never before appreciated physical location of my heart wrt other organs as much as while reading ...
Custom machine kept man alive without #lungs for 48 hours: Infections had turned his lungs to soup and had to be cleared before transplant, 20260129,
by Jacek K,
https://arstechnica.com/health/2026/01/custom-machine-kept-man-alive-without-lungs-for-48-hours/
#acuteRespiratoryDistressSyndrome #ARDS #bacterialInfection #health #humanPhysiology
'Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India' - a #JaypeeJournals UN #SDG03 article on #ScienceOpen:
🔓🔗 https://www.scienceopen.com/document?vid=d8600d43-91fe-4b4f-b1b6-754307deb66b
#AdenoviralPneumonia #PediatricCriticalCare #ARDS #GlobalHealth
<div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e210"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e211">Background and aims</h5> <p dir="auto" id="d874711e213">Adenoviral pneumonia is a significant cause of morbidity and mortality among children. There is limited data about the clinical profile, intensive care needs, and outcomes of children with adenoviral pneumonia from resource-limited settings. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e215"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e216">Patients and methods</h5> <p dir="auto" id="d874711e218">This retrospective study was conducted in the pediatric emergency room (PER) and pediatric intensive care unit (PICU) of a tertiary care hospital in North India over a period of a period of 2 years (July 2022 to June 2024). The data collection included demographic and clinical features, laboratory investigations, complications, treatment, intensive care needs, and outcomes. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e220"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e221">Results</h5> <p dir="auto" id="d874711e223">Eighty-five children were enrolled, majority were <1 year of age and males (71.7% each). All presented with fever and respiratory symptoms. The common complications were acute respiratory distress syndrome (ARDS) (47%), multiple organ dysfunction syndrome (MODS) (26%), shock (25%), and encephalopathy (25%). PICU admission was needed in 46% of children. The intensive care needs included invasive mechanical ventilation (48%), CPAP (39%), HFNC (9%), vasoactive drugs (25%), IVIG (8%), RRT (6%), and cidofovir (5%). The duration of ER, PICU, and hospital stay was 48 (24–96) hours, 7 (4–14) days, and 9 (5–18) days, respectively. The mortality rate was 22%. On multivariate analysis, the independent predictors of mortality were low admission pH, myocardial dysfunction, acute kidney (AKI), ARDS, shock, encephalopathy, MODS, and healthcare-associated infection (HCAI). </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e225"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e226">Conclusion</h5> <p dir="auto" id="d874711e228">Infants constituted the largest group of patients requiring admission for adenoviral infection to pediatric emergency in a tertiary care center. Common complications were ARDS, shock, MODS, and encephalopathy. Nearly half required PICU admission for organ support. The mortality rate was 22%; and low admission pH, myocardial dysfunction, AKI, ARDS, shock, encephalopathy, MODS, and HCAI were independent predictors of mortality. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d874711e230"> <!-- named anchor --> </a> <h5 class="section-title" id="d874711e231">How to cite this article</h5> <p dir="auto" id="d874711e233">Vyasam S, Jayaram J, Sarkar S, Angurana SK, Raj S, Bora I, <i>et al</i>. Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India. Indian J Crit Care Med 2025;29(7):586–591. </p> </div>
'Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study' - a #JaypeeJournals 'Preventive and Emergency Medicine Insights' publication on #ScienceOpen:
📄🔓 https://www.scienceopen.com/document?vid=ef4064ab-03e0-469c-a83e-efd50f96cce2
#ARDS #GlobalARDSDefinition #HFNO #CriticalCare #COVID19Research
