Hypertonic treatment of acute respiratory distress syndrome
Many viral infections, including the COVID-19 infection, are associated with the hindrance of blood oxygenation due to the accumulation of fluid, inflammatory cells, and cell debris in the lung alveoli. This condition is similar to Acute Respiratory Distress Syndrome (ARDS). Mechanical positive-pres...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1250312/full |
| _version_ | 1797652664947834880 |
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| author | Weiyu Li Judith Martini Marcos Intaglietta Daniel M. Tartakovsky |
| author_facet | Weiyu Li Judith Martini Marcos Intaglietta Daniel M. Tartakovsky |
| author_sort | Weiyu Li |
| collection | DOAJ |
| description | Many viral infections, including the COVID-19 infection, are associated with the hindrance of blood oxygenation due to the accumulation of fluid, inflammatory cells, and cell debris in the lung alveoli. This condition is similar to Acute Respiratory Distress Syndrome (ARDS). Mechanical positive-pressure ventilation is often used to treat this condition, even though it might collapse pulmonary capillaries, trapping red blood cells and lowering the lung’s functional capillary density. We posit that the hyperosmotic-hyperoncotic infusion should be explored as a supportive treatment for ARDS. As a first step in verifying the feasibility of this ARDS treatment, we model the dynamics of alveolar fluid extraction by osmotic effects. These are induced by increasing blood plasma osmotic pressure in response to the increase of blood NaCl concentration. Our analysis of fluid drainage from a plasma-filled pulmonary alveolus, in response to the intravenous infusion of 100 ml of 1.28 molar NaCl solution, shows that alveoli empty of fluid in approximately 15 min. These modeling results are in accordance with available experimental and clinical data; no new data were collected. They are used to calculate the temporal change of blood oxygenation, as oxygen diffusion hindrance decreases upon absorption of the alveolar fluid into the pulmonary circulation. Our study suggests the extraordinary speed with which beneficial effects of the proposed ARDS treatment are obtained and highlight its practicality, cost-efficiency, and avoidance of side effects of mechanical origin. |
| first_indexed | 2024-03-11T16:33:17Z |
| format | Article |
| id | doaj.art-75fcd52beb33490ba24b1ec97923beaf |
| institution | Directory Open Access Journal |
| issn | 2296-4185 |
| language | English |
| last_indexed | 2024-03-11T16:33:17Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj.art-75fcd52beb33490ba24b1ec97923beaf2023-10-23T21:20:53ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852023-10-011110.3389/fbioe.2023.12503121250312Hypertonic treatment of acute respiratory distress syndromeWeiyu Li0Judith Martini1Marcos Intaglietta2Daniel M. Tartakovsky3Department of Energy Science and Engineering, Stanford University, Stanford, CA, United StatesDepartment of Anaesthesia and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Bioengineering, University of California, San Diego, San Diego, CA, United StatesDepartment of Energy Science and Engineering, Stanford University, Stanford, CA, United StatesMany viral infections, including the COVID-19 infection, are associated with the hindrance of blood oxygenation due to the accumulation of fluid, inflammatory cells, and cell debris in the lung alveoli. This condition is similar to Acute Respiratory Distress Syndrome (ARDS). Mechanical positive-pressure ventilation is often used to treat this condition, even though it might collapse pulmonary capillaries, trapping red blood cells and lowering the lung’s functional capillary density. We posit that the hyperosmotic-hyperoncotic infusion should be explored as a supportive treatment for ARDS. As a first step in verifying the feasibility of this ARDS treatment, we model the dynamics of alveolar fluid extraction by osmotic effects. These are induced by increasing blood plasma osmotic pressure in response to the increase of blood NaCl concentration. Our analysis of fluid drainage from a plasma-filled pulmonary alveolus, in response to the intravenous infusion of 100 ml of 1.28 molar NaCl solution, shows that alveoli empty of fluid in approximately 15 min. These modeling results are in accordance with available experimental and clinical data; no new data were collected. They are used to calculate the temporal change of blood oxygenation, as oxygen diffusion hindrance decreases upon absorption of the alveolar fluid into the pulmonary circulation. Our study suggests the extraordinary speed with which beneficial effects of the proposed ARDS treatment are obtained and highlight its practicality, cost-efficiency, and avoidance of side effects of mechanical origin.https://www.frontiersin.org/articles/10.3389/fbioe.2023.1250312/fullARDShypertonic treatmentintravascular infusionpulmonarymathematical model |
| spellingShingle | Weiyu Li Judith Martini Marcos Intaglietta Daniel M. Tartakovsky Hypertonic treatment of acute respiratory distress syndrome Frontiers in Bioengineering and Biotechnology ARDS hypertonic treatment intravascular infusion pulmonary mathematical model |
| title | Hypertonic treatment of acute respiratory distress syndrome |
| title_full | Hypertonic treatment of acute respiratory distress syndrome |
| title_fullStr | Hypertonic treatment of acute respiratory distress syndrome |
| title_full_unstemmed | Hypertonic treatment of acute respiratory distress syndrome |
| title_short | Hypertonic treatment of acute respiratory distress syndrome |
| title_sort | hypertonic treatment of acute respiratory distress syndrome |
| topic | ARDS hypertonic treatment intravascular infusion pulmonary mathematical model |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2023.1250312/full |
| work_keys_str_mv | AT weiyuli hypertonictreatmentofacuterespiratorydistresssyndrome AT judithmartini hypertonictreatmentofacuterespiratorydistresssyndrome AT marcosintaglietta hypertonictreatmentofacuterespiratorydistresssyndrome AT danielmtartakovsky hypertonictreatmentofacuterespiratorydistresssyndrome |