Respiratory medicine最新文献

{"title":"The risk factors for chronic cough in children: A meta-analysis covering five continents","authors":"","doi":"10.1016/j.rmed.2024.107752","DOIUrl":"10.1016/j.rmed.2024.107752","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to explore the risk factors for chronic cough in children and provide a reference for prevention and healthcare measures.</p></div><div><h3>Methods</h3><p>PubMed, Web of Science, Cochrane, and EMBASE were searched for observational studies published up to April 2024. Outcome included risk factors associated with chronic cough in children. Two investigators independently searched and screened the literature, evaluated the qualities and extracted baseline datas. Results were analyzed using random-effects models with odds ratios and their 95 % confidence intervals to address heterogeneity. Subgroup analyses, sensitivity analyses and assessment of publication bias were performed. Stata17 and GRADEwas used for the meta-analysis.</p></div><div><h3>Results</h3><p>18 studies including 97,462 children were reviewed. Asthma(OR = 4.06, 95%CI: 2.37–6.96, P＜0.01), NO₂(OR = 1.19, 95%CI: 1.01–1.39, P = 0.031), Home remodeling history (OR = 1.82,95 % CI: 1.61–2.05, P＜0.01), Environment Tobacco Smoke(OR = 1.41, 95 % CI: 1.15–1.73, P = 0.001), Pet exposure (OR = 1.56, 95%CI: 1.25–1.95, P＜0.01), Mould (OR = 1.64,95%CI: 1.45–1.85, P＜0.01), Age＜1 year(OR = 3.19, 95 % CI: 1.8–5.63, P＜0.01) were reported as risk factors for chronic cough in children, these results were discussed qualitatively in the study.</p></div><div><h3>Conclusion</h3><p>Asthma, NO₂, Home remodeling history, Environment Tobacco Smoke(ETS), Pet exposure, Mould, and Age＜1 year are risk factors for chronic coughing in children. Due to the few studies and insufficient evidence, other potential risk factors need to be robustly confirmed by subsequent large-sample and multicenter trials.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879332","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":"Respiratory physiological mechanism of two types of equal-intensity inspiratory muscle training in stable patients with chronic obstructive pulmonary disease","authors":"","doi":"10.1016/j.rmed.2024.107747","DOIUrl":"10.1016/j.rmed.2024.107747","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the respiratory physiological changes resulting from short-term inspiratory resistance training (R-IMT) and inspiratory threshold training (T-IMT) in patients with chronic obstructive pulmonary disease (COPD) and to compare the mechanisms of the two training methods.</p></div><div><h3>Patients and methods</h3><p>A total of 75 stable patients with COPD combined with inspiratory muscle weakness were randomly allocated to three groups: R-IMT (n = 26), T-IMT (n = 24), and control (n = 25). Before and after 8 weeks of inspiratory muscle training(IMT), cardiopulmonary exercise tests were conducted to assess respiratory patterns, respiratory central drive, exercise tolerance, and ventilation efficiency.</p></div><div><h3>Results</h3><p>After 8 weeks of IMT, Inspiratory muscle strength, represented by MIP (maximum inspiratory mouth pressure) and exercise capacity increased during exercise in both IMT groups (P &lt; 0.05). In the R-IMT group, inspiratory time (Ti) prolonged (P &lt; 0.05), tidal volume (Vt) increased (P &lt; 0.05), ventilation efficiency (represented by ventilation-center coupling) increased (P &lt; 0.05) during exercise. Conversely, the T-IMT group did not exhibit any of these changes after IMT (P &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>In summary, the improvement in exercise tolerance was associated with an increase in inspiratory muscle reserve in both R-IMT and T-IMT. However, only R-IMT was associated with deeper and slower breathing, as well as improved ventilation efficiency.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875817","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":"Diagnostic yield and safety of repeat bronchoscopy in pulmonary disease: A five-year retrospective analysis","authors":"","doi":"10.1016/j.rmed.2024.107759","DOIUrl":"10.1016/j.rmed.2024.107759","url":null,"abstract":"<div><h3>Aim</h3><p>In this study, we aim to analyze the frequency and indications of repeat bronchoscopic procedures performed at our hospital over a five-year period.