Respiration最新文献

{"title":"Poor Correlation between Diaphragm Ultrasound and Invasive Gold Standard Technique Derived Respiratory Muscle Strength Assessment in Patients after Hospitalisation for COVID-19.","authors":"Janina Friedrich, Binaya Regmi, Benedikt Jörn, Mehdi Senol, Alberto Giannoni, Matthias Boentert, Florian Kahles, Ayham Daher, Michael Dreher, Jens Spiesshoefer","doi":"10.1159/000541632","DOIUrl":"10.1159/000541632","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals who survive acute coronavirus disease 2019 (COVID-19) might experience diaphragm muscle weakness. Diaphragm ultrasound may be an easy-to-obtain bedside tool for determining diaphragm function. However, twitch transdiaphragmatic pressure (twPdi) following magnetic stimulation (MS) of the phrenic nerves is the gold standard for non-volitional assessment of diaphragm strength. This study investigated whether diaphragm thickening ratio (DTR) measured on diaphragm ultrasound reflects diaphragm strength as measured by twPdi following MS of the phrenic nerves or other (volitional) invasively obtained pressure values and could therefore be used to accurately diagnose diaphragm weakness.</p><p><strong>Methods: </strong>One year after discharge, 50 individuals (14 female, age 58 ± 12 years) who had been hospitalised and treated for moderate-severe COVID-19 underwent standard spirometry and diaphragm ultrasound. TwPdi following cervical MS of the phrenic nerve and volitional inspiratory manoeuvres (Sniff and Mueller manoeuvre) were measured using oesophageal and gastric balloon catheters after transnasal placement.</p><p><strong>Results: </strong>At follow-up, no clinically meaningful restrictive lung function impairment was evident on spirometry. On diaphragm ultrasound, diaphragm dysfunction, i.e., an impaired DTR was detected in 24% (12/50) of participants. An objective diagnosis of diaphragm dysfunction, defined as twPdi <16 cm H2O, was made in 60% (30/50) of participants. The measurement results of the two methods did not agree, given that there were many false-negative but also false-positive results, so diaphragm ultrasound diagnosed in parts other patients with diaphragm dysfunction than twPdi. Diaphragm ultrasound had a sensitivity of 26.67% and a specificity of 80.0% in the detection of diaphragm dysfunction (positive predictive value 66.67%, negative predictive value 42.10%).</p><p><strong>Conclusion: </strong>Diagnosis of diaphragm weakness in individuals who have recovered from COVID-19 cannot be made accurately on diaphragm ultrasound (via DTR) but requires twPdi as the gold standard for assessment of diaphragm strength.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"231-239"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576812","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}

{"title":"The Impact of Balloon Use during Endobronchial Ultrasound: A Randomized Pilot Study.","authors":"Taha Huseini, Andrew DeMaio, Lonny Yarmus, Clare Pollock, Amit Katz, Basil Nasir, Adnan Majid, Stephan Soder, Moishe Liberman","doi":"10.1159/000542448","DOIUrl":"10.1159/000542448","url":null,"abstract":"<p><strong>Introduction: </strong>During endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), a saline-filled balloon placed over the tip of the bronchoscope is used to improve coupling of the ultrasound transducer to the airway wall. However, it is unknown whether it objectively improves image quality or affects procedural outcomes. Our aim was to establish whether the use of a balloon during EBUS impacts image quality, diagnostic yield, procedure duration or complications.</p><p><strong>Methods: </strong>A pilot randomized control trial of patients undergoing EBUS-TBNA of mediastinal lymph nodes was performed at a single academic center. Patients were randomized to use a saline-filled balloon (versus no balloon use) during EBUS-TBNA of the right lower paratracheal lymph node (station 4R). The EBUS videos were recorded and scored on a 4-point Likert scale by three blinded external reviewers. The primary outcome of this study was ultrasound image quality. Secondary outcomes included diagnostic yield, procedure duration, and complications.</p><p><strong>Results: </strong>Forty-six patients were randomized. In the balloon group, 61% of patients had an image quality score of \"excellent\" or \"good,\" compared to 47% in the no balloon group (p = 0.009). There was no significant difference in diagnostic yield, procedure duration, or complications between the groups.</p><p><strong>Conclusion: </strong>Inflation of the balloon during EBUS-TBNA at the right lower paratracheal lymph node improves ultrasound image quality but does not impact diagnostic yield, procedure duration, or safety. This study provides a framework for additional studies with complete nodal assessment to determine if balloon use has a clinically meaningful benefit to procedural outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"272-280"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668806","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}

