Respirology最新文献

{"title":"Early Intervention With Biologics for Asthma Remission: Promising or Premature?","authors":"Santi Nolasco, Jaime Bernaola, Parameswaran Nair","doi":"10.1002/resp.70276","DOIUrl":"10.1002/resp.70276","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"783-786"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309377","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":"Right Atrial Pressure/Pulmonary Artery Wedge Pressure Ratio Correlates With Early Outcomes After Pulmonary Endarterectomy for Chronic Thromboembolic Pulmonary Hypertension.","authors":"Cze Ci Chan, Bárbara Lacerda Teixeira, Angela Bautista, Melissa D Stinson, Thao T Drcar, Jenny Z Yang, Mona Alotaibi, Timothy M Fernandes, Demosthenes G Papamatheakis, David S Poch, Kim M Kerr, Michael M Madani, Nick H Kim","doi":"10.1002/resp.70255","DOIUrl":"10.1002/resp.70255","url":null,"abstract":"<p><strong>Background and objective: </strong>The expected right atrial pressure (RAP) to pulmonary arterial wedge pressure (PAWP) ratio is < 1. Inversion of this ratio (RAP ≥ PAWP) has been linked to poor outcomes in pulmonary arterial hypertension, but its relevance in chronic thromboembolic pulmonary hypertension (CTEPH) is unknown. For patients undergoing pulmonary endarterectomy (PEA), this ratio may be associated with postoperative outcomes and guide postoperative management.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive CTEPH patients who underwent PEA at the University of California San Diego from January 2021 to December 2023. RAP/PAWP ratios ≥ 1 and < 1 were compared for postoperative outcomes. Haemodynamic data were derived from preoperative right heart catheterization. Outcomes included reperfusion pulmonary edema (RPE), ventilator days, re-intubation, ICU and hospital length of stay (LOS), and 30-day mortality.</p><p><strong>Results: </strong>A total of 462 CTEPH patients met study criteria. Of these, 128 (27.7%) were in the inverse group (RAP/PAWP ≥ 1) and 334 (72.3%) in the control group (RAP/PAWP < 1). The inverse group had worse baseline functional class, cardiac index, NT-proBNP, and more haemoptysis. Postoperatively, rates of RPE (14% vs. 6%, p = 0.005) and re-intubation (5% vs. 1%, p = 0.036) were higher in the inverse group. They also required more ventilator days (2 vs. 1, p < 0.001) and had longer ICU (4 vs. 3 days, p = 0.002) and hospital LOS (13 vs. 11 days, p < 0.001). Thirty-day mortality was numerically higher in the inverse group (3% vs. 1%), though not statistically significant (p = 0.080).</p><p><strong>Conclusion: </strong>RAP/PAWP ratio > 1 prior to PEA surgery was associated with higher rates of early postoperative complications.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"830-839"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779725","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":"Predicting Failure at Initiation of High-Flow Nasal Oxygen in Patients With COVID-19: Literature Review, Development and Internal Validation of a Prediction Model.","authors":"Daphne J T Sjauw, Matthijs L Janssen, Yasemin Türk, Carmen A T Reep, Leo Heunks, Sara J Baart, Evert-Jan Wils","doi":"10.1002/resp.70254","DOIUrl":"10.1002/resp.70254","url":null,"abstract":"<p><strong>Background and objective: </strong>High-Flow Nasal Oxygen (HFNO) can reduce the need for invasive mechanical ventilation in patients with acute hypoxemic respiratory failure (AHRF) from viral pneumonias, like COVID-19. Early prediction of HFNO failure is useful for timely decision-making at HFNO initiation. This study aimed to develop a prediction model for HFNO failure using predictors available just prior to HFNO initiation in patients with COVID-19 AHRF and compare its performance to existing models.</p><p><strong>Methods: </strong>This multicenter, prospective observational cohort study included hospitalized patients from 10 centers in the Netherlands between December 2020 and July 2021. Adults who tested positive for SARS-CoV-2, had no treatment limitations, and initiated HFNO for hypoxemia were included. The primary outcome was HFNO failure, defined as the event of endotracheal intubation. Pre-defined candidate predictors were selected by multivariable logistic regression for prediction model development. Internal validation was conducted using bootstrapping.</p><p><strong>Results: </strong>Out of 608 patients, 277 (46%) experienced HFNO failure. Independent predictors of HFNO failure included (odds ratio [95% CI]): age (1.02 [1.00-1.03]), urea (1.04 [1.00-1.08]), platelet count (0.94 [0.92-0.97]), respiratory rate (1.05 [1.02-1.08]), oxygen saturation (0.89 [0.84-0.94]), and FiO₂ (conventional oxygen 10-15 L/min vs. < 10 L/min: 3.00 [1.71-5.29], 15 L/min vs. < 10 L/min: 4.95 [3.19-7.70]) prior to HFNO initiation. The model C-statistic was 0.767; 95% CI [0.727-0.803], with excellent calibration (intercept: -0.005, slope: 1.001), and stable performance after internal validation.</p><p><strong>Conclusions: </strong>This newly developed model, using variables available at HFNO initiation, effectively predicted HFNO failure in hospitalized hypoxemic patients due to COVID-19 pneumonia with good performance.</p><p><strong>Registration number clinical trial: </strong>Dutch Trial Registry: DTR, NL9067.