RespirologyPub Date : 2024-09-01Epub Date: 2024-07-14DOI: 10.1111/resp.14792
Christine F McDonald, Philip G Bardin, Martin MacDonald
{"title":"Asthma-COPD overlap and asthma progressing to COPD: A complementary perspective.","authors":"Christine F McDonald, Philip G Bardin, Martin MacDonald","doi":"10.1111/resp.14792","DOIUrl":"10.1111/resp.14792","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617051","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}
RespirologyPub Date : 2024-09-01Epub Date: 2024-07-15DOI: 10.1111/resp.14793
Christine F McDonald, John Serginson, Saad AlShareef, Catherine Buchan, Huw Davies, Belinda R Miller, Maitri Munsif, Natasha Smallwood, Lauren Troy, Yet Hong Khor
{"title":"Thoracic Society of Australia and New Zealand clinical practice guideline on adult home oxygen therapy.","authors":"Christine F McDonald, John Serginson, Saad AlShareef, Catherine Buchan, Huw Davies, Belinda R Miller, Maitri Munsif, Natasha Smallwood, Lauren Troy, Yet Hong Khor","doi":"10.1111/resp.14793","DOIUrl":"10.1111/resp.14793","url":null,"abstract":"<p><p>This Thoracic Society of Australia and New Zealand Guideline on the provision of home oxygen therapy in adults updates a previous Guideline from 2015. The Guideline is based upon a systematic review and meta-analysis of literature to September 2022 and the strength of recommendations is based on GRADE methodology. Long-term oxygen therapy (LTOT) is recommended for its mortality benefit for patients with COPD and other chronic respiratory diseases who have consistent evidence of significant hypoxaemia at rest (PaO2 ≤ 55 mm Hg or PaO2 ≤59 mm Hg in the presence of hypoxaemic sequalae) while in a stable state. Evidence does not support the use of LTOT for patients with COPD who have moderate hypoxaemia or isolated nocturnal hypoxaemia. In the absence of hypoxaemia, there is no evidence that oxygen provides greater palliation of breathlessness than air. Evidence does not support the use of supplemental oxygen therapy during pulmonary rehabilitation in those with COPD and exertional desaturation but normal resting arterial blood gases. Both positive and negative effects of LTOT have been described, including on quality of life. Education about how and when to use oxygen therapy in order to maximize its benefits, including the use of different delivery devices, expectations and limitations of therapy and information about hazards and risks associated with its use are key when embarking upon this treatment.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620865","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}
RespirologyPub Date : 2024-08-29DOI: 10.1111/resp.14821
Rodrigo Torres-Castro, Williams Hinojosa, Amaya Martínez-Meñaca, Ernest Sala Llinas, Josefa Jiménez Arjona, Joaquín Rueda Soriano, Agueda Aurtenetxe, Joan Albert Barberà, Pilar Escribano-Subías, Isabel Blanco
{"title":"Epidemiology of supplemental oxygen in patients with pulmonary hypertension.","authors":"Rodrigo Torres-Castro, Williams Hinojosa, Amaya Martínez-Meñaca, Ernest Sala Llinas, Josefa Jiménez Arjona, Joaquín Rueda Soriano, Agueda Aurtenetxe, Joan Albert Barberà, Pilar Escribano-Subías, Isabel Blanco","doi":"10.1111/resp.14821","DOIUrl":"https://doi.org/10.1111/resp.14821","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients with pulmonary hypertension (PH) may present with hypoxaemia at rest or during daily activities. There is no epidemiological data on the prescription of long-term oxygen therapy (LTOT) in patients with PH. The study sought to analyse the prevalence and incidence of LTOT prescription among patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) in Spain and to determine predictors for this prescription.</p><p><strong>Methods: </strong>A retrospective analysis was performed from the Spanish Registry of Pulmonary Arterial Hypertension (REHAP). Collected data included demographics and anthropometric measurements, functional class (FC), arterial blood gases, pulmonary function tests, haemodynamic measurements, six-minute walking distance (6MWD) and LTOT prescription. In addition, we assessed the prevalence and incidence of LTOT prescription by PH group and subtype and potential predictors for LTOT initiation in the first 5 years after diagnosis.