Pulmonary Therapy最新文献

{"title":"Peri-intubation Cardiovascular Collapse During Emergency Airway Management.","authors":"Samuel I Garcia, Nathan J Smischney, Benjamin J Sandefur, Jacopo D'Andria Ursoleo, Diana J Kelm, Patrick M Wieruszewski","doi":"10.1007/s41030-025-00326-x","DOIUrl":"https://doi.org/10.1007/s41030-025-00326-x","url":null,"abstract":"<p><p>Emergency airway management is a lifesaving procedure but can be associated with significant risks, including hypoxia, hypotension, cardiac arrest, and death. Peri-intubation hypotension, reported in ≥ 40% of cases, is strongly associated with increased morbidity and mortality. While clinical guidelines emphasize the importance of preoxygenation and hemodynamic optimization prior to intubation, the latter remains poorly defined, with limited available data to guide evidence-based strategies to mitigate cardiovascular collapse during rapid sequence intubation. This review synthesizes current knowledge on the epidemiology, risk factors, and pathophysiology of peri-intubation hemodynamic deterioration. We review targeted strategies for hemodynamic optimization of physiologic parameters before intubation. These include volume expansion with fluid resuscitation, vasopressor utilization, selection of pharmacologic agents, invasive hemodynamic monitoring, and advanced preoxygenation techniques. In selected high-risk patients, we also discuss the potential role of extracorporeal membrane oxygenation as an adjunctive or rescue therapy. Our goal is to provide airway specialists with a comprehensive framework for mitigating cardiovascular collapse during emergent airway management and to stimulate further research into this high-risk and understudied domain.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of the Protocol Investigating Whether Remote Care Can Reduce Clinic Attendance in Lung Transplantation.","authors":"Rebecca J Varley, Rebecca Borton, David Van Dellen, Karthik Santhanakrishnan, Colin Edwards, Elana Pizzo, John F Blaikley","doi":"10.1007/s41030-025-00320-3","DOIUrl":"https://doi.org/10.1007/s41030-025-00320-3","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing lung transplantation require regular monitoring to ensure that the transplanted lung(s) stay healthy. This is usually achieved through a combination of home spirometry combined with regular reviews in hospital outpatient clinics. Administering questionnaires remotely could reduce the need for regular hospital clinic visits. This study aims to investigate whether a remotely administered questionnaire combined with home spirometry can reduce the number of hospital clinic visits.</p><p><strong>Methods: </strong>Patients will be randomised to the intervention arm (questionnaire and home spirometry) or standard of care arm (home spirometry + clinic visit). Quality of life (St George's Respiratory Questionnaire), health economic data and usage acceptability will be collected at the beginning and end of the study period.</p><p><strong>Planned outcomes: </strong>The primary outcome is to evaluate whether the number of hospital clinic visits are reduced in the intervention arm compared to the control arm. Secondary outcomes will evaluate the intervention influence on healthcare usage, the associated costs of service delivery and its environmental impact.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov NCT05916495.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching to the Dry Powder Inhaler: Disease Control with a Lower Carbon Footprint.","authors":"Christer Janson, Hanna Hisinger-Mölkänen, Lilla Tamasi, Ville Vartiainen, Lauri Lehtimäki","doi":"10.1007/s41030-025-00319-w","DOIUrl":"https://doi.org/10.1007/s41030-025-00319-w","url":null,"abstract":"<p><strong>Introduction: </strong>Dry powder inhalers (DPIs) have a 20-40-fold lower carbon footprint compared to pressurized metered-dose inhalers (pMDIs). Switching from pMDI to DPI is therefore beneficial from an environmental perspective, but many health care professionals are concerned that this may worsen treatment outcomes in asthma and chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>We analyzed patient outcomes and carbon footprints of switching inhaler treatment from pMDI to DPI. We performed a post hoc analysis on clinical outcomes data from a 12-week real-world, non-interventional study of adult patients with asthma or COPD who switched treatment from pMDI to the budesonide-formoterol Easyhaler DPI. Clinical end points included asthma control test (ACT), Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ), lung function tests, and reliever use (asthma), and COPD assessment test (CAT), and modified Medical Research Council dyspnea scale (mMRC) (COPD). In the carbon footprint calculation, we used estimates from the Montreal Protocol for pMDI and for DPI the estimate as reported.