Pulmonary Edema Research Articles

Torsemide as a Primary Choice in Edema Associated with Heart Failure.

Heart failure (HF) is the fastest-growing disease with a higher fatality rate. The most differentiating feature of HF is pulmonary or peripheral edema, which is characterized by a gradient between intravascular and extravascular pressure. Loop diuretics were chosen as the primary treatment for edema associated with HF due to their efficacy and early onset of action. If an oral dose had not been provided, intravenous (IV) administration of torsemide, or equal doses of furosemide and bumetanide, was preferred. However, the key variables for selecting and administering loop diuretics are their pharmacological qualities as well as their clinical efficacy. Torsemide has greater bioavailability, a higher rate of absorption, a longer duration of action, and lesser ototoxicity, making it the primary choice in the management of edematous HF.

A Novel Approach for Stratifying Pulmonary Edema Severity on Chest X-ray via Dual-Mechanic Self-Learning and Bidirectional Multi-Modal Cross-Attention Algorithms

Abstract Accurate assessment of pulmonary edema severity in acute decompensated congestive heart failure (CHF) patients is vital for treatment decisions. Traditional methods face challenges due to the complexity of chest X-ray (CXR) and unstructured radiology reports. We proposed a method combining self-supervised learning and multimodal cross-attention to address these challenges. Dual-mechanic self-supervised pre-training enhances feature extraction using contrastive learning between text and image features, and generative learning between images. A bidirectional multi-modal cross-attention model integrates image and text information for fine-tuning, improving model performance. Four CXR datasets consisting of 519, 437 images were used for pre-training; 1200 randomly selected image-text pairs were used for fine-tuning and partitioned into train, validation, and test sets at 3: 1: 1. Ablation studies for pre-training and fine-tuning approaches indicated their practicality as evidenced by the optimal macro F1 score of 0.667 and optimal macro-AUC of 0.904. It also outperformed other state-of-the-art multi-modality methods. The novel approach could accurately assess pulmonary edema severity, offering crucial support for CHF patient management.

Effect of different priming fluids on extravascular lung water, cell integrity and oxidative stress in cardiopulmonary bypass surgery.

Discussions continue on the ideal priming fluid in adult cardiac surgery. The purpose of this prospective study was to evaluate the effects of different types of priming fluids on extravascular lung water, cell integrity and oxidative stress status. Thirty elective coronary artery bypass surgery patients were randomised prospectively into two groups. The first group received colloid priming fluid, while the second group received crystalloid priming fluid. Extravascular lung water index, advanced oxidative protein products, total thiol, free haemoglobin, ischaemic modified albumin and sialic acid levels were measured. Moreover, intra-operative and postoperative outcomes were reviewed. There were no significant differences between the groups with regard to extravascular lung water index, oxidative stress parameters or cell integrity (p > 0.05). Similarly, no significant differences were observed between the patients with regard to intra-operative and postoperative outcomes (p > 0.05). The presumed superiority of colloidal priming for cardiopulmonary bypass could not be confirmed in our study.

Study on the correlation between angiopoietin-2 and prognosis in patients with acute respiratory distress syndrome

