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Article ; Online: Lung ultrasound for diagnosis and management of ARDS.

Smit, Marry R / Mayo, Paul H / Mongodi, Silvia

2024

Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Editorial
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-024-07422-7
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Article ; Online: Reply to Volpicelli and Bouhemad.

Smit, Marry R / Bos, Lieuwe D J

American journal of respiratory and critical care medicine

2023 Volume 208, Issue 1, Page(s) 113–114

MeSH term(s)	Humans ; Lung ; Respiratory Distress Syndrome
Language	English
Publishing date	2023-04-25
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202304-0683LE
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Article ; Online: The Global Definition of Acute Respiratory Distress Syndrome: Ready for Prime Time?

Smit, Marry R / Brower, Roy G / Parsons, Polly E / Phua, Jason / Bos, Lieuwe D J

American journal of respiratory and critical care medicine

2023 Volume 209, Issue 1, Page(s) 14–16

MeSH term(s)	Humans ; Respiratory Distress Syndrome/diagnosis ; Respiratory Insufficiency
Language	English
Publishing date	2023-09-06
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202308-1369ED
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Article ; Online: Slicing and dicing ARDS: we almost forgot the lungs.

Smit, Marry R / Bos, Lieuwe D J

Critical care (London, England)

2021 Volume 25, Issue 1, Page(s) 180

Language	English
Publishing date	2021-05-28
Publishing country	England
Document type	Editorial
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-021-03611-8
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Zs.A 5517: Show issues

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Article ; Online: Lung ultrasound to discriminate non-cardiogenic interstitial syndrome from cardiogenic pulmonary edema: Is "gestalt" as good as it gets?

Heldeweg, Micah L A / Haaksma, Mark E / Smit, Jasper M / Smit, Marry R / Tuinman, Pieter R

Journal of critical care

2022 Volume 73, Page(s) 154180

MeSH term(s)	Humans ; Pulmonary Edema/diagnostic imaging ; Pulmonary Edema/etiology ; Lung/diagnostic imaging ; Ultrasonography
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Letter
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2022.154180
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Zs.A 2152: Show issues

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Article: HS-GC-MS analysis of volatile organic compounds after hyperoxia-induced oxidative stress: a validation study.

Lilien, Thijs A / Fenn, Dominic W / Brinkman, Paul / Hagens, Laura A / Smit, Marry R / Heijnen, Nanon F L / van Woensel, Job B M / Bos, Lieuwe D J / Bem, Reinout A

Intensive care medicine experimental

2024 Volume 12, Issue 1, Page(s) 14

Abstract: Background: Exhaled volatile organic compounds (VOCs), particularly hydrocarbons from oxidative stress-induced lipid peroxidation, are associated with hyperoxia exposure. However, important heterogeneity amongst identified VOCs and concerns about their ... ...

Abstract	Background: Exhaled volatile organic compounds (VOCs), particularly hydrocarbons from oxidative stress-induced lipid peroxidation, are associated with hyperoxia exposure. However, important heterogeneity amongst identified VOCs and concerns about their precise pathophysiological origins warrant translational studies assessing their validity as a marker of hyperoxia-induced oxidative stress. Therefore, this study sought to examine changes in VOCs previously associated with the oxidative stress response in hyperoxia-exposed lung epithelial cells. Methods: A549 alveolar epithelial cells were exposed to hyperoxia for 24 h, or to room air as normoxia controls, or hydrogen peroxide as oxidative-stress positive controls. VOCs were sampled from the headspace, analysed by gas chromatography coupled with mass spectrometry and compared by targeted and untargeted analyses. A secondary analysis of breath samples from a large cohort of critically ill adult patients assessed the association of identified VOCs with clinical oxygen exposure. Results: Following cellular hyperoxia exposure, none of the targeted VOCs, previously proposed as breath markers of oxidative stress, were increased, and decane was significantly decreased. Untargeted analysis did not reveal novel identifiable hyperoxia-associated VOCs. Within the clinical cohort, three previously proposed breath markers of oxidative stress, hexane, octane, and decane had no real diagnostic value in discriminating patients exposed to hyperoxia. Conclusions: Hyperoxia exposure of alveolar epithelial cells did not result in an increase in identifiable VOCs, whilst VOCs previously linked to oxidative stress were not associated with oxygen exposure in a cohort of critically ill patients. These findings suggest that the pathophysiological origin of previously proposed breath markers of oxidative stress is more complex than just oxidative stress from hyperoxia at the lung epithelial cellular level.
Language	English
Publishing date	2024-02-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2740385-3
ISSN	2197-425X
ISSN	2197-425X
DOI	10.1186/s40635-024-00600-3
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Article ; Online: Breath metabolomics for diagnosis of acute respiratory distress syndrome.

