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ISSN 2448-8909 (Print)

2017, Number 4

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Med Crit 2017; 31 (4)

Effect of aspirin on the mortality of acute respiratory distress syndrome in patients admitted to the Intensive Care Unit of the Juarez hospital in Mexico

Vásquez CAI, Pérez NO, Pozos CP, Hinojosa EI, Zamora GSE

Language: Spanish
References: 31
Page: 230-237
PDF size: 174.73 Kb.


ABSTRACT

Objective: To determine the effect on morbidity and mortality at 28 days with the use of aspirin in patients with ARDS.
Material and methods: An experimental, prospective randomized clinical trial simply was conducted during the period from December 1, 2015 to June 30, 2016 in the ICU of Hospital Juarez of Mexico. all patients admitted to the ICU during the study period with a diagnosis of ARDS and were divided into two groups randomly included. Group A received 100 mg of aspirin in addition to standard treatment for ARDS, group B received only standard medical treatment for ARDS. changes in the values of PaO2/FiO2, the values of the DA-aO2 and CESTAT, days of mechanical ventilation, as well as the association of the values of APACHE II score and its relationship with morbidity and mortality in both groups were quantified. Statistical T Student test was used for independent variables.
Results: Mortality in group A was 60% versus 80% in group B. No difference was observed in both groups in the PaO2/FiO2 (p = 0.097). In group A, an average of days of mechanical ventilation of 15.8 days versus 16.8 in group B (p = 0.860, 95%) compared to the days of stay in the ICU and hospital stay was found no statistically significant difference was observed.
Conclusions: The use of aspirin in patients with ARDS established, regardless of severity; it does not decrease mortality, days of stay in the ICU or Hospital, nor diminish the days of mechanical ventilation, or improve PaO2/FiO2, the DAaO2, and CESTAT.


REFERENCES

  1. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;149(3, pt. 1):818-824.

  2. Phua J, Stewart TE, Ferguson ND. Acute respiratory distress syndrome 40 years later: time to revisit its definition. Crit Care Med. 2008;36(10):2912-2921.

  3. Ranieri VM, Rubenfeld DG, Thompson BT. The ARDS Definition Task Force. Acute respiratory distress syndrome. The Berlin Definition. JAMA. 2012;307(23):2526-2533.

  4. Villar J, Blanco J, Añón JM, Santos-Bouza A, Blanch L, Ambrós A, et al. The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med. 2011;37:1932-1941.

  5. Tomashefski JF. Pulmonary pathology of acute respiratory distress syndrome. Clin Chest Med. 2000;21(3):425-466.

  6. Peñuelas O, Aramburu JA, Frutos-Vivar F, Esteban A. Pathology of acute lung injury and acute respiratory distress syndrome: a clinical-pathological correlation. Clin Chest Med. 2006;27:571-578.

  7. Andrew J Boyle, Stefania Di Gangi, Umar I Hamid, et al. Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis. Crit Care. 2015;19:109.

  8. Eickmeier O, Seki H, Haworth O, Hilberath JN, Gao F, Uddin M, et al. Aspirin-triggered resolvin D1 reduces mucosal inflammation and promotes resolution in a murine model of acute lung injury. Mucosal Immunol. 2013;6(2):256-266.

  9. Boyle AJ, Mac Sweeney R, McAuley DF. Pharmacological treatments in ARDS a state-of-the-art update. BMC Med. 2013;11:166.

  10. Imran HU, J Conlon, S Spence, A Krasnodembskaya, A Kissenpfennig, DF McAuley, CM O’Kane. Aspirin reduces neutrophilic pulmonary inflammation in a human model of acute respiratory distress syndrome induced by inhaled lipopolysaccharide. Intensive Care Medicine Experimental. 2014;2(Suppl 1):P80.

  11. Zarbock A, Polanowska-Grabowska RK, Ley K. Platelet-neutrophilinteractions: linking hemostasis and inflammation. Blood Rev. 2007;21:99-111.

  12. Ruiz FA, Lea CR, Oldfield E, Docampo R. Human platelet dense granules contain polyphosphate and are similar to acidocalcisomes of bacteria and unicellular eukaryotes. J Biol Chem. 2004;279:44250-44257.

