Respiratory medicine最新文献

{"title":"Influence of chronic obstructive pulmonary disease on cardiovascular outcomes and mortality benefits of sodium glucose co-transporter inhibitors in heart failure patients: A systematic review and meta-analysis","authors":"Rohab Sohail ,&nbsp;Zaraq Ahmad Khan ,&nbsp;Ridda Khattak ,&nbsp;Prakhar Anand ,&nbsp;Vyom Patel ,&nbsp;Marcos Alberto ,&nbsp;Mark Georgy ,&nbsp;Karan Dhand ,&nbsp;Andrei Feldiorean ,&nbsp;Seemab Fatima ,&nbsp;Sana Murtaza ,&nbsp;Manjeet Singh ,&nbsp;Syed Nazeer Mehmood","doi":"10.1016/j.rmed.2026.108685","DOIUrl":"10.1016/j.rmed.2026.108685","url":null,"abstract":"<div><h3>Background</h3><div>By 2030, healthcare expenditures related to congestive heart failure (CHF) in the United States are projected to surpass $70 billion. Despite substantial advances in guideline-directed medical therapy, morbidity and mortality remain unacceptably high, particularly among patients with concomitant chronic obstructive pulmonary disease (COPD), a comorbidity reported in approximately 5%–41% of individuals with CHF. Although COPD is independently associated with worse CHF outcomes, its influence on the mortality benefit conferred by sodium–glucose cotransporter-2 (SGLT-2) inhibitors remains poorly defined.</div></div><div><h3>Objective</h3><div>To evaluate whether COPD alters the cardiovascular and mortality benefit of SGLT-2 inhibitors in CHF patients.</div></div><div><h3>Methods</h3><div>PubMed, Cochrane and Google Scholar were searched from inception to February 2025 to identify studies meeting inclusion criteria. Review Manager was employed to calculate results in the form of relative risk (RR) with 95% confidence interval.</div></div><div><h3>Results</h3><div>Our analysis of 15,058 patients (1725 (11%) COPD patients) showed that COPD was associated with significantly higher risks of composite outcomes (RR = 1.63; 95% CI: 1.49–1.79; p &lt; 0.00001), CV mortality (RR = 1.62; 95% CI: 1.39–1.88; p &lt; 0.0001), heart failure hospitalization (RR = 1.84; 95% CI: 1.40–2.40; p &lt; 0.00001), and all-cause mortality (RR = 1.59; 95% CI: 1.42–1.78; p &lt; 0.00001). Additionally, adverse outcomes were more frequent in COPD patients, including volume depletion (RR = 1.34; 95% CI: 1.25–1.51; p &lt; 0.00001), and adverse renal events (RR = 1.46, 95% CI: 1.17–1.82; P = 0.0007).</div></div><div><h3>Conclusion</h3><div>Our analysis indicates that heart failure (HF) patients with COPD may drive a somewhat attenuated benefit from SGLT-2 inhibitors, underscoring a clinical profile that merits careful consideration.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108685"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126364","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":"Monitoring home mechanical ventilation: Polysomnography or built-in ventilator software?","authors":"Jean-Michel Arnal ,&nbsp;Sonia Khirani","doi":"10.1016/j.rmed.2026.108713","DOIUrl":"10.1016/j.rmed.2026.108713","url":null,"abstract":"<div><div>Monitoring of home mechanical ventilation (HMV) and continuous positive airway pressure (CPAP) is essential to guarantee an efficient ventilation. Hospital attended polysomnography (PSG), or at least respiratory polygraphy, remains the gold standard for the monitoring of HMV/CPAP. However, it is time-consuming, costly and not practical. Built-in ventilator software data represent a good alternative, but some limitations have to be acknowledged. Adherence, leaks and patient-ventilator asynchrony (PVA) are among the main data to monitor, and the analysis of these data can be easily done using built-in ventilator software. Residual respiratory events can also be monitored using built-in ventilator software, with the limitation that their identification and characterization are not always optimal. PSG may be indicated when the analysis of breath-by-breath waveforms of built-in ventilator software is not conclusive. PSG or thoraco-abdominal belts connected to a ventilator may also be useful to identify PVA related to an insufficient pressure support. This review summarizes the information available when using built-in ventilator software data, highlighting their advantages and drawbacks as compared to PSG for the monitoring of HMV/CPAP, and addresses the situations where one approach may be more appropriate than the other. The availability of thoraco-abdominal belts for additional ventilators may represent a valuable development, enabling an improved monitoring of HMV/CPAP, particularly in settings with limited resources.