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Article ; Online: Approach to the patient with the acute respiratory distress syndrome.

Janz, David R / Ware, Lorraine B

2014 Volume 35, Issue 4, Page(s) 685–696

Abstract: Given the high incidence and mortality of acute respiratory distress syndrome (ARDS ... in critically ill patients, every practitioner needs a bedside approach both for early identification of patients ... Recent advances such as the Lung Injury Prediction score, the Early Acute Lung Injury score, and ...

Abstract	Given the high incidence and mortality of acute respiratory distress syndrome (ARDS) in critically ill patients, every practitioner needs a bedside approach both for early identification of patients at risk for ARDS and for the appropriate evaluation of patients who meet the diagnostic criteria of ARDS. Recent advances such as the Lung Injury Prediction score, the Early Acute Lung Injury score, and validation of the SpO(2)/Fio(2) ratio for assessing the degree of hypoxemia are all practical tools to aid the practitioner in caring for patients at risk of ARDS.
MeSH term(s)	Critical Care/methods ; Humans ; Point-of-Care Systems ; Radiography ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult/diagnosis ; Respiratory Distress Syndrome, Adult/diagnostic imaging ; Respiratory Distress Syndrome, Adult/therapy ; Respiratory Function Tests
Language	English
Publishing date	2014-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	447455-7
ISSN	1557-8216 ; 0272-5231
ISSN (online)	1557-8216
ISSN	0272-5231
DOI	10.1016/j.ccm.2014.08.007
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Article ; Online: A pretrain-finetune approach for improving model generalizability in outcome prediction of acute respiratory distress syndrome patients.

Lin, Songlu / Yang, Meicheng / Liu, Chengyu / Wang, Zhihong / Long, Xi

International journal of medical informatics

2024 Volume 186, Page(s) 105397

Abstract: Background: Early prediction of acute respiratory distress syndrome (ARDS) of critically ill ... a "pretrain-finetune" approach was applied, where we pretrained models on the eICU-CRD dataset and performed ... model.: Conclusions: The proposed pretrain-finetune approach can effectively improve model ...

Abstract	Background: Early prediction of acute respiratory distress syndrome (ARDS) of critically ill patients in intensive care units (ICUs) has been intensively studied in the past years. Yet a prediction model trained on data from one hospital might not be well generalized to other hospitals. It is therefore essential to develop an accurate and generalizable ARDS prediction model adaptive to different hospital or medical centers. Methods: We analyzed electronic medical records of 200,859 and 50,920 hospitalized patients within 24 h after being diagnosed with ARDS from the Philips eICU Institute (eICU-CRD) and the Medical Information Mart for Intensive Care (MIMIC-IV) dataset, respectively. Patients were sorted into three groups, including rapid death, long stay, and recovery, based on their condition or outcome between 24 and 72 h after ARDS diagnosis. To improve prediction performance and generalizability, a "pretrain-finetune" approach was applied, where we pretrained models on the eICU-CRD dataset and performed model finetuning using only a part (35%) of the MIMIC-IV dataset, and then tested the finetuned models on the remaining data from the MIMIC-IV dataset. Well-known machine-learning algorithms, including logistic regression, random forest, extreme gradient boosting, and multilayer perceptron neural networks, were employed to predict ARDS outcomes. Prediction performance was evaluated using the area under the receiver-operating characteristic curve (AUC). Results: Results show that, in general, multilayer perceptron neural networks outperformed the other models. The use of pretrain-finetune yielded improved performance in predicting ARDS outcomes achieving a micro-AUC of 0.870 for the MIMIC-IV dataset, an improvement of 0.046 over the pretrain model. Conclusions: The proposed pretrain-finetune approach can effectively improve model generalizability from one to another dataset in ARDS prediction.
MeSH term(s)	Humans ; Prognosis ; Algorithms ; Critical Care ; Electronic Health Records ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/therapy
Language	English
Publishing date	2024-03-02
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2024.105397
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Article ; Online: Fibrinolytic therapy in patients with COVID-19 and acute respiratory distress syndrome: Is this a feasible approach?

Savioli, Felicio / Rocha, Leonardo / Góis, Aécio / Nakano, Luis Carlos

The journal of trauma and acute care surgery

2020 Volume 89, Issue 6, Page(s) e187–e188

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/blood ; Coronavirus Infections/drug therapy ; Humans ; Pandemics ; Pneumonia, Viral/blood ; Pneumonia, Viral/drug therapy ; Randomized Controlled Trials as Topic ; Respiratory Distress Syndrome/drug therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2 ; Thrombolytic Therapy ; Tissue Plasminogen Activator/administration & dosage
Chemical Substances	Tissue Plasminogen Activator (EC 3.4.21.68)
Keywords	covid19
Language	English
Publishing date	2020-08-31
Publishing country	United States
Document type	Letter
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000002931
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Article ; Online: Individualized Multimodal Physiologic Approach to Mechanical Ventilation in Patients With Obesity and Severe Acute Respiratory Distress Syndrome Reduced Venovenous Extracorporeal Membrane Oxygenation Utilization.

