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Efficacy and safety of a 72-h infusion of prostacyclin (1 ng/kg/min) in mechanically ventilated patients with pulmonary infection and endotheliopathy-protocol for the multicenter randomized, placebo-controlled, blinded, investigator-initiated COMBAT-ARF trial.
Acta Anaesthesiol Scand
January 2025
CAG Center for Endotheliomics, Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Background: Acute respiratory failure (ARF) is common in critically ill patients, and 50% of patients in intensive care units require mechanical ventilation [3, 4]. The COVID-19 pandemic revealed that COVID-19 infection induced ARF caused by damage to the microvascular pulmonary endothelium. In a randomized clinical trial, mechanically ventilated COVID-19 patients with severe endotheliopathy, as defined by soluble thrombomodulin (sTM) ≥ 4 ng/mL, were randomized to evaluate the effect of a 72-h infusion of low-dose prostacyclin 1 ng/kg/min or placebo.
View Article and Find Full Text PDFIloprost and Organ Dysfunction in Adults With Septic Shock and Endotheliopathy: A Randomized Clinical Trial.
JAMA Netw Open
September 2024
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Article Synopsis
- Soluble thrombomodulin is linked to worse outcomes in septic shock, prompting a study on iloprost's effect on organ failure in patients with elevated levels of this marker.
- The study was a randomized, double-blind trial involving 279 ICU patients in Denmark, comparing iloprost treatment to a placebo over 72 hours.
- Results showed no significant difference in organ failure severity between the two groups, leading to the trial being stopped early due to futility.
The Influence of Pulmonary Arterial Hypertension In Pregnancy: A Review.
Cardiol Rev
September 2024
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Pulmonary arterial hypertension (PAH) is a severe condition characterized by increased pulmonary vascular resistance and right ventricular failure. This review examines the intersection of PAH and pregnancy, highlighting the significant physiological, hemodynamic, and hormonal changes that exacerbate PAH during gestation. Pregnancy is contraindicated in PAH patients due to high maternal and fetal morbidity and mortality rates.
View Article and Find Full Text PDFEvaluation of changes in cardiac longitudinal strain rate in patients with systemic sclerosis undergoing iloprost treatment: an observational study.
Rheumatology (Oxford)
August 2024
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Objectives: Systemic Sclerosis (SSc) is characterized by widespread microangiopathy and fibrosis of skin and visceral organs. Left ventricle involvement is usually subclinical, characterized by systolic and/or diastolic dysfunction. The global longitudinal strain (GLS), a validated and reliable technique for the measurement of ventricular longitudinal deformation by means of echocardiography, may detect subclinical systolic dysfunction of SSc myocardium.
View Article and Find Full Text PDFIloprost infusion reduces serological cytokines and hormones of hypoxia and inflammation in systemic sclerosis patients.
Clin Exp Med
May 2024
Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Dell'Università 37, 00185, Rome, Italy.
Introduction: Systemic sclerosis (SSc) is characterized by microvascular damage of skin and internal organs with chronic hypoxia and release of cytokines and hormones such as neutrophil gelatinase-associated lipocalin (NGAL), fibroblast growth factor-23 (FGF-23) and Klotho. Aim of the study was to evaluate FGF-23, Klotho and NGAL serum levels in SSc patients and healthy controls (HC) and to evaluate serum levels changes of FGF-23, Klotho and NGAL after Iloprost.
Methods: Twenty-one SSc patients and 20 HC were enrolled.
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