Respiration最新文献

{"title":"Retropharyngeal Abscess Complicated by Mediastinitis in Infants.","authors":"Ann Thomas, Shaun Adam, Pierre Goussard, Shyam Sunder B Venkatakrishna, Savvas Andronikou, Johan Grobbelaar","doi":"10.1159/000540525","DOIUrl":"10.1159/000540525","url":null,"abstract":"<p><strong>Introduction: </strong>Most paediatric upper respiratory infections are virally mediated and result in self-limiting reactive lymphadenopathy. In children younger than 5 years, retropharyngeal lymph nodes may give rise to deep neck space infections in this potential space. Retropharyngeal infections are rare after 5 years because lymph nodes undergo atrophy.</p><p><strong>Methods: </strong>We present a series of 6 cases of paediatric retropharyngeal abscesses (RPA) complicated by mediastinitis, managed at a tertiary hospital over a 4-year period.</p><p><strong>Results: </strong>All our cases presented with fever, difficulty feeding, and neck swelling. The age range was 11 weeks-11 months, and all tested negative for human immunodeficiency virus. The diagnosis and complications were confirmed on computed tomography (CT) scan. The CT scans consistently revealed RPA with varying degrees of deep neck space and mediastinal extension. All children were promptly taken to theatre for source control. Two were extubated successfully immediately after surgery, and the other 4 were extubated in the paediatric intensive care unit, with the longest duration of intubation being 3 days. Methicillin-sensitive Staphylococcus aureus (MSSA) was cultured in all 6 cases.</p><p><strong>Conclusion: </strong>Management of these cases may be challenging, and young children with RPA require close care and airway monitoring. CT or magnetic resonance imaging is essential to delineate the extent of infection. Surgical drainage should be performed when there is a large abscess, a complication occurs, or an inadequate response in 24-48 h to medical management.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"651-659"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860739","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":"Effects of 5-Week Oral Acetazolamide on Incremental Cycling Exercise in Pulmonary Arterial and Chronic Thromboembolic Pulmonary Hypertension: A Randomized Placebo-Controlled, Double-Blinded, Crossover Trial.","authors":"Julian Müller, Paula Appenzeller, Mona Lichtblau, Stéphanie Saxer, Charlotte Berlier, Simon R Schneider, Michael Furian, Esther I Schwarz, Erik R Swenson, Konrad E Bloch, Silvia Ulrich","doi":"10.1159/000536399","DOIUrl":"10.1159/000536399","url":null,"abstract":"<p><strong>Introduction: </strong>Acetazolamide (AZA) improves nocturnal and daytime blood oxygenation in patients with pulmonary vascular disease (PVD), defined as pulmonary arterial and distal chronic thromboembolic pulmonary hypertension (CTEPH), and may improve exercise performance.</p><p><strong>Methods: </strong>We investigated the effect of 5 weeks of AZA (250 mg bid) versus placebo on maximal load during incremental cycling ramp exercise in patients with PVD studied in a randomized controlled, double-blind, crossover design, separated by &gt; 2 weeks of washout.</p><p><strong>Results: </strong>Twenty-five patients (12 pulmonary arterial hypertension, 13 CTEPH, 40% women, age 62 ± 15 years) completed the trial according to the protocol. Maximum load was similar after 5 weeks of AZA versus placebo (113 ± 9 vs. 117 ± 9 watts [W]), mean difference -4 W (95% CI: -9 to 1, p = 0.138). With AZA, maximum (max)-exercise partial pressure of O2 (PaO2) was significantly higher by 1.1 kPa (95% CI: 0.5-1.8, p = 0.003), while arterial pH and partial pressure of CO2 were significantly lower. Gas exchange threshold was reached at a higher load with AZA (108 ± 8 W vs. 97 ± 8 W) and was therefore delayed by 11 W (95% CI: 3-19, p = 0.013), while the ventilatory equivalent for O2 and CO2 were significantly higher at both the max-exercise and gas exchange threshold with AZA versus placebo.</p><p><strong>Conclusion: </strong>AZA for 5 weeks did not significantly change maximum exercise capacity in patients with PVD despite a significant increase in PaO2. The beneficial effects of increased blood oxygenation may have been diminished by increased ventilation due to AZA-induced metabolic acidosis and increased dyspnea.