<div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d893418e180"> <!-- named anchor --> </a> <h5 class="section-title" id="d893418e181">Background and aims</h5> <p dir="auto" id="d893418e183">A recent acute respiratory distress syndrome (ARDS) definition included patients receiving high-flow nasal oxygen (HFNO) when fulfilling the oxygenation and radiological criteria of ARDS Berlin definition. However, outcome of patients treated may be better than those who fulfilled the corresponding class of Berlin definition. This study was aimed to compare the survival between patients fulfilling Berlin definition and patients managed by HFNO initially. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d893418e185"> <!-- named anchor --> </a> <h5 class="section-title" id="d893418e186">Patients and methods</h5> <p dir="auto" id="d893418e188">Patients fulfilling the World Health Organization case definition of severe or critical COVID-19 infection requiring HFNO (at least 30 L/minute of flow), noninvasive ventilation (NIV) (at least a positive end-expiratory pressure (PEEP) of 5 cm H <sub>2</sub>O), or invasive mechanical ventilation (at least a PEEP of 5 cm H <sub>2</sub>O) were included in this study provided they fulfilled oxygenation and radiological criteria of ARDS as per Berlin definition. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d893418e196"> <!-- named anchor --> </a> <h5 class="section-title" id="d893418e197">Results</h5> <p dir="auto" id="d893418e199">All-cause hospital mortality rate in patients who fulfilled Berlin definition ( <i>n</i> = 193) was 47.6% (mild ARDS), 64.9% (moderate ARDS), and 67.9% (severe ARDS) ( <i>p</i> = 0.23). Multivariable survival analysis reported that hazard of death was higher in patients who fulfilled Berlin definition as opposed to those who were initially managed by HFNO (adjusted hazard ratio (95% confidence interval) 1.68 (1.15–2.45), <i>p</i> = 0.007) after adjustment for age, Charlson comorbidity index, and baseline PaO <sub>2</sub>/FiO <sub>2</sub> ratio. Multiple pairwise comparison reported that hazard of death was lower in patients with moderate ARDS requiring HFNO as compared with the moderate ARDS patients as per Berlin definition ( <i>p</i> = 0.024). However, no difference was observed in patients of mild ( <i>p</i> = 0.39) and severe ARDS ( <i>p</i> = 0.24). </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d893418e226"> <!-- named anchor --> </a> <h5 class="section-title" id="d893418e227">Conclusion</h5> <p dir="auto" id="d893418e229">We have found a statistically significant higher survival in ARDS patients managed by HFNO in the first 24 hours after intensive care unit (ICU) admission when compared with the patients receiving NIV or invasive mechanical ventilation. So, we conclude that outcome of patients fulfilling the global definition of ARDS is largely different from those who fulfilled Berlin definition. Hence, prospective multicentric validation is required before its bedside use. </p> </div><div xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="section"> <a class="named-anchor" id="d893418e231"> <!-- named anchor --> </a> <h5 class="section-title" id="d893418e232">How to cite this article</h5> <p dir="auto" id="d893418e234">Maitra S, Baidya DK, Ray BR, Kayina CA, Haritha D, Nair PR, <i>et al</i>. Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study. Indian J Crit Care Med 2025;29(7):556–561. </p> </div>
Precision mRNA Nanomedicine for Targeted Vascular Therapies in ARDS & Atherosclerosis
https://www.science.org/content/article/new-nanoparticle-therapies-target-two-major-killers
https://www.biorxiv.org/content/10.1101/2025.01.09.632179v1
https://news.ycombinator.com/item?id=43535352
Nanoparticle therapies target two major killers
* ARDS: acute respiratory distress syndrome
* atherosclerosis
#nanoparticles #mRNA #ARDS #RespiratoryDistress #VascularDisease #atherosclerosis
Mhm ob cash wirklich gegen #ards hilft?🤔
https://en.m.wikipedia.org/wiki/Acute_respiratory_distress_syndrome
But yes, it's #BusinessAsUsual because #Crapitalism requires people to #ConsumeConsumeConsume!