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108713"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202578","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":"Effect of high-intensity interval training versus moderate intensity continuous training in heart failure patients on cardiorespiratory fitness and quality of life: a systematic review and meta-analysis","authors":"Lino Sergio Rocha Conceição ,&nbsp;Mansueto Gomes-Neto ,&nbsp;Camila Souza Gama Rocha ,&nbsp;Acauã Oliveira Coelho ,&nbsp;Vitor Oliveira Carvalho","doi":"10.1016/j.rmed.2026.108662","DOIUrl":"10.1016/j.rmed.2026.108662","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure is a major global health problem. High-intensity interval training (HIIT) is a form of aerobic exercise that involves repeated bouts of high-intensity effort interspersed with recovery periods. Previous meta-analyses have shown that HIIT has superior effects compared to moderate intensity continuous training (MICT) in terms of VO2peak improvements; however, discussions now focus on how exercise protocols may contribute to this superiority. Therefore, the aim of this study perform a systematic review of the eeffects of HIIT versus MICT on cardiorrespiratory fitness and health related quality of life (HRQoL) in individuals with heart failure.</div></div><div><h3>Methods</h3><div>We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We performed a comprehensive search in the following databases: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials and PEDro up to April 2025.</div></div><div><h3>Results</h3><div>18 studies were included in this systematic review. HIIT improved VO2 peak by 1.49 mL/kg/min (95 % confidence interval [CI]: 0.74 to 2.24; I² = 61.2 %; N = 682) compared to the MICT group. However, our subanalysis of isocaloric exercise protocols according to the left ventricular ejection fraction (LVEF) showed no statistical significance between HIIT and MICT exercise training groups. No statistical difference was observed between HIIT and MICT for HRQoL.</div></div><div><h3>Conclusion</h3><div>This systematic review demonstrates that HIIT is superior to MICT in an overall context of HFrEF and HFpEF collectively. However, when comparing HIIT and MICT under isocaloric conditions, and considering LVEF, the superiority of HIIT over MICT in improving VO₂peak disappears.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108662"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047111","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":"Safety and efficacy of performing medical thoracoscopy on a “dry space” using an optical trocar","authors":"Kimia G. Ganjaei ,&nbsp;Diana Mihalache ,&nbsp;Sung H. Choi ,&nbsp;Abhinav Agrawal ,&nbsp;Udit Chaddha","doi":"10.1016/j.rmed.2026.108667","DOIUrl":"10.1016/j.rmed.2026.108667","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical thoracoscopy (MT) to obtain pleural biopsies ideally requires a pleural effusion to safely access the pleural space. In the absence of an effusion (“dry space”), accessing the pleural space is more challenging, with variably reported success.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of all MTs at a single center in New York City from January 2023 to November 2025. Documented dry spaces were selected for analysis. An optical trocar was used for direct visualization of the parietal pleura in addition to obtaining tactile feedback, to induce an <em>ex-vacuo</em> pneumothorax and access the pleural space. We also performed a literature review of MT performed on patients with absent or minimal pleural effusion.</div></div><div><h3>Results</h3><div>A total of 226 MTs were performed, of which 54 were dry spaces. The parietal pleura was accessed and pleural biopsies were successfully performed in all cases. Some degree of adhesiolysis was required in 62 % of cases to optimize a thorough inspection of the space. Common diagnoses obtained included acute or chronic organizing pleuritis (59.3 %), followed by malignancy (24.1 %). The diagnostic sensitivity for malignancy was 100 %. There were no significant intra-procedural complications.</div></div><div><h3>Conclusion</h3><div>Dry space MT, using an optical trocar to access the pleural space, can be safely and effectively performed.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108667"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041373","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 stepping up treatment from LABA/LAMA to extrafine single inhaler triple therapy on exacerbations of Greek patients with Chronic Obstructive Pulmonary Disease: The IMPROVE study","authors":"Epaminondas Kosmas ,&nbsp;Konstantinos Bartziokas ,&nbsp;Stylianos Loukides ,&nbsp;Petros Bakakos ,&nbsp;Nikoletta Rovina ,&nbsp;Niki Georgatou ,&nbsp;Dimosthenis Papapetrou ,&nbsp;Panos Katerelos ,&nbsp;Evangelia Papapostolou ,&nbsp;Petros Efstathopoulos ,&nbsp;Paschalis Steiropoulos ,&nbsp;Konstantinos Kostikas","doi":"10.1016/j.rmed.2026.108682","DOIUrl":"10.1016/j.rmed.2026.108682","url":null,"abstract":"<div><h3>Objective</h3><div>Extrafine single inhaler triple therapy (efSITT) with beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G 87/5/9 μg) has shown clinical benefits in Chronic Obstructive Pulmonary Disease (COPD) patients, including fewer exacerbations in randomized controlled trials. The IMPROVE study evaluated its real-world effectiveness in Greece in COPD patients previously treated with dual bronchodilation, focusing on exacerbations and other clinical outcomes.