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"124-133"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932662","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":"Novel Insights from Clinical Practice Autologous Blood Patch Pleurodesis and Endobronchial Valves for Management of Persistent Air Leaks in Two Cases of Tuberculosis.","authors":"Aida F Martinez, Zachary Tom, David W Hsia, Janine Vintch, Nathan Yee","doi":"10.1159/000537992","DOIUrl":"10.1159/000537992","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary infections, such as tuberculosis, can result in numerous pleural complications including empyemas, pneumothoraces with broncho-pleural fistulas, and persistent air leak (PAL). While definitive surgical interventions are often initially considered, management of these complications can be particularly challenging if a patient has an active infection and is not a surgical candidate.</p><p><strong>Case presentation: </strong>Autologous blood patch pleurodesis and endobronchial valve placement have both been described in remedying PALs effectively and safely. PALs due to broncho-pleural fistulas in active pulmonary disease are rare, and we present two such cases that were managed with autologous blood patch pleurodesis and endobronchial valves.</p><p><strong>Conclusion: </strong>The two cases presented illustrate the complexities of PAL management and discuss the treatment options that can be applied to individual patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"289-294"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991001","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 Association between Objectively Measured Physical Activity and the Prevalence of Comorbidities in Lung Transplant Recipients.","authors":"Sofie Breuls, Astrid Blondeel, Marieke Wuyts, Geert M Verleden, Robin Vos, Wim Janssens, Thierry Troosters, Heleen Demeyer","doi":"10.1159/000536607","DOIUrl":"10.1159/000536607","url":null,"abstract":"<p><strong>Introduction: </strong>Lung transplant recipients are often physically inactive and are at risk of developing comorbidities. We investigated whether objectively measured physical activity was associated with the prevalence of comorbidities.</p><p><strong>Methods: </strong>Physical activity (accelerometry) and the presence of cardiovascular disease, symptoms of depression and anxiety, diabetes, dyslipidaemia, hypertension, lower extremity artery disease, muscle weakness, obesity, and osteoporosis were assessed in 108 lung transplant recipients. Patients were divided into four groups based on daily step count.</p><p><strong>Results: </strong>A cohort of 108 patients (60 ± 7 years, 51% male, 20 ± 14 months since transplantation) was included. Active patients (&gt;7,500 steps/day) had significantly fewer comorbidities (4 comorbidities) compared to severely inactive patients (&lt;2,500 steps/day, 6 comorbidities), and muscle weakness and high symptoms of depression were less prevalent. Severely inactive patients had significantly more cardiovascular comorbidities compared to all other groups. No other significant differences were observed.</p><p><strong>Conclusion: </strong>Physically active lung transplant recipients have fewer comorbidities, lower prevalence of muscle weakness, and fewer symptoms of depression compared to very inactive patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"251-256"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050274","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":"Artificial Intelligence Algorithm Can Predict Lymph Node Malignancy from Endobronchial Ultrasound Transbronchial Needle Aspiration Images for Non-Small Cell Lung Cancer.","authors":"Yogita S Patel, Anthony A Gatti, Forough Farrokhyar, Feng Xie, Waël C Hanna","doi":"10.1159/000541365","DOIUrl":"10.1159/000541365","url":null,"abstract":"<p><strong>Introduction: </strong>Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) for lung cancer staging is operator dependent, resulting in high rates of non-diagnostic lymph node (LN) samples. We hypothesized that an artificial intelligence (AI) algorithm can consistently and reliably predict nodal metastases from the ultrasound images of LNs when compared to pathology.</p><p><strong>Methods: </strong>In this analysis of prospectively recorded B-mode images of mediastinal LNs during EBUS-TBNA, we used transfer learning to build an end-to-end ensemble of three deep neural networks (ResNet152V2, InceptionV3, and DenseNet201). Model hyperparameters were tuned, and the optimal version(s) of each model was trained using 80% of the images. A learned ensemble (multi-layer perceptron) of the optimal versions was applied to the remaining 20% of the images (Test Set). All predictions were compared to the final pathology from nodal biopsies and/or surgical specimen.