Apheresis for severe malaria complicated by cerebral malaria, acute respiratory distress syndrome, acute renal failure, and disseminated intravascular coagulation

1992 ◽  
Vol 7 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Giuseppe Lercari ◽  
Giorgio Paganini ◽  
Libera Malfanti ◽  
Davide Rolla ◽  
Anna Maria Machi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cerebral Malaria ◽  
Severe Malaria ◽  
Disseminated Intravascular Coagulation ◽  
Distress Syndrome ◽  
Intravascular Coagulation

scholarly journals Histological Changes in the Components of Aerogematic Barrier in 24 Hours after Modeling of Acute Renal Failure

2021 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
I. P. Klishch ◽  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Ultrastructural Changes ◽  
Blood Capillaries

Nowadays, acute renal failure remains one of the most complex problems in modern medicine. Multiple studies have proved that acute renal failure is frequently accompanied by the development of acute lung injury and its most severe form – acute respiratory distress syndrome. According to the literature, lethality in case of acute lung injury or acute respiratory distress syndrome is extremely high and is 30-65%. In case of combination of acute renal failure and acute lung injury or acute respiratory distress syndrome, the most frequently observed in critical patients, lethality reaches 80%. The purpose of the study was to study the possibility of ultrastructural changes of the respiratory tract in the lungs due to experimental modeling of acute renal failure. Materials and methods. The experiments were performed on 30 mature white male rats weighting 180-220 grams. Acute renal failure was induced by intramuscular administration of 50% glycerol water solution in dose of 10 ml per 1 kg of body mass. The sampling of lung tissue for electron microscopy study was carried out under the ketamine anaesthesia in 24 hours after beginning of the experiment. The pieces of lung tissue were fixed in 2.5% solution of gluteraldehyde with further postfixation in 1% solution of osmium tetroxide. After dehydration, the material was poured over epon araldite. The cuts, obtained on ultramicrotome “Tesla BS-490”, were studied using electron microscope “PEM-125K”. Results and discussion. In 24 hours after the beginning of the experiment, the changes in the alveolocytes of types I and II, endotheliocytes, alveolar macrophages are accompanied by the development of intracellular edema with ultrastructural disorder of organelles. Because of endotheliocytes edema and aggregation of forming blood elements, some blood capillaries lumens are closed or drastically narrowed. In some blood capillaries, we observe disorder of the luminal membrane integrity of endothelial cells accompanied by exit of the intracellular content into the micro blood vessel lumen. The expressed disorders of structural organization of the components of pulmonary aero-hematic barrier cause the exit of forming blood elements into the interstitial tissue and alveoli. Conclusion. Тhe detected changes in 24 hours of the experiment have a dystrophic-destructive character and are manifested by the development of edema in alveolocytes of types I and II, alveolar macrophages, endotheliocytes of hemocapillaries. Perspective for further research. Considering the severity of ultrastructural changes that develop in experimental acute renal failure, it would be reasonable to conduct a further study in order to find possible methods of prevention and timely correction

scholarly journals Recombinant Human Thrombomodulin for Pneumonia-Induced Severe Acute Respiratory Distress Syndrome Complicated by Disseminated Intravascular Coagulation in Children: A feasibility study

2019 ◽  
Author(s):  
Naoyuki Hirata ◽  
Dong Tien Ngo ◽  
Phuc Huu Phan ◽  
Akira Ainai ◽  
Thuy Thi Bich Phung ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Feasibility Study ◽  
Disseminated Intravascular Coagulation ◽  
Distress Syndrome ◽  
Laboratory Findings ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Cardiopulmonary Support