</div></div><div><h3>Methods</h3><div>This prospective, multicenter, observational study was conducted over 52 weeks. The 1103 eligible patients had moderate-to-severe COPD, an indication for treatment with efSITT, and were symptomatic despite receiving dual bronchodilation. The number of exacerbations, COPD Assessment Test (CAT) score, lung function parameters, use of rescue medication and adherence were recorded at baseline (visit 1), 6 months (visit 2), and 12 months (visit 3) after treatment.</div></div><div><h3>Results</h3><div>The percentage of patients with ≥1 exacerbation decreased from 100 % at visit 1 to 23.1% at visit 3 (p &lt; 0.001). The mean CAT score decreased from 22.5 points at visit 1, to 16.6 at visit 2 and 14.2 at visit 3 (p &lt; 0.001 for all pair comparisons). The mean TAI score increased from 44.6 points at visit 1, to 47.1 at visit 2 and 47.6 at visit 3. (p &lt; 0.001 for V1/2 and V1/3 pairs, p = 0.024 for V2/3). Between visit 1 and visit 3, mean FEV1 increased from 1.6 L to 1.7 L (p &lt; 0.001, n = 396).</div></div><div><h3>Conclusions</h3><div>The IMPROVE findings indicate that extrafine BDP/FF/G improves clinical outcomes in symptomatic COPD patients previously treated with dual bronchodilation in a real-world setting in Greece.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108682"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093852","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":"Based on the historical data of lung cancer in China and the analysis of its related influencing factors","authors":"Yang Gao ,&nbsp;Guangyuan Liu ,&nbsp;Mengqi Zhang ,&nbsp;Peng Cheng ,&nbsp;Hong Huang ,&nbsp;Hongli Xie ,&nbsp;Mo Hao","doi":"10.1016/j.rmed.2026.108684","DOIUrl":"10.1016/j.rmed.2026.108684","url":null,"abstract":"<div><h3>Background</h3><div>To analyze the long-term trend and spatial distribution of lung cancer incidence in China, and to analyze the potential influences of major environmental and socioeconomic factors.</div></div><div><h3>Methods</h3><div>Collect the data on the incidence of lung cancer in China over the years from 2010 to 2018, as well as the annual reports of the Chinese Cancer Registry during the same period and the environmental and socio-economic data of each tumor surveillance site. The jointpoint technique was used to analyze the long-term trend of lung cancer incidence. SatScan technology was used to visualize the spatial distribution of lung cancer incidence. A spatial regression model was used to quantitatively analyze the potential association between lung cancer incidence and major environmental and socioeconomic factors.</div></div><div><h3>Results</h3><div>During 2010–2018, the incidence of lung cancer in China showed an increasing trend. The primary cluster area with high incidence is located in the eastern coastal area of China, with a radius of 283.09 km. The primary cluster area with low incidence is located in northwest China, with a radius of 767.09 km. The primary cluster with high mortality is also located in the eastern coastal areas of China, with a radius of 283.09 km. The primary cluster with low mortality is located in northwest China, with a radius of 828.12 km. PM_2.5, annual mean temperature, and population density were positively associated with the incidence of lung cancer in men, while annual mean air temperature and population density were positively correlated with the incidence of lung cancer in women. PM_2.5 and population density were positively associated with male lung cancer mortality, while total grain production and population density were positively correlated with female lung cancer mortality.</div></div><div><h3>Conclusions</h3><div>From 2010 to 2018, The incidence of lung cancer is increasing in all regions of China, with a particularly high incidence in the eastern coastal areas and a low incidence in the western and southern parts. PM2.5, average annual temperature, population density, and total grain production were significantly associated with the incidence of lung cancer.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108684"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100463","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":"Obesity and impaired muscle function in severe asthma: a cross sectional study","authors":"Ariele Pedroso ,&nbsp;Joice M. Oliveira ,&nbsp;Vanessa L. Clark ,&nbsp;Rebecca F. McLoughlin ,&nbsp;Karina C. Furlanetto ,&nbsp;Peter G. Gibson ,&nbsp;Vanessa M. McDonald","doi":"10.1016/j.rmed.2026.108698","DOIUrl":"10.1016/j.rmed.2026.108698","url":null,"abstract":"<div><h3>Aims</h3><div>To compare physical, functional and inflammatory characteristics between adults with severe asthma and controls with and without obesity, and to evaluate factors associated with sarcopenia and muscle quality.</div></div><div><h3>Methods</h3><div>This cross-sectional study included four groups: adults with severe asthma and controls (without respiratory diseases), stratified by the presence or absence of obesity. Assessments included lung function, asthma outcomes, clinical variables, body composition, sarcopenia, muscle quality index (MQI), muscle function and strength, 6-min walk distance (6MWD), and inflammatory markers.</div></div><div><h3>Results</h3><div>A total of 233 participants were included (140 with severe asthma, 93 controls). The group with obesity and severe asthma showed worse core function, limb strength, MQI and 6MWD, compared to the other groups (P &lt; 0.0001 for all). No significant differences were observed in lean mass (P = 0.123) or in the prevalence of sarcopenia (P = 0.291) between groups. Inflammatory markers were elevated in asthma, regardless of obesity. A multiple linear regression model including age, sex, asthma, fat mass, lower limb strength and 6MWD explained 43.3% of the variability in appendicular skeletal muscle mass index (ASMMI).</div></div><div><h3>Conclusion</h3><div>Obesity plays a key role in muscle dysfunction on core, upper, and lower limb muscle groups. This reinforces the need for integrated clinical approaches addressing both asthma and obesity.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108698"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132612","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":"RNA-seq analysis of nintedanib effects on interstitial pneumonia in preoperative NSCLC patients","authors":"Hiroaki Kuroda ,&nbsp;Katsuhiro Masago ,&nbsp;Katsutoshi Seto ,&nbsp;Yoshitsugu Horio ,&nbsp;Eiichi Sasaki ,&nbsp;Shiro Fujita ,&nbsp;Hirokazu Matsushita","doi":"10.1016/j.rmed.2026.108704","DOIUrl":"10.1016/j.rmed.2026.108704","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer patients with interstitial pneumonia (IP) have limited treatment options due to the risks associated with therapeutic intervention. The underlying causes of IP in these patients are diverse, and there is currently no detailed molecular pathological classification or an established understanding of the effectiveness of anti-fibrotic medications such as nintedanib. This study aimed to elucidate the mechanism of action of nintedanib by analyzing differential RNA expression between normal and fibrotic lung tissues from lung cancer patients with IP.</div></div><div><h3>Methods</h3><div>RNA was analyzed from the non-tumor lung tissue of 7 patients with IP who received nintedanib before surgery. Non-tumor lung tissue was obtained from 12 lung cancer patients without IP complications who underwent radical surgery between 2017 and 2022 from the tissue bank of our institution. Fibrotic lung tissue from six IP patients who received nintedanib before surgery and 7 who did not (where RNA analysis was possible). Gene expression and microenvironmental analyses were performed using RNA sequencing data.</div></div><div><h3>Results</h3><div>Nintedanib modulated inflammation in non-tumor lung tissue, suppressing PLA2G2D and upregulating CST2 and MMP11, suggesting minimal impact on normal tissue and a favorable safety profile. In fibrotic lung lesions, nintedanib suppressed MUC6, ITLN1, and AREG expression. xCell2 analysis indicated reduced plasma cells and increased smooth muscle, muscle, adipocyte, and endothelial cells, suggesting normalization of tissue remodeling.</div></div><div><h3>Interpritation</h3><div>Nintedanib appears to exert anti-inflammatory effects and promote tissue repair in non-tumor lung, while facilitating tissue remodeling in fibrotic areas, indicating potential benefits in patients with interstitial pneumonia and lung cancer.