To evaluate the predictive value of angiopoietin-2 (Ang-2) for the prognosis in patients with acute respiratory distress syndrome (ARDS). A retrospective study was conducted, and ARDS patients admitted to the department of emergency medicine of Tongde Hospital of Zhejiang Province from December 2020 to September 2022 were enrolled. General information including gender, age, causes of ARDS, disease severity scores, plasma Ang-2 levels before treatment and at 24, 48, and 72 hours after treatment, and record the 60-day prognosis were collected. Differences in clinical data between groups were compared. Multivariate Logistic regression analysis was used to identify the independent risk factors affecting the 60-day prognosis of ARDS patients, and the receiver operator characteristic curve (ROC curve) was plotted to assess the predictive value of these risk factors for patient outcomes. Pearson correlation analysis was used to assess the correlation between Ang-2 and pulmonary vascular permeability index (PVPI) and extravascular lung water index (EVLWI). A total of 132 ARDS patients were included, of which 49 patients died within 60 days and 83 patients survived. In the death group, plasma Ang-2 levels showed a gradually increasing trend, all significantly higher than before treatment (μg/L: 12.75±1.81, 12.74±1.48, 13.45±2.21 vs. 5.98±0.57, all P < 0.05), while the trend in the survival group was not significant. At 24, 48, and 72 hours after treatment, plasma Ang-2 levels in the death group were significantly higher than those in the survival group (μg/L: 12.75±1.81 vs. 7.48±1.22, 12.74±1.48 vs. 7.41±1.19, 13.45±1.41 vs. 6.88±1.41, all P < 0.05). After adjusting for confounding variables, increased plasma Ang-2 level was an independent risk factor for prognosis in ARDS patients within 60 days [odds ratio (OR) = 0.998, 95% confidence interval (95%CI) was 0.997-0.999, P < 0.01]. ROC curve analysis demonstrated that Ang-2 levels had predictive value for prognosis in ARDS patients [area under the ROC curve (AUC) = 0.985, 95%CI was 0.971-1.000, approximate maximum Youden's index 0.867, optimal cut-off value 8.43 μg/L]. Pearson correlation analysis showed that plasma Ang-2 levels were positively correlated with PVPI and EVLWI ( r values were 0.620 and 0.712 respectively, both P < 0.01). Elevated level of Ang-2 is an independent risk factor for increased mortality in patients with ARDS. Higher Ang-2 levels within 72 hours after treatment may indicate poorer prognosis.

Клінічний випадок хірургічного лікування гострої мітральної недостатності на тлі гострого інфаркту міокарда

Papillary muscle rupture is a rare mechanical complication of the natural course of acute myocardial infarction. It to severe mitral valve insufficiency, which occurs acutely and may be accompanied by cardiogenic shock and pulmonary edema, requiring urgent intensive therapy. However, purely medical treatment of these patients is associated with a mortality rate as high as 75 % within the first 24 hours after onset. Therefore, emergent surgical intervention is a method of choice in the treatment of this pathology. We present a clinical case of successful surgical treatment of acute mitral insufficiency caused by papillary muscle rupture in the context of acute myocardial infarction.

Risk Factors for Postoperative Atrial Fibrillation in Myocardial Revascularization Surgery: A 15-Year Experience.

Background: Myocardial revascularization surgery (MRV) is a revascularization therapy for coronary artery disease aimed at improving survival conditions. Elderly patients with increased comorbidities undergoing MRV face challenges in preventing postoperative complications, including atrial fibrillation (AF), a common arrhythmia occurring in 40% of cases or even in 80% of cases if the procedure is combined with valve surgery. This study aimed to determine the risk factors associated with the appearance of postoperative AF (POAF) in patients undergoing isolated MRV. Methods: This is an epidemiological, retrospective, and analytical case-control study (90 cases and 360 controls). Results: Mortality within the group of patients who presented with POAF in the study population was 15.5%, and 9.44% in the control group. Logistic regression showed an association of AF with the presurgical variables age >60 years and urgent/emergency surgery and the postsurgical variables cardiogenic shock, blood transfusion, pulmonary edema, pleural effusion, orotracheal reintubation, and mechanical ventilation time. Conclusions: Strategies should be proposed for the timely identification of risk factors and postoperative complications related to AF onset to avoid the increased morbidity and mortality associated with this type of arrhythmia during the postoperative period.

