AIMS: Among patients with cardiogenic shock, immediate initiation of extracorporeal membrane oxygenation (ECMO) did not demonstrate any benefit at 30 days. The present study evaluated 1-year clinical outcomes of the Extracorporeal Membrane Oxygenation in the therapy of Cardiogenic Shock (ECMO-CS) trial. METHODS AND RESULTS: The ECMO-CS trial randomized 117 patients with severe or rapidly progressing cardiogenic shock to immediate initiation of ECMO or early conservative strategy. The primary endpoint for this analysis was 1-year all-cause mortality. Secondary endpoints included a composite of death, resuscitated cardiac arrest or implantation of another mechanical circulatory support device, duration of mechanical ventilation, and the length of intensive care unit (ICU) and hospital stays. In addition, an unplanned post-hoc subgroup analysis was performed. At 1 year, all-cause death occurred in 40 of 58 (69.0%) patients in the ECMO arm and in 40 of 59 (67.8%) in the early conservative arm (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.66-1.58; p = 0.93). The composite endpoint occurred in 43 (74.1%) patients in the ECMO group and in 47 (79.7%) patients in the early conservative group (HR 0.83, 95% CI 0.55-1.25; p = 0.29). The durations of mechanical ventilation, ICU stay and hospital stay were comparable between groups. Significant interaction with treatment strategy and 1-year mortality was observed in subgroups according to baseline mean arterial pressure (MAP) indicating lower mortality in the subgroup with low baseline MAP (<63 mmHg: HR 0.58, 95% CI 0.29-1.16; pinteraction = 0.017). CONCLUSIONS: Among patients with severe or rapidly progressing cardiogenic shock, immediate initiation of ECMO did not improve clinical outcomes at 1 year compared to the early conservative strategy. However, immediate ECMO initiation might be beneficial in patients with advanced haemodynamic compromise.
- MeSH
- Time Factors MeSH
- Intensive Care Units MeSH
- Shock, Cardiogenic * therapy mortality MeSH
- Middle Aged MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation * methods MeSH
- Survival Rate trends MeSH
- Aged MeSH
- Respiration, Artificial methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
OBJECTIVES: To evaluate the effect of short-term inhalational exposure to nanoparticles released during dental composite grinding on oxidative stress and antioxidant capacity markers. MATERIALS AND METHODS: Twenty-four healthy volunteers were examined before and after exposure in dental workshop. They spent 76.8 ± 0.7 min in the testing room during grinding of dental nanocomposites. The individual exposure to aerosol particles in each participant ́s breathing zones was monitored using a personal nanoparticle sampler (PENS). Exhaled breath condensate (EBC), blood, and urine samples were collected pre- and post-exposure to measure one oxidative stress marker, i.e., thiobarbituric acid reactive substances (TBARS), and two biomarkers of antioxidant capacity, i.e., ferric-reducing antioxidant power (FRAP) and reduced glutathione (GSH) by spectrophotometry. Spirometry and fractional exhaled nitric oxide (FeNO) were used to evaluate the effect of acute inhalational exposure. RESULTS: Mean mass of dental nanocomposite ground away was 0.88 ± 0.32 g. Average individual doses of respirable particles and nanoparticles measured by PENS were 380 ± 150 and 3.3 ± 1.3 μg, respectively. No significant increase of the post-exposure oxidative stress marker TBARS in EBC and plasma was seen. No decrease in antioxidant capacity biomarkers FRAP and GSH in EBC post-exposure was seen, either. Post-exposure, conjunctival hyperemia was seen in 62.5% volunteers; however, no impairment in spirometry or FeNO results was observed. No correlation of any biomarker measured with individual exposure was found, however, several correlations with interfering factors (age, body mass index, hypertension, dyslipidemia, and environmental pollution parameters) were seen. CONCLUSIONS: This study, using oxidative stress biomarker and antioxidant capacity biomarkers in biological fluids of volunteers during the grinding of dental nanocomposites did not prove a negative effect of this intense short-term exposure. However, further studies are needed to evaluate oxidative stress in long-term exposure of both stomatologists and patients and diverse populations with varying health statuses.
