RespirationPub Date : 2026-03-16DOI: 10.1159/000551452
Kyle G P J M Boyle, Andrea A Beglinger, Anna Stahel, Esther Irene Schwarz, Christina M Spengler
{"title":"The Effect of Body Position on Responses to Rapid Bilateral Anterolateral Magnetic Phrenic Nerve Stimulation in Healthy Humans (PosiStim).","authors":"Kyle G P J M Boyle, Andrea A Beglinger, Anna Stahel, Esther Irene Schwarz, Christina M Spengler","doi":"10.1159/000551452","DOIUrl":"10.1159/000551452","url":null,"abstract":"<p><strong>Introduction: </strong>Mechanical ventilation can induce lung injury and diaphragmatic dysfunction. Diaphragmatic activation via rapid bilateral anterolateral magnetic phrenic nerve stimulation (rBAMPS) may attenuate both conditions. Given a change in body position during mechanical ventilation alters patient prognosis, this study compared inspiratory responses and side effects to rBAMPS in different body positions in healthy volunteers.</p><p><strong>Methods: </strong>A total of 17 healthy participants underwent three blocks of 1-s rBAMPS at 25 Hz starting at 20% of maximal stimulator output with increases in 10% increments (until participant cessation or 100%) while lying semirecumbent, lying supine, and while seated. Esophageal and gastric balloon catheters were used to assess transdiaphragmatic pressure (P<sub>di</sub>). Tidal volume (V<sub>T</sub>) was calculated from flow recorded with a pneumatometer. Discomfort, pain, and paresthesia were assessed via numerical visual scales. Tolerability to rBAMPS was assessed as the highest stimulator output achieved in each position.</p><p><strong>Results: </strong>Body position significantly affected both V<sub>T</sub> (p = 0.007) and P<sub>di,mean</sub> (p = 0.044). The semirecumbent position resulted in higher V<sub>T</sub> and P<sub>di,mean</sub> compared to the supine (+2.6 mL⋅kg-1 ideal body weight [IBW]; +2.5 cm H<sub>2</sub>O) and sitting (+1.7 mL⋅kg-1 IBW; +0.5 cm H<sub>2</sub>O) positions. The lowest stimulator output tolerability was observed in the sitting position, and the highest stimulator output tolerability in the semirecumbent position. However, differences in tolerability were not reflected in changes of any sensory rating.</p><p><strong>Conclusion: </strong>rBAMPS could produce physiological resting breathing in semirecumbent, supine and sitting positions. The semirecumbent position may optimize the stimulus to the diaphragm, while the supine position may limit V<sub>T</sub> and lung overdistension.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-14"},"PeriodicalIF":2.6,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469054","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}
RespirationPub Date : 2026-03-09DOI: 10.1159/000550801
Franziska C Trudzinski, Felix Herth, Judith Löffler-Ragg, Sabina Janciauskiene, Kathrin Kahnert, Filiz Oezkan, Daiana Stolz, Katrin Milger
{"title":"Gender, Medical Error, and the Culture of Scrutiny in Respiratory Medicine.","authors":"Franziska C Trudzinski, Felix Herth, Judith Löffler-Ragg, Sabina Janciauskiene, Kathrin Kahnert, Filiz Oezkan, Daiana Stolz, Katrin Milger","doi":"10.1159/000550801","DOIUrl":"10.1159/000550801","url":null,"abstract":"","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-4"},"PeriodicalIF":3.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390800","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}
RespirationPub Date : 2026-03-05DOI: 10.1159/000551084
María-Florencia Pilia, David Espejo, Irene Sansano, Christian Romero, Marta Andreu-Casas, Antia Ferreiro-Posse, Ana Villar, María Jesú Cruz, Xavier Muñoz, Iñigo Ojanguren
{"title":"Long-Term Prognosis and Transition Period until Progression in Fibrotic Hypersensitivity Pneumonitis.","authors":"María-Florencia Pilia, David Espejo, Irene Sansano, Christian Romero, Marta Andreu-Casas, Antia Ferreiro-Posse, Ana Villar, María Jesú Cruz, Xavier Muñoz, Iñigo Ojanguren","doi":"10.1159/000551084","DOIUrl":"10.1159/000551084","url":null,"abstract":"<p><strong>Introduction: </strong>Hypersensitivity pneumonitis (HP) is an interstitial lung disease that may present as fibrotic (fHP) or non-fibrotic (nfHP). Fibrosis is associated with progression and poor outcomes; however, the transition to progressive pulmonary fibrosis (PPF) and its predictors remain unclear.</p><p><strong>Methods: </strong>We retrospectively reviewed adult patients diagnosed with HP at a tertiary hospital (2010 and 2022). Patients were classified as having fHP or nfHP and were followed up for at least 1 year. Clinical, functional, radiological, and histological variables were analyzed. PPF was defined according to the 2022 clinical practice guideline of the American Thoracic Society (ATS), European Respiratory Society (ERS), Japanese Respiratory Society (JRS), and Asociación Latinoamericana de Tórax (ALAT).