{"title":"The Role of Transbronchial Cryobiopsy in the Detection of Pulmonary Graft-versus-Host Disease.","authors":"Alicja Sadowska-Klasa, Wojciech Karolak, Agnieszka Piekarska, Jacek Kowalski, Sławomir Żegleń, Alicja Janowicz, Tomasz Nadolny, Jacek Wojarski, Jan Maciej Zaucha","doi":"10.1159/000542463","DOIUrl":"10.1159/000542463","url":null,"abstract":"<p><strong>Introduction: </strong>We investigated the incidence of chronic pulmonary complications in allogeneic hematopoietic cell transplantation (HCT) recipients and analyzed the role of transbronchial cryobiopsy (cryoTBB) as a tool to determine the nature of pulmonary changes and to guide clinical decisions.</p><p><strong>Methods: </strong>Patients who survived at least 6 months post HCT were included in the study. Pulmonary functional tests (PFTs) were performed in all patients as a screening tool. In case of abnormal results computed tomography (CT) was done to verify inflammatory changes and the presence of air trapping. Next, patients were qualified for microbiological analysis of bronchoalveolar lavage fluid. If the results of noninvasive tests were inconclusive, cryoTBB was performed.</p><p><strong>Results: </strong>Among 186 patients, we identified 13 cases (7%) with abnormal PFTs. Mild, moderate, and severe chronic graft-versus-host disease (GvHD) was diagnosed in 1 (8%), 6 (46%), and 2 (15%) patients, respectively. Four (31%) patients did not present any manifestations of cGvHD at FEV1 decline. Eight 8 (62%) patients met the bronchiolitis obliterans syndrome criteria, 5 (48%) had restrictive disease, or mixed phenotype based on PFTs, only in 1 case air trapping was present in CT. Pulmonary GvHD was confirmed by cryoTBB histopathology in 5 of 11 (45%) cases. Immunosuppression was either stopped or decreased in 6 patients with negative results for GvHD with further clinical improvement.</p><p><strong>Conclusion: </strong>CryoTBB can be a helpful tool to verify the cause of chronic pulmonary complications in the HCT population. Based on negative biopsy results, some patients may benefit from immunosupressive therapy discontinuation or reduction to mitigate recurrences of infectious complications and further lung destruction.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"264-271"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771473","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}

{"title":"Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis.","authors":"Fatemeh Sodeifian, Naghmeh Kian, Amirhomayoun Atefi, Alvand Naserghandi, Moein Zangiabadian, Sara Sadeghzade, Kosar Namakin, Zahra Sadat Seghatoleslami, Lia D'Ambrosio, Mohammad Javad Nasiri, Giovanni Battista Migliori","doi":"10.1159/000543319","DOIUrl":"10.1159/000543319","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is a leading cause of cancer-related deaths worldwide, with rising incidence in resource-limited settings. Research suggests an increased risk of lung cancer in individuals with a history of pulmonary tuberculosis (TB), but the association needs further clarification. This systematic review aims to provide a more comprehensive understanding of this relationship.</p><p><strong>Methods: </strong>We systematically searched the PubMed/Medline, EMBASE, and Scopus databases for relevant studies up to March 15, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models, depending on the level of heterogeneity. All statistical analyses were performed using Comprehensive Meta-Analysis Software, version 3.0.</p><p><strong>Results: </strong>A total of 37 studies were included (9 cohort and 28 case-control). A significant association between prior pulmonary TB and lung cancer was found in both cohort (OR: 2.3; 95% CI, 1.4-3.8) and case-control (OR: 1.9; 95% CI, 1.4-2.5) studies. Subgroup analyses revealed a stronger association in East Asia (OR: 2.4; 95% CI, 1.3-4.1).</p><p><strong>Conclusion: </strong>Our study provides strong evidence of an increased risk of lung cancer following pulmonary TB. The findings emphasize the need for comprehensive public health strategies, including targeted screening, early detection, and smoking cessation. Future studies should investigate the mechanisms linking TB and lung cancer, as well as the effectiveness of integrated prevention programs, particularly in high-burden regions.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-16"},"PeriodicalIF":3.5,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903198","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}