</p><p><strong>Results: </strong>A total of 2,569 LN images from 773 patients were used. The Training Set included 2,048 LNs, of which 70.02% were benign and 29.98% were malignant on pathology. The Testing Set included 521 LNs, of which 70.06% were benign and 29.94% were malignant on pathology. The final ensemble model had an overall accuracy of 80.63% (95% confidence interval [CI]: 76.93-83.97%), 43.23% sensitivity (95% CI: 35.30-51.41%), 96.91% specificity (95% CI: 94.54-98.45%), 85.90% positive predictive value (95% CI: 76.81-91.80%), 79.68% negative predictive value (95% CI: 77.34-81.83%), and AUC of 0.701 (95% CI: 0.646-0.755) for malignancy.</p><p><strong>Conclusion: </strong>There now exists an AI algorithm which can identify nodal metastases based only on ultrasound images with good overall accuracy, specificity, and positive predictive value. Further optimization with larger sample sizes would be beneficial prior to clinical application.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"741-751"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294146","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":"Deventilation Syndrome in COPD Patients Receiving Long-Term Home Noninvasive Ventilation: A Systematic Scoping Review.","authors":"Maximilian Wollsching-Strobel, Karsten Stannek, Daniel Sebastian Majorski, Friederike Sophie Magnet, Doreen Kroppen, Melanie Patricia Berger, Maximilian Zimmermann, Wolfram Windisch, Sarah Bettina Stanzel","doi":"10.1159/000535704","DOIUrl":"10.1159/000535704","url":null,"abstract":"<p><p>The treatment of patients with COPD and chronic hypercapnic respiratory failure using noninvasive ventilation (NIV) is well established. A \"deventilation syndrome\" (DVS) has been described as acute dyspnea after cessation of NIV therapy. A systematic scoping review reporting according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) searching Embase was conducted in September 2021. A final manual search followed in February 2023. Literature synthesis was blinded using Rayyan by three different reviewers. A total of 2,009 studies were screened. Five studies met the eligibility criteria. Four articles presented original data. Three articles examined potential treatment options. Three studies were prospective; none were randomized. A total of 122 patients were included. DVS was defined differently in all studies. Seventy-four patients were identified to suffer from DVS (48 controls). Patients were evaluated by blood gas analysis, transcutaneous TcCO2 measurement, spirometry, whole-body plethysmography, respiratory muscle assessments, diaphragmatic electromyography, ultrasound, 6-min walk test, polysomnography, and questionnaires. Treatment approaches studied were minimization of \"patient-ventilator asynchrony\" (PVA) and use of pursed- lip breathing ventilation. Pathophysiological mechanisms discussed were PVA, high inspiratory positive airway pressure, hyperinflation, respiratory muscle impairment, and increased respiratory rates. Compared with controls, patients with DVS appeared to suffer from more severe airway obstruction, hyperinflation, and PaCO2 retention; worse exercise test scores; and poorer quality of life. The available evidence does not allow for definite conclusions about pathophysiological mechanisms, ethology, or therapeutic options. Future studies should focus on a consistent definition and possible pathomechanisms.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"60-69"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576617","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":"COVID-19 after 2 Years from Hospital Discharge: A Pulmonary Function and Chest Computed Tomography Follow-Up Study.","authors":"Simone Mennella, Cristiano Alicino, Marco Anselmo, Giuliana Carrega, Gianluca Ficarra, Luca Garra, Alessandro Gastaldo, Paola Gnerre, Flavia Lillo, Rodolfo Tassara, Anna Terrile, Manlio Milanese","doi":"10.1159/000535732","DOIUrl":"10.1159/000535732","url":null,"abstract":"<p><strong>Introduction: </strong>Serial follow-up with pulmonary function testing (PFT) and chest computed tomography (CT) after severe COVID-19 are recommended. As a result, many longitudinal studies have been published on COVID-19 of different grade of severity up to 1-year follow-up. Therefore, we aimed at a long-term observational study throughout 2 years after severe COVID-19.