</p><p><strong>Results: </strong>We analysed 4533 patients (69.9% PAH and 30.1% CTEPH), mostly female (64.5%), with a mean age of 53.0 ± 18.3 years. The prevalence of LTOT was 19.3% for all patients. The incidence of LTOT prescriptions decreased from 5.6% to 1.6% between 2010 and 2019, respectively. Predictors for LTOT prescription, excluding those that represent the indication for oxygen therapy were: FC (HR: 1.813), 6MWD (HR: 1.002), mean pulmonary arterial pressure (mPAP) (HR: 1.014), cardiac index (CI) (HR: 1.253), pulmonary vascular resistance (PVR) (HR: 1.023) and diffusing capacity of carbon monoxide (DL<sub>CO</sub>) (HR: 1.294).</p><p><strong>Conclusion: </strong>The prevalence of LTOT in PAH and CTEPH patients is close to 20%. FC, 6MWD, mPAP, CI, PVR and DL<sub>CO</sub> were predictors for LTOT prescription.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111460","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}
RespirologyPub Date : 2024-08-28DOI: 10.1111/resp.14823
Giovanni Franco, Marie-Pierre Debray, Niccolò Anzani, Almerico Marruchella, Aurélie Cazes, Pierre Le Guen, Camille Taillé, Paola Faverio, Raphaël Borie, Fabrizio Luppi, Bruno Crestani
{"title":"Cystic lung in sarcoidosis: Clinico-radiologic characteristic and evolution.","authors":"Giovanni Franco, Marie-Pierre Debray, Niccolò Anzani, Almerico Marruchella, Aurélie Cazes, Pierre Le Guen, Camille Taillé, Paola Faverio, Raphaël Borie, Fabrizio Luppi, Bruno Crestani","doi":"10.1111/resp.14823","DOIUrl":"https://doi.org/10.1111/resp.14823","url":null,"abstract":"<p><strong>Background and objective: </strong>Sarcoidosis can manifest with atypical findings on chest computed tomography (CT). Cysts are a rare manifestation of lung sarcoidosis. The aim of the study was to describe a series of patients with cystic sarcoidosis and their clinical-radiological characteristics and progression.</p><p><strong>Methods: </strong>In this retrospective, bicentric study we recruited all patients affected by sarcoidosis with lung cystic lesions at chest CT. We collected clinical characteristics, pulmonary tests and tracked number, distribution and size of the cysts at diagnosis and at the last evaluation.</p><p><strong>Results: </strong>Twelve patients (6 males, median age 53 years) were identified (prevalence: 1.9%; 95% Confidence Interval: 0.8%-2.9%). All patients presented multiple cystic lesions (median number: 14 [range: 2-216]) with a bilateral distribution in 10/12, micronodules and nodules in 11/12 and fibrotic lesions in 4/12. Seven patients had normal lung function test, three had an obstructive syndrome, one had a restrictive syndrome and one had coexistence of both. During follow-up (median: 10 years [range 1-16 years]), an increase of the number of cysts was observed in four patients. At last evaluation, 3/12 patients experienced a decline of forced vital capacity >10% and 3/12 patients a decline of diffusing capacity for carbon monoxide (DLCO) >10%. A lower DLCO at diagnosis, and the presence of nodules or fibrotic lesions on CT were associated with an increase in the number of cysts.</p><p><strong>Conclusion: </strong>Cystic lung lesions are rare in patients with sarcoidosis and do not influence long term prognosis.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093718","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}
RespirologyPub Date : 2024-08-28DOI: 10.1111/resp.14822
Changhao Zhong, Enguo Chen, Zhuquan Su, Difei Chen, Feng Wang, Xiaoping Wang, Guangnan Liu, Xiaoju Zhang, Fengming Luo, Nan Zhang, Hongwu Wang, Longyu Jin, Fa Long, Chunfang Liu, Shiman Wu, Qing Geng, Xiang Wang, Chunli Tang, Ruchong Chen, Felix J F Herth, Jiayuan Sun, Shiyue Li
