Respirology最新文献

{"title":"Fixed CPAP at 10 cmH₂O May Replace Manual Titration in Moderate to Severe OSA Patients: A Preliminary Randomised Controlled Trial.","authors":"Wang Lu, Yan Chen, Qishan Wei, Yingxin Wu, Cuizhen Huang, Shanfeng Liang, Joerg Steier, Peter Catcheside, Danny Eckert, Andrew Wellman, Yuanming Luo","doi":"10.1111/resp.70037","DOIUrl":"https://doi.org/10.1111/resp.70037","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patient compliance with continuous positive airway pressure (CPAP) is similar using manual-titrated pressure compared to auto-titration, although auto-titration pressures are usually 2-5 cmH₂O higher than manual pressure, indicating that CPAP moderately higher than the optimal pressure will not necessarily impair compliance. We try to find the tolerable highest CPAP which does not increase respiratory effort based on changes in lung volume, diaphragm electromyography (EMG) and breathing sensations in healthy volunteers and OSA patients to simplify pressure titration.</p><p><strong>Methods: </strong>Part 1, 12 healthy subjects and 16 OSA patients were enrolled in the measurement of expiratory reserve volume, diaphragm EMG, and expiratory muscle EMG at different CPAP levels. Breathing difficulty during different CPAP levels was assessed using a customised questionnaire in 35 healthy subjects and 33 OSA patients. Part 2, a two-night randomised crossover double-blind trial using the tolerable highest CPAP (10 cmH₂O) based on the results derived from Part 1 and the manually titrated pressure was performed in 25 OSA patients.</p><p><strong>Results: </strong>End expiratory lung volume increased significantly with increasing CPAP. In general, diaphragm EMG changed little when CPAP ≤ 10 cmH₂O. Expiratory muscle activity appeared when CPAP > 12 cmH₂O. There was no significant difference in subjective sensation of breathing difficulty with CPAP ≤ 10 cmH₂O. Sleep structure, AHI, and patient preference with 10 cmH₂O CPAP were not different from those under titrated pressure.</p><p><strong>Conclusions: </strong>This study suggests that most patients with moderate to severe OSA can be effectively treated with CPAP at an initial pressure of 10 cmH₂O without pressure titration.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04925466.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701383","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":"Sliding Into Misdiagnosis? Distinguishing Bullous Emphysema From Pneumothorax With Lung Ultrasound.","authors":"Casper Falster","doi":"10.1111/resp.70038","DOIUrl":"https://doi.org/10.1111/resp.70038","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701386","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":"Enhancing COPD Care for Women: A Predictive Tool for Palliative Needs.","authors":"Syed Ahmar Shah","doi":"10.1111/resp.70031","DOIUrl":"https://doi.org/10.1111/resp.70031","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693133","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":"Quantitative Assessment of Systemic Sclerosis-Related Interstitial Lung Disease via 3D-Imaging.","authors":"Hiromasa Nakayasu, Yuzo Suzuki, Masato Kono, Dai Hashimoto, Shinpei Kato, Koshi Yokomura, Yusuke Inoue, Hideki Yasui, Hironao Hozumi, Masato Karayama, Kazuki Furuhashi, Noriyuki Enomoto, Tomoyuki Fujisawa, Naoki Inui, Takafumi Suda","doi":"10.1111/resp.70024","DOIUrl":"https://doi.org/10.1111/resp.70024","url":null,"abstract":"<p><strong>Background and objective: </strong>Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in patients with systemic sclerosis (SSc). The disease course of SSc-related ILD (SSc-ILD) is heterogeneous, and several risk-based models have been developed. This study aimed to quantitatively measure volume loss and disease extent and subsequently evaluate their associations with the development of end-stage lung disease (ESLD).</p><p><strong>Methods: </strong>Lung volume (LV) and disease extent were retrospectively and quantitatively evaluated in two cohorts (exploratory: n = 70; validation: n = 42) using high-resolution computed tomography at the time of SSc-ILD diagnosis, compared to controls (n = 70). LV was quantitatively measured using three-dimensional imaging (3D-image) and standardised by predicted forced vital capacity (standardised LV). The ratio of the normally attenuated LV (range, -950 to -750 Hounsfield units) to the whole-LV (NL%) was also measured using 3D-image. The associations of these variables with ESLD were evaluated.</p><p><strong>Results: </strong>Volume loss and normal lung area loss were noted in patients with SSc-ILD compared with controls, especially in the lower lobes. Meanwhile, extended ILD lesions without volume reduction were observed in the upper lobes. Both decreased standardised LV and NL% were associated with ESLD development, and age and NL% were significant risk factors for ESLD independent of pulmonary function test parameters and standardised LV. A composite model consisting of age and NL% successfully stratified patients with SSc-ILD based on the risk of ESLD.