Marija Kojicic - Academia.edu (original) (raw)

Papers by Marija Kojicic

PubMed, Oct 1, 2009

Acute lung injury (ALI ) and its more severe form, acute respiratory distress syndrome (ARDS ), a... more Acute lung injury (ALI ) and its more severe form, acute respiratory distress syndrome (ARDS ), are important critical care syndromes for which the treatment options are limited once the condition is fully established. Enormous basic and clinical research efforts have led to improvements in supportive treatment, but surprisingly little has been done on the prevention of this devastating syndrome. The development and progression of ALI /ARDS may be triggered by various intrahospital exposures including but not limited to transfusion, aspiration, mechanical ventilation, certain medications and delayed treatment of shock and infection. Early recognition of patients with or at risk of ALI /ARDS is essential for designing novel prevention and treatment strategies. Automated electronic screening tools and novel scoring systems applied at the time of hospital admission may facilitate enrollment of patients into mechanistic and outcome studies, as well as future ALI /ARDS prevention trials.

Bosnian Journal of Basic Medical Sciences, Oct 20, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diff use impairment of alveolocapillary membrane in the settings of diff erent predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Th erapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lungprotective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter signifi cant physical and psychological impairments.

Transfusion, 2009

BACKGROUND-The diagnostic workup of TRALI requires an exclusion of TACO. Brain natriuretic peptid... more BACKGROUND-The diagnostic workup of TRALI requires an exclusion of TACO. Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic (NT-pro-BNP) accurately diagnosed TACO in preliminary studies that did not include patients with TRALI. STUDY DESIGN AND METHODS-In this prospective cohort study two critical care experts blinded to serum levels of BNP and NT-pro-BNP determined the diagnosis of TRALI, TACO, and possible TRALI based on the consensus conference definitions. The accuracy of BNP and NT-pro-BNP was assessed based on the area under the receiver operating curve (AUC). RESULTS-Of 115 patients who developed acute pulmonary edema after transfusion, 34 were identified with TRALI, 31 with possible TRALI, and 50 with TACO. Median BNP was 375pg/mL (interquartile range [IQR], 122.5 to 780.5pg/mL) in TRALI, 446pg/mL (IQR, 128 to 743.3pg/mL) in possible TRALI and 559pg/mL (IQR, 287.8 to 1347.8pg/mL) in TACO patients (p=0.038). The NT-pro-BNP levels among patients with TRALI, possible TRALI and TACO differed significantly with a median value of 1558.5pg/mL(IQR, 628.5 to 5114pg/mL), 2349pg/mL(IQR, 919 to 4610pg/mL) and 5197pg/mL(IQR, 1695 to 15714pg/mL)(p=0.0036), respectively. The accuracy of BNP and NT-pro-BNP to diagnose TACO was moderate with an area under curve (AUC) of 0.63(95% confidence interval [CI] 0.51 to 0.74) and 0.70(95%CI 0.59 to 0.80). CONCLUSIONS-Natriuretic peptides are of limited diagnostic value in a differential diagnosis of pulmonary edema after transfusion in the critically ill patients.

Resuscitation, Oct 1, 2012

Acta Medica Academica, May 15, 2011

Objective. The relationship between specific causative organisms and development of ARDS in pneum... more Objective. The relationship between specific causative organisms and development of ARDS in pneumonia patients has not been explored. Several case reports have described the development of ARDS in patients with Legionella pneumonia. The aim is of this study was to determine frequency and outcomes of ARDS in patients with Legionella Pneumonia. Methods. A retrospective cohort study of patients with Legionella pneumonia hospitalized at two Mayo Clinic Rochester hospitals was conducted. To identify the patients with Legionella pneumonia we searched the Mayo Clinic Life Sciences System (MCLSS) database from 01/01/2003 to 12/31/2007. Electronic medical records of patients with active Legionella pneumonia based on positive cultures and/or urinary antigen were reviewed. ARDS was diagnosed on the basis of the criteria of the North American/European consensus conference definition. Results. We identified 15 patients with microbiologically proven Legionella pneumonia of whom 11 were admitted to the intensive care unit (ICU), 6 required mechanical ventilation and 5 met the criteria for ARDS. Age (median 42 vs. 50 years, p=0.32) and gender (4/10 vs. 1/5 female, p=0.60) were similar in patients with and without ARDS. Septic shock was present in 4 of the 5 patients with ARDS and only 1 without. Patients with ARDS had longer ICU length of stay (median 9 vs. 1 days, P=0.03). Only one patient (from the ARDS group) died in the hospital. Conclusion. In this retrospective study ARDS occurred in one third of patients with microbiologically proven Legionella pneumonia and was associated with prolonged length of ICU stay.