</p></div><div><h3>Methods</h3><p>This retrospective study was conducted at the Department of Pulmonary Diseases, Akdeniz University, and included patients who underwent bronchoscopy between January 1, 2018, and May 31, 2024. Patients who required a repeat bronchoscopy were identified. Inclusion criteria for the repeat bronchoscopy group were non-diagnostic initial bronchoscopy or the need for additional samples for molecular testing in lung cancer patients. Exclusion criteria included patients with incomplete medical records or those who did not provide informed consent for the repeat procedure.</p></div><div><h3>Findings</h3><p>A total of 3877 patients underwent bronchoscopy in this time periods. Among these, 69 patients (1.8 %) required a repeat bronchoscopy. The mean age of these patients was 61.3 ± 11.7 years, with 54 (78 %) being male. The most common reason for the repeat procedure was the non-diagnostic outcome of the initial bronchoscopy (n = 53, 77 %), followed by cases where the initial bronchoscopy was diagnostic for lung cancer but insufficient for molecular testing (n = 16, 23 %). Among the 16 patients who underwent molecular testing, sufficient samples for molecular tests were obtained in 12 patients (75 %) following the second bronchoscopy. Molecular tests were negative for driver mutations in 6 patients, while 6 patients tested positive (PD-L1, n = 5; EGFR, n = 1). In 4 patients (25 %), the sample was reported as insufficient for molecular testing. Patients who underwent repeat bronchoscopy had the second procedure an average of 38.5 ± 59.7 days after the initial procedure. No complications developed in patients undergoing repeat bronchoscopy, except for bleeding not requiring intervention related to the bronchoscopy procedure.</p></div><div><h3>Conclusion</h3><p>In conclusion, regardless of the reason, repeated bronchoscopy in suitable patients is safe and has a high diagnostic yield.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879331","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":"Treatment intensity level as a proxy for severity of chronic obstructive pulmonary disease: A risk stratification tool","authors":"","doi":"10.1016/j.rmed.2024.107742","DOIUrl":"10.1016/j.rmed.2024.107742","url":null,"abstract":"<div><h3>Background</h3><p>Increasing severity of chronic obstructive pulmonary disease (COPD) is associated with increasing risk of poor outcomes. Using health registry data, we aimed to assess the association between treatment intensity levels (TIL), as a proxy for underlying COPD severity, and long-term outcomes.</p></div><div><h3>Methods</h3><p>Using Danish nationwide registries, we identified patients diagnosed with COPD during 2001–2016, who were alive at index date of 1 January 2017. We stratified patients into exclusive TILs from least to most severe: no use, short term therapy, mono-, dual-, triple therapy, oral corticosteroid (OCS), and long-term oxygen treatment (LTOT). Survival analyses were used to assess 5-year outcomes by TIL.</p></div><div><h3>Results</h3><p>We identified 53,803 patients with COPD in the study period (median age: 72 years [inter quartile range, 64–80], 48 % male). The three most severe TILs were associated with a significant incremental increase in all-cause mortality with an adjusted hazard ratio (aHR) for triple therapy, OCS and LTOT of 1.44 (95 % CI: 1.38–1.51), 1.67 (95 % CI: 1.59–1.75), and 2.91 (95 % CI: 2.76–3.07) compared with those receiving no therapy as reference. The same pattern was evident for the composite outcome of 5-year mortality or COPD-related hospitalization with an aHR for triple therapy, OCS and LTOT of 2.30 (95 % CI: 2.22–2.38), 2.85 (95 % CI: 2.74–2.96), and 4.00 (95 % CI: 3.81–4.20), respectively.</p></div><div><h3>Conclusion</h3><p>Increasing TILs were associated with increasing five-year mortality and risk of COPD-related hospitalization. TILs may be used as a proxy for underlying COPD severity in epidemiological studies.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879333","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-world data on polysomnography- and patient-reported outcomes in hypoglossal nerve stimulation and auto-titrating positive airway pressure therapy for obstructive sleep apnea","authors":"","doi":"10.1016/j.rmed.2024.107750","DOIUrl":"10.1016/j.rmed.2024.107750","url":null,"abstract":"<div><h3>Background</h3><p>Few data are available comparing first-line positive airway pressure (PAP) therapy of obstructive sleep apnea (OSA), especially auto-adjusting PAP (aPAP), with second-line hypoglossal nerve stimulation (HGNS) therapy. The aim of this study was to directly compare these therapeutic options by standard polysomnography (PSG)-related parameters and patient-reported outcomes in comparable groups.</p></div><div><h3>Methods</h3><p>20 patients (aged 57.30 ± 8.56 years; 6 female) were included in the HGNS and 35 patients (aged 56.83 ± 9.20 years; 9 female) were included in the aPAP group. In both groups participants had to fit the current guideline criteria for HGNS treatment. Groups were compared by analysis of covariance (ANCOVA) using inverse propensity score weighting.</p></div><div><h3>Results</h3><p>Propensity scores did not differ between groups. Pre-therapeutic AHI (HGNS: 40.22 ± 12.78/h; aPAP: 39.23 ± 12.33/h) and ODI (HGNS: 37.9 ± 14.7/h, aPAP: 34.58 ± 14.74/h) were comparable between the groups. After 413.6 ± 116.66 days (HGNS) and 162.09 ± 140.58 days (aPAP) of treatment AHI (HGNS: 30.22 ± 17.65/h, aPAP group: 4.71 ± 3.42/h; p &lt; 0.001) was significantly higher in the HGNS group compared to the aPAP group. However, epworth sleepiness scale (ESS) was post-interventionally significantly lower in the HGNS group compared to the aPAP group (pretherapeutic: HGNS: 13.32 ± 5.81 points, aPAP: 9.09 ± 4.71 points; posttherapeutic: HGNS: 7.17 ± 5.06 points; aPAP: 8.38 ± 5.41 points; p &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>These are novel real-world data. More research on the key parameters regarding titration of the HGNS neurostimulation parameter tuning and on the impact of factors influencing HGNS adherence is needed.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0954611124002257/pdfft?md5=05a4c58aef528c2f89be22f683ada96c&pid=1-s2.0-S0954611124002257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860740","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":"Association of naples prognostic score and lung health: A population-based study","authors":"","doi":"10.1016/j.rmed.2024.107751","DOIUrl":"10.1016/j.rmed.2024.107751","url":null,"abstract":"<div><h3>Background</h3><p>The Naples Prognostic Score (NPS) is a novel indicator of inflammatory and nutritional status, but its relationship to lung health is unknown.</p></div><div><h3>Objective</h3><p>To evaluate the relationship of NPS to lung health problems.</p></div><div><h3>Methods</h3><p>A total of 15,600 participants aged 20 years or older with an available assessment of chronic lung diseases were enrolled from the National Health and Nutrition Examination Survey 2007–2012. The NPS was calculated based on serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio. Associations of NPS with chronic lung disease (diagnosed asthma, chronic bronchitis, and emphysema), respiratory symptoms (cough, phlegm production, wheeze, and exertional dyspnea), and spirometric measurements (FEV₁, FVC, and obstructive or restrictive spirometry pattern) were evaluated. Kaplan-Meier survival analysis and multiple Cox regressions were used to assess the significance of NPS in relation to all-cause mortality and chronic lower respiratory diseases mortality in participants. Furthermore, to comprehensively assess the association between NSP and chronic lower respiratory diseases mortality, Fine-Gray subdistribution hazards model was performed to analyze non-chronic lower respiratory diseases mortality as a competitive risk.</p></div><div><h3>Results</h3><p>People with a higher NPS score were associated with greater odds of asthma, chronic bronchitis, respiratory symptoms (including phlegm production, wheeze, and exertional dyspnea), and a greater risk of obstructive and restrictive spirometry. A higher NPS score was significantly associated with decreased FEV₁ and FVC in both overall participants and those with lung health problems. Longitudinally, we found that those in the category with highest NPS were at greater risk of all-cause mortality and chronic lower respiratory diseases mortality in those with chronic lung disease, and respiratory symptoms.</p></div><div><h3>Conclusions</h3><p>An elevated NPS is associated with a host of adverse pulmonary outcomes. Prospective studies to define NPS as a biomarker for impaired lung health are warranted.