- MeSH
- Antioxidants analysis MeSH
- Biomarkers * analysis MeSH
- Breath Tests MeSH
- Adult MeSH
- Glutathione analysis MeSH
- Inhalation Exposure * adverse effects analysis MeSH
- Thiobarbituric Acid Reactive Substances analysis MeSH
- Humans MeSH
- Nanocomposites * chemistry MeSH
- Nitric Oxide analysis metabolism MeSH
- Oxidative Stress * MeSH
- Occupational Exposure * analysis adverse effects MeSH
- Dentists MeSH
- Dental Materials MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
3-methylglutaconic aciduria (3-MGCA) is a biochemical finding in a diverse group of inherited metabolic disorders. Conditions manifesting 3-MGCA are classified into two major categories, primary and secondary. Primary 3-MGCAs involve two inherited enzymatic deficiencies affecting leucine catabolism, whereas secondary 3-MGCAs comprise a larger heterogeneous group of conditions that have in common compromised mitochondrial energy metabolism. Here, we report 3-MGCA in two siblings presenting with sensorineural hearing loss and neurological abnormalities associated with a novel, homozygous missense variant (c.1999C>G, p.Leu667Val) in the YME1L1 gene which encodes a mitochondrial ATP-dependent metalloprotease. We show that the identified variant results in compromised YME1L1 function, as evidenced by abnormal proteolytic processing of substrate proteins, such as OPA1 and PRELID1. Consistent with the aberrant processing of the mitochondrial fusion protein OPA1, we demonstrate enhanced mitochondrial fission and fragmentation of the mitochondrial network in patient-derived fibroblasts. Furthermore, our results indicate that YME1L1L667V is associated with attenuated activity of rate-limiting Krebs cycle enzymes and reduced mitochondrial respiration, which may explain the build-up of 3-methylglutaconic and 3-methylglutaric acid due to the diversion of acetyl-CoA, not efficiently processed in the Krebs cycle, towards the formation of 3-methylglutaconyl-CoA, the precursor of these metabolites. In summary, our findings classify YME1L1 deficiency as a new type of secondary 3-MGCA, thus expanding the genetic landscape and facilitating the diagnosis of inherited metabolic disorders featuring this biochemical phenotype.
- MeSH
- Child MeSH
- Fibroblasts metabolism MeSH
- Glutarates MeSH
- Humans MeSH
- Metalloendopeptidases * genetics metabolism MeSH
- Mutation, Missense MeSH
- Mitochondrial Dynamics MeSH
- Mitochondrial Proteins * genetics MeSH
- Mitochondria metabolism MeSH
- Hearing Loss, Sensorineural genetics MeSH
- Siblings MeSH
- Metabolism, Inborn Errors * genetics MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
U pacientů s časným karcinomem hrtanu je v současnosti chirurgická léčba zachovávající funkci hrtanu preferovanou primární léčebnou modalitou. Cílem je odstranění karcinomu hrtanu s negativními okraji se současným zachováním přiměřené kvality hlasu a dýchání bez nutnosti tracheostomie. Mezi chirurgické postupy šetřící hrtan patří transorální endoskopická chirurgie, robotická mikrochirurgie hrtanu a vertikální parciální laryngektomie ze zevního přístupu (VPL). Cíl: Cílem studie bylo analyzovat faktory, které jsou zohledňovány při současných indikacích parciálních laryngektomií prováděných ze zevního přístupu pro glotický karcinom a zhodnotit chirurgické a onkologické výsledky těchto operací. Materiál a metodika: Do retrospektivní studie bylo zařazeno 18 pacientů, u nichž byla od 1. 1. 2012 do 31. 12. 2022 na Klinice otorinolaryngologie a chirurgie hlavy a krku FN u sv. Anny v Brně provedena VPL pro glotický spinocelulární karcinom. U 12 (67 %) pacientů byla předléčebná klasifikace nádoru cT1, u 6 (33 %) pacientů cT2. Nejčastěji prováděným výkonem byla laryngofi sura s rozšířenou chordektomií, která byla indikována u 17 (94 %) pacientů; frontální parciální laryngektomie byla provedena u jednoho pacienta (6 %). Nejčastější indikací k VPL byla konverze původně zvoleného endoskopického přístupu u 10 (56 %) pacientů, u 3 (17 %) pacientů se jednalo o revizní výkon po neradikálním endoskopické operaci a v 5 (28 %) případech byla VPL indikována z jiných důvodů. Výsledky: Mezi nejvýznamnější klinické rizikové faktory zohledněné při indikaci VPL patřily: omezená expozice nitra hrtanu v 11 případech, infiltrace přední komisury v 10 případech, šíření nádoru do paraglotického prostoru v 5 případech, subglotická propagace ve 4 případech, postižení processus vocalis ve 3 případech a nádorové šíření do laryngeálního ventrikulu ve 3 případech. Hodnocení resekčních okrajů prokázalo negativní resekční okraje (R0) u 8 (44 %) pacientů, blízké okraje (R0) u 6 (33 %) pacientů a pozitivní resekční okraje (R1) u 4 (22 %) pacientů. Pooperační průběh byl u většiny pacientů příznivý, přičemž u 15 (71 %) pacientů nenastaly žádné komplikace. Mírné lokální komplikace se vyskytly u 5 (24 %) pacientů, zatímco závažné komplikace nebyly zaznamenány u žádného z nich. Medián doby sledování činil 3,0 roku s interkvartilovým rozptylem 2,0 až 5,0 let. U jednoho pacienta byla dia- gnostikována recidiva karcinomu po VPL a adjuvantní radioterapii. U tohoto pacienta byla finálně indikována záchranná totální laryngektomie. Pravděpodobnost přežití byla stanovena Kaplan-Meierovou analýzou: 1 rok 90,5 %; 2 roky 85,7 %; 3 roky 85,7 %; 4 roky 77,1 %; 5 let 66,1 %. Závěr: Ačkoli jsou indikace pro zevní přístupy v současnosti velmi omezené, VPL stále představují záložní chirurgickou variantu u pacientů s omezenou expozicí vnitra hrtanu a u glotických nádorů postihujících rizikové anatomické sublokality, především přední komisuru a paraglotický prostor. I s ohledem na naše výsledky lze laryngofisuru s rozšířenou chordektomií považovat za hrtan šetřicí postup, který nabízí funkčně přijatelné a onkologicky srovnatelné výsledky léčby časného glotického karcinomu v porovnání s preferovanými endoskopickými přístupy a radioterapií.
For patients with early-stage laryngeal carcinoma, function-preserving surgical treatment is currently the preferred primary therapeutic modality. The goal is to achieve complete tumor removal with negative margins while preserving adequate voice quality and respiration without the need for a tracheostomy. Larynx-preserving surgical approaches include transoral endoscopic surgery, robotic microlaryngeal surgery, and external vertical partial laryngectomy (VPL). Objective: The aim of this study was to analyze the factors influencing current indications for open partial laryngectomies for glottic carcinoma and to evaluate the surgical and oncological outcomes of these procedures. Materials and methods: 18 patients who underwent VPL for glottic squamous cell carcinoma from 1. 1. 2012 to 31. 12. 2022 at the Department of Otorhinolaryngology and Head and Neck Surgery, St. Anne‘s Hospital in Brno were included in the retrospective study. Pre-treatment tumor classification was cT1 in 12 (67%) patients and cT2 in 6 (33%) patients. The most commonly performed procedure was laryngofissure with extended chordectomy in 17 (94%) patients; frontal partial laryngectomy was performed in one patient (6%). The most frequent indication for VPL was conversion of the initially chosen endoscopic approach in 10 (56%) patients, revision surgery following a non-radical endoscopic procedure in 3 (17%) patients, and other indications in 5 (28%) cases. Results: The most significant clinical risk factors considered in the indication for VPL included: limited exposure of the larynx in 11 cases, anterior commissure infiltration in 10 cases, tumor spread to the paraglottic space in 5 cases, subglottic extension in 4 cases, involvement of the vocal process in 3 cases, and tumor spread to the laryngeal ventricle in 3 cases. Evaluation of resection margins showed negative resection margins (R0) in 8 (44%) patients, close margins (R0) in 6 (33%) patients, and positive resection margins (R1) in 4 (22%) patients. Postoperative course was favorable in most patients, with no complications in 15 (71%) patients. Mild local complications occurred in 5 (24%) patients, while no severe complications were noted in any of them. The median follow-up period was 3.0 years, with an interquartile range of 2.0 to 5.0 years. Recurrence of carcinoma after VPL and adjuvant radiotherapy was diagnosed in one patient, who ultimately underwent salvage total laryngectomy. Survival probability was estimated using the Kaplan-Meier analysis: 1-year survival at 90.5%, 2-year survival at 85.7%, 3-year survival at 85.7%, 4-year survival at 77.1%, and 5-year survival at 66.1%. Conclusion: Although indications for external approaches are currently very limited, VPL still represents a salvage surgical option for patients with limited laryngeal exposure and for glottic tumors affecting high-risk anatomical subsites, particularly the anterior commissure and paraglottic space. Even considering our results, laryngofissure with extended cordectomy can be regarded as a larynx-preserving procedure that offers functionally acceptable and oncologically comparable treatment outcomes for early glottic carcinoma in comparison with preferred endoscopic approaches and radiotherapy.