Bedside quantification of dead-space fraction using routine clinical data in patients with acute ... more Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials

Bosnian Journal of Basic Medical Sciences, 2009

Even though it is considered a 21st century term, translational research has been present for muc... more Even though it is considered a 21st century term, translational research has been present for much longer. Idea of translating experimental discovery to its’ clinical application and use is old as research itself. However, it is the understanding of missing links between the basic science research and clinical research that emerged in the past decade and mobilized scientific and clinical communities and organizations worldwide. Hence term, translational research, which represents an “enterprise of harnessing knowledge from basic sciences to produce new drugs, devices, and treatment options for patients” (1). It has been also characterized as “effective translation of the new knowledge, mechanisms, and techniques generated by advances in basic science research into new approaches for prevention, diagnosis, and treatment of disease, which is essential for improving health” (2).This translation is a complex process and involves more than one step for transfer of research knowledge. At ...

Critical Care, 2012

Introduction: Although pneumonia has been identified as the single most common risk factor for ac... more Introduction: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia. Methods: A retrospective cohort study of adult patients with microbiologically positive pneumonia, hospitalized at two Mayo Clinic Rochester hospitals between January 1, 2005, and December 31, 2007. In a subsequent nested case-control analysis, we evaluated the differences in prehospital and intrahospital exposures between patients with and without ALI/acute respiratory distress syndrome (ARDS) matched by specific pathogen, isolation site, gender, and closest age in a 1:1 manner. Results: The study included 596 patients; 365 (61.2%) were men. The median age was 65 (IQR, 53 to 75) years. In total, 171 patients (28.7%) were diagnosed with ALI. The occurrence of ALI was less frequent in bacterial (n = 99 of 412, 24%) compared with viral (n = 19 of 55, 35%), fungal (n = 39 of 95, 41%), and mixed isolates pneumonias (n = 14 of 34, 41%; P = 0.002). After adjusting for baseline severity of illness and comorbidities, patients in whom ALI developed had a markedly increased risk of hospital death (OR adj 9.7; 95% CI, 6.0 to 15.9). In a nested case-control study, presence of shock (OR, 8.9; 95% CI, 2.8 to 45.9), inappropriate initial antimicrobial treatment (OR, 3.2; 95% CI, 1.3 to 8.5), and transfusions (OR, 4.8; 95% CI, 1.5 to 19.6) independently predicted ALI development. Conclusions: The development of ALI among patients hospitalized with infectious pneumonia varied among pulmonary pathogens and was associated with increased mortality. Inappropriate initial antimicrobial treatment and transfusion predict the development of ALI independent of pathogen.

Introduction: Although pneumonia has been identified as the single most common risk factor for ac... more Introduction: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia.

Abstract: This retrospective population-based study evaluated the effects of alcohol consumption ... more Abstract: This retrospective population-based study evaluated the effects of alcohol consumption on the development of acute respiratory distress syndrome (ARDS). Alcohol consumption was quantified based on patient and/or family provided information at the time of hospital admission. ARDS was defined according to American-European consensus conference (AECC). From 1,422 critically ill Olmsted county residents, 1,357 had information about alcohol use in their medical records, 77 (6%) of whom developed ARDS. A history of significant alcohol consumption (more than two drinks per day) was reported in 97 (7%) of patients. When adjusted for underlying ARDS risk factors (aspiration, chemotherapy, high-risk surgery, pancreatitis, sepsis, shock), smoking, cirrhosis and gender, history of significant alcohol consumption was associated with increased risk of ARDS development (odds ratio 2.9, 95 % CI 1.3–6.2). This population-based study confirmed that excessive alcohol consumption is associate...

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diff use impairment of alveolocapillary membrane in the settings of diff erent predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or wors-en ARDS. Th erapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter signifi cant physi-cal and psychological impairments.