</p><p><strong>Methods: </strong>Severe COVID-19 patients were consecutively recruited after hospital discharge between March and June 2020 and prospectively followed up for 24 months, with mMRC dyspnea scale and PFT at 6, 12, and 24 months. Chest CT was performed when clinically indicated.</p><p><strong>Results: </strong>One hundred one patients enrolled completed the observational study. At 24 months, those with reduced total lung capacity (TLC) were 16%, associated with fibrotic ground glass opacity (GGO) and mMRC score &gt;1, respectively, in 75% and 69% of them. At 24 months, those with a reduced diffusing capacity of the lung for CO were 41%, associated with fibrotic GGO and mMRC score &gt;1, respectively, in 53% and 22% of them.</p><p><strong>Conclusion: </strong>Two years after hospitalization for severe COVID-19, a non-negligible number of patients still suffer from \"long COVID\" due to respiratory damage.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"22-31"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404142","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":"Successful Endobronchial Valve Placement in the Treatment of Persistent Bronchopleural Fistula and Empyema Allows the Avoidance of Right Completion Pneumonectomy.","authors":"Didier Lardinois, Kathleen Jahn, Aljaz Hojski, Spasenija Savic Prince, Nikolay Tsvetkov, Zeljko Djakovic, Helga Bachmann, Michael Tamm","doi":"10.1159/000542018","DOIUrl":"10.1159/000542018","url":null,"abstract":"<p><strong>Introduction: </strong>This case report addresses the complexity of management of air leak and persisting infection in polymorbid patients.</p><p><strong>Case presentation: </strong>A 56-year-old former marble mason presented with major hemoptysis. Chest CT revealed severe silicosis and pneumonia with an abscess in the right lower lobe and a pulmonary artery pseudoaneurysm. An open lower bilobectomy with empyema debridement was performed, and the posterior upper lobe segment was covered with a serratus anterior muscle flap. The second examination revealed persistent air leakage from the infected posterior upper lobe segment and necrosis of the muscle flap. Atypical resection of this segment was performed, and the surface of the lower part of the remnant lung was covered with a fat flap and then the omentum. The patient was discharged but was readmitted 2 weeks later due to empyema. During reoperation, a persistent infection in the remnant posterior upper lobe segment was observed in addition to a bronchopleural fistula. The only possible surgery that would cure the patient was right completion pneumonectomy. To avoid this high-risk operation, an endobronchial valve was placed intraoperatively in the posterior segment bronchus, leading to closure of the fistula and resolution of the infection. The patient recovered well and was discharged 10 days later. At the 1-year follow-up, the patient was free of symptoms and reported a good quality of life.</p><p><strong>Conclusion: </strong>This case is an excellent example of successful cooperation between an interventional pulmonologist and a thoracic surgeon to avoid right pneumonectomy in a polymorbid patient.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"777-781"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11633892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506866","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":"Sex Difference in Characteristics and Predictors of In-Hospital Mortality among Patients with COVID-19.","authors":"Shirui Meng, Zechun Zeng, Huijuan Zuo, Jinwen Wang","doi":"10.1159/000539281","DOIUrl":"10.1159/000539281","url":null,"abstract":"<p><strong>Introduction: </strong>With a surge in the prevalence of coronavirus disease-2019 (COVID-19) in Beijing starting in October 2022, hospitalisation rates increased markedly. This study aimed to evaluate factors associated with in-hospital mortality in patients with COVID-19.</p><p><strong>Methods: </strong>Using data from hospitalised patients, sex-based differences in clinical characteristics, in-hospital management, and in-hospital mortality among patients diagnosed with COVID-19 were evaluated. Predictive factors associated with mortality in 1,091 patients admitted to the Beijing Anzhen Hospital (Beijing, China) for COVID-19 between October 2022 and January 2023 were also evaluated.