Einzeltreffer — DigiBib

Background: Neuromuscular blockade (NMB) is a therapy for acute respiratory distress syndrome (ARDS). However, the mechanism by which NMB may improve outcome for ARDS patients remains unclear. We sought to determine whether NMB attenuates biomarkers of epithelial and endothelial lung injury and systemic inflammation in ARDS patients, and whether the association is dependent on tidal volume size and the initial degree of hypoxemia.

Methods: We performed a secondary analysis of patients enrolled in the ARDS network low tidal volume ventilation (ARMA) study. Our primary predictor variable was the number of days receiving NMB between study enrollment and day 3. Our primary outcome variables were the change in concentration of biomarkers of epithelial injury (serum surfactant protein-D (SP-D)), endothelial injury (von Willebrand factor (VWF)), and systemic inflammation (interleukin (IL)-8). Multivariable regression analysis was used to compare the change in biomarker concentration controlling for multiple covariates. Patients were stratified by treatment arm (12 versus 6 cm 3 /kg) and by an initial arterial oxygen tension (PaO 2 ) to fractional inspired oxygen (FiO 2 ) (P/F) ratio of 120.

Results: A total of 446 (49%) patients had complete SP-D, VWF, and IL-8 measurements on study enrollment and day 3. After adjusting for baseline differences, each day of NMB was associated with a decrease in SP-D (-23.7 ng/ml/day, p = 0.029), VWF (-33.5% of control/day, p = 0.015), and IL-8 (-362.6 pg/ml/day, p = 0.030) in patients with an initial P/F less than or equal to 120 and receiving low tidal volume ventilation. However, patients with a P/F ratio of greater than 120 or receiving high tidal volume ventilation had either no change or an increase in SP-D, WVF, or IL-8 concentrations.

Conclusion: NBM is associated with decreased biomarkers of epithelial and endothelial lung injury and systemic inflammation in ARDS patients receiving low tidal volume ventilation and those with a P/F ratio less than or equal to 120.

Titel:	Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with moderate-to-severe acute respiratory distress syndrome.
Autor/in / Beteiligte Person:	Sottile, PD ; Albers, D ; Moss, MM
Link:	View record at Springer (Volltext)
Zeitschrift:	Critical care (London, England), Jg. 22 (2018-03-10), Heft 1, S. 63
Veröffentlichung:	London, UK : BioMed Central Ltd ; <i>Original Publication</i>: London : Current Science Ltd, c1997-, 2018
Medientyp:	academicJournal
ISSN:	1466-609X (electronic)
DOI:	10.1186/s13054-018-1974-4
Schlagwort:	Adult Aged Analysis of Variance Biomarkers analysis Biomarkers blood Cohort Studies Female Humans Interleukin-8 analysis Interleukin-8 blood Male Middle Aged Multivariate Analysis Neuromuscular Blockade methods Prospective Studies Pulmonary Surfactant-Associated Protein D analysis Pulmonary Surfactant-Associated Protein D blood Respiratory Distress Syndrome blood Tidal Volume physiology von Willebrand Factor analysis Neuromuscular Blockade adverse effects Respiratory Distress Syndrome physiopathology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Crit Care] 2018 Mar 10; Vol. 22 (1), pp. 63. <i>Date of Electronic Publication: </i>2018 Mar 10. MeSH Terms: Neuromuscular Blockade / adverse effects ; Respiratory Distress Syndrome / physiopathology ; Adult ; Aged ; Analysis of Variance ; Biomarkers / analysis ; Biomarkers / blood ; Cohort Studies ; Female ; Humans ; Interleukin-8 / analysis ; Interleukin-8 / blood ; Male ; Middle Aged ; Multivariate Analysis ; Neuromuscular Blockade / methods ; Prospective Studies ; Pulmonary Surfactant-Associated Protein D / analysis ; Pulmonary Surfactant-Associated Protein D / blood ; Respiratory Distress Syndrome / blood ; Tidal Volume / physiology ; von Willebrand Factor / analysis References: N Engl J Med. 2010 Sep 16;363(12):1176-80. (PMID: 20843254) ; Crit Care Med. 2008 Nov;36(11):3019-23. (PMID: 18824913) ; Thorax. 2003 Nov;58(11):983-8. (PMID: 14586055) ; N Engl J Med. 2010 Sep 16;363(12):1107-16. (PMID: 20843245) ; Crit Care Med. 2003 Jan;31(1):20-7. (PMID: 12544988) ; Am Rev Respir Dis. 1974 Nov;110(5):556-65. (PMID: 4611290) ; N Engl J Med. 2013 Aug 1;369(5):428-37. (PMID: 23902482) ; Crit Care Med. 2001 Dec;29(12):2325-31. (PMID: 11801836) ; Intensive Care Med. 2016 Sep;42(9):1427-36. (PMID: 27342819) ; N Engl J Med. 2000 May 4;342(18):1301-8. (PMID: 10793162) ; JAMA. 2016 Feb 23;315(8):788-800. (PMID: 26903337) ; Chest. 2015 Jun;147(6):1539-1548. (PMID: 26033126) ; Crit Care Med. 2006 Nov;34(11):2749-57. (PMID: 16932229) ; Ann N Y Acad Sci. 1975 Sep 30;258:190-200. (PMID: 941) ; Anesthesiology. 2016 May;124(5):1100-8. (PMID: 26872367) ; Am J Respir Crit Care Med. 1995 Jan;151(1):15-20. (PMID: 7812545) ; Lancet Respir Med. 2014 Aug;2(8):611-20. (PMID: 24853585) ; Crit Care Med. 2012 Jun;40(6):1731-7. (PMID: 22610178) ; Anesthesiology. 2016 Jan;124(1):132-40. (PMID: 26540149) ; J Clin Invest. 1990 Aug;86(2):474-80. (PMID: 2384595) ; Annu Rev Pathol. 2011;6:147-63. (PMID: 20936936) ; Am J Respir Crit Care Med. 2017 Apr 15;195(8):1033-1042. (PMID: 27748627) Grant Information: R01 LM006910 United States LM NLM NIH HHS; UL1TR001082 National Institutes of Health; LM06910 National Library of Medicine; UL1 TR001082 United States TR NCATS NIH HHS; HL069223 National Institutes of Health Contributed Indexing: Keywords: Adult; Biomarkers; Mechanical; Neuromuscular blockade; Respiratory distress syndrome; Ventilator-induced lung injury; Ventilators Substance Nomenclature: 0 (Biomarkers) ; 0 (CXCL8 protein, human) ; 0 (Interleukin-8) ; 0 (Pulmonary Surfactant-Associated Protein D) ; 0 (von Willebrand Factor) Entry Date(s): Date Created: 20180311 Date Completed: 20181001 Latest Revision: 20201209 Update Code: 20231215 PubMed Central ID: PMC5845220

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with moderate-to-severe acute respiratory distress syndrome.