- MeSH
- Laryngectomy * classification methods statistics & numerical data MeSH
- Larynx surgery pathology MeSH
- Humans MeSH
- Laryngeal Neoplasms surgery diagnosis MeSH
- Otorhinolaryngologic Surgical Procedures methods MeSH
- Retrospective Studies MeSH
- Carcinoma, Squamous Cell surgery diagnosis MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
Graphene-based materials (GBMs) have shown significant promise in cancer therapy due to their unique physicochemical properties, biocompatibility, and ease of functionalization. Their ability to target solid tumors, penetrate the tumor microenvironment (TME), and act as efficient drug delivery platforms highlights their potential in nanomedicine. However, the complex and dynamic nature of the TME, characterized by metabolic heterogeneity, immune suppression, and drug resistance, poses significant challenges to effective cancer treatment. GBMs offer innovative solutions by enhancing tumor targeting, facilitating deep tissue penetration, and modulating metabolic pathways that contribute to tumor progression and immune evasion. Their functionalization with targeting ligands and biocompatible polymers improves their biosafety and specificity, while their ability to modulate immune cell interactions within the TME presents new opportunities for immunotherapy. Given the role of metabolic reprogramming in tumor survival and resistance, GBMs could be further exploited in metabolism-targeted therapies by disrupting glycolysis, mitochondrial respiration, and lipid metabolism to counteract the immunosuppressive effects of the TME. This review focuses on discussing research studies that design GBM nanocomposites with enhanced biodegradability, minimized toxicity, and improved efficacy in delivering therapeutic agents with the intention to reprogram the TME for effective anticancer therapy. Additionally, exploring the potential of GBM nanocomposites in combination with immunotherapies and metabolism-targeted treatments could lead to more effective and personalized cancer therapies. By addressing these challenges, GBMs could play a pivotal role in overcoming current limitations in cancer treatment and advancing precision oncology.
- MeSH
- Graphite * chemistry therapeutic use MeSH
- Immunotherapy methods MeSH
- Drug Delivery Systems methods MeSH
- Humans MeSH
- Tumor Microenvironment * drug effects MeSH
- Neoplasms * drug therapy metabolism MeSH
- Nanocomposites * chemistry therapeutic use MeSH
- Antineoplastic Agents pharmacology therapeutic use MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Mitochondria are central to cellular energy metabolism, contributing to synaptic transmission and plasticity. The mitochondrial membranes present the cannabinoid type-1 receptor (mito-CB1R), which has been functionally linked to neuronal energy supply and cognitive processing. Prenatal exposure to Δ9-tetrahydrocannabinol (pTHC) has been associated with cognitive impairments associated with molecular cellular and functional abnormalities in several brain regions, including the hippocampus. This study aims at assessing whether, besides the memory impairment, pTHC exposure may result in mitochondrial molecular and functional alterations in the hippocampus of the offspring. Moreover, the assessment of CB1R expression is also carried out as a proxy of CB1 signalling in pTHC-exposed offspring. THC (2 mg/Kg), or vehicle, was administered to the dams from gestational day (GD) 5 to GD20, and the offspring were tested for declarative memory using the Novel Object Recognition test in the L-maze. We also assessed: mitochondrial respiration by high-resolution respirometry; mitochondrial respiratory complex-I subunit NDUFS1 protein levels, and mito-CB1R expression by ELISA. Our results revealed: significant memory impairment in pTHC-exposed offspring; attenuated mitochondrial respiration in the hippocampus alongside a marked reduction in complex-I-subunit NDUFS1; a significant increase in mito-CB1R expression. This is the first evidence of pTHC exposure-induced impairment in memory processing in the offspring that suggests a functional link between an attenuation in mitochondrial bioenergetics and abnormal CB1R signalling in the hippocampus.