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108704"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137809","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":"Feasibility of tracking mental health in cystic fibrosis registries: lessons from current practice","authors":"Anna M. Georgiopoulos ,&nbsp;Alexandra L. Quittner ,&nbsp;Michael S. Schechter ,&nbsp;Jianghua He ,&nbsp;Nivedita Chaudhary ,&nbsp;Riley C. Merowitz ,&nbsp;Ruobin Wei ,&nbsp;Edward R. Canda ,&nbsp;Katie Kirby ,&nbsp;Laura Tillman ,&nbsp;Cathy T. Price ,&nbsp;Beth A. Smith","doi":"10.1016/j.rmed.2026.108703","DOIUrl":"10.1016/j.rmed.2026.108703","url":null,"abstract":"<div><h3>Background</h3><div>Patient registries are central to improving cystic fibrosis (CF) treatment and outcomes. Although mental health (MH) is a top research priority, MH data in the CF Foundation Patient Registry (CFFPR) is limited. We aimed to inform the feasibility of including additional MH variables in CF registries such as the CFFPR.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional healthcare provider survey (N = 100; March-April 2023) regarding current practices in MH screening and data tracking at US CF programs. We then purposively sampled survey respondents to participate in a focus group and post-survey (N = 11; September 2024).</div></div><div><h3>Results</h3><div>Nearly all programs screened adolescents and adults for anxiety/depression with GAD-7/PHQ-9 and 95% systematically tracked MH data (e.g., in database, spreadsheet, electronic medical records). Respondents with &gt;5 years of CF experience were more likely to track total and item-level GAD-7/PHQ-9 scores; there were no differences by region or program size. Over 80% screened using paper. Half screened for MH side effects of modulators; 16% screened for MH conditions beyond anxiety/depression. Few (27%) pediatric programs screened children &lt;12 years. Focus group participants endorsed adding new variables to the CFFPR, identifying barriers, facilitators and resource needs.</div></div><div><h3>Conclusions</h3><div>CF programs are successfully screening and tracking GAD-7/PHQ-9 scores, supporting feasibility of including these data in patient registries. Further work to increase electronic screening and to recommend screening measures for children &lt;12 and for other MH conditions is needed. Expanding the scope of mental health data collection will enable CF registries to support longitudinal CF mental health research that addresses identified priorities.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108703"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197879","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":"Dynamic ultrasound evaluation of inferior vena cava and lung B-lines predicts intradialytic hypotension in critically ill AKI patients","authors":"Débora Soares ,&nbsp;Conrado Lysandro ,&nbsp;José Hermógenes Rocco Suassuna ,&nbsp;Renata de Souza Mendes","doi":"10.1016/j.rmed.2026.108705","DOIUrl":"10.1016/j.rmed.2026.108705","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the utility of ultraportable ultrasound in predicting intradialytic hypotension (IDH) and early interruption of renal replacement therapy (RRT) due to hemodynamic instability, by assessing the inferior vena cava collapsibility index (IVCCi) and pulmonary B-lines (BL) in mechanically ventilated patients with acute kidney injury (AKI) undergoing RRT.</div></div><div><h3>Methods</h3><div>A total of 150 RRT sessions were evaluated in 72 mechanically ventilated patients with AKI. The IVCCi and BL were assessed at baseline (T0), 30 min (T30), and 60 min (T60) after initiation. Predictors of IDH and early session interruption were identified using generalized linear mixed models. Receiver operating characteristic (ROC) curve analysis was conducted to determine the predictive performance of the change in IVCCi between T0 and T30 (ΔIVCCi) and to identify a potential cutoff value.</div></div><div><h3>Results</h3><div>The IDH occurred in 57.3% of the sessions and early interruption occurred in 26%. Significant predictors of IDH included lower MAP at T0 (OR 0.92, p = 0.002), norepinephrine use (OR 2.67, p = 0.038), ΔIVCCi (OR 0.96, p = 0.031), and BL (OR 0.96, p = 0.007). Early interruption was associated with lower MAP at T0 (OR 0.93, p = 0.005), norepinephrine use (OR 11.04, p = 0.029), ΔIVCCi T30 (OR 0.94, p = 0.014), and BL T30 (OR 0.87, p = 0.034). ROC analysis for ΔIVCCi yielded an AUC of 0.601, with best cutoff of −9.315 (sensitivity, 87.5%; specificity, 65.1%).</div></div><div><h3>Conclusions</h3><div>IVCCi variation between T0 and T30 and pulmonary B-lines were predictive of IDH and early interruption of RRT in critically ill patients. The identified ΔIVCCi cutoff of −9.315 may serve as a practical tool for early risk stratification and timely adjustment of dialysis prescriptions within the first 30 min of therapy, potentially preventing hemodynamic instability and premature discontinuation.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108705"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126285","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}