</p><p><strong>Results: </strong>Among all 237 patients (142 asthma, 95 COPD) by switching their treatment clinical improvements were observed in all the outcome measures (p < 0.001). Furthermore, the need for reliever medication decreased among patients with asthma (p < 0.001). The amount of estimated kg CO₂e emissions per year for maintenance treatment was 97.0% lower for the DPI than for pMDI. For reliever medication among patients with asthma, it was 99.6% lower. Among them, the emission savings could amount to approximately 131 kg CO₂e annually. This is of similar magnitude, as individual high-impact environmental actions such as eating a plant-based diet or purchasing green energy.</p><p><strong>Conclusions: </strong>Our results show that disease control was maintained among patients with asthma or COPD when they switched from pMDI to DPI, while the carbon footprint of inhaler treatment was reduced.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Observational Study on COVID-19 Patients Receiving Treatment with Nirmatrelvir/Ritonavir (PAXLOVID).","authors":"Mariam M Murad, Stephen L Atkin, Pearl W Wasif, Alwaleed Abdulaziz Behzad, Aamal M J Abdulla Husain, Florence Lefebvre d'Hellencourt, Jean Joury, Mohamed Abdel Aziz, Hammam Haridy, Julia Spinardi, Lu Wang, Fiona Boland, Moe H Kyaw, Manaf Al-Qahtani","doi":"10.1007/s41030-025-00316-z","DOIUrl":"https://doi.org/10.1007/s41030-025-00316-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study was undertaken in COVID-19 patients treated with and without Paxlovid™ (Paxlovid) in an outpatient setting to determine hospitalization from the community.</p><p><strong>Methods: </strong>This retrospective secondary data observational cohort study was conducted between February and November 2022. All patients diagnosed by polymerase chain reaction for COVID-19 and at risk of COVID-19 disease progression were offered Paxlovid in the outpatient setting. Potential associations between Paxlovid use and likelihood of hospitalization, antibiotic use, and other clinical outcomes were explored using regression models as appropriate (i.e., logistic, multinomial, ordinal), adjusted for World Health Organization risk classification.</p><p><strong>Results: </strong>Of 3011 COVID-19 patients offered Paxlovid, 2005 (67%) were treated with Paxlovid and 1006 (33%) chose not to take treatment. There was no evidence of a difference between groups in terms of vaccination status, viral load, age, or gender, although more patients of Arab ethnicity chose not to take treatment (p < 0.001). There were fewer hospital admissions in the group that took Paxlovid (p < 0.001). Some evidence of a reduction in the number of hospitalizations was found when adjusted for World Health Organization risk category (adjusted odds ratio [aOR] 0.60, 95% confidence interval [CI] 0.45-0.77), and a reduction was similarly found for the number of hospitalizations among patients with readmission (aOR 0.47, 95% CI 0.26-0.84). A reduction in the odds of antibiotic use was observed in the treated group for any cause (aOR 0.80, 95% CI 0.67-0.94) and specifically for COVID-19 (aOR 0.58, 95% CI 0.44-0.77).</p><p><strong>Conclusions: </strong>Paxlovid treatment reduced hospitalization and antibiotic use, indicating its benefit in reducing severe outcomes and healthcare burden and supporting its use for reducing severe outcomes in COVID-19 patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier, NCT06291831.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyspnea in Chronic Obstructive Pulmonary Disease: Expert Assessment of Management in Clinical Practice.","authors":"Nirupama Putcha, Diego J Maselli, Jessica Bon, Michael G Lester, M Bradley Drummond","doi":"10.1007/s41030-025-00318-x","DOIUrl":"https://doi.org/10.1007/s41030-025-00318-x","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a multifaceted lung condition characterized by persistent airflow limitation that leads to chronic symptoms, including dyspnea, cough, and exacerbations. To date, a major focus for the assessment and management of COPD has been on mitigating exacerbations. However, dyspnea is the most common symptom of COPD and is responsible for substantial negative effects on patients' quality of life. Dyspnea is also a substantial contributor to the symptoms associated with acute exacerbations in COPD. Though a portion of the current recommendations for the assessment and management of COPD are dedicated to dyspnea treatment intervention strategies, there remains a need for improvement in communication between healthcare practitioners and their patients regarding the understanding of dyspnea and the implementation of key nonpharmacologic and pharmacologic treatment options. This clinical commentary outlines practical considerations and recommendations for the real-world assessment and management of dyspnea in COPD, including underlying causes, patient and healthcare provider dialogue, measurement of severity, and management strategies.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Administered Home Sleep Testing Model in Screening of OSA in Healthcare Workers-Sohew Study: A National Multicenter Study in Vietnam.","authors":"Sy Duong-Quy, Thai Nguyen-Duy, Tran V Hoc, Lien Nguyen-Thi-Hong, Tram Tang-Thi-Thao, Khue Bui-Diem, Diep Nguyen-Thi-Hong, Bang Nguyen-Trong, Anh Nguyen-Tuan, Hoang Nguyen-Huu, Quan Vu-Tran-Thien, Toi Nguyen-Van, Trung Mai-Xuan, Viet Nguyen-Ba, Thu Vo-Pham-Minh-Thu, Thuc Pham-Van, Linh Pham-Van, Giap Vu-Van, Bao Le-Khac, Dung Nguyen-Thi-Thu, Khue Luong-Ngoc, Ngoc Luu-Bich, Thuy Tran-Phan-Chung, Huong Le-Thi-Minh, Vinh Nguyen-Nhu, Nhung Nguyen-Viet, Timothy Craig, Franck Soyez, Francis Martin, Thomas Penzel","doi":"10.1007/s41030-025-00315-0","DOIUrl":"https://doi.org/10.1007/s41030-025-00315-0","url":null,"abstract":"<p><strong>Background: </strong>Sleep disorders, including snoring and obstructive sleep apnea (OSA), are significant health concerns. OSA affects an estimated 4 million (8.5%) individuals in Vietnam, with 2.3 million suffering from moderate-to-severe conditions. Despite the high prevalence, underdiagnosis and limited accessibility to sleep diagnostics remain challenges. This study aims to assess the feasibility and effectiveness of a guided, self-administered home sleep study using a level 3 diagnostic model.</p><p><strong>Methods: </strong>A cross-sectional multicenter survey conducted from September 2023 to March 2024 included healthcare professionals (HCPs) across Vietnam. Participants completed questionnaires (Epworth Sleepiness Scale, STOP-BANG), and high-risk individuals underwent respiratory polygraphy using ApneaLink Air devices. Standardized instructions and technical support were provided remotely by trained technicians.</p><p><strong>Results: </strong>Out of 1721 participants, 21.9% were diagnosed with OSA, comprising mild (32.4%), moderate (19.6%), and severe cases (9.2%). Prevalent symptoms included insomnia (22.2%), daytime sleepiness (40.7%), and memory decline (49.4%). Technical issues were minimal, supporting the feasibility of this approach.</p><p><strong>Conclusion: </strong>A level 3 home sleep study model is effective for large-scale OSA screening. Integrating such approaches into public health initiatives can enhance early diagnosis and treatment access, reducing OSA-related health and economic burdens. Graphical abstract available for this article.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab Versus Mepolizumab for COPD: Evaluating Efficacy Outcomes Using Placebo-Adjusted Indirect Treatment Comparison.","authors":"Surya P Bhatt, Nick Freemantle, Mena Soliman, Jigna Heble, Yann Cabon, Ernesto Mayen Herrera, Joe Yang, Yingxin Xu","doi":"10.1007/s41030-025-00322-1","DOIUrl":"https://doi.org/10.1007/s41030-025-00322-1","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 40% of patients with chronic obstructive pulmonary disease (COPD) exhibit elevated blood eosinophils, reflective of type 2 inflammation. Dupilumab and mepolizumab versus standard of care have demonstrated moderate-to-severe exacerbation reductions of 30-34% and 15-18%, respectively, over 52 weeks. This study compared their relative efficacy using indirect treatment comparison (ITC).</p><p><strong>Methods: </strong>A Bucher ITC was performed on 52-week phase 3 trials of dupilumab (BOREAS/NOTUS) and mepolizumab (MATINEE/METREX/METREO). The primary ITC endpoint was annualized moderate-to-severe exacerbation rates in patients from BOREAS + NOTUS versus MATINEE + METREX (modified intention-to-treat high stratum cohort, representing an eosinophilic phenotype); sensitivity analyses were performed using different combinations of mepolizumab data including MATINEE + METREX + METREO (100-mg arm). Other 52-week endpoints included mean difference in pre-bronchodilator forced expiratory volume in 1 s (FEV₁), proportion of St. George's Respiratory Questionnaire (SGRQ) improvement ≥ 4 points, proportion of Evaluating Respiratory Symptoms in COPD (E-RS:COPD) improvement ≥ 2 points, and annualized severe exacerbation rate. Rate ratios (RRs)/odds ratios (ORs) with 95% confidence intervals (CIs) are reported.</p><p><strong>Results: </strong>The primary ITC resulted in an RR of 0.82 (95% CI 0.66, 1.01), showing a numerical advantage for dupilumab versus mepolizumab in reducing moderate-to-severe exacerbation. Sensitivity analyses confirmed findings from the primary ITC (BOREAS + NOTUS vs. MATINEE + METREX + METREO: RR 0.83 [95% CI 0.68, 1.01]). Dupilumab demonstrated significantly greater FEV₁ improvement (mean difference 83.4 mL [95% CI 36.1, 130.7]) and proportion of E-RS:COPD improvement ≥ 2 points (OR 1.71; [95% CI 1.18, 2.48]), with a numerical difference favoring dupilumab for the proportion of SGRQ improvement ≥ 4 points (OR 1.16; [95% CI 0.86, 1.56]) and for annualized severe exacerbation rate (RR 0.61 [95% CI 0.33, 1.13]) versus mepolizumab.</p><p><strong>Conclusion: </strong>This ITC suggests potential clinical benefits of dupilumab over mepolizumab in reducing exacerbations and improving lung function, respiratory symptoms, and quality of life in patients with COPD and type 2 inflammation. Direct head-to-head trials are necessary to confirm these results and better guide treatment choices.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Neutropenia on Clinical Outcomes in Critically Ill Patients with Acute Respiratory Failure.","authors":"Hwan Il Kim, Seong Mi Moon, Hyo Seok Oh, Ryoung-Eun Ko","doi":"10.1007/s41030-025-00317-y","DOIUrl":"https://doi.org/10.1007/s41030-025-00317-y","url":null,"abstract":"<p><strong>Introduction: </strong>Neutropenia is a common clinical condition in critically ill patients and may be associated with poor outcomes, particularly in the context of acute respiratory failure (ARF). However, evidence on its prognostic impact remains inconsistent, and there are a lack of data, particularly in noncancer and immunocompetent populations. This study evaluates the association between neutropenia and mortality in critically ill patients with ARF and identifies risk factors for mortality among patients with neutropenia.</p><p><strong>Methods: </strong>In this retrospective cohort study, 2412 adult patients with ARF admitted to the intensive care unit (ICU) of a tertiary center between January 2019 and December 2023 were analyzed. Neutropenia was defined as an absolute neutrophil count < 1.5 × 10⁹/L at ICU admission. The primary outcome was hospital mortality; secondary outcomes included ICU mortality. Multivariable Cox proportional hazards models were used to assess the association between neutropenia and outcomes. Subgroup analyses and risk factor assessments were conducted among patients with neutropenia.</p><p><strong>Results: </strong>Among the 2412 patients, 411 (17.0%) had neutropenia at ICU admission. Compared with their counterparts without neutropenia, patients with neutropenia had higher ICU mortality (48.0% versus 18.9%, P < 0.001) and hospital mortality (60.1% versus 28.3%, P = 0.007). Neutropenia remained independently associated with increased ICU (adjusted hazard ratio [HR] 1.48; 95% confidence interval [CI], 1.20-1.83) and hospital mortality (adjusted HR 1.27; 95% CI 1.07-1.52). The association was more pronounced in patients without cancer (adjusted HR 3.08) than in patients with cancer (adjusted HR 1.48; P for interaction < 0.001). Among patients with neutropenia, sequential organ failure assessment (SOFA) score was an independent predictor of hospital mortality (adjusted HR 1.15; 95% CI 1.11-1.20; P < 0.001).</p><p><strong>Conclusions: </strong>Neutropenia at ICU admission is independently associated with increased mortality in patients with ARF, particularly among those without cancer. SOFA score is a strong prognostic indicator among patients with neutropenia. These findings highlight the need for improved risk stratification, and suggest that patients with neutropenia may benefit from specific management strategies, which should be investigated in future studies.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Comparative Effectiveness in Patients with Asthma Newly Initiating Fluticasone Furoate/Vilanterol or Budesonide/Formoterol: A United Kingdom General Practice Cohort Study.","authors":"Ashley Woodcock, John Blakey, Arnaud Bourdin, Giorgio Walter Canonica, Christian Domingo, Alexander Ford, Rosie Hulme, Theo Tritton, Ines Palomares, Sanchayita Sadhu, Arunangshu Biswas, Manish Verma","doi":"10.1007/s41030-025-00313-2","DOIUrl":"https://doi.org/10.1007/s41030-025-00313-2","url":null,"abstract":"<p><strong>Introduction: </strong>It is important that treatment recommendations reflect real-world data when available, as randomised controlled trials have stringent eligibility criteria and do not represent the entire asthma population or their usual ecosystem of care. Limited real-world evidence has compared the effectiveness of fluticasone furoate/vilanterol (FF/VI) and budesonide/formoterol (BUD/FOR) to date in asthma; we explored this in England using patients from general practice.</p><p><strong>Methodology: </strong>We retrospectively compared new FF/VI users and new BUD/FOR users from 1 December 2015 to 28 February 2019, based on de-identified data from the Clinical Practice Research Datalink. The baseline period pre-index was ≥ 1 year; the follow-up period was 1 year. At index, eligible adults (≥ 18 years) with diagnosed asthma had ≥ 1 prescription for FF/VI or BUD/FOR, ≥ 1 years' general practitioner registration and records eligible for linkage to Hospital Episode Statistics. Chronic obstructive pulmonary disease was an exclusion criterion. The primary study outcome assessed the overall asthma exacerbation rate in new FF/VI or BUD/FOR users. Secondary outcomes included oral corticosteroid (OCS) use and medication persistence (analysed using Kaplan-Meier curves). For each treatment comparison, propensity scores were generated and confounding between baseline group characteristics was adjusted via inverse probability of treatment weighting, separately carried out for each study outcome. Intercurrent events (ICEs) were considered for analyses, such as death, loss to follow-up, rescue-medication use, treatment discontinuation or switching.</p><p><strong>Results: </strong>Between groups, baseline attributes were well balanced. Annual per-person rates of exacerbation were numerically similar in the while on-treatment population (measuring outcome until ICE; FF/VI, 0.1356; BUD/FOR, 0.1583 [P = 0.3023]). Patients who continued initiation treatment for 1 year without interruption had significantly lower annual per-person exacerbation rates with FF/VI (0.0722 [n = 425]) versus BUD/FOR (0.2258 [n = 546]) (rate ratio 0.3197 [P = 0.0003]). Patients indexed on FF/VI had significantly fewer OCS prescriptions and lower OCS dosage versus BUD/FOR (respective coefficients: - 0.29 [P = 0.0352]; 0.41 [P = 0.0004]) and improved treatment persistence (hazard ratio: 0.62 [P < 0.0001]).</p><p><strong>Conclusions: </strong>Patients who continued initiation treatment for a year without interruption had reduced exacerbation rates with FF/VI versus BUD/FOR. The FF/VI group also had reduced treatment discontinuation and OCS use.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Portable Oxygen Concentrators and Inspired Oxygen Levels in a Model of Respiratory Failure.","authors":"Douglas S Gardenhire, Robert B Murray, Robin E Gardenhire, Kyle J Brandenberger, Gerald S Zavorsky","doi":"10.1007/s41030-025-00314-1","DOIUrl":"https://doi.org/10.1007/s41030-025-00314-1","url":null,"abstract":"<p><strong>Introduction: </strong>This bench study evaluated the inspired oxygen fraction (FiO₂) delivered by different portable oxygen concentrators (POCs) compared to wall oxygen and a standalone concentrator (control device) using a respiratory failure-specific lung simulator replicating an adult with chronic respiratory disease at respiratory rates of 15, 20, 30, and 40 breaths per minute.</p><p><strong>Methods: </strong>A lung simulator replicated an adult with chronic lung disease in respiratory failure. POCs and controls were tested at device-specific settings 2, 3, 5, and 6. One-way analysis of variance (ANOVA) assessed FiO₂ differences when more than two groups were compared; independent t tests were used for two-group comparisons.</p><p><strong>Results: </strong>Wall oxygen generally delivered higher FiO₂ across all settings and respiratory rates. At 40 breaths/min and setting 2, however, the CAIRE FreeStyle^® Comfort^® with autoSAT^® delivered a slightly higher FiO₂ than wall oxygen (0.25 vs. 0.24, p < 0.01). Among POCs, the CAIRE FreeStyle^® Comfort^® (with or without autoSAT^®) achieved the highest FiO₂ values at elevated respiratory rates, while devices like the Inogen G4^® and G5^® performed more variably and showed reduced oxygen delivery at higher breathing frequencies.</p><p><strong>Conclusions: </strong>Wall oxygen and standalone concentrators consistently outperformed POCs across most breathing conditions. While the CAIRE FreeStyle^® Comfort^® with autoSAT^® offered relative advantages at high respiratory rates, most POCs may not adequately sustain oxygenation during exertion or stress. These findings inform home oxygen therapy decisions, emphasizing the importance of device selection based on respiratory demand. Clinical validation of these bench findings is warranted.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}