</p><p><strong>Results: </strong>Data from 1,091 patients hospitalised with COVID-19 were included in the analysis. In-hospital mortality rates for male and female patients were 14.9% and 10.4%, respectively. Multifactorial logistic analysis indicated that lymphocyte percentage (LYM%) (odds ratio [OR] 0.863, 95% confidence interval [CI] 0.805-0.925; p &lt; 0.001), uric acid (OR 1.004, 95% CI: 1.002-1.006; p = 0.001), and high-sensitivity C-reactive protein (OR 1.094, 95% CI: 1.012-1.183; p = 0.024) levels were independently associated with COVID-19-related in-hospital mortality. Among female patients, multifactorial analysis revealed that LYM% (OR 0.856, 95% CI: 0.796-0.920; p &lt; 0.001), older age (OR 1.061, 95% CI: 1.020-1.103; p = 0.003), obesity (OR 2.590, 95% CI: 1.131-5.931; p = 0.024), and a high high-sensitivity troponin I level (OR 2.602, 95% CI: 1.157-5.853; p = 0.021) were risk factors for in-hospital mortality. Receiver operating characteristic (ROC) curve analysis, including area under the ROC curve, showed that the efficacy of LYM% in predicting in-hospital death was 0.800 (sensitivity, 63.2%; specificity, 83.2%) in male patients and 0.815 (sensitivity, 87.5%; specificity, 64.4%) in female patients.</p><p><strong>Conclusion: </strong>LYM% is a consistent predictor of in-hospital mortality for both sexes. Older age and markers of systemic inflammation, myocardial injury, and metabolic dysregulation are also associated with a high mortality risk. These findings may help identify patients who require closer monitoring and tailored interventions to improve outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"480-487"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071032","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":"Endobronchial Valves in Treatment of Persistent Air Leak: European Case-Series Study and Best Practice Recommendations - From an Expert Panel.","authors":"Illaa Smesseim, Louis-Vincent Morin-Thibault, Felix J F Herth, James Tonkin, Pallav L Shah, Dirk-Jan Slebos, David T Koster, Chris Dickhoff, Johannes Marlene Andreas Daniels, Jouke Annema, Peter Bonta","doi":"10.1159/000539573","DOIUrl":"10.1159/000539573","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent air leak (PAL) is associated with prolonged hospitalization, high morbidity and increased treatment costs. Conservative treatment consists of observation, chest tube drainage, and pleurodesis. Guidelines recommend surgical evaluation if air leak does not respond after 3-5 days. One-way endobronchial valves (EBV) have been proposed as a treatment option for patients with PAL in which surgical treatment is not feasible, high risk or has failed. We aimed to provide a comprehensive overview of reported EBV use for PAL and issue best practice recommendations based on multicenter experience.</p><p><strong>Methods: </strong>We conducted a retrospective observational case-series study at four different European academic hospitals and provided best practice recommendations based on our experience. A systematic literature review was performed to summarize the current knowledge on EBV in PAL.</p><p><strong>Results: </strong>We enrolled 66 patients, male (66.7%), median age 59.5 years. The most common underlying lung disease was chronic obstructive pulmonary disease (39.4%) and lung cancer (33.3%). The median time between pneumothorax and valve placement was 24.5 days (interquartile range: 14.0-54.3). Air leak resolved in 40/66 patients (60.6%) within 30 days after EBV treatment. Concerning safety outcome, no procedure-related mortality was reported and complication rate was low (6.1%). Five patients (7.6%) died in the first 30 days after intervention.</p><p><strong>Conclusion: </strong>EBV placement is a treatment option in patients with PAL. In this multicenter case-series of high-risk patients not eligible for lung surgery, we show that EBV placement resulted in air leak resolution in 6 out of 10 patients with a low complication rate. Considering the minimally invasive nature of EBV to treat PAL as opposed to surgery, further research should investigate if EBV treatment should be expanded in low to intermediate risk PAL patients.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"544-562"},"PeriodicalIF":3.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318115","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}