{"title":"Cryoablation for the Treatment of Post-Tracheostomy Tracheal Stenosis in Neurological Patients.","authors":"Lukas Ley, Pascal Klingenberger, Jürgen Hetzel, Tamara Schlitter, Hossein Ardeschir Ghofrani, Jens Allendörfer, Dirk Bandorski","doi":"10.1159/000543103","DOIUrl":"10.1159/000543103","url":null,"abstract":"<p><strong>Introduction: </strong>Post-tracheostomy tracheal stenosis is a clinically relevant late complication of tracheostomy. To date, there is no standardized treatment strategy for post-tracheostomy tracheal stenosis. Contact cryoablation is one of the applicable methods. The aim of the present study was to explore the efficacy and safety of contact cryoablation for the treatment of post-tracheostomy tracheal stenosis.</p><p><strong>Methods: </strong>A total of 63 consecutive patients were included in this unicentre, combined retrospective and prospective observational study in an intensive care unit of a German neurological specialist hospital from 30 April 2020 to 21 March 2024. Post-tracheostomy tracheal stenoses were confirmed by tracheoscopy. All eligible patients were primarily treated with contact cryoablation. Primary endpoint was the rate of successful removal of the tracheostomy tube (decannulation) until hospital discharge. Technical success was defined as the absence of an endoscopically relevant residual post-tracheostomy tracheal stenosis, and clinical success was defined as the absence of symptoms, e.g., dyspnoea and stridor, both at discretion of the endoscopist and treating physician.</p><p><strong>Results: </strong>A total of 78 interventions were performed (median: 1 per patient). Cryoablation was applied in 67% of patients at least once. A total of 70% of patients could be decannulated after treatment. Technical success and clinical success were achieved in 88% and 70% of patients, and in only 5% of patients surgical treatment was performed. No complications were observed.</p><p><strong>Conclusion: </strong>Contact cryoablation appears to be an effective, complication-free, simple, and non-surgical treatment option for patients with post-tracheostomy tracheal stenosis. It could be an excellent option for every patient with suitable stenosis morphology. However, other endoscopic modalities must be available or complementarily used for non-suitable stenosis morphologies.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882766","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}

{"title":"SARS-CoV-2 Vaccination in Primary Humoral Immunodeficiency: Experience from a German Lung Clinic.","authors":"Sophie Rosendahl, Franziska C Trudzinski, Markus Polke, Felix J F Herth, Michael Kreuter, Thomas Giese","doi":"10.1159/000543146","DOIUrl":"10.1159/000543146","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, the effectiveness of vaccines against SARS-CoV-2 in immunodeficient patients not only did affect the individual risk of these vulnerable patients but endangered the selection of new variants of concern due to prolonged virus shedding by these patients.</p><p><strong>Methods: </strong>In a tertiary center for pulmonary diseases, we investigated the immune response of 11 patients with primary humoral immunodeficiency and 13 healthy controls on the humoral and cellular level after full vaccination with an mRNA or vector vaccine against SARS-CoV-2.</p><p><strong>Results: </strong>In the majority of patients (73%), we found antibodies against the spike protein above the threshold of positivity. Likewise, patients showed a promising cellular response: the upregulated production of INFγ, TNFα, and CXCL10 by T cells did not differ from the response of healthy controls.</p><p><strong>Conclusion: </strong>These results stress the importance to further discern an adequate immunological correlate of protection and the need to follow the effect of booster immunizations in this population at risk.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865366","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}