- MeSH
- Maze Learning drug effects MeSH
- Cell Respiration drug effects MeSH
- Hippocampus * metabolism drug effects MeSH
- Rats MeSH
- Mitochondria * metabolism drug effects MeSH
- Memory drug effects MeSH
- Memory Disorders * metabolism chemically induced MeSH
- Rats, Wistar MeSH
- Receptor, Cannabinoid, CB1 * metabolism MeSH
- Pregnancy MeSH
- Dronabinol * toxicity MeSH
- Prenatal Exposure Delayed Effects * metabolism chemically induced MeSH
- Animals MeSH
- Check Tag
- Rats MeSH
- Male MeSH
- Pregnancy MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
Numerous studies have reported that increased interleukin 6 (IL-6) and soluble IL-6 receptor (sIL-6) levels induce inflammatory conditions. However, the exact mechanisms by which IL-6 drives inflammatory conditions remain unclear. Therefore, we investigated the potential role of IL-6/sIL-6R in inducing energy metabolism, including glycolysis, oxidative phosphorylation, lactate secretion and Akt/mTOR phosphorylation, in Jurkat cells, and whether IL-6 would increase the risk of developing inflammatory conditions due to the high metabolic profile of the T cells. Jurkat CD4 T-cell lines were stimulated with IL-6/sIL-6R for 24 h prior to 48-h stimulation with anti-CD3/CD28. Lactate secretion, glycolysis and oxidative phosphorylation levels were characterized using the Seahorse XF analyser. The Akt and mTOR phosphorylation status was detected using Western blotting. IL-6/sIL-6R significantly induced glycolysis and oxidative phosphorylation and their related parameters, including glycolytic capacity and maximal respiration, followed by significantly increased lactate secretion. Akt and mTOR phosphorylation were increased, which could have resulted from energy metabolism. Here we show that IL-6 enhanced the metabolic profile of Jurkat cells. This effect could have consequences for the metabolism-related signalling pathways, including Akt and mTOR, suggesting that IL-6 might promote T-cell energy metabolism, where T-cell hyperactivity might increase the inflammatory disease risk. The findings should be validated using studies on primary cells isolated from humans.
- MeSH
- Energy Metabolism * drug effects MeSH
- Phosphorylation drug effects MeSH
- Glycolysis drug effects MeSH
- Interleukin-6 * metabolism MeSH
- Jurkat Cells MeSH
- Lactic Acid metabolism MeSH
- Humans MeSH
- Oxidative Phosphorylation drug effects MeSH
- Proto-Oncogene Proteins c-akt * metabolism MeSH
- Signal Transduction * drug effects MeSH
- TOR Serine-Threonine Kinases * metabolism MeSH
- Inflammation * metabolism MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
The sodium/calcium exchanger (NCX) type 1 has been well described in various cancers, but little is known about the other two NCX types (NCX2 and NCX3). In this study, we used the selective blocker of NCX3 - YM-244769 to investigate changes in apoptosis induction, migration, proliferation, intracellular calcium and ATP in four cancer cell lines - DLD1, HeLa, MDA-MB-231 and JIMT1. In all four cell lines we observed a concentration-dependent increase in the number of apoptotic cells, as well as reduced migration and proliferation. Induction of hypoxic conditions did not alter the response of these cells to YM-244769 in any of the above-mentioned parameters. These results indicate the role of NCX3 in cancer cell migration, proliferation and apoptosis, as inhibition of NCX1 by the specific blocker SEA0400 had no significant effect on these parameters. However, we verified the effect of NCX3 inhibition by using CRISPR/Cas9 to generate clones in which the SLC8A3 (NCX3) gene was deleted, and we obtained the same results. In addition, mitochondrial respiration was impaired in the clones with NCX3 knocked-out, suggesting that NCX3 also play a role in bioenergetics. In conclusion, we have clearly shown that NCX3 plays an important anti-apoptotic, pro-migratory and proliferative role in the cancer cells by affecting mitochondrial bioenergetics, thus supporting their survival and fate.