</p><p><strong>Conclusion: </strong>3D-image may be a useful technique for assessing disease severity and predicting the risk for ESLD in patients with SSc-ILD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650090","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":"Objective Effects and Patient Preferences for Ambulatory Oxygen in Fibrotic Interstitial Lung Disease With Isolated Exertional Hypoxaemia: A Placebo-Controlled 6-Minute Walk Test Study.","authors":"Giuseppina Ciarleglio, Paolo Cameli, David Bennett, Behar Cekorja, Paola Rottoli, Elisabetta A Renzoni, Piersante Sestini, Elena Bargagli","doi":"10.1111/resp.70020","DOIUrl":"https://doi.org/10.1111/resp.70020","url":null,"abstract":"<p><strong>Background and objective: </strong>The available evidence on the effects of ambulatory oxygen on exercise impairment in patients with fibrotic interstitial lung diseases (F-ILD) is of limited quality.</p><p><strong>Methods: </strong>We conducted a randomised, double-blind, placebo-controlled crossover trial with 32 normoxaemic F-ILD patients, desaturating to ≤ 88% during a baseline 6-minute walk test (6MWT) on ambient air. After determining the oxygen flow needed to prevent desaturation, patients completed two double-blind 6MWTs with either oxygen or placebo (compressed medical air) at the same personalised flow. Objective measures included oxygen saturation, pulse rate, and distance walked. Patient-reported outcomes, assessed via visual analogue scales, included end-of-test dyspnoea, fatigue, and preferences for walking with oxygen or placebo versus each other and ambient air.</p><p><strong>Results: </strong>Ambulatory oxygen, compared to placebo, prevented desaturation, reduced tachycardia, increased walking distance by 37 m (95% CI: 10-74, p = 0.008), and lessened dyspnoea and fatigue. The mean preference score for oxygen over placebo was 2.6 (95% CI: 1.9-3.2, p < 0.0005), significantly greater than equivalence. The preference score for placebo over ambient air was -1.5 (-2.4 to 0.64, p = 0.005), significantly lower than equivalence, while the score for oxygen over ambient air was 0.4 (-0.7 to 1.5), not significantly different from equivalence.</p><p><strong>Conclusions: </strong>Our data confirm that ambulatory oxygen provides significant benefits beyond a placebo effect; although in some patients it is associated with a negative perception that may hinder treatment acceptance. This strengthens the evidence supporting current recommendations and suggests that incorporating patient preferences recorded at the time of the 6MWT into clinical discussions can aid shared decision making regarding ambulatory oxygen.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT02668029.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606279","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":"Mapping Bullous Emphysema With Lung Ultrasound: A Prospective Multicentre Study.","authors":"Kinan El Husseini, Thomas Flament, Sophie Laroumagne, Damien Basille, Mathilde Le Brun, Elise Noël-Savina, Philippe Richard, Gilles Mangiapan, Elise Artaud-Macari","doi":"10.1111/resp.70021","DOIUrl":"https://doi.org/10.1111/resp.70021","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lung ultrasound holds high diagnostic performance for pleural diseases, notably pneumothorax. Bullous emphysema is a potential differential diagnosis of pneumothorax on ultrasound, but its precise semiology is poorly known. This study aimed to delineate the sonographic presentation of bullous emphysema and assess the diagnostic performance of common ultrasound features in identifying bullae.</p><p><strong>Methods: </strong>From June 2019 to June 2021, patients with CT scanner-confirmed bullous emphysema were prospectively included. Investigators performed a standardised 14-region lung ultrasound. Sonographic features of bullous and non-bullous regions were compared. Diagnostic performances for bullae were calculated for each sign, and an additive score was constructed using signs with specificity > 85%. Pearson's correlation was used to examine the relationship between this score, bulla size, and respiratory functional parameters.</p><p><strong>Results: </strong>Thirty-six patients were included, mostly male (n = 33 patients, 91.7%), with an average age of 62 ± 11 years. Bullae mostly affected apical regions (n = 24 patients, 67%). Bullous regions displayed a more frequent absence of lung sliding (34% vs. 11% in non-bullous regions, p < 0.01), barcode sign (15% vs. 3%, p < 0.01), increased A-line visibility (16% vs. 8%, p = 0.048), and absence of Z lines (62% vs. 44%, p = 0.018). A bulla-point sign was visualised in 4% of bullous regions. Absent lung sliding was more frequent in patients with pulmonary distension and in apical regions. Patient bulla score (3 [2-6]) correlated with bulla size (r = 0.53 [0.25;0.73], p < 0.001), FEV₁ (r = -0.38 [-0.60;-0.03], p = 0.022), and forced vital capacity (r = -0.38 [-0.64;-0.08], p = 0.021).</p><p><strong>Conclusion: </strong>Our findings challenge previous data about the specificity of ultrasound signs of pneumothorax in patients with bullous emphysema, highlighting the need for cautious interpretation in clinical practice.</p><p><strong>Trial registration: </strong>NCT04012359.