Respirology最新文献

{"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":"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":"970-978"},"PeriodicalIF":6.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486357/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clean Sweep or Just a Wash? What BAL Lymphocytes Really Say About Steroid Outcomes in ILD.","authors":"Jasmine Vakhshoorzadeh, Daniel J Kass","doi":"10.1111/resp.70129","DOIUrl":"https://doi.org/10.1111/resp.70129","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081399","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":"Pathological Endotypic Traits of Paediatric Obstructive Sleep Apnea: Age and Sex Differences.","authors":"Chien-Heng Lin, Liang-Wen Hang, Eysteinn Finnsson, Jón S Ágústsson, Scott A Sands, Wan-Ju Cheng","doi":"10.1111/resp.70128","DOIUrl":"https://doi.org/10.1111/resp.70128","url":null,"abstract":"<p><strong>Background and objective: </strong>Paediatric obstructive sleep apnea (OSA) has a distinct pathophysiology and management from that of adults, yet endotypic traits in this population remain underreported. Understanding how these traits vary by age and sex could provide insights into respiratory system development. This study aims to examine the association of age and sex with endotypic traits in children and adolescents with OSA.</p><p><strong>Methods: </strong>Between April 2020 and September 2024, we prospectively enrolled 88 patients aged ≤ 18 years who were referred to a single clinical sleep center in Taiwan for in-laboratory diagnostic polysomnography. Patients with an apnea-hypopnea index (AHI) ≥ 1 h^-1 were included. Endotypic traits were estimated using polysomnographic signals. Linear regression analysis was performed to assess the associations of endotypic traits with AHI, age, and sex.</p><p><strong>Results: </strong>Poor compensation, worse collapsibility, and high loop gain were associated with higher AHI, with compensation explaining the largest variance (12.85%) among all endotypic traits. Patients older than 12 years exhibited a more compromised upper airway (V_min: 64.3 vs. 71.4% eupnea) and higher loop gain (LG₁: 0.45 vs. 0.34) than younger patients, independent of AHI. No significant sex differences in endotypic traits were observed.</p><p><strong>Conclusions: </strong>In addition to upper airway collapsibility, inadequate compensatory activity of the dilator muscles significantly contributed to higher AHI in paediatric patients with OSA. The age-related decrease in upper airway patency may result from the interplay between upper airway and craniofacial development.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041197","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":"Letter From the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD)-Navigating Reform: South Korea's Healthcare System at a Crossroads.","authors":"So Ri Kim, Moo Suk Park","doi":"10.1111/resp.70130","DOIUrl":"https://doi.org/10.1111/resp.70130","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030562","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 Association Between Use of Inhaled Corticosteroids and Long-Acting Beta2-Agonists During Pregnancy and Adverse Fetal Outcomes.","authors":"Yea-Chwen Wu, I-Te Wang, Hsin-Yi Huang, Chung-Hsuen Wu","doi":"10.1111/resp.70124","DOIUrl":"https://doi.org/10.1111/resp.70124","url":null,"abstract":"<p><strong>Background and objective: </strong>Women with asthma should continue controller therapy during pregnancy, but current evidence on the effects of inhaled corticosteroids (ICS) and long-acting beta2-agonists (LABA) on adverse fetal outcomes remains unclear.</p><p><strong>Methods: </strong>This was a population-based retrospective cohort study. Data were derived from the Health and Welfare Database, Birth Certificate Application, and Maternal and Child Health Database in Taiwan, from January 1, 2007 to December 31, 2018. Pregnant women with asthma were enrolled. Three independent variables included ICS use, ICS dose-response effects, and LABA use during pregnancy. Adverse fetal outcomes included low birth weight, small for gestational age, preterm birth, and congenital anomalies. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for confounders, including sociodemographics, comorbidities, comedications, and asthma severity. Logistic regression models were used to calculate adjusted odds ratios (aORs).