{"title":"Analysis of Risk Factors for Restenosis after Interventional Treatment of Tuberculous Airway Stenosis.","authors":"Wei Huang, Chao Xu, Baochu Wei, Xuyang Li, Fanqi Wu, Yue Hou, Hong Wang","doi":"10.1159/000542909","DOIUrl":"10.1159/000542909","url":null,"abstract":"<p><strong>Introduction: </strong>Airway stenosis is the most common and serious complication of tracheobronchial tuberculosis (TBTB). Systemic anti-tuberculosis treatment is the basic treatment for TBTB airway stenosis, and supplemented with tracheoscopic intervention, it can effectively minimize the occurrence of TBTB stenosis or reduce the degree of stenosis; however, some patients still have restenosis after the intervention. However, some patients still have restenosis after intervention.</p><p><strong>Methods: </strong>We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year of the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression.</p><p><strong>Results: </strong>A total of 154 patients with tuberculous airway stenosis were included in this study, including 64 patients in the restenosis group, and the restenosis rate was 41.6%. Univariate analysis showed that the systemic immune inflammation index (SII) was higher in the restenosis group than in the non-restenosis group, and the composition of diabetic patients, stenosis length >3 cm, and positive antacid staining of tracheal secretions were higher in the restenosis group than in the non-restenosis group (all p < 0.05). The composition of microscopically inactive, anti-tuberculosis treatment before intervention and balloon dilatation was lower (all p < 0.05). Multifactorial binary logistic regression analysis showed that diabetes (OR = 5.758, 95% CI: 1.434-23.119), stenosis length (OR = 6.349, 95% CI: 2.653-15.197), SII (OR = 1.002, 95% CI: 1.001-1.003), anti-tuberculosis treatment before interventional therapy (OR = 0.250, 95% CI: 0.084-0.746), and TBTB microscopic classification and staging (OR = 0.306, 95% CI: 0.099-0.941) were independent influencing factors of restenosis after interventional therapy for tuberculous airway stenosis.</p><p><strong>Conclusion: </strong>Diabetes, stenosis length >3 cm, and high SII were independent risk factors for restenosis after intervention for tuberculous airway stenosis, before interventional anti-tuberculosis treatment and microscopic inactivity were independent protective factors.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-8"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865343","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}

{"title":"Real-Life Nationwide Outcomes of Bronchoscopic Lung Volume Reduction with Endobronchial Valves in Severe Chronic Obstructive Pulmonary Disease.","authors":"Morten Borg, Rikke Ibsen, Ole Hilberg, Anders Løkke","doi":"10.1159/000543010","DOIUrl":"10.1159/000543010","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally, characterized by airflow limitation and lung hyperinflation due to emphysema. Bronchoscopic lung volume reduction (BLVR) with endobronchial valves offers a minimally invasive treatment option for emphysema, aiming to reduce lung hyperinflation, thereby improving lung function and exercise tolerance.</p><p><strong>Methods: </strong>This study evaluated the efficacy of BLVR in a real-life nationwide setting using comprehensive Danish registries. The study population included patients who underwent BLVR between January 1, 2013, and December 31, 2021. We assessed clinical outcomes, including forced expiratory volume in 1 s (FEV1), Medical Research Council (MRC) dyspnea score, and the rates of exacerbations and pneumonia before and after the procedure. A control cohort of matched COPD patients was also analyzed.</p><p><strong>Results: </strong>Following BLVR, a significant increase in FEV1, similar to the improvements reported in randomized controlled trials, was observed. Additionally, the proportion of patients classified as GOLD stage IV decreased from 71.3% to 60.6% after BLVR. The incidence rate ratio for severe exacerbations significantly dropped to 0.56 (95% confidence interval 0.47-0.67, p < 0.01) after BLVR. No significant changes were observed in the rates of moderate and severe pneumonia, and mortality rates did not differ significantly from those in the matched control cohort.</p><p><strong>Conclusion: </strong>This study demonstrates the real-life efficacy of BLVR using endobronchial valves, highlighting a significant improvement in FEV1 and a reduction in severe COPD exacerbations. The procedure did not increase pneumonia rates or affect mortality, supporting continued use of BLVR for managing patients with COPD.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":3.5,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865362","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}