</p><p><strong>Results: </strong>Of 298 HP patients, 191 were included (153 fHP and 38 nfHP). Among patients with fHP, 76 (49.7%) developed PPF after a median of 3.2 years. Median survival was 4.8 years in fHP with PPF versus 6.3 years without, with 1.6 years from PPF onset to death or transplantation. The independent predictors of PPF and survival were lower forced vital capacity, elevated lactate dehydrogenase, fibroblastic foci, and microscopic honeycombing.</p><p><strong>Conclusion: </strong>Nearly half of fHP patients progressed to PPF within a few years, with markedly reduced survival. Early recognition of high-risk patients may support timely antifibrotic treatment and improve outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":3.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366407","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}
RespirationPub Date : 2026-03-03DOI: 10.1159/000551036
Jacopo Saccomanno, Thomas Sgarbossa, Konrad Neumann, Kaid Darwiche, Stefan Andreas, Stephan Eisenmann, Bernd Schmidt, Wolfgang Gesierich, Nicolas Dickgreber, Christian Geltner, Joachim H Ficker, Angelique Holland, Björn Schwick, Stephan Eggeling, Ralf Eberhardt, Christian Grah, Christoph Hünerman, Urte Sommerwerck, Andreas Fertl, Sylke Kurz, Peter Schramm, Joanna Krist, Grit Barten-Neiner, Martin Witzenrath, Ralf-Harto Hübner
{"title":"Treatment Outcomes of Endoscopic Lung Volume Reduction with Valves in Advanced Lung Emphysema Patients Are Largely Independent of Body Mass Index: Data from the German Lung Emphysema Registry.","authors":"Jacopo Saccomanno, Thomas Sgarbossa, Konrad Neumann, Kaid Darwiche, Stefan Andreas, Stephan Eisenmann, Bernd Schmidt, Wolfgang Gesierich, Nicolas Dickgreber, Christian Geltner, Joachim H Ficker, Angelique Holland, Björn Schwick, Stephan Eggeling, Ralf Eberhardt, Christian Grah, Christoph Hünerman, Urte Sommerwerck, Andreas Fertl, Sylke Kurz, Peter Schramm, Joanna Krist, Grit Barten-Neiner, Martin Witzenrath, Ralf-Harto Hübner","doi":"10.1159/000551036","DOIUrl":"10.1159/000551036","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic lung volume reduction (ELVR) via valves is a proven therapeutic option for patients with advanced chronic obstructive pulmonary disease (COPD) and emphysema without collateral ventilation. Body mass index (BMI), a simple measure of adiposity, has a complex relationship with COPD. A lower BMI is associated with increased mortality in this patient population. However, the influence of BMI on the outcome of ELVR remains unclear.</p><p><strong>Methods: </strong>This analysis was conducted with data from the Lung Emphysema Registry (<ext-link ext-link-type=\"uri\" xlink:href=\"http://www.lungenemphysemregister.de\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">www.lungenemphysemregister.de</ext-link>), a national, prospective, multicentric, producer-independent, open-label clinical trial. The aim of this study was to evaluate the impact of baseline BMI on treatment outcomes after ELVR. Patients were grouped according to their BMI as follows: underweight (BMI <20 kg/m2, n = 76), normal weight (20-24.9 kg/m2, n = 282), overweight (BMI = 25-30 kg/m2, n = 146), and obese (BMI >30 kg/m2, n = 45).</p><p><strong>Results: </strong>Baseline parameters were characteristic of patients with advanced lung emphysema. Emphysema scores and heterogeneity indices of the target lobe were greater in patients with lower BMI. Patients with a lower BMI had worse lung function parameters (FEV1, RV, DLCO, pCO<sub>2</sub>) and a higher CAT score. All groups showed significant improvements after ELVR at the 3-month follow-up in terms of lung function parameters, exercise capacity, and quality of life. Treatment outcomes were comparable across BMI groups, with the notable exception of more pronounced improvement in CAT scores among underweight patients. The complication rates were low and comparable among the groups, although obese patients had a higher rate of ICU admissions.</p><p><strong>Conclusion: </strong>This study suggests that ELVR provides meaningful clinical benefits regardless of BMI in patients with advanced lung emphysema, particularly when dyspnea is primarily attributable to pulmonary pathology. The findings suggest that BMI should be considered as a reflection of disease phenotype and clinical state rather than serving as a predictor for treatment response after ELVR.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-13"},"PeriodicalIF":3.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348936","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}
