Canadian Journal of Respiratory Therapy最新文献

{"title":"The importance of quantifying training loads and applying exercise principles in respiratory muscle training studies.","authors":"Rodrigo Torres-Castro, Luis Vasconcello-Castillo, Homero Puppo, Matías Otto-Yáñez","doi":"10.29390/001c.147869","DOIUrl":"10.29390/001c.147869","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"293-295"},"PeriodicalIF":1.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>When life looks like easy street, there's danger at your door</i>: Why the respiratory therapy profession should evolve.","authors":"Marco Zaccagnini, Jason Nickerson, Rena Sorensen, Elizabeth Rohrs","doi":"10.29390/001c.147368","DOIUrl":"https://doi.org/10.29390/001c.147368","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems are rapidly transforming in response to demographic pressures, changing funding models, technological advances, and new models of care. As a result, professions must adapt in parallel to remain relevant. In Canada, respiratory therapy stands at an inflection point. Respiratory Therapists (RTs) provide essential and complex care across diverse clinical settings, yet the profession remains anchored in traditional roles. Questions remain about whether RTs are evolving in step with broader system changes, and what may be lost if they do not.</p><p><strong>Methods: </strong>This paper originates from a panel at the 2025 Canadian Society of Respiratory Therapists annual conference. We used narrative methodology and composite narrative techniques to synthesize the reflections of four clinician-researcher panelists into a unified account. Drawing on clinical, professional, policy, and research perspectives, we co-constructed a narrative that highlights shared insights, tensions, and opportunities in the profession.</p><p><strong>Results: </strong>We identified multiple sources of tension. RTs engage with evidence daily, yet most of this evidence comes from other health professions. This reliance constrains the development of RT-specific frameworks, guidelines, and research agendas. Additionally, scholarship in respiratory therapy often remains undervalued and narrowly defined, treated as an optional activity rather than a core part of professional identity. Finally, structural, cultural, and organizational barriers, further restrict the integration of evidence and scholarship into routine work.</p><p><strong>Discussion: </strong>Moving forward requires deliberate action to embed scholarship and evidence generation within the respiratory therapy profession. We suggest that strengthening research literacy at entry-to-practice, creating formal roles for clinical scholars, recognizing scholarly work within career structures and innovation incubators and interprofessional collaborations can position RTs as co-creators of solutions to health system challenges. By embracing these suggestions, the profession can evolve in step with health system change, enhance its influence, and secure its relevance in the future of healthcare.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"283-292"},"PeriodicalIF":1.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12648816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative versus liberal oxygen therapy in mechanically ventilated patients: A systematic review with meta-analysis.","authors":"Gabriela Freitas Valverde, Bruno Prata Martinez, Dimitri Gusmão Flôres, Cássio Magalhães da Silva E Silva, Sérgio Fernandes de Oliveira Jezler, Iura Gonzalez Alves","doi":"10.29390/001c.146707","DOIUrl":"10.29390/001c.146707","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials comparing liberal versus conservative oxygen therapy strategies in patients requiring mechanical ventilation have shown contradictory results regarding the best strategy for improving mortality outcomes, length of stay, and ventilator-free days. To summarize the evidence regarding the effects of conservative oxygen therapy compared with liberal oxygen therapy in adult patients admitted to an intensive care unit (ICU).</p><p><strong>Methods: </strong>This systematic review with meta-analysis included controlled and randomized clinical trials obtained from the MEDLINE/PubMed, Embase, the Cochrane Library, Lilacs/bvs, PEDro and ScienceDirect. The effect estimate for mortality was expressed as the relative risk (<i>RR</i>), whereas the other variables were expressed as the mean difference (<i>MD</i>). A meta-analysis of the data was conducted via Review Manager software version 5.3 (Cochrane Collaboration).</p><p><strong>Results: </strong>Nineteen randomized clinical trials involving more than 10,000 patients were included. Liberal oxygen therapy did not significantly differ from conventional oxygen therapy in terms of mortality (<i>RR</i> 1.00; 95% CI: 0.93-1.07, GRADE moderate), length of stay (<i>MD</i> 0.18; 95% CI: - 2.69-3.05, GRADE very low) or ventilator-free days (<i>MD</i> 0.25; 95% CI: -1.78-2.27, GRADE very low).</p><p><strong>Conclusion: </strong>The findings of this review show no significant differences in clinical outcomes between liberal and conventional oxygen therapy in adult ICU patients. As the burden of proof rests on the intervention, the absence of evidence for the superiority of liberal oxygen therapy means its benefit cannot be assumed.