{"title":"Safety and efficacy of a novel transbronchial radiofrequency ablation system for lung tumours: One year follow-up from the first multi-centre large-scale clinical trial (BRONC-RFII).","authors":"Changhao Zhong, Enguo Chen, Zhuquan Su, Difei Chen, Feng Wang, Xiaoping Wang, Guangnan Liu, Xiaoju Zhang, Fengming Luo, Nan Zhang, Hongwu Wang, Longyu Jin, Fa Long, Chunfang Liu, Shiman Wu, Qing Geng, Xiang Wang, Chunli Tang, Ruchong Chen, Felix J F Herth, Jiayuan Sun, Shiyue Li","doi":"10.1111/resp.14822","DOIUrl":"https://doi.org/10.1111/resp.14822","url":null,"abstract":"<p><strong>Background and objective: </strong>Radiofrequency ablation (RFA) is an emerging treatment of lung cancer, yet it is accompanied by certain safety concerns and operational limitations. This first multi-centre, large-scale clinical trial aimed to investigate the technical performance, efficacy and safety of an innovative transbronchial RFA system for lung tumours.</p><p><strong>Methods: </strong>The study enrolled patients with malignant lung tumours who underwent transbronchial RFA using an automatic saline microperfusion system between January 2021 and December 2021 across 16 medical centres. The primary endpoint was the complete ablation rate. The performance and safety of the technique, along with the 1-year survival rates, were evaluated.</p><p><strong>Results: </strong>This study included 126 patients (age range: 23-85 years) with 130 lung tumours (mean size: 18.77 × 14.15 mm) who had undergone 153 transbronchial RFA sessions, with a technique success rate of 99.35% and an average ablation zone size of 32.47 mm. At the 12-month follow-up, the complete ablation rate and intrapulmonary progression-free survival rates were 90.48% and 88.89%, respectively. The results of patients with ground-glass nodules (GGNs) were superior to those of the patients with solid nodules (12-month complete ablation rates: solid vs. pure GGN vs. mixed GGN: 82.14% vs. 100% vs. 96.08%, p = 0.007). No device defects were reported. Complications such as pneumothorax, haemoptysis, pleural effusion, pulmonary infection and pleural pain were observed in 3.97%, 6.35%, 8.73%, 11.11% and 10.32% of patients, respectively. Two subjects died during the follow-up period.</p><p><strong>Conclusion: </strong>Transbronchial RFA utilizing an automatic saline microperfusion system is a viable, safe and efficacious approach for the treatment for lung tumours, particularly for patients with GGNs.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093720","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}
RespirologyPub Date : 2024-08-27DOI: 10.1111/resp.14824
Ken Ka Pang Chan, David Shu Cheong Hui
{"title":"Letter from Hong Kong: Vaccination trends for respiratory viral infections in Hong Kong.","authors":"Ken Ka Pang Chan, David Shu Cheong Hui","doi":"10.1111/resp.14824","DOIUrl":"https://doi.org/10.1111/resp.14824","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073801","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}
RespirologyPub Date : 2024-08-21DOI: 10.1111/resp.14819
Mark Lavercombe
{"title":"Recommendations from the Medical Education Editor.","authors":"Mark Lavercombe","doi":"10.1111/resp.14819","DOIUrl":"https://doi.org/10.1111/resp.14819","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018489","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}
RespirologyPub Date : 2024-08-19DOI: 10.1111/resp.14817
Thomas McCrabb, Brigitte Borg, Caroline X Gao, Catherine Smith, Claire F O'Sullivan, David Brown, Jillian Ikin, Annie Makar, Tyler Lane, Michael J Abramson, Bruce R Thompson
{"title":"Ventilation heterogeneity is increased in adults exposed to coal mine fire-related PM<sub>2.5</sub>.","authors":"Thomas McCrabb, Brigitte Borg, Caroline X Gao, Catherine Smith, Claire F O'Sullivan, David Brown, Jillian Ikin, Annie Makar, Tyler Lane, Michael J Abramson, Bruce R Thompson","doi":"10.1111/resp.14817","DOIUrl":"https://doi.org/10.1111/resp.14817","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Hazelwood Health Study was set up to study long-term health effects of a mine fire that blanketed residents of the Latrobe Valley with smoke for 45 days in 2014. The Respiratory Stream specifically assessed the impact of fine particulate matter <2.5 μm diameter (PM<sub>2.5</sub>) exposure from mine fire smoke on lung health. The multiple breath nitrogen washout (MBW) test assesses ventilation heterogeneity, which may detect sub-clinical airways dysfunction not identified using standard tests such as spirometry. This analysis assessed the association of PM<sub>2.5</sub> exposure with measures of ventilation heterogeneity.