RespirationPub Date : 2026-01-01Epub Date: 2025-08-27DOI: 10.1159/000548173
Paola Gutierrez-Gallegos, Alanna Barrios-Ruiz, Britney N Hazelett, David Abia-Trujillo, Sebastian Fernandez-Bussy
{"title":"Robotic-Assisted Bronchoscopic Management of an Intraparenchymal Emphysematous Bulla: A Case Report.","authors":"Paola Gutierrez-Gallegos, Alanna Barrios-Ruiz, Britney N Hazelett, David Abia-Trujillo, Sebastian Fernandez-Bussy","doi":"10.1159/000548173","DOIUrl":"10.1159/000548173","url":null,"abstract":"","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"82-84"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966775","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}
RespirationPub Date : 2026-01-01Epub Date: 2025-09-25DOI: 10.1159/000548596
Xiaoxuan Zheng, Jiani Ji, Lijun Yan, Qin Zhang, Yujun Pan, Shuaiyang Liu, Jiayuan Sun
{"title":"Hybrid Argon Plasma Coagulation as a Novel Local Treatment Method for Superficial Mucosal Lung Cancer.","authors":"Xiaoxuan Zheng, Jiani Ji, Lijun Yan, Qin Zhang, Yujun Pan, Shuaiyang Liu, Jiayuan Sun","doi":"10.1159/000548596","DOIUrl":"10.1159/000548596","url":null,"abstract":"<p><strong>Introduction: </strong>Early identification and treatment are vital for managing central airway carcinomas, with endobronchial treatment recommended for patients who are unsuitable for or refuse surgery. Hybrid argon plasma coagulation (Hybrid-APC) is an innovative technique whose value in treating superficial mucosal lung cancer remains underreported. This prospective single-arm study aimed to evaluate the efficacy and safety of Hybrid-APC in adult patients with superficial mucosal lung cancer.</p><p><strong>Methods: </strong>Eligible patients diagnosed with superficial mucosal lung cancer were treated with Hybrid-APC under general anaesthesia. The primary endpoint was the complete remission rate at 3 months post-procedure. The secondary endpoints included total procedure time, injected water cushion rate, progression-free survival, overall survival, and possible complications.</p><p><strong>Results: </strong>From December 2018 to November 2021, 15 patients were initially enrolled. Fourteen patients underwent Hybrid-APC treatment, and 10 patients eventually completed the primary endpoint at 3 months of follow-up. Pathological biopsies at 3 months showed no malignant tumour cells in 9 patients, indicating a complete remission rate of 90%. All Hybrid-APC ablations were successfully completed. The median total procedure time was 31.5 min (range, 14-60 min) with minor complications. The successful injected water cushion rate was 100%. The 3-year progression-free survival and overall survival estimates were 70% (95% CI: 32.9%-89.2%) and 90% (95% CI: 47.3%-98.5%), respectively.</p><p><strong>Conclusion: </strong>Hybrid-APC appeared to be safe and efficient for superficial mucosal lung cancer, providing patients unfit for or refusing surgery with a promising alternative to surgical treatment.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"312-323"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150565","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":"Validation of the Efficacy and Safety of Targeted Pulsed Ablation of the Bronchus with a Novel Navigated Pulsed Electric Field Ablation System.","authors":"Jisong Zhang, Weiwen Li, Lin Tao, Shuhan Xu, Yalun Li, Mengzhen You, Enguo Chen","doi":"10.1159/000549998","DOIUrl":"10.1159/000549998","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchial rheoplasty with non-thermal pulsed electric field (PEF) ablation has excellent developmental potential for the therapy of chronic bronchitis (CB) subtypes of chronic obstructive pulmonary disease (COPD). However, the volume of reported clinical studies is quite limited. Also, repeated and missed ablations are involved during the procedure, affecting the targeted therapy and PEF further development. Evaluating the feasibility, safety, and efficacy of a novel navigated PEF ablation system in the therapy of CB, promoting the COPD therapeutic field toward a new stage of greater precision and efficiency.</p><p><strong>Methods: </strong>First, real-time navigated bronchial rheoplasty were performed in 18 live pigs by a novel navigated PEF ablation system (variable-diameter navigated PEF ablation catheter with a length of 1.4 m and an outer diameter of 1.5 mm) with 84 days of follow-up. Subsequently, bilateral bronchial rheoplasty was conducted in 4 patients with CB using this system. Changes in CAT scores, mMRC scores, CT tests, and lung function were explored during the 6-month follow-up. The feasibility, safety and efficacy of the technique were further evaluated.</p><p><strong>Results: </strong>Real-time navigated bronchial rheoplasty was performed successfully in 18 live pigs without any serious complications. Pathologic results showed complete recovery of mild tissue inflammation during follow-up from 4 h to 28 days. In the clinical trial, a total of 8 PEFs were performed in 4 patients with CB subtype COPD, achieving a technical success rate of 100%. There were no device- or procedure-related serious adverse events within 6 months.</p><p><strong>Conclusions: </strong>Precision-targeted ablation of patients with CB by a novel navigated PEF ablation system is a safe, feasible, and effective approach.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"727-736"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782702","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}
RespirationPub Date : 2026-01-01Epub Date: 2025-12-11DOI: 10.1159/000549732
Friedrich Hohmann, Falk Fichtner, Tobias Becher, Dirk Schaedler, Christian Putensen, Thomas Muders, Ines Schroeder, Christian Karagiannidis, Hermann Wrigge, David Berger, Margarethe Grupp, Felicitas Grundeis, Victoria Buenger, Alexandra Sachkova, Stefan Henkel, Marit Habicher, Michael Sander, Sven Laudi, Steffen Weber-Carstens, Onnen Moerer
{"title":"Clinical Guideline for Treating Acute Respiratory Insufficiency with Invasive Ventilation and Extracorporeal Membrane Oxygenation: Updated Evidence-Based Recommendations for Choosing Modes and Setting Parameters of Mechanical Ventilation.","authors":"Friedrich Hohmann, Falk Fichtner, Tobias Becher, Dirk Schaedler, Christian Putensen, Thomas Muders, Ines Schroeder, Christian Karagiannidis, Hermann Wrigge, David Berger, Margarethe Grupp, Felicitas Grundeis, Victoria Buenger, Alexandra Sachkova, Stefan Henkel, Marit Habicher, Michael Sander, Sven Laudi, Steffen Weber-Carstens, Onnen Moerer","doi":"10.1159/000549732","DOIUrl":"10.1159/000549732","url":null,"abstract":"<p><p><p>Invasive mechanical ventilation remains a cornerstone in the treatment of critically ill patients suffering from acute respiratory failure, providing life-sustaining gas exchange while necessitating careful selection of modes and settings to maximize benefit and minimize harm. This guideline-derived review synthesizes updated, critically appraised, and evidence-based recommendations on choosing ventilatory modes and setting key parameters in adults with acute respiratory insufficiency. Building on a systematic GRADE process and presented digitally in the MAGICapp, the 2025 guideline for the German, Austrian, and Swiss healthcare context retains a pragmatic taxonomy of ventilatory modes and updates several clinical recommendations. In invasively ventilated patients with moderate-to-severe ARDS, early neuromuscular blockade is no longer favored; instead, early assisted strategies that allow spontaneous breathing are suggested when clinically appropriate. Pressure-controlled, minute ventilation-supporting modes that enable spontaneous breathing during both inspiration and expiration may be considered in hypoxemic respiratory failure, acknowledging very low certainty of evidence and notable heterogeneity across trials. For the first time, our guideline issues recommendations on adaptive ventilation modes. Some adaptive modes (e.g., ASV/INTELLiVENT-ASV) and neurally adjusted ventilatory assist may be considered on a case-by-case basis, whereas flow- and volume-proportional assist ventilation (e.g., PAV/PAV+) is not recommended given low-certainty evidence and frequent intolerance. Parameter recommendations emphasize lung-protective ventilation with VT ≈ 6 mL/kg predicted body weight (range 4-8 mL/kg), a plateau pressure ≤30 cm H<sub>2</sub>O, and a driving pressure ≤14 cm H<sub>2</sub>O. Positive end-expiratory pressure should be higher in moderate/severe ARDS and individualized using bedside physiology, while oxygen targets of SaO<sub>2</sub>/SpO<sub>2</sub> 92-96% or PaO<sub>2</sub> 70-90 mm Hg balance hypoxemia and hyperoxia risks. Continuous cardiorespiratory monitoring and capnography for tube placement confirmation and trend assessment are endorsed. Collectively, these recommendations aim to support safe, effective, and implementable ventilatory care while transparently conveying where certainty of evidence remains limited. </p>.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"782-798"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744200","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}
RespirationPub Date : 2026-01-01Epub Date: 2025-12-12DOI: 10.1159/000549999
Peter Kardos, Sven Becker, Kai-Roland Heidenreich, Ludger Klimek, Thomas Köhnlein, Joachim Labenz, Norbert Mülleneisen, Dorothea Pfeiffer-Kascha, Isabell Pink, Helmut Sitter, Frederik Trinkmann, Heinrich Worth, Cordula Winterholler
