOD) to reduce the severity of endotoxin-induced lung injury. Endotoxin instillation produced a severe lung injury, which was attenuated by EC-SOD overexpression in comparison to animals that received vehicle or null vector. EC-SOD completely attenuated the decrease in static lung compliance (Fig. 2b ) and the increase in peak airway pressure (Fig. 2c) following endotoxin-induced injury. In conclusion, intrapulmonary delivery of EC-SOD decreased the severity of endotoxin-induced lung injury, demonstrating the potential beneficial effects of EC-SOD overexpression in the setting of ALI. doi = 10.1007/s00134-011-2309-y id = cord-266067-wrouqdcj author = Haywood, Nathan title = Isolated Lung Perfusion in the Management of Acute Respiratory Distress Syndrome date = 2020-09-17 keywords = ARDS; EVLP; IVLP; lung; perfusion summary = The ability of EVLP to rehabilitate lungs injured in a porcine sepsis model [21] has provided the basis for a similar application-the use of isolated lung perfusion in vivo in the management of ARDS. Here, early animal studies have demonstrated the ability of in vivo lung perfusion (IVLP) to rehabilitate sepsis-induced ARDS [22] . Below, we review the history and current evidence for isolated lung perfusion techniques, with a focus on how EVLP has provided the basis for and led to investigations into the use of IVLP for the treatment of ARDS. Using both murine and porcine models, we have demonstrated that the addition of a selective adenosine 2A receptor (A2AR) agonist to the EVLP perfusate is associated with less pulmonary edema, lower levels of pro-inflammatory cytokines, and improved lung function [43, 44] . doi = 10.3390/ijms21186820 id = cord-003397-fvrd128w author = Herath, H. M. L. Y. title = Spotted fever rickettsioses causing myocarditis and ARDS: a case from Sri Lanka date = 2018-12-29 keywords = ARDS; Lanka; Sri summary = title: Spotted fever rickettsioses causing myocarditis and ARDS: a case from Sri Lanka We describe a patient with rapidly progressing ARDS and myocarditis secondary to spotted fever caused by Rickettsia conorii. He was confirmed to have spotted fever rickettsial infection with rising titre of indirect immunofluorescence antibodies to Ricketssia conorii and made a complete recovery with appropriate antibiotic therapy and supportive care. Emergence of spotted fever group of rickettsial infections in the hilly central province of Sri Lanka was first observed in early nineties [1] . The following case report highlights myocarditis and acute respiratory distress syndrome (ARDS) as complications in a severely ill patient with spotted fever group of rickettsioses where timely diagnosis and intervention saved the life. This case demonstrates a rather rare presentation of spotted fever rickettsial infection where patient deteriorated within short time leading to shock and ARDS. Cutaneous manifestations of spotted fever rickettsial infections in the Central Province of Sri Lanka: a descriptive study doi = 10.1186/s12879-018-3631-6 id = cord-273426-55vu6b3u author = Iba, Toshiaki title = Coagulopathy of Coronavirus Disease 2019 date = 2020-05-26 keywords = ARDS; COVID-19; SARS; patient summary = Conclusions: Severe acute respiratory syndrome coronavirus 2/ coronavirus disease 2019 frequently induces hypercoagulability with both microangiopathy and local thrombus formation, and a systemic coagulation defect that leads to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism in critically ill hospitalized patients. Conclusions: Severe acute respiratory syndrome coronavirus 2/ coronavirus disease 2019 frequently induces hypercoagulability with both microangiopathy and local thrombus formation, and a systemic coagulation defect that leads to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism in critically ill hospitalized patients. (Crit Care Med 2020; XX:00-00) Key Words: coagulopathy; coronavirus; coronavirus disease 2019; disseminated intravascular coagulation; hypercoagulability; thromboembolism I ncreasing communications worldwide have reported that hospitalized, critically ill coronavirus disease 2019 (COVID-19) patients are frequently developing laboratory abnormalities compatible with hypercoagulability and clinically a high prevalence of thromboembolic events (1). doi = 10.1097/ccm.0000000000004458 id = cord-299125-kuvnwdn6 author = Ikegami, Saya title = Suspected Virus-Inducing Severe Acute Respiratory Distress Syndrome Treated by Multimodal Therapy Including Extracorporeal Membrane Oxygenation and Immune Modulation Therapy date = 2020-06-22 keywords = ARDS; ECMO summary = title: Suspected Virus-Inducing Severe Acute Respiratory Distress Syndrome Treated by Multimodal Therapy Including Extracorporeal Membrane Oxygenation and Immune Modulation Therapy We report a case of suspected virus-inducing severe ARDS treated by multimodal therapy including extracorporeal membrane oxygenation (ECMO) and immune modulation therapy that led to a favorable outcome for the patient. The risk factor in the present case was unspecified pneumonia, and an unspecified virus was considered the most likely cause based on the negative results of all cultures, β-D glucan, and rapid test for bacteria and influenza. As the present case also showed marked hypoxia despite mechanical ventilation with a high concentration of oxygen and high PEEP, ECMO was introduced, and the lung rest setting was selected. We presented a case of suspected virus-inducing severe ARDS that was treated by multimodal therapy including ECMO and immune modulation therapy. doi = 10.7759/cureus.8768 id = cord-260577-t4w4pw12 author = Imai, Yumiko title = The renin–angiotensin system in acute respiratory distress syndrome date = 2006-08-07 keywords = ACE2; ARDS summary = The importance of RAS in acute respiratory distress syndrome (ARDS) has recently re-emerged owing to the identification of ACE2 as a receptor for the SARS-coronavirus. Recent studies have demonstrated that ACE2 protects mice from acute lung injury as well as SARS-mediated lung injury. Angiotensin-converting enzyme (ACE) and ACE2 share homology in their catalytic domain and provide different key functions in the renin-angiotensin system (RAS). The importance of the RAS in acute respiratory distress syndrome (ARDS) has recently re-emerged owing to the identification of ACE2 as a receptor for the severe acute respiratory syndrome-coronavirus (SARS-CoV) [5] . Importantly, the treatment with catalytically active, but not enzymatically inactive, recombinant ACE2 protein improved the symptoms of acute lung injury in wild type mice as well as in ace2 knockout mice, suggesting ACE2 protein as a possible novel therapeutic target for ARDS (Fig. 2) . A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury doi = 10.1016/j.ddmec.2006.06.012 id = cord-263879-e36l3t1g author = Jamaati, Hamidreza title = A Fourteen-day Experience with Coronavirus Disease 2019 (COVID-19) Induced Acute Respiratory Distress Syndrome (ARDS): An Iranian Treatment Protocol date = 2020 keywords = ARDS summary = title: A Fourteen-day Experience with Coronavirus Disease 2019 (COVID-19) Induced Acute Respiratory Distress Syndrome (ARDS): An Iranian Treatment Protocol The clinical spectrum of COVID-19 pneumonia ranges from mild to critically ill cases and Acute Respiratory Distress Syndrome. An expert panel was held and an internal protocol was developed to manage the COVID-19 induced ARDS according to WHO recommendations and NIH guidelines. The clinical presentation of COVID-19 pneumonia may present from mild to severe illness including Acute Respiratory Distress Syndrome (ARDS). Finally, an internal protocol was developed to manage the COVID-19 induced ARDS according to WHO recommendations and NIH guidelines (3). Of the 231 suspected cases of COVID-19 admitted to the hospital during two weeks, 72 patients were admitted to ICU with diagnosis confirmed by RT-PCR. Of the 231 suspected cases of COVID-19 admitted to the hospital during two weeks, 72 patients were admitted to ICU with diagnosis confirmed by RT-PCR. doi = 10.22037/ijpr.2020.113337.14239 id = cord-006251-danl62io author = Jansen, Oliver title = Extracorporeal membrane oxygenation in spina bifida and (H1N1)-induced acute respiratory distress syndrome date = 2017-09-13 keywords = ARDS; ECMO summary = We report on a 45-year-old spina bifida patient with confirmed H1N1 influenza virus infection causing acute respiratory failure, who was successfully weaned from 42-day veno-venous extracorporeal membrane oxygenation (vv-ECMO) treatment with an excellent outcome. Adding prone positioning therapy to ECMO patients is recommended by the guidelines for adult respiratory failure from the extracorporeal life support organization if radiological imaging shows posterior consolidation of the lung fields [8] . As ECMO blood flow could be reduced and, therefore, resulted in less inflow pressure problems and less dependency on the patients'' position, we began to establish a regimen of intermittent prone positioning therapy to improve alveolar recruitment of the posterior consolidated lung fields and, therefore, pulmonary capacity (Fig. 3) . Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients doi = 10.1007/s10047-017-0992-3 id = cord-266423-s8lqdpvn author = Jose, Ricardo J. title = Does Coronavirus Disease 2019 Disprove the Obesity Paradox in Acute Respiratory Distress Syndrome? date = 2020-05-22 keywords = ARDS summary = Obesity is associated with a decrease in mortality in patients with Adult Respiratory Distress Syndrome (ARDS) and is referred to as the obesity paradox.1 ARDS is a type of respiratory failure characterised by rapid onset of widespread inflammation in the lungs and is usually the result of infectious or chemical injury. Obesity is associated with a decrease in mortality in patients with acute respiratory distress syndrome (ARDS) and this is referred to as the obesity paradox (2) . Clinicians tend to consider patients with obesity at higher risk of worse outcomes; thus, this might result in earlier admission to the intensive care unit for monitoring purposes in normal circumstances (6) . Taken together, these elements may contribute to difficulties for patients with obesity in accessing care during a pandemic if they are wrongly perceived by clinicians and policy makers to be at a higher risk for worse outcomes.O doi = 10.1002/oby.22835 id = cord-252085-8dq3gdo8 author = Kaisy, Dr. Maythem Abdulhassan Al title = Chest Drain Insertion following Pneumothorax due to CPR in a COVID – 19 Patient. date = 2020-08-14 keywords = ARDS; patient summary = title: Chest Drain Insertion following Pneumothorax due to CPR in a COVID – 19 Patient. Chest Drain Insertion following Pneumothorax due to CPR in a COVID -19 Patient. Thus, in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection lungs are fragile and especially those with positive pressure ventilations, the dangers of pneumothorax arise, and comprehensive management is warranted. A 42 years old male patient was transferred to our hospital, intubated on mechanical ventilation, he had a 1 week history of fever, cough and shortness of breath, with positive PCR test for COVID-19, and CT scan showing extensive bilateral multiple, multilobed ground glass appearance with areas of consolidation, there was no given history of previous lung diseases or smoking history ( Figure 1 ). A portable chest x-ray was ordered, and the patient was found to have significant amount of left sided -pneumothorax with underlying lung collapse , mild mediastinal shift to the right side, with progressive course regarding the right side opacities (Figure 2 ), compared to previous x-ray. doi = 10.1016/j.visj.2020.100862 id = cord-014538-6a2pviol author = Kamilia, Chtara title = Proceedings of Réanimation 2017, the French Intensive Care Society International Congress date = 2017-01-10 keywords = ARDS; Antoine; Ben; Care; ECMO; EEG; Fig; France; François; ICU; Intensive; January; Jean; Mohamed; NIV; Nicolas; Pierre; VAP; acute; associate; day; group; high; mortality; patient; study summary = Other parameters that were significantly different between the patients who died and those who survived were an advanced age, an elevated IGS II score at hospital admission, an elevated SOFA score at study entry, a late healthcare-associated infection and several biological variables: a high C reactive protein, low albumin and prealbumin and a poor percent of monocytes expressing HLA-DR, all measured at day 7. Parameters collected were demographic features, comorbidities, regular treatment, dyspnea assessed by the MRC scale, initial clinical severity reflected by SAPS II and APACHE II scores, modalities and ICU admission deadlines, initial arterial blood gas analysis, management of patients in the ICU (ventilation modalities, prescription of antibiotics, use of vasoactive drugs) and their outcomes (incidence of nosocomial infections and their sites, length of stay and ICU mortality). doi = 10.1186/s13613-016-0224-7 id = cord-001661-dj9bxhwb author = Kao, Kuo-Chin title = Diffuse alveolar damage associated mortality in selected acute respiratory distress syndrome patients with open lung biopsy date = 2015-05-15 keywords = ARDS; DAD; patient summary = title: Diffuse alveolar damage associated mortality in selected acute respiratory distress syndrome patients with open lung biopsy INTRODUCTION: Diffuse alveolar damage (DAD) is the pathological hallmark of acute respiratory distress syndrome (ARDS), however, the presence of DAD in the clinical criteria of ARDS patients by Berlin definition is little known. A pathological finding of DAD in ARDS patients is associated with hospital mortality and there are no clinical characteristics that could identify DAD patients before open lung biopsy. The following data were collected from the hospital chart of each patient and analyzed: age, sex, underlying diseases, acute physiology and chronic health evaluation (APACHE) II score on the day of ICU admission [28] , sequential organ failure assessment (SOFA) score on the day of ICU admission and the day of open lung biopsy [29] , lung injury score (LIS) [30] , PaO 2 /FiO 2 ratio, PEEP, tidal volume, diagnostic procedures before open lung biopsy (HRCT or BAL), complications related to surgery (i.e., postoperative air leak, pneumothorax, subcutaneous emphysema, bleeding, and wound infection), pathological diagnosis, hospital mortality, and therapeutic alterations. doi = 10.1186/s13054-015-0949-y id = cord-003219-iryb3v0z author = Kao, Kuo-Chin title = Predictors of survival in patients with influenza pneumonia-related severe acute respiratory distress syndrome treated with prone positioning date = 2018-09-24 keywords = ARDS; patient; prone summary = title: Predictors of survival in patients with influenza pneumonia-related severe acute respiratory distress syndrome treated with prone positioning CONCLUSIONS: In the present study, in evaluating the effect of prone positioning in patients with influenza pneumonia-related ARDS, pneumonia severity index, renal replacement therapy and increase in dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumonia-related ARDS receiving prone positioning. After multivariate Cox regression analysis, PSI, renal replacement therapy and increased dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumonia-related ARDS receiving prone positioning. The present study in influenza pneumonia-related ARDS patients receiving prone positioning also found that increased dynamic driving pressure (hazard ratio 1.372, 95% confidence interval 1.095-1.718; p = 0.006) was identified as After multivariate Cox regression analysis, it was found that PSI, renal replacement therapy and increased dynamic driving pressure were associated with 60-day mortality in patients with influenza pneumoniarelated ARDS receiving prone positioning. doi = 10.1186/s13613-018-0440-4 id = cord-351624-32opyo0i author = Kappel, Coralea title = A case of possible Fournier’s gangrene associated with proning in COVID-19 ARDS date = 2020-07-27 keywords = ARDS summary = title: A case of possible Fournier''s gangrene associated with proning in COVID-19 ARDS Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus responsible for the coronavirus disease (COVID-19) pandemic, has contributed to significant morbidity and mortality, and presents with a myriad of clinical manifestations. We report a case of a 46yr old obese male with acute respiratory distress syndrome (ARDS) secondary to COVID-19, who went on to develop Fournier''s gangrene following prolonged and repeated ventilation in prone position (proning). Despite optimized positive end-expiratory pressure (20 cmH 2 O) and lungprotective ventilation, the patient had ongoing hypoxia with PaO 2 /F I O 2 ratios less than 150, and by day 4 of ICU admission was started on a 16-18 hrÁday -1 proning protocol. Nevertheless, given the prolonged duration of ventilation required by most COVID-19 patients and the risk of both common and unique complications due to proning (as highlighted by this case), clinicians ought to be increasingly vigilant with monitoring. doi = 10.1007/s12630-020-01772-8 id = cord-328396-p2gvpe8i author = Kaur, Savneet title = The Enigma of Endothelium in COVID-19 date = 2020-08-04 keywords = ARDS; COVID-19; SARS summary = In the current perspective, we envisage a key role of mEC in the pathogenesis of coronavirus disease 2019 caused by the novel coronavirus, severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV2). These studies along with the fact that the pulmonary epithelium is more resistant to injury than the endothelium signify that SARS-CoV-2-induced ARDS and associated coagulopathy may be caused by a direct endothelial infection by the virus in the lungs (Matthay et al., 2019) . A summary of such recent reviews and short reports is provided in Table 1 (Alvarado-Moreno and Majluf-Cruz, 2020; Amraei and Rahimi, 2020; Cure and Cure, 2020; Froldi and Dorigo, 2020; Guler et al., 2020; Gupta et al., 2020; Gustafson et al., 2020; Mangalmurti et al., 2020; Marchetti, 2020; Mondal et al., 2020; Panfoli, 2020; Pons et al., 2020; Sardu et al., 2020b; Teuwen et al., 2020) . doi = 10.3389/fphys.2020.00989 id = cord-028337-md9om47x author = Ketcham, Scott W. title = Causes and characteristics of death in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: a retrospective cohort study date = 2020-07-03 keywords = AHRF; ARDS; death summary = Patients with ARDS more often had pulmonary dysfunction as the primary cause of death (28% vs 19%; p = 0.04) and were also more likely to die while requiring significant respiratory support (82% vs 64%; p < 0.01). Specifically, two critical-care trained physicians reviewed each AHRF hospitalization to determine whether patients met Berlin Criteria [15, 16] for ARDS: (1) new or worsening respiratory symptoms began within 1 week of a known clinical insult, (2) PaO 2 /FIO 2 ≤ 300 while receiving a positive end-expiratory pressure ≥ 5 cm H 2 O, (3) bilateral opacities on chest x-ray, (4) unlikely to be cardiogenic pulmonary edema, and (5) no other explanation for these findings. In this contemporary cohort study of 385 patients who died after AHRF, the most common primary causes of death were sepsis and pulmonary dysfunction. doi = 10.1186/s13054-020-03108-w id = cord-324869-f14n0hk6 author = Khan, Hafiz Muhammad Waqas title = Unusual Early Recovery of a Critical COVID-19 Patient After Administration of Intravenous Vitamin C date = 2020-07-25 keywords = ARDS; ICU summary = CONCLUSIONS: This report highlights the potential benefits of high-dose intravenous vitamin C in critically ill COVID-19 patients in terms of rapid recovery and shortened length of mechanical ventilation and ICU stay. We describe a case of COVID-19 with septic shock and ARDS who received high doses of intravenous vitamin C and was the first case to be able to be taken off of mechanical ventilation (MV) early and recover from the disease at our institute. In our case, the patient was treated with high-dose vitamin C as a continuous intravenous infusion and was the first COVID-19 patient to be able to be taken off mechanical ventilation early and recover from the disease at our institution. Our results show the importance of further investigation of intravenous vitamin C in the form of randomized controlled trials for the treatment of SARS-CoV-2 to accurately assess its efficacy in critically ill COVID-19 patients requiring mechanical ventilation and ICU care. doi = 10.12659/ajcr.925521 id = cord-253355-dii5zszf author = Khan, Sheharyar title = Awake Proning: A Necessary Evil During the COVID-19 Pandemic date = 2020-07-03 keywords = ARDS; prone summary = Patients presenting with ARDS need mechanical ventilation, as their lungs are unable to oxygenate blood on their own due to fluid accumulation. One way to manage this excess pressure of fluid build-up around the lung tissues is to relieve the dorsal alveoli by prompting the patient to lie face down on the stomach; this is called awake proning. Awake proning delays the use of mechanical ventilation and facilitates the patients with severe ARDS or severe pneumonia in maintaining the supply of oxygen to the body tissues. As it progresses, the disease presents with more severe symptoms like viral pneumonia, which causes acute respiratory distress syndrome (ARDS). The blood oxygen levels also improved after the cycles of prone positioning, and endotracheal intubation was avoided in patients with ARDS, which would have been the only option to opt from if awake proning was not administered [17] . A COVID-19 patient presenting with severe pneumonia or ARDS can be managed with awake proning as a supportive treatment to relieve symptoms. doi = 10.7759/cureus.8989 id = cord-253129-v5lck9l7 author = Kim, Kyeong Tae title = Model-based PEEP titration versus standard practice in mechanical ventilation: a randomised controlled trial date = 2020-02-01 keywords = ARDS; RCT; cure; patient; peep summary = BACKGROUND: Positive end-expiratory pressure (PEEP) at minimum respiratory elastance during mechanical ventilation (MV) in patients with acute respiratory distress syndrome (ARDS) may improve patient care and outcome. The Clinical utilisation of respiratory elastance (CURE) trial is a two-arm, randomised controlled trial (RCT) investigating the performance of PEEP selected at an objective, model-based minimal respiratory system elastance in patients with ARDS. Secondary outcomes include length of time of MV, ventilator-free days (VFD) up to 28 days, ICU and hospital length of stay, AUC of oxygen saturation (SpO(2))/FiO(2) during MV, number of desaturation events (SpO(2) < 88%), changes in respiratory mechanics and chest x-ray index scores, rescue therapies (prone positioning, nitric oxide use, extracorporeal membrane oxygenation) and hospital and 90-day mortality. Following the study, a phase-2 randomised controlled trial (RCT) was designed to assess mechanical ventilation at minimal elastance PEEP in patients with ARDS versus standard practice of care in a single-centre hospital. doi = 10.1186/s13063-019-4035-7 id = cord-006366-qpjvmwmp author = Kinikar, Aarti Avinash title = Predictors of Mortality in Hospitalized Children with Pandemic H1N1 Influenza 2009 in Pune, India date = 2011-10-20 keywords = ARDS; H1N1; ICU summary = METHODS: Data were abstracted from available hospital records of children less than 12 y of age, who were admitted to Sassoon General Hospital in Pune, India, with confirmed pandemic 2009 H1N1 influenza infection from August 2009 through January 2010. A recent publication reported that factors independently associated with in-hospital mortality in adults and children were, requirement for invasive ventilation at intensive care unit (ICU) admission, older age and presence of any co-existing conditions [6] . The following data were collected: demographic characteristics like age, gender