Zadek, Francesco / Rubin, Jonah / Grassi, Luigi / Van Den Kroonenberg, Daniel / Larson, Grant / Capriles, Martin / De Santis Santiago, Roberta / Florio, Gaetano / Imber, David A / Bittner, Edward A / Hibbert, Kathryn A / Legassey, Alex / LaRocque, Jeliene / Cudemus-Deseda, Gaston / Bagchi, Aranya / Crowley, Jerome / Shelton, Kenneth / Kacmarek, Robert / Berra, Lorenzo

Critical care explorations

2021 Volume 3, Issue 7, Page(s) e0461

Abstract: ... in patients with obesity and acute respiratory distress syndrome and decrease ICU and hospital length of stay ... from June 2015 to June 2019.: Patients: All patients with obesity and acute respiratory distress syndrome ... generating study, individualized optimization of mechanical ventilation of patients with acute respiratory ...

Abstract	Objective: To investigate whether individualized optimization of mechanical ventilation through the implementation of a lung rescue team could reduce the need for venovenous extracorporeal membrane oxygenation in patients with obesity and acute respiratory distress syndrome and decrease ICU and hospital length of stay and mortality. Design: Single-center, retrospective study at the Massachusetts General Hospital from June 2015 to June 2019. Patients: All patients with obesity and acute respiratory distress syndrome who were referred for venovenous extracorporeal membrane oxygenation evaluation due to hypoxemic respiratory failure. Intervention: Evaluation and individualized optimization of mechanical ventilation by the lung rescue team before the decision to proceed with venovenous extracorporeal membrane oxygenation. The control group was those patients managed according to hospital standard of care without lung rescue team evaluation. Measurement and main results: All 20 patients (100%) allocated in the control group received venovenous extracorporeal membrane oxygenation, whereas 10 of 13 patients (77%) evaluated by the lung rescue team did not receive venovenous extracorporeal membrane oxygenation. Patients who underwent lung rescue team evaluation had a shorter duration of mechanical ventilation ( Conclusions: In this hypothesis-generating study, individualized optimization of mechanical ventilation of patients with acute respiratory distress syndrome and obesity by a lung rescue team was associated with a decrease in the utilization of venovenous extracorporeal membrane oxygenation, duration of mechanical ventilation, and ICU length of stay. Mortality was not modified by the lung rescue team intervention.
Language	English
Publishing date	2021-06-29
Publishing country	United States
Document type	Journal Article
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000000461
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Article ; Online: The hemoglobin level impact on arterial oxygen saturation during venous-venous-extracorporeal membrane oxygenation support of acute respiratory distress syndrome patients: a mathematical marginal approach.

Carvalho, Luisa Tajra / Mendes, Pedro Vitale / Besen, Bruno Adler Maccagnan Pinheiro / Park, Marcelo

Revista Brasileira de terapia intensiva

2022 Volume 34, Issue 3, Page(s) 393–395

Title translation	Efeito da taxa de hemoglobina na saturação arterial de oxigênio durante suporte com oxigenação por membrana extracorpórea veno-venosa em pacientes com síndrome do desconforto respiratório agudo: uma abordagem matemática marginal.
MeSH term(s)	Humans ; Extracorporeal Membrane Oxygenation ; Oxygen Saturation ; Respiratory Distress Syndrome/therapy ; Oximetry ; Hemoglobins/metabolism ; Oxygen
Chemical Substances	Hemoglobins ; Oxygen (S88TT14065)
Language	Portuguese
Publishing date	2022-09-19
Publishing country	Brazil
Document type	Letter
ZDB-ID	2732162-9
ISSN	1982-4335 ; 1982-4335
ISSN (online)	1982-4335
ISSN	1982-4335
DOI	10.5935/0103-507X.20220465-pt
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Article ; Online: Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in COVID-19 patients.

Convertino, Irma / Tuccori, Marco / Ferraro, Sara / Valdiserra, Giulia / Cappello, Emiliano / Focosi, Daniele / Blandizzi, Corrado

Critical care (London, England)

2020 Volume 24, Issue 1, Page(s) 331

Abstract: Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS ... pharmacological approaches. ...

Abstract	Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS), which require intensive care unit admission. These conditions have rapidly overwhelmed healthcare systems, with detrimental effects on the quality of care and increased mortality. Social isolation strategies have been implemented worldwide with the aim of reducing hospital pressure. Among therapeutic strategies, the use of immunomodulating drugs, to improve prognosis, seems promising. Particularly, since pneumonia and ARDS are associated with a cytokine storm, drugs belonging to therapeutic classes as anti-IL-6, anti-TNF, and JAK inhibitors are currently studied. In this article, we discuss the potential advantages of the most promising pharmacological approaches.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/therapy ; Critical Illness ; Cytokines ; Humans ; Intensive Care Units ; Pandemics ; Pneumonia, Viral/therapy ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Cytokines
Keywords	covid19
Language	English
Publishing date	2020-06-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-020-03020-3
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Article: Therapeutic Approaches in Modulating the Inflammatory and Immunological Response in Patients With Sepsis, Acute Respiratory Distress Syndrome, and Pancreatitis: An Expert Opinion Review.

