Expert Review of Respiratory Medicine最新文献_第6页

Not all nebulizers are created equal: Considerations in choosing a nebulizer for aerosol delivery during mechanical ventilation. 并非所有雾化器都是平等的:在机械通气期间选择雾化器进行气溶胶输送的考虑因素。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2183194

Ronan MacLoughlin, Ignacio Martin-Loeches

{"title":"Not all nebulizers are created equal: Considerations in choosing a nebulizer for aerosol delivery during mechanical ventilation.","authors":"Ronan MacLoughlin, Ignacio Martin-Loeches","doi":"10.1080/17476348.2023.2183194","DOIUrl":"https://doi.org/10.1080/17476348.2023.2183194","url":null,"abstract":"Introduction: Aerosol therapy is commonly prescribed in the mechanically ventilated patient. Jet nebulizers (JN) and vibrating mesh nebulizers (VMN) are the most common nebulizer types, however, despite VMN's well established superior performance, JN use remains the most commonly used of the two. In this review, we describe the key differentiators between nebulizer types and how considered selection of nebulizer type may enable successful therapy and the optimization of drug/device combination products.Areas covered: Following a review of the published literature up to February 2023, the current state of the art in relation to JN and VMN is discussed under the headings of in vitro performance of nebulizers during mechanical ventilation, respective compatibility with formulations for inhalation, clinical trials making use of VMN during mechanical ventilation, distribution of nebulized aerosol throughout the lung, measuring the respective performance of nebulizers in the patient and non-drug delivery considerations in nebulizer choice.Expert opinion: Whether for standard care, or the development of drug/device combination products, the choice of nebulizer type should not be made without consideration of the unique needs of the combination of each of drug, disease and patient types, as well as target site for deposition, and healthcare professional and patient safety.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"131-142"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

An expert overview of pulmonary fibrosis in sarcoidosis. 结节病肺纤维化的专家综述。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2183193

Rohit Gupta, Jin Sun Kim, Robert P Baughman

{"title":"An expert overview of pulmonary fibrosis in sarcoidosis.","authors":"Rohit Gupta, Jin Sun Kim, Robert P Baughman","doi":"10.1080/17476348.2023.2183193","DOIUrl":"https://doi.org/10.1080/17476348.2023.2183193","url":null,"abstract":"Introduction: Advanced pulmonary sarcoidosis refers to phenotypes of pulmonary sarcoidosis that often lead to significant loss of lung function, respiratory failure, or death. Around 20% of patients with sarcoidosis may progress to this state which is mainly driven by advanced pulmonary fibrosis. Advanced fibrosis often presents with associated complications of sarcoidosis including infections, bronchiectasis, and pulmonary hypertension.Areas covered: This article will focus on the pathogenesis, natural history of disease, diagnosis, and potential treatment options of pulmonary fibrosis in sarcoidosis. In the expert opinion section, we will discuss the prognosis and management of patients with significant disease.Expert opinion: While some patients with pulmonary sarcoidosis remain stable or improve with anti-inflammatory therapies, others develop pulmonary fibrosis and further complications. Although advanced pulmonary fibrosis is the leading cause of death in sarcoidosis, there are no evidence-based guidelines for the management of fibrotic sarcoidosis. Current recommendations are based on expert consensus and often include multidisciplinary discussions with experts in sarcoidosis, pulmonary hypertension, and lung transplantation to facilitate care for such complex patients. Current works evaluating treatments include the use of antifibrotic therapies for treatment in advanced pulmonary sarcoidosis.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"119-130"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9186112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Respiratory management in the premature neonate. 早产儿的呼吸管理。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2183843

Vikramaditya Dumpa, Indirapriya Avulakunta, Vineet Bhandari

{"title":"Respiratory management in the premature neonate.","authors":"Vikramaditya Dumpa, Indirapriya Avulakunta, Vineet Bhandari","doi":"10.1080/17476348.2023.2183843","DOIUrl":"https://doi.org/10.1080/17476348.2023.2183843","url":null,"abstract":"Introduction: Advances in neonatal care have made possible the increased survival of extremely preterm infants. Even though there is widespread recognition of the harmful effects of mechanical ventilation on the developing lung, its use has become imperative in the management of micro-/nano-preemies. There is an increased emphasis on the use of less-invasive approaches such as minimally invasive surfactant therapy and non-invasive ventilation that have been proven to result in improved outcomes.Areas covered: Here, we review the evidence-based practices surrounding the respiratory management of extremely preterm infants including delivery room interventions, invasive and non-invasive ventilation approaches, and specific ventilator strategies in respiratory distress syndrome and bronchopulmonary dysplasia. Adjuvant relevant respiratory pharmacotherapies used in preterm neonates are also discussed.Expert opinion: Early use of non-invasive ventilation and use of less invasive surfactant administration are key strategies in the management of respiratory distress syndrome in preterm infants. Ventilator management in bronchopulmonary dysplasia must be tailored according to the individual phenotype. There is strong evidence to start caffeine early to improve respiratory outcomes, but evidence is lacking on the use of other pharmacological agents in preterm neonates, and an individualized approach has to be considered for their use.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"155-170"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Managing cystic fibrosis in children aged 6-11yrs: a critical review of elexacaftor/tezacaftor/ivacaftor combination therapy. 6-11岁儿童囊性纤维化的治疗:elexaftor /tezacaftor/ivacaftor联合治疗的重要回顾

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2179989

Kamyron D Jordan, Edith T Zemanick, Jennifer L Taylor-Cousar, Jordana E Hoppe

{"title":"Managing cystic fibrosis in children aged 6-11yrs: a critical review of elexacaftor/tezacaftor/ivacaftor combination therapy.","authors":"Kamyron D Jordan, Edith T Zemanick, Jennifer L Taylor-Cousar, Jordana E Hoppe","doi":"10.1080/17476348.2023.2179989","DOIUrl":"https://doi.org/10.1080/17476348.2023.2179989","url":null,"abstract":"Introduction: Cystic fibrosis is a life-limiting, autosomal recessive genetic disorder resulting in multi-organ disease due to CF transmembrane conductance regulator (CFTR) protein dysfunction. CF treatment previously focused on mitigation of disease signs and symptoms. The recent introduction of highly effective CFTR modulators, for which ~90% of people with CF are CFTR variant-eligible, has resulted in substantial health improvements.Areas covered: In this review, we will describe the clinical trials leading to approval of the highly effective CFTR modulator, elexacaftor-tezacaftor-ivacaftor (ETI), with a focus on the safety and efficacy of this treatment in children aged 6-11 years.Expert opinion: The use of ETI in variant-eligible children aged 6-11 is associated with marked clinical improvements with a favorable safety profile. We anticipate that introduction of ETI in early childhood may result in the prevention of pulmonary, gastrointestinal, and endocrine complications from CF, consequently leading to previously unimaginable gains in the quality and quantity of life. However, there is an urgent need to develop effective treatments for the remaining 10% of people with CF who are not eligible or unable to tolerate ETI treatment, and to increase access of ETI to more pwCF across the world.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"97-108"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

The prevention and management strategies for neonatal chronic lung disease. 新生儿慢性肺病的预防和管理策略。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2183842

Christopher Harris, Anne Greenough

{"title":"The prevention and management strategies for neonatal chronic lung disease.","authors":"Christopher Harris, Anne Greenough","doi":"10.1080/17476348.2023.2183842","DOIUrl":"https://doi.org/10.1080/17476348.2023.2183842","url":null,"abstract":"Introduction: Survival from even very premature birth is improving, but long-term respiratory morbidity following neonatal chronic lung disease (bronchopulmonary dysplasia (BPD)) has not reduced. Affected infants may require supplementary oxygen at home, because they have more hospital admissions particularly due to viral infections and frequent, troublesome respiratory symptoms requiring treatment. Furthermore, adolescents and adults who had BPD have poorer lung function and exercise capacity.Areas covered: Antenatal and postnatal preventative strategies and management of infants with BPD. A literature review was undertaken using PubMed and Web of Science.Expert opinion: There are effective preventative strategies which include caffeine, postnatal corticosteroids, vitamin A, and volume guarantee ventilation. Side-effects, however, have appropriately caused clinicians to reduce use of systemically administered corticosteroids to infants only at risk of severe BPD. Promising preventative strategies which need further research are surfactant with budesonide, less invasive surfactant administration (LISA), neurally adjusted ventilatory assist (NAVA) and stem cells. The management of infants with established BPD is under-researched and should include identifying the optimum form of respiratory support on the neonatal unit and at home and which infants will most benefit in the long term from pulmonary vasodilators, diuretics, and bronchodilators.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"143-154"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mepolizumab for the treatment of chronic rhinosinusitis with nasal polyps in adults. Mepolizumab用于治疗成人慢性鼻窦炎伴鼻息肉。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2181794

Josh Neposlan, Leigh J Sowerby, Ameen Biadsee

{"title":"Mepolizumab for the treatment of chronic rhinosinusitis with nasal polyps in adults.","authors":"Josh Neposlan, Leigh J Sowerby, Ameen Biadsee","doi":"10.1080/17476348.2023.2181794","DOIUrl":"https://doi.org/10.1080/17476348.2023.2181794","url":null,"abstract":"Introduction: The treatment paradigm for chronic rhinosinusitis with nasal polyps (CRSwNP) is complex, consisting of a combination of conservative, medical and surgical management. High rates of recurrence despite current standard of care has led to the search for treatments that can improve outcomes and limit the treatment burden for patients living with this chronic condition.Areas covered: Eosinophils are granulocytic white blood cells that proliferate as part of the innate immune response. IL5 is an inflammatory cytokine implicated in the development of eosinophil-associated diseases that has emerged as a target for biologic therapy. Mepolizumab (NUCALA) is a humanized antiIL5 monoclonal antibody that represents a novel therapeutic approach to CRSwNP. The results of multiple clinical trials are encouraging but its real-world implementation requires a thorough cost-benefit analysis across a range of clinical situations.Expert opinion: : Mepolizumab is an emerging biologic therapy that shows promising potential for the treatment of CRSwNP. It appears to provide both objective and subjective improvement as an addon therapy to standard of care treatment. Its specific role in treatment algorithms remains a topic of discussion. Future research surrounding its efficacy and cost effectiveness as compared to alternative options is needed.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"109-118"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of kidney transplantation on indices of cardiorespiratory fitness assessed with cardiopulmonary exercise testing: a systematic review and meta-analysis. 肾移植对心肺运动试验评估的心肺功能指标的影响:系统回顾和荟萃分析。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI: 10.1080/17476348.2023.2182772

Eva Pella, Maria-Eleni Alexandrou, Afroditi Boutou, Marieta Theodorakopoulou, Konstantina Dipla, Andreas Zafeiridis, Pantelis Sarafidis

{"title":"Effect of kidney transplantation on indices of cardiorespiratory fitness assessed with cardiopulmonary exercise testing: a systematic review and meta-analysis.","authors":"Eva Pella, Maria-Eleni Alexandrou, Afroditi Boutou, Marieta Theodorakopoulou, Konstantina Dipla, Andreas Zafeiridis, Pantelis Sarafidis","doi":"10.1080/17476348.2023.2182772","DOIUrl":"https://doi.org/10.1080/17476348.2023.2182772","url":null,"abstract":"Background: Patients with kidney failure often present with reduced cardiovascular reserve. Kidney transplantation (KT) is the optimal treatment for patients with end-stage kidney disease as it is associated with longer survival and improved quality of life compared to dialysis.Methods: This is a systematic review and meta-analysis of studies using cardiopulmonary-exercise-testing to examine the cardiorespiratory fitness of patients with kidney failure before and after KT. The primary outcome was difference in pre- and post-transplantation values of peak oxygen uptake (VO2peak). Literature search involved three databases (PubMed-Web of Science-Scopus), manual search, and grey literature.Results: From 379 records initially retrieved, six studies were included in final meta-analysis. A marginal, but not significant, improvement was observed in VO2peak after KT compared to pre-transplantation values (SMD: 0.32, 95%CI -0.02; 0.67). Oxygen consumption at anaerobic threshold was significantly improved after KT (WMD: 2.30 ml/kg/min, 95%CI 0.50; 4.09). Consistent results were shown between preemptive and after-dialysis-initiation transplantation and a trend for improvement in VO2peak was observed at least 3 months post-transplantation, but not earlier.Conclusion: Several major indices of cardiorespiratory fitness tend to improve after KT. This finding may represent another modifiable factor contributing to better survival rates of kidney transplant recipients compared to patients undergoing dialysis.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 2","pages":"171-179"},"PeriodicalIF":3.9,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter to the editor: "Clinical controversies in the management of acute pulmonary embolism". 致编辑的信：“急性肺栓塞治疗中的临床争议”。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-05-18 DOI: 10.1080/17476348.2023.2214733

Scott D Casey, Samuel G Rouleau, David R Vinson, Nareg H Roubinian

引用次数: 0

Response to letter to the editor: "Clinical controversies in the management of acute pulmonary embolism: evaluation of four important but controversial aspects of acute pulmonary embolism management that are still subject of debate and research". 回复编辑的信：“急性肺栓塞治疗中的临床争议：对急性肺栓塞管理的四个重要但有争议的方面的评估，这些方面仍然是争论和研究的主题”。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-05-19 DOI: 10.1080/17476348.2023.2215015

Dieuwke Luijten, Frederikus A Klok, Thijs E van Mens, Menno V Huisman

引用次数: 0

Identification and management of connective tissue disease-associated interstitial lung disease: evidence-based Japanese consensus statements. 结缔组织病相关间质性肺病的识别与管理：循证日本共识声明。

IF 3.9 3区医学

Expert Review of Respiratory Medicine Pub Date : 2023-01-01 Epub Date: 2023-02-20 DOI: 10.1080/17476348.2023.2176303

Masataka Kuwana, Masashi Bando, Yutaka Kawahito, Shinji Sato, Takafumi Suda, Yasuhiro Kondoh

{"title":"Identification and management of connective tissue disease-associated interstitial lung disease: evidence-based Japanese consensus statements.","authors":"Masataka Kuwana, Masashi Bando, Yutaka Kawahito, Shinji Sato, Takafumi Suda, Yasuhiro Kondoh","doi":"10.1080/17476348.2023.2176303","DOIUrl":"10.1080/17476348.2023.2176303","url":null,"abstract":"Background: Interstitial lung disease (ILD) is a common complication of connective tissue diseases (CTD), but there are few clinical trials to guide disease management. We aimed to develop expert consensus statements and an algorithm for CTD-ILD management.Research design and methods: Based on a targeted literature review, we developed 109 statements on managing CTD-ILD across six domains. We used a modified Delphi process to survey 22 physicians in Japan involved in managing CTD-ILD (specialists in pulmonology, rheumatology, pathology, and radiology). These panelists participated in two rounds of web-based survey to establish consensus statements, which were used to define an algorithm. Consensus was defined as a mean value ≥70 on a scale of 0 (strong disagreement) to 100 (strong agreement).Results: Between May-August 2022, consensus was reached on 93 statements on CTD-ILD management. The most important consensus statements included screening CTD patients for ILD (typically with high-resolution computed tomography), using imaging, pulmonary function testing and serum biomarkers for diagnosis and severity assessment, regularly following up patients, and multidisciplinary management of CTD-ILD. Consensus statements were interpreted into an algorithm for clinical guidance.Conclusions: Using the Delphi process, we have developed consensus statements and an algorithm to guide clinical decision-making for CTD-ILD.","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":"17 1","pages":"71-80"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9525848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0