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586571","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 New Opportunity in Respirology.","authors":"Toshiaki Kikuchi","doi":"10.1111/resp.14899","DOIUrl":"10.1111/resp.14899","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"181-182"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123500","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":"Reducing ethnic inequities: Patterns of asthma medication use and hospital discharges in Māori in Aotearoa New Zealand.","authors":"Allie Eathorne, Jonathan Noble, Lee Hatter, Tom Hills, Selwyn Te Paa, Matire Harwood, Mark Weatherall, Richard Beasley","doi":"10.1111/resp.14865","DOIUrl":"10.1111/resp.14865","url":null,"abstract":"<p><strong>Background and objective: </strong>In Aotearoa New Zealand (NZ) widespread transition to budesonide/formoterol maintenance and/or reliever regimens in clinical practice is temporally associated with reduced rates of asthma hospitalization. It is unknown whether this association is observed in Māori, the indigenous population of NZ, who experience a disproportionate burden from asthma. We investigated patterns in asthma medication use and hospital admissions in Māori in NZ.</p><p><strong>Methods: </strong>Review of NZ national dispensing data for asthma inhaler medications and asthma hospital discharge data from January 2013 to December 2023 in the 12+ age group, with calculation of the relative change in dispensed medication and asthma hospitalization rates for Māori and non-Māori. The most recent six-month period, July to December 2023, is compared with the corresponding six-month period 4 years earlier, July to December 2019.</p><p><strong>Results: </strong>Budesonide/formoterol dispensing increased for both Māori and non-Māori for 2019-2023, with a relative 111% and 115% increase, respectively. Between the two periods, asthma hospital discharges reduced from 142.5 to 97.3 per 100,000, absolute difference 45.2 per 100,000, a 32% reduction for Māori; and 49.4-37.9 per 100,000, absolute difference 11.5 per 100,000; a 23% reduction for non-Māori.</p><p><strong>Conclusion: </strong>The temporal association between a marked increase in dispensing of budesonide/formoterol maintenance and/or reliever regimens and reduced asthma hospitalization was observed for Māori and non-Māori, with a greater reduction in asthma hospitalization for Māori. Despite this reduction in health inequities, asthma hospitalization rates are two and a half times greater for Māori compared to non-Māori.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"206-216"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812969","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":"Association of short-term exposure to PM₁ with hospital admission from total and cause-specific respiratory diseases.","authors":"Chenghui Zhong, Qi Tian, Jing Wei, Wenfeng Lu, Ruijun Xu, Meiqi Lan, Nan Hu, Lan Qiu, Han Zhang, SaiFeng Li, Chunxiang Shi, Yuewei Liu, Yun Zhou","doi":"10.1111/resp.14864","DOIUrl":"10.1111/resp.14864","url":null,"abstract":"<p><strong>Background and objective: </strong>Evidence of short-term exposure to particulate matter with an aerodynamic diameter ≤1 μm (PM₁) on hospital admission for respiratory diseases (RDs) is limited. We aimed to estimate the associated risk of PM₁ on hospital admissions for RDs.</p><p><strong>Methods: </strong>In this time-stratified case-crossover study, we assigned cases who had been admitted to hospital for RDs in Guangdong, China between 2016 and 2019. Exposure to PM₁ was assigned on the basis of the patient's residence for each case day and its control days. Conditional logistic regression models and distributed lag nonlinear models were used to quantify the association of PM₁ exposure with hospital admission for RDs at lag 0-1 days.</p><p><strong>Results: </strong>A total of 408, 658 hospital admissions for total RDs were recorded in the study period. Each 10 μg/m³ increase in PM₁ was significantly associated with a 1.39% (95% confidence interval [CI]: 0.87%-1.91%), 1.97% (95% CI: 1.06%-2.87%) and 1.69% (95% CI: 0.67%-2.71%) increase in odds of hospital admissions for total RDs, chronic obstructive pulmonary disease (COPD) and pneumonia. The excess fraction of hospital admission for total RDs attributable to PM₁ exposure was 6.03%, while 6.59% for COPD and 7.48% for pneumonia. Besides, higher excess fractions were more pronounced for hospital admission of total RDs in older patients (>75 years).</p><p><strong>Conclusion: </strong>Our results support that PM₁ is associated with increased risks of hospital admissions for RDs. It emphasizes the needs to pay attention to the effects of PM₁ on respiratory health, especially among elderly patients.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"242-252"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771998","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":"Assessing Disparities in Asthma and Respiratory Health in Indigenous People.","authors":"Allison Michaud, Richard Leigh","doi":"10.1111/resp.14885","DOIUrl":"10.1111/resp.14885","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"183-185"},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034118","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}