and location of residence; clinical characteristics on admission including duration of symptoms, co-morbid illnesses; clinical findings at presentation; and hospital course including use of antibiotics, corticosteroids and antiviral drugs, requirement of bubble continuous positive airway pressure (CPAP)or mechanical ventilation, presence of co-infections, laboratory and radiologic findings. doi = 10.1007/s12098-011-0578-7 id = cord-347871-w6274bdg author = Kloc, Malgorzata title = The multiple sclerosis (MS) drugs as a potential treatment of ARDS in COVID-19 patients date = 2020-07-31 keywords = ARDS summary = These drugs, through the inhibition of the RhoA/actin-dependent expression of virus receptors in the macrophages and macrophage recruitment to the lungs, have the potential to inhibit cytokine storm of long macrophages, reduce or eliminate ARDS and improve the outcome of COVID-19 infection. In our search for clinically applicable RhoA pathway inhibitors we found that drugs clinically approved for the treatment of multiple sclerosis (MS), Fingolimod and Siponimod, also inhibit RhoA and RhoA/actin-dependent macrophage receptors recycling, and expression, and can be potentially used as an anti-chronic rejection therapy in human transplantation (11, 12) . Because these clinically approved drugs inhibit, via RhoA/ actin pathway, macrophage movement, and expression of macrophage receptors, they have also a potential to inhibit ACE2 receptors expression and the recruitment of macrophages to the lungs of the COVId-19 patients, which in turn would decrease cytokine storm and attenuate ARDS. Macrophage/monocyte-specific deletion of RhoA down-regulates fractalkine receptor and inhibits chronic rejection of mouse cardiac allografts doi = 10.1016/j.msard.2020.102437 id = cord-290460-d5e6y2r8 author = Knighton, Andrew J. title = Multi-factorial barriers and facilitators to high adherence to lung-protective ventilation using a computerized protocol: a mixed methods study date = 2020-07-28 keywords = ARDS; CDS; ICU; LPV summary = We analyzed 47 key informant interviews of ICU physicians, respiratory therapists (RTs), and nurses in 3 of the ICUs using a qualitative content analysis paradigm to investigate site variation as defined by adherence level (low, medium, high) and to identify barriers and facilitators to LPV and LPV CDS tool use. We developed an interview guide using a deductive, multi-method approach: a scoping review [21] [22] [23] [24] to examine the barriers and facilitators to the use of LPV and the LPV CDS tool and interventions to improve adherence; a technical expert panel that included 4 critical care physicians, 2 hospitalists/health services researchers, 2 ICU nurse managers, 1 emergency department (ED) physician, 1 respiratory therapist (RT), and 1 implementation scientist, to identify already known or suspected barriers to implementation (simultaneous triangulation) [25] ; and categorization and summary of findings according to the Consolidated Framework for Implementation Research (CFIR) [26, 27] by two experienced implementation scientists (AK, RS). doi = 10.1186/s43058-020-00057-x id = cord-303232-0lwmzjxz author = Konig, Maximilian F title = Targeting the catecholamine-cytokine axis to prevent SARS-CoV-2 cytokine storm syndrome date = 2020-04-08 keywords = ARDS; COVID-19 summary = The mortality of Coronavirus disease 2019 (COVID-19) appears to be driven by acute respiratory distress syndrome (ARDS) and a dysregulated immune response to SARS-CoV-2. Emerging evidence suggests that a subset of COVID-19 is characterized by the development of a cytokine storm syndrome (CSS), and interleukin (IL)-6 levels are predictors of COVID-19 severity and in-hospital mortality. As high infection rates threaten to overwhelm hospital capacity during this pandemic, preventative approaches that ameliorate COVID-19 severity and reduce excessive mortality are desperately needed. We hypothesize that treatment with prazosin of individuals who test positive for SARS-CoV-2 could reduce catecholamine surges, secondary cytokine dysregulation, and mortality. Prospective, randomized clinical trials of alpha-1 receptor antagonists (e.g. prazosin) administered prior to the onset of severe symptoms are needed to assess their efficacy in preventing CSS and reducing mortality in COVID-19. Prospective, double-blinded clinical trials of ⍺1-AR antagonists in high-risk patients, when administered prior to symptom onset, will therefore be required to assess their utility in preventing COVID-19-CSS. doi = 10.1101/2020.04.02.20051565 id = cord-002078-38rmx65j author = Korkmaz Ekren, Pervin title = Can fiberoptic bronchoscopy be applied to critically ill patients treated with noninvasive ventilation for acute respiratory distress syndrome? Prospective observational study date = 2016-05-31 keywords = ARDS; FOB; NIV summary = title: Can fiberoptic bronchoscopy be applied to critically ill patients treated with noninvasive ventilation for acute respiratory distress syndrome? The primary outcome of this prospective observational study was to evaluate the feasibility, safety and contribution in diagnosis and/or modification of the ongoing treatment of fiberoptic bronchoscopy (FOB) in patients with ARDS treated with NIV. METHODS: ARDS patients treated with NIV and who require FOB as the diagnostic or therapeutic procedure were included the study. Fiberoptic bronchoscopy (FOB) may be required in some patients with acute respiratory failure in intensive care units (ICU), mainly as diagnostic tool or to remove abundant secretions [7, 8] . Abbreviations APACHE II: Acute Physiology and Chronic Health Evaluation II; ARDS: acute respiratory distress syndrome; BAL: bronchoalveolar lavage; COPD: chronic obstructive pulmonary disease; EPAP: expiratory positive airway pressures; FOB: fiberoptic bronchoscopy; ICU: intensive care unit; IPAP: inspiratory positive airway pressure; NIV: noninvasive ventilation; PEEP: positive end expiratory pressure. doi = 10.1186/s12890-016-0236-y id = cord-003832-q1422ydi author = Koyama, Kansuke title = Biomarker profiles of coagulopathy and alveolar epithelial injury in acute respiratory distress syndrome with idiopathic/immune-related disease or common direct risk factors date = 2019-08-19 keywords = ARDS; ICU; patient summary = title: Biomarker profiles of coagulopathy and alveolar epithelial injury in acute respiratory distress syndrome with idiopathic/immune-related disease or common direct risk factors This study aimed to investigate the biomarker profiles of coagulopathy and alveolar epithelial injury in two subtypes of ARDS: patients with direct common risk factors (dARDS) and those with idiopathic or immune-related diseases (iARDS), which are classified as "ARDS without common risk factors" based on the Berlin definition. Although no risk factors or causes are identified in this subgroup of ARDS, recent studies have shown that many patients with idiopathic interstitial pneumonia have clinical features that suggest an underlying immune process, indicating that the pathobiology of idiopathic and immunerelated diseases may partially overlap [9, 10] . The aim of this study was to examine the profiles of the plasma biomarkers that reflect coagulopathy and alveolar epithelial injury in patients with idiopathic/immune-related ARDS (iARDS) and in those with common direct risk factors (dARDS). doi = 10.1186/s13054-019-2559-6 id = cord-283779-mudwcypl author = Lauretani, Fulvio title = Assessment and treatment of older individuals with COVID-19 multi-system disease: clinical and ethical implications date = 2020-05-11 keywords = ARDS; COVID-19; SARS; clinical; infection; old; patient; phase summary = The chronic increase in inflammatory cytokines, augmented by COVID-19 infection, may explain the higher tendency for "the cascade leading to pulmonary fibrosis and insufficiency and activation of clotting" and poorer clinical prognosis, especially in multimorbid older persons (4) . In case of persistent fever, higher than 37.5°C for a time longer than 3 days and peripheral oxygen level lower than 95% after starting therapy, we should consider and proceed to hospitalization especially in multimorbid older patients with cardiac, respiratory diseases and diabetes. First, patients at risk for poor outcomes and higher mortality following infection with SARS-CoV-2, namely older adults and multimorbid individuals, should be checked for malnutrition through screening and assessment. Older patients infected by COVID-19 often experience atypical and less severe symptoms in older persons, side-effects of the drugs and require specific nutritional and motor treatment for avoiding disability and death. doi = 10.23750/abm.v91i2.9629 id = cord-005699-uf59ls0g author = Leclerc, F. title = Inhaled nitric oxide for a severe respiratory syncytial virus infection in an infant with bronchopulmonary dysplasia date = 1994 keywords = ARDS; RSV summary = title: Inhaled nitric oxide for a severe respiratory syncytial virus infection in an infant with bronchopulmonary dysplasia After 3 h of inhaled NO (i h at 80 ppm), PEEP was reduced from 10-6 cm H20; crepitations were noted and PIP, peak inspiratory pressure; PEEP, positive end-expiratory pressure; *, FIO 2 delivered by the ventilator; tcSaO2, transcutaneous oxygen saturation (mean value of at least 3 measurements during the period); SAP and MAP, systolic and mean arterial pressures; nd, not determined pulmonary infiltrates worsened, suggesting pulmonary oedema, and leading to increase PEEP to I2 cm H20. Then, his condition progressively improved; 20 days after inhaled NO withdrawal, daytime controlled ventilation could be stopped with oxygen (1 l/rain into the tracheostomy tube) tcSaO 2 was 100%, and capillary blood gas was pH 7,44 units PCO z 52 mmHg. Three months after this RSV infection, his condition was the same as that before ARDS and remained stable with oral aminophylline, salbutamol, and cisapride. A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection doi = 10.1007/bf01711907 id = cord-355208-hpldjsc5 author = Leisman, Daniel E. title = Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated inflammation date = 2020-04-28 keywords = ARDS; COVID-19 summary = The reported inflammatory response in COVID-19 is also not consistent with either typical ARDS or cytokine-release syndromes (CRS) or "cytokine storm. Reports of increased respiratory dead space suggest lung-vascular thrombosis from thrombotic microangiopathy or pulmonary embolism. Reported findings indicate that immunosuppression, endothelial activation, and direct viral-mediated tissue damage, rather than hyperinflammatory injury, mediate COVID-induced organ dysfunction. Viral injury, disordered cytokine release, and damage-associated Fig. 1 (1) The SARS-CoV-2 virus infects an endothelial cell by binding to ACE-2. Cellular infection initiates localized inflammation, endothelial activation, tissue damage, and disordered cytokine release. ACE, angiotensin-converting enzyme; AngI, angiotensin-I; AngII, angiotensin-II; Ang (1-7), angiotensin (1-7); DAMPs, damage-associated molecular pattern molecules molecular patterns (DAMPs) induce localized microvascular inflammation, which triggers endothelial activation, leading to vasodilation and pro-thrombotic conditions. Among the known effects of AngII are vasoconstriction, endothelial activation, and pro-inflammatory cytokine release. COVID-induced respiratory failure involves physiologic, clinical, and immunologic phenotypes that are not consistent with either ARDS or cytokine-release syndromes. doi = 10.1007/s00134-020-06059-6 id = cord-316056-lk2upygf author = Lepper, Philipp M. title = Mechanical ventilation in early COVID-19 ARDS date = 2020-11-06 keywords = ARDS summary = As published in EClinicalMedicine, Mittermaier and colleagues [2] investigated the effects of IMV, positive end-expiratory pressure (PEEP) and prone positioning (PP) on oxygenation and lung recruitability in patients with COVID-19-related ARDS (CARDS). PEEP has been used in the first description of ARDS and led to an increase in P a O 2 or oxygen saturation in five of the twelve initial patients treated this way [3] . In the present study, pulmonary compliance was relatively preserved but increasing FRC by high PEEP levels led to significantly improved oxygenation. The present study does not answer the question of whether PEEP applied by non-invasive ventilation (NIV) can improve oxygenation in a similar way as IMV. Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis Prone position improves mechanics and alveolar ventilation in acute respiratory distress syndrome doi = 10.1016/j.eclinm.2020.100616 id = cord-005910-byffqwjd author = Lewandowski, K. title = Der alte Mann und die „I sea U“: Essay über Vertrauen, Schicksal und Evidenz – im Stil von Hemingway date = 2016-12-06 keywords = ARDS; Patienten; der; die; ist; und; von summary = Die haben bewiesen, dass 6 ml/kg bei volumenkontrollierter Beatmung genau das richtige Verfahren ist." "Wäre es nicht besser, ihn aufzusetzen und auf der Seite zu lagern? Anecdotes as topic · Evidence-based medicine · Intensive care units · Acute respiratory distress syndrome · Sepsis "Und wäre es nicht besser, ihn wach werden zu lassen und ihm Spontanatmung zu ermöglichen?" "Keine Evidenz. Und noch was: War das nicht die Studie, in der uraltes Blut transfundiert wurde?" "Ja, aber es gibt nun mal diese Evidenz, und wirhaltenuns daran. Im Laufe der letzten 16 Jahre hat dieses Protokoll weite Akzeptanz gefunden; es haben sich aber auch folgende neue Sichtweisen und Modifikationen ergeben: Die Grenzen für das Oxygenierungsziel sind möglicherweise zu niedrig angesetzt. Eine Metaanalyse, die 3 randomisierte, kontrollierte Studien ("randomized controlled trial", RCT) der gleichen Arbeitsgruppe einschloss, ergab, dass die Kurzzeitanwendung (48 h) von Cisatracurium bei ARDS-Patienten zu einer Verbesserung der Krankenhaussterblichkeitsrate und zu einem niedrigeren Risiko für die Entwicklung eines Barotraumas führt. doi = 10.1007/s00101-016-0239-3 id = cord-006773-61ezrjuq author = Li, Hongqiang title = T follicular regulatory cells infiltrate the human airways during the onset of acute respiratory distress syndrome and regulate the development of B regulatory cells date = 2018-07-27 keywords = ARDS; Tfr; Treg summary = First, we observed that the Foxp3 expression level in mini-BAL samples was not significantly different between Tfr cells and non-Tfr Treg cells (Fig. 2b) . The IL-10 expression by non-Tfr Treg cells and Tfr cells was lower in healthy controls and significantly higher in ARDS PBMCs and ARDS mini-BAL (Fig. 3c) . The higher IL-10 and TGF-β in ARDS mini-BAL compared to autologous PBMCs likely indicated that the Tfr and non-Tfr Treg cells in the lung infiltrates were further activated. As a result, the suppression studies were performed using Tfr cells from PBMCs. Since the Tfr cells from Fig. 2 The frequency of Treg cells and Tfr cells in the mini-BAL from ARDS patients at day 1, day 2, and day 3 after disease onset. NS not significant Fig. 3 The expression of inhibitory molecules by non-Tfr Treg cells and Tfr cells from healthy controls and ARDS patients. doi = 10.1007/s12026-018-9014-7 id = cord-285684-iiqyzqsb author = Li, Jin-ze title = Mechanically Stretched Mesenchymal Stem Cells Can Reduce the Effects of LPS-Induced Injury on the Pulmonary Microvascular Endothelium Barrier date = 2020-10-30 keywords = ARDS; LPS; MSC summary = title: Mechanically Stretched Mesenchymal Stem Cells Can Reduce the Effects of LPS-Induced Injury on the Pulmonary Microvascular Endothelium Barrier The aim of this study was to evaluate the potential therapeutic effects of MS-MSCs on pulmonary microvascular endothelium barrier injuries induced by LPS. These data demonstrated that the MS-MSC groups had potential therapeutic effects on the LPS-treated ECs; these results might be useful in the treatment of ARDS. We introduced a transwell coculture system to evaluate the effects of MS-MSCs on the paracellular permeability of LPS-treated ECs. Treatment with LPS significantly increased the paracellular permeabil-ity of the pulmonary microvascular endothelium barrier (Figure 6 (a); * * p < 0:01). We demonstrated that mechanical stretch could impact MSC morphology and biological function in a time-and magnitude-dependent manner and that MS-MSCs could restored the increased permeability of endothelial cells induced by LPS. In this study, we tried to discover evidences of mechanically stretched MSCs in restoring increased permeability of endothelial barrier induced by LPS. doi = 10.1155/2020/8861407 id = cord-012045-1cqqj84n author = Li, Tiao title = The Role of Deubiquitinating Enzymes in Acute Lung Injury and Acute Respiratory Distress Syndrome date = 2020-07-08 keywords = ALI; ARDS; CYLD; SARS; regulate summary = IL-1R8/Sigirr [40] Suppresses lung inflammation [40] PTEN [41] Regulates cell apoptosis [41] MCL1 [42] Regulates transformation of fibroblasts [42] STAT1 [55] Regulates IFN Signaling [55] STING [56] Negatively regulates antiviral responses [56] USP-14 I-kB [31] Increases cytokine release [31] CBP [32] Lung inflammation [32] USP-15 IκBα [57] NF-κB activation [57] USP-17 HDAC2 [58] Reverses glucocorticoid resistance [58] TRAF2/TRAF3 [59] Lung inflammation [59] [92] Inhibits type I IFN signaling and antiviral response [92] POH1 pro-IL-1β [93] Negatively regulates the immune response [93] BRCC3 NLRP3 [94] Promotes the inflammasome activation [94] STAMBP NALP7 [95] Reduces pro-inflammatory stress [95] Alveolar residential macrophages are central to the development of the inflammatory response by recruiting neutrophils and circulating macrophages to the site of injury, their functions are modulated by deubiquitinating enzymes [96, 97] . doi = 10.3390/ijms21144842 id = cord-290392-kpjp0sx4 author = Li, Xu title = Acute respiratory failure in COVID-19: is it “typical” ARDS? date = 2020-05-06 keywords = ARDS; COVID-19 summary = In December 2019, an outbreak of coronavirus disease 2019 (COVID19) , which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broke out in Wuhan, China [1] [2] [3] . COVID-19 was of clustering onset and mainly affected the respiratory system with some patients rapidly progressing to acute respiratory distress syndrome (ARDS); other organ functions were less involved [5, 6] . In addition, the lung compliance was relatively high in some COVID-19-related ARDS patients, which was inconsistent with the severity of hypoxemia. A previous study reported that more than 50% of patients with moderate and severe ARDS according to the Berlin definition did not show diffuse alveolar damage [17] . Currently published studies did not report the proportion of different respiratory support according to COVID-19-related ARDS classification. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China doi = 10.1186/s13054-020-02911-9 id = cord-326805-c5co9cfq author = Lin, Shi-hui title = Coronavirus Disease 2019 (COVID-19): Cytokine Storms, Hyper-Inflammatory Phenotypes, and Acute Respiratory Distress Syndrome date = 2020-06-29 keywords = ARDS; COVID-19 summary = title: Coronavirus Disease 2019 (COVID-19): Cytokine Storms, Hyper-Inflammatory Phenotypes, and Acute Respiratory Distress Syndrome Cytokine storms are a pathophysiological feature of COVID-19 and play an important role in distinguishing hyper-inflammatory subphenotypes of ARDS. Furthermore, we discuss inflammation-related indicators that have the potential to identify hyper-inflammatory subphenotypes of COVID-19, especially for those with a high risk of ARDS. [12, 27] Furthermore, other observational COVID-19 studies have suggested that cytokine 4 storms (comprised of IL-1β, IL-1RA, IL-7, and IL-8) may be associated with disease severity.[7, 12, 5 28] For example, higher concentrations of granulocyte colony-stimulating factor (GCSF), IP10, 6 MCP1, MIP1A, and TNF-α were found in patients who required admission into an intensive care 7 unit (ICU). In COVID-19, there is also suggestive evidence of hyper-inflammatory subphenotypes of ARDS. Circulating IL-1ra and 42 IL-10 levels are increased but do not predict the development of acute respiratory distress 43 syndrome in at-risk patients doi = 10.1016/j.gendis.2020.06.009 id = cord-284598-ksoonwf9 author = Liu, Shan title = Mesenchymal stem cells as a potential therapy for COVID-19 date = 2020-05-04 keywords = ARDS; covid-19 summary = The main pathologic features of severe or critical COVID-19 were consistent with acute lung injure (ALI)/acute respiratory distress syndrome (ARDS), characterized by cellular fibromyxoid exudates, extensive pulmonary inflammation, pulmonary edema, and hyaline membrane formation. Mesenchymal stem cells (MSCs) can balance the inflammatory response and has been mentioned to be effective on ALI/ARDS from both infectious and noninfectious causes previously, presenting an important opportunity to be applied to COVID-19. In this commentary, we summarize the clinical trials of MSCs treatments on ALI/ARDS and raise MSCs as a hopefully alternative therapy for severe or critical COVID-19. Clinical application of mesenchymal stem cell-derived extracellular vesicle-based therapeutics for inflammatory lung diseases Mesenchymal stem (stromal) cells for treatment of ARDS: a phase 1 clinical trial Mesenchymal stromal cell treatment prevents H9N2 avian influenza virus-induced acute lung injury in mice In vivo effects of mesenchymal stromal cells in two patients with severe acute respiratory distress syndrome doi = 10.1186/s13287-020-01678-8 id = cord-004462-e8fbg6i6 author = Liu, Songqiao title = Optimal mean airway pressure during high-frequency oscillatory ventilation in an experimental model of acute respiratory distress syndrome: EIT-based method date = 2020-03-06 keywords = ARDS; EIT; HFOV summary = title: Optimal mean airway pressure during high-frequency oscillatory ventilation in an experimental model of acute respiratory distress syndrome: EIT-based method Our objective was to evaluate the air distribution, ventilatory and hemodynamic effects of individual mPaw titration during HFOV in ARDS animal based on oxygenation and electrical impedance tomography (EIT). CONCLUSION: Our data suggested personalized optimal mPaw titration by EIT-based indices improves regional ventilation distribution and lung homogeneity during high-frequency oscillatory ventilation. But the ventilation distribution and homogeneity remain unknown toward the methods mentioned above to titrate mPaw. Electrical impedance tomography (EIT) might allow the clinician to better adjust these ventilatory settings. In the present study, our objective was to evaluate the air distribution, ventilatory, and hemodynamic effects of individual mPaw titration in HFOV based on oxygenation and EIT. Our data provide personalized optimal mPaw titration in HFOV with EIT-based indices, which may provide a new insight of regional ventilation distribution and lung homogeneity during high-frequency oscillatory ventilation. doi = 10.1186/s13613-020-0647-z id = cord-315093-ifeulv55 author = Longobardo, Alessia title = Inhaled nitric oxide produces minimal improvement in oxygenation in COVID-19 related ARDS date = 2020-10-14 keywords = ARDS summary = Baseline PaO 2 : FiO 2 ratio, dose of iNO, use of steroid, prone position ventilation, C-reactive protein, D-dimer levels, N-terminal B-type natriuretic peptide (NT-BNP) levels, fluid balance, driving pressure, days from ICU admission to iNO, pulmonary compliance, diagnosis of VTE, or body mass index did not discriminate between COVID-19 patients who responded to iNO or not (Supplementary Figure 1) . 5 However, we found that the increase in PaO 2 :FiO 2 ratio in COVID-19 ARDS patients in response to iNO was significantly lower compared to ARDS patients without ARDS, consistent with another published series. 