Zhang, Shiqi / Hagens, Laura A / Heijnen, Nanon F L / Smit, Marry R / Brinkman, Paul / Fenn, Dominic / van der Poll, Tom / Schultz, Marcus J / Bergmans, Dennis C J J / Schnabel, Ronny M / Bos, Lieuwe D J

Critical care (London, England)

2024 Volume 28, Issue 1, Page(s) 96

Abstract: Background: Acute respiratory distress syndrome (ARDS) poses challenges in early identification. Exhaled breath contains metabolites reflective of pulmonary inflammation.: Aim: To evaluate the diagnostic accuracy of breath metabolites for ARDS in ... ...

Abstract	Background: Acute respiratory distress syndrome (ARDS) poses challenges in early identification. Exhaled breath contains metabolites reflective of pulmonary inflammation. Aim: To evaluate the diagnostic accuracy of breath metabolites for ARDS in invasively ventilated intensive care unit (ICU) patients. Methods: This two-center observational study included critically ill patients receiving invasive ventilation. Gas chromatography and mass spectrometry (GC-MS) was used to quantify the exhaled metabolites. The Berlin definition of ARDS was assessed by three experts to categorize all patients into "certain ARDS", "certain no ARDS" and "uncertain ARDS" groups. The patients with "certain" labels from one hospital formed the derivation cohort used to train a classifier built based on the five most significant breath metabolites. The diagnostic accuracy of the classifier was assessed in all patients from the second hospital and combined with the lung injury prediction score (LIPS). Results: A total of 499 patients were included in this study. Three hundred fifty-seven patients were included in the derivation cohort (60 with certain ARDS; 17%), and 142 patients in the validation cohort (47 with certain ARDS; 33%). The metabolites 1-methylpyrrole, 1,3,5-trifluorobenzene, methoxyacetic acid, 2-methylfuran and 2-methyl-1-propanol were included in the classifier. The classifier had an area under the receiver operating characteristics curve (AUROCC) of 0.71 (CI 0.63-0.78) in the derivation cohort and 0.63 (CI 0.52-0.74) in the validation cohort. Combining the breath test with the LIPS does not significantly enhance the diagnostic performance. Conclusion: An exhaled breath metabolomics-based classifier has moderate diagnostic accuracy for ARDS but was not sufficiently accurate for clinical use, even after combination with a clinical prediction score.
MeSH term(s)	Humans ; Critical Care ; Lung ; Lung Injury ; Pneumonia ; Respiratory Distress Syndrome/diagnosis
Language	English
Publishing date	2024-03-23
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-024-04882-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5517: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Prone Positioning Decreases Inhomogeneity and Improves Dorsal Compliance in Invasively Ventilated Spontaneously Breathing COVID-19 Patients-A Study Using Electrical Impedance Tomography.

Pierrakos, Charalampos / van der Ven, Fleur L I M / Smit, Marry R / Hagens, Laura A / Paulus, Frederique / Schultz, Marcus J / Bos, Lieuwe D J

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 10

Abstract: Background: We studied prone positioning effects on lung aeration in spontaneously breathing invasively ventilated patients with coronavirus disease 2019 (COVID-19).: Methods: changes in lung aeration were studied prospectively by electrical ... ...

Abstract	Background: We studied prone positioning effects on lung aeration in spontaneously breathing invasively ventilated patients with coronavirus disease 2019 (COVID-19). Methods: changes in lung aeration were studied prospectively by electrical impedance tomography (EIT) from before to after placing the patient prone, and back to supine. Mixed effect models with a random intercept and only fixed effects were used to evaluate changes in lung aeration. Results: fifteen spontaneously breathing invasively ventilated patients were enrolled, and remained prone for a median of 19 [17 to 21] hours. At 16 h the global inhomogeneity index was lower. At 2 h, there were neither changes in dorsal nor in ventral compliance; after 16 h, only dorsal compliance (βFe +18.9 [95% Confidence interval (CI): 9.1 to 28.8]) and dorsal end-expiratory lung impedance (EELI) were increased (βFe, +252 [95% CI: 13 to 496]); at 2 and 16 h, dorsal silent spaces was unchanged (βFe, -4.6 [95% CI: -12.3 to +3.2]). The observed changes induced by prone positioning disappeared after turning patients back to supine. Conclusions: in this cohort of spontaneously breathing invasively ventilated COVID-19 patients, prone positioning decreased inhomogeneity, increased lung volumes, and improved dorsal compliance.
Language	English
Publishing date	2022-09-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12102281
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Article ; Online: Personalized mechanical ventilation guided by ultrasound in patients with acute respiratory distress syndrome (PEGASUS): study protocol for an international randomized clinical trial.

Sinnige, Jante S / Smit, Marry R / Ghose, Aniruddha / de Grooth, Harm-Jan / Itenov, Theis Skovsgaard / Ischaki, Eleni / Laffey, John / Paulus, Frederique / Póvoa, Pedro / Pierrakos, Charalampos / Pisani, Luigi / Roca, Oriol / Schultz, Marcus J / Szuldrzynski, Konstanty / Tuinman, Pieter R / Zimatore, Claudio / Bos, Lieuwe D J

Trials

2024 Volume 25, Issue 1, Page(s) 308

Abstract: Background: Acute respiratory distress syndrome (ARDS) is a frequent cause of hypoxemic respiratory failure with a mortality rate of approximately 30%. Identifying ARDS subphenotypes based on "focal" or "non-focal" lung morphology has the potential to ... ...

