RATIONALE RSV bronchiolitis causes significant infant mortality. Bronchiolitis is characterised by airway epithelial cell (AEC) death, however the mode of death remains unknown. OBJECTIVES To determine whether necroptosis contributes to RSV bronchiolitis pathogenesis via high mobility group box 1 (HMGB1) release. METHODS Nasopharyngeal samples were collected from children presenting to hospital with

BACKGROUND Antenatal factors, such as chorioamnionitis(CA) and preeclampsia(PE), and postnatal injury are associated with an increased risk for BPD and PH after preterm birth. IGF-1 is markedly decreased in normal preterm infants, but whether IGF-1 treatment can prevent BPD or PH is unknown. OBJECTIVE To evaluate whether postnatal treatment with rhIGF-1/BP3 improves lung growth and prevents PH in 2

Endothelial cells (ECs) are vascular nonconventional immune cells that play a major role in the systemic response following bacterial infection to limit its dissemination. Triggered by exposure to pathogens, microbial toxins, or endogenous danger signals, EC responses are polymorphous, heterogeneous, and multifaceted. During sepsis, ECs shift toward a proapoptotic, proinflammatory, pro-adhesive and

RATIONALE Bronchiectasis guidelines regard treatment to prevent exacerbation and treatment of daily symptoms as separate objectives. OBJECTIVE We hypothesized that patients with greater symptoms would be at higher risk of exacerbations and therefore a treatment aimed at reducing daily symptoms would also reduce exacerbations in highly symptomatic patients. METHODS An observational cohort of 333 patients

Rationale Monitoring and controlling respiratory drive and effort may help to minimize lung and diaphragm injury. Airway occlusion pressure (P0.1) is a non-invasive measure of respiratory drive. Objectives To determine: (1) the validity of 'ventilator' P0.1 displayed on the screen (P0.1vent) as a measure of drive, (2) the ability of P0.1 to detect potentially injurious levels of effort, and (3) how

Long-term cognitive impairment is common among ICU survivors, but its natural history remains unclear. In this systematic review, we report the frequency of cognitive impairment in ICU survivors across various time points following ICU discharge that were extracted from 46 of the 3350 screened records. Prior studies used a range of cognitive instruments including subjective assessments (10 studies)

RATIONALE Parapneumonic effusions have a wide clinical spectrum. The majority settle with conservative management but some progress to complex collections requiring intervention. For decades, physicians have relied on pleural fluid pH to determine the need for chest tube drainage despite a lack of prospective validation and no ability to predict the requirement for fibrinolytics or thoracic surgery

RATIONALE Bronchopulmonary dysplasia (BPD) is a leading complication of preterm birth that affects infants born in the saccular stage of lung development at <32 weeks of gestation. Although the mechanisms driving BPD remain uncertain, exposure to hyperoxia is thought to contribute to disease pathogenesis. OBJECTIVE To determine the effects of hyperoxia on epithelial-mesenchymal interactions and to

For approximately the last 50 years, bronchoscopy, especially flexible fiberoptic bronchoscopy, has been a mainstay for airway inspection, the diagnosis of airway lesions, therapeutic aspiration of airway secretions and transbronchial biopsy to diagnose parenchymal lung disorders. Its utility for the diagnosis of peripheral pulmonary nodules and for therapeutic treatments outside of the aspiration

RATIONALE Patients receiving prolonged mechanical ventilation experience low survival rates and incur high health care costs. However, little is known about how to optimally organize and manage their care. OBJECTIVE To identify a set of effective care practices for patients with prolonged mechanical ventilation. METHODS We performed a focused ethnographic evaluation at eight long-term acute care hospitals

RATIONALE The pre-clinical natural history of progressive lung fibrosis is poorly understood. OBJECTIVES Our goal was to identify risk factors for interstitial lung abnormalities (ILA) on high-resolution computed tomography (HRCT) scans, and determine progression towards clinical interstitial lung disease (ILD) among participants in a longitudinal cohort of self-reported unaffected first-degree relatives

RATIONALE Although relatives of patients with familial pulmonary fibrosis (FPF) are at an increased risk for interstitial lung disease (ILD), the risk among relatives of sporadic pulmonary fibrosis (PF) is not known. OBJECTIVES To identify the prevalence of interstitial lung abnormalities (ILA) and ILD among relatives of patients with FPF and sporadic PF. METHODS Undiagnosed first-degree relatives