Left Lobe Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease Patient: A Case Report

Hepatocellular Carcinoma (HCC) is the second most common cause of death from cancer worldwide, affecting more men than women with a ratio of 2:1. Approximately 70–90% of HCC patients have risk factors such as chronic liver disease and liver cirrhosis. Another significant risk factor is non-alcoholic fatty liver disease (NAFLD). We report a case of left lobe hepatocellular carcinoma in a 54-year-old woman who presented with heartburn and shortness of breath, with a history of hypertension but no alcohol consumption. Chest X-ray revealed cardiomegaly without pulmonary congestion. A whole abdominal CT scan identified a left lobe hepatic tumor measuring ± 11x12x13 cm. Pathology examination revealed an epithelial mass with infiltrative, trabecular, acinar, and solid arrays, indicative of a malignant liver tumor.

Administration of carperitide in cases of pulmonary edema with preeclampsia: a pilot case series

Administration of carperitide in cases of pulmonary edema with preeclampsia: a pilot case series

Acute post-streptococcal glomerulonephritis with bilateral pleural effusion in a 12-year-old child in rural area: A case report

Background: Nephritic syndrome is a group of symptoms such as hematuria, hypertension, oliguria and edema. The most common cause of acute nephritic syndrome in children is acute glomerulonephritis after streptococcal infection. Case Presentation: A 12-year-old child came to the ER with shortness of breath for 3 days and swelling of the face. There was no history of fever or diarrhea. The patient had a history of itching of the feet 2 weeks earlier. Vital signs found blood pressure of 160/120 mmHg and edema was found on the face especially in the eyelids. Urine examination found a high number of leukocytes and erythrocytes and there was albumin +2 in the urine. Examination of kidney function showed an increase in urea and creatinine. Chest X-ray examination showed pulmonary edema and bilateral effusion. ASTO titer examination obtained a level of 200 IU/ml. The patient was given therapy in the form of antihypertensives, antibiotics and corticosteroids. After 1 week of hospitalization, the blood pressure target and clinical improved, the patient was able to leave the hospital, checked into the polyclinic to continue treatment and evaluated urine examination of kidney function every 2 weeks. Summary: Acute nephritic syndrome is a disease that is rarely found in pediatric patients, most of the causes are acute glomerulonephritis after streptococcal infection with clinical manifestations in the form of throat infection or skin infection in the form of impetigo. With proper diagnosis and management, this disease can be cured with perfect healing, but some cases can occur acute kidney failure so that monitoring is needed.

Transplantation, bridging, and support technologies in pulmonary hypertension.

Despite the progress made in medical therapies for treating pulmonary hypertension (PH), a subset of patients remain susceptible to developing a maladaptive right ventricular phenotype. The effective management of end-stage PH presents substantial challenges, necessitating a multidisciplinary approach and early identification of patients prone to acute decompensation. Identifying potential transplant candidates and assessing the feasibility of such a procedure are pivotal tasks that should be undertaken early in the treatment algorithm. Inclusion on the transplant list is contingent upon a comprehensive risk assessment, also considering the specific type of PH and various factors affecting waiting times, all of which should inform the decision-making process. While bilateral lung transplantation is the preferred option, it demands expert intra- and post-operative management to mitigate the heightened risks of pulmonary oedema and primary graft dysfunction in PH patients.Despite the availability of risk assessment tools, the occurrence of acute PH decompensation episodes can be unpredictable, potentially leading to refractory right ventricular failure even with optimal medical intervention, necessitating the use of rescue therapies. Advancements in right ventricular assist techniques and adjustments to graft allocation protocols for the most critically ill patients have significantly enhanced the survival in intensive care, affording the opportunity to endure while awaiting an urgent transplant. Given the breadth of therapeutic options available, specialised centres capable of delivering comprehensive care have become indispensable for optimising patient outcomes. These centres are instrumental in providing holistic support and management tailored to the complex needs of PH patients, ultimately enhancing their chances of a successful transplant and improved long-term prognosis.

CMR to characterize myocardial structure and function in heart failure with preserved left ventricular ejection fraction.