Bosnian Journal of Basic Medical Sciences, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diffuse impairment of alveolocapillary membrane in the settings of different predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Therapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter significant physical and psychological impairments

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2013

Several studies demonstrated a six-fold increase in plasma concentration of endothelin-1 (ET-1) i... more Several studies demonstrated a six-fold increase in plasma concentration of endothelin-1 (ET-1) in diaysis patients (hemodialysis and peritoneal dialysis) compared to healthy control subjects. However, the effects of ET-1 on respiratory function in these patients are less known. The aim of this study was to determine the potential differences in spirometric values in relation to ET-1 levels. The study included 28 patients (15 male, 13 female, mean age 55.9 +/- 16. 2 years) with end stage renal diseases (ESRD) receiving regular hemodialysis (HD), 23 patients (10 males, 13 females, mean age 55.8 +/- 15.8 years) with ESRD treated with continuous ambulatory peritoneal dialysis (CAPD) without any cardiovascular or respiratory diseases, and 30 healthy volunteers (14 male, 16 female, mean age 51.8 +/- 15.6 years) in control group. In each of the three groups the participants were divided into two additional sub-groups according to the serum levels of ET-1. The spirometry values were record...

Central European Journal of Medicine, 2011

Patients suffering from both sleep apnea-hypopnea syndrome (SAHS) and chronic obstructive pulmona... more Patients suffering from both sleep apnea-hypopnea syndrome (SAHS) and chronic obstructive pulmonary disease (COPD) have a more severe form of sleep apnea. Knowing all pathophysiological aspects that mutually interact in sleep disorders and COPD, we aimed to investigate if the introduction of long-acting β2 agonists (LABA) during the night could improve overnight oxygenation and the ability to perform daily activities in stage I COPD patients with mild SAHS. We conducted a prospective study of 22 patients with stage I COPD and SAHS confirmed by overnight polygraph screening, without nocturnal CPAP treatment. During twelve weeks, all patients used LABA (salmeterol 50 mcg) with a metered dose inhaler before bedtime. The levels of apnea hypopnea index, oxygen saturation, heart rate, and Epworth daytime sleepiness scale (ESS) were recorded before and after the treatment. There was a significant improvement of lowest and average overnight oxygenation compared to baseline (mean difference ...

Bosnian journal of basic medical sciences / Udruženje basičnih mediciniskih znanosti = Association of Basic Medical Sciences, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diffuse impairment of alveolocapillary membrane in the settings of different predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Therapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter significant physical and psychological impairments.

World journal of critical care medicine, Jan 4, 2015

Processes to ensure world-wide best-practice for critical care delivery are likely to minimize pr... more Processes to ensure world-wide best-practice for critical care delivery are likely to minimize preventable death, disability and costly complications for any healthcare system's sickest patients, but no large-scale efforts have so far been undertaken towards these goals. The advances in medical informatics and human factors engineering have provided possibility for novel and user-friendly clinical decision support tools that can be applied in a complex and busy hospital setting. To facilitate timely and accurate best-practice delivery in critically ill patients international group of intensive care unit (ICU) physicians and researchers developed a simple decision support tool: Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). The tool has been refined and tested in high fidelity simulated clinical environment and has been shown to improve performance of clinical providers faced with simulated emergencies. The aim of this international educational interven...

Vojnosanitetski pregled, 2011

Background/Aim. Asthma is one of the most common chronic pulmonary diseases. The number of asthma... more Background/Aim. Asthma is one of the most common chronic pulmonary diseases. The number of asthmatics has been continuously increasing all over the world. Depending on its causing agent, asthma is classified as allergic and nonallergic. Asthma is often associated with other allergic diseases, and it is most commonly preceded by the symptoms of rhinitis. The aim of this study was to establish the type and frequency of allergic sensitization to inhalatory allergens, frequency of concomitant rhinitis, gender and age-related distribution of asthma, and the presence of some risk factors in patients with diagnosed asthma. Methods. This retrospective and partially prospective analysis included 733 patients with asthma diagnosed in the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica over the period January, 2004-December, 2008. The obtained date were statistically processed. Results. Females were significantly more often affected by asthma (p < 0.05), most frequently at 2...