</p><p><strong>Methods: </strong>Exposed (Morwell) and unexposed (Sale) participants were recruited 3.5-4 years after the fire from those who had participated in an Adult Survey. MBW was performed to measure lung clearance index (LCI), functional residual capacity (FRC), acinar (Sacin) and conductive (Scond) ventilation heterogeneity. PM<sub>2.5</sub> exposure was estimated with emission and chemical transport models. Multivariable linear regression models were fitted controlling for confounders.</p><p><strong>Results: </strong>We recruited 519 participants. MBW tests were conducted on 504 participants with 479 acceptable test results (40% male; 313 exposed, 166 unexposed). Exposure to mine fire-related PM<sub>2.5</sub> was associated with increasing Scond (β = 1.57/kL, 95%CI: 0.20-2.95, p = 0.025), which was comparable to the estimated effect on Scond of 4.7 years of aging. No other MBW outcomes were statistically different.</p><p><strong>Conclusion: </strong>Increasing exposure to PM<sub>2.5</sub> was associated with increased ventilation heterogeneity in the conductive region of the lungs 4 years after the event.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005133","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}
RespirologyPub Date : 2024-08-15DOI: 10.1111/resp.14811
Po-Wei Hu, Chun-Ku Chen, Yi-Han Hsiao, Ching-Yao Weng, Ying-Chi Lee, Kang-Cheng Su, Jia-Yih Feng, Kun-Ta Chou, Diahn-Warng Perng, Hsin-Kuo Ko
{"title":"Correlations between blood vessel distribution, lung function and structural change in idiopathic pulmonary fibrosis.","authors":"Po-Wei Hu, Chun-Ku Chen, Yi-Han Hsiao, Ching-Yao Weng, Ying-Chi Lee, Kang-Cheng Su, Jia-Yih Feng, Kun-Ta Chou, Diahn-Warng Perng, Hsin-Kuo Ko","doi":"10.1111/resp.14811","DOIUrl":"https://doi.org/10.1111/resp.14811","url":null,"abstract":"<p><strong>Background and objective: </strong>Correlations between the image analysis of CT scan, lung function and quality of life in patients with idiopathic pulmonary fibrosis (IPF) remain unclear. This study aimed to investigate the impacts of pulmonary blood-vessel distribution and the extent of fibrosis on the lung function and quality of life of patients with IPF.</p><p><strong>Methods: </strong>Patients were enrolled in an IPF registry and had completed pulmonary function tests, chest HRCT, St. George Respiratory Questionnaire (SGRQ) and echocardiography. Pulmonary blood-vessel distribution, specific image-derived airway volume (siVaw) and fibrosis extent (siVfib) were quantitatively calculated by functional respiratory imaging on HRCT.</p><p><strong>Results: </strong>The study subjects were categorized into DLco <40% pred. (n = 40) and DLco ≥40% pred. (n = 19) groups. Patients with DLco <40% pred. had significantly higher scores of SGRQ, composite physiologic index (CPI), exercise oxygen desaturation (∆SpO<sub>2</sub>), siVaw, lower FVC% pred. and 6-minute walking distance% pred. The proportion of small blood vessels in the upper lobes (BV5PR-UL) was significantly correlated with CPI, DLco % Pred., FVC% pred., SGRQ and ∆SpO<sub>2</sub>. Only BV5PR-UL had a significant impact on all indices but not BV5PR in the lower lobes (BV5PR-LL). siVfib was significantly negatively correlated with BV5PR-UL, DLco% pred. and FVC% pred., as well as positively correlated with CPI, ∆SpO<sub>2</sub> and siVaw.</p><p><strong>Conclusion: </strong>BV5PR-UL and siVfib had significant correlations with lung function and may become important indicators to assess the severity of IPF and the impact on quality of life.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988723","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}