Despite remarkable progress in therapeutic drugs, morbidity, and mortality for heart failure (HF) remains high in developed countries. HF with preserved ejection fraction (HFpEF) now accounts for around half of all HF cases. It is a heterogeneous disease, with multiple aetiologies, and as such poses a significant diagnostic challenge. Cardiac magnetic resonance (CMR) has become a valuable non-invasive modality to assess cardiac morphology and function, but beyond that, the multi-parametric nature of CMR allows novel approaches to characterize haemodynamics and with magnetic resonance spectroscopy (MRS), the study of metabolism. Furthermore, exercise CMR, when combined with lung water imaging provides an in-depth understanding of the underlying pathophysiological and mechanistic processes in HFpEF. Thus, CMR provides a comprehensive phenotyping tool for HFpEF, which points towards a targeted and personalized therapy with improved diagnostics and prevention.

Acute leptospirosis in horses: A retrospective study of 11 cases (2015-2023).

Reports of leptospirosis in horses are limited. To describe the clinical and diagnostic findings of acute systemic leptospirosis in horses. Eleven client-owned horses presented to an equine hospital because of acute onset of disease between 2015 and 2023. Retrospective case series. Horses diagnosed with leptospirosis by 1 or more of urine PCR, serologic microscopic agglutination test (MAT), and histopathology. Common clinical signs included lethargy (10), anorexia (10), fever (9), tachypnea (9), abnormal lung sounds (9), and epistaxis (6). Acute kidney injury was present in all cases. Evidence of pulmonary hemorrhage and liver disease was found in 8 (73%) and 6 (55%) horses, respectively. In 6 (55%) horses, kidneys, lungs, and liver were affected. Urine quantitative polymerase chain reaction for detection of pathogenic Leptospira spp. was positive in 6 (55%) cases. On serology Leptospira interrogans serovar Australis, Autumnalis, and Bratislava accounted for 86% of all titers ≥1 : 800. Overall case fatality rate was 4/11 (36%). Main findings on necropsy were tubular necrosis, interstitial nephritis, hemorrhage in the alveoli, pulmonary edema, periportal hepatitis and necrosis, cholestasis, and cholangitis. Leptospirosis should be considered as a differential diagnosis in horses with evidence of acute systemic inflammation and acute renal injury, epistaxis, or hepatic disease. For increased likelihood of identifying positive cases, both MAT serology and urine PCR should be performed.

Tetramethylpyrazine ameliorates LPS-induced acute lung injury via the miR-369-3p/DSTN axis

Acute lung injury (ALI) is a severe clinical respiratory condition characterized by high rates of mortality and morbidity, for which effective treatments are currently lacking. In this study, lipopolysaccharide (LPS) was used to induce ALI mice, demonstrating the efficacy of tetramethylpyrazine (TMP) in ameliorating ALI. Subsequent we perfored high-throughput sequencing analysis and used Targetscan 8.0 and miRWalk 3.0 databases to predict the interaction between microRNAs and destrin (DSTN), ultimately identifying miR-369-3p as the focus of the investigation. The adenovirus carrying miR-369-3p was administered one week prior to LPS-induced in order to assess its potential efficacy in ameliorating ALI in mice. The findings indicated that the overexpression of miR-369-3p resulted in enhanced lung function, reduced pulmonary edema, inflammation, and permeability in LPS-induced ALI mice, while the suppression of miR-369-3p exacerbated the damage in these mice. Furthermore, the beneficial effects of TMP on LPS-induced ALI were negated by the downregulation of miR-369-3p. The results of our study demonstrate that TMP mitigates LPS-induced ALI through upregulation of miR-369-3p. Consequently, the findings of this study advocate for the clinical utilization of TMP in ALI treatment, with miR-369-3p emerging as a promising target for future ALI interventions.

Identifying Early Risk Factors for Postoperative Pulmonary Complications in Cardiac Surgery Patients.