{"title":"Increased Resistance of the Peripheral Airways in Patients with Unexplained Chronic Cough.","authors":"Ewa Ternesten-Hasséus, Ewa-Lena Johansson, Eva Millqvist","doi":"10.1159/000543008","DOIUrl":"10.1159/000543008","url":null,"abstract":"<p><strong>Introduction: </strong>Troublesome coughing that persists for more than 8 weeks without evident aetiology or effective therapy is termed unexplained chronic cough (UCC). Using impulse oscillometry (IOS) and spirometry, we assessed the functionalities of the large and small airways, respectively, in patients with UCC and in healthy control subjects.</p><p><strong>Methods: </strong>On a single occasion, 50 patients with UCC (mean age, 61 years; 82% women) and 23 subjectively healthy controls (mean age, 58.9 years; 95.7% women) underwent IOS and spirometry. Patients with UCC were also subjected to fractional exhaled nitric oxide (FeNO) measurement, and they answered a local questionnaire, a visual analogue scale (VAS) for cough and cough-related symptoms, and a health-related quality of life questionnaire.</p><p><strong>Results: </strong>Forty-nine (98%) patients with UCC reported cough symptoms from exposure to chemicals, 39 (78%) had problems with cold air, and 38 (76%) had cough symptoms following exercise. The mean VAS cough score was 62 mm in the patient group. FeNO was measured in 25 patients, showing a mean value of 16.6 ppb. Women with UCC had significantly greater airway resistance and reactance than men with UCC. The UCC group showed significantly increased peripheral airway resistance and reactance, and lower FEV1% predicted values (albeit within the normal range), as compared with the healthy control group.</p><p><strong>Conclusion: </strong>Patients with UCC show increased peripheral airway resistance and significantly lower FEV1% predicted values compared with healthy control subjects. Routine measurements of lung function with both IOS and spirometry could have added value to the diagnosis of UCC.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-8"},"PeriodicalIF":3.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814131","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}

{"title":"First in Human Evaluation of a Novel Thin Convex Probe Endobronchial Ultrasound System.","authors":"Nicholas J Pastis, Vidhya Y Aroumougame, Christopher R Gilbert, Adam H Fox, Nichole T Tanner, Travis L Ferguson, Gerard A Silvestri","doi":"10.1159/000542966","DOIUrl":"10.1159/000542966","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of pulmonary imaging abnormalities continues to increase. While standard convex probe endobronchial ultrasound bronchoscope (CP-EBUS) is safe and accurate, it has limited reach through smaller bronchi. Olympus BF-Y0069 thin convex probe EBUS (TCP-EBUS) has a smaller diameter and improved angulation. We assessed the safety and feasibility of the TCP-EBUS to evaluate lesions not accessible with CP-EBUS.</p><p><strong>Methods: </strong>A single-center, prospective, pilot study evaluating TCP-EBUS enrolled patients undergoing bronchoscopy for lesions within the inner two-thirds of the lung. Patients underwent CP-EBUS to attempt visualization and biopsy. If unsuccessful, TCP-EBUS was used. Safety, lesion characteristics, and pathology results were collected.</p><p><strong>Results: </strong>Fifty-one patients were enrolled with multiple lesion locations and no adverse safety events with TCP-EBUS. Seven cases (13.7%) were omitted as the target lesion was visualized by CP-EBUS and TCP-EBUS. CP-EBUS failed to provide biopsy for 44 cases. CP-EBUS visualized 7/44, however, was unable to biopsy. TCP-EBUS visualized 36/44 (81.8%) lesions and biopsied 27/44 (61%) lesions. 8/44 (15.7%) lesions could not be visualized with either device. Median lesion size biopsied with CP-EBUS was 41 mm (IQR: 22-48). Median size of lesions visualized with TCP-EBUS was 20 mm (IQR: 15.3-38), range 8-70. The median distance from the main carina was 62 mm (IQR: 60-89) for lesions biopsied with the CP-EBUS and 63.3 (IQR: 48.5-78.8) for TCP-EBUS. While average distances from main carina were similar in both groups, the furthest lesion TCP-EBUS visualized was 120 mm from the carina compared to 100 mm with CP-EBUS.</p><p><strong>Conclusions: </strong>The use of TCP-EBUS was safe and effective without observed patient-associated complications, and it provided real-time ultrasonographic visualization and biopsy of lesions not accessible with CP-EBUS.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-9"},"PeriodicalIF":3.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807406","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}