Abstract	Background: Acute respiratory distress syndrome (ARDS) is a frequent cause of hypoxemic respiratory failure with a mortality rate of approximately 30%. Identifying ARDS subphenotypes based on "focal" or "non-focal" lung morphology has the potential to better target mechanical ventilation strategies of individual patients. However, classifying morphology through chest radiography or computed tomography is either inaccurate or impractical. Lung ultrasound (LUS) is a non-invasive bedside tool that can accurately distinguish "focal" from "non-focal" lung morphology. We hypothesize that LUS-guided personalized mechanical ventilation in ARDS patients leads to a reduction in 90-day mortality compared to conventional mechanical ventilation. Methods: The Personalized Mechanical Ventilation Guided by UltraSound in Patients with Acute Respiratory Distress Syndrome (PEGASUS) study is an investigator-initiated, international, randomized clinical trial (RCT) that plans to enroll 538 invasively ventilated adult intensive care unit (ICU) patients with moderate to severe ARDS. Eligible patients will receive a LUS exam to classify lung morphology as "focal" or "non-focal". Thereafter, patients will be randomized within 12 h after ARDS diagnosis to receive standard care or personalized ventilation where the ventilation strategy is adjusted to the morphology subphenotype, i.e., higher positive end-expiratory pressure (PEEP) and recruitment maneuvers for "non-focal" ARDS and lower PEEP and prone positioning for "focal" ARDS. The primary endpoint is all-cause mortality at day 90. Secondary outcomes are mortality at day 28, ventilator-free days at day 28, ICU length of stay, ICU mortality, hospital length of stay, hospital mortality, and number of complications (ventilator-associated pneumonia, pneumothorax, and need for rescue therapy). After a pilot phase of 80 patients, the correct interpretation of LUS images and correct application of the intervention within the safe limits of mechanical ventilation will be evaluated. Discussion: PEGASUS is the first RCT that compares LUS-guided personalized mechanical ventilation with conventional ventilation in invasively ventilated patients with moderate and severe ARDS. If this study demonstrates that personalized ventilation guided by LUS can improve the outcomes of ARDS patients, it has the potential to shift the existing one-size-fits-all ventilation strategy towards a more individualized approach. Trial registration: The PEGASUS trial was registered before the inclusion of the first patient, https://clinicaltrials.gov/ (ID: NCT05492344).
MeSH term(s)	Humans ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/diagnostic imaging ; Respiratory Distress Syndrome/mortality ; Respiration, Artificial/methods ; Randomized Controlled Trials as Topic ; Lung/diagnostic imaging ; Lung/physiopathology ; Treatment Outcome ; Ultrasonography, Interventional/methods ; Time Factors ; Multicenter Studies as Topic ; Predictive Value of Tests ; Precision Medicine/methods
Language	English
Publishing date	2024-05-07
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-024-08140-7
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Article: Prognostic Value of the Radiographic Assessment of Lung Edema Score in Mechanically Ventilated ICU Patients.

Filippini, Daan F L / Hagens, Laura A / Heijnen, Nanon F L / Zimatore, Claudio / Atmowihardjo, Leila N / Schnabel, Ronny M / Schultz, Marcus J / Bergmans, Dennis C J J / Bos, Lieuwe D J / Smit, Marry R

Journal of clinical medicine

2023 Volume 12, Issue 4

Abstract: Introduction: The Radiographic Assessment of Lung Edema (RALE) score provides a semi-quantitative measure of pulmonary edema. In patients with acute respiratory distress syndrome (ARDS), the RALE score is associated with mortality. In mechanically ... ...

Abstract	Introduction: The Radiographic Assessment of Lung Edema (RALE) score provides a semi-quantitative measure of pulmonary edema. In patients with acute respiratory distress syndrome (ARDS), the RALE score is associated with mortality. In mechanically ventilated patients in the intensive care unit (ICU) with respiratory failure not due to ARDS, a variable degree of lung edema is observed as well. We aimed to evaluate the prognostic value of RALE in mechanically ventilated ICU patients. Methods: Secondary analysis of patients enrolled in the 'Diagnosis of Acute Respiratory Distress Syndrome' (DARTS) project with an available chest X-ray (CXR) at baseline. Where present, additional CXRs at day 1 were analysed. The primary endpoint was 30-day mortality. Outcomes were also stratified for ARDS subgroups (no ARDS, non-COVID-ARDS and COVID-ARDS). Results: 422 patients were included, of which 84 had an additional CXR the following day. Baseline RALE scores were not associated with 30-day mortality in the entire cohort (OR: 1.01, 95% CI: 0.98-1.03, Conclusions: The prognostic value of the RALE score cannot be extended to mechanically ventilated ICU patients in general. Only in ARDS patients, early changes in RALE score were associated with mortality.
Language	English
Publishing date	2023-02-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12041252
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