Background and Objectives: Postoperative pulmonary complications (PPCs) are common in patients who undergo cardiac surgery and are widely acknowledged as significant contributors to increased morbidity, mortality rates, prolonged hospital stays, and healthcare costs. Clinical manifestations of PPCs can vary from mild to severe symptoms, with different radiological findings and varying incidence. Detecting early signs and identifying influencing factors of PPCs is essential to prevent patients from further complications. Our study aimed to determine the frequency, types, and risk factors significant for each PPC on the first postoperative day. The main goal of this study was to identify the incidence of pleural effusion (right-sided, left-sided, or bilateral), atelectasis, pulmonary edema, and pneumothorax as well as detect specific factors related to its development. Materials and Methods: This study was a retrospective single-center trial. It involved 314 adult patients scheduled for elective open-heart surgery under CPB. Results: Of the 314 patients reviewed, 42% developed PPCs within 12 h post-surgery. Up to 60.6% experienced one PPC, while 35.6% developed two PPCs. Pleural effusion was the most frequently observed complication in 89 patients. Left-sided effusion was the most common, presenting in 45 cases. Regression analysis showed a significant association between left-sided pleural effusion development and moderate hypoalbuminemia. Valve surgery was associated with reduced risk for left-sided effusion. Independent parameters for bilateral effusion include increased urine output and longer ICU stays. Higher BMI was inversely related to the risk of pulmonary edema. Conclusions: At least one PPC developed in almost half of the patients. Left-sided pleural effusion was the most common PPC, with hypoalbuminemia as a risk factor for effusion development. Atelectasis was the second most common. Bilateral effusion was the third most common PPC, significantly related to increased urine output. BMI was an independent risk factor for pulmonary edema development.

POCUS literature primer: key papers on cardiac and lung POCUS.

Although point of care ultrasound (POCUS) use has become prevalent in medicine, clinicians may not be familiar with the evidence supporting its utility in patient care. The objective of this study is to identify the top five most influential papers published on the use of cardiac POCUS and lung POCUS in adult patients. A 14-member expert panel from the Canadian Association of Emergency Physicians (CAEP) Emergency Ultrasound Committee and the Canadian Ultrasound Fellowship Collaborative used a modified Delphi process. Panel members are ultrasound fellowship trained or equivalent, are engaged in POCUS scholarship, and are leaders in POCUS locally and nationally in Canada. The modified Delphi process consisted of three rounds of sequential surveys and discussion to achieve consensus on the top five most influential papers on cardiac POCUS and lung POCUS. A total of 66 relevant papers on cardiac POCUS and 68 relevant papers on lung POCUS were nominated by the panel. There was 100% participation by the panel members in all three rounds of the modified Delphi process. At the end of this process, we identified the top five most influential papers on cardiac POCUS and lung POCUS. Papers include studies supporting the use of POCUS for accurately assessing left ventricular systolic function, diagnosing pericardial effusion, clarifying its test characteristics for pulmonary embolism, identifying pulmonary edema and pneumonia, as well as consensus statements on the use of cardiac and lung POCUS in clinical practice. We have created a list of the top five influential papers on cardiac POCUS and lung POCUS as an evidence-based resource for trainees, clinicians, and researchers. This will help trainees and clinicians better understand how to use POCUS when scanning the heart and lungs, and it will also help researchers better understand where to direct their scholarly efforts with future research.

Imaging Identifies Superior Inflammation Targeting of M1 Macrophages for Cryo-Shocked Cell Pulmonary Drug Delivery to Treat Acute Lung Injury.

In the realm of combating acute lung injury (ALI) induced by a myriad of triggers including sepsis, pneumonia, aspiration, trauma, and pancreatitis, macrophages emerge as crucial players. However, traditional treatments such as systemic administration of glucocorticoids come with the baggage of severe side effects, curtailing their utility. Enter an innovative solution: a biomimetic drug delivery system fashioned from cryo-shocked macrophages, tailored for pulmonary drug delivery. Positron emission tomography (PET) imaging has shed light on the remarkable targeting abilities of live M1 macrophages, showcasing their unparalleled efficacy in homing in on local inflammatory foci when contrasted with naive, M1, and M2 macrophages. Building upon this foundation, liquid nitrogen-treated (LNT) M1 macrophages are developed, engineered to preserve their inflammation-targeting prowess while sidestepping the release of pro-inflammatory cytokines. This breakthrough allows for the delivery of glucocorticoids directly to inflamed lung tissues, efficiently quelling inflammation and mitigating pulmonary edema while drastically reducing systemic drug exposure. Inspired by the effectiveness of live M1 macrophages, the potential of glucocorticoid-loaded LNT M1 macrophages are harnessed, utilizing them as a stealthy "Trojan horse" in the battle against pneumonia-induced ALI. This innovative approach holds promise as a safe and potent treatment avenue for acute lung injury.

A case of renal artery stenosis combined with scintillation pulmonary edema

A case of renal artery stenosis combined with scintillation pulmonary edema

Semaglutide: An emerging treatment option for patients with obesity related HFpEF.

Dear Madam, Heart failure is a key contributor to patient morbidity and mortality and affects a staggering 64 million individuals around the globe1. An important sub-phenotype of heart failure is HFpEF, which is characterised by a left ventricular ejection fraction (LVEF) of 50 per-cent. Alarmingly, the incidence of this subtype has been rising globally, making the need for new treatment options extremely crucial2. Initially, the use of Semaglutide, a glucagon-like peptide-1 receptor agonist, showed favourable outcomes in cardiac function of mice. This study observed that weight loss achieved using Semaglutide was met with improvements in several factors associated with HFpEF (reduced LV hypertrophy and fibrosis, improved diastolic function, reduced lung congestion and improved exercise capacity) as compared to weight loss achieved through simple dietary means3. A step further in this direction is a clinical trial that shows that a weekly dosage of 2.4mg of Semaglutide in obesity related HFpEF patients is associated with significantly reduced symptoms and physical limitations, improved exercise function and greater weight loss than placebo4. Of the several parameters observed, improvements in CSS (Clinical Survey Score) of KCCQ (Kansas City Cardiomyopathy Questionnaire) and six minute walking distance were the most clinically meaningful. These promising findings are of particular value to Pakistani population, which has been prey to obesity and HF owing to Westernised eating habits, sedentary lifestyles and fewer healthcare facilities. In addition, South Asians have more fat content per BMI as compared to their white counterparts which coupled with the rising trends in NCD risks in South Asia5, are an immediate call for innovation in therapeutics. Semaglutide, considering its array of cardiometabolic benefits, may provide our doctors with a chance to step away from prescribing long lists of medications that are conventionally given to HF patients for symptom improvement. In a low- income country like Pakistan, this will ensure a better drug compliance and reduced disease burden. It is high time that we tap into the potential of Semaglutide and test its efficacy of it in our native population and take strides in ensuring its easy availability.

A rare case of ABO grouping discrepancy due to probable blood group switching which presented as lost antigens detectable only with indigenous reagents in less sensitive platforms compared to highly sensitive automated platforms using non indigenous reagents