4, 7 In contrast, patients with coronavirus-related SARS, where increased thrombosis was not a hallmark, demonstrated significant PaO 2 :FiO 2 ratio improvements in response to iNO. In summary, more than half of patients with refractory hypoxaemia secondary to COVID-19 ARDS did not show an increase in PaO 2 :FiO 2 ratio in response to iNO. doi = 10.1016/j.bja.2020.10.011 id = cord-316923-b81uaooh author = Luks, Andrew M. title = Reply: COVID-19 Lung Injury and “Typical” Acute Respiratory Distress Syndrome: The Danger of Presumed Equivalency date = 2020-09-17 keywords = ARDS; COVID-19 summary = For example, in COVID-19 lung disease, a hypoxemic condition that progresses over several days in which many patients do not appear to be in distress, what is more injurious: accepting a lower oxygen saturation as measured by pulse oximetry or initiating invasive mechanical ventilation? With great respect for the authors'' well-meaning concern to avoid patient harm, let me be clear about mine: I am concerned that the alveolar filling/collapse, low-compliance pulmonary disease being seen in the intensive care unit is predominantly due to ventilator-induced lung injury rather than to the natural evolution of COVID-19 disease. Finally, the author states, without supporting evidence, that patients with COVID-19 have "normal or near-normal pulmonary compliance." To date, only three published reports have documented static compliance in COVID-19, and in two of them (2, 3) the average static compliance was low (,35 ml/cm H 2 O) and consistent with that seen in prior studies of ARDS. doi = 10.1513/annalsats.202005-430le id = cord-019010-9xgwjvsv author = Luna, C. M. title = Life-threatening Respiratory Failure from H1N1 Influenza: Lessons from the Southern Cone Outbreak date = 2010-06-23 keywords = ARDS; H1N1; influenza; patient summary = Consistent with this particular situation, the health system in the metropolitan area of Buenos Aires began to show evidences of collapse, use of ventilators increased critically, achieving an extremely unusual level; about a quarter of the available ICU beds were occupied by young and previously healthy patients with ARDS associated with severe bilateral pneumonia due to ''swine flu'' who needed mechanical ventilation. These figures are difficult to extrapolate globally and to confirm, as epidemiological studies looking at the population at risk in different world areas are lacking, but the huge number of severely ill patients with ARDS due to primary influenza pneumonia (an extremely unusual complication) observed in the Southern Cone, suggest that these estimations could be realistic. Viral cultures of respiratory specimens, especially if A 29 year-old obese male with arterial hypertension secondary to Cushing''s disease (hypophyseal adenoma) developed bilateral pneumonia and died from respiratory failure secondary to acute respiratory distress syndrome (ARDS) after 13 days on mechanical ventilation, with multiple organ failure, including renal and hemodynamic compromise requiring high doses of vasopressors. doi = 10.1007/978-3-642-10286-8_20 id = cord-331500-l3hkn2li author = Luyt, Charles-Edouard title = Pulmonary infections complicating ARDS date = 2020-11-11 keywords = ARDS; ECMO; ICU; VAP; infection; patient summary = Whatever the initial lung injury, patients with ARDS are prone to develop secondary pulmonary infection, namely ventilator-associated pneumonia (VAP). While glucocorticoids are classically considered as immunosuppressive drugs, it has been shown that they can prevent the immune reprogramming observed after inflammatory response [16] , thus limiting the susceptibility of patients admitted to the intensive care unit (ICU) to respiratory complications such as pneumonia or ARDS and improving outcomes of patients with ARDS [17] . Peripheral blood markers have the advantage of avoiding the need for bronchoscopic sampling and are therefore easier to obtain; however, they are generally less able to discriminate pneumonia from other infections Table 1 Summary of host-based biomarkers for diagnosis of pneumonia in ARDS ARDS acute respiratory distress syndrome, RCT randomized controlled trial, sTREM soluble triggering receptor expressed on myeloid cells, VAP ventilator-associated pneumonia, HLA human leukocyte antigen doi = 10.1007/s00134-020-06292-z id = cord-326613-253v48i0 author = Lv, Dandan title = A novel cell-based assay for dynamically detecting neutrophil extracellular traps-induced lung epithelial injuries date = 2020-05-29 keywords = ARDS; net summary = title: A novel cell-based assay for dynamically detecting neutrophil extracellular traps-induced lung epithelial injuries Previously, the excessive recruitment and activation of neutrophils (polymorphonuclear leukocytes [PMNs]), accompanied by neutrophil extracellular traps (NETs) formation were reported being implicated in the pathogenesis of ALI/ARDS. Therefore, we established a cell-based assay for detecting NETs during lung epithelial cells-neutrophils co-culture using the xCELLigence system, a recognized real-time, dynamic, label-free, sensitive, and high-throughput apparatus. Our results demonstrated that lung epithelial injuries, reflected by declines in cell index (CI) values, could be induced by lipopolysaccharide (LPS)-activated PMNs, or NETs in a time and dose-dependent manner. Moreover, this cell-based assay identified that PMNs from severe pneumonia patients had a high NETs formative potential. Protein-based therapies for acute lung injury: targeting neutrophil extracellular traps Neutrophil extracellular traps directly induce epithelial and endothelial 669 cell death: a predominant role of histones Maladaptive role of neutrophil extracellular traps in 671 pathogen-induced lung injury doi = 10.1016/j.yexcr.2020.112101 id = cord-017853-mgsuwft0 author = Machado, Roberto F. title = Genomics of Acute Lung Injury and Vascular Barrier Dysfunction date = 2010-06-28 keywords = ALI; ARDS; IL-6; MIF; PBEF; gene summary = In this chapter, we utilize a systems biology approach combining cellular signaling pathway analysis with population-based association studies to review established and suspected candidate genes that contribute to dysfunction of endothelial cell barrier integrity and ALI susceptibility. Genes encoding proinflammatory cytokines, growth factors and mediators, receptors for barrier-regulatory agonists, and mechanical-stress-sensitive genes expressed in endothelium which regulate inflammatory responses also serve as attractive ALI candidate genes and are representative of the diverse but fertile areas of exploration for candidate SNPs affecting ALI susceptibility and severity. Interrogating the prospective pathways involved in endothelial permeability and correlation with these differentially expressed genes in VALI models identified the most putative ALI genes such as myosin light chain kinase (MYLK), sphingosine 1-phosphate receptor 1, cMet, and vascular endothelial growth factor (VEGF) mechanical stress [37, 38] . Role of macrophage migration inhibitory factor (MIF) in human and animal models of acute lung injury (ALI) and sepsis: association of a promoter polymorphism and increased gene expression doi = 10.1007/978-0-387-87429-6_63 id = cord-020490-sjz5mbbr author = Mahida, R. Y. title = Extracellular Vesicles in ARDS: New Insights into Pathogenesis with Novel Clinical Applications date = 2019-11-30 keywords = ARDS; BALF; extracellular summary = Several studies have reported that intravenous administration of endothelial extracellular vesicles in rodents induced lung injury with alveolar neutrophilic infiltration, pulmonary edema, elevated inflammatory cytokines (myeloperoxidase [MPO] , interleukin [IL]-1β and tumor necrosis factor [TNF]-α), and increased lung endothelial permeability [6] [7] [8] . Intravenous administration of these extracellular vesicles to naïve mice caused lung injury via macrophage TLR4 activation, including increased alveolar vascular permeability and inflammatory cell infiltration [17] . In a pig model of influenza-induced lung injury, administration of mesenchymal stromal cell extracellular vesicles similarly reduced lung injury, alveolar protein permeability, and inflammatory cytokine release. In addition, an experimental model of infant respiratory distress syndrome and bronchopulmonary dysplasia in newborn mice showed a therapeutic effect of extracellular vesicles isolated from mesenchymal stromal cells in reducing lung injury and restoring lung function, in part through induction of antiinflammatory and pro-resolving macrophages [35] . doi = 10.1007/978-3-030-37323-8_4 id = cord-354829-god79qzw author = Mao, Kaimin title = Identification of robust genetic signatures associated with lipopolysaccharide-induced acute lung injury onset and astaxanthin therapeutic effects by integrative analysis of RNA sequencing data and GEO datasets date = 2020-09-23 keywords = ALI; ARDS; AST; LPS; RNA; gene summary = title: Identification of robust genetic signatures associated with lipopolysaccharide-induced acute lung injury onset and astaxanthin therapeutic effects by integrative analysis of RNA sequencing data and GEO datasets Here we performed a statistical meta-analysis of five publicly available gene expression datasets from LPS-induced ALI mouse models, conducted RNA-sequencing (RNA-seq) to screen differentially expressed genes (DEGs) in response to LPS administration and AST treatment, and integrative analysis to determine robust genetic signatures associated with LPS-induced ALI onset and AST administration. We subsequently integrated the RNA-seq and microarray meta-analysis data, and 11 core DEGs (Timp1, Ly6i, Cxcl13, Irf7, Cxcl5, Ccl7, Isg15, Saa3, Saa1, Tgtp1, and Gbp11) that were upregulated in ALI models and downregulated significantly after AST treatment were identified ( Table 2) . To further identify the robust expression signature related to LPS-induced ALI and investigate the transcriptional changes in response to the treatment of ALI by AST, we performed RNA-seq on three groups of mice and integrated the data with the results of the above mentioned meta-analysis. doi = 10.18632/aging.104042 id = cord-352365-b9cmviny author = Marchetti, Monia title = COVID-19-driven endothelial damage: complement, HIF-1, and ABL2 are potential pathways of damage and targets for cure date = 2020-06-24 keywords = ARDS; SARS; covid-19; endothelial summary = This review also highlights potential targets for prevention and therapy of COVID-19-related organ damage and discusses the role of marketed drugs, such as eculizumab and imatinib, as suitable candidates for clinical trials. Also, C3a complement fraction plays a relevant role in the pathogenesis of infection-related lung injury: high serum C3a predicts evolution to ARDS [9, 10] , while both C3a and C5a increase endothelial permeability and activate endothelial cells, thereby increasing the expression of adhesion molecules and cytokines [11, 12] , and the distal complement activation product C5 b-9 triggers intracellular fluxes of calcium in epithelial and endothelial cells. Apoptosis of human pulmonary microvascular endothelial cell may be chronically triggered by inflammation, such as in COPD, or acutely induced by ARDS; the latter is mediated by Bruton kinase (BTK), IL-17, and macrophage stimulating-1, while IL-35 seems protective [41] [42] [43] [44] . doi = 10.1007/s00277-020-04138-8 id = cord-321499-17n9tj70 author = Marini, John J. title = Integrating the evidence: confronting the COVID-19 elephant date = 2020-07-25 keywords = ARDS; COVID-19 summary = The acute respiratory distress syndrome (ARDS) that figures so prominently in severe cases of COVID infection may seem familiar but has historically predisposed to such logical missteps [6] . This simple perception provided for adult patients a convenient explanation that paralleled that of the infant respiratory distress syndrome, a condition for which the root cause mechanism had already been confirmed [8] . As pathologic severity increases, key definitional features of ARDS (extensive infiltrates, hypoxemia) usually proceed in synch, serving to guide clinical treatment and prognosis by gas exchange criteria. Respiratory system compliance is not invariably low in the presence of severe hypoxemia Do patients progress to diffuse airspace disease via patient self-inflicted lung injury (PSILI)? Covid-19 does not lead to a "typical" acute respiratory distress syndrome Management of Covid-19 respiratory distress Potential for lung recruitment and ventilation-perfusion mismatch in patients with the acute respiratory distress syndrome from coronavirus disease 2019 doi = 10.1007/s00134-020-06195-z id = cord-335977-f00758o2 author = Martin-Loeches, I. title = Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection date = 2010-11-24 keywords = ARDS; ICU; corticosteroid; patient summary = title: Use of early corticosteroid therapy on ICU admission in patients affected by severe pandemic (H1N1)v influenza A infection Recent guidelines for management of human infection with pandemic (H1N1)v influenza A infection recommend that corticosteroid therapy should not be used routinely, although low doses may be considered for patients in septic shock who require vasopressors and have suspected adrenal insufficiency [15, 16] . The main objective of this study is therefore to assess the effect on survival of early corticosteroid therapy compared with those who did not receive corticosteroids or received them subsequently as rescue therapy, in a cohort of patients hospitalized with severe presentation of pandemic (H1N1)v influenza A infection in the ICU. This analysis of a large, cohort, prospective, multicenter research study suggests that prompt use of corticosteroid therapy on ICU admission does not result in a reduction of mortality for critically ill patients admitted with pandemic (H1N1)v influenza A infection. doi = 10.1007/s00134-010-2078-z id = cord-031033-v4yetn4f author = Martin-Loeches, Ignacio title = The importance of airway and lung microbiome in the critically ill date = 2020-08-31 keywords = ARDS; gut; lung; microbiome summary = In this narrative review, we will focus on the rationale and current evidence for a pathogenic role of the lung microbiome in the exacerbation of complications of critical illness, such as acute respiratory distress syndrome and ventilator-associated pneumonia. In this narrative review, we will focus on the rationale and current evidence for a pathogenic role of the lung microbiome in the exacerbation of complications of critical illness, such as acute respiratory distress syndrome (ARDS) and ventilator-associated pneumonia (VAP). This study found that a single streamlined protocol offering an integrated genomic portrait of pathogen, microbiome and host transcriptome represents a new tool for diagnosis in lower respiratory tract infections (LRTI). Alternatively, the mere onset of critical illness-be it sepsis, ARDS or any number of conditions, is associated with alterations of the gut Fig. 2 Island model for the development of lung injury based on sites of dysbiosis microbiome, which may be independent of antibiotic administration [61] . doi = 10.1186/s13054-020-03219-4 id = cord-301830-nxtfhxjd author = Mauri, Tommaso title = Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019 date = 2020-04-28 keywords = ARDS; EIT; peep summary = title: Potential for Lung Recruitment and Ventilation-Perfusion Mismatch in Patients With the Acute Respiratory Distress Syndrome From Coronavirus Disease 2019 MEASUREMENTS AND MAIN RESULTS: At each positive end-expiratory pressure level, we assessed arterial blood gases, respiratory mechanics, ventilation inhomogeneity, and potential for lung recruitment by electrical impedance tomography. The recruitment to inflation ratio presented median value higher than previously reported in acute respiratory distress syndrome patients but with large variability (median, 0.79 [0.53–1.08]; range, 0.16–1.40). CONCLUSIONS: In patients with acute respiratory distress syndrome from coronavirus disease 2019, potential for lung recruitment presents large variability, while elevated dead space fraction may be a specific pathophysiological trait. In this study, we assessed the respiratory mechanics, gas exchange, ventilation inhomogeneity, potential for lung recruitment, and ventilation/perfusion mismatch by electrical impedance tomography (EIT) in a cohort of intubated patients with ARDS from COVID-19. doi = 10.1097/ccm.0000000000004386 id = cord-277031-yt0lafin author = McGurk, Kevin title = A primer on proning in the emergency department date = 2020-07-04 keywords = ARDS; prone summary = Historically, the prone position was used almost exclusively in the ICU for patients suffering from refractory hypoxemia due to acute respiratory distress syndrome (ARDS). Improved oxygenation in patients with acute respiratory failure: the prone position Efficacy of prone position in acute respiratory distress syndrome patients: a pathophysiology-based review Effect of mechanical ventilation in the prone position on clinical outcomes in patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis Prone positioning in severe acute respiratory distress syndrome Prone positioning improves oxygenation in spontaneously breathing nonintubated patients with hypoxemic acute respiratory failure: a retrospective study Early prone position at the emergency room in acute respiratory distress syndrome: a pilot study Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis Positioning of patients with acute respiratory distress syndrome: combining prone and upright makes sense Transport of a prone position acute respiratory distress syndrome patient doi = 10.1002/emp2.12175 id = cord-010443-4jblod8j author = Meduri, Gianfranco Umberto title = General Adaptation in Critical Illness: Glucocorticoid Receptor-alpha Master Regulator of Homeostatic Corrections date = 2020-04-22 keywords = ARDS; HPA; cell; dna; glucocorticoid; receptor; vitamin summary = In critical illness, NF-κB-driven systemic inflammation, also known as a "cytokine storm" (14) , activates a multi-system response that includes at least three major domains: (i) the stress system composed by the hypothalamic-pituitary-adrenal (HPA) axis and the locus caeruleus-norepinephrine/sympathetic nervous system activated to provide sufficient energy and hemodynamic stability to overcome the initial phase of critical illness (15) ; (ii) the acute-phase reaction (APR), which has several adaptive functions, including increasing the production of procoagulant factors in preparation for possible tissue damage (16) ; and (iii) the tissue defense response (TDR) of the target organs [ Figure 1 ; (11, 17) ]. In patients with septic shock (170, 171) or ARDS (172, 173) , prolonged glucocorticoid (hydrocortisone or methylprednisolone) treatment resulted in the following: (i) increased plasma activated protein C levels (173); (ii) reduction in markers of endothelial injury such as sICAM-1 (35); (iii) rapid and consistent improvement in capillary perfusion, independently of the cortisol response to ACTH (170) ; and (iv) improvement in alveolar-capillary (172) and renal (171) endothelial permeability. doi = 10.3389/fendo.2020.00161 id = cord-296182-hhswage4 author = Meng, Lingzhong title = Intubation and Ventilation amid the COVID-19 Outbreak: Wuhan’s Experience date = 2020-04-08 keywords = ARDS; COVID-19; China; Wuhan; patient summary = Healthcare providers, who are tasked with taking care of critically ill patients, need to perform the best practices of intubation and ventilation tailored explicitly to the victims of this sweeping COVID-19 outbreak and, at the same time, adhere to strict self-protection precautions. The Chinese Society of Anesthesiology Task Force on Airway Management released a fast-track publication with the recommendation to proceed with endotracheal intubation for patients showing no improvement in respiratory distress, tachypnea (respiratory rate greater than 30 per minute), and poor oxygenation (Pao 2 to Fio 2 ratio less than 150 mmHg) after 2-h highflow oxygen therapy or noninvasive ventilation. Although the aerosol-generating potential of noninvasive ventilation is a potential concern to some providers, 19 the bilevel positive airway pressure machine is widely used amid this outbreak for patients with acute hypoxemic respiratory failure in Wuhan and the rest of China. doi = 10.1097/aln.0000000000003296 id = cord-261146-ppe8br4z author = Mohammed, Amira title = Δ9-Tetrahydrocannabinol Prevents Mortality from Acute Respiratory Distress Syndrome through the Induction of Apoptosis in Immune Cells, Leading to Cytokine Storm Suppression date = 2020-08-28 keywords = ARDS; SEB; cell; figure; seb+thc; thc summary = Thus, in the current study based on single-cell RNA sequencing data, we determined whether THC induces apoptosis in activated immune cells in the lungs following SEB-induced ARDS and, if so, whether it was through the death receptor or mitochondrial pathway. Our data demonstrated that THC decreased the expression of miR-185-3p in SEB-activated immune cells, thereby promoting the induction of a number of genes related to the mitochondrial pathway of apoptosis, causing an alteration in metabolism of immune cells, leading to the attenuation of inflammation and ARDS. These studies suggested THC mediated the induction of apoptosis and autophagic cell death by altering the cytochrome c oxidases of the mitochondrial electron transport chain in MNCs infiltrating the lung in SEB-induced ARDS. These studies suggested THC mediated the induction of apoptosis and autophagic cell death by altering the cytochrome c oxidases of the mitochondrial electron transport chain in MNCs infiltrating the lung in SEB-induced ARDS. doi = 10.3390/ijms21176244 id = cord-005812-hx6lkuj0 author = Morty, Rory E. title = Alveolar fluid clearance in acute lung injury: what have we learned from animal models and clinical studies? date = 2007-05-25 keywords = AFC; ALI; ARDS summary = To complement that report this review focuses on how intact organ and animal models and clinical studies have facilitated our understanding of alveolar edema fluid clearance in acute lung injury and acute respiratory distress syndrome. Given the established importance of the type II cell in AFC [6] and the emerging importance of the type I cell in AFC with the recent discovery that type I cells also contain functional sodium and chloride channels [12] , this epithelial damage Fig. 1 Factors that cause impaired alveolar fluid clearance in ALI/ARDS that have been investigated in animal and organ models and in clinical studies. This idea was further supported by the observations that adenovirus-mediated transfer of β-adrenergic receptor genes to live rats improved AFC due to increased sensitivity to endogenous catecholamines and consequent upregulation of Na,K-ATPase activity and ENaC protein expression the lung [73] . doi = 10.1007/s00134-007-0662-7 id = cord-292862-ezrkg0dc author = Myerson, Jacob W. title = Supramolecular Organization Predicts Protein Nanoparticle Delivery to Neutrophils for Acute Lung Inflammation Diagnosis and Treatment date = 2020-04-18 keywords = ARDS; DBCO; LPS; PBS; Supplementary; figure; lung summary = We show that polystyrene nanoparticles and five liposome formulations do not accumulate in injured lungs, indicating that nanostructures that are not based on protein are not intrinsically drawn to marginated neutrophils in acute inflammation. 