Respirology最新文献

{"title":"Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique ('Essen Tunnel') for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions.","authors":"Erik Büscher, Faustina Funke, Jane Winantea, Hanna Zellerhoff, Johannes Wienker, Marcel Opitz, Christian Taube, Kaid Darwiche","doi":"10.1111/resp.70053","DOIUrl":"https://doi.org/10.1111/resp.70053","url":null,"abstract":"<p><strong>Background and objective: </strong>Diagnosing intraparenchymal pulmonary lesions lacking a bronchus sign remains challenging. Bronchoscopic transparenchymal nodule access (BTPNA) for reaching such lesions has seen limited clinical adoption due to insufficient evidence and practical challenges. This study evaluates the feasibility and diagnostic yield of a modified BTPNA (mBTPNA) technique-referred to as the 'Essen tunnel'-which eliminates the need for a guide sheath.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients undergoing virtual bronchoscopic navigation (VBN) incorporating the mBTPNA technique at our centre, from December 2019 to March 2024. The 'Essen tunnel' was created by a needle under virtual navigation guidance, enabling direct insertion of an ultrathin bronchoscope (UTB) or radial endobronchial ultrasound (R-EBUS) probe to biopsy intraparechymal lesions.</p><p><strong>Results: </strong>Among 266 lesions targeted via VBN, 37 (14%) intraparenchymal lesions (mean target length: 12.7 ± 4.1 mm) were accessed using mBTPNA. The tunnel was successfully created in 97.3% of cases with UTB intubation in 51.4%. R-EBUS was inserted into the tunnel in 83.8% of cases. Semicircular to circular patterns (SCP) were detected in 19.4% before and 61.3% after tunnel creation (p < 0.01). SCP presence on R-EBUS following mBTPNA was associated with a diagnostic accuracy of 66.7%, comparable to that observed in non-tunnel lesions exhibiting a bronchus sign (72.9%, p = 0.58). No severe complications were observed.</p><p><strong>Conclusion: </strong>The mBTPNA technique is a feasible and safe method that enhances endosonographic lesion detection and achieves promising diagnostic accuracy for challenging intraparenchymal lesions.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111832","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}

{"title":"World Bronchiectasis 2025-Inclusive Lungs, Diverse Solutions.","authors":"Rachel Mary Thomson, Lucy Catriona Morgan","doi":"10.1111/resp.70063","DOIUrl":"https://doi.org/10.1111/resp.70063","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110848","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}

{"title":"High Flow Nasal Oxygen and Low Flow Oxygen Are Equally Effective in Providing Oxygenation During Bronchoscopy Under Conscious Sedation: A Randomised Controlled Trial.","authors":"Georgia Burton, Paul Kelly, Brooke Carroll, Chris Frampton, Lutz Beckert","doi":"10.1111/resp.70051","DOIUrl":"https://doi.org/10.1111/resp.70051","url":null,"abstract":"<p><strong>Background and objective: </strong>Oxygen desaturations and hypoxaemia are common during bronchoscopy despite the use of conventional low flow oxygen (LFO). Some researchers suggest high flow nasal oxygen (HFNO) may improve oxygenation in patients undergoing bronchoscopy; however, trials have varied widely in their methodology and patient population. Evidence of use in a broad patient cohort and assessment of other important considerations, including clinician/patient satisfaction, is lacking. We hypothesised that HFNO during bronchoscopy and EBUS would reduce desaturations/hypoxaemia, oxygen titrations, respiratory rate, and cough frequency when compared to LFO. We also explored clinician and patient satisfaction.</p><p><strong>Methods: </strong>Participants undergoing diagnostic bronchoscopy or EBUS with conscious sedation were randomised to receive LFO or HFNO. Data was collected via physiological monitoring devices, health records, and clinician/patient questions. The primary outcome was time spent with SpO₂ < 90%.</p><p><strong>Results: </strong>A total of 121 participants were included. There was no difference in oxygenation and desaturations between LFO (n = 61) and HFNO (n = 60) in all procedures. This was also observed within the separate strata of bronchoscopy (n = 75) and EBUS (n = 46). HFNO reduced the respiratory rate in EBUS procedures (p < 0.05). The clinician satisfaction score was higher with HFNO in bronchoscopy procedures (p < 0.05). The requirement for oxygen titrations was lower with HFNO, but this did not reach statistical significance. There was no difference in cough frequency.</p><p><strong>Conclusion: </strong>LFO and HFNO were equally effective in maintaining oxygenation during bronchoscopy and EBUS in our population. HFNO had higher clinician satisfaction during bronchoscopy and may have a physiological advantage during EBUS as demonstrated by a lower respiratory rate.</p><p><strong>Trial registration: </strong>ANZCTRN12623001262695.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111834","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}