  13. Shi G, Morrell CN. Platelets as initiators and mediators of inflammation at the vessel wall. Thromb Res. 2011;127:387-390.

  14. Yaguchi A, Lobo FL, Vincent JL, Pradier O. Platelet function in sepsis. J Thromb Haemost. 2004;2:2096-2102.

  15. Gros A, Ollivier V, Ho-Tin-Noé B. Platelets in inflammation: regulation of leukocyte activities and vascular repair. Front Immunol. 2015;5:1-8.

  16. Smith TL, Weyrich AS. Platelets as central mediators of systemic inflammatory responses. Thromb Res. 2011;127:391-394.

  17. McDonald B, Urrutia R, Yipp BG, Jenne CN, Kubes P. Intravascular neutrophil extracellular traps capture bacteria from the bloodstream during sepsis. Cell Host Microbe. 2012;12:324-333.

  18. Zawrotniak M, Rapala-Kozik M. Neutrophil extracellular traps (NETs)-formation and implications. Acta Biochim Pol. 2013;60:277-284.

  19. Fuchs T, Brill A, Duerschmied D, Schatzberg D, Monestier M, Myers DD, et al. Extracellular DNA traps promote thrombosis. Proc Natl Acad Sci USA. 2010;107:15880-15885.

  20. Asaduzzaman M, Lavasani S, Rahman M, Rahman M, Zhang S, Braun OO, et al. Platelets support pulmonary recruitment of neutrophils in abdominal sepsis. Crit Care Med. 2009;37:1389-1396.

  21. Hidalgo A, Chang J, Jang JE, Peired A, Chiang EY, Frenette PS. Heterotypic interactions enabled by polarized neutrophil microdomains mediate thromboinflammatory injury. Nat Med. 2009;15:384-391.

  22. Goff CD, Corbin RS, Theiss SD, Frierson HF, Cephas GA, Tribble CG, et al. Postinjury thromboxane receptor blockade ameliorates acute lung injury. Ann Thorac Surg. 1997;64:826-829.

  23. Grommes J, Alard JE, Drechsler M, Wantha S, Morgelin M, Kuebler WM, et al. Disruption of platelet-derived chemokine heteromers prevents neutrophil extravasation in acute lung injury. Am J Respir Crit Care Med. 2012;185:628-636.

  24. Eisen DP. Manifold beneficial effects of acetyl salicylic acid and nonsteroidal anti-inflammatory drugs on sepsis. Intensive Care Med. 2012;38:1249-1257.

  25. Gawaz M, Dickfeld T, Bogner C, Fateh-Moghadam S, Neumann FJ. Platelet function in septic multiple organ dysfunction syndrome. Intensive Care Med. 1997;23:379-385.

  26. Idell S, Maunder R, Fein AM, Switalska HI, Tuszynski GP, McLarty J, et al. Platelet-specific alpha-granule proteins and thrombospondin in bronchoalveolar lavage in the adult respiratory distress syndrome. Chest. 1989;96:1125-1132.

  27. Ortiz-Muñoz G, Mallavia B, Bins A, Headley M, Krummel MF, Looney MR. Aspirin-triggered 15-epi-lipoxin A4 regulates neutrophil-platelet aggregation and attenuates acute lung injury in mice. Blood. 2014;23:2625-2634.

  28. Mandal RV, Mark EJ, Kradin RL. Megakaryocytes and platelet homeostasis in diffuse alveolar damage. Exp Mol Pathol. 2007;83:327-331.

  29. Floyd CN, Ferro A. Mechanisms of aspirin resistance. Pharmacol Ther. 2014;141:69-78.

  30. Weber C, Erl W, Pietsch A, Weber PC. Aspirin inhibits nuclear factor B mobilization and monocyte adhesion in stimulated human endothelial cells. Circulation. 1995;91:1914-1917.

  31. Taubert D, Berkels R, Grosser N, Schröder H, Gründemann D, Schömig E. Aspirin induces nitric oxide release from vascular endothelium: a novel mechanism of action. Br J Pharmacol. 2004;143:159-165.




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