6, 10, 14, 18 Single cell suspensions prepared from mouse lungs were probed by flow cytometry to further characterize pulmonary neutrophils in naïve mice and in mice following LPS-induced inflammation. The protein component of each particle was labeled with 125 I for tracing in biodistributions, and assessed 30 minutes after IV administration of NPs. Both absolute LDNG lung uptake and ratio of lung uptake to liver uptake registered a ~25-fold increase between naïve control and LPS-injured animals (Figure 2A , Supplementary Table 1) . As with LDNGs and albumin NPs in Figure 2C -H, single cell suspensions were prepared from LPS-inflamed and naïve control lungs after circulation of fluorescent DBCO-IgG liposomes. doi = 10.1101/2020.04.15.037564 id = cord-293736-nyvwv31m author = Méry, Geoffroy title = COVID-19: Underlying Adipokine Storm and Angiotensin 1-7 Umbrella date = 2020-07-21 keywords = ACE2; ARDS; Ang1; COVID-19; SARS summary = Here we seek to explore what underlies the link between immune response and respiratory failure in CoV infections on the one hand, and the current observation of obesity as a risk factor for severe outcome in COVID-19 on the other. Indeed, during COVID-19 infection, most patients exhibit a specific cytokine profile, associating innate immunity chemokines (such as monocyte chemoattractant protein 3 and interferon gamma-induced protein 10 (IP-10), which are suggestive of macrophage activation and epithelial suffering), and pro-inflammatory macrophage-produced cytokines such as IL-6 (45). We suggest that the tampering with such pathways could also lead to abnormalities in the inflammatory response observed in severe CoV infections through their influence on immune regulation and cytokine production. Besides suffering from a pro-inflammatory environment, which favors macrophage activation and neutrophil production, obese patients exhibit abnormal responses to viral infection. doi = 10.3389/fimmu.2020.01714 id = cord-006700-df8ard9o author = Müller-Redetzky, Holger C. title = Dynamics of pulmonary endothelial barrier function in acute inflammation: mechanisms and therapeutic perspectives date = 2014-03-06 keywords = ARDS; FTY720; LPS; endothelial; injury; lung; s1p summary = However, upon infectious or sterile inflammatory stimulation via either the alveolar (e.g., in pneumonia and mechanical ventilation) or the vascular lumen (e.g., in bacteremia and sepsis), pulmonary endothelial barrier homeostasis may be disturbed, resulting in increased permeability, protein-rich fluid extravasation, lung oedema and finally acute respiratory distress syndrome (ARDS) with mortality rates ranging from 27 to 45 % depending on severity (Ranieri, et al. Although the underlying mechanisms of leukocyte mediated barrier failure are of highest scientific interest, therapeutic interference to ameliorate acute lung injury by depletion or blocking of cell recruitment should raise concerns as neutrophils and monocytes are key players of pulmonary and systemic innate immune responses and therapeutic intervention at this level might leave the patient functionally immunosuppressed. In mice, Ang-1-induced Tie-2 receptor phosphorylation stimulated the p190RhoGTPaseactivating protein (p190RhoGAP) via PI3-kinase and Rac1 to inactivate RhoA, resulting in reduced F-actin stress fibre formation and diminished endothelial permeability (Mammoto et al. doi = 10.1007/s00441-014-1821-0 id = cord-285955-fzm6036f author = Nasir, N. title = Treatment of ARDS and hyperinflammation in COVID-19 with IL-6 antagonist Tocilizumab: a tertiary care experience from Pakistan date = 2020-06-26 keywords = ARDS; COVID-19 summary = Cytokine release syndrome in COVID-19 is characterized by hyperinflammation which manifests as ARDS, multi-organ failure, and high inflammatory parameters. We conducted a retrospective descriptive study from Feb 2020 to May 2020 on COVID-19 patients with ARDS and hyperinflammation characterized by raised CRP and/or ferritin. While limited studies from China have shown improved outcomes in COVID-19 patients with hyperinflammation and ARDS 9 , a study from Italy did not show significant mortality benefit 10 . Hence, we would like to report our clinical experience of the management of ARDS and hyperinflammation with the IL-6 inhibitor Tocilizumab which will be the first from a lower-middle-income country (LMIC). We conducted an observational study describing patient outcomes in those critically ill patients of COVID-19 who received tocilizumab intravenously for hyperinflammation and ARDS. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality doi = 10.1101/2020.06.23.20134072 id = cord-339293-7ks3bopm author = Nejatifard, Marzieh title = Probable Positive Effects of the Photobiomodulation as an Adjunctive Treatment in COVID-19: A Systematic Review date = 2020-10-12 keywords = ARDS; COVID-19; PBM; effect summary = Therefore, this review study was conducted to evaluate the direct effect of PBM on the acute lung inflammation or ARDS and also accelerating the regeneration of the damaged tissues. Therefore, this study was conducted to evaluate the direct effect of the PBM on the acute lung inflammation or ARDS and accelerating the regeneration of the damaged tissue. The included papers were evaluated for the effect of light therapy, PBM, or low -level laser therapy on the lung inflammation, ARDS, lymphocytes, neutrophils, and lung parenchyma. All the studies confirmed that the PBM can reduce the lung inflammation, neutrophil recruitment, and pro-inflammatory cytokine production. All the papers have shown the anti-inflammatory effects of the PBM including reducing the lung edema, cytokines in the bronchoalveolar lavage (BAL) fluid, neutrophil influx, myeloperoxidase (MPO) activity, and damage to the endothelial cytoskeleton. doi = 10.1016/j.cyto.2020.155312 id = cord-277788-6ls21tkr author = Nelson, Brian C title = Clinical Outcomes Associated with Methylprednisolone in Mechanically Ventilated Patients with COVID-19 date = 2020-08-09 keywords = ARDS; COVID-19 summary = METHODS: Clinical outcomes associated with the use of methylprednisolone were assessed in an unmatched, case-control study; a subset of patients also underwent propensity-score matching. Our study evaluated the association of methylprednisolone treatment with duration of mechanical ventilation and mortality in intubated, critically-ill patients with COVID-19. We observed an increase in the number of ventilator-free days and the likelihood of extubation, as well as a statistically non-significant trend towards improved mortality, in the corticosteroid group when compared to control patients in a propensity-matched cohort by day 28. Although this benefit was greatest in the subset of patients that required mechanical ventilation, the trial only evaluated outcomes through hospital day 28 and did not assess other corticosteroids, such as methylprednisolone [14] . We found that treatment with methylprednisolone increased the number of ventilator-free days and probability of extubation compared with a propensity matched control group among patients with severe COVID-19 requiring mechanical ventilation, but we did not detect a significant difference in mortality. doi = 10.1093/cid/ciaa1163 id = cord-004092-wb150n8w author = Nieman, Gary F. title = Prevention and treatment of acute lung injury with time-controlled adaptive ventilation: physiologically informed modification of airway pressure release ventilation date = 2020-01-06 keywords = ARDS; Fig; TCAV; lung summary = Understanding how ARDS alters the dynamic alveolar inflation physiology enables us to adjust the mechanical breath profile (MB P -all airway pressures, volumes, flows, rates and the time at inspiration and expiration at which they are applied) necessary to minimize VILI [12] . The ARDSnet Low Vt (LVt) method is intended to protect the non-dependent normal lung tissue from overdistension (OD) and reduce alveolar recruitment/ derecruitment (R/D) with positive end expiratory pressure (PEEP), while resting severely injured tissue by allowing it to remain collapsed throughout the ventilation cycle [2] . Abbreviations ARDS: acute respiratory distress syndrome; VILI: ventilator-induced lung injury; APRV: airway pressure release ventilation; FRC: functional residual capacity; TCAV: time-controlled adaptive ventilation; CPAP: continuous positive airway pressure; TC-PEEP: time controlled-positive end expiratory pressure; T Low : time at low pressure; T High : time at high pressure; P High : pressure at inspiration; P Low : pressure at expiration; PEEP: positive end expiratory pressure; E FT : expiratory flow termination; E FP : expiratory flow peak; RCT : randomized controlled trial; OLA: open lung approach; MB P : mechanical breath pattern; CT: computerized axial tomography. doi = 10.1186/s13613-019-0619-3 id = cord-317619-o7qfugjw author = Nye, Steven title = Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome date = 2016-11-24 keywords = ARDS; H1N1; RSV; respiratory; virus summary = While the overall incidence of respiratory virus infection, in particular RSV and influenza A (H1N1) virus, leading to lower respiratory tract disease is widely studied (12, 13), the frequency of progression to pediatric ARDS has yet to be clearly determined. While post-pandemic studies suggest a decrease in influenza A (H1N1) virus disease severity and burden (20, 21), it continues to be a significant cause of severe illness and pediatric ARDS (22). In RSV infection, development of lower respiratory track disease in premature infants, with or without chronic neonatal lung disease is associated with a significantly higher risk of hospitalization, intensive care unit admission, need for mechanical ventilation, and death (12, [70] [71] [72] [73] . Disease severity and viral load are correlated in infants with primary respiratory syncytial virus infection in the community Motavizumab treatment of infants hospitalized with respiratory syncytial virus infection does not decrease viral load or severity of illness doi = 10.3389/fped.2016.00128 id = cord-001938-n2d5fw2f author = Ong, David S. Y. title = Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome date = 2016-03-01 keywords = ARDS; CMV; ICU summary = Furthermore, CMV reactivation in critically ill patients has been associated with a prolonged duration of mechanical ventilation [2, 4, [9] [10] [11] [12] [13] , an increased length of stay in the ICU [3, 5, 9, 10, 13] , and excess mortality [2, 4, [7] [8] [9] . Nevertheless, it remains uncertain whether these findings imply that CMV reactivation is a truly independent risk factor with respect to these observed poor clinical outcomes because most studies that have assessed these associations did not adequately account for all possible sources of bias. Possible confounders that were screened included all patient characteristics and therapeutic interventions listed in Table 1 , and some markers of disease severity: Acute Physiology and Chronic Health Evaluation APACHE Acute Physiology and Chronic Health Evaluation, ARDS acute respiratory distress syndrome, COPD chronic obstructive pulmonary disease, ICU intensive care unit, PEEP positive end expiratory pressure, P/F partial pressure of oxygen in arterial blood to fraction of inspired oxygen ratio (APACHE) IV score, presence of septic shock, partial pressure of oxygen in arterial blood to fraction of inspired oxygen ratio, and positive end expiratory pressure (PEEP) setting. doi = 10.1007/s00134-015-4071-z id = cord-005511-h5d2v4ga author = Ospina-Tascón, Gustavo A. title = Microcirculatory dysfunction and dead-space ventilation in early ARDS: a hypothesis-generating observational study date = 2020-03-24 keywords = ARDS summary = We sought to evaluate the relationships between dynamic variations in V(D)/V(T) and extra-pulmonary microcirculatory blood flow detected at sublingual mucosa hypothesizing that an altered microcirculation, which is a generalized phenomenon during severe inflammatory conditions, could influence ventilation/perfusion mismatching manifested by increases in V(D)/V(T) fraction during early stages of ARDS. Thus, considering microcirculatory dysfunction during inflammatory conditions as a generalized phenomenon, which may involve systemic and pulmonary vascular beds, we hypothesized that alterations in microvascular blood flow distribution evaluated at the sublingual mucosa as representative of an extra-pulmonary territory could be related to variations in dead-space ventilation V D /V T during early phases of moderate and severe ARDS. doi = 10.1186/s13613-020-00651-1 id = cord-277648-9kxwkcbl author = Overholt, Kalon J. title = Dissecting the common and compartment-specific features of COVID-19 severity in the lung and periphery with single-cell resolution date = 2020-06-19 keywords = ARDS; BALF; cell; covid-19; figure summary = Bulk RNA sequencing (bulk RNA-seq) and single-cell RNA sequencing (scRNA-seq) studies have identified stark transcriptional differences between bronchoalveolar lavage fluid (BALF) and peripheral blood mononuclear cell (PBMC) samples in hospitalized COVID-19 patients, indicating that immunological responses may be highly compartment-specific [21, 22] . We used identical methods to separately analyze multi-donor scRNA-seq datasets from bronchoalveolar lavage fluid (BALF) and peripheral blood mononuclear cells (PBMCs) in COVID-19 patients classified by severity strata as well as healthy control subjects to investigate severity-specific immune dysregulation in the lung and periphery. When we increased this analysis to include all of the cell types found in the BALF (Figure 3A We next investigated pathway-level changes occurring in PBMCs and found that differential gene expression between ARDS and non-ARDS patients supported the detection of statistically enriched pathways through GSEA. doi = 10.1101/2020.06.15.147470 id = cord-344061-gsl84nv6 author = Pariani, Elena title = Influenza and Other Respiratory Viruses Involved in Severe Acute Respiratory Disease in Northern Italy during the Pandemic and Postpandemic Period (2009–2011) date = 2014-06-12 keywords = ARDS; SARI summary = We evaluated the proportion of SARI/ARDS cases and deaths due to influenza A(H1N1)pdm09 infection and the impact of other respiratory viruses during pandemic and postpandemic period (2009–2011) in northern Italy; additionally we searched for unknown viruses in those cases for which diagnosis remained negative. 206 respiratory samples were collected from SARI/ARDS cases and analyzed by real-time RT-PCR/PCR to investigate influenza viruses and other common respiratory pathogens; also, a virus discovery technique (VIDISCA-454) was applied on those samples tested negative to all pathogens. This study aimed at evaluating the proportion of SARI/ARDS cases and deaths due to A(H1N1)pdm09 infection and assessing the impact of other respiratory pathogens during pandemic and postpandemic period (2009) (2010) (2011) in northern Italy as well as searching for unknown viruses in those cases for which diagnosis remained negative. During pandemic and postpandemic period, several pathogens cocirculated and were associated to severe respiratory infections; however, influenza A(H1N1)pdm09 virus had the greatest impact (58.3%) in our SARI/ARDS series. doi = 10.1155/2014/241298 id = cord-258896-ck7lh9rg author = Perez-Nieto, Orlando Ruben title = Impact of Asynchronies in Acute Respiratory Distress Syndrome Due to Coronavirus Disease 2019 date = 2020-08-20 keywords = ARDS summary = To the Editor: T he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Mexico, in the month of May, has reached an alarming case fatality rate (CFR) of 11%, with a high prevalence of acute respiratory distress syndrome (ARDS) by coronavirus disease 2019 (COVID-19). Asynchronies are common in patients with ARDS, and invasive mechanical ventilation (IMV) is common and can occur in all ventilatory modes. Patients with ARDS due to COVID-19 that needed intubation and IMV present a challenge for the physician and have been associated with a mortality rate of 24.5% (2) , despite this, to this date, it has not been described the prevalence of asynchronies in patients with ARDS because of COVID-19 infection and its relationship with the prognosis of their disease. Studies are needed to determine the prevalence of asynchronies in patients with IMV and SARS-CoV-2 infection and its association with poor results. Asynchronies during mechanical ventilation are associated with mortality Pathological findings of COVID-19 associated with acute respiratory distress syndrome doi = 10.1097/cce.0000000000000200 id = cord-005583-hmv8jjfl author = Peters, M. J. title = Acute hypoxemic respiratory failure in children: case mix and the utility of respiratory severity indices date = 2013-12-27 keywords = AHRF; ARDS; respiratory summary = In an individual patient, such a response to intervention should be indicated by their best, rather than worst, measure of gas exchange, Therefore, the purpose of the present prospective, single institution study of AHRF in children was to assess whether the best, early respiratory indices in non-survivors were significantly different from those who survived. Table 2 Comparison of previously published [2] [3] [4] [5] respiratory severity parameters with the present series (PPV positive predictive value for mortality, VI ventilation index, OI oxygenation index, PIP peak inspiratory pressure (cmH20), A-aDO 2 alveolar arterial oxygen gradient (mmHg), MAP mean airway pressure (cmH20), LR + the likelihood ratio for a positive test result, i.e. the ratio of finding the predictor in non-survivors to finding it in survivors) * indicates intermediate to high diagnostic impact, ns not significant Proposed PPV LR + PPV p predictors (95 % confidence interval) in present study doi = 10.1007/s001340050647 id = cord-010550-lfbjvche author = Petran, Jan title = Validation of RESP and PRESERVE score for ARDS patients with pumpless extracorporeal lung assist (pECLA) date = 2020-05-02 keywords = ARDS; RESP; preserve summary = METHODS: In a retrospective single center cohort study we calculated and evaluated RESP, PRESERVE, and SOFA score for 73 ARDS patients with pumpless Extracorporeal Lung Assist treated between 2002 and 2016 using the XENIOS iLA Membrane Ventilator. Specific mortality risk scores, especially the Respiratory ECMO Survival Prediction (RESP) score [1] and the PRedicting dEath for SEvere ARDS on VV-ECMO (PRE-SERVE) score [2] , were developed and validated for ARDS patients with veno-venous high-flow Extracorporeal Membrane Oxygenation (ECMO). RESP and/or PRESERVE scores have been compared and evaluated in several studies for ECMO therapy [10] [11] [12] [13] [14] [15] [16] , but both scores as well as SOFA score have not been validated for ARDS patients treated with a primary extracorporeal CO 2 removal, like pECLA. In this retrospective study we tested the hypothesis that RESP and PRESERVE score are suitable to assume the mortality risk of pECLA therapy in case of ARDS and are superior to the SOFA score, which is not specific for Extracorporeal Lung Support and ARDS. doi = 10.1186/s12871-020-01010-0 id = cord-011363-o1f398vn author = Pitoni, Sara title = Tidal Volume Lowering by Instrumental Dead Space Reduction in Brain-Injured ARDS Patients: Effects on Respiratory Mechanics, Gas Exchange, and Cerebral Hemodynamics date = 2020-04-22 keywords = ARDS; peep summary = title: Tidal Volume Lowering by Instrumental Dead Space Reduction in Brain-Injured ARDS Patients: Effects on Respiratory Mechanics, Gas Exchange, and Cerebral Hemodynamics Previous authors highlighted that replacing HME with HH decreases dead space, promotes CO 2 clearance and allows V T and plateau pressure reduction during ARDS [17] [18] [19] [20] : however, no data clarify to what extent ∆P is reduced by this approach and whether this is safe in patients with concomitant brain injury, for whom tight control of PaCO 2 is mandatory and any intervention has to be evaluated also from the perspective of cerebral hemodynamics. The use of HH in patients with brain injury and ARDS reduces instrumental dead space and allows to reduce tidal volume and driving pressure in isocapnic conditions, with no alveolar derecruitment, hypoxemia, changes in cerebral perfusion pressure nor blood flow. doi = 10.1007/s12028-020-00969-5 id = cord-004515-x22q1f21 author = Pottecher, Julien title = Protocol for TRAUMADORNASE: a prospective, randomized, multicentre, double-blinded, placebo-controlled clinical trial of aerosolized dornase alfa to reduce the incidence of moderate-to-severe hypoxaemia in ventilated trauma patients date = 2020-03-18 keywords = ARDS; ICU; dna; patient; study; trauma summary = title: Protocol for TRAUMADORNASE: a prospective, randomized, multicentre, double-blinded, placebo-controlled clinical trial of aerosolized dornase alfa to reduce the incidence of moderate-to-severe hypoxaemia in ventilated trauma patients Dornase alfa is a US Food and Drug Administration-approved recombinant DNase, which cleaves extracellular DNA and may therefore break up the backbone of NETs and DAMPs. Aerosolized dornase alfa was shown to reduce trauma-induced lung injury in experimental models and to improve arterial oxygenation in ventilated patients. The primary trial objective is to demonstrate a reduction in the incidence of moderate-to-severe hypoxaemia in severe trauma patients during the first 7 days from 45% to 30% by providing aerosolized dornase alfa as compared to placebo. The primary objective of the TRAUMADORNASE study is to demonstrate a reduction in the incidence of moderateto-severe hypoxaemia from 45% to 30% in severe trauma patients during the first 7 ICU days by providing aerosolized dornase alfa once during the first 2 ICU days as compared to equivalent provision of placebo (NaCl 0.9%). doi = 10.1186/s13063-020-4141-6 id = cord-310240-otf9ruvj author = Prohaska, Stefanie title = Intravenous immunoglobulin fails to improve ARDS in patients undergoing ECMO therapy date = 2018-02-26 keywords = ARDS; IVIG; patient summary = METHODS: ARDS patients admitted to the intensive care unit (ICU) who were placed on ECMO and treated with (IVIG group; n = 29) or without (control group; n = 28) intravenous IgM-enriched immunoglobulins for 3 days in the initial stages of ARDS were analyzed retrospectively. CONCLUSION: We conclude that administration of IgM-enriched immunoglobulins as an additional therapy did not have a beneficial effect in patients with severe ARDS requiring ECMO support. Although this treatment was omitted in recent sepsis guidelines due to a lack of supporting evidence in high-quality trials [8] , several studies, including one meta-analysis, describe beneficial effects of immunoglobulins in acute pneumonia induced by drug-resistant bacterial infections [9] [10] [11] . Based on these data, we treated patients with ARDS requiring ECMO therapy with IgM-enriched immunoglobulins immediately after intensive care unit (ICU) admission. The purpose of this analysis was to systematically investigate the potential effect of IgM-enriched immunoglobulins on the outcomes of ARDS patients requiring ECMO therapy. doi = 10.1186/s40560-018-0278-8 id = cord-025920-9p5x26ge author = Qadir, Nida title = Adjunctive Therapies in ARDS: The Disconnect Between Clinical Trials and Clinical Practice date = 2020-06-03 keywords = ARDS summary = In this issue of CHEST, Duggal et al 2 set out to address an important issue: the use of adjunctive therapies in patients with moderate to severe ARDS, a timely subject in the setting of COVID-19. Although the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) previously assessed the frequency of adjunctive therapy use all patients with ARDS, 3 a closer look at patients with a PaO 2 /FIO 2 ratio <150 is needed, as it is primarily this subset of patients in whom adjunctive therapies are recommended. This study 2 sheds some light on the patient-, clinician-, and systems-level factors associated with the use of adjunctive therapy, but many questions remain. Randomized controlled trials, including the Reevaluation Of Systemic Early Neuromuscular Blockade (ROSE) 6 and Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome (EOLIA), 7 chestjournal.org blockade or extracorporeal membrane oxygenation in patients with ARDS with specific levels of hypoxia. Patterns of use of adjunctive therapies in patients with early moderate to severe ARDS: insights from the LUNG SAFE Study doi = 10.1016/j.chest.2020.03.022 id = cord-281945-jvnjzjds author = Radnis, Caitlin title = Radiographic and clinical neurologic manifestations of COVID-19 related hypoxemia date = 2020-09-06 keywords = ARDS; covid-19; patient summary = Survivors of critical illness and ARDS often experience neurocognitive impairment but, to date, there is scant literature correlating radiographic hypoxic brain injury to hypoxemia related to ARDS. In this case series, we describe three cases of hypoxic brain injury seen on magnetic resonance imaging (MRI) in patients with hypoxemia secondary to COVID-19-related ARDS. Of patients with severe disease, approximately 16% had acute respiratory distress syndrome (ARDS), 14.5% required invasive mechanical ventilation, and 99% had pneumonia [4] . A recent autopsy case series found evidence of hypoxic changes in the brain tissue of patients who had succumbed to COVID-19, but there was no report of whether these patients developed ARDS, duration of mechanical ventilation if required, whether extracorporeal membrane oxygenation (ECMO) was used, presence or absence of cardiac arrest, or cause of death [21] . In this case series, we describe three cases of hypoxic brain injury seen on MRI, along with clinical correlations, in patients with hypoxemia secondary to COVID-19 related ARDS. doi = 10.1016/j.jns.2020.117119 id = cord-325755-n7vjjw9r author = Rai, Deependra Kumar title = Post covid 19 pulmonary fibrosis- Is it real threat? date = 2020-11-10 keywords = ARDS; COVID-19; fibrosis summary = This review addressed underlying mechanism, Risk factors, course of disease and treatment option for post covid pulmonary fibrosis. One of the risk factors for the development of lung fibrosis in COVID-19 is advanced age and this finding is same as in MERS and SARS-CoV. The follow-up of 36 MERS patients for average 43 days showed that lung fibrosis developed in a significant number of convalescents, and risk was found highest with patient who were elderly, hospitalised with severe disease in ICU 19 . Nintedanib use associated with increase the risk of bleeding as most of the covid 19 patient are on anticoagulant Evidence is also coming for use of pirfenidone, azithromycin and prednisolone in the management of pulmonary fibrosis post-H1N1 ARDS, based on data from a case report of three patients 25 . Elderly patient, severe disease who require ICU care and mechanical ventilation are highest risk to develop lung fibrosis doi = 10.1016/j.ijtb.2020.11.003 id = cord-005573-mryrl1s1 author = Raimondi, Francesco title = Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications date = 2018-07-20 keywords = ARDS; LUS; Lung; TTN; ultrasound summary = We report the description of the main ultrasound features of neonatal respiratory disorders and functional applications of LUS aiming to help a clinical decision (such as surfactant administration, chest drainage etc). 24 However, the same process seems more variable and heterogeneous in human neonates, as LUS appearance may be influenced by respiratory support, gestational age, fluid intake, pre-existing condition (pure RDS or a more complex situation with superimposed lung inflammation and surfactant catabolism, such as acute respiratory distress syndrome (ARDS)) and the eventual simultaneous development of broncho-pulmonary dysplasia (BPD). In the meantime, available data demonstrate that a visually calculated LUS score is a useful and easy tool to predict surfactant need in preterm neonates with RDS, to evaluate lung aeration while titrating the respiratory support or to be used as a research outcome measure. doi = 10.1038/s41390-018-0114-9 id = cord-352065-960xqft4 author = Rello, Jordi title = Update in COVID-19 in the Intensive Care Unit from the 2020 HELLENIC Athens International Symposium date = 2020-10-22 keywords = ARDS; COVID-19; ICU; SARS; patient summary = Experts reviewed the latest literature relating to the COVID-19 pandemic in critically ill patients, such as epidemiology, pathophysiology, phenotypes of infection, COVID-19 as a systematic infection, molecular diagnosis, mechanical ventilation, thromboprophylaxis, COVID-19 associated co-infections, immunotherapy, plasma treatment, Catheter-Related bloodstream infections, artificial intelligence for COVID-19, and vaccination. A major problem of the coronavirus pandemic is the considerable burden imposed on National Health Systems worldwide due to the hyperacute outbreak and the proportional increase of patients requiring intensive care unit (ICU) support in an extremely limited period of time, while outcomes vary according to the burden of the disease in each country. Acute respiratory distress syndrome (ARDS) is the primary cause of death in COVID-19 [7] and a recent scope review found that for COVID-19, < 5% of patients were reported as experiencing bacterial/fungal coinfection at admission, but development of secondary infections during ICU admission is common [8, 9] . doi = 10.1016/j.accpm.2020.10.008 id = cord-256051-87alqfkd author = Revzin, Margarita V. title = Multisystem Imaging Manifestations of COVID-19, Part 1: Viral Pathogenesis and Pulmonary and Vascular System Complications date = 2020-10-01 keywords = ARDS; COVID-19; Coronavirus; Fig; SARS; patient summary = Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. Although SARS-CoV-2 disease (or coronavirus disease 2019 ) primarily manifests as a lung infection, with symptoms ranging from those of a mild upper respiratory infection to severe pneumonia and acute respiratory distress syndrome (ARDS), other multisystemic manifestations of this disease and related complications are becoming more commonly recognized (3) . Thromboembolic complications, including pulmonary embolism (PE), peripheral venous and arterial thrombosis, and acute stroke (seen also in patients older than 50 years without risk factors) have all been reported (50-57). On the basis of the pattern and distribution of the opacities and the presence or absence of certain clinical signs (such as obesity), the authors developed a chest radiography severity scoring system that could be used as a prognostic factor of outcomes in young adult patients with COVID-19 (Fig 3) . doi = 10.1148/rg.2020200149 id = cord-028835-jby1btv7 author = Rilinger, Jonathan title = Prone positioning in severe ARDS requiring extracorporeal membrane oxygenation date = 2020-07-08 keywords = ARDS; ECMO summary = BACKGROUND: Prone positioning (PP) has shown to improve survival in patients with severe acute respiratory distress syndrome (ARDS). To this point, it is unclear if PP is also beneficial for ARDS patients treated with veno-venous extracorporeal membrane oxygenation (VV ECMO) support. METHODS: We report retrospective data of a single-centre registry of patients with severe ARDS requiring VV ECMO support between October 2010 and May 2018. CONCLUSION: In this propensity score matched cohort of severe ARDS patients requiring VV ECMO support, prone positioning at any time was not associated with improved weaning or survival. In case of severe acute respiratory distress syndrome (ARDS), veno-venous extracorporeal membrane oxygenation (VV ECMO) support may be considered when lung-protective mechanical ventilation is not able to prevent hypoxia or hypercapnia [1] [2] [3] . We performed a retrospective analysis of ARDS patients treated with PP during ECMO support at our centre. doi = 10.1186/s13054-020-03110-2 id = cord-271180-cnrs0zpg author = Rizvi, Saniya title = Cytosorb Filter: An adjunct for survival in the COVID-19 patient in cytokine storm? A case report. date = 2020-09-18 keywords = ARDS; cytokine; day; patient summary = CytosorbentsⓇ cytokine filter is a potential treatment methodology aimed at reducing the cytokine storm, thus serving as a bridge for therapy in the acutely ill patients infected with COVID-19. The following case report demonstrates the utility in a critically ill patient who survived the cytokine storm after receiving the cytokine filter via continuous renal replacement therapy bridging him to further definitive therapy. The following is a case report on a patient encounter and management course through the course of illness in which the Cytosorbents Ⓡ filter was used for his presentation of COVID-19 with severe ARDS, worsening renal dysfunction and evidence of evolving cytokine storm. Chest x-ray hospital day 16, 5 days after the initiation of cytokine filter when the patient developed worsening hypoxia and increased oxygen requirements as indicated in Table 2 below. doi = 10.1016/j.hrtlng.2020.09.007 id = cord-329985-5rji08p7 author = Robba, Chiara title = Distinct phenotypes require distinct respiratory management strategies in severe COVID-19 date = 2020-05-11 keywords = ARDS; covid-19; patient summary = The abnormalities observed on chest computed tomography (CT) and the clinical presentation of COVID-19 patients are not always like those of typical acute respiratory distress syndrome (ARDS) and can change over time. Few data are available on the efficacy of noninvasive support-which includes continuous positive airway pressure (CPAP), noninvasive ventilation (NIV), and high flow nasal oxygen (HFNO)-in COVID-19 pneumonia. When hypoxemia and respiratory failure persist or worsen after oxygen therapy or within a short time (1 hour) of placement of HFNO or NIV support, or in case of persistent hypercapnia, organ failure, coma, risk or aspiration, or hemodynamic instability, invasive mechanical ventilation should J o u r n a l P r e -p r o o f be implemented as soon as possible (Fig. 2) . As noted above, we have found that chest CT findings in COVID-19 fall into three different phenotypes, each warranting unique mechanical ventilation settings and management strategies, which should thus be individualized based on clinical and CT features (Fig. 1, Additional File 1, Fig. S1 ). doi = 10.1016/j.resp.2020.103455 id = cord-005621-a4bspoii author = Roch, Antoine title = Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center date = 2013-10-30 keywords = ARDS; ECMO; sofa summary = PURPOSE: Patients with severe acute respiratory distress syndrome (ARDS) are candidates for extracorporeal membrane oxygenation (ECMO) therapy. Abstract Purpose: Patients with severe acute respiratory distress syndrome (ARDS) are candidates for extracorporeal membrane oxygenation (ECMO) therapy. Conclusions: Age, SOFA score, and a diagnosis of influenza may be used to accurately evaluate the risk of death in ARDS patients considered for retrieval under ECMO from distant hospitals. The technique of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) involves placing them on a venovenous or venoarterial life-support circuit with a membrane oxygenator to temporarily take over the gas exchange and, sometimes, cardiac function [1] . In the present study, we evaluated early prognostic factors in ARDS patients treated with ECMO in distant hospitals by our mobile team and brought to our center during a 3-year period. doi = 10.1007/s00134-013-3135-1 id = cord-282474-74273qgk author = Roehrig, Stefan title = Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19: A structured summary of a study protocol for a randomised controlled trial date = 2020-09-11 keywords = ARDS; patient; ventilation summary = title: Flow controlled ventilation in Acute Respiratory Distress Syndrome associated with COVID-19: A structured summary of a study protocol for a randomised controlled trial OBJECTIVES: This study aims to demonstrate the positive effects on oxygenation of flow-controlled ventilation compared to conventionally ventilated patients in patients suffering from Acute respiratory distress syndrome (ARDS) associated with COVID-19.We define ARDS according to the "Berlin" definition integrating the oxygenation index (P/F ratio), the level of Positive End Expiratory Pressure (PEEP), radiological and clinical findings. TRIAL REGISTRATION: The protocol was registered before starting subject recruitment under the title: "Flow controlled ventilation in ARDS associated with COVID-19" in ClinicalTrials.org with the registration number: NCT04399317. Although the severely ill patients will need intubation and invasive ventilation according to ARDS treatment strategies including low tidal volumes and low end-expiratory pressures, not all patients recover their pulmonary function [3, 4] . doi = 10.1186/s13063-020-04708-1 id = cord-323303-q0hjtsgi author = Roy, A. title = Physiological Effect of Prone Positioning in Mechanically Ventilated SARS- CoV-2 Infected Patients with Severe ARDS: Preliminary Analysis of an Observational Study date = 2020-09-18 keywords = ARDS summary = title: Physiological Effect of Prone Positioning in Mechanically Ventilated SARSCoV-2 Infected Patients with Severe ARDS: Preliminary Analysis of an Observational Study There was a significant decrease in plateau airway pressure (p<0.0001), peak airway pressure (p<0.0001) and driving pressure(p<0.0001) and increase in static compliance (p=0.001), P/F ratio (p<0.0001), PaO2 (p=0.0002)and SpO2 (p=0.0004) at 4h and 16h since initiation of prone session and also after return of supine position. Hence, in this preliminary analysis of an observational study, physiological effect of prone position in SARS-CoV-2 infected severe ARDS patients have been reported. . https://doi.org/10.1101/2020.09.16.20195958 doi: medRxiv preprint As per ICU protocol, in the absence of contraindication, all mechanically ventilated ARDS patients with PaO 2 / FiO 2 < 150 were placed in at least 16h/day prone position for consecutive days till the criteria is met. . https://doi.org/10.1101/2020.09.16.20195958 doi: medRxiv preprint respiratory system compliance in prone position in ARDS patients [6], whereas we have found a significant decrease in driving pressure and static compliance. doi = 10.1101/2020.09.16.20195958 id = cord-325461-q8igdvq4 author = Ryan, Donal title = Pulmonary vascular dysfunction in ARDS date = 2014-08-22 keywords = ARDS; PVR; pulmonary; vascular summary = We consider the factors that influence pulmonary arterial pressure, both in normal lungs and in the presence of ARDS, including the important effects of mechanical ventilation. (Am J Respir Crit Care Med 182:1123–1128, 2010) have recently reported that elevated pulmonary vascular resistance (PVR) and TPG were independently associated with increased mortality in ARDS, in a large trial with protocol-defined management strategies and using lung-protective ventilation. Studies were identified after a literature search using key terms (ARDS or acute respiratory distress or ALI or acute lung injury) together with any of the following: pulmonary haemodynamics, pulmonary artery pressure, pulmonary vascular resistance, pulmonary vascular dysfunction, right ventricle, right ventricular failure, acute cor pulmonale, or pulmonary artery catheter. There are very few studies which have measured pulmonary vascular resistance in ARDS patients ventilated with lower tidal volumes, perhaps due to the reduction in the use of the pulmonary artery catheter just as lung-protective ventilation was gaining widespread acceptance [60] . doi = 10.1186/s13613-014-0028-6 id = cord-306153-aurm848i author = Schenck, Edward J. title = Respiratory Mechanics and Gas Exchange in COVID-19–associated Respiratory Failure date = 2020-09-17 keywords = ARDS summary = The coronavirus disease (COVID-19) pandemic has dramatically increased the number of patients requiring mechanical ventilation for respiratory failure. This single center cohort study of patients with COVID-19, with a positive RT-PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), treated with mechanical ventilation was performed at New York Presbyterian Hospital-Weill Cornell Medicine from March 1st, 2020 through April 20th, 2020. This study of 267 patients demonstrates that respiratory failure related to COVID-19 meets the criteria for moderate to severe ARDS, given the initial median P:F ratio of 103. In this cohort, the baseline extrinsic PEEP, driving pressure, and static compliance were similar to ARDS Network trials, and the recent worldwide observational study, LUNGSAFE (Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE) (10) (11) (12) . Ventilatory ratio in hypercapnic mechanically ventilated patients with COVID-19-associated acute respiratory distress syndrome Respiratory pathophysiology of mechanically ventilated patients with COVID-19: a cohort study doi = 10.1513/annalsats.202005-427rl id = cord-321149-hffj7s4o author = Schmidt, Matthieu title = Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: a retrospective cohort study date = 2020-08-13 keywords = ARDS; COVID-19; ECMO; ICU; patient summary = Methods This retrospective cohort study was done in the Paris–Sorbonne University Hospital Network, comprising five intensive care units (ICUs) and included patients who received ECMO for COVID-19 associated ARDS. This retrospective study, with 83 patients included and a complete follow-up until day 60 post-ECMO initiation is, to our knowledge, the largest to date reporting the outcomes after rescue ECMO for the most severe forms of COVID-19 ARDS, in the Paris-Sorbonne University Hospital Network (Paris, France), the principal hospital referral network for ICU care in Greater Paris, including one of the largest European ECMO centres (Pitié-Salpêtrière Hospital). Following early reports of severe COVID-19 associated coagulopathy [16] [17] [18] and frequent thromboembolic events on ECMO, inclu ding massive pulmonary embolism, 19, 20 we decided to increase the targeted activated partial thromboplastin time for anticoagulation of venovenous ECMO with unfractionated heparin to 60-75 s or anti-Xa activity 0·3-0·5 IU/mL (respective values were 40-55 s or 0·2-0·3 IU/mL in the EOLIA trial 3 ) before we treated our first patients with COVID-19 ARDS. doi = 10.1016/s2213-2600(20)30328-3 id = cord-005985-csc3lfbm author = Seeger, W. title = Alveolar surfactant and adult respiratory distress syndrome: Pathogenetic role and therapeutic prospects date = 1993 keywords = ARDS; alveolar; surfactant summary = Mechanisms of surfactant alterations in ARDS include: (a) lack of surface-active compounds (phospholipids, apoproteins) due to reduced generation/release by diseased pneumocytes or to increased loss of material (this feature includes changes in the relative composition of the surfactant phospholipid and/or apoprotein profiles); (b) inhibition of surfactant function by plasma protein leakage (inhibitory potencies of different plasma proteins have been defined); (c) "incorporation" of surfactant phospholipids and apoproteins into polymerizing fibrin upon hyaline membrane formation; and (d) damage/inhibition of surfactant compounds by inflammatory mediators (proteases, oxidants, nonsurfactant lipids). Mechanisms of surfactant alterations in ARDS include: (a) lack of surface-active compounds (phospholipids, apoproteins) due to reduced generation/ release by diseased pneumocytes or to increased loss of material (this feature includes changes in the relative composition of the surfactant phospholipid and/or apoprotein profiles); (b) inhibition of surfactant function by plasma protein leakage (inhibitory potencies of different plasma proteins have been defined); (c) °'' incorporation" of surfacrant phospholipids and apoproteins into polymerizing fibrin upon hyaline membrane formation; and (d) damage/inhibition of surfactant compounds by inflammatory mediators (proteases, oxidants, nonsurfactant lipids). doi = 10.1007/bf00180100 id = cord-257613-o0q7hvn3 author = Shafiee, Abbas title = Coronavirus disease 2019: A tissue engineering and regenerative medicine perspective date = 2020-08-21 keywords = ARDS; COVID-19; SARS; cell summary = To date, numerous studies have been conducted to evaluate the safety and efficacy of tissue engineering and regenerative medicine (TERM) products, including mesenchymal stem cells (MSCs), and their derivatives (eg, exosomes) for coronavirus infections, which could be applied for the COVID‐19. Over the COVID-19 outbreak, the funding for many TERM projects is being cut, which has a significant impact on the present and future of Current clinical trials highlight the potential benefits of stem cell therapies for COVID-19 patients. Effective multi-institutional collaboration and adequate funding from government and nongovernment sources are also needed to collect and analyze the data from ongoing and new human trials, to better understand the potential benefits of stem cell therapies for COVID-19 patients. Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic Influenza A (H7N9) infection, a hint for COVID-19 treatment. Treatment with allogeneic mesenchymal stromal cells for moderate to severe acute respiratory distress syndrome (START study): a randomised phase 2a safety trial doi = 10.1002/sctm.20-0197 id = cord-316647-jj8anf5g author = Shang, You title = Management of critically ill patients with COVID-19 in ICU: statement from front-line intensive care experts in Wuhan, China date = 2020-06-06 keywords = AKI; ARDS; China; ICU; SARS; clinical; covid-19; patient summary = RESULTS: A comprehensive document with 46 statements are presented, including protection of medical personnel, etiological treatment, diagnosis and treatment of tissue and organ functional impairment, psychological interventions, immunity therapy, nutritional support, and transportation of critically ill COVID-19 patients. Statement 8 Convalescent plasma therapy should probably be used for severe and critically ill patients with COVID-19 (Grade 2+, weak recommendation). However, critically ill patients with COVID-19 have a longer mechanical ventilation time, and daily sedatives interruption is not suggested for patients receiving deep sedation in order to reduce lung damage during early stage of severe ARDS. Light sedation is suggested for severe COVID-19 patients receiving HFNC oxygen therapy and non-invasive mechanical ventilation, and also for critically ill patients in the recovering stage (expert opinion). Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial doi = 10.1186/s13613-020-00689-1 id = cord-285202-aiap6z9u author = Short, Briana title = Rapid implementation of a mobile prone team during the COVID-19 pandemic date = 2020-08-25 keywords = ARDS; COVID-19 summary = CONCLUSION: The rapid development of a mobile prone team safely provided prone positioning to a large number of COVID-19 patients with moderate-to-severe ARDS. The rapid implementation of the mobile COVID-19 Prone Team that travelled to multiple ICUs at our institution during the height of the COVID-19 pandemic, increased the ability to prone patients with moderate-to-severe ARDS. By utilizing OTs and PTs who were familiar with critical illness and positioning patients, and by developing a careful but efficient training program, the COVID-19 Prone Team was able to safely provide an evidence-based intervention to critically ill patients with ARDS in a variety of ICU settings. During the COVID-19 pandemic, the rapid development and implementation of a mobile prone team allowed for increased capacity to prone patients with moderate-to-severe ARDS in ICUs beyond the MICUs to meet the surge of critically ill patients during the height of the pandemic. doi = 10.1016/j.jcrc.2020.08.020 id = cord-293259-o51fnvuw author = Sinaei, Reza title = Why COVID-19 is less frequent and severe in children: a narrative review date = 2020-09-25 keywords = ARDS; COVID-19; MIS; SARS; child summary = Thus far, only a small number of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection have involved children, so that they have accounted for only 1-5% of total patients [2, [6] [7] [8] [9] [10] . Severe SARS-CoV-2 infection is characterized by a hyperproinflammatory response or cytokine storm state that results to acute respiratory distress syndrome (ARDS) and multisystem inflammatory syndrome (MIS). The search strategy was constructed based on searching terms 2019 novel coronavirus, COVID-19, SARS-CoV-2 with using and/or, also the terms of child, pediatric, newborn, infant, adolescence, adult, age, age groups, severity, epidemiology, prevalence, difference, immune system, etiology, reasons in title, abstract, and key words. The first results stem from some considerations that children have a less vigorous immune response to the virus than adults because the cytokine storm is thought to be important in the pathogenesis of severe SARS-CoV-2 infections [28] . doi = 10.1007/s12519-020-00392-y id = cord-325408-uy5ew3ki author = Singer, Benjamin D. title = A Call for Rational Intensive Care in the Era of COVID-19 date = 2020-07-17 keywords = ARDS; RSV summary = As intensive care physicians, we have been trained to treat viral pneumonia and its attendant complications of acute respiratory distress syndrome (ARDS) and multiorgan failure. In fact, the patients enrolled in the ARMA (Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress) trial of low-tidal-volume ventilation and the PROSEVA (Proning Severe ARDS Patients) trial of prone positioning exhibited myriad etiologies, compliances, and shunt fractions but nevertheless benefited from the targeted interventions (4, 5) . Currently, numerous agents are being administered to patients with COVID-19 outside of controlled trials, including hydroxychloroquine, azithromycin, doxycycline, remdesivir, lopinavir-ritonavir, heparin, low-molecular-weight heparin, tissue plasminogen activator, glucocorticoids, tocilizumab, eculizumab, IFN-b, IFN-g, IL-1 inhibitors, mesenchymal stem cells, convalescent plasma, nitric oxide, vitamin C, and others. We show in the present study that severe RSV infection in infants is associated with a marked upregulation of CD32 on T cells. doi = 10.1165/rcmb.2020-0151le id = cord-330257-fliudtls author = Singh, Gurmeet title = Commentary: Protecting the Right Ventricle in COVID-19 ARDS - More Data Required date = 2020-07-16 keywords = ARDS summary = title: Commentary: Protecting the Right Ventricle in COVID-19 ARDS More Data Required Oxy-RVAD has been proposed for COVID-19-associated ARDS as superior to mechanical 2 ventilation and, by implication, ECMO, because it provides RV support. Clearly, any future study of an oxy-RVAD in this setting, as with ECMO, should 34 be accompanied by detailed cost-benefit analyses. Notwithstanding the 48 separate issue of extubating patients during ECMO (or oxy-RVAD) support, the broader 49 hypothesis may be applicable to any severe ARDS patient with concomitant severe RV 50 4 dysfunction. Clearly, more data are needed, and we look forward to Dr. Joyce''s planned 51 multicenter randomized clinical trial. Experts'' opinion on management of 54 hemodynamics in ARDS patients: focus on the effects of mechanical ventilation Severe Acute Respiratory Distress Syndrome and Posterior Probability of Mortality Benefit 61 in a Post Hoc Bayesian Analysis of a Randomized Clinical Trial Injury in Acute Respiratory Failure doi = 10.1016/j.jtcvs.2020.07.043 id = cord-014464-m5n250r2 author = Sole-Violan, J title = Lethal influenza virus A H1N1 infection in two relatives with autosomal dominant GATA-2 deficiency date = 2013-03-19 keywords = AKI; APACHE; ARDS; Care; ICU; IL-6; Introduction; RBC; TBI; day; figure; group; hour; method; mortality; outcome; patient; peep; result; signifi; sofa; study summary = Results In preliminary analysis of categorical data, a signifi cantly (Fisher exact test) greater proportion of patients with compared with without the following fi ndings did not survive; history of alcohol use (P = 0.05); the presence of lethargy (P = 0.01), confusion (P = 0.03), nausea (P = 0.04), abdominal pain (P = 0.02), or the need for vasopressors (P = 0.002), oxygen, mechanical ventilation, or steroids (all P = 0.004) at presentation; and excessive bleeding at surgery (P = 0.01). Methods To prospectively re-evaluate the normal range and to analyze the potential impact of biometric data on ICG-PDR, we measured ICG-PDR (i.v. injection of 0.25 mg/kg ICG; LiMON, Pulsion, Munich, Introduction Mixed venous oxygen saturation (SVO 2 ) represents a well-recognized parameter of oxygen delivery (DO 2 )-consumption (VO 2 ) mismatch and its use has been advocated in critically ill patients in order to guide hemodynamic resuscitation [1] and oxygen delivery optimization. doi = 10.1186/cc11953 id = cord-035326-qjp37j7x author = Sryma, P.B. title = Reinventing the Wheel in ARDS: Awake Proning in COVID-19 date = 2020-11-11 keywords = ARDS summary = 7 Though this may be due to confounding by the severity of illness leading to a more complicated course in intubated patients, it is possible that ventilator-induced lung injury and hemodynamic effects of ventilation played a role and may argue for the judicious use of non-invasive respiratory support in COVID-19. In case of any respiratory distress ROX index of ≤2.85 at 2 h, and ≤3.47 at 6 h may suggest poor response and should prompt escalation of care In case of sustained improvement in saturation to more than 93% in room air after 2 h of stopping prone positioning pattern may suggest an added advantage of PP in COVID-19 ARDS patients. Most recently, awake proning in 50 patients of COVID-19 hypoxemic respiratory failure in the emergency department resulted in significant improvement in saturation from 84% to 94% at the same concentration of inspired oxygen, and 64% patients improved avoiding intubation. doi = 10.1016/j.arbr.2020.06.013 id = cord-102679-6dpo073b author = TRONCHE, P.-A. title = Assessment of a Novel Method for Non-invasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome Patients Receiving Inhaled Sedation with Sevoflurane: the ANAISS Study Protocol date = 2020-10-07 keywords = ARDS; October; fluid summary = title: Assessment of a Novel Method for Non-invasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome Patients Receiving Inhaled Sedation with Sevoflurane: the ANAISS Study Protocol Therefore, collection of this fluid represents a promising, non-invasive method for sampling the distal airspace in patients with acute respiratory distress syndrome (ARDS) and for facilitating a mechanistic understanding of this devastating disease. Methods and analysis: A total of 30 adult patients within 24 hours of meeting the Berlin criteria for moderate-severe ARDS and receiving inhaled sevoflurane as standard sedation in participating centres will be eligible for inclusion into this investigator-initiated, exploratory, prospective, bicentre study. The primary hypothesis of the ANAISS study is that fluid collection from the AnaConDa-S device could be a novel method for assessing the distal airspace in mechanically ventilated patients with ARDS who are receiving inhaled sedation with sevoflurane. doi = 10.1101/2020.10.05.20207217 id = cord-013306-35jiycem author = Tarazan, Nehal title = Neuromuscular blocking agents in acute respiratory distress syndrome: updated systematic review and meta-analysis of randomized trials date = 2020-10-23 keywords = ARDS; NMBA summary = Eligible studies met all of the following criteria: (1) the design was a parallel-group RCT; (2) the population was adults with ARDS of any severity; (3) the intervention included any continuous NMBA infusion, at any dose or duration, compared to placebo or no continuous NMBA infusion but allowing the use of as needed NMBA boluses; (4) outcomes included any of: mortality at 28 days, ICU discharge, or hospital discharge (truncated at 90 days); long-term outcomes (physical function at 3 months; quality of life at 3 months; cognitive function at 3 months); ICU-acquired weakness; duration of mechanical ventilation; ventilator-free days (VFDs); ICU or hospital length of stay; barotrauma (including pneumothorax, pneumomediastinum, pneumatocele, or subcutaneous emphysema); or changes in oxygenation measured by using the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PO 2 /FiO 2 ratio). doi = 10.1186/s40635-020-00348-6 id = cord-002016-vzn338ub author = Thompson, B. Taylor title = Steroids are part of rescue therapy in ARDS patients with refractory hypoxemia: no date = 2016-02-16 keywords = ARDS; acute summary = Rescue therapies for acute respiratory distress syndrome (ARDS) usually target patients with severe hypoxia and/ or hypercarbia refractory to conventional therapies and are considered when rapid deterioration in the patient''s condition over a period of hours suggests an increased risk of death. These encouraging data suggest corticosteroids at lower doses early in the course of pneumonia or ARDS improve lung function but that the onset of action is too slow and inconsistent and the magnitude of the effect too small to be recommended as a reliable life-saving rescue therapy. Table 1 Steroid-responsive conditions which may present with severe acute respiratory distress syndrome Some diseases, such as granulomatosis with polyangiitis leading to diffuse alveolar hemorrhage, require additional immunosupressive treatment with cyclophosphamide or rituximab [7] . Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis doi = 10.1007/s00134-016-4255-1 id = cord-003615-vpzzsdld author = Thompson, Kelly B. title = Late immune consequences of combat trauma: a review of trauma-related immune dysfunction and potential therapies date = 2019-04-24 keywords = ARDS; IL-10; immune; injury; patient; trauma summary = Trauma leads to the dysregulation of both the innate and adaptive immune responses, which places the injured at risk for several late consequences, including delayed wound healing, late onset sepsis and infection, multi-organ dysfunction syndrome, and acute respiratory distress syndrome, which are significant for their association with the increased morbidity and mortality of wounded personnel. Patients with less severe trauma may develop late MODS due to new surgical stress, general anesthesia, transfusion of blood products, infection, or ischemia/reperfusion injury triggering the reactivation of the inflammatory response in a "two-hit" model of MODS [19, 58] . Among these consequences, delayed wound healing, late onset sepsis and infection, multi-organ dysfunction syndrome, acute respiratory distress syndrome, and persistent inflammation-immunosuppression and catabolic syndrome are significant in their association with the increased morbidity and mortality of wounded personnel. doi = 10.1186/s40779-019-0202-0 id = cord-310069-ay4af6xr author = Tobin, Martin J. title = Does making a diagnosis of ARDS in COVID-19 patients matter? date = 2020-07-21 keywords = ARDS; patient summary = The question "Do patients with COVID-19 develop typical ARDS?" is arousing fevered debate. Observing that respiratory failure occurred 8-12 days after first symptoms of 3 COVID-19 in Chinese series, Li and Ma 3 concluded that these patients should not be diagnosed as ARDS. 8 This criticism does not apply to respiratory failure in COVID-19 patients: we know it is caused by SARS-CoV-2 and no therapy is effective against the virus. Given that tidal volume 12 ml/kg is not employed in any patient, making a diagnosis of ARDS does not impact selection of any ventilator setting. For the doctor at the bedside of a COVID-19 patient, making a diagnosis of ARDS is completely irrelevant. Screening of ARDS patients using standardized ventilator settings: influence on enrollment in a clinical trial Abbreviations List: AECC: American-European Consensus Committee ARDS: Acute respiratory distress syndrome COVID-19: Coronavirus disease doi = 10.1016/j.chest.2020.07.028 id = cord-337010-dgy7qbl5 author = Tomazini, B. M. title = COVID-19-associated ARDS treated with DEXamethasone (CoDEX): Study design and rationale for a randomized trial. date = 2020-06-26 keywords = ARDS; international; patient summary = We designed a trial to evaluate the effectiveness of early intravenous dexamethasone administration on the number of days alive and free of mechanical ventilation within 28 days after randomization in adult patients with moderate or severe ARDS due to confirmed or probable COVID-19. METHODS: This is a pragmatic, prospective, randomized, stratified, multicenter, open-label, controlled trial including 350 patients with early-onset (less than 48h before randomization) moderate or severe ARDS, defined by the Berlin criteria, due to COVID-19. Therefore, we propose a pragmatic, randomized, open-label, controlled clinical trial, comparing standard treatment versus standard treatment added to early administration of dexamethasone for 10 days in patients with moderate and severe ARDS due to COVID-19. Our primary objective is to evaluate the effectiveness of early intravenous (IV) dexamethasone administration on the number of days alive and free of mechanical ventilation within 28 days after randomization in adult patients with moderate or severe ARDS due to confirmed or probable COVID-19. doi = 10.1101/2020.06.24.20139303 id = cord-318067-4hdeuweo author = Torrego, Alfons title = Bronchoscopy in Patients with COVID-19 with Invasive Mechanical Ventilation: A Single-Center Experience date = 2020-07-15 keywords = ARDS; COVID-19 summary = Bronchoscopy in critically ill patients with COVID-19 has been required to manage complications (atelectasis, hemoptysis, etc.) as well as to obtain samples for microbiological cultures and to assist in the management of artificial airways (guide intubation and percutaneous tracheostomy) (3) . Because no series of intubated patients with COVID-19 submitted to bronchoscopy has been published so far, we describe our experience in performing flexible bronchoscopies in patients with COVID-19 with severe acute hypoxemic respiratory failure requiring invasive mechanical ventilation during the first 3 weeks of the epidemic outbreak. Bronchoscopic examination included orotracheal tube positioning check, direct inspection of tracheal and bronchial mucosa, suctioning of secretions, and mucoactive agent instillation if necessary (hypertonic saline combined with hyaluronic acid), and in 63 cases, a mini-BAL with 60-ml saline aliquots at room temperature was performed just before the end of procedure for microbiological sampling. Most patients admitted to the ICU with a severe presentation of coronavirus disease (COVID-19) fulfill the acute respiratory distress syndrome (ARDS) criteria (1) and require invasive mechanical ventilation (2) . doi = 10.1164/rccm.202004-0945le id = cord-338319-9v8yw2pl author = Trahtemberg, Uriel title = What have we learned ventilating COVID-19 patients? date = 2020-10-12 keywords = ARDS summary = A number of editorials, opinion pieces, and small reports have suggested that COVID-19 ARDS is atypical, since some patients with severe hypoxemia had relatively normal respiratory compliance, with implications for ventilatory management [4, 5] . Although some patients with COVID-19 can be managed with supplemental oxygen and non-invasive ventilation, patients with severe respiratory failure require endotracheal intubation and invasive mechanical ventilation. It has been suggested that prone positioning should be minimized in COVID-19 ARDS patients with higher compliances, based on the argument that the putative different respiratory physiology makes prone ventilation unlikely to be beneficial [5] . Pathophysiology of COVID-19-associated acute respiratory distress syndrome: a multicentre prospective observational study COVID-19-associated acute respiratory distress syndrome: is a different approach to management warranted? Respiratory pathophysiology of mechanically ventilated patients with COVID-19: a cohort study Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome associated with COVID-19: a retrospective cohort study doi = 10.1007/s00134-020-06275-0 id = cord-011875-ga0dzj3v author = Tsolaki, Vasiliki title = Are Patients with COVID-19 Dying of or with Cardiac Injury? date = 2020-07-15 keywords = ARDS; patient summary = Indeed, they quote a sentence in which Dr. Laghi and I say that physicians do not initiate mechanical ventilation consequent to "slotting a patient into a particular diagnostic pigeonhole." (2) Dr. Modesto-Alapont and colleagues claim that the Berlin definition enhances the ability to make a precise diagnosis of acute respiratory distress syndrome (ARDS) in patients with coronavirus disease (COVID-19). Cardiac involvement probably complicates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients, but the true incidence (considering specific echocardiographic findings) and the attributable mortality are aspects not yet well clarified. Very few reports have used echocardiographic criteria beyond biomarkers to diagnose cardiac injury, but none have differentiated between myocarditis, cardiomyopathy (stress or septic), ACS, and acute heart failure in the era of COVID-19. In a recent report involving 416 hospitalized patients from Wuhan, 19.7% presented with "acute myocardial injury." The diagnosis relied on increased cardiac biomarker (hypersensitive troponin I) levels, regardless of the electrocardiographic and echocardiographic findings (3). doi = 10.1164/rccm.202004-1083le id = cord-343940-fdnmeuh8 author = Tzotzos, Susan J. title = Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey date = 2020-08-21 keywords = ARDS summary = title: Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey Seventeen studies reporting results from 2486 hospitalized COVID-19 patients in five countries fitted the inclusion criteria (Tables 1 and 2 ). Calculation of weighted averages for these parameters incorporating data from individual studies for which data is available indicate that among hospitalized COVID-19 patients, approximately 1/3 (33%) develop ARDS, 1/4 (26%) require transfer to Patient numbers for Chen T study not included an ICU, 1/6 (16%) receive IMV, and 1/6 (16%) die (Table 1 ). For COVID-19 patients transferred to an ICU, nearly 2/3 (63%) receive IMV and 3/4 (75%) have ARDS ( Table 2 ). Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China Treatment for severe acute respiratory distress syndrome from COVID-19 Authors'' contributions SJT conducted the literature search and survey. The authors read and approved the final manuscript. doi = 10.1186/s13054-020-03240-7 id = cord-006565-5c14oqn4 author = Umans, U. title = Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern date = 2001-02-24 keywords = ARDS; HSVP summary = The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). Abstract The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). The radiologist may suggest the diagnosis of HSVP when bilateral airspace consolidation or mixed opacities appear in a susceptible group of patients who are not thought to have ARDS or pulmonary edema. Each chest radiograph was evaluated for the following findings: pattern of lung opacities (airspace consolidation, interstitial opacities, or mixed); location (unilateral, bilateral, focal, diffuse) and extent (segmental, lobar, whole lung) of the abnormalities; atelectasis (not-present, lobar, segmental, subsegmental); pleural effusion (not present, moderate, i.e., less than one-third of the hemithorax, large, i.e., more than one-third of the hemithorax). doi = 10.1007/s003300000696 id = cord-006505-u3znxf2b author = Van Bever, H. P. title = Adult respiratory distress syndrome associated withMycoplasma pneumoniae infection date = 1992 keywords = ARDS summary = title: Adult respiratory distress syndrome associated withMycoplasma pneumoniae infection A 13-year-old boy is described who developed severe adult respiratory distress syndrome (ARDS), biochemical pancreatitis and skin vasculitis after an acute respiratory infection due toMycoplasma pneumoniae. Four days before admis-Offprint requests to: H.P. Van Bever Abbreviation." ARDS = adult respiratory distress syndrome Fig. 1 . Chest X-ray film at day 4 after admission, showing diffuse bilateral infiltrates tropics, including dopamine (25 gg/kg per minute), dobutamine (15 ~tg/kg per minute) and noradrenaline (16 gg/min). Our patient was discharged without clinical symptoms, but with major disturbances of the lung function tests, suggesting that there might be some degree of interstitial fibrosis. M. pneumoniae infections have been associated with the development of ARDS in adults [3, 4, 6] . Adult respiratory distress syndrome caused by Mycoplasma pneurnoniae Adult respiratory distress syndrome in pediatric patients. doi = 10.1007/bf01954392 id = cord-014533-6qfecv5h author = Velasquez, T. title = ESICM LIVES 2016: part three: Milan, Italy. 