{"title":"Diagnosis and Treatment of Adult Patients with Cough.","authors":"Peter Kardos, Sven Becker, Kai-Roland Heidenreich, Ludger Klimek, Thomas Köhnlein, Joachim Labenz, Norbert Mülleneisen, Dorothea Pfeiffer-Kascha, Isabell Pink, Helmut Sitter, Frederik Trinkmann, Heinrich Worth, Cordula Winterholler","doi":"10.1159/000549999","DOIUrl":"10.1159/000549999","url":null,"abstract":"<p><p><p>This is the 4th edition of the Cough Guidelines of the German Respiratory Society (DGP), written by and for respiratory, internal medicine, allergy, ear-nose-throat, gastroenterology specialists, speech therapists, and physiotherapists. In a modified Delphi process, the authors developed 12 key questions on classification, common causes of acute, subacute, and chronic cough: both as a symptom of respiratory diseases including the upper airways, reflux, and drug-related cough, and as a primary disease, i.e., unexplained chronic cough and refractory chronic cough due to hypersensitivity of the cough reflex. An in-person guideline conference followed to find evidence-based answers and recommendations, which were graded as strong, weak, or insufficient evidence for recommendation. A brief scientific background to the respective questions was then compiled by expert groups of authors. Diagnostic algorithms were created for acute, subacute, and chronic cough and reflux-related cough. The significantly reduced scope and improved overview make it easy to use it in daily practice. The guideline is available in digital form as a smartphone application (currently only in German): <ext-link ext-link-type=\"uri\" xlink:href=\"https://www.leila.de/de/\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">https://www.leila.de/de/</ext-link>. </p>.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"998-1028"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744216","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}
RespirationPub Date : 2026-01-01Epub Date: 2026-02-27DOI: 10.1159/000551142
Brice Touilloux, Claire Descombes, Philipp Suter, Christophe Von Garnier, Alessio Casutt
{"title":"Impact of Transitioning from Race-Specific to Race-Neutral GLI Equation on Lung Function in a Predominantly Caucasian Population.","authors":"Brice Touilloux, Claire Descombes, Philipp Suter, Christophe Von Garnier, Alessio Casutt","doi":"10.1159/000551142","DOIUrl":"10.1159/000551142","url":null,"abstract":"<p><p><p>Introduction: Diagnosis and treatment decisions for many respiratory diseases are based on spirometric values. We compared the impact of changing the reference equations from GLI-2012 (race-specific) to GLI-2022 (race-neutral) in a predominantly Caucasian urban population.</p><p><strong>Methods: </strong>PneumoLaus is a sub-study of CoLaus|PsyCoLaus, an ongoing prospective observational study conducted in Lausanne, Switzerland. Participants performed spirometry at baseline (2014-2017) and at follow-up (2018-2021, FU). We analysed changes of %predicted values (PV) for forced expiratory volume in 1 second (FEV<sub>1</sub>) and forced vital capacity (FVC) by comparing the GLI-2022 reference equation to GLI-2012. Sub-group analyses were performed for social class, sex, and age using paired t tests corrected by Holm-Bonferroni. We analysed the association of age, sex, and social class on the differences using linear regression.</p><p><strong>Results: </strong>A total of 3,330 participants were included at baseline and 2,005 at FU, >97% Caucasian. Employing GLI-2022 equations, the %PV and z score increased significantly for both FEV<sub>1</sub> (4.2% PV and +0.31 z score at baseline, 4.6% PV and +0.28 z score at FU, both p < 0.0001) and FVC (4.9% PV and +0.34 z score at baseline, 5.6% PV and + 0.29 z score at FU, both p < 0.0001). Younger individuals, males, and participants with only compulsory school education experienced the greatest increase. The prevalence of low FEV<sub>1</sub> and low FVC decreased using GLI-2022 references, while the prevalence of obstructive ventilatory impairment increased at baseline and FU (all p < 0.05).</p><p><strong>Conclusion: </strong>In this predominantly Caucasian urban population-based cohort, applying GLI-2022 equations led to a general FEV<sub>1</sub> and FVC %PV increase, particularly among younger individuals, males, and participants with only compulsory school education. Applying GLI-2022 equations also led to a general FEV<sub>1</sub> and FVC z score increase. These findings changes may carry relevant implications for clinical care and social policy decisions. </p>.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"987-997"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318297","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}