Respiratory care最新文献

{"title":"Impact of Real-Time Assessment of Pulse Oximetry on the 6-Min Walk Distance in Patients With Chronic Respiratory Disease.","authors":"Litiele E Wagner, Gustavo H Rosa, Franciele Plachi, Amanda Becker da Silva, Ariane da S Imperador, Anna Carolina de Azevedo, Marcelo B Gazzana, J Alberto Neder, Danilo C Berton","doi":"10.4187/respcare.11751","DOIUrl":"10.4187/respcare.11751","url":null,"abstract":"<p><strong>Background: </strong>Continuous monitoring of pulse oximetry (S_pO₂ ) is recommended during the 6-min walk test (6MWT) to ensure that the lowest S_pO₂ is recorded. In this case, severe exercise-induced desaturation (EID; S_pO₂ < 80%) triggers walking interruption by the examiner. Our main objective was to assess the impact of this approach on 6MWT distance in patients with chronic respiratory diseases and, second, to evaluate the safety of the test without interruption due to severe EID.</p><p><strong>Methods: </strong>6MWTs with continuous monitoring of S_pO₂ were prospectively performed in subjects with chronic respiratory disease. The participants were randomly allocated to walk with or without S_pO₂ real-time assessment. S_pO₂ visualization during the test execution was available only in the first group, and walking interruption was requested by the examiner if S_pO₂ < 80%.</p><p><strong>Results: </strong>One hundred forty-five participants were included in each group (68.6% females, 62 [52-69] y old) without differences in demographic and resting lung function parameters between them. The main respiratory conditions were COPD (<i>n</i> = 101), asthma (<i>n</i> = 73), pulmonary hypertension (<i>n</i> = 47), and interstitial lung disease (<i>n</i> = 39). The walked distance was similar comparing groups (349.5 ± 117.5 m vs 351.2 ± 105.4 m). Twenty-five subjects presented with severe EID in the group with real-time S_pO₂ assessment, and 20 subjects had severe EID in the group without real-time assessment respectively (overall prevalence of 15.5%). The 23 participants who had their test interrupted by the examiner due to severe EID in the first group (2 subjects stopped by themselves due to excessive symptoms) walked a shorter distance compared to the 11 subjects with severe EID without test interruption in the second group (9 subjects stopped by themselves due to excessive symptoms): 240.6 ± 100.2 m versus 345.9 ± 73.4 m. No exercise-related serious adverse events were observed.</p><p><strong>Conclusions: </strong>Interruption driven by severe EID reduced the walked distance during the 6MWT. No serious adverse event, in turn, was observed in subjects with severe desaturation without real-time S_pO₂ assessment.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1294-1304"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aerosol Delivery With High-Frequency Assisted Airway Clearance Therapy in an Adult Airway and Lung Model: A Perfect Marriage?","authors":"Tim Gilmore","doi":"10.4187/respcare.12428","DOIUrl":"10.4187/respcare.12428","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 10","pages":"1345-1346"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of High-Flow Nasal Cannula Flow on Intrapharyngeal Pressure During Fiberoptic Bronchoscopy Under Deep Sedation.","authors":"Jie Li, Bin Liu, Lin Gao, Na Li, Xiao-Zhong Yuan, Yi-Xuan Zhu, Kang Deng","doi":"10.4187/respcare.11697","DOIUrl":"10.4187/respcare.11697","url":null,"abstract":"<p><strong>Background: </strong>The flow reaching the vocal folds may be lower than that at the output of high-flow nasal cannula (HFNC) system. This could be due to upper-respiratory obstruction, oxygen leakage, or other factors. The objective of this study was to observe the effect of flow through a nasopharyngeal airway on intrapharyngeal pressure (IPP) in subjects undergoing fiberoptic bronchoscopy (FOB).</p><p><strong>Methods: </strong>Patients scheduled for FOB were invited to participate. Measurements were performed at flows of 0-60 L/min; the subjects wore WN-N95 folding medical protective masks (N95) and either underwent FOB or not. IPP at each flow was recorded following 15 s of ventilation, and the cross-sectional area (CSA) of the gastric sinus was measured before and after FOB. Hypoxemia, reflux aspiration, and other pertinent events were recorded.</p><p><strong>Results: </strong>Sixty subjects undergoing FOB at the Affiliated Hospital of Jiaxing University participated in this trial from October 2022-September 2023. IPP increased significantly with an increase in flow and also increased after placing the N95 mask with the same flow (<i>P</i> < .001). When results from before to after FOB were compared, the difference in CSA was statistically significant 263.6 (220.7-300.5) mm² vs 305.5 (275.4-329.5) mm², <i>P</i> < .001, but the difference in the risk of reflux aspiration was not statistically significant (0% vs 6.7%, <i>P</i> = .13). Complication rates during treatment were 8.3% for hypoxemia, 0% for reflux aspiration, 1.7% for hypertension, 1.7% for hypotension, 6.7% for tachycardia, 5% for bradycardia, and 10% for postoperative nausea and vomiting.