1–5 October 2016 date = 2016-09-29 keywords = AKI; ARDS; CPR; Care; Hospital; ICU; Intensive; group; introduction; method; objective; patient; peep; result; study summary = P. Tirapu; Navarro-Guillamón, L.; Cordovilla-Guardia, S.; Iglesias-Santiago, A.; Guerrero-López, F.; Fernández-Mondéjar, E.; Vidal, A.; Perez, M.; Juez, A.; Arias, N.; Colino, L.; Perez, J. Methods: This descriptive observational study was conducted on consecutive 100 pediatric surgical patients who admitted to PSICUs at Cairo University Hospitals starting from 1/6-1/12/2015.After approval by research ethics committee,informed consents were obtained from parents and pediatric cases aged from 1 month-18 years and stayed for > 48 h were enrolled.MPV and PLC were obtained and recorded at baseline(preoperative values),on the day of ICU admission(day 0),1 st ,2 nd ,3 rd ,5 th and 7 th days.To measure daily MPV changes; (ΔMPV) was constructed and computed where ΔMPV = ([MPVday(X) − MPVday (0)]/MPVday(0) × 100 %. Results: The results obtained after analyzing the two homogeneous groups according to age, gender, type of admission and severity influencing the physiotherapy care in ICU quality indicators, in the Sagrada Esperança clinic, highlights the decrease of the average number of days with mechanical ventilation but it is not observed a significant relation between physical therapy and this indicator (p = 0:06). doi = 10.1186/s40635-016-0100-7 id = cord-349197-3trr8d0u author = Ventura, Francesco title = Two Fatal Cases of Hidden Pneumonia in Young People date = 2010-04-28 keywords = ARDS; acute; case summary = In both cases the cause of death was cardio‐respiratory failure following an acute bilateral pneumonia with diffuse alveolar damage and ARDS associated with sepsis and disseminated intravascular coagulation. Our cases suggest on one side the importance of an early diagnosis to avoid unexpected death while on the other that the diagnosis of ARDS has to be confirmed on the basis of a careful postmortem examination and a complete microscopy and microbiological study. Acute respiratory distress syndrome (ARDS) is a severe lung disease characterized by inflammation of the lung parenchyma leading to impaired gas exchange with concomitant systemic release of inflammatory mediators by local epithelial and endothelial cells, causing inflammation, hypoxemia resulting often in multiple organ failure (MOF), and disseminate intravascular coagulation (DIC) (1) . The clinical presentation, the radiological and laboratory findings in one case, and the postmortem examination with histological, immunohistochemical, and microbiological exams in both cases, led us to conclude for an acute cardio-respiratory failure secondary to bilateral pneumonia with DAD and consequently ARDS associated with sepsis and DIC. doi = 10.1111/j.1556-4029.2010.01413.x id = cord-305703-ypeibwje author = Veronese, Nicola title = Use of Corticosteroids in Coronavirus Disease 2019 Pneumonia: A Systematic Review of the Literature date = 2020-04-24 keywords = ARDS; COVID-19; SARS summary = For each article, we extracted data regarding authors, year of publication, country, city or region in which the study was conducted, the period of observation, how the diagnosis of COVID-19 was obtained, the stage of COVID-19 infection (asymptomatic forms, pneumonia, acute respiratory distress syndrome (ARDS), requiring intensive care unit, ICU; convalescent), sample size included, number of males and females, mean age and its standard deviation (or similar information such as median and range), the percentage of people treated with corticosteroids in the sample as a whole, and, if possible, the route of administration and type of corticosteroid considered. Overall, two studies reported negative findings regarding these medications, one reported no significant association between corticosteroids and clinical outcomes, and one concluded that methylprednisolone was associated with a significant reduction of mortality in patients with COVID-19 pneumonia developing ARDS. doi = 10.3389/fmed.2020.00170 id = cord-286901-whvq8y1p author = Vidali, Sofia title = D-dimer as an indicator of prognosis in SARS-CoV-2 infection: a systematic review date = 2020-07-13 keywords = ARDS; COVID-19; SARS summary = This study aims to highlight the correlation between elevated D-dimer (an indirect thrombosis marker) and the increased rate of poor prognosis-associated conditions, and to introduce D-dimer-labelled anticoagulant administration as a potentially useful tool to prevent complications and positively influence coronavirus disease 2019 (COVID-19) course. The keywords and their variants (differently combined) used for the search were "COVID-19", "2019-nCoV", "2019 novel coronavirus", "SARS-CoV-2", "D-dimer", "coagulation", "hypercoagulative state", "laboratory analysis", "ARDS", "haemostasis", "thrombosis", "pulmonary embolism", "disseminated intravascular coagulation (DIC)", "heparin" and "anti-coagulation". The alterations of coagulation factors during SARS-CoV-2 infection and specifically that of D-dimer are, as documented in the clinical experiences described here, severe, constant and correlated with prognosis, complications and CEP rates. Among the factors that were demonstrated to be connected to the clinical outcome of COVID-19 patients, the presence of comorbidities may represent a confounding factor for the interpretation of D-dimer and other coagulation parameter alterations, especially considering the heterogeneous aetiology of thrombotic and thrombophilic states. doi = 10.1183/23120541.00260-2020 id = cord-324232-nupi7f72 author = Villar, Jesús title = Rationale for Prolonged Corticosteroid Treatment in the Acute Respiratory Distress Syndrome Caused by Coronavirus Disease 2019 date = 2020-04-29 keywords = ARDS; CST; patient summary = The analysis to support the Task Force''s recommendations was limited to nine randomized controlled trials (RCTs) that investigated methylprednisolone (n = 322) (7) and hydrocortisone (n = 494) treatment in ARDS for a duration of at least 7 days. Clinical investigators in Spain recently completed a large confirmatory RCT (Efficacy Study of Dexamethasone to Treat the Acute Respiratory Distress Syndrome [DEXA-ARDS]) enrolling 277 patients with moderate-to-severe ARDS and receiving LTV ventilation (6) . Second, they ignored the positive findings of two large studies (5,327 patients with severe acute respiratory syndrome [SARS] [24] and 2,141 patients with influenza H1N1 pneumonia [25] ) that evaluated the impact of time, dose, and duration of CST and reported a significant reduction in mortality with dosage and duration similar to the one recommended by SCCM and ESICM Task Force (5) . doi = 10.1097/cce.0000000000000111 id = cord-003198-1kw5v6rm author = Vuillard, Constance title = Clinical features and outcome of patients with acute respiratory failure revealing anti-synthetase or anti-MDA-5 dermato-pulmonary syndrome: a French multicenter retrospective study date = 2018-09-11 keywords = ARDS; ICU; patient; syndrome summary = The following data were collected on a standardized anonymized case record form: demographic characteristics (age, gender), severity scores upon ICU admission (Sequential Organ Failure Assessment [23] and Simplified Acute Physiology Score II [24] ), main comorbidities, delay between first respiratory sign and ICU admission, clinical examination (respiratory and extra-respiratory manifestations) and laboratory findings at the time of ICU admission (blood leukocytes and platelets counts, serum procalcitonine, C-reactive protein, creatine kinase and creatinine levels, PaO 2 /FiO 2 with FiO 2 calculated according to the following formula [25, 26] : FiO 2 = oxygen flow in liter per minute × 0.04 + 0.21 when standard oxygen was used), radiological findings on chest X-ray and CT scan, cytological and bacteriological analyses of broncho-alveolar lavage (BAL) fluid, type of positive autoantibodies (Jo-1, PL7, PL12, OJ, EJ, KS, Zo, YRS/Tyr/ Ha or aMDA-5), immunosuppressive treatments received (corticosteroids, cyclophosphamide, rituximab, basiliximab, tacrolimus, cyclosporine, methotrexate, intravenous immunoglobulins or plasma exchange), organ supports in the ICU (invasive mechanical ventilation, extra-corporeal membrane oxygenation (ECMO), renal replacement therapy, vasopressors), ICU and hospital length of stay, ICU and hospital mortality. doi = 10.1186/s13613-018-0433-3 id = cord-001215-aj8nxi3x author = Wang, Chen Yu title = One-year mortality and predictors of death among hospital survivors of acute respiratory distress syndrome date = 2014-01-17 keywords = ARDS; hospital summary = PURPOSE: Advances in supportive care and ventilator management for acute respiratory distress syndrome (ARDS) have resulted in declines in short-term mortality, but risks of death after survival to hospital discharge have not been well described. Our objective was to quantify the difference between short-term and long-term mortality in ARDS and to identify risk factors for death and causes of death at 1 year among hospital survivors. Abstract Purpose: Advances in supportive care and ventilator management for acute respiratory distress syndrome (ARDS) have resulted in declines in short-term mortality, but risks of death after survival to hospital discharge have not been well described. Our objective was to quantify the difference between shortterm and long-term mortality in ARDS and to identify risk factors for death and causes of death at 1 year among hospital survivors. We sought to quantify the survival gap between short-and long-term ARDS mortality and identify risk factors for death and causes of death at 1 year for hospital survivors. doi = 10.1007/s00134-013-3186-3 id = cord-296435-6dergkha author = Wang, Tiehua title = Thrombocytopenia Is Associated with Acute Respiratory Distress Syndrome Mortality: An International Study date = 2014-04-14 keywords = ARDS; Beijing; Boston; ICU summary = BACKGROUND: Early detection of the Acute Respiratory Distress Syndrome (ARDS) has the potential to improvethe prognosis of critically ill patients admitted to the intensive care unit (ICU). CONCLUSIONS: This study of ICU patients in both China and US showed that thrombocytopenia is associated with an increased risk of ARDS and platelet count in combination with ARDS had a high predictive value for patient mortality. Although patient specific data was not available, protocolled low tidal volume ventilation was standardized in study ICUs. Among predisposing conditions for ARDS in all enrolled patients, sepsis and/or septic shock (n = 149, 83%) were the most [20] were associated with development of ARDS.Respiratory rate (.30 breaths/min), aspiration, and .1 risks for ARDS were also evaluated in model selection but were eliminated during model selection (not significant). In both Beijing and Boston cohorts, the combination of thrombocytopenia and ARDS further increased risk of 60-day mortality among critically ill patients. doi = 10.1371/journal.pone.0094124 id = cord-330919-dep3v1pt author = Whyte, Claire S title = Fibrinolytic abnormalities in acute respiratory distress syndrome (ARDS) and versatility of thrombolytic drugs to treat COVID‐19 date = 2020-04-23 keywords = ARDS; COVID-19; acute; respiratory summary = The global pandemic of coronavirus disease 2019 (COVID‐19) is associated with the development of acute respiratory distress syndrome (ARDS), which requires ventilation in critically ill patients. Tissue factor (TF) is exposed on damaged alveolar endothelial cells and on the surface of leukocytes promoting fibrin deposition, while significantly elevated levels of plasminogen activator inhibitor 1 (PAI‐1) from lung epithelium and endothelial cells create a hypofibrinolytic state. In severe cases, patients with COVID-19 develop a type of acute respiratory distress syndrome (ARDS), sepsis and multiorgan failure. However, the principal fibrinolytic inhibitor described in the pathogenesis of ARDS is plasminogen activator inhibitor 1 (PAI-1), which is known to be elevated in severe acute respiratory syndrome coronavirus (SARS-CoV) and ALI [11, 61] . Tissue Plasminogen Activator (tPA) as a Novel Treatment for Refractory COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS)? Activator (tPA) Treatment for COVID-19 Associated Acute Respiratory Distress Syndrome (ARDS): A Case Series doi = 10.1111/jth.14872 id = cord-303101-3s9mjcf7 author = Wrigge, H. title = Spezifische Therapie des akuten Lungenversagens date = 2020-09-23 keywords = ARDS; PEEP; Patienten; die summary = Dabei ist die Idee, dass abhängig von Körpergröße und Geschlecht über das ideale Körpergewicht ( Infobox 1) eine Abschätzung des endexspiratorischen Lungenvolumens (EELV) oder der funktionellen Residualkapazität ermöglicht wird. Das heißt konkret, wenn nur wenige Alveolen belüftet sind und an der Ventilation teilnehmen können, ist bei gleichem VT die Abstract Specific treatment of acute lung failure Due to a high heterogeneity and dynamic changes in the course of acute respiratory distress syndrome (ARDS), intensive care physicians are faced with extraordinary challenges. Die Ergebnisse der weltweit durchgeführten LUNG-SAFE-Studie [5] zeigen allerdings, dass in der praktischen Anwendung selten ein PEEP höher als 10 cm H2O auch bei Patienten mit schwerem ARDS angewendet wird, was aus Sicht des Autors auf größere Defizite im Bereich der individualisierten Beatmungseinstellung hinweisen kann. Spezielle Aspekte der Beatmung und Therapie von COVID-19-bedingtem Acute respiratory distress syndrome Eine abschließende Bewertung der Therapieprinzipien für dieses Patientenkollektiv ist zum Zeitpunkt der Erstellung dieses Beitrags noch zu früh, auch weil die Evidenzlage noch gering ist. doi = 10.1007/s00101-020-00844-0 id = cord-326874-rdwvsm4s author = Wu, Chaomin title = Corticosteroid therapy for coronavirus disease 2019-related acute respiratory distress syndrome: a cohort study with propensity score analysis date = 2020-11-10 keywords = ARDS; COVID-19; corticosteroid summary = In Cox regression analysis using corticosteroid treatment as a time-varying variable, corticosteroid treatment was associated with a significant reduction in risk of in-hospital death within 60 days after adjusting for age, sex, SOFA score at hospital admission, propensity score of corticosteroid treatment, comorbidities, antiviral treatment, and respiratory supports (HR 0.42; 95% CI 0.21, 0.85; p = 0.0160). CONCLUSION: In this clinical practice setting, low-dose corticosteroid treatment was associated with reduced risk of in-hospital death within 60 days in COVID-19 patients who developed ARDS. However, there was comprehensive controversy on its efficacy [9, 10] , due to the results of observational studies that showed corticosteroid treatment was associated with increased mortality and nosocomial infections for influenza and delayed virus clearance for severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) [11] . In this observational study, prescription of low-to-moderate dose systemic corticosteroids was associated with lower risk of 60-day in-hospital death among COVID-19 patients who developed ARDS. doi = 10.1186/s13054-020-03340-4 id = cord-010509-gipjuhhc author = Xu, Jing title = Increased mortality of acute respiratory distress syndrome was associated with high levels of plasma phenylalanine date = 2020-04-30 keywords = ARDS; Fig; Phenylalanine; survivor summary = Univariate and multivariate statistical analysis were performed on metabolomic profiles from blood plasma of ARDS patients and healthy controls to screen for "functional metabolites", which were determined by variable importance in projection (VIP) scores and P value. Previous studies have performed metabolomic analysis of plasma, pulmonary edema fluid and bronchoalveolar lavage fluid (BALF) in ARDS patients, preliminarily results revealed a broad range of metabolites that could help in diagnosis and stratify ARDS [3] [4] [5] [6] . Blood plasma samples of patients with ARDS and healthy controls were collected, and metabolomics analysis was conducted to find differential metabolites and altered pathways that are associated with the ARDS mortality. Of note, we showed that the level of Phenylalanine increased in the non-survivors compared to the survivors and we confirmed using a mouse model that Phenylalanine administration increased the lung injury and mortality of mice with ARDS. doi = 10.1186/s12931-020-01364-6 id = cord-011197-bmigh2rs author = Yener, Nazik title = Airway Pressure Release Ventilation as a Rescue Therapy in Pediatric Acute Respiratory Distress Syndrome date = 2020-03-03 keywords = APRV; ARDS; CMV summary = OBJECTIVES: To describe experience with airway pressure release ventilation (APRV) in children with severe acute respiratory distress syndrome (ARDS) refractory to conventional low tidal volume ventilation. CONCLUSIONS: The results of this study support the hypothesis that APRV may offer potential clinical advantages for ventilatory management and may be considered as an alternative rescue mechanical ventilation mode in pediatric ARDS patients refractory to conventional ventilation. No consensus has been reached on the optimal mode of ventilation for pediatric ARDS patients refractory to conventional mechanical ventilation (CMV) using low tidal volume combined with sufficient positive end expiratory pressure (PEEP). In adult patients with ARDS, compared with other conventional ventilatory modes, APRV may improve oxygenation due to increased recruitment of lung volumes, length of stay in the intensive care unit and ventilator-free days [5, 6] . doi = 10.1007/s12098-020-03235-w id = cord-002801-6myqgme3 author = Yoon, Byung Woo title = Possible therapeutic effect of orally administered ribavirin for respiratory syncytial virus-induced acute respiratory distress syndrome in an immunocompetent patient: a case report date = 2017-12-20 keywords = ARDS; RSV; respiratory summary = title: Possible therapeutic effect of orally administered ribavirin for respiratory syncytial virus-induced acute respiratory distress syndrome in an immunocompetent patient: a case report Respiratory syncytial virus-induced severe pneumonia or acute respiratory distress syndrome in immunocompetent adults has been rarely described. We report a case of respiratory syncytial virus-induced acute respiratory distress syndrome occurring in a previously healthy man successfully treated with orally administered ribavirin. CONCLUSION: This case demonstrates the potential usefulness of orally administered ribavirin as a therapeutic option for severe respiratory syncytial virus infection, at least in an immunocompetent host. RSV-induced severe pneumonia or acute respiratory distress syndrome (ARDS) in immunocompromised patients is not uncommon. Here we report a case of ARDS due to RSV occurring in a previously healthy adult successfully treated with orally administered ribavirin. In addition, this case suggests that orally administered ribavirin could be a therapeutic option even for severe pneumonia or ARDS due to RSV, at least in immunocompetent hosts, especially if other antiviral agents are unavailable. doi = 10.1186/s13256-017-1514-x id = cord-011286-8wxih7v6 author = You, Qinghai title = MiR-802 alleviates lipopolysaccharide-induced acute lung injury by targeting Peli2 date = 2019-11-06 keywords = ARDS; Fig; LPS; peli2 summary = Acute respiratory distress syndrome (ARDS) is a severe lung inflammatory disorder commonly characterized by infection or injury inducing the development of diffuse alveolar damage that results in severe hypoxemia. Macrophages are a key cell type in lung in response to LPS challenge and proinflammatory cytokine production is a critical step that mediates LPSinduced tissue damage. To evaluate the effect of miR-802 on LPS-induced lung acute injury in vivo, the mice were administrated with miR-802 or scramble control intragastrically before being subjected to sepsis challenge. As shown (Fig. 5b) , co-transfection of Peli2 with miR-802 abolished the antagonizing effect of the miRNA on LPS-induced TNFα expression. In ARDS, modified expression of miRNAs has been studied to develop the diagnosis and treatment for a The protein expressions of Peli2 in lung tissues between LPS-induced ARDS model and sham group were compared by ELISA analysis (n = 15, for each group). doi = 10.1007/s00011-019-01295-z id = cord-349201-d88g5toc author = Yu, Feng title = Exploring the biomarkers associated with different host inflammation of acute respiratory distress syndrome (ARDS) from lung metabolomics in mice date = 2020-10-13 keywords = ALI; ARDS; CLP; LPS; Splen summary = title: Exploring the biomarkers associated with different host inflammation of acute respiratory distress syndrome (ARDS) from lung metabolomics in mice RATIONALE: The aim of this study was to analyze the metabolomics of lung with different host inflammation of acute respiratory distress syndrome (ARDS) for the identification of biomarkers for predicting severity under different inflammatory conditions. RF analysis of lung-targeted metabolomics data defined a set of 15 metabolites that constitute the best predictors of differences in host inflammation status: in particular, increased 4hydroxyphenylacetic acid, 1-aminocyclopentanecarboxylic acid (ACPC), and cis-aconitic acid, Tridecane and hydroxybenzoic acid were strong predictors of the hyper-inflammatory subgroup in CLP-induced ALI ( Figure 3B ). Interestingly, RF analysis of lung-targeted metabolomics data showed that the metabolic biomarker group with 5 products was a strong predictor of the hyper-inflammatory subgroup in CLP-induced ALI ( Figure 3B ). doi = 10.1002/rcm.8971 id = cord-005875-yp1ehpeg author = Zhang, Dong title = Crocin alleviates lipopolysaccharide-induced acute respiratory distress syndrome by protecting against glycocalyx damage and suppressing inflammatory signaling pathways date = 2020-01-10 keywords = ARDS; CTL; Fig; LPS summary = OBJECTIVE: To explore the mechanisms of crocin against glycocalyx damage and inflammatory injury in lipopolysaccharide (LPS)-induced acute respiratory distress syndrome (ARDS) mice and LPS-stimulated human umbilical vein endothelial cells (HUVECs). RESULTS: This study showed that crocin can improve the pulmonary vascular permeability in mice with LPS-induced ARDS and inhibit the inflammatory signaling pathways of high mobility group box, nuclear factor κB, and mitogen-activated protein kinase in vivo and in vitro. The preceding results indicated that crocin might inhibit the expression of HPA by inhibiting the upstream protein of CTL in LPS-induced ARDS mice and LPS-stimulated HUVECs. The results in vivo showed that the expression of MMP-9 by LPS stimulation was significantly increased compared with that of the control group (Fig. 4c, d) . These results suggested that crocin can inhibit the activation of MAPK pathway in LPS-induced ARDS mice and LPS-stimulated HUVECs. The HMGB1 and NF-κB signaling pathway also regulate lung injury of the inflammatory process. doi = 10.1007/s00011-019-01314-z id = cord-283780-h4lwzpl9 author = Zhang, John J Y title = Risk Factors of Severe Disease and Efficacy of Treatment in Patients Infected with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression Analysis date = 2020-05-14 keywords = ARDS; ICU summary = title: Risk Factors of Severe Disease and Efficacy of Treatment in Patients Infected with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression Analysis We conducted a systematic review and meta-analysis of all published studies up to March 15, 2020 which reported COVID-19 clinical features and/or treatment outcomes. To address this gap in the literature, we conducted a systematic review, meta-analysis and meta-regression to 1) investigate the predictive value of laboratory investigations for severe disease and adverse outcomes, and 2) evaluate the efficacy of antivirals and corticosteroids for COVID-19. Among the patients with antiviral use reported in our meta-analysis, overall rates of mortality, ICU admission and ARDS were 5.7%, 11.8% and 20.2%, respectively. Our meta-analysis suggested that the use of corticosteroids is associated with disease severity (ICU admission) and higher ARDS rates. To the best of our knowledge, this is the first systematic review and meta-analysis of COVID-19 to describe specific laboratory predictors of severe disease and adverse outcomes. doi = 10.1093/cid/ciaa576 id = cord-001910-6zfz2ns5 author = Zhang, Xianming title = Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome date = 2016-01-08 keywords = ARDS; BIPAP summary = title: Abdominal Muscle Activity during Mechanical Ventilation Increases Lung Injury in Severe Acute Respiratory Distress Syndrome The purpose of this study was to test the hypothesis that abdominal muscle activity during mechanically ventilation increases lung injury in severe ARDS. Therefore, we hypothesized that abdominal muscle activity during mechanically ventilation increases lung injury in severe acute respiratory distress syndrome. In an oleic acid-induced model of experimental ARDS in beagles, our findings suggested that abdominal muscle activity during mechanically ventilation increases lung injury in severe acute respiratory distress syndrome. In an oleic acid-induced ARDS model, our study showed that BIPAP AP had lower mRNA expression of IL-6 and IL-8 in lung tissues and less total cumulative histopathological lung injury scores compared with BIPAP SB group. doi = 10.1371/journal.pone.0145694 id = cord-000539-uh3q65we author = Zhang, Yi title = Acute Respiratory Distress Syndrome Induced by a Swine 2009 H1N1 Variant in Mice date = 2012-01-03 keywords = ARDS; H1N1; mouse; virus summary = BACKGROUND: Acute respiratory distress syndrome (ARDS) induced by pandemic 2009 H1N1 influenza virus has been widely reported and was considered the main cause of death in critically ill patients with 2009 H1N1 infection. Mice infected with SD/09 virus showed typical ARDS symptoms characterized by 60% lethality on days 8–10 post-inoculation, highly edematous lungs, inflammatory cellular infiltration, alveolar and interstitial edema, lung hemorrhage, progressive and severe hypoxemia, and elevated levels of proinflammatory cytokines and chemokines. In the present mouse model, the number of leukocytes observed in the BALF of virus-infected mice significantly increased compared with the control mice on day 8 p.i. Different counts in BALF showed that the proportion of neutrophils dramatically increased. doi = 10.1371/journal.pone.0029347 id = cord-272937-ala32ub5 author = Zhao, Xuan title = Mesenchymal stem cells represent a potential therapeutic option for coronavirus disease 2019-related acute respiratory distress syndrome date = 2020-06-10 keywords = ARDS; H7N9 summary = title: Mesenchymal stem cells represent a potential therapeutic option for coronavirus disease 2019-related acute respiratory distress syndrome [1] reported that the transplantation of allogeneic