Abstract Background Recombinant human soluble thrombomodulin (rTM) has been used to treat disseminated intravascular coagulation (DIC). Recent studies have shown the efficacy of rTM through its anti-inflammatory effects for treatment of adults with acute respiratory distress syndrome (ARDS). However, the safety and efficacy of rTM in children with severe ARDS complicated by DIC have not been reported. In this study, we investigated the feasibility of using rTM for the treatment of pneumonia-induced severe ARDS complicated by DIC in children. Methods Six children (age: median 10 month-old) with pneumonia-induced severe ARDS complicated by DIC were enrolled in this feasibility study. rTM (380 U/kg) was administered for a maximum of 6 days, in addition to conventional therapies including cardiopulmonary support, antibiotics and/or antivirus drugs administration, steroid administration and intravenous immunoglobulin after diagnosis of severe ARDS complicated by DIC. After administration of rTM, we measured changes in the plasma TM concentration and evaluated the clinical course, status of DIC and ARDS, and other laboratory findings, including levels of cytokines, chemokines, and biomarkers. Results In all six children, the plasma concentration of TM increased and DIC scores decreased after administration of rTM. Four of the six children recovered from the severe ARDS complicated by DIC after treatment in the pediatric intensive care unit, and were discharged from the hospital with no complications. In surviving children, levels of soluble receptors for advanced glycation end products, interleukin-6, interleukin-8 and monocyte chemotactic protein-1 decreased after administration of rTM. Conclusions The rTM administration is feasible as a therapeutic strategy for children over 2 months with pneumonia-induced severe ARDS complicated by DIC.

scholarly journals Features of imported falciparum malaria: the case report

2021 ◽  
pp. 68-73
Author(s):  
O. Golubovska ◽  
O. Gudzenko ◽  
A. Zaplotna ◽  
I. Shestakova ◽  
O. Bezrodna ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Falciparum Malaria ◽  
Clinical Case ◽  
Distress Syndrome ◽  
Severe Anemia

The clinical case of imported falciparum malaria is described in the article. The diagnosis was confirmed on the 6-th day of the disease when cerebral presentations manifested. The course of the disease was severe and it was characterized by serious complications due to late diagnosis and starting of treatment: malaria coma, malaria alhid, acute respiratory distress syndrome, nozocomial pneumonia, acute renal failure, malaria hepatitis, severe hemolytic anemia. The patient recovered. Presentations of severe anemia progressed after plasmodium disappearance in the blood and persisted after discharge of patient from the hospital.

scholarly journals CLINICAL COURSE AND OUTCOME OF COVID-19 ACUTE RESPIRATORY DISTRESS SYNDROME: DATA FROM A NATIONAL REPOSITORY

2020 ◽  
Author(s):  
Ali A. El-Solh ◽  
Umberto G. Meduri ◽  
Yolanda Lawson ◽  
Michael Carter ◽  
Kari A. Mergenhagen
Keyword(s):  
Septic Shock ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Hospitalized Patients ◽  
Historical Cohort ◽  
Risk Of Death

ABSTRACTBackgroundMortality attributable to coronavirus disease-19 (COVID-19) 2 infection occurs mainly through the development of viral pneumonia-induced acute respiratory distress syndrome (ARDS).Research QuestionThe objective of the study is to delineate the clinical profile, predictors of disease progression, and 30-day mortality from ARDS using the Veterans Affairs Corporate Data Warehouse.Study Design and MethodsAnalysis of a historical cohort of 7,816 hospitalized patients with confirmed COVID-19 infection between January 1, 2020, and August 1, 2020. Main outcomes were progression to ARDS and 30-day mortality from ARDS, respectively.ResultsThe cohort was comprised predominantly of men (94.5%) with a median age of 69 years (interquartile range [IQR] 60-74 years). 2,184 (28%) were admitted to the intensive care unit and 643 (29.4%) were diagnosed with ARDS. The median Charlson Index was 3 (IQR 1-5). Independent predictors of progression to ARDS were body mass index (BMI)≥ 40 kg/m2, diabetes, lymphocyte counts<700×109/L, LDH>450 U/L, ferritin >862 ng/ml, C-reactive protein >11 mg/dL, and D-dimer >1.5 ug/ml. In contrast, the use of an anticoagulant lowered the risk of developing ARDS (OR 0.66 [95% CI 0.49-0.89]. Crude 30-day mortality rate from ARDS was 41% (95% CI 38%-45%). Risk of death from ARDS was significantly higher in those who developed acute renal failure and septic shock. Use of an anticoagulant was associated with two-fold reduction in mortality. Survival benefit was observed in patients who received corticosteroids and/or remdesivir but there was no advantage of combination therapy over either agent alone.ConclusionsAmong those hospitalized for COVID-19, nearly one in ten progressed to ARDS. Septic shock, and acute renal failure are the leading causes of death in these patients. Treatment with either remdesivir and corticosteroids reduced the risk of mortality from ARDS. All hospitalized patients with COVID-19 should be placed at a minimum on prophylactic doses of anticoagulation.

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