</p><p><strong>Conclusions: </strong>HFNC can provide effective oxygen therapy for people undergoing FOB, and increases in IPP with flow in the range of 0-60 L/min may not increase the risk of reflux aspiration.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1275-1283"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Commentary.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 10","pages":"i"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vitro Comparison of Aerosol Delivery in High-Frequency Assisted Airway Clearance Devices With Integrated Nebulizers.","authors":"Niko Kontoudios, Hattie R KenKnight, Robert M DiBlasi","doi":"10.4187/respcare.11988","DOIUrl":"10.4187/respcare.11988","url":null,"abstract":"<p><strong>Background: </strong>High-frequency assisted airway clearance systems combine positive expiratory pressure or oscillatory positive airway pressure with integrated nebulizers to improve the delivery of aerosols and assist with airway clearance. This aerosol study evaluated lung delivery efficiency during positive expiratory pressure and oscillatory positive airway pressure therapy of 2 high-frequency assisted airway clearance/nebulizer systems.</p><p><strong>Methods: </strong>Aerosol delivery was evaluated during positive expiratory pressure therapy of 10 cm H₂O and oscillatory positive airway pressure therapy of 20 cm H₂O with the BiWaze Clear and the Volara high-frequency assisted airway clearance/nebulizer systems. The handset and nebulizer were attached to an anatomic upper-airway model via a mouthpiece and placed into a plethysmograph. A tracheal filter was placed to capture the inhaled aerosol. A vacuum filter entrained fugitive aerosols from the plethysmograph. After nebulization of technetium in 3.0 mL normal saline solution, the components were scanned by using scintigraphy and the decay-corrected radiation counts were referenced to the initial nebulizer technetium charges.</p><p><strong>Results: </strong>Aerosol delivery during positive expiratory pressure therapy of 10 cm H₂O resulted in higher lung deposition with the BiWaze Clear versus the Volara (28 vs 6.2%; <i>P</i> < .001; 95% CI 16.5-27.7), and higher fugitive losses (23.7 vs 2.8%; <i>P</i> = .004) and nebulizer losses (55 vs 3.3%; <i>P</i> < .001) with the Volara than with the BiWaze Clear. Aerosol delivery during oscillatory positive airway pressure of 20 cm H₂O resulted in a higher lung deposition with the BiWaze Clear versus the Volara (16.3 vs 7.3%; <i>P</i> = .005; 95% CI 3.3-15) and higher fugitive (22.3 vs 3.8%; <i>P</i> = .02) and nebulizer (58.8 vs 7.2%; <i>P</i> = .004) losses with the Volara. There were no differences at the other locations during testing.</p><p><strong>Conclusions: </strong>The BiWaze Clear system showed greater delivery efficiency than did the Volara during positive expiratory pressure and oscillatory positive airway pressure. The high residual nebulizer dose and fugitive aerosol losses through the handset leak valve contributed to the lower delivery efficiency observed with the Volara. The nebulizer type, circuit design, and handset are important factors when targeting effective aerosol delivery to the lungs with high-frequency assisted airway clearance therapy.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1221-1230"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a New Method for Evaluating Heat and Moisture Exchanger Performance.","authors":"Kouhei Nagata, Tomio Andoh, Ken Kishimoto, Kunihisa Eguchi, Yutaka Usuda, Toshihiro Tsuji, Go Hirabayashi, Koichi Maruyama","doi":"10.4187/respcare.11696","DOIUrl":"10.4187/respcare.11696","url":null,"abstract":"<p><strong>Background: </strong>A model system described in International Organization for Standardization 9360 is the standard method for estimating the humidifying performance of heat and moisture exchangers (HMEs). However, there are no reliable bedside methods for evaluating the ongoing humidification performance of HMEs. Therefore, this study aimed to develop 2 clinically applicable methods for estimating the ongoing humidifying performance of HMEs and to evaluate their reliability in a model system.</p><p><strong>Methods: </strong>Physiologically expired gas was simulated using a heated humidifier, and ventilation was delivered using a ventilator with constant flow through 3 different types of HMEs. Relative humidity (RH) was measured using a capacitive-type moisture sensor. Water content lost during expiration was calculated by integrating absolute humidity (AH), instantaneous gas flow measured at the expiratory outlet of the ventilator, and time. We also calculated the water content released and captured by the HMEs during tidal ventilation by integrating the difference in AH across the HMEs, instantaneous gas flow, and time.</p><p><strong>Results: </strong>We found that the RH, temperature, and AH were almost constant on the expiratory outlet of the ventilator but rapidly varied near the HMEs. The water content lost by the 3 HMEs was associated with the manufacturer-reported values and inversely correlated with the calculated values of the water content exchanged by the HMEs. The water content released and captured by HMEs was closely correlated with the difference in HME weight measured at the end of inspiration and expiration; however, the water content captured by HMEs seemed to be overestimated.</p><p><strong>Conclusions: </strong>Our results demonstrated that our system was able to detect the differences in the performance of 3 models of HMEs and suggest that our method for calculating water loss is reliable for estimating the water retention performance of HMEs during mechanical ventilation, even in the presence of a constant flow.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1245-1254"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of PEEP on Ventilation Distribution in ARDS.","authors":"Bruno Louis, Martin Cour, Laurent Argaud, Claude Guérin","doi":"10.4187/respcare.11569","DOIUrl":"10.4187/respcare.11569","url":null,"abstract":"<p><strong>Background: </strong>The first aim of this study was to evaluate the capacity of electrical impedance tomography (EIT) to identify the effect of PEEP on regional ventilation distribution and the regional risk of collapse, overdistention, hypoventilation, and pendelluft in mechanically ventilated patients. The second aim was to evaluate the feasibility of EIT for estimating airway opening pressure (AOP).</p><p><strong>Methods: </strong>The EIT signal was recorded both during baseline cyclic ventilation and slow insufflation for one breath for 9 subjects with moderate-to-severe ARDS. From these data, the AOP and volumes insufflated to lung regions with or without the risk of either collapse, overdistention, hypoventilation, or pendelluft were assessed at 3 PEEP levels (5, 10, and 15 cm H₂O). PEEP levels were compared by Friedman analysis of variance and the AOP measured by EIT evaluated using an F-test and the Bland and Altman method.</p><p><strong>Results: </strong>The volume for which there was no specific risk significantly decreased at the highest PEEP from 55 ± 31% tidal volume (V_T) at PEEP 5 or 82 ± 18% V_T at PEEP 10 to 10 ± 30% V_T at PEEP 15 (<i>P</i> = .038 between PEEP 5 vs PEEP 15; <i>P</i> = .01 between PEEP 10 vs PEEP 15). The volume associated with overdistention significantly increased with increasing PEEP, whereas that associated with atelectrauma significantly decreased. Pendelluft significantly decreased with increasing PEEP: V_T of 8.9 ± 18.6%, 3.6 ± 7.0%, and 3.2 ± 7.1% for PEEP 5, PEEP 10, and PEEP 15, respectively. The center of ventilation tended to increase in the dependent direction with higher PEEP. The AOPs assessed by EIT and from the pressure-volume curve were in good agreement (bias 0.48 cm H₂O).</p><p><strong>Conclusions: </strong>Our results suggest that EIT could aid clinicians in making personalized and reasoned choices in setting the PEEP for subjects with ARDS.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1231-1238"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Bronchodilator Responsiveness: A Comparison of Old Versus New Criteria.","authors":"Solanus de la Serna, Becky Skinner, Andrei Schwartz, Spyridon Fortis","doi":"10.4187/respcare.11603","DOIUrl":"10.4187/respcare.11603","url":null,"abstract":"<p><strong>Background: </strong>In 2021, the European Respiratory Society (ERS)/American Thoracic Society (ATS) guidelines issued a new definition of bronchodilator responsiveness, which is now defined as an increase in FEV₁ or FVC by ≥ 10% of the predicted FEV₁ or FVC. The impact of this revised definition on bronchodilator responsiveness prevalence has been relatively understudied.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 2,696 subjects who performed pulmonary function testing at the University of Iowa from 1997 to 2018. We compared the prevalence of bronchodilator responsiveness by using the 2005 (FEV₁ or FVC increase ≥ 12% baseline value and ≥ 200 mL) and 2021 (FEV₁ or FVC increase ≥ 200 mL and ≥ 12% of baseline value) ERS/ATS definitions, across several different respiratory diagnosis categories. We compared the prevalence of bronchodilator responsiveness using the 2 definitions by applying the McNemar test and assessed concordance of bronchodilator responsiveness by calculating kappa coefficients for the whole study population and within each diagnosis category.</p><p><strong>Results: </strong>The prevalence of bronchodilator responsiveness increased from 9% when using the 2005 ERS/ATS definition to 16% when using the 2021 definition within the entire cohort and also within each respiratory diagnosis category. In the subjects with normal pre-bronchodilator spirometry, there was a low prevalence of bronchodilator responsiveness (3%) when using the 2005 definition, and the prevalence increased (8%) when using the 2021 definition. In the subjects with normal pre-bronchodilator spirometry and FEV₁ Z score ≥ 0, 2% had bronchodilator responsivness according to the 2005 guidelines, whereas 7% had bronchodilator responsiveness according to the 2021 guidelines.</p><p><strong>Conclusions: </strong>The prevalence of bronchodilator responsiveness increased when using the new 2021 ERS/ATS definition compared with the 2005 definition. In the subjects with normal pre-bronchodilator spirometry, the prevalence of bronchodilator responsiveness increased when using the 2021 definition, in particular, among those with an FEV₁ Z score ≥ 0, which raises concerns for overdiagnosis. Future investigations should examine the correlation of bronchodilator responsiveness with clinical outcomes in this group of subjects.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1266-1274"},"PeriodicalIF":2.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Illness Perception on Medication Adherence to Inhaler Therapy in Elderly Individuals With COPD.","authors":"You-Ran Liu, Yan Wang, Xiulan Peng, Hui Xie","doi":"10.4187/respcare.12056","DOIUrl":"10.4187/respcare.12056","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence to inhaler therapy is pivotal for optimizing the management of COPD. Individuals with COPD often have suboptimal adherence behaviors to inhaler therapy. Illness perception and beliefs about medicines have been proved to be associated with medication adherence. Nevertheless, the influence of illness perception and medication beliefs on adherence to inhaler therapy among elderly individuals with COPD in China remains unclear.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 252 elderly subjects with COPD in China from June 2022-September 2023. The Test of Adherence to Inhalers, the Brief Illness Perception Questionnaire, and the Belief About Medicines Questionnaire (BMQ) were utilized. Spearman correlations, regression analysis, and parallel mediation analysis were employed to assess the correlations and mediating effects among beliefs about medicines, illness perception, and medication adherence to inhaler therapy.</p><p><strong>Results: </strong>Medication adherence to inhaler therapy exhibited a negative correlation with concerns beliefs, while showing positive correlations with illness perception, necessity beliefs, and total BMQ scores. Mediating effects of concerns beliefs and necessity beliefs were observed in the relationship between perception of illness and medication adherence to inhaler therapy.</p><p><strong>Conclusions: </strong>This study suggests that essential interventions targeting beliefs about medicines in elderly individuals with COPD should be implemented to optimize the level of their inhaler adherence, particularly in those with low levels of necessity beliefs or high levels of concerns beliefs.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic Characteristics, Indicators of Quality, and Hospital Visits in Patients With COPD During COVID-19.","authors":"Henry Jensen, Tina Bech Olesen, Anne Mette Falstie-Jensen, Henrik Møller, Jens Winther Jensen, Anders Løkke","doi":"10.4187/respcare.11341","DOIUrl":"https://doi.org/10.4187/respcare.11341","url":null,"abstract":"<p><strong>Background: </strong>Evidence on quality of care and sociodemographics in patients with COPD needing care during the COVID-19 pandemic is scarce. We aimed to examine indicators of quality and clinical outcomes (eg, readmissions, death) and sociodemographics in patients with COPD in need of hospital care during the COVID-19 pandemic compared to before the pandemic.</p><p><strong>Methods: </strong>This was a nationwide register-based study of subjects with a hospital contact due to COPD from January 1, 2015-December 15, 2021, in Denmark. A generalized linear model using Poisson distribution was used to estimate prevalence ratios (PRs) for variables of interest.</p><p><strong>Results: </strong>During the pandemic, the early average of admissions was 36% lower than before the pandemic; the average number of out-patients was 23% lower. The proportion of readmissions for exacerbation within 30 d of discharge decreased during the pandemic (PR 0.93 [95% CI 0.90-0.96]). The proportion of subjects who died within 30 d of admission remained unchanged (PR 0.98 [0.94-1.03]). Among out-patients, the proportion with 2 or more exacerbations in the preceding year was lower during the pandemic (PR 0.82 [0.80-0.84]). During the pandemic, both in-patients and out-patients were less likely to be younger, to live alone, and to have a lower educational level.</p><p><strong>Conclusions: </strong>In this nationwide study of subjects with COPD, hospital contacts decreased during the pandemic due to lockdowns and isolation, which led to a decrease in infections overall in the society. Meanwhile, in-hospital care remained unaltered. However, concerns are raised about patients with COPD and low educational level and immigrants not seeking relevant health care.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}