Abstract: Blood group switching in the form of loss or diminished expression of RBC antigens has been reported in malignancies and infections. Blood group antigens are present on the red cell surface. ABO blood group system is the most clinically significant system. Some cases can present as grouping discrepancy. Here we present a rare case of ABO grouping discrepancy due to probable blood group switching which presented as lost antigens detectable only with indigenous reagents in less sensitive platforms compared to highly sensitive automated platforms using non indigenous reagents. 66 year old female whose historic blood group was A Rh D positive with history of uneventful transfusion of 2 units of A Rh D positive packed red cell one and half years back now presented with mycoplasma pneumonia and acute pulmonary edema. On routine complete blood count testing her hemoglobin was 3.6 gm%, request send to blood bank for pretransfusion testing. Testing performed via conventional tube technique and ABO blood group discrepancy was noted with forward grouping turned to be A Rh D positive (positive reaction with anti A1 lectin) and on reverse grouping 3+ reactions was observed in both A and B cell giving a picture of O blood group. Blood grouping was performed in different platforms including fully automated, semi automated and manual using commercially available antisera and human plasma as a source of anti A, anti B antibodies for forward grouping. The antisera used in automated platforms are non indigenous and that for manual are indigenous. Discrepancy was noted (Forward A and Reverse O) in CTT with commercially available antisera and human plasma as reagents for forward grouping .The same discrepancy was noted with CAT in neutral card with commercially available antisera for manual grouping. But when grouping performed with Column Agglutination Technology using matrix grouping gel card the discrepancy was resolved reporting the blood group as O. For further confirmation we repeated the blood grouping in another fully automated platform, SPRCA Technology (Immucore NEOIRIS) and in that also no discrepancy noted giving a picture of O group. This patient probably had undergone a blood group switching from A to O by losing some but not all A epitopes and started anti A antibody production. Some A epitopes which were not lost had been picked up by the commercially available antisera intended for manual grouping. These antisera are indigenous in origin. Also when human plasma was used as source of antibodies the A epitopes which were not lost were detected. But when grouping was done with non-indigenous antisera in both manual and automatic platform the A epitopes were not detected. This case points towards the relevance of incorporating indigenous antisera in automated platforms.

Dachengqi decoction dispensing granule ameliorates LPS-induced acute lung injury by inhibiting PANoptosis in vivo and in vitro

Ethnopharmacological relevanceAcute lung injury (ALI) is a serious health-threatening syndrome of intense inflammatory response in the lungs, with progression leading to acute respiratory distress syndrome (ARDS). Dachengqi decoction dispensing granule (DDG) has a pulmonary protective role, but its potential modulatory mechanism to alleviate ALI needs further excavation. Aim of the studyThis study aims to investigate the effect and potential mechanism of DDG on lipopolysaccharide (LPS)-induced ALI models in vivo and in vitro. Materials and methodsLPS-treated Balb/c mice and BEAS-2B cells were used to construct in vivo and in vitro ALI models, respectively. Hematoxylin-eosin (HE), Wet weight/Dry weight (W/D) calculation of lung tissue, and total protein and Lactic dehydrogenase (LDH) assays in BALF were performed to assess the extent of lung tissue injury and pulmonary edema. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), and interleukin-18 (IL-18) in BALF, serum, and cell supernatant. The qRT-PCR was used to detect inflammatory factors, Z-DNA binding protein 1 (ZBP1), and receptor-interacting protein kinase 1 (RIPK1) expression in lung tissues and BEAS-2B cells. Double immunofluorescence staining and co-immunoprecipitation were used to detect the relative expression and co-localization of ZBP1 and RIPK1. The effects of LPS and DDG on BEAS-2B cell activity were detected by Cell Counting Kit-8 (CCK-8). Western blot (WB) was performed to analyze the expression of PANoptosis-related proteins in lung tissues and BEAS-2B cells. ResultsIn vivo, DDG pretreatment could dose-dependently improve the pathological changes of lung tissue in ALI mice, and reduce the W/D ratio of lung, total protein concentration, and LDH content in BALF. In vitro, DDG reversed the inhibitory effect of LPS on BEAS-2B cell viability. Meanwhile, DDG significantly reduced the levels of inflammatory factors in vitro and in vivo. In addition, DDG could inhibit the expression levels of PANoptosis-related proteins, especially the upstream key regulatory molecules ZBP1 and RIPK1. ConclusionDDG could inhibit excessive inflammation and PANoptosis to alleviate LPS-induced ALI, thus possessing good anti-inflammatory and lung-protective effects. This study establishes a theoretical basis for the further development of DDG and provides a new prospect for ALI treatment by targeting PANoptosis.