Respirology最新文献

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Time trends in the incidence of interstitial lung disease across Brazil, Russia, India, China and South Africa (BRICS) from 1990 to 2019: An age-period-cohort analysis. 1990-2019年巴西、俄罗斯、印度、中国和南非(金砖五国)间质性肺病发病率的时间趋势:年龄段队列分析。
IF 6.6 2区 医学
Respirology Pub Date : 2024-06-30 DOI: 10.1111/resp.14785
Zhen Yang, Zhiqin Xie, Zequan Wang, Yunyu Du, Shihan Chen, Xiuqiang Wu, Shengliang Zhou, Linxia Yi, Peiyao Zhang, Tianxin Xiang, Chaozhu He
{"title":"Time trends in the incidence of interstitial lung disease across Brazil, Russia, India, China and South Africa (BRICS) from 1990 to 2019: An age-period-cohort analysis.","authors":"Zhen Yang, Zhiqin Xie, Zequan Wang, Yunyu Du, Shihan Chen, Xiuqiang Wu, Shengliang Zhou, Linxia Yi, Peiyao Zhang, Tianxin Xiang, Chaozhu He","doi":"10.1111/resp.14785","DOIUrl":"https://doi.org/10.1111/resp.14785","url":null,"abstract":"<p><strong>Background and objective: </strong>The global incidence of interstitial lung disease (ILD) has risen over the past few decades. However, few studies have evaluated the status and incidence trends of ILD in Brazil, Russia, India, China and South Africa (BRICS). This study assesses the trends of ILD incidence across the BRICS with an emphasis on ILD changes from 1990 to 2019.</p><p><strong>Methods: </strong>Incidence rates were estimated by the data obtained from the Global Burden of Disease Study 2019 (GBD 2019). Age-period-cohort modelling was used to estimate the effects on ILD from 1990 to 2019, and the net drift and local drift were calculated.</p><p><strong>Results: </strong>In 2019, a total of 11.4 million cases of ILD were reported in the BRICS countries. From 1990 to 2019, the incidence rate of ILD in BRICS showed an upward trend. India consistently reported the highest incidence rate, while China showed the fastest growth rate (107.6%). Russia reported a similar incidence rates for men and women, with a lower age of peak incidence compared to the other four countries. We found the time effect was unfavourable for BRICS in the first decade, especially for Brazil; in China and Brazil, the risk of people born after 1960 has rapidly decreased.</p><p><strong>Conclusion: </strong>ILD shows a rising incidence in BRICS. with the trends varying based on age and other environmental factors. BRICS should strengthen specific public health approaches and policies for different stages and populations.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is remission the new target in asthma management? 缓解是哮喘治疗的新目标吗?
IF 6.6 2区 医学
Respirology Pub Date : 2024-06-27 DOI: 10.1111/resp.14783
Constance H Katelaris
{"title":"Is remission the new target in asthma management?","authors":"Constance H Katelaris","doi":"10.1111/resp.14783","DOIUrl":"https://doi.org/10.1111/resp.14783","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Computed tomography mucus plugs and airway tree structure in patients with chronic obstructive pulmonary disease: Associations with airflow limitation, health-related independence and mortality. 慢性阻塞性肺病患者的计算机断层扫描粘液栓和气道树结构:与气流受限、健康相关独立性和死亡率的关系。
IF 6.6 2区 医学
Respirology Pub Date : 2024-06-24 DOI: 10.1111/resp.14776
Naoya Tanabe, Kaoruko Shimizu, Hiroshi Shima, Nobuyasu Wakazono, Yusuke Shiraishi, Kunihiko Terada, Satoru Terada, Tsuyoshi Oguma, Ryo Sakamoto, Masaru Suzuki, Hironi Makita, Atsuyasu Sato, Susumu Sato, Masaharu Nishimura, Satoshi Konno, Toyohiro Hirai
