Experimental Lung Research

Acute respiratory distress syndrome (ARDS) presents a complex and challenging condition characterized by severe and refractory hypoxia, often triggered by intense inflammatory processes. Despite extensive efforts, the existing treatment and support strategies for ARDS have shown limited efficacy in reducing short- or long-term mortality rates. Lung-protective ventilation and conservative fluid therapy, aimed at mitigating ventilator-induced lung injury (VILI) and pulmonary edema, respectively, have yielded only marginal improvements. Moreover, the optimal approach to lung-protective ventilation remains elusive, and evidence suggests the absence of safe tidal volume and airway pressure thresholds for ARDS patients. Additionally, the translocation of proinflammatory mediators and bacterial products from the injured epithelium and endothelium fuel systemic inflammation, further complicating the management of ARDS.

In light of the challenges posed by ARDS and the limited success of conventional treatments, exploring alternative extrapulmonary oxygen support strategies has gained significant importance. These novel approaches offer potential benefits by bypassing the injured lungs, promoting parenchymal repair, and augmenting systemic oxygenation while reducing the risk of VILI. Among the current extrapulmonary oxygen delivery methods, extracorporeal membrane oxygenation (ECMO) stands as the only approved option. However, the utilization of ECMO presents challenges, such as the need for high-dose anticoagulants, which can elevate bleeding risks and pose complications. An alternative approach to extrapulmonary oxygenation has the potential to revolutionize the clinical management of ARDS and acute hypoxemic respiratory failure (AHRF), significantly enhancing patient care.

This collection aims to solicit manuscripts from esteemed researchers detailing their ground-breaking work on extrapulmonary oxygenation strategies. The collection of articles will focus on research that explores innovative ways to deliver oxygen to critically ill patients, circumventing the limitations of conventional ventilation methods. We invite submissions that present cutting-edge research on extrapulmonary oxygen support, including studies on novel technologies, experimental models, and clinical trials. Manuscripts discussing the safety, efficacy, and potential impact of these strategies in various patient populations will be welcomed. The proposed collection seeks to encompass a wide range of article types, including original research articles, reviews, case studies, and perspectives, aiming to create a comprehensive and informative resource for the medical community. Together, this collection will inspire further advancements and foster collaborations in the quest for more effective treatment strategies for patients with ARDS and respiratory failure.

Dr. Keely Buesing is a physician-scientist and Acute Care Surgeon who specializes in traumatically injured and critically ill patients at the University of Nebraska Medical Center (UNMC) & Nebraska Medicine (NM), an academic-affiliated Level 1 Trauma Center in Omaha, Nebraska. Dr. Buesing and her research team focus their investigations on lung pathology secondary to inhalation injury and potential novel therapeutic strategies. Dr. Buesing’s interest in the deleterious effects of isolated smoke inhalation originated from her prior experience as an Emergency Medical Technician and Firefighter, and has since expanded to include countermeasures targeted to inhalational bioterrorism agents through her work with various Department of Defense (DoD) contracting agencies.

Disclosure Statement: Dr. Buesing serves as a member on the Scientific Advisory Board for Respirogen, Inc., which aims to develop oxygen microbubble therapy as a treatment strategy for extrapulmonary oxygenation in patients with acute hypoxic respiratory failure. She receives compensation in the form of stock options.

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