menstrual-blood-derived mesenchymal stem cells (MSCs) significantly reduced the mortality of influenza A (H7N9)-virus-induced acute respiratory distress syndrome (ARDS) without harmful side effects. Multiple studies have shown that fulminant pneumonia and ARDS can be induced by various viral infections, such as severe acute respiratory syndrome coronavirus (SARS-CoV) [4] , Middle East respiratory syndrome coronavirus (MERS-CoV) [5] , and H7N9 virus [6] . This is the first meaningful report demonstrating both the short-and long-term effectiveness of MSC transplantation to treat ARDS caused by virus infection. Clinical study of mesenchymal stem cell treating acute respiratory distress syndrome induced by epidemic influenza A (H7N9) infection: a hint for COVID-19 treatment. The effect of acute respiratory distress syndrome on bone marrow-derived mesenchymal stem cells doi = 10.1016/j.eng.2020.05.015 id = cord-001262-8s7g2wvd author = Zheng, Guoping title = Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study date = 2014-04-04 keywords = ARDS; acute; cell; day; msc summary = title: Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study The objectives of this study were first to examine the possible adverse events after systemic administration of allogeneic adipose-derived MSCs in ARDS patients and second to determine potential efficacy of MSCs on ARDS. METHODS: Twelve adult patients meeting the Berlin definition of acute respiratory distress syndrome with a PaO(2)/FiO(2) ratio of < 200 were randomized to receive allogeneic adipose-derived MSCs or placebo in a 1:1 fashion. Many studies, including publications from our group [11, 12] , have demonstrated compelling evidence of the benefits of MSCs from both bone marrow [13] [14] [15] and adipose tissues [16] [17] [18] in animal models for lung injury and ARDS. In this randomized, placebo-controlled phase I clinical trial, the primary goal was to evaluate the safety and feasibility of systemic administration of allogeneic adipose-derived MSCs in ARDS patients. doi = 10.1186/1465-9921-15-39 id = cord-004067-psjyjvbu author = Zhou, Yile title = The regulatory effect of microRNA-21a-3p on the promotion of telocyte angiogenesis mediated by PI3K (p110α)/AKT/mTOR in LPS induced mice ARDS date = 2019-12-26 keywords = ARDS; E2F8; LPS; cell summary = Bioinformatics analysis was used to screen significantly differentially expressed microRNAs (miRNAs) in cultured TCs stimulated with LPS, and the regulation of downstream angiogenesis genes by these miRNAs was analysed and verified. The PI3K p110α inhibitor decreased vascular endothelial growth factor levels in LPS-stimulated TCs and reversed the enhancing effect of TCs culture medium on EOMA cells proliferation. In the current study, the p110α isoform in PI3K/AKT/mTOR signalling pathway was demonstrated to be involved in miR-21a-3p-mediated angiogenic factor induction in TCs. However, the alteration of other protein levels and HIF-1α in TCs treated with LPS and the miR-21a-3p inhibitor indicated that more complex signalling pathways were involved in regulating the angiogenic function of TCs. Culture medium from LPS-induced TCs promoted EOMA cells proliferation in vitro, accompanied by elevated levels of VEGF mRNA and secretion, which further demonstrated that the functional miR-21a-3p was generated by TCs. These data support the hypothesis that miR-21a-3p plays a role in angiogenesis and profoundly demonstrate the mechanisms mediated by PI3K p110α. doi = 10.1186/s12967-019-02168-z id = cord-004385-xna32qve author = Zhou, Yuqing title = Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis date = 2020-02-20 keywords = ARDS; corticosteroid; study summary = title: Use of corticosteroids in influenza-associated acute respiratory distress syndrome and severe pneumonia: a systemic review and meta-analysis We obtained the following data: (a) characteristics of studies (design, setting, country, period, methodological details for quality assessment); (b) characteristics of participants (demographics, co-morbid illnesses, disease severity, numbers in each group, influenza virus type); (c) characteristics of interventions (type, dose, timing and duration of corticosteroid use); and (d) outcomes. Another study reporting the result of 62 patients with acute respiratory failure due to influenza showed no statistically significant difference between low dose and high dose corticosteroid therapy (8/19 versus 7/19, p > 0.05) 16 . The overall findings of this meta-analysis indicated that patients with pneumonia or acute respiratory distress syndrome who were administered corticosteroids had significantly higher mortality and incidence of nosocomial infection but the use of corticosteroids did not influence the length of hospital stay. doi = 10.1038/s41598-020-59732-7 id = cord-344829-adlp2rjy author = de Rivero Vaccari, Juan Carlos title = The Inflammasome in Times of COVID-19 date = 2020-10-08 keywords = ARDS; COVID-19; NLRP3; SARS; activation; inflammasome summary = Here we review the literature regarding the mechanism of inflammasome activation by CoV infection, the role of the inflammasome in ARDS, ventilator-induced lung injury (VILI), and Disseminated Intravascular Coagulation (DIC) as well as the potential mechanism by which the inflammasome may contribute to the damaging effects of inflammation in the cardiac, renal, digestive, and nervous systems in COVID-19 patients. Here we review the literature on the role of the inflammasome in CoV infections, which includes how CoVs activate inflammasomes upon infection, the role of the inflammasome in acute respiratory distress syndrome (ARDS), how ventilator-induced lung injury (VILI) activates the inflammasome, how the inflammasome plays a role in the systemic complications associated with COVID-19, and how the inflammasome is involved in the process of Disseminated Intravascular Coagulation (DIC). doi = 10.3389/fimmu.2020.583373 id = cord-003532-lcgeingz author = nan title = 39th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium, 19-22 March 2019 date = 2019-03-19 keywords = AKI; APACHE; ARDS; AUC; Care; Critical; DIC; ECMO; Fig; Hospital; ICU; Intensive; LOS; MAP; conclusion; figure; group; high; introduction; level; method; mortality; patient; result; score; sofa; study; table summary = It''s proposed to evaluate the association between myocardial injury biomarkers, high-sensitive troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-ProBNP), with inflammatory mediators (IL-6, IL-1Β , IL-8, IL-10, IL-12 / IL-23p40, IL17A, IL-21 and TNF-α ) and biomarkers, C protein reactive (CPR) and procalcitonin (PCT), in septic patients Methods: This was a prospective cohort study performed in three intensive care units, from September 2007 to September 2010 enrolling patients with sepsis (infection associated with organ dysfunction), and septic shock (hypotension refractory by fluids infusion requiring vasopressor). Blood samples were collected up to 48h after the development of first organ dysfunction (D0) and on the 7th day after inclusion in the study (D7) Results: Ninety-five patients were enrolled, with median age 64 years (interquatile?48-78), APACHE II: median 19 (14-22), SOFA: median 8 (5-10); 24.2% were admitted in ICU with sepsis and 75.8% with septic shock. doi = 10.1186/s13054-019-2358-0 id = cord-005646-xhx9pzhj author = nan title = 2nd World Congress on Pediatric Intensive Care 1996 Rotterdam, The Netherlands, 23–26 June 1996 Abstracts of Oral Presentations, Posters and Nursing Programme date = 1996 keywords = ARDS; CPB; Care; Children; ECMO; Hospital; ICU; Intensive; PICU; Pediatric; Unit; age; blood; case; child; conclusion; day; failure; group; high; hour; increase; infant; level; mean; method; patient; prism; pulmonary; respiratory; result; severe; study; ventilation; year summary = Aims and methods The aim of both a prospective and retrospective survey conducted in German pediatric intensive care units in 1993 was to accumulate data on the epidemiology, risk factors, natural history and treatment strategies in a large group of pediatric ARDS patients who were treated in the tt~ee year period from 1991 to 1993.All patients had acute bilateral alveolar infiltration of noncardiogenic origin and a pO2~iO2 ratio < 150mmHg. The influence of sex, underlying disease and single organ failure was analyzed using the Fischer''s exact test, the influence of additional organ failure on mortality was tested with the Cochran-Mantel-Haenszet statistics. doi = 10.1007/bf02316512 id = cord-005777-6rvfsx4p author = nan title = PS 0420-0716 date = 2007-08-25 keywords = APACHE; ARDS; CVVH; Care; GCS; Glasgow; Hospital; ICP; ICU; Intensive; TEG; VAP; conclusion; day; group; mean; method; mortality; patient; peep; result; study summary = We prospectively recorded data of all patients who were newly diagnosed with AF and all those with a septic shock on a surgical ICU (no cardiac surgery) during a one year period according to the requirements of the local ethical committee. Our aim was to evaluate the predictive role of admission APACHE II, admission and total maximum SOFA score, hypoalbuminemia, increased serum creatinine, C-reactive protein, lactate, and serum blood glucose for the 30-day mortality of septic patients admitted to medical ICU. The aim of this study was to analyze the clinical presentation and to evaluate mortality associated factors (timing and accurancy of diagnosis, timing of surgery, severity score and organ failure, surgical and medical treatments). Data were extracted independently to assess intention to treat intensive care unit (ICU) and hospital mortality, days of mechanical ventilation, length of stay, incidence of ventilator-associated pneumonia and pneumothorax, and associated complications of the implemented intervention. doi = 10.1007/s00134-007-0823-8 id = cord-005814-ak5pq312 author = nan title = 8th European Congress of Intensive Care Medicine Athens - Greece, October 18–22, 1995 Abstracts date = 1995 keywords = AMI; APACHE; ARDS; ARF; COPD; CPB; CPR; CVP; Care; ECG; ECMO; Group; H20; Hospital; ICP; ICU; III; IL-6; Intensive; January; LPS; MOF; PSV; SAPS; TNF; Unit; University; acute; blood; cardiac; change; conclusion; control; day; effect; failure; follow; high; hour; increase; level; mean; measure; method; mortality; objective; patient; peep; pressure; pulmonary; respiratory; result; study; treatment; value summary = Results: In 5 patients with treated SS, 16 tests were performed (VL n=8; Dobu n=4; NA n=4 Method: Septic shock was defined as severe sepsis with either persistent hypotension (mean arterial pressure; MAP<70 mmHg) or the requirement for a noradrenaline (NA) infusion ~> 0.1 ~g/kg/min with a MAP _< 90mmHg. Cardiovascular support was limited to NA + dobutamine (DB), 546C88 was administered for up to 8 h at a fixed dose-rate of either i, 2.5, 5, 10 or 20 mg/kg/h iv. Methods: Fourteen cases were s~udied,their gestational age ranged from(27-32)ws.Continnous positive air way pressure was applied to six cases at Peep level from (3-6)cm H2o through nasal pronge,(group I),the other 8 cases were managed as routine,(group II).Blood gases, TcPO2,TcCo2,resp.rate,depth and pattern were monitored for assessment of tissue Oxygenation and ventilation, Results: Our rasults showed that early application of CPAP improve ventilation among (83.3%)of cases,while (16.7%)of cases need IMV.The cases of group II need IMV among (75%)of the studied cases during the second or the third day of life. doi = 10.1007/bf02426401 id = cord-015021-pol2qm74 author = nan title = Third International Congress on the Immune Consequences of Trauma, Shock and Sepsis —Mechanisms and Therapeutic Approaches date = 1994 keywords = APACHE; ARDS; CD14; CD4; CLP; CRP; CSF; ELISA; ICU; IFN; III; IL-1; IL-2; IL-4; IL-6; IL-8; LEH; LPS; MOF; PAF; PMN; SIRS; TNF; University; animal; blood; cell; control; cytokine; day; effect; endotoxin; factor; follow; group; high; increase; injury; level; method; mouse; patient; production; rat; release; response; result; sepsis; septic; shock; study; trauma summary = It is our current understanding that LPS is responsible for many of the pathophysiological events observed during gramnegative infections and that one of the major mechanisms leading to shock and death is the LPS-induced activation of macrophages resulting in the production and release of lipid and peptide mediators, among which tumor necrosis factor seems to be the most important. However plasma IL-6 estimation revealed a statistically significant reduction at 6 hours in tanrine-treated animals compared to glycino and TW controls ( Objective: To evaluate the effects of allogeneic blood transfusion, thermal injury and bacterial garage on interteukin 4 (IL-4), tumor necrosis factor alpha (TNF) production and host mortality and to study if the administration of thymopentth (THY) could affect these events. doi = 10.1007/bf02258437 id = cord-015024-2xzc0uc5 author = nan title = ESICM 2010 WEDNESDAY SESSIONS 13 October 2010 date = 2010-08-31 keywords = APACHE; ARDS; CVP; Care; ECMO; Hospital; ICU; Intensive; conclusion; day; group; high; increase; introduction; level; method; objectives; patient; result; sepsis; sofa; study summary = We performed a prospective clinical study in a 17-bed multidisciplinary intensive care unit, including 21 patients with controlled mechanical ventilation and monitored with the Vigileo Ò monitor, for whom the decision to give fluids was taken due to the presence of circulatory, including arterial hypotension (MAP B 65 mmHg or systolic arterial pressure \90 mmHg), and preserved preload-responsiveness condition, defined as SVV C10%. The aim of this study was to compare and evaluate four severity scoring systems in intensive care unit (ICU), including APACHE II, APACHE III, SASP II and MODS in severe septic patient. A prospective observational study was performed in 16 mechanically ventilated critically ill patients (12 M, age 49 ± 17 yr, BMI 25 ± 5 kg/m 2 , ICU admission day 5 ± 3, APACHE II on study 20 ± 7; mean ± SD) and 6 healthy subjects (3 M, age 24 ± 9 year, BMI 24 ± 45 kg/m 2 ). doi = 10.1007/s00134-010-2001-7 id = cord-015126-cyhcbk1j author = nan title = PS 0036-0344 date = 2007-08-25 keywords = APACHE; ARDS; Care; HFOV; Hospital; ICU; Intensive; PCT; VAP; blood; conclusion; day; group; increase; introduction; method; mortality; patient; peep; pressure; result; sofa; study summary = We compared them with ≥70 years old and an ICU stay < 30 days patients, the differences in ICU mortality, Apache II, age, gender and the necessity for renal replacement therapy (RRT) were not significant (see table) . The patients with mild form of acute pancreatitis had low mortality rate (similar to general ward population) despite positive ICU admission criteria in our case series with fifty per cent development of severe form with organ dysfunction/failure later on. Collected data:Demographics,Management prior and during ICU hospitalization (sedation, catecolamin drug use, blood product transfusion, intra-cranial pressure monitoring, neurosurgical emergency surgery etc.),CT-Scan results, Daily worst Glasgow coma scale, admission Simplified Acute Physiology Score II. This prospective interventional study performed in a surgical Intensive Care Unit of a tertiary University Hospital included 35 (21 males) mechanically ventilated and sedated patients with acute cardiovascular failure requiring cardiac output measurement (transpulmonary thermodilution technique)and a fluid challenge. doi = 10.1007/s00134-007-0820-y id = cord-017126-7ebo3cy3 author = nan title = Lungenversagen date = 2007 keywords = ARDS; Jet; acute; der; die; respiratory summary = Nach der „American-European Consensus Conference" (Bernard et al., 1994) wird zwischen einem ARDS — acute respiratory distress syndrom und einem ALI — acute lung injury unterschieden. Bei Patienten mit ALI/ARDS kann das Auftreten apoptotischer Vorgänge an pulmonalen epithelialen Zellen (Song Y et al., 1999 , Li et al., 2004 , Martin et al., 2005 (Abraham, 2003) derselben, sodass es zur Aufrechterhaltung eines von Leukozyten geführten inflammatorischen Prozesses kommt, der typisch für eine akute Lungenschädigung ist (Wang et al., 1999 , Yum et al., 2001 Die verminderte Apoptose der Neutrophilen ist bedingt durch: 1. Beneficial effects of the "Open lung Approach" with low distending pressures in acute respiratory distress syndrom; A prospective randomized study on mechanical ventilation Combining high-frequency oscillatory ventilation and recruitment maneuvers in adults with early acute respiratory distress syndrome: the treatment with oscillation and an Open Lung Strategy (TOOLS) trial pilot study Effect of alveolar recruitment maneuver in early acute respiratory distress syndrome according to antiderecruitment strategy, etiological category of diffuse lung injury, and body position of the patient doi = 10.1007/978-3-211-29682-0_10 id = cord-335975-m6lkrehi author = nan title = Proceedings of Réanimation 2018, the French Intensive Care Society International Congress date = 2018-02-05 keywords = AKI; ARDS; CKD; December; ECMO; Fig; ICU; IQR; January; NIV; SAPS; VAP; care; day; group; introduction; mortality; patient; result; sofa; study summary = A qSOFA score relying on 3 simple clinical criteria (respiratory rate, mental status and systolic blood pressure) has been proposed to better identify septic patients with associated higher mortality outside the intensive care unit (Seymour CW et al., JAMA 2016) . We propose to determine whether the arterial oxygen pressure (PaO2) at intensive care unit (ICU) admission affects mortality at day 28 (D28) in patients with septic shock subjected to mechanical out-of-hospital ventilation. Conclusion: In this study, we report a significant association between hyperoxemia at ICU admission and mortality at D28 in patients with septic shock subjected to pre-hospital invasive mechanical ventilation. The aim of this study was to describe outcome of pediatric patient with hematologic disease hospitalized in our intensive care unit for respiratory failure and to investigate the clinical variables associated with mortality. doi = 10.1186/s13613-017-0345-7 id = cord-341063-3rqnu5bu author = nan title = 38th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 20-23 March 2018 date = 2018-03-29 keywords = AKI; APACHE; ARDS; Care; Critical; Fig; Hospital; ICU; IQR; IVC; Intensive; LOS; TBI; University; VAP; conclusion; day; group; high; introduction; method; mortality; patient; peep; result; score; sofa; study; table summary = Procacitonin (PCT) emerges as a possible predictive tool in cardiothoracic intensive care unit (CTICU).We aim at testing the predictive power of PCT for early morbidity, prolonged ventilation, ICU and hospital stay, in patients developing early fever after cardiac surgery Methods: A retrospective descriptive study done in tertiary cardiac center, enrolling patients who stayed for more than 24 hours post-operatively in the CTICU Risk stratification included additive Euro score and PCT immunoluminometricaly prior to surgery and every 48 hours in response to onset of fever. Prognostic accuracy of quick sequential organ failure assessment (qSOFA) score for mortality: systematic review and meta-analysis Introduction: The purpose of this study was to summarize the evidence assessing the qSOFA [1] , calculated in admission of the patient in emergency department (ED) or intensive care unit (ICU), as a predictor of mortality. doi = 10.1186/s13054-018-1973-5 id = cord-355038-o2hr5mox author = nan title = Proceedings of Réanimation 2020, the French Intensive Care Society International Congress date = 2020-02-11 keywords = AKI; ARDS; CHU; COPD; Care; Correspondence; December; ECMO; Fig; France; Hospital; ICU; IQR; January; NIV; PICU; VAP; day; french; group; high; invitation; method; mortality; patient; rationale; result; sofa; study summary = Conclusion: In patients with moderate-to-severe ARDS, a higher tidal volume under PSV within the 72 h following neuromuscular blockers cessation is independently associated with the 28-day mortality.Compliance with ethics regulations: Yes. Kaplan-Meier estimate of the cumulative probability of survival according to the mean tidal volume (Vt)-lower of higher than 8 ml/ kg-under pressure support ventilation (PSV) during the "transition period" transfusion is associated with adverse events, and equipoise remains on the optimal transfusion strategy in oncologic patients in surgical setting. Compliance with ethics regulations: Yes. Patients and methods: In a retrospective monocentric study (01/2013-01/2017) conducted in cardio-vascular surgical intensive care unit (ICU) in Henri Mondor teaching hospital, all consecutive adult patients who underwent peripheral VA-ECMO were included, with exclusion of those dying in the first 24 h. Compliance with ethics regulations: Yes. Rationale: Acute respiratory failure is the leading reason for intensive care unit (ICU) admission in immunocompromised patients and the need for invasive mechanical ventilation has become a major clinical end-point in randomized controlled trials (RCT). doi = 10.1186/s13613-020-0623-7 id = cord-296656-4q0jdyrh author = van der Stap, Janneke title = Acute respiratoire insufficiëntie date = 2020-07-14 keywords = ARDS summary = Bij covid-19 raken veel patiënten acuut respiratoir insufficiënt, maar ook bij andere ziektebeelden kan dat voorkomen. In dit artikel lees je wat er gebeurt bij acute respiratoire insufficiëntie en wat je kunt doen. Het acute respiratory distress syndrome (ARDS) is een pulmonale uiting van een systemische inflammatoire respons (hyperactieve ontstekingsreactie). Het is een ernstige acute longaandoening, gekenmerkt door diffuse bilaterale infiltraten (beiderzijds ontstekingen in de long), hypoxemie, verminderde longcompliantie (rekbaarheid van de long) en respiratoire insufficiëntie. ARDS kan optreden in het verloop van uiteenlopende ziekteprocessen (zowel primair in de longen als daarbuiten). 20-40% van de patiënten met sepsis ontwikkelt een ARDS. ARDS wordt ook bij ongeveer 40% van de covid-19-patiënten waargenomen. 9 Beademing kan een patiënt met ARDS ondersteunen, maar het is vooral belangrijk dat de onderliggende oorzaak wordt behandeld. De mortaliteit is hoger bij patiënten met een hogere leeftijd en multiorgaanfalen. Acute respiratory distress syndrome doi = 10.1007/s41193-020-0109-x id = cord-318209-llucxztc author = Öztürk, Selçuk title = Therapeutic Applications of Stem Cells and Extracellular Vesicles in Emergency Care: Futuristic Perspectives date = 2020-08-24 keywords = ARDS; MSC; cell; clinical; stem; study; therapeutic summary = A phase-1 clinical trial investigating autologous BM-derived mononuclear cell (BM-MNC) infusion in pediatric TBI patients indicated that Fig. 1 Main pathological conditions requiring acute emergency care that can benefit from stem cell therapies or extracellular vesicle therapies in the future harvesting and infusion of stem cells is safe in children with no infusion related toxicity or death [30] . The regenerative potential of various types of stem cells, with different sources, dosages, delivery routes, application times and end-points has been investigated in preclinical animal models and human clinical trials with the expectation that these cells would successfully engraft into the damaged brain tissue, differentiate into functional neuronal and vascular system cells and promote full recovery after stroke. A recently published systematic review of 76 studies testing stem cells in rodent ischemic stroke models and 4 randomized human clinical trials encompassing ischemic stroke patients treated with autologous stem cells with at least one year follow-up period demonstrated that stem cell therapies show beneficial effects in terms of behavior and histological outcomes in rodents. doi = 10.1007/s12015-020-10029-2