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875815","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 1-min sit-to-stand test as a screening tool to assess exercise-induced oxygen desaturation in normoxemic people with interstitial lung disease","authors":"","doi":"10.1016/j.rmed.2024.107748","DOIUrl":"10.1016/j.rmed.2024.107748","url":null,"abstract":"<div><h3>Background</h3><p>In patients with interstitial lung disease (ILD), exercise-induced desaturation during the 6-min walk test (6MWT), specifically nadir oxygen saturation (nSpO2) of ≤88 % is a negative prognostic marker. As the 6MWT is often impractical for ILD patients, the aim of this study is to compare the 1-min sit-to-stand test (1minSTS) with the 6MWT to detect exercise-induced desaturation.</p></div><div><h3>Methods</h3><p>Participants were recruited from a tertiary referral clinic with both tests performed on the same day. Utilising Bland-Altman analysis, the relationship between nSpO2 on 1minSTS and 6MWT was determined. An area under the receiver operating characteristic curve (AUC) determined the ability of nSpO2 on 1minSTS test to predict SpO2 ≤88 % on 6MWT.</p></div><div><h3>Results</h3><p>Fifty participants completed the study (idiopathic pulmonary fibrosis n = 24, 48 %; connective tissue disease associated ILD n = 20, 40 %; other ILD n = 6, 12 %). Mean (SD) FVC%pred was 73 ± 16 %, mean DLCO%pred 57 ± 16 % and resting SpO2 99 ± 1 %. The 1minSTS resulted in less exercise-induced oxygen desaturation, with a median IQR nSpO2 of 95 % (89–98) and 93 % (85–96) respectively (p &lt; 0.001). Moderate agreement was determined between the nSpO2 on both tests, with a mean difference of 3.2 % [-14 to +3.0 %]. The 1minSTS test accurately identified participants with nSpO2 ≤88 % on 6MWT (AUC 0.96). Oxygen desaturation ≤94 % during the 1minSTS test provided 100 % sensitivity and 87 % specificity for oxygen desaturation ≤88 % at 6MWT.</p></div><div><h3>Conclusion</h3><p>This study demonstrates that exercise-induced oxygen desaturation during the 1minSTS test correlates with oxygen desaturation on 6MWT. The 1minSTS may be a practical screening tool for ILD patients who would benefit from further exercise testing.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793360","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":"Prescriptions of respiratory medications in children aged 0–10 years: A longitudinal drug utilization study in the POMME database","authors":"","doi":"10.1016/j.rmed.2024.107741","DOIUrl":"10.1016/j.rmed.2024.107741","url":null,"abstract":"<div><h3>Introduction</h3><p>Respiratory tract disorders are common in children. However, there is no available data on the prescription of respiratory medications for children in France. This study aimed to provide an overview of medications for obstructive airway diseases prescriptions for children during the initial ten years of their lives within POMME, a French population-based cohort of children.</p></div><div><h3>Material and methods</h3><p>This longitudinal, population-based study used data from the French POMME birth cohort, comprising children born in Haute Garonne between July 2010 and June 2011. Anonymous medical information, including medication reimbursement data, was collected between ages 0 and 10 years. Exposure was defined as at least one prescription for respiratory medications (ATC code R03*), focusing on specific subclasses. Data were analyzed by age, season, and prescribing physicians' specialties.</p></div><div><h3>Results</h3><p>Out of 5956 children, 4951 (83.1 %) received respiratory medication prescriptions. Inhaled corticosteroids (ICSs) were the most prescribed (95.3 %), followed by short-acting β2-agonists (68.8 %). The number of prescriptions increased with age, except for ICSs alone, which peaked between 6 months and 2 years. The average number of prescriptions per child was relatively low.</p></div><div><h3>Discussion</h3><p>This study highlighted high prescription rates of respiratory medications in children under 10 years, with ICSs being the most prevalent. While these medications are primarily intended for asthma management, the findings suggested a significant proportion of off-label prescriptions, especially in young children. Further research and clinical guidance are warranted to ensure appropriate medication use in the pediatric population.