Mehta, Yatin / Dixit, Subhal B / Zirpe, Kapil / Sud, Randhir / Gopal, Palepu B / Koul, Parvaiz A / Mishra, Vijay K / Ansari, Abdul S / Chamle, Vijay S

Cureus

2021 Volume 13, Issue 9, Page(s) e18393

Abstract: ... acute respiratory distress syndrome (ARDS), and acute pancreatitis (AP). Hyperactive immune response ... Immunomodulation has long been an adjunct approach in treating critically ill patients with sepsis ... storm, especially with steroids, has shown to improve the outcomes in COVID-19 patients. In this review ...

Abstract	Immunomodulation has long been an adjunct approach in treating critically ill patients with sepsis, acute respiratory distress syndrome (ARDS), and acute pancreatitis (AP). Hyperactive immune response with immunopathogenesis leads to organ dysfunction and alters the clinical outcomes in critically ill. Though the immune response in the critically ill might have been overlooked, it has gathered greater attention during this novel coronavirus disease 2019 (COVID-19) pandemic. Modulating hyperactive immune response, the cytokine storm, especially with steroids, has shown to improve the outcomes in COVID-19 patients. In this review, we find that immune response pathogenesis in critically ill patients with sepsis, ARDS, and AP is nearly similar. The use of immunomodulators such as steroids, broad-spectrum serine protease inhibitors such as ulinastatin, thymosin alpha, intravenous immunoglobulins, and therapies such as CytoSorb and therapeutic plasma exchange may help in improving the clinical outcomes in these conditions. As the experience of the majority of physicians in using such therapeutics may be limited, we provide our expert comments regarding immunomodulation to optimize outcomes in patients with sepsis/septic shock, ARDS, and AP.
Language	English
Publishing date	2021-09-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.18393
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Article ; Online: Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in COVID-19 patients

Convertino, Irma / Tuccori, Marco / Ferraro, Sara / Valdiserra, Giulia / Cappello, Emiliano / Focosi, Daniele / Blandizzi, Corrado

Critical Care

2020 Volume 24, Issue 1

Keywords	Critical Care and Intensive Care Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2041406-7
ISSN	1364-8535
ISSN	1364-8535
DOI	10.1186/s13054-020-03020-3
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in COVID-19 patients

Convertino, Irma / Tuccori, Marco / Ferraro, Sara / Valdiserra, Giulia / Cappello, Emiliano / Focosi, Daniele / Blandizzi, Corrado

Crit Care

Abstract: Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS ... pharmacological approaches. ...

Abstract	Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS), which require intensive care unit admission. These conditions have rapidly overwhelmed healthcare systems, with detrimental effects on the quality of care and increased mortality. Social isolation strategies have been implemented worldwide with the aim of reducing hospital pressure. Among therapeutic strategies, the use of immunomodulating drugs, to improve prognosis, seems promising. Particularly, since pneumonia and ARDS are associated with a cytokine storm, drugs belonging to therapeutic classes as anti-IL-6, anti-TNF, and JAK inhibitors are currently studied. In this article, we discuss the potential advantages of the most promising pharmacological approaches.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #593538
Database	COVID19

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Article ; Online: Exploring pharmacological approaches for managing cytokine storm associated with pneumonia and acute respiratory distress syndrome in COVID-19 patients

Irma Convertino / Marco Tuccori / Sara Ferraro / Giulia Valdiserra / Emiliano Cappello / Daniele Focosi / Corrado Blandizzi

Critical Care, Vol 24, Iss 1, Pp 1-

2020 Volume 6

Abstract: Abstract Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS ... pharmacological approaches. ...

Abstract	Abstract Sars-CoV-2 complications include pneumonia and acute respiratory distress syndrome (ARDS), which require intensive care unit admission. These conditions have rapidly overwhelmed healthcare systems, with detrimental effects on the quality of care and increased mortality. Social isolation strategies have been implemented worldwide with the aim of reducing hospital pressure. Among therapeutic strategies, the use of immunomodulating drugs, to improve prognosis, seems promising. Particularly, since pneumonia and ARDS are associated with a cytokine storm, drugs belonging to therapeutic classes as anti-IL-6, anti-TNF, and JAK inhibitors are currently studied. In this article, we discuss the potential advantages of the most promising pharmacological approaches.
Keywords	Sars-CoV-2 ; COVID-19 ; Cytokines ; Interleukin-6 ; Tumor necrosis factor ; Janus kinases ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; covid19
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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