- MeSH
- Apoptosis drug effects MeSH
- Humans MeSH
- Mitochondria metabolism drug effects MeSH
- Cell Line, Tumor MeSH
- Neoplasms * metabolism pathology genetics MeSH
- Cell Movement drug effects MeSH
- Cell Proliferation drug effects MeSH
- Sodium-Calcium Exchanger * metabolism genetics antagonists & inhibitors MeSH
- Calcium metabolism MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Cardiovascular diseases are associated with an altered cardiomyocyte metabolism. Because of a shortage of human heart tissue, experimental studies mostly rely on alternative approaches including animal and cell culture models. Since the use of isolated primary cardiomyocytes is limited, immortalized cardiomyocyte cell lines may represent a useful tool as they closely mimic human cardiomyocytes. This study is focused on the AC16 cell line generated from adult human ventricular cardiomyocytes. Despite an increasing number of studies employing AC16 cells, a comprehensive proteomic, bioenergetic, and oxygen-sensing characterization of proliferating vs. differentiated cells is still lacking. Here, we provide a comparison of these two stages, particularly emphasizing cell metabolism, mitochondrial function, and hypoxic signaling. Label-free quantitative mass spectrometry revealed a decrease in autophagy and cytoplasmic translation in differentiated AC16, confirming their phenotype. Cell differentiation led to global increase in mitochondrial proteins [e.g. oxidative phosphorylation (OXPHOS) proteins, TFAM, VWA8] reflected by elevated mitochondrial respiration. Fatty acid oxidation proteins were increased in differentiated cells, whereas the expression levels of proteins associated with fatty acid synthesis were unchanged and glycolytic proteins were decreased. There was a profound difference between proliferating and differentiated cells in their response to hypoxia and anoxia-reoxygenation. We conclude that AC16 differentiation leads to proteomic and metabolic shifts and altered cell response to oxygen deprivation. This underscores the requirement for proper selection of the particular differentiation state during experimental planning.NEW & NOTEWORTHY Proliferating and differentiated AC16 cell lines exhibit distinct proteomic and metabolic profiles with critical implications for experimental design. Proliferating cells predominantly utilize glycolysis and are highly sensitive to hypoxia, whereas differentiated cells display enhanced mitochondrial biogenesis, oxidative phosphorylation, and resistance to anoxia-reoxygenation. These findings provide novel insights into the metabolic adaptations during differentiation and highlight the necessity of selecting the appropriate cellular stage to ensure accurate experimental outcomes.
- MeSH
- Cell Differentiation * physiology MeSH
- Cell Line MeSH
- Energy Metabolism MeSH
- Cell Hypoxia physiology MeSH
- Myocytes, Cardiac * metabolism MeSH
- Humans MeSH
- Mitochondrial Proteins metabolism MeSH
- Mitochondria * metabolism MeSH
- Oxidative Phosphorylation MeSH
- Cell Proliferation MeSH
- Proteomics methods MeSH
- Signal Transduction * physiology MeSH
- Mitochondria, Heart * metabolism MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Respirační selhání zůstává jedním z nejčastějších důvodů vedoucích k hospitalizaci na jednotkách intenzivní a resuscitační péče. etiologie tohoto stavu je poměrně široká, nicméně infekce dolních dýchacích cest převažují jako hlavní vyvolávající faktor. součástí léčby respiračního selhání je podpora či náhrada plicních funkcí pomocí oxygenoterapie, neinvazivní a invazivní umělé plicní ventilace a dále postupy zahrnující aplikaci inhalačního oxidu dusnatého či pronační polohu. V případech, kdy tyto metody selhávají, je nezbytná mimotělní podpora životních funkcí. V následující kazuistice se věnujeme komplikovanému průběhu pneumonie u pacienta, jehož zdravotní stav vyžadoval připojení na mimotělní membránovou oxygenaci a byl komplikován rozvojem septického šoku, masivním krvácením a renálním selháním.
Respiratory failure remains one of the most common reasons leading to hospitalization in paediatric intensive care units. the aetiology of this condition is quite broad, however, lower respiratory tract infections predominate as the main triggering factor. the treatment of respiratory insufficiency includes support or replacement of lung function by oxygen therapy, non-invasive and invasive mechanical ventilation, and procedures such as inhaled nitric oxide or prone positioning. in situations where these methods fail, extracorporeal life support is necessary. in the following case report, we discuss the complicated course of pneumonia in a patient whose condition required connection to extracorporeal membrane oxygenation and was complicated by development of septic shock, massive bleeding and renal failure.
- MeSH
- Diagnostic Imaging methods MeSH
- Disseminated Intravascular Coagulation etiology complications MeSH
- Child MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation * methods MeSH
- Pneumonia * etiology drug therapy complications MeSH
- Respiratory Insufficiency etiology complications therapy MeSH
- Respiratory Syncytial Viruses pathogenicity drug effects MeSH
- Shock, Septic etiology complications MeSH
- Positive-Pressure Respiration methods instrumentation MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH