Respiration最新文献_第10页

Acquired Tracheal Stenosis in an HIV-Positive Child Presenting with Persistent Respiratory Symptoms after Being Ventilated for Pneumocystis jirovecii Pneumonia and Cytomegalovirus Pneumonia: Diagnosis and Management in a Severely Immunosuppressed Child. 1例HIV阳性儿童因PJP和巨细胞病毒肺炎通气后出现持续呼吸道症状的获得性气管狭窄：严重免疫抑制儿童的诊断和治疗

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-11-10 DOI: 10.1159/000549478

Pierre Goussard, Ernst Eber, Lisa Frigati, Leonore Greybe, Shyam Sunder B Venkatakrishna, Jacques Janson, Zane Ismail, Pawel Tomasz Schubert, Lars Ebert, Janette Verster, Andre Gie, Savvas Andronikou

{"title":"Acquired Tracheal Stenosis in an HIV-Positive Child Presenting with Persistent Respiratory Symptoms after Being Ventilated for <italic>Pneumocystis jirovecii</italic> Pneumonia and Cytomegalovirus Pneumonia: Diagnosis and Management in a Severely Immunosuppressed Child.","authors":"Pierre Goussard, Ernst Eber, Lisa Frigati, Leonore Greybe, Shyam Sunder B Venkatakrishna, Jacques Janson, Zane Ismail, Pawel Tomasz Schubert, Lars Ebert, Janette Verster, Andre Gie, Savvas Andronikou","doi":"10.1159/000549478","DOIUrl":"10.1159/000549478","url":null,"abstract":"Introduction: Pneumocystis jirovecii pneumonia (PJP) is a significant cause of morbidity and mortality in children with advanced HIV disease (AHD) and other immunosuppressive conditions. Acquired tracheal stenosis in children living with HIV (CLHIV) has not been described.Case presentation: A 4-month and 3-week-old child living with HIV presented with persistent respiratory symptoms after mechanical ventilation for 10 days for confirmed PJP and cytomegalovirus (CMV) pneumonia at the age of 3 months and 1 week. She tested positive for HIV at 3 months of age and had a high viral load of log 2.7 copies/mL. She was re-admitted to the PICU with multilobar pneumonia, requiring non-invasive ventilation with metapneumovirus identified from nasopharyngeal aspirate. Persistent wheeze and stridor were noted. During hospitalization, the mother was diagnosed with confirmed tuberculosis (TB). The child was referred for bronchoscopy due to the possibility of pulmonary TB and airway compression. A chest CT scan revealed short segment tracheal stenosis of >50% but no signs of TB as a possible cause. Bronchoscopy demonstrated significant narrowing occurring in the midtracheal region with the acquired nature configuration. The stenosis was successfully dilated twice, first with rigid bronchoscopy, followed by dilatation with flexible bronchoscopy and an angioplasty balloon.Conclusion: Acquired tracheal stenosis in CLHIV is not well documented, although many young children with HIV infection have been ventilated for severe pneumonia. Bronchoscopy should be considered in children with persistent respiratory symptoms, and endoscopic procedures can be safely performed in immunosuppressed children.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"538-544"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489613","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

First European Results of Shape-Sensing Robotic-Assisted Bronchoscopy. 形状感应机器人辅助支气管镜检查的第一个欧洲结果。

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI: 10.1159/000549197

Judith Maria Brock, A Susanne Dittrich, Konstantina Kontogianni, Claus-Peter Heussel, Laura V Klotz, Hauke Winter, Mavi Schellenberg, Ulrich Keppler, Felix Herth

{"title":"First European Results of Shape-Sensing Robotic-Assisted Bronchoscopy.","authors":"Judith Maria Brock, A Susanne Dittrich, Konstantina Kontogianni, Claus-Peter Heussel, Laura V Klotz, Hauke Winter, Mavi Schellenberg, Ulrich Keppler, Felix Herth","doi":"10.1159/000549197","DOIUrl":"10.1159/000549197","url":null,"abstract":"Introduction: Shape-sensing robotic-assisted bronchoscopy (ssRAB) was shown to be superior in diagnosing peripheral pulmonary nodules (PPNs) compared to conventional bronchoscopy. Although RAB is established in the USA since 2019, the ION™ Endoluminal System was not CE marked in Europe until 2023.Methods: The first prospective European single-center, premarket study, conducted between 2022 and 2023, assessed the diagnosis of PPNs with ssRAB, using the ION™ Endoluminal System. Patients with suspected lung cancer or metastasis, PPNs of 1-3 cm, and ≥3 airway generations out were included in this study and followed up for up to 6 months. The primary outcome was the rate of tool-in-lesion (TIL), confirmed by mobile cone-beam computed tomography or with malignant index biopsy finding. Secondary outcomes included procedural characteristics, diagnostic yield, and adverse events.Results: A total of 43 patients with a mean nodule size of 19.2 × 16.9 × 15.8 mm, a mean distance of 17.4 ± 15.5 mm to the pleura, and mean 6.6th generation of airway were analyzed. TIL was achieved in 90.7% of all cases. Strict diagnostic yield was 67.4% and sensitivity for malignancy was 78.6%. No pneumothorax and no adverse events were reported outside of 3 cases of Nashville ≤2 bleeding. Predictors for successful diagnosis were the inner or middle third location (OR: 4.19, p = 0.039), CT bronchus sign (OR: 4, p = 0.044), and distance from pleural wall (OR: 1.05, p = 0.048). The lower lobe location (OR: 0.06, p < 0.001) was associated with nondiagnostic cases.Conclusion: The first European cases show ssRAB is a safe procedure with promising results for enabling diagnosis of PPNs.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"599-607"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471856","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

Effects of Multidisciplinary Rehabilitation on Body Weight Loss Management in Interstitial Lung Disease. 多学科康复对间质性肺疾病减重管理的影响。

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1159/000548818

Taichi Kaneko, Atsuhito Nakazawa, Eri Hagiwara, Yoichi Tagami, Tsuneyuki Oda, Akimasa Sekine, Shigeru Komatsu, Takeshi Kaneko, Takashi Ogura

{"title":"Effects of Multidisciplinary Rehabilitation on Body Weight Loss Management in Interstitial Lung Disease.","authors":"Taichi Kaneko, Atsuhito Nakazawa, Eri Hagiwara, Yoichi Tagami, Tsuneyuki Oda, Akimasa Sekine, Shigeru Komatsu, Takeshi Kaneko, Takashi Ogura","doi":"10.1159/000548818","DOIUrl":"10.1159/000548818","url":null,"abstract":"Introduction: Body weight (BW) loss is common in interstitial lung disease (ILD) patients and correlated with poor prognosis. This study aimed to verify whether multidisciplinary interventions combining pulmonary rehabilitation and nutritional management affect BW loss and prognosis in ILD.Methods: We retrospectively examined changes in body composition including BW in ILD patients who were admitted to our hospital for the comprehensive pulmonary rehabilitation program. These parameters were measured 6 months before, at the beginning, and 6 months after the program. We investigated the program's impact on BW loss and its association with survival.Results: Of the 169 program participants, 40 ILD patients with tracked BW trends were enrolled. A significant BW loss was observed during 6 months before the program (p < 0.001); however, the intervention successfully halted further BW loss (p = 0.116). Patients on antifibrotic medications also showed similar BW trends. Notably, patients with pleuroparenchymal fibroelastosis showed a significant BW loss before the program (-1.8 kg, p < 0.001) but exhibited BW gain following the intervention (+1.0 kg, p = 0.475). Regarding the survival, BW loss halted group (effective group) had a significantly longer survival (log rank, p = 0.022). In multivariate analysis, BW loss >5% was identified as a prognostic indicator. This program successfully halted BW loss and increased survival.Conclusion: Multidisciplinary rehabilitation effectively managed BW, leading to better survival in ILD. In particular, there is currently no treatment for pleuroparenchymal fibroelastosis, and multidisciplinary rehabilitation offers a promising treatment option.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"339-349"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281089","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

Erratum. 勘误表。

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-12-30 DOI: 10.1159/000549811

引用次数: 0

Invasive Cardiopulmonary Exercise Testing Identifies Distinctive Hemodynamic Phenotypes in Patients with Interstitial Lung Disease and Exercise Intolerance. 有创心肺运动试验识别间质性肺疾病和运动不耐受患者的独特血流动力学表型

IF 2.6 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-12-15 DOI: 10.1159/000550078

Bathmapriya Balakrishnan, Ahbilash Marakini, Luke Detloff, Gauranga Mahalwar, James E Lane, Deborah Paul, Adriano R Tonelli

{"title":"Invasive Cardiopulmonary Exercise Testing Identifies Distinctive Hemodynamic Phenotypes in Patients with Interstitial Lung Disease and Exercise Intolerance.","authors":"Bathmapriya Balakrishnan, Ahbilash Marakini, Luke Detloff, Gauranga Mahalwar, James E Lane, Deborah Paul, Adriano R Tonelli","doi":"10.1159/000550078","DOIUrl":"10.1159/000550078","url":null,"abstract":"Introduction: Pulmonary vascular abnormalities coexist with interstitial lung disease (ILD), leading to a spectrum of physiologic impairments. We hypothesized that ILD patients with exercise intolerance have a heterogenous hemodynamic profile when assessed by invasive cardiopulmonary exercise testing (iCPET).Methods: From January 2018 to December 2023, we prospectively performed iCPET for several conditions. The primary outcome of the study was to assess the hemodynamic phenotypes both at rest and during exercise of ILD patients with exercise intolerance, which cannot be fully explained by the severity of ILD.Results: Of the 43 ILD patients included in the study, 10 (23%) had no pulmonary hypertension (PH), 16 (37%) had no PH with pulmonary vascular resistance (PVR) >2 WU, 7 (16%) had precapillary PH, 7 (16%) had postcapillary or combined pre- and postcapillary PH, and 3 (7%) had unclassified PH. Four (9%) patients had exercise PH. Forced vital capacity, diffusion capacity for carbon monoxide, peak oxygen consumption, and resting partial pressure of oxygen (PaO2) were significantly lower across the no PH to precapillary PH spectrum. Peak exercise PaO2 decreased (97 ± 25, 73 ± 15, and 62 ± 10 mm Hg, p = 0.001) while mPAP/CO slope (1.9 ± 1.1, 3.1 ± 2.1, and 5.1 ± 2.7, p = 0.009) and PAWP/CO slope (0.9 ± 0.7, 0.9 ± 0.7, and 3.0 ± 3.0, p = 0.007) increased from no PH, to no PH with high PVR, to precapillary PH. No associations were noted for gender, presence of fibrotic ILD and scleroderma, and mPAP/CO >3 WU across this spectrum.Conclusion: Patients with ILD and exercise intolerance have several hemodynamic phenotypes with parameters that reveal worse exercise performance from no PH to no PH with elevated PVR to precapillary PH. .","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"715-726"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763685","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}

引用次数: 0

Novel Combination of a 1.4-mm Radiofrequency Ablation Catheter with Ultrathin Bronchoscope for Subpleural Peripheral Lung Tumor Ablation. 1.4mm射频消融导管与超薄支气管镜联合用于胸膜下周围性肺肿瘤消融。

IF 2.6 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-09-15 DOI: 10.1159/000548327

Sze Shyang Kho, Chan Sin Chai, Noor Annisa Darman, Swee Kim Chan, Swee Kiong Kho, Choon Seong Ang, Don Tanaka, Shashank Raina, Pei Jye Voon, Siew Teck Tie

{"title":"Novel Combination of a 1.4-mm Radiofrequency Ablation Catheter with Ultrathin Bronchoscope for Subpleural Peripheral Lung Tumor Ablation.","authors":"Sze Shyang Kho, Chan Sin Chai, Noor Annisa Darman, Swee Kim Chan, Swee Kiong Kho, Choon Seong Ang, Don Tanaka, Shashank Raina, Pei Jye Voon, Siew Teck Tie","doi":"10.1159/000548327","DOIUrl":"10.1159/000548327","url":null,"abstract":"Introduction: Bronchoscopic ablation is a promising minimally invasive treatment for peripheral lung tumors, avoiding the high complications associated with percutaneous approaches. However, existing ablation catheters are mostly incompatible with ultrathin bronchoscope (UTB), potentially limiting access to subpleural lesions. We report a case of successful bronchoscopic ablation using a novel 1.4-mm radiofrequency (RF) catheter delivered through a UTB.Case presentation: A 53-year-old woman with oligometastatic gastroesophageal adenocarcinoma underwent bronchoscopic ablation for a 12-mm apical right upper lobe metastasis. The UTB was navigated to the 8th airway generation under direct bronchoscopic vision, and the flexible RF catheter was smoothly inserted through the UTB's 1.7-mm working channel. Real-time cone-beam CT confirmed accurate catheter positioning, ensuring safe ablation without pleural puncture. A total of 26 kJ of energy was delivered over 513 s. The patient recovered without complications and was discharged 48 h post-procedure.Conclusion: The RF catheter's small diameter and high flexibility allow UTB to remain precise and maneuverable in the peripheral airway. As peripheral bronchoscopy evolves beyond diagnostics, integrating miniaturized therapeutic tools such as the 1.4-mm RF catheter will be crucial in expanding its clinical utility. Further results from ongoing clinical trials are highly anticipated to validate the long-term feasibility and safety of this technique.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"324-329"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065539","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

Italian Translation and Cross-Cultural Adaptation of S3-NIV Questionnaire for Patients on Long-Term Home Noninvasive Mechanical Ventilation. 长期家庭无创机械通气患者S-3-NIV问卷的意大利语翻译与跨文化适应

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-10-27 DOI: 10.1159/000549156

Paola Pierucci, Claudia Crimi, Maria Luisa de Candia, Gualtiero Ermando Romano, Alessandro Pilon, Nicola Bartolomeo, Letizia Lorusso, Anna Annunziata, Paolo Banfi, Antonietta Coppola, Giuseppe Fiorentino, Teresa Renda, Raffaele Scala, Giovanna Elisiana Carpagnano, Annalisa Carlucci

{"title":"Italian Translation and Cross-Cultural Adaptation of S3-NIV Questionnaire for Patients on Long-Term Home Noninvasive Mechanical Ventilation.","authors":"Paola Pierucci, Claudia Crimi, Maria Luisa de Candia, Gualtiero Ermando Romano, Alessandro Pilon, Nicola Bartolomeo, Letizia Lorusso, Anna Annunziata, Paolo Banfi, Antonietta Coppola, Giuseppe Fiorentino, Teresa Renda, Raffaele Scala, Giovanna Elisiana Carpagnano, Annalisa Carlucci","doi":"10.1159/000549156","DOIUrl":"10.1159/000549156","url":null,"abstract":"Introduction: Long-term home noninvasive ventilation (LTH-NIV) supports patients with chronic respiratory failure. The S3-NIV questionnaire is an easy and quick tool to evaluate outpatients initiated to home mechanical ventilation. The aim of our study was to translate and validate the Italian version of the S3-NIV questionnaire and test its internal consistency and factorial structure, providing with Italian cultural adaptation of the original S3-NIV questionnaire.Methods: This is a prospective, national, observational, multicenter study enrolling consecutive outpatients accessing between December 2023 and June 2024 to a dedicated ambulatory for chronic respiratory failure requiring LTH-NIV for different underlying diseases (i.e., chronic obstructive pulmonary disease, neuromuscular disorders, obesity hypoventilation syndrome). Internal consistency was assessed using Cronbach's alpha.Results: The translation and back-translation process from the English version was performed. A total of 228 out of 340 screened patients were enrolled Internal consistency of the total score was good (Cronbach's α coefficient of 0.84) as well as for the \"respiratory symptoms\" and the 'sleep and side effects' subdomains (0.82 and 0.74, respectively). Kaiser exploratory analysis confirmed good homogeneity: 0.85.Conclusion: The S3-NIV questionnaire Italian translation and cultural adaptation has good global reliability and internal consistency. This tool has been confirmed to be a simple, quickly available, and easy-to-use tool for the outpatients' clinical assessment of stable patients with chronic respiratory failure initiated on LTH-NIV.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"445-453"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378544","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

Home Non-Invasive Ventilation in Patients with Chronic Obstructive Pulmonary Disease: A Survey of Current Practice in Italy. 慢性阻塞性肺疾病患者的家庭无创通气：意大利目前实践的调查

IF 2.6 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1159/000549778

Claudia Crimi, Annalisa Carlucci, Lara Pisani, Scott Gibson, Carlo Bellatorre, Anna Panza, Sarah Alami

{"title":"Home Non-Invasive Ventilation in Patients with Chronic Obstructive Pulmonary Disease: A Survey of Current Practice in Italy.","authors":"Claudia Crimi, Annalisa Carlucci, Lara Pisani, Scott Gibson, Carlo Bellatorre, Anna Panza, Sarah Alami","doi":"10.1159/000549778","DOIUrl":"10.1159/000549778","url":null,"abstract":"Introduction: Optimal initiation and management of long-term home non-invasive ventilation (LTH-NIV) therapy requires a personalised approach that may not be possible within some healthcare systems. This survey of Italian physicians determined current practices regarding LTH-NIV initiation and follow-up in patients with chronic hypercapnic chronic obstructive pulmonary disease (COPD), areas for process improvements, and use of telemonitoring.Methods: A 35-question survey was developed then sent via email for completion using computer-assisted web interviewing methodology. Respondents were Italian hospital-based physicians identified using a healthcare professional database who had 3 years' experience in pulmonology, treated/followed up at least 50 patients on NIV, and consented to participate.Results: Sixty of 71 physicians approached completed the online survey. Of these, 41/60 (68%) said that LTH-NIV prescription followed hospitalisation for acute COPD exacerbation. The most important clinical aspects to monitor early after discharge and during long-term follow-up were reported as mask fit and patient quality of life. Physicians reported a high workload for management of patients on LTH-NIV but felt that many therapy management tasks could be performed by other providers, especially outpatient pulmonologists and homecare providers. Only 32% of respondents were currently using telemonitoring; reasons for non-use were lack of human resources (63%) or regulatory framework (37%), and cost/reimbursement issues (22%).Conclusion: These data highlight substantial differences between LTH-NIV clinical practice for chronic hypercapnic COPD in Italy and current guidelines, suggesting that guideline-mandated processes may not be achievable or sustainable in real-world settings. Involvement of homecare providers and use of telemonitoring could help improve the management of LTH-NIV therapy.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"642-653"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688003","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

A Systematic Review of the Safety of Sedation during Flexible Bronchoscopy. 柔性支气管镜检查中镇静安全性的系统回顾。

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-09-16 DOI: 10.1159/000548435

Sandhya Matthes, Marcel Treml, Ralf-Harto Hübner, Jürgen Hetzel, Ralf Eberhardt, Karl-Josef Franke, Felix J Herth, Angélique Holland, Torsten Loop, Helmut Sitter, Winfried J Randerath, Lars Hagmeyer

{"title":"A Systematic Review of the Safety of Sedation during Flexible Bronchoscopy.","authors":"Sandhya Matthes, Marcel Treml, Ralf-Harto Hübner, Jürgen Hetzel, Ralf Eberhardt, Karl-Josef Franke, Felix J Herth, Angélique Holland, Torsten Loop, Helmut Sitter, Winfried J Randerath, Lars Hagmeyer","doi":"10.1159/000548435","DOIUrl":"10.1159/000548435","url":null,"abstract":"Introduction: Sedation during flexible bronchoscopy can be administered by a second physician, an anesthesiologist or as nurse-administered sedation (NAS). Propofol is often administered by non-anesthesiologists. It is unclear whether complications differ with various sedation protocols.Methods: We searched PubMed for clinical trials of sedation during bronchoscopy and conducted a systematic review of complications (death ≤24 h post-procedure or intensive care unit (ICU) admission/predefined cardiopulmonary escalation [CPE]). Outcomes were analyzed according to the staff administering sedation, complexity of procedure, for propofol-containing regimes, and the ASA physical status classification of the patient.Results: This analysis (120 articles, 39,475 procedures) showed a mortality rate of 0.01% for sedation bronchoscopy. ICU admission rate was 0.12%, and CPE was reported in 0.57%. Significantly higher CPE was recorded for anesthesiologists compared to NAS and second physicians (1.16% vs. 0.65% vs. 0.07%, respectively, p < 0.001) with higher ICU admission for NAS compared to anesthesiologists and second physicians (0.35% vs. 0.00% vs. 0.03%, respectively, p < 0.001). Endobronchial ultrasound did not increase complication rates. Admission to ICU and CPE remained <1% in propofol-containing regimes, although complications were slightly lower without propofol. Comparison of lower risk ASA 1-2 studies compared to studies with ASA 1-3 showed no significant difference in outcome.Conclusion: Sedation bronchoscopy is a safe procedure. The staff administering sedation may react differently to periprocedural respiratory and cardiovascular events. Propofol application is not associated with a clinically relevant increase in complication rate. There is no evidence that ASA status is a predictor of individual risk at bronchoscopy.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"37-56"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076027","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 Endobronchial Valve Treatment on Skeletal Muscles, Fatigue, and Sleep in Severe Emphysema Patients. 支气管内瓣膜治疗对严重肺气肿患者骨骼肌、疲劳和睡眠的影响。

IF 3.8 3区医学

Respiration Pub Date : 2026-01-01 Epub Date: 2025-09-18 DOI: 10.1159/000548426

Else A M D Ter Haar, Dirk-Jan Slebos, Jorine E Hartman

{"title":"Effect of Endobronchial Valve Treatment on Skeletal Muscles, Fatigue, and Sleep in Severe Emphysema Patients.","authors":"Else A M D Ter Haar, Dirk-Jan Slebos, Jorine E Hartman","doi":"10.1159/000548426","DOIUrl":"10.1159/000548426","url":null,"abstract":"Introduction: Skeletal muscle dysfunction, fatigue, and poor sleep quality are common in severe emphysema patients. Endobronchial valve (EBV) treatment is a bronchoscopic procedure which improves pulmonary function, quality of life, and exercise capacity in these patients. However, its potential beneficial effects on skeletal muscle function, fatigue, and sleep are unclear. Our aim was to investigate the effects of EBV treatment on these outcomes.Methods: We conducted a prospective cohort study assessing the second parasternal intercostal muscle thickening fraction, and quadriceps muscle thickness and rectus femoris cross-sectional area (RFCSA), both using ultrasound, limb muscle function using the 30-s sit-to-stand test, fatigue with the Checklist Individual Strength (CIS) fatigue subscale (score ≥36 indicating severe fatigue), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI) at baseline and 6 months following EBV treatment.Results: A total of 20 patients were included. At the 6-month follow-up, significant improvements were observed in pulmonary function, quadriceps thickness, and RFCSA in the nondominant leg, as well as in limb muscle function. Intercostal thickening fraction did not change following treatment. Fatigue decreased significantly, reducing severe fatigue prevalence from 70% to 25%. Sleep quality was generally poor and remained unchanged.Conclusion: Our results show that quadriceps muscle size and function, as well as fatigue, significantly improve following EBV treatment in severe emphysema patients. However, BLVR seems to have no impact on intercostal thickening fraction and patient-reported sleep quality. This study highlights the beneficial extrapulmonary effects of EBV treatment in patients with severe emphysema, further supporting its clinical use.","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"283-293"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086938","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