</p><p><strong>Results: </strong>There were 4538 pregnant women with asthma enrolled in this study. After adjustment, neither ICS nor LABA use was significantly associated with any adverse fetal outcomes. However, among women exposed to ICS, high-dose ICS use during pregnancy was associated with a significantly higher risk of congenital anomalies (aOR: 3.87; 95% CI: 1.29-11.60) within 1 year of delivery.</p><p><strong>Conclusions: </strong>ICS or LABA use during pregnancy was not associated with the risk of adverse fetal outcomes. Pregnant women with asthma should be advised to maintain controller therapy and avoid potential allergens to reduce the need for high-dose ICS.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024161","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":"Prediction of Pulmonary Ground-Glass Nodule Progression State on Initial Screening CT Using a Radiomics-Based Model.","authors":"Liang Jin, Zhongsheng Liu, Yingli Sun, Pan Gao, Zhuangxuan Ma, Haoyi Ye, Zhifeng Liu, Xue Dong, Yunbao Sun, Jun Han, Lei Lv, Dongwei Guan, Ming Li","doi":"10.1111/resp.70115","DOIUrl":"https://doi.org/10.1111/resp.70115","url":null,"abstract":"<p><strong>Background and objective: </strong>Diagnosing pulmonary ground-glass nodules (GGNs) on chest CT imaging remains challenging in clinical practice. Moreover, different stages of GGNs may require different clinical treatments. Hence, we sought to predict the progressive state of pulmonary GGNs (absorption or persistence) for accurate clinical treatment and decision-making.</p><p><strong>Methods: </strong>We retrospectively enrolled 672 patients (absorption group: 299; control group: 373) from two medical centres from January 2017 to March 2023. Clinical information and radiomic features extracted from regions of interest of all patients on chest CT imaging were collected. All patients were randomly divided into training and test sets at a ratio of 7:3. Three models were constructed-Rad-score (Model 1), clinical factor (Model 2), and clinical factors and Rad-score (Model 3)-to identify GGN progression. In the test dataset, two radiologists (with over 8 years of experience in chest imaging) evaluated the models' performance. Receiver operating characteristic curves, accuracy, sensitivity, and specificity were analysed.</p><p><strong>Results: </strong>In the test set, the area under the curve (AUC) of Model 1 and Model 2 was 0.907 [0.868-0.946] and 0.918 [0.88-0.955], respectively. Model 3 achieved the best predictive performance, with an AUC of 0.959 [0.936-0.982], an accuracy of 0.881, a sensitivity of 0.902, and a specificity of 0.856. The intraclass correlation coefficient of Model 3 (0.86) showed better performance than radiologists (0.83 and 0.71).</p><p><strong>Conclusion: </strong>We developed and validated a radiomics-based machine-learning method that achieved good performance in predicting the progressive state of GGNs on initial computed tomography. The model may improve follow-up management of GGNs.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016128","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":"'Physician, Heal Thyself'? Personal, Professional, and Systemic Strategies.","authors":"Mark Lavercombe","doi":"10.1111/resp.70127","DOIUrl":"https://doi.org/10.1111/resp.70127","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001444","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":"Letter From the Hong Kong Thoracic Society.","authors":"King-Pui Florence Chan, Macy Mei-Sze Lui","doi":"10.1111/resp.70123","DOIUrl":"https://doi.org/10.1111/resp.70123","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993471","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":"Rebranding COPD Care and Research in the 21st Century.","authors":"Joan B Soriano, Mona Bafadhel, Christine R Jenkins","doi":"10.1111/resp.70118","DOIUrl":"10.1111/resp.70118","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966900","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":"Race-Neutral Reference Values for Improved Mortality Risk Prediction in COPD.","authors":"Triya Damayanti, Wiwien Heru Wiyono","doi":"10.1111/resp.70079","DOIUrl":"10.1111/resp.70079","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"792-793"},"PeriodicalIF":6.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302786","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}