PubMed, Oct 1, 2009

Acute lung injury (ALI ) and its more severe form, acute respiratory distress syndrome (ARDS ), a... more Acute lung injury (ALI ) and its more severe form, acute respiratory distress syndrome (ARDS ), are important critical care syndromes for which the treatment options are limited once the condition is fully established. Enormous basic and clinical research efforts have led to improvements in supportive treatment, but surprisingly little has been done on the prevention of this devastating syndrome. The development and progression of ALI /ARDS may be triggered by various intrahospital exposures including but not limited to transfusion, aspiration, mechanical ventilation, certain medications and delayed treatment of shock and infection. Early recognition of patients with or at risk of ALI /ARDS is essential for designing novel prevention and treatment strategies. Automated electronic screening tools and novel scoring systems applied at the time of hospital admission may facilitate enrollment of patients into mechanistic and outcome studies, as well as future ALI /ARDS prevention trials.

Bosnian Journal of Basic Medical Sciences, Oct 20, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diff use impairment of alveolocapillary membrane in the settings of diff erent predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Th erapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lungprotective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter signifi cant physical and psychological impairments.

Transfusion, 2009

BACKGROUND-The diagnostic workup of TRALI requires an exclusion of TACO. Brain natriuretic peptid... more BACKGROUND-The diagnostic workup of TRALI requires an exclusion of TACO. Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic (NT-pro-BNP) accurately diagnosed TACO in preliminary studies that did not include patients with TRALI. STUDY DESIGN AND METHODS-In this prospective cohort study two critical care experts blinded to serum levels of BNP and NT-pro-BNP determined the diagnosis of TRALI, TACO, and possible TRALI based on the consensus conference definitions. The accuracy of BNP and NT-pro-BNP was assessed based on the area under the receiver operating curve (AUC). RESULTS-Of 115 patients who developed acute pulmonary edema after transfusion, 34 were identified with TRALI, 31 with possible TRALI, and 50 with TACO. Median BNP was 375pg/mL (interquartile range [IQR], 122.5 to 780.5pg/mL) in TRALI, 446pg/mL (IQR, 128 to 743.3pg/mL) in possible TRALI and 559pg/mL (IQR, 287.8 to 1347.8pg/mL) in TACO patients (p=0.038). The NT-pro-BNP levels among patients with TRALI, possible TRALI and TACO differed significantly with a median value of 1558.5pg/mL(IQR, 628.5 to 5114pg/mL), 2349pg/mL(IQR, 919 to 4610pg/mL) and 5197pg/mL(IQR, 1695 to 15714pg/mL)(p=0.0036), respectively. The accuracy of BNP and NT-pro-BNP to diagnose TACO was moderate with an area under curve (AUC) of 0.63(95% confidence interval [CI] 0.51 to 0.74) and 0.70(95%CI 0.59 to 0.80). CONCLUSIONS-Natriuretic peptides are of limited diagnostic value in a differential diagnosis of pulmonary edema after transfusion in the critically ill patients.

Resuscitation, Oct 1, 2012

Acta Medica Academica, May 15, 2011

Objective. The relationship between specific causative organisms and development of ARDS in pneum... more Objective. The relationship between specific causative organisms and development of ARDS in pneumonia patients has not been explored. Several case reports have described the development of ARDS in patients with Legionella pneumonia. The aim is of this study was to determine frequency and outcomes of ARDS in patients with Legionella Pneumonia. Methods. A retrospective cohort study of patients with Legionella pneumonia hospitalized at two Mayo Clinic Rochester hospitals was conducted. To identify the patients with Legionella pneumonia we searched the Mayo Clinic Life Sciences System (MCLSS) database from 01/01/2003 to 12/31/2007. Electronic medical records of patients with active Legionella pneumonia based on positive cultures and/or urinary antigen were reviewed. ARDS was diagnosed on the basis of the criteria of the North American/European consensus conference definition. Results. We identified 15 patients with microbiologically proven Legionella pneumonia of whom 11 were admitted to the intensive care unit (ICU), 6 required mechanical ventilation and 5 met the criteria for ARDS. Age (median 42 vs. 50 years, p=0.32) and gender (4/10 vs. 1/5 female, p=0.60) were similar in patients with and without ARDS. Septic shock was present in 4 of the 5 patients with ARDS and only 1 without. Patients with ARDS had longer ICU length of stay (median 9 vs. 1 days, P=0.03). Only one patient (from the ARDS group) died in the hospital. Conclusion. In this retrospective study ARDS occurred in one third of patients with microbiologically proven Legionella pneumonia and was associated with prolonged length of ICU stay.