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"798-807"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691659","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":"Heated Tobacco Product Use and Lower Physical Activity Among Japanese Adults With and Without Respiratory Diseases: Findings From the JACSIS Study.","authors":"Mitsuo Hashimoto, Hiroki Yoshida, Takahiro Tabuchi","doi":"10.1002/resp.70256","DOIUrl":"10.1002/resp.70256","url":null,"abstract":"<p><strong>Background and objective: </strong>Physical inactivity contributes to adverse health outcomes and is particularly detrimental in respiratory diseases. Despite being promoted as safer cigarette alternatives, the behavioural effects of heated tobacco products (HTPs) on physical activity remain unclear. This study examined the association between HTP use and physical activity among Japanese adults, particularly those with respiratory diseases.</p><p><strong>Methods: </strong>A cross-sectional study used data from the 2023 Japan COVID-19 and Society Internet Survey (JACSIS), including 28,353 participants aged ≥ 15 years. Tobacco use was classified as never, current, or former use of cigarettes and/or HTPs. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) and expressed in MET-min/week. Multivariable analyses applied analysis of covariance (ANCOVA) and logistic regression comparing low versus moderate/high physical activity, adjusting for demographic, behavioural, and health factors.</p><p><strong>Results: </strong>Predicted means of physical activity from the ANCOVA model were 1100.9 for never smokers, 1006.8 for cigarette smokers, and 945.6 MET-min/week for HTP users. Current cigarette smokers (β = -94.1 [95% CI: -176.7 to -11.5], p = 0.026) and current HTP users (β = -155.3 [95% CI: -252.7 to -57.9], p = 0.002) exhibited significantly lower physical activity than never smokers. Sensitivity analyses using log-transformed IPAQ scores and logistic regression confirmed these findings. Subgroup analyses indicated reduced activity among HTP users with asthma, but no clear pattern for COPD.</p><p><strong>Conclusion: </strong>Cigarette smoking and HTP use were associated with lower physical activity, independent of confounders. Smoking cessation, particularly in asthma, should be prioritized, alongside promoting physical activity among tobacco users.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"819-829"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779632","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":"Preliminary Development of a Patient-Reported Outcome Measure for Inducible Laryngeal Obstruction: Findings From a Delphi Process.","authors":"Siobhan Ludlow, Stephen Fowler, Jamie Kirkham, Lucie Byrne-Davis","doi":"10.1002/resp.70262","DOIUrl":"10.1002/resp.70262","url":null,"abstract":"<p><strong>Background and objective: </strong>Inducible laryngeal obstruction (ILO) is a laryngeal disorder that intermittently affects breathing. A psychometrically robust patient-reported outcome measure for ILO is required. We have generated items from individual patient interviews and a scoping review. The objective of this study is to ascertain which items covering the physical, social, and psychological impact of ILO were relevant for measuring the impact of living with ILO to inform a new patient-reported outcome measure.</p><p><strong>Methods: </strong>An international two-round online Delphi study was conducted amongst a group including patients with ILO and relevant health care professionals. Participants judged the relevance of 80 items about the impact of ILO on a 9-point scale. We defined consensus as a minimum of 70% of participants rating items as 7-9. Participants were asked to give a reason for their ratings.</p><p><strong>Results: </strong>Forty-six participants registered for the Delphi survey, with 37/46 (80%) and 29/37 (78%) completing rounds one and two, respectively. Participants were patients living with ILO (63%), respiratory physicians (10%), speech and language therapists (16%), physiotherapists (5%), a psychologist (3%) and a nurse (3%). Consensus was reached after round two for 37/80 (46%) to include, 11/80 (14%) not important to include and 32/80 (40%) being important but not critical to include [therefore 43/80 (54%) excluded].</p><p><strong>Conclusion: </strong>Stakeholders agreed on 37 items that should be included in a PROM for ILO. Further studies to establish the psychometrics of a PROM based on these items are required.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"840-847"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975020","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":"Supplemental Oxygen Therapy in Advanced Lung Disease-New Evidence Raises New Questions.","authors":"Kristopher P Clark, Anne E Holland","doi":"10.1002/resp.70271","DOIUrl":"10.1002/resp.70271","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"780-782"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212345","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":"Prenatal Air Pollution Exposure and Child Lungs: Innovations in Measurement and Causal Inference.","authors":"John P McCracken","doi":"10.1002/resp.70280","DOIUrl":"10.1002/resp.70280","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"776-777"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456567","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":"Prenatal PM₂ _.5 Exposure and Airway Mechanics in Taiwanese Schoolchildren: Identifying Critical Windows of Susceptibility.","authors":"Hsin-Yi Huang, Hui-Ju Tsai, Chih-Da Wu, Yinq-Rong Chern, Shen-Hao Lai, Chi-Yen Hung, Chia-Hua Ho, Nai-Chia Fan, Yu-Lun Tseng, Wen-Chi Pan, Tsung-Chieh Yao","doi":"10.1002/resp.70253","DOIUrl":"10.1002/resp.70253","url":null,"abstract":"<p><strong>Background and objective: </strong>Exposure to ambient particulate matter ≤2.5 μm (PM_2.5) is associated with lung function impairment, particularly in children. However, the impact of prenatal PM_2.5 exposure on childhood airway mechanics remains unclear. We aimed to assess associations between prenatal PM_2.5 exposure and airway mechanics in school-age children.