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12633335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of respiratory muscle training on muscle strength, pulmonary function, symptoms, and quality of life in COPD.","authors":"Chris Russian, Sharon Armstead, Elizabeth Rosenthal, Michael Shapiro","doi":"10.29390/001c.146372","DOIUrl":"10.29390/001c.146372","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is characterized by respiratory muscle weakness, hyperinflation, and systemic inflammation, leading to impaired pulmonary function and quality of life. Respiratory muscle training (RMT) may strengthen the inspiratory and expiratory muscles, improve pulmonary function, reduce dyspnea, and enhance functional outcomes. This study assessed the impact of concurrent RMT on respiratory muscle strength, spirometry, dyspnea, and quality of life in patients with COPD.</p><p><strong>Materials and methods: </strong>This was a single-cohort pre/post-intervention study initially recruiting 43 patients with COPD to participate in an 8-week RMT program using a threshold pressure device. Both inspiratory and expiratory training were performed using a PowerLung device with adjustable resistance. Training consisted of three sets of ten breaths twice daily for each mode, and participants were instructed to increase resistance incrementally when the load became easy. Assessments included spirometry, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), COPD Assessment Test (CAT), Medical Research Council (MRC) Breathlessness Scale, and Airways Questionnaire 20 (AQ20). Data were collected at baseline and post-intervention and analyzed using paired <i>t</i>-tests and Wilcoxon signed-rank tests, stratified by GOLD category.</p><p><strong>Results: </strong>Twenty-seven participants completed the study. Statistically significant improvements were observed in MIP (mean increase 14.1 cm H₂O, <i>p</i> < .001), MEP (mean increase 20.1 cm H₂O, <i>p</i> < .001), CAT (mean decrease 2.92, <i>p</i> = .020), and AQ20 (mean decrease 1.67, <i>p</i> = .005). FEV₁ improved modestly but did not reach statistical significance (mean increase 0.0367 L, <i>p</i> = .064). The GOLD distribution included eight participants in GOLD 2, 12 in GOLD 3, and seven in GOLD 4. Improvements in MIP and MEP were statistically significant within all GOLD categories. A clinically meaningful increase in FEV₁ (≥ 60 mL) was observed in participants in GOLD 3 and 4 stages, though not statistically significant. Correlations between muscle strength improvements and symptom scores were moderate to strong.</p><p><strong>Discussion: </strong>Concurrent RMT improves respiratory muscle strength and quality of life in patients with COPD, with the greatest benefits observed in advanced disease stages. Enhanced respiratory muscle efficiency may reduce dyspnea and promote exercise tolerance.</p><p><strong>Conclusion: </strong>RMT is a promising intervention for COPD management that offers improved respiratory muscle strength and quality of life. Future studies should explore the long-term effects and optimize protocols for broader implementation.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"262-271"},"PeriodicalIF":1.1,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes and behaviours of evidence-informed practice in respiratory therapy: A cross-sectional survey.","authors":"Marco Zaccagnini, Andrew J West, Ian D Graham","doi":"10.29390/001c.146171","DOIUrl":"10.29390/001c.146171","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Using evidence to guide clinical practice is recognized as the cornerstone of safe, effective, and patient-centred care and is embedded within the national competency framework of respiratory therapists (RTs) as evidence-informed practice (EIP). However, how this competency is enacted in practice remains unclear. RTs, like many health professionals, encounter challenges in enacting EIP and are influenced by individual, contextual, and organizational factors. As part of a broader program of research, our team conceptualized EIP in respiratory therapy as comprising three interrelated components: reflective practice, shared decision-making, and research awareness. In this study, we examined the current knowledge, attitudes, and behaviours of RTs in Canada related to these three core components of EIP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We surveyed credentialed RTs across Canada to assess their knowledge, attitudes and behaviours relating to three components of EIP: reflective practice, shared decision-making, and research awareness. Participants were randomly assigned to complete one of three surveys, each of which related to one of the components. We used a simple-randomized, stratified sampling to enhance generalizability, and analyzed the data using descriptive statistics, one-way ANOVA, and exploratory analyses of demographic and practice-related variables. We analyzed open-ended responses using qualitative content analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The three surveys were accessed 442 times. After removing non-responses and incomplete data, we analyzed the data from 288 participants (response rate = 10.2%). Out of the possible 100 score, shared decision-making yielded the highest mean knowledge score (&lt;i&gt;M&lt;/i&gt; = 86.4, SD = 6.4), while research awareness scored highest for attitudes (&lt;i&gt;M&lt;/i&gt; = 81.4, &lt;i&gt;SD&lt;/i&gt; = 13.4) and behaviours (&lt;i&gt;M&lt;/i&gt; = 78.3, &lt;i&gt;SD&lt;/i&gt; = 10.4). Reflective practice showed the lowest mean scores across domains (knowledge &lt;i&gt;M&lt;/i&gt; = 40.6; attitudes &lt;i&gt;M&lt;/i&gt; = 53.3; behaviours &lt;i&gt;M&lt;/i&gt; = 61.3). ANOVAs indicated significant group differences across all domains (&lt;i&gt;p&lt;/i&gt; &lt; .001). Using the open-ended responses, 79.2% of participants emphasized that research evidence is the most significant feature of EIP. The open-ended responses related to training needs for EIP focused on condition- or population-specific application (29.5%), preferred formats, such as journal clubs, webinars, and