Bedside quantification of dead-space fraction using routine clinical data in patients with acute ... more Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials

Bosnian Journal of Basic Medical Sciences, 2009

Even though it is considered a 21st century term, translational research has been present for muc... more Even though it is considered a 21st century term, translational research has been present for much longer. Idea of translating experimental discovery to its’ clinical application and use is old as research itself. However, it is the understanding of missing links between the basic science research and clinical research that emerged in the past decade and mobilized scientific and clinical communities and organizations worldwide. Hence term, translational research, which represents an “enterprise of harnessing knowledge from basic sciences to produce new drugs, devices, and treatment options for patients” (1). It has been also characterized as “effective translation of the new knowledge, mechanisms, and techniques generated by advances in basic science research into new approaches for prevention, diagnosis, and treatment of disease, which is essential for improving health” (2).This translation is a complex process and involves more than one step for transfer of research knowledge. At ...

Critical Care, 2012

Introduction: Although pneumonia has been identified as the single most common risk factor for ac... more Introduction: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia. Methods: A retrospective cohort study of adult patients with microbiologically positive pneumonia, hospitalized at two Mayo Clinic Rochester hospitals between January 1, 2005, and December 31, 2007. In a subsequent nested case-control analysis, we evaluated the differences in prehospital and intrahospital exposures between patients with and without ALI/acute respiratory distress syndrome (ARDS) matched by specific pathogen, isolation site, gender, and closest age in a 1:1 manner. Results: The study included 596 patients; 365 (61.2%) were men. The median age was 65 (IQR, 53 to 75) years. In total, 171 patients (28.7%) were diagnosed with ALI. The occurrence of ALI was less frequent in bacterial (n = 99 of 412, 24%) compared with viral (n = 19 of 55, 35%), fungal (n = 39 of 95, 41%), and mixed isolates pneumonias (n = 14 of 34, 41%; P = 0.002). After adjusting for baseline severity of illness and comorbidities, patients in whom ALI developed had a markedly increased risk of hospital death (OR adj 9.7; 95% CI, 6.0 to 15.9). In a nested case-control study, presence of shock (OR, 8.9; 95% CI, 2.8 to 45.9), inappropriate initial antimicrobial treatment (OR, 3.2; 95% CI, 1.3 to 8.5), and transfusions (OR, 4.8; 95% CI, 1.5 to 19.6) independently predicted ALI development. Conclusions: The development of ALI among patients hospitalized with infectious pneumonia varied among pulmonary pathogens and was associated with increased mortality. Inappropriate initial antimicrobial treatment and transfusion predict the development of ALI independent of pathogen.

Introduction: Although pneumonia has been identified as the single most common risk factor for ac... more Introduction: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia.

Abstract: This retrospective population-based study evaluated the effects of alcohol consumption ... more Abstract: This retrospective population-based study evaluated the effects of alcohol consumption on the development of acute respiratory distress syndrome (ARDS). Alcohol consumption was quantified based on patient and/or family provided information at the time of hospital admission. ARDS was defined according to American-European consensus conference (AECC). From 1,422 critically ill Olmsted county residents, 1,357 had information about alcohol use in their medical records, 77 (6%) of whom developed ARDS. A history of significant alcohol consumption (more than two drinks per day) was reported in 97 (7%) of patients. When adjusted for underlying ARDS risk factors (aspiration, chemotherapy, high-risk surgery, pancreatitis, sepsis, shock), smoking, cirrhosis and gender, history of significant alcohol consumption was associated with increased risk of ARDS development (odds ratio 2.9, 95 % CI 1.3–6.2). This population-based study confirmed that excessive alcohol consumption is associate...

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diff use impairment of alveolocapillary membrane in the settings of diff erent predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or wors-en ARDS. Th erapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter signifi cant physi-cal and psychological impairments.