{"title":"Impact of Pulmonary Artery Pressure on the Response to Oxygen Administration for Exertional Desaturation in Interstitial Lung Disease.","authors":"Jun Hirasawa, Ryo Teramachi, Jun Fukihara, Fumiko Watanabe, Tomoya Ogawa, Reoto Takei, Yasuhiko Yamano, Kensuke Kataoka, Kazuaki Soejima, Tomoki Kimura, Yasuhiro Kondoh","doi":"10.1111/resp.70032","DOIUrl":"https://doi.org/10.1111/resp.70032","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with interstitial lung disease (ILD) often experience exertional desaturation even without resting hypoxemia, resulting in limited exercise capacity. While oxygen administration can extend exercise time in a majority of patients with ILD, the factors determining the oxygen effects are unclear. We aimed to investigate the clinical significance of respiratory and pulmonary haemodynamic parameters for the oxygen effects on exercise time in patients with ILD.</p><p><strong>Methods: </strong>We retrospectively analysed patients with ILD who underwent comprehensive evaluation including right heart catheterisation from 2017 to 2021. Patients were divided into oxygen responders, defined as an improvement of at least 100 s or 33% in exercise time with oxygen supplementation compared with medical air inhalation, and non-responders. Univariate and multivariate logistic regression analyses were conducted to evaluate significant factors for oxygen responders.</p><p><strong>Results: </strong>Among 86 patients, 50 (58.1%) were oxygen responders. Pulmonary functional tests and ventilation parameters at cardiopulmonary exercise testing were similar between the groups. Mean pulmonary arterial pressure (mPAP) (21 mmHg vs. 19 mmHg, p = 0.049) was higher in oxygen responders. Univariate logistic analysis demonstrated that the ILD-Gender-Age-Physiology index, mPAP, 6-min walking distance, peak work rate, and lowest ventilatory equivalent for carbon dioxide were significant variables for oxygen effects on exercise time. Multivariate analysis demonstrated that elevated mPAP was independently associated with the oxygen effects on exercise time.</p><p><strong>Conclusion: </strong>Approximately 60% of the patients with ILD who experienced exertional desaturation without resting hypoxemia were oxygen responders. mPAP was associated with the oxygen effects on exercise time.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111865","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}

{"title":"Video Killed the Radio Star.","authors":"Philip G Bardin","doi":"10.1111/resp.70064","DOIUrl":"https://doi.org/10.1111/resp.70064","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094898","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}

{"title":"Aetiology of Adult Community-Acquired Lung Abscess in Hong Kong.","authors":"Wai Cho Yu, Man Ying Ho, Ellen Lok-Man Yu, Carmen Li, Cindy Tse, Ka Pang Chan, Pik Shan Cheung, Kit Man Sin, Wai Man Johnny Chan, David Chi Leung Lam, Kah Lin Choo, Chi Kai Chow, Yu Hong Chan, Ming Chiu Chan, Kin Keung Kwong, Margaret Ip","doi":"10.1111/resp.70050","DOIUrl":"https://doi.org/10.1111/resp.70050","url":null,"abstract":"<p><strong>Background and objective: </strong>Knowing the pattern of pathogens in community-acquired lung abscess (CALA) is important in the choice of initial empiric antibiotics. Early studies established the anaerobes as the predominant pathogen, followed by aerobic streptococci and aerobic Gram-negative bacilli. However, recent reports indicated that Klebsiella pneumoniae and aerobic streptococci predominated.</p><p><strong>Methods: </strong>We performed a retrospective study on CALA cases from all public hospitals in Hong Kong over a nine-year period. Only cases with uncontaminated specimens sent for bacterial culture were included. Cases caused by mycobacteria and fungi were excluded.</p><p><strong>Results: </strong>There were 606 eligible subjects-episodes. Mean age of subjects was 57.7 years and male to female ratio was 3.3:1. Two hundred and thirty-two subjects had at least one positive bacterial culture, with a total of 338 pathogens isolated. Anaerobes were the predominant pathogen group with 103 isolates (30.5% of total). This was followed by aerobic streptococci (90, 26.6%), aerobic Gram-negative bacilli (67, 19.8%), and Staphylococcus aureus (56, 16.6%). Isolation of Staphylococcus aureus was closely linked to intravenous drug abuse, while isolation of Klebsiella pneumoniae (28 cases) was related to extrapulmonary abscesses, particularly of the liver. There were 14 cases of Pseudomonas aeruginosa with underlying chronic lung disease and major organ failure being risk factors.</p><p><strong>Conclusion: </strong>Anaerobes and aerobic streptococci appear to be the major pathogens for primary CALA. Secondary lung abscess caused by haematogenous spread is commonly attributable to Staphylococcus aureus or Klebsiella pneumoniae. Choice of empiric antibiotics should take these into consideration together with local patterns of antibiotic resistance.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094785","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}