{"title":"Computed tomography mucus plugs and airway tree structure in patients with chronic obstructive pulmonary disease: Associations with airflow limitation, health-related independence and mortality.","authors":"Naoya Tanabe, Kaoruko Shimizu, Hiroshi Shima, Nobuyasu Wakazono, Yusuke Shiraishi, Kunihiko Terada, Satoru Terada, Tsuyoshi Oguma, Ryo Sakamoto, Masaru Suzuki, Hironi Makita, Atsuyasu Sato, Susumu Sato, Masaharu Nishimura, Satoshi Konno, Toyohiro Hirai","doi":"10.1111/resp.14776","DOIUrl":"https://doi.org/10.1111/resp.14776","url":null,"abstract":"<p><strong>Background and objective: </strong>Mucus plugs and underlying airway tree structure can affect airflow limitation and prognosis in patients with chronic obstructive pulmonary disease (COPD), but their relative roles are unclear. This study used two COPD cohorts to examine whether mucus plugs on computed tomography (CT) were associated with airflow limitation and clinical outcomes independent of other airway structural changes and emphysema.</p><p><strong>Methods: </strong>Based on visual CT assessment, patients with mucus plugs in 0, 1-2 and ≥3 lung segments were assigned to no-, low- and high-mucus groups. Loss of health-related independence and mortality were prospectively recorded for 3 and 10 years in the Kyoto-Himeji and Hokkaido cohorts, respectively. The percentages of the wall area of the central airways (WA%), total airway count (TAC) and emphysema were quantified on CT.</p><p><strong>Results: </strong>Of 199 and 96 patients in the Kyoto-Himeji and Hokkaido cohorts, 34% and 30%, respectively, had high mucus scores. In both cohorts, TAC was lower in the high-mucus group than in the no-mucus group, whereas their emphysema severity did not differ. High mucus score and low TAC were independently associated with airflow limitation after adjustment for WA% and emphysema. In multivariable models adjusted for WA% and emphysema, TAC, rather than mucus score, was associated with a greater rate of loss of independence, whereas high mucus score, rather than TAC, was associated with increased mortality.</p><p><strong>Conclusion: </strong>Mucus plugs and lower airway branch count on CT had distinct roles in airflow limitation, health-related independence and mortality in patients with COPD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
First-in-human use of a new robotic electromagnetic navigation bronchoscopic platform with integrated Tool-in-Lesion Tomosynthesis (TiLT) technology for peripheral pulmonary lesions: The FRONTIER study. 首次在人体上使用新型机器人电磁导航支气管镜平台,该平台集成了Tool-in-Lesion Tomosynthesis(TiLT)技术,用于治疗外周肺部病变:FRONTIER 研究。
IF 6.6 2区 医学
Respirology Pub Date : 2024-06-24 DOI: 10.1111/resp.14778
Tajalli Saghaie, Jonathan P Williamson, Martin Phillips, Dona Kafili, Sarika Sundar, D Kyle Hogarth, Alvin Ing
{"title":"First-in-human use of a new robotic electromagnetic navigation bronchoscopic platform with integrated Tool-in-Lesion Tomosynthesis (TiLT) technology for peripheral pulmonary lesions: The FRONTIER study.","authors":"Tajalli Saghaie, Jonathan P Williamson, Martin Phillips, Dona Kafili, Sarika Sundar, D Kyle Hogarth, Alvin Ing","doi":"10.1111/resp.14778","DOIUrl":"https://doi.org/10.1111/resp.14778","url":null,"abstract":"<p><strong>Background and objective: </strong>As the presentation of pulmonary nodules increases, the importance of a safe and accurate method of sampling peripheral pulmonary nodules is highlighted. First-generation robotic bronchoscopy has successfully assisted navigation and improved peripheral reach during bronchoscopy. Integrating tool-in-lesion tomosynthesis (TiLT) may further improve yield.</p><p><strong>Methods: </strong>We performed a first-in-human clinical trial of a new robotic electromagnetic navigation bronchoscopy system with integrated digital tomosynthesis technology (Galaxy System, Noah Medical). Patients with moderate-risk peripheral pulmonary nodules were enrolled in the study. Robotic bronchoscopy was performed using electromagnetic navigation with TiLT-assisted lesion guidance. Non-specific results were followed up until either a clear diagnosis was achieved or repeat radiology at 6 months demonstrated stability.</p><p><strong>Results: </strong>Eighteen patients (19 nodules) were enrolled. The average lesion size was 20 mm, and the average distance from the pleura was 11.6 mm. The target was successfully reached in 100% of nodules, and the biopsy tool was visualized inside the target lesion in all cases. A confirmed specific diagnosis was achieved in 17 nodules, 13 of which were malignant. In one patient, radiological monitoring confirmed a true non-malignant result. This translates to a yield of 89.5% (strict) to 94.7% (intermediate). Complications included one pneumothorax requiring observation only and another requiring an overnight chest drain. There was one case of severe pneumonia following the procedure.</p><p><strong>Conclusion: </strong>In this first-in-human study, second-generation robotic bronchoscopy using electromagnetic navigation combined with integrated digital tomosynthesis was feasible with an acceptable safety profile and demonstrated a high diagnostic yield for small peripheral lung nodules.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Treatable traits and exacerbation risk in patients with uncontrolled asthma prescribed GINA step 1-3 treatment: A nationwide asthma cohort study. GINA 1-3 级治疗处方中未得到控制的哮喘患者的可治疗特征和病情恶化风险:一项全国性哮喘队列研究。
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-10 DOI: 10.1111/resp.14774
Jon R Konradsen, Stina Selberg, Maria Ödling, Johanna Karlsson Sundbaum, Apostolos Bossios, Caroline Stridsman
{"title":"Treatable traits and exacerbation risk in patients with uncontrolled asthma prescribed GINA step 1-3 treatment: A nationwide asthma cohort study.","authors":"Jon R Konradsen, Stina Selberg, Maria Ödling, Johanna Karlsson Sundbaum, Apostolos Bossios, Caroline Stridsman","doi":"10.1111/resp.14774","DOIUrl":"https://doi.org/10.1111/resp.14774","url":null,"abstract":"<p><strong>Background and objective: </strong>Uncontrolled asthma in patients treated for mild/moderate disease could be caused by non-pulmonary treatable traits (TTs) that affect asthma control negatively. We aimed to identify demographic characteristics, behavioural (smoking) and extrapulmonary (obesity, comorbidities) TTs and the risk for future exacerbations among patients with uncontrolled asthma prescribed step 1-3 treatment according to the Global Initiative for Asthma (GINA).</p><p><strong>Methods: </strong>Twenty-eight thousand five hundred eighty-four asthma patients (≥18 y) with a registration in the Swedish National Airway Register between 2017 and 2019 were included (index-date). The database was linked to other national registers to obtain information on prescribed drugs 2-years pre-index and exacerbations 1-year post-index. Asthma treatment was classified into step 1-3 or 4-5, and uncontrolled asthma was defined based on symptom control, exacerbations and lung function.</p><p><strong>Results: </strong>GINA step 1-3 included 17,318 patients, of which 9586 (55%) were uncontrolled (UCA 1-3). In adjusted analyses, UCA 1-3 was associated with female sex (OR 1.34, 95% CI 1.27-1.41), older age (1.00, 1.00-1.00), primary education (1.30, 1.20-1.40) and secondary education (1.19, 1.12-1.26), and TTs such as smoking (1.25, 1.15-1.36), obesity (1.23, 1.15-1.32), cardiovascular disease (1.12, 1.06-1.20) and depression/anxiety (1.13, 1.06-1.21). Furthermore, UCA 1-3 was associated with future exacerbations; oral corticosteroids (1.90, 1.74-2.09) and asthma hospitalization (2.55, 2.17-3.00), respectively, also when adjusted for treatment step 4-5.</p><p><strong>Conclusion: </strong>Over 50% of patients treated for mild/moderate asthma had an uncontrolled disease. Assessing and managing of TTs such as smoking, obesity and comorbidities should be conducted in a holistic manner, as these patients have an increased risk for future exacerbations.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sustained remission induced by 2 years of treatment with benralizumab in patients with severe eosinophilic asthma and nasal polyposis. 嗜酸性粒细胞严重哮喘和鼻息肉患者接受苯拉利珠单抗治疗两年后病情持续缓解。
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-07 DOI: 10.1111/resp.14767
Corrado Pelaia, Claudia Crimi, Alida Benfante, Maria Filomena Caiaffa, Raffaele Campisi, Claudio Candia, Giovanna Elisiana Carpagnano, Isabella Carrieri, Maria D'Amato, Aikaterini Detoraki, Maria Pia Foschino Barbaro, Nicola Lombardo, Luigi Macchia, Angelantonio Maglio, Elena Minenna, Santi Nolasco, Giuseppe Paglino, Francesco Papia, Luisa Ricciardi, Nicola Scichilone, Giulia Scioscia, Giuseppe Spadaro, Pasquale Tondo, Simona Uletta Lionetti, Giuseppe Valenti, Alessandro Vatrella, Nunzio Crimi, Girolamo Pelaia
{"title":"Sustained remission induced by 2 years of treatment with benralizumab in patients with severe eosinophilic asthma and nasal polyposis.","authors":"Corrado Pelaia, Claudia Crimi, Alida Benfante, Maria Filomena Caiaffa, Raffaele Campisi, Claudio Candia, Giovanna Elisiana Carpagnano, Isabella Carrieri, Maria D'Amato, Aikaterini Detoraki, Maria Pia Foschino Barbaro, Nicola Lombardo, Luigi Macchia, Angelantonio Maglio, Elena Minenna, Santi Nolasco, Giuseppe Paglino, Francesco Papia, Luisa Ricciardi, Nicola Scichilone, Giulia Scioscia, Giuseppe Spadaro, Pasquale Tondo, Simona Uletta Lionetti, Giuseppe Valenti, Alessandro Vatrella, Nunzio Crimi, Girolamo Pelaia","doi":"10.1111/resp.14767","DOIUrl":"https://doi.org/10.1111/resp.14767","url":null,"abstract":"<p><strong>Background and objective: </strong>Several randomized controlled trials (RCTs) have shown that benralizumab is characterized by a good profile of efficacy and safety, thereby being potentially able to elicit clinical remission on-treatment of severe eosinophilic asthma (SEA). The main goal of this multicentre observational study was to verify the effectiveness of benralizumab in inducing a sustained remission on-treatment of SEA in patients with or without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>Throughout 2 years of treatment with benralizumab, a four-component evaluation of sustained remission of SEA was performed, including the assessment of SEA exacerbations, use of oral corticosteroids (OCSs), symptom control and lung function.</p><p><strong>Results: </strong>The present study recruited 164 patients suffering from SEA. After 24 months of add-on biological therapy with benralizumab, 69 (42.1%) achieved the important target of sustained remission on-treatment (exacerbation rate = 0, OCS dose = 0, pre-bronchodilator FEV<sub>1</sub> ≥80% pred., ACT score ≥ 20). During the same period, a persistent improvement of CRSwNP (SNOT-22 < 30, NP recurrence = 0) was observed in 33 (40.2%) out of 82 subjects with concomitant NP. The latter comorbidity and post-bronchodilator reversibility of airflow limitation were two independent predictors of sustained remission on-treatment (OR = 2.32, p < 0.05 and OR = 5.59, p < 0.01, respectively).</p><p><strong>Conclusion: </strong>Taken together, the results of this real-life clinical investigation indicate that benralizumab can induce a sustained remission on-treatment of SEA, especially in those patients with comorbid CRSwNP and reversible airflow limitation.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of spirometry to detect airflow obstruction. 使用肺活量检测气流阻塞。
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-01 Epub Date: 2024-03-04 DOI: 10.1111/resp.14699
Chi Chiu Leung
{"title":"Use of spirometry to detect airflow obstruction.","authors":"Chi Chiu Leung","doi":"10.1111/resp.14699","DOIUrl":"10.1111/resp.14699","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing exercise tolerance in interstitial lung disease with high-flow nasal cannula oxygen therapy: A randomized crossover trial. 通过高流量鼻插管氧气疗法提高间质性肺病患者的运动耐受性:随机交叉试验
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-01 Epub Date: 2024-02-22 DOI: 10.1111/resp.14684
Yorihide Yanagita, Shinichi Arizono, Koshi Yokomura, Kumiko Ito, Hikaru Machiguchi, Yuichi Tawara, Norimasa Katagiri, Yuki Iida, Eiji Nakatani, Takako Tanaka, Ryo Kozu
{"title":"Enhancing exercise tolerance in interstitial lung disease with high-flow nasal cannula oxygen therapy: A randomized crossover trial.","authors":"Yorihide Yanagita, Shinichi Arizono, Koshi Yokomura, Kumiko Ito, Hikaru Machiguchi, Yuichi Tawara, Norimasa Katagiri, Yuki Iida, Eiji Nakatani, Takako Tanaka, Ryo Kozu","doi":"10.1111/resp.14684","DOIUrl":"10.1111/resp.14684","url":null,"abstract":"<p><strong>Background and objective: </strong>Interstitial lung disease (ILD) is characterized by dyspnoea on exertion and exercise-induced hypoxaemia. High-flow nasal cannula (HFNC) therapy reduces the respiratory workload through higher gas flow and oxygen supplementation, which may affect exercise tolerance. This study aimed to examine the effects of oxygen and gas flow rates through HFNC therapy on exercise tolerance in ILD patients.</p><p><strong>Methods: </strong>We conducted three-treatment crossover study. All ILD patients performed the exercises on room air (ROOM AIR setting: flow, 0 L/min; fraction of inspired oxygen [FiO<sub>2</sub>], 0.21), HFNC (FLOW setting: flow 40 L/min, FiO<sub>2</sub> 0.21), and HFNC with oxygen supplementation (FLOW + OXYGEN setting: flow 40 L/min, FiO<sub>2</sub> 0.6). The primary endpoint was the endurance time, measured using constant-load cycle ergometry exercise testing at a peak work rate of 80%.</p><p><strong>Results: </strong>Twenty-five participants (10 men, 71.2 ± 6.7 years) were enrolled. The increase in exercise duration between the ROOM AIR and FLOW was 46.3 s (95% CI, -6.1 to 98.7; p = 0.083), and the FLOW and FLOW + OXYGEN was 91.5 s (39.1-143.9; p < 0.001). The percutaneous oxygen saturation (SpO<sub>2</sub>) at rest was significantly higher with the FLOW + OXYGEN setting than with the ROOM AIR and FLOW settings, and the difference persisted during exercise. At equivalent time points during exercise, the SpO<sub>2</sub> with the FLOW setting was significantly higher than that with the ROOM AIR setting.</p><p><strong>Conclusion: </strong>Oxygen supplementation in HFNC therapy improved exercise tolerance and SpO<sub>2</sub>. We found that gas flow alone did not improve exercise tolerance, but improved SpO<sub>2</sub> during exercise.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Low bleeding rates following transbronchial lung cryobiopsy in unclassifiable interstitial lung disease. 对无法分类的间质性肺病进行经支气管肺冷冻活组织检查后出血率低。
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-01 Epub Date: 2024-02-14 DOI: 10.1111/resp.14678
John Taverner, Carmen M Lucena, Justin L Garner, Christopher M Orton, Andrew G Nicholson, Sujal R Desai, Athol U Wells, Pallav L Shah
{"title":"Low bleeding rates following transbronchial lung cryobiopsy in unclassifiable interstitial lung disease.","authors":"John Taverner, Carmen M Lucena, Justin L Garner, Christopher M Orton, Andrew G Nicholson, Sujal R Desai, Athol U Wells, Pallav L Shah","doi":"10.1111/resp.14678","DOIUrl":"10.1111/resp.14678","url":null,"abstract":"<p><strong>Background and objective: </strong>Bronchoscopic transbronchial lung cryobiopsy (TBLC) is a guideline-endorsed alternative to surgical lung biopsy for tissue diagnosis in unclassifiable interstitial lung disease (ILD). The reported incidence of post-procedural bleeding has varied widely. We aimed to characterize the incidence, severity and risk factors for clinically significant bleeding following TBLC using an expert-consensus airway bleeding scale, in addition to other complications and diagnostic yield.</p><p><strong>Methods: </strong>A retrospective cohort study of consecutive adult outpatients with unclassifiable ILD who underwent TBLC following multidisciplinary discussion at a single centre in the UK between July 2016 and December 2021. TBLC was performed under general anaesthesia with fluoroscopic guidance and a prophylactic endobronchial balloon.</p><p><strong>Results: </strong>One hundred twenty-six patients underwent TBLC (68.3% male; mean age 62.7 years; FVC 86.2%; DLCO 54.5%). Significant bleeding requiring balloon blocker reinflation for >20 min, admission to ICU, packed red blood cell transfusion, bronchial artery embolization, resuscitation or procedural abandonment, occurred in 10 cases (7.9%). Significant bleeding was associated with traction bronchiectasis on HRCT (OR 7.1, CI 1.1-59.1, p = 0.042), a TBLC histological pattern of UIP (OR 4.0, CI 1.1-14, p = 0.046) and the presence of medium-large vessels on histology (OR 37.3, CI 6.5-212, p < 0.001). BMI ≥30 (p = 0.017) and traction bronchiectasis on HRCT (p = 0.025) were significant multivariate predictors of longer total bleeding time (p = 0.017). Pneumothorax occurred in nine cases (7.1%) and the 30-day mortality was 0%. Diagnostic yield was 80.6%.