Bosnian Journal of Basic Medical Sciences, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diffuse impairment of alveolocapillary membrane in the settings of different predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Therapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter significant physical and psychological impairments

Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo, 2013

Several studies demonstrated a six-fold increase in plasma concentration of endothelin-1 (ET-1) i... more Several studies demonstrated a six-fold increase in plasma concentration of endothelin-1 (ET-1) in diaysis patients (hemodialysis and peritoneal dialysis) compared to healthy control subjects. However, the effects of ET-1 on respiratory function in these patients are less known. The aim of this study was to determine the potential differences in spirometric values in relation to ET-1 levels. The study included 28 patients (15 male, 13 female, mean age 55.9 +/- 16. 2 years) with end stage renal diseases (ESRD) receiving regular hemodialysis (HD), 23 patients (10 males, 13 females, mean age 55.8 +/- 15.8 years) with ESRD treated with continuous ambulatory peritoneal dialysis (CAPD) without any cardiovascular or respiratory diseases, and 30 healthy volunteers (14 male, 16 female, mean age 51.8 +/- 15.6 years) in control group. In each of the three groups the participants were divided into two additional sub-groups according to the serum levels of ET-1. The spirometry values were record...

Central European Journal of Medicine, 2011

Patients suffering from both sleep apnea-hypopnea syndrome (SAHS) and chronic obstructive pulmona... more Patients suffering from both sleep apnea-hypopnea syndrome (SAHS) and chronic obstructive pulmonary disease (COPD) have a more severe form of sleep apnea. Knowing all pathophysiological aspects that mutually interact in sleep disorders and COPD, we aimed to investigate if the introduction of long-acting β2 agonists (LABA) during the night could improve overnight oxygenation and the ability to perform daily activities in stage I COPD patients with mild SAHS. We conducted a prospective study of 22 patients with stage I COPD and SAHS confirmed by overnight polygraph screening, without nocturnal CPAP treatment. During twelve weeks, all patients used LABA (salmeterol 50 mcg) with a metered dose inhaler before bedtime. The levels of apnea hypopnea index, oxygen saturation, heart rate, and Epworth daytime sleepiness scale (ESS) were recorded before and after the treatment. There was a significant improvement of lowest and average overnight oxygenation compared to baseline (mean difference ...

Bosnian journal of basic medical sciences / Udruženje basičnih mediciniskih znanosti = Association of Basic Medical Sciences, 2009

Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are charact... more Acute lung injury and its more severe form acute respiratory distress syndrome (ARDS) are characterized by diffuse impairment of alveolocapillary membrane in the settings of different predisposing conditions such as sepsis, trauma and shock. Many intrahospital exposures, including aspiration, delayed resuscitation, high tidal volume mechanical ventilation and non critical use of transfusions may contribute or worsen ARDS. Therapy is targeted to treatment of predisposing condition, life supportive measures and prevention of nosocomial complications. Rigorous adherence to lung-protective mechanical ventilation is critical to prevent ventilator induced lung injury and decrease mortality. Although survival of ARDS patients has improved in the last decades ARDS mortality rates are still high and survivors encounter significant physical and psychological impairments.

World journal of critical care medicine, Jan 4, 2015

Processes to ensure world-wide best-practice for critical care delivery are likely to minimize pr... more Processes to ensure world-wide best-practice for critical care delivery are likely to minimize preventable death, disability and costly complications for any healthcare system's sickest patients, but no large-scale efforts have so far been undertaken towards these goals. The advances in medical informatics and human factors engineering have provided possibility for novel and user-friendly clinical decision support tools that can be applied in a complex and busy hospital setting. To facilitate timely and accurate best-practice delivery in critically ill patients international group of intensive care unit (ICU) physicians and researchers developed a simple decision support tool: Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). The tool has been refined and tested in high fidelity simulated clinical environment and has been shown to improve performance of clinical providers faced with simulated emergencies. The aim of this international educational interven...

Vojnosanitetski pregled, 2011

Background/Aim. Asthma is one of the most common chronic pulmonary diseases. The number of asthma... more Background/Aim. Asthma is one of the most common chronic pulmonary diseases. The number of asthmatics has been continuously increasing all over the world. Depending on its causing agent, asthma is classified as allergic and nonallergic. Asthma is often associated with other allergic diseases, and it is most commonly preceded by the symptoms of rhinitis. The aim of this study was to establish the type and frequency of allergic sensitization to inhalatory allergens, frequency of concomitant rhinitis, gender and age-related distribution of asthma, and the presence of some risk factors in patients with diagnosed asthma. Methods. This retrospective and partially prospective analysis included 733 patients with asthma diagnosed in the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica over the period January, 2004-December, 2008. The obtained date were statistically processed. Results. Females were significantly more often affected by asthma (p < 0.05), most frequently at 2...