modules (24.7%), and skills for engaging with research (21.2%). Exploratory analyses suggested some differences in knowledge, attitudes and behaviours of EIP by gender, race, geography, practice setting, age, and years in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;RTs in Canada demonstrated variable knowledge, attitudes and behaviours across all components of EIP. While reflective practice stood out as the component with the lowest scores across knowledge, attitudes, and behaviours, scores in all three component","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"244-261"},"PeriodicalIF":1.1,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12577734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing research priorities for the Respiratory Therapy profession in Canada: A modified Delphi study.","authors":"Shirley Quach, Marco Zaccagnini, Andrew J West, Mika L Nonoyama","doi":"10.29390/001c.143703","DOIUrl":"10.29390/001c.143703","url":null,"abstract":"<p><strong>Background: </strong>Respiratory therapists (RTs) play an important role in delivering care across diverse clinical settings. However, the research questions guiding the profession remain underdeveloped and often shaped by external professions. To address this gap, we conducted a national Delphi study to identify research priorities directly informed by the RT profession in Canada.</p><p><strong>Methods: </strong>We used a modified Delphi method, informed by a prior qualitative study, which aimed to identify and prioritize research needs across RT practice domains. We developed and distributed a list of 74 research items categorized into four domains to RTs across Canada through two rounds of online surveys. Consensus for items was defined as ≥70% agreement in Round 1 and ≥80% agreement in Round 2. Subgroup analyses were conducted by primary practice setting.</p><p><strong>Results: </strong>In Round 1, 286 participants reviewed 74 items and identified 11 (14.8%) as priorities. After incorporating open-ended feedback, some statements were combined, resulting in 53 statements carried forward. In Round 2, 165 participants reviewed 53 items and identified an additional 11 items (20.7%) as important. These topics reflect the breadth of RT practice, including airway management, rapid response teams, personalized ventilation strategies, and system-level contributions. Workforce sustainability issues such as burnout, staffing ratios, and retention were also identified. Subgroup analyses revealed meaningful variation in research priorities across different practice areas in Round 1 and 2.</p><p><strong>Conclusion: </strong>This study presents a profession-driven research agenda for respiratory therapy in Canada. These findings can inform future research, continuing professional development, and policy advocacy aligned with the profession's evolving roles and contexts.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"218-232"},"PeriodicalIF":1.1,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of using electrical impedance tomography to guide positive pressure airway clearance in children with cystic fibrosis and tracheobronchomalacia.","authors":"Julie Depiazzi, Crystal Bourke, Adelaide Withers","doi":"10.29390/001c.143315","DOIUrl":"10.29390/001c.143315","url":null,"abstract":"<p><strong>Aim: </strong>Positive expiratory pressure devices are frequently used for airway clearance in children with cystic fibrosis and tracheobronchomalacia. This study aimed to establish if electrical impedance tomography is a feasible measure to titrate pressures in non-sedated children.</p><p><strong>Method: </strong>Ten children with cystic fibrosis and tracheobronchomalacia performed airway clearance using positive pressure devices whilst monitored with electrical impedance tomography. Feasibility was measured as tolerability and completion of the intervention; ease of administration and interpretation of software data; ability to determine differences in regional lung ventilation; and compatibility for use in the clinic. A pre-determined score of ≥70% was deemed successful for each measure and reported as means and ranges.</p><p><strong>Results: </strong>Criterion met success for tolerability (98%; 86-100) and intervention completion (95%; 90-100). Regions of interest display (96%; 80-100) and software data analysis (96%; 90-100) allowed regional lung ventilation changes to be observed with different pressures. Ease of administration and compatibility for the clinic highlighted difficulties with automated software functionality and clinician time (66%; 10-100% and 75%; 0-100).</p><p><strong>Conclusion: </strong>Use of electrical impedance tomography is feasible in non-sedated children with cystic fibrosis. It has potential as a tool for guiding positive pressure titration for airway clearance. Results and application to clinical practice require further study.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"218-228"},"PeriodicalIF":1.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of tobacco and electronic nicotine delivery systems use among health science students in low- and middle-income countries: A scoping review.","authors":"Libia A Bedoya-Ruiz, María V Gómez-Marentes, Angel A Muegues-Salas, Rodrigo A Ruiz Lurduy, Kelly J Jerez-Sierra","doi":"10.29390/001c.142508","DOIUrl":"10.29390/001c.142508","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of tobacco use is high among health science students in low- and middle-income countries. This population participates in tobacco and nicotine delivery systems prevention strategies. We sought to determine the status of tobacco and nicotine delivery systems used among health sciences students in low- and middