Journal of thoracic disease最新文献

{"title":"Initial experience of complete portal robotic esophagectomy for esophageal carcinoma in semi-prone position under single-lumen insertion for anaesthesia.","authors":"Mu-Zi Yang, Zi-Hui Tan, Yuan-Yuan Zhang, Wei Gan, Chu-Long Xie, Tian-Yu Sun, Hao-Xian Yang","doi":"10.21037/jtd-24-1410","DOIUrl":"10.21037/jtd-24-1410","url":null,"abstract":"<p><p>Although robot-assisted esophagectomy has been widely used for the treatment of esophageal cancer (EC), no unified surgical technique is available. Thus, we summarized our own technique of robotic portal esophagectomy with four arms (RPE-4) for the surgical treatment of EC. A total of 22 patients with RPE-4 between June 2018 and October 2023 were included in the study. These patients received RPE-4 in the semi-prone position for thoracic procedures and in the supine position for abdominal procedures using the Da Vinci Si/Xi system. Four arms of the Da Vinci Si/Xi system combined with a 12-mm assistant port were used in all cases. Single-lumen tracheal tube insertion was performed for anesthesia, with the use of CO₂ insufflation. The mean age of the entire cohort was 62.4±5.4 years, and 77.3% (17/22) of the patients were male. All patients completed surgeries successfully without perioperative death or conversion to open surgery. The median operative time was 325.0 min [interquartile range (IQR), 296.3-391.3 min], and the median blood loss was 100.0 mL (IQR, 100.0-125.0 mL). The median number of harvested lymph nodes (LNs) was 28.0 (IQR, 21.3-45.3), and the median length of postoperative stay was 9.0 days (IQR, 6.8-12.5 days). There was no intraoperative complication. Four patients had postoperative complications, but all of them were cured by conservative therapy. In conclusion, RPE-4 under single-lumen insertion for anaesthesia with artificial pneumothorax in the semi-prone position was a safe and effective technique for surgical treatment of EC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2693-2704"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three key factors predicting the severity of exacerbations of chronic obstructive pulmonary disease: T lymphocytes, lactate, and prealbumin.","authors":"Haijun Wang, Peter S P Cho, Vasileios Kouritas, Lanfang Feng","doi":"10.21037/jtd-2025-416","DOIUrl":"10.21037/jtd-2025-416","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a significant disease, and the main burden on global human health and economy. Currently, the pulmonary function test is the most common method for diagnosing AECOPD in clinical practice. The three levels (Grade I, II and III) of AECOPD exhibit different clinical characteristics and have a significant impact on the treatment and prognosis of patients. This study examined the correlation between serum lactic acid, pre-albumin, and lymphocyte levels, and the severity of AECOPD.</p><p><strong>Methods: </strong>A total of 261 patients with AECOPD were divided into the following three grades: Grade I: patients without respiratory failure. Grade II: patients with non-life-threatening respiratory failure; and Grade III: patients with life-threatening respiratory failure. The serum markers of the patients were analyzed. Flow cytometry was used to identify T, B, and natural killer (NK) lymphocyte subgroups, while immunoturbidimetry and an enzyme-linked immunosorbent assay (ELISA) were used to detect pre-albumin and lactic acid levels, respectively.</p><p><strong>Results: </strong>Cluster of differentiation (CD)3⁺ T cells, CD4⁺ T cells, and the CD4⁺/CD8⁺ ratio were significantly higher in the Grade I group, while CD19⁺ B cells were significantly lower in the Grade II group. The Grade I group also had higher levels of CD56⁺ cells than the Grade III group. Serum pre-albumin levels were significantly lower in Grade II and III groups, while serum lactate levels were significantly higher in the Grade III group. C-reactive protein (CRP) levels were also higher in the Grade II group.</p><p><strong>Conclusions: </strong>Serum pre-albumin, lactate, and lymphocyte levels were found to be closely related to the severity of AECOPD, and could be potential biomarkers for clinical diagnosis.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2386-2393"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert consensus on cancer treatment-related lung injury.","authors":"Xinqing Lin, Hui Guo, Wei Zhao, Min Li, Gen Lin, Qian Chu, Enguo Chen, Liang'an Chen, Rui Chen, Tianqing Chu, Haiyi Deng, Yu Deng, Hangming Dong, Wen Dong, Yuchao Dong, Wenfeng Fang, Xin Gan, Liang Gong, Yingying Gu, Qian Han, Yue Hao, Yong He, Chengping Hu, Jie Hu, Yi Hu, Yongliang Jiang, Yang Jin, Fen Lan, Weimin Li, Weifeng Li, Wenhua Liang, Anwen Liu, Dan Liu, Ming Liu, Mengjie Liu, Zhuo Liu, Zhefeng Liu, Qun Luo, Liyun Miao, Chuanyong Mu, Pinhua Pan, Ping Peng, Jianwen Qin, Yinyin Qin, Panxiao Shen, Minhua Shi, Yong Song, Chunxia Su, Jin Su, Xin Su, Xiaowu Tan, Kejing Tang, Xiaomei Tang, Panwen Tian, Binchao Wang, Huijuan Wang, Kai Wang, Mengzhao Wang, Qi Wang, Wenxian Wang, Zhijie Wang, Di Wu, Fei Xu, Yan Xu, Chunwei Xu, Zhanhong Xie, Xiaohong Xie, Boyan Yang, Meng Yang, Feng Ye, Xiaoqun Ye, Zongyang Yu, Jian Zhang, Jianqing Zhang, Xiaoju Zhang, Fei Zhao, Xiaobin Zheng, Bo Zhu, Zhengfei Zhu, Jianya Zhou, Jianying Zhou, Min Zhou, Qing Zhou, Zihua Zou, Biniam Kidane, Elena Bignami, Fumio Sakamaki, Giandomenico Roviello, Hirokazu Taniguchi, Kyeongman Jeon, Lenko Saric, Miguel Ariza-Prota, Ninh M La-Beck, Nobuhiro Kanaji, Satoshi Watanabe, Takehito Shukuya, Tomohiro Akaba, Tracy L Leong, Wolfgang Gesierich, Yasuhiko Koga, Yoshinori Tanino, Yuji Uehara, Shiyue Li, Rongchang Chen, Chengzhi Zhou","doi":"10.21037/jtd-2025-292","DOIUrl":"10.21037/jtd-2025-292","url":null,"abstract":"<p><strong>Background: </strong>Although advancements in cancer therapies have substantially improved the survival of cancer patients, these treatments may also result in acute or chronic lung injury. Cancer treatment-related lung injury (CTLI) presents with a diverse array of clinical manifestations and can involve multiple sites. Due to the lack of specific diagnostic protocols, CTLI can deteriorate rapidly and may be life-threatening if not promptly addressed. Unfortunately, there is no universally accepted consensus document on the diagnosis and management of CTLI.</p><p><strong>Methods: </strong>A multidisciplinary panel comprising experts from respiratory and critical care medicine, oncology, radiation oncology, thoracic surgery, radiology, pathology, infectious diseases, pharmacy, and rehabilitation medicine participated in this consensus development. Through a systematic literature review and detailed panel discussions, the team formulated nine key recommendations.</p><p><strong>Results: </strong>This consensus document addresses the concept, epidemiology, pathogenesis, risk factors, diagnostic approach, evaluation workflow, management strategies, differential diagnosis, type-specific management and clinical staging of CTLI. Emphasis is placed on raising awareness among clinicians and therapeutic practices through comprehensive guidelines.</p><p><strong>Conclusions: </strong>The consensus provides a detailed diagnostic protocol for CTLI and introduces a structured management framework based on grading, typing, and staging. It highlights the critical role of multidisciplinary team (MDT) collaboration and emphasizes the need for individualized, whole-process patient care strategies to optimize clinical outcomes.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1844-1875"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of OK-432 pleurodesis on long-term survival outcomes after pulmonary lobectomy for lung cancer patients: a retrospective case-control study.","authors":"Hisashi Oishi, Ken Onodera, Hirotsugu Notsuda, Tatsuaki Watanabe, Yui Watanabe, Takaya Suzuki, Takeo Togo, Sakiko Kumata, Yoshinori Okada","doi":"10.21037/jtd-2024-2253","DOIUrl":"10.21037/jtd-2024-2253","url":null,"abstract":"<p><strong>Background: </strong>OK-432 (Picibanil), derived from <i>Streptococcus pyogenes</i> type A3, is widely used for both cancer immunotherapy and pleurodesis to manage pleural effusions and air leaks. While its efficacy and safety in pleurodesis are well-established, its potential immunomodulatory effects on long-term survival outcomes in lung cancer patients remain unclear. This study aims to evaluate whether OK-432 pleurodesis influences postoperative survival and recurrence outcomes following pulmonary lobectomy for non-small cell lung cancer.</p><p><strong>Methods: </strong>This retrospective study analyzed data from 413 patients who underwent pulmonary lobectomy for non-small cell lung cancer between January 2010 and December 2016. Patients were categorized into two groups: those who underwent OK-432 pleurodesis for prolonged air leaks or chylothorax (n=23) and a control group receiving other treatments or none (n=390). We examined demographics, surgical outcomes, and postoperative complications, assessing survival and recurrence using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>The administration of OK-432 effectively managed air leaks and chylothorax without significant complications. There were no statistically significant differences in overall survival (OS), lung cancer-specific survival (LCSS), or recurrence-free survival (RFS) between the groups. Advanced pathological stages were significant predictors of mortality and recurrence.</p><p><strong>Conclusions: </strong>While OK-432 pleurodesis is effective for the management of air leaks and chylothorax following pulmonary lobectomy, this study did not demonstrate any impact on OS, LCSS, or RFS. These findings confirm the utility of OK-432 in addressing immediate postoperative challenges but do not support its use as a prognostic factor in the long-term management of lung cancer. Further investigation is necessary to explore the full spectrum of OK-432's biological effects and potential benefits in a broader oncological context.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2067-2077"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bibliometric analysis of malignant pleural mesothelioma from 2010 to 2023.","authors":"Sheng Chen, Ce Zhao, Ruiqi Liu, Wenjie Jiao","doi":"10.21037/jtd-24-1778","DOIUrl":"10.21037/jtd-24-1778","url":null,"abstract":"<p><strong>Background: </strong>Malignant pleural mesothelioma (MPM) is an aggressive tumor originating from the mesothelial lining of the pleural cavity. It is characterized by extensive nodular pleural thickening and has a propensity to invade the pleural adipose tissue and adjacent chest structures. The prognosis is poor, with a median survival time rarely exceeding 12 months following diagnosis.</p><p><strong>Methods: </strong>This bibliometric analysis systematically assessed global trends in MPM research from 2010 to 2023 using 6,487 publications indexed in PubMed. Quantitative evaluations of publication metrics, international collaboration, and keyword co-occurrence networks were conducted using R software with the bibliometrix package. Network construction and thematic mapping were employed to analyze the temporal evolution of research topics.</p><p><strong>Results: </strong>The United States and Europe have played pivotal roles in this research, while contributions from China and Japan have been steadily increasing. Traditional treatment approaches and etiological studies are relatively well-established. Meanwhile, immunotherapy has emerged as a prominent focus of recent research.</p><p><strong>Conclusions: </strong>Future global collaboration in this field should be enhanced, as precision medicine related to immunology and genetics has the potential to transform the treatment landscape of MPM.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2014-2027"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-use flexible bronchoscope evaluation for bronchoalveolar lavage.","authors":"Ajay Wagh, David Hoffman, Christina Cool, Audra Schwalk","doi":"10.21037/jtd-2024-2118","DOIUrl":"10.21037/jtd-2024-2118","url":null,"abstract":"<p><strong>Background: </strong>Since their initial release in 2009, single-use flexible bronchoscopes (SUFBs) have significantly evolved from simple tools largely used for airway inspection with limited functionality to highly advanced instruments with the same capabilities as reusable flexible bronchoscopes (RFBs). Despite this, scrutiny still exists. The purpose of this study was to better understand the performance and preference of six industry leading SUFBs.</p><p><strong>Methods: </strong>Thirty-one physicians who regularly use bronchoscopes performed two simulated bronchoalveolar lavages (BALs) on low fidelity lung models with six SUFBs: Ambu aScope 4 and 5 (with integrated sampler system), Boston Scientific Exalt Model B, Olympus H-SteriScope, and Verathon B-Flex and B-Flex 2 (all with a Lukens trap). After completing BALs with each scope, physicians answered an 18-question survey with a five-point rating system where 1 indicated unacceptable, 3 indicated satisfactory, and 5 indicated excellent.</p><p><strong>Results: </strong>The Ambu aScope 5 Broncho HD rated highest in each of the 18 evaluated categories with an overall average performance score of 4.47 and sampling score of 4.40. A two-sample <i>t</i>-test found that the average score of the Ambu aScope 5 HD was significantly higher than the other SUFBs for both performance and sampling.</p><p><strong>Conclusions: </strong>All six SUFBs included in the study scored above \"satisfactory\" in both the performance and sampling metrics measured. Of the six, the aScope 5 Broncho HD with an integrated sampling system had the highest average rating for both performance and sampling metrics, followed by the Exalt Model B for performance and the aScope 4 Broncho for sampling. As the annual volume of procedures continues to increase, SUFBs that combine safety, superb performance, and convenience will help further evolve bronchoscopy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2186-2193"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of different prone ventilation strategies on mechanical power and respiratory mechanics in acute respiratory distress syndrome patients: a prospective, single-center observational study.","authors":"Pei Hong, Yuequn Chen, Junli Xia, Salim Surani, Yexing Dai, Junhong Zhu","doi":"10.21037/jtd-2025-267","DOIUrl":"10.21037/jtd-2025-267","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is a common pathological condition among critically ill patients that often requires mechanical ventilation support. However, mechanical ventilation increases the risk of ventilator-induced lung injury (VILI). Different prone ventilation strategies may have varying effects on mechanical power (MP) and respiratory mechanics. This study aimed to compare the effects of prone ventilation and lateral-prone ventilation on MP and respiratory mechanics in ARDS patients to assess the relative risks of VILI associated with these strategies.</p><p><strong>Methods: </strong>This prospective, single-center observational study employed a randomized trial. One hundred and twenty-two patients with moderate-to-severe ARDS admitted to the Department of Critical Care Medicine at Lishui Central Hospital between December 2021 and April 2024 were enrolled in this study. Patients were randomly assigned to receive either prone or lateral-prone ventilation strategies. The primary outcomes included MP, driving pressure (DP), static lung compliance (Cstat), airway resistance (Raw), the oxygenation index [i.e., the oxygen saturation to fraction of inspired oxygen (SpO₂/FiO₂) ratio], the mortality rate, and the duration of the mechanical ventilation. Statistical analyses were performed to compare the effects of the two ventilation strategies on the respiratory mechanics and clinical outcomes.</p><p><strong>Results: </strong>The baseline characteristics of the patients, such as age, gender, and body mass index, were comparable between the two groups. No significant differences were found between the groups in terms of the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. No significant differences were observed in the SpO₂/FiO₂ ratio, mean arterial pressure (MAP), or Raw at different time points. However, MP differed significantly between the prone and lateral-prone groups. No significant differences were found between the two groups regarding heart rate (HR), MAP, and Cstat.</p><p><strong>Conclusions: </strong>Compared to prone ventilation, lateral-prone ventilation significantly reduced MP in ARDS patients. The early adoption of lateral-prone ventilation may help mitigate the risk of VILI. This strategy holds clinical promise and warrants further validation and optimization.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2411-2422"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinicopathologic features and prognosis between surgically resected pulmonary large-cell neuroendocrine carcinoma and small-cell lung cancer.","authors":"Yuke Mao, Hao Chang, Lu Wang, Jinlong Teng, Tianjun Li, Luca Ampollini, Yoshinobu Ichiki, Robert A Ramirez, Hong Liu, Baohui Han, Jing Wang, Yanan Wang","doi":"10.21037/jtd-2025-345","DOIUrl":"10.21037/jtd-2025-345","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung cancer (SCLC) are classified as types of high-grade neuroendocrine carcinoma (HGNEC). The aim of this study was to determine the similarities and differences in clinical features and prognosis between LCNEC and SCLC.</p><p><strong>Methods: </strong>We retrospectively compared the clinical features and prognosis of LCNEC and SCLC, along with well as their two subtypes, including pure LCNEC (P-LCNEC) and combined LCNEC (C-LCNEC) and SCLC combined with LCNEC and SCLC combined with non-LCNEC, respectively. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>We included 341 patients with LCNEC and 580 patients with SCLC who underwent surgical treatment. Significant differences in smoking history, primary site, tumor location, pathological (p) N stage, pTNM stage, and visceral pleural invasion (VPI) were observed between LCNEC and SCLC groups (all P values <0.05). The subgroups of LCNEC (P-LCNEC and C-LCNEC) and SCLC (SCLC/LCNEC and SCLC/non-LCNEC) displayed differences in smoking history, primary site, tumor location, pT stage, pN stage, pTNM stage, VPI, adjuvant chemotherapy, and postoperative adjuvant radiotherapy. LCNEC and its subtypes P-LCNEC and C-LCNEC were associated with superior DFS and OS than were SCLC and its subtypes SCLC/LCNEC and SCLC/non-LCNEC (DFS: P=0.008, P=0.001, P=0.049; OS: P=0.005, P=0.005, P=0.006). Compared to patients who did not receive adjuvant chemotherapy, those with stage I SCLC or LCNEC who underwent adjuvant chemotherapy demonstrated a significantly improved DFS (P=0.005 and P=0.048) and OS (P=0.004 and P=0.03).</p><p><strong>Conclusions: </strong>LCNEC and SCLC, as well as their subtypes, have distinct clinical features and survival outcomes. SCLC exhibited more malignant biological behavior and was associated with a worse prognosis compared to LCNEC. Postoperative chemotherapy is recommended for patients with stage I HGNEC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2394-2410"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of clinical severity and ventilation time on the use of timed inspiratory effort (TIE) as a predictor of success in ventilatory weaning.","authors":"Lilian Elisabete Bernardes Delazari, Lígia Dos Santos Roceto Ratti, Adria Cristina da Silva, Melissa Sibinelli, Rodrigo Marques Tonella, Larissa Olivato, Beatriz Bueno Dos Santos, Antonio Luís Eiras Falcão","doi":"10.21037/jtd-24-1764","DOIUrl":"10.21037/jtd-24-1764","url":null,"abstract":"<p><strong>Background: </strong>Weaning from mechanical ventilation (MV) is a critical phase in the recovery of patients undergoing prolonged ventilation. Previous studies have suggested the timed inspiratory effort (TIE) index as a potential predictor of weaning success. This study aimed to evaluate the predictive value of TIE and the impact of clinical severity and ventilation time on weaning outcomes.</p><p><strong>Methods: </strong>A prospective observational study was conducted in patients undergoing prolonged MV. Analysis included TIE measurements, duration of MV, and clinical severity as assessed by the Simplified Acute Physiology Score 3 (SAPS3). Logistic regression and receiver operator characteristic (ROC) curve analyses were performed to determine the predictive value of TIE for weaning success. All statistical tests were performed with a significance level of P<0.05.</p><p><strong>Results: </strong>TIE showed limited utility as an independent predictor of weaning success, with an area under the ROC curve (AUC) of 0.529 and a non-significant P value (P=0.79). In contrast, clinical severity as measured by the SAPS3 score was a significant predictor of weaning success (P=0.01). Patients with lower SAPS3 scores were more likely to be weaned successfully.</p><p><strong>Conclusions: </strong>TIE as an isolated tool is limited in predicting successful weaning from MV. Clinical severity, as assessed by tools such as the SAPS3 score, appears to be more relevant. Integrating multiple clinical parameters into decision models may improve weaning outcomes in ventilated patients.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1934-1941"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel neoadjuvant immunotherapy treatment and surveillance strategies in resectable esophageal cancer: innovation leads to improved outcomes.","authors":"Kenneth M Williams, Kian C Banks, Jeffrey B Velotta","doi":"10.21037/jtd-24-1867","DOIUrl":"10.21037/jtd-24-1867","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1802-1806"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}