Canadian teen with #BirdFlu was on #LifeSupport, new report reveals
The hospitalized teen was also given three #antiviral treatments, underscoring how severe #H5N1 infection can be
By Nicole Karlis, January 6, 2025
"In November, a teenager in British Columbia was infected and hospitalized with bird flu, caused by the H5N1 virus. While most cases have been mild, commonly characterized by #conjunctivitis and respiratory symptoms, this previously healthy Canadian teen was hospitalized from the virus in critical condition. Their symptoms started with double conjunctivitis, also known as pink eye, and turned into a fever and coughing. A few days later the teenager was admitted to intensive care after developing acute respiratory distress syndrome [#ARDS].
"'This was a healthy teenager prior to this, so no underlying conditions,' said British Columbia’s health officer, Bonnie Henry, at a news conference at the time. 'It just reminds us that in young people this is a virus that can progress and cause quite severe illness.'
"Now, a recent report brings to light more details about the teenager’s case. In the report, published in the New England Journal of Medicine (NEJM), researchers explain that the 13-year-old girl spent weeks fighting for her life after contracting a severe H5N1 infection from an unknown source. In finding her diagnosis, researchers say that she initially tested positive for influenza A, but not the seasonal subtype. Further testing suggested she had a high viral load of a novel influenza A infection, which researchers discovered to be the H5N1 avian flu.
"The next day doctors started her on oseltamivir, also known under the brand name Tamiflu. However, her respiratory functions declined rapidly causing her to be intubated. She was also placed on extracorporeal membrane oxygenation (ECMO), a machine that is a form of life support for people with life-threatening illnesses. In addition to the ECMO machine, the teenager received a plasma exchange and two more antiviral medication treatments — amantadine and baloxavir.
"In an accompanying editorial, experts noted while mutations were detected in her case, it’s 'unclear whether these #mutations were present in the infecting virus or emerged during the course of the patient’s illness.'
"In other words, it’s unclear if the virus #mutated to be more severe in humans.
"'The mutations evident in the Canadian case highlight the urgent need for vigilant surveillance of emerging mutations and assessment of the threat of human-to-human transmission,' the editorial stated, adding that vaccine development and therapeutics are also needed — perhaps to treat more severe illness. 'The Canadian case showed higher viral loads in the lower airway and very prolonged shedding, despite therapy, which highlights the potential need for longer therapy.'
"Researchers concluded their editorial with an acknowledgment that 'many questions remain.' For example, the severity of cases is likely to depend on host immunity, the route of exposure, or other changes in the virus.
"Currently, the CDC says that the risk to most Americans remains low.
"'We do have candidate vaccines and antivirals available to try to mitigate severe influenza in the case of wider spread,' the report stated. 'That said, a balance between enhanced vigilance and ‘business as usual’ is needed."
https://www.salon.com/2025/01/06/new-report-on-severe-case-of-canadian-teen-with-bird-flu/
#HPAI #BirdFluMutations #Flu
"Canadian teen in critical condition with suspected bird flu; source of exposure is unknown
The teen has been receiving care at BC Children’s Hospital in Vancouver since Friday, the same day an initial test came back positive for H5 influenza. Government testing confirmed that the strain is H5N1. The young person’s first symptoms, which began a week before they were hospitalized, were conjunctivitis or red eyes, fever and cough, said Dr. Bonnie Henry, an epidemiologist who is the provincial health officer for British Columbia. The illness has progressed to acute respiratory distress syndrome, or ARDS. People with ARDS typically need help breathing with machines such as a ventilator, but officials did not offer specifics on the teen’s treatment except to say they’re receiving antiviral medications. This is the first known human case of bird flu acquired in Canada. The country had one case in 2014, which was travel-related, Henry said. It is still unknown how the teen caught this strain of flu, which has been circulating widely in wild birds, poultry and some mammals, including cattle in North America since 2022."
Source: CNN, shared by Adam Tooze https://adamtooze.substack.com/
A newsletter on economics, geopolitics and history from Adam Tooze. More substantial than the twitter feed. More freewheeling than what you might read from me in FT, Foreign Policy, New Statesman. Click to read Chartbook, by Adam Tooze, a Substack publication with hundreds of thousands of subscribers.
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