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0954611124002166/pdfft?md5=68ef434fede20811990bbbcf004faa60&pid=1-s2.0-S0954611124002166-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767205","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":"Evaluating the impact of short-term nitrate-rich dietary supplementation on endothelial function in COPD: A randomized crossover study","authors":"","doi":"10.1016/j.rmed.2024.107745","DOIUrl":"10.1016/j.rmed.2024.107745","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to investigate the acute effects of dietary nitrate ingestion through <span>l</span>-arginine supplementation or dehydrated beet consumption on endothelial function in chronic obstructive pulmonary disease (COPD) patients. The secondary outcome was to analyze arterial stiffness, plasma nitrate, and nitrate/protein concentration.</p></div><div><h3>Methods</h3><p>In this randomized crossover study, subjects with COPD underwent three series of supplementation: (1) <span>l</span>-arginine, (2) dehydrated beetroot, and (3) a placebo that appeared like the other supplements. Each intervention lasted 14 days, with a 7-day washout period between series. Participants underwent endothelial function assessment using flow-mediated dilatation (FMD), and plasma nitrate levels were measured at the end of each supplementation series.</p></div><div><h3>Results</h3><p>Seventeen subjects (twelve male) completed the study protocol. Only five subjects presented endothelial dysfunction (RHI ≤0.51) at baseline. The mean baseline characteristics included age 66.5 ± 9.4 years, BMI 27.5 ± 4.5 kg/m², FEV_1, 0.79 (0.67–1.06) L. There were no differences (p &gt; 0.05) between the groups or from pre-to post-interventions for RHI and arterial stiffness index (AIx) values, as well as parameters of endothelium-dependent vasodilation, such as blood flow velocity (BFV), shear stress, shear rate, FMD (mm), and FMD%. There was also no differences (p &gt; 0.05) between the groups or from pre-to post-interventions plasma nitrate levels.</p></div><div><h3>Conclusions</h3><p>Acute dietary supplementation with nitrates, at the doses provided, did not show a significant improvement in endothelial function assessed by FMD, EndoPAT, or plasma nitrate levels in COPD. These findings suggest that a higher dose or prolonged supplementation might be required to achieve a therapeutic effect.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760658","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":"Five sessions of hyperbaric oxygen for critically ill patients with COVID-19-induced ARDS: A randomised, open label, phase II trial","authors":"","doi":"10.1016/j.rmed.2024.107744","DOIUrl":"10.1016/j.rmed.2024.107744","url":null,"abstract":"<div><h3>Background</h3><p>Few treatment options exist for patients with COVID–19–induced acute respiratory distress syndrome (ARDS). Data on the benefits and harms of hyperbaric oxygen treatment (HBOT) for this condition is limited.</p></div><div><h3>Objective</h3><p>To evaluate benefits and harms of HBOT in patients with COVID-19 induced ARDS.</p></div><div><h3>Methods</h3><p>In this open-label trial conducted at three hospitals in Sweden and Germany, patients with moderate to severe ARDS and at least two risk factors for unfavourable outcome, were randomly assigned (1:1) to medical oxygen 100 %, 2·4 Atmospheres absolute (ATA), 80 min (HBOT) adjuvant to best practice or to best practice alone (Control). Randomisation was stratified by sex and site. The primary endpoint was ICU admission by Day 30.</p></div><div><h3>Results</h3><p>Between June 4, 2020, and Dec 1, 2021, 34 subjects were randomised to HBOT (N = 18) or Control (N = 16). The trial was prematurely terminated for futility. There was no statistically significant difference in ICU admission, 5 (50 %) in Control vs 13 (72 %) in HBOT. OR 2·54 [95 % CI 0·62-10·39], p = 0·19.</p></div><div><h3>Harms</h3><p>102 adverse events (AEs) were recorded. 16 (94 %) subjects in the HBOT group and 14 (93 %) in the control group had at least one AE. Three serious adverse events (SAEs), were at least, possibly related to HBOT. All deaths were unlikely related to HBOT.</p></div><div><h3>Conclusions</h3><p>HBOT did not reduce ICU admission or mortality in patients with COVID–19–induced ARDS. The trial cannot conclude definitive benefits or harms. Treating COVID–19–induced ARDS with HBOT is feasible with a favourable harms profile.</p></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0954611124002191/pdfft?md5=1bdf276cbdbc1266e692958fcc01d07e&pid=1-s2.0-S0954611124002191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767204","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}