</p><p><strong>Methods: </strong>Data from 1324 singleton children (745 boys, 56.3%; mean age, 6.5 years) participating in a population-based cohort in Taiwan were analysed. Prenatal ambient PM_2.5 exposure near residence was estimated using hybrid kriging-land use regression models with an XGBoost algorithm. Airway mechanics were measured by impulse oscillometry.</p><p><strong>Results: </strong>Each 10 μg/m³ increase in prenatal PM_2.5 exposure across the entire pregnancy was associated with higher total airway resistance (R₅: β, 0.67; 95% CI, 0.30-1.03), proximal airway resistance (R₂₀: β, 0.37; 95% CI, 0.12-0.62), peripheral airway resistance (R₅-R₂₀: β, 0.30; 95% CI, 0.05-0.55), and airway impedance (Z₅) (β, 0.58; 95% CI, 0.21-0.94). Distributed lag nonlinear models identified sensitive windows during late pregnancy: 30-34 gestational weeks for R₅, 30-34 gestational weeks for Z₅, and at 26-33 gestational weeks for AX, respectively. Stratified analyses indicated stronger associations in girls, children exposed to prenatal environmental tobacco smoke, and those not breastfed.</p><p><strong>Conclusion: </strong>Higher prenatal PM_2.5 exposure, particularly during late pregnancy, may be associated with adverse changes in airway mechanics in school-age children, especially girls, children exposed to prenatal environmental tobacco smoke, and those not breastfed, highlighting the importance of minimizing PM_2.5 exposure during late pregnancy to protect long-term respiratory health.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"808-818"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779750","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":"Active Cycle of Breathing Technique Versus Oscillating Positive Expiratory Pressure Therapy Versus Exercise With Huffing During an Exacerbation of Bronchiectasis: A Randomised, Controlled Trial.","authors":"Jennifer Phillips, Rodney Pope, Wayne Hing, Ashleigh Canov, Nicole Harley, Annemarie L Lee","doi":"10.1002/resp.70265","DOIUrl":"10.1002/resp.70265","url":null,"abstract":"<p><strong>Background and objective: </strong>The relative effectiveness of airway clearance techniques (ACTs) during an exacerbation of bronchiectasis is unknown. This study aimed to compare the effects of three ACTs on sputum expectoration, health-related quality-of-life (HRQOL), and exacerbation rates in adults hospitalised with an exacerbation of bronchiectasis.</p><p><strong>Methods: </strong>A randomised controlled trial of active cycle of breathing technique (ACBT), oscillating positive expiratory pressure (OPEP) therapy and walking with huffing. Sputum wet weight was collected during ACT sessions, 1-h post-session and the following 23 h on day 2 and day of discharge. HRQOL was assessed using the Quality of Life-Bronchiectasis (QoL-B) questionnaire and Leicester Cough Questionnaire (LCQ) on day 2 and day of discharge. Time to first exacerbation was explored for 6 months following discharge.</p><p><strong>Results: </strong>Fifty-five participants were recruited. ACBT was associated with smaller sputum wet weight 1-h post session on day of discharge compared to walking with huffing (mean difference -2.58 g); no other significant differences between groups in sputum weights were observed. ACBT and walking with huffing significantly improved selected measures of HRQOL (LCQ total score and multiple QOL-B domains) at hospital discharge while OPEP therapy produced minimal changes. ACBT (158 days, 95% CI 139-177) resulted in a longer time to first exacerbation than walking with huffing (118 days, 95% CI 83-154) and OPEP therapy (89 days, 95% CI 69-111) but this finding should be interpreted with caution due to loss to follow-up.</p><p><strong>Conclusion: </strong>Walking with huffing and ACBT gave similar improvements in sputum expectoration and HRQOL during hospitalisation in adults with an exacerbation of bronchiectasis.</p><p><strong>Trial registration: </strong>The study was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12621000428864) on 16-04-2021.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"787-797"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975026","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":"RAP/PAWP Following CTEPH Surgery: A Simple Ratio for Complex Risk.","authors":"Saeed Torbati, Colm McCabe","doi":"10.1002/resp.70264","DOIUrl":"10.1002/resp.70264","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"778-779"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974343","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}