{"title":"Understanding Nontuberculous Mycobacterial Pulmonary Disease as a Chronic Lung Disease.","authors":"Hyung-Jun Kim, Jae-Joon Yim","doi":"10.1111/resp.70059","DOIUrl":"https://doi.org/10.1111/resp.70059","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079967","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}

{"title":"Obstructive Sleep Apnoea Screening and Diagnosis Across Adult Populations: Are We Ready?","authors":"Nur K Abdul Jafar, Darren R Mansfield","doi":"10.1111/resp.70058","DOIUrl":"https://doi.org/10.1111/resp.70058","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079962","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}

{"title":"A Global Achievement: Introducing the Inducible Laryngeal Dysfunction/Vocal Cord Dysfunction Toolkit-A Free Global, Peer-Reviewed Clinical Resource.","authors":"Paul Leong, Vanessa L Clark, Peter G Gibson, Vanessa M McDonald, Philip G Bardin","doi":"10.1111/resp.70055","DOIUrl":"https://doi.org/10.1111/resp.70055","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031005","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}

{"title":"The High Burden of Asthma Readmission Among Australian Children: A Population-Based Cohort Study.","authors":"Md Mahbubur Rashid, Nan Hu, Jahidur Rahman Khan, Mei Chan, Melinda Gray, Louisa Owens, Adam Jaffe, Nusrat Homaira","doi":"10.1111/resp.70049","DOIUrl":"https://doi.org/10.1111/resp.70049","url":null,"abstract":"<p><strong>Background and objective: </strong>Worldwide, up to 40% of all asthma hospitalisations are due to repeat admissions. This study aimed to estimate the burden of asthma readmission among children aged 2 to 17 years in New South Wales (NSW), Australia.</p><p><strong>Methods: </strong>A retrospective longitudinal whole-of-population-based cohort study was conducted using linked administrative data. Children born in NSW from 2005 to 2015 having at least one asthma hospitalisation after the age of 2 years were included in the study and followed up for 12 months from the asthma index hospitalisation. The incidence rates for asthma first readmission within 12 months and associated direct medical costs were calculated.</p><p><strong>Results: </strong>During 2007-2022, 48,217 asthma hospitalisations occurred in children, with 28,177 children hospitalised for asthma as a primary diagnosis identified as asthma index hospitalisations. Among them, 21.6% experienced first asthma readmissions within 12 months, including over 80% from the 2-4 years age group and a significant proportion from socioeconomically disadvantaged areas. The overall incidence rate of first asthma readmission was 23.8 per 100 person-years and 28.7 per 100 person-years for children aged 2-4 years. The highest incidence rate (38.3 per 1000 person-months) occurred within 1 month. The total direct medical cost of the first asthma readmission within 12 months was AU$ 15.6 million.</p><p><strong>Conclusion: </strong>Our study suggests that pre-school children have the highest rate of asthma readmission, with a significant economic burden highlighting the need for identifying modifiable factors such as asthma management after discharge to reduce the burden of asthma hospital readmission in children.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032204","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}