RECENT FINDINGS: Recent advances in hydrogel-based engineering of vascularized organ bud enable vascular regeneration in self-assembled cellular niche containing parenchymal and stromal cells. The emerging technology of whole-organ decellularization provides scaffold materials that serve as extracellular niche guiding vascular regeneration to recapitulate native organ's vascular anatomy. Increasing morphological and molecular evidences suggest endothelial heterogeneity across different organs and across different vascular compartments within an organ. Deriving organ-specific endothelium from pluripotent stem cells has been shown to be possible by combining endothelial induction with parenchymal differentiation.
SUMMARY: Engineering organ-specific vasculature requires the combination of organ-specific endothelium with its unique cellular and extracellular niches. Future investigations are required to further delineate the mechanisms for induction and maintenance of organ-specific vascular phenotypes, and how to incorporate these mechanisms to engineering organ-specific vasculature.
METHODS: Patients with PARDS from 10 paediatric intensive care units across Asia from 2009 to 2015 were identified. Data on epidemiology and clinical outcomes were collected. Patients on HFOV were compared to patients on other modes of ventilation. The primary outcome was 28-day mortality and secondary outcomes were 28-day ventilator- (VFD) and intensive care unit- (IFD) free days. Genetic matching (GM) method was used to analyse the association between HFOV treatment with the primary outcome. Additionally, we performed a sensitivity analysis, including propensity score (PS) matching, inverse probability of treatment weighting (IPTW) and marginal structural modelling (MSM) to estimate the treatment effect.
RESULTS: A total of 328 patients were included. In the first 7 days of PARDS, 122/328 (37.2%) patients were supported with HFOV. There were significant differences in baseline oxygenation index (OI) between the HFOV and non-HFOV groups (18.8 [12.0, 30.2] vs. 7.7 [5.1, 13.1] respectively; p