</p><p><strong>Conclusion: </strong>TBLC has an acceptable safety profile in experienced hands. Radiological traction bronchiectasis and obesity increase the risk of significant bleeding following TBLC.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapeutic bronchoscopy for malignant central airway obstruction: Introduction to the EpiGETIF registry. 恶性中央气道阻塞的治疗性支气管镜检查:EpiGETIF 登记简介。
IF 6.9 2区 医学
Respirology Pub Date : 2024-06-01 Epub Date: 2024-03-03 DOI: 10.1111/resp.14697
Nicolas Guibert, Pascalin Roy, Lyria Amari, Julien Legodec, Bruno Escarguel, Clément Fournier, Frederic Wallyn, Laurent Cellerin, Christine Lorut, Daniela Usturoi, Thomas Egenod, Nicolas Favrolt, Pascal Schlossmacher, Valerian Bourinet, Perrot Loïc, Samy Lachkar, Juliette Camuset, Amandine Briault, Romain Kessler, Christophe Gut-Gobert, Gilles Mangiapan, Nicolas Carnot, Eric Briens, Adrian Crutu, Armelle Marceau, Bénédicte Toublanc, Gaëtan Deslée, Maxime Dewolf, Julien Dutilh, Julie Tronchetti, Philippe Astoul, Jean-Michel Vergnon, Hervé Dutau
{"title":"Therapeutic bronchoscopy for malignant central airway obstruction: Introduction to the EpiGETIF registry.","authors":"Nicolas Guibert, Pascalin Roy, Lyria Amari, Julien Legodec, Bruno Escarguel, Clément Fournier, Frederic Wallyn, Laurent Cellerin, Christine Lorut, Daniela Usturoi, Thomas Egenod, Nicolas Favrolt, Pascal Schlossmacher, Valerian Bourinet, Perrot Loïc, Samy Lachkar, Juliette Camuset, Amandine Briault, Romain Kessler, Christophe Gut-Gobert, Gilles Mangiapan, Nicolas Carnot, Eric Briens, Adrian Crutu, Armelle Marceau, Bénédicte Toublanc, Gaëtan Deslée, Maxime Dewolf, Julien Dutilh, Julie Tronchetti, Philippe Astoul, Jean-Michel Vergnon, Hervé Dutau","doi":"10.1111/resp.14697","DOIUrl":"10.1111/resp.14697","url":null,"abstract":"<p><strong>Background and objective: </strong>EpiGETIF is a web-based, multicentre clinical database created in 2019 aiming for prospective collection of data regarding therapeutic rigid bronchoscopy (TB) for malignant central airway obstruction (MCAO).</p><p><strong>Methods: </strong>Patients were enrolled into the registry from January 2019 to November 2022. Data were prospectively entered through a web-interface, using standardized definitions for each item. The objective of this first extraction of data was to describe the population and the techniques used among the included centres to target, facilitate and encourage further studies in TB.</p><p><strong>Results: </strong>Overall, 2118 patients from 36 centres were included. Patients were on average 63.7 years old, mostly male and smokers. Most patients had a WHO score ≤2 (70.2%) and 39.6% required preoperative oxygen support, including mechanical ventilation in 6.7%. 62.4% had an already known histologic diagnosis but only 46.3% had received any oncologic treatment. Most tumours were bronchogenic (60.6%), causing mainly intrinsic or mixed obstruction (43.3% and 41.5%, respectively). Mechanical debulking was the most frequent technique (67.3%), while laser (9.8%) and cryo-recanalization (2.7%) use depended on local expertise. Stenting was required in 54.7%, silicone being the main type of stent used (55.3%). 96.3% of procedure results were considered at least partially successful, resulting in a mean 4.1 points decrease on the Borg scale of dyspnoea. Complications were noted in 10.9%.</p><p><strong>Conclusion: </strong>This study exposes a high volume of TB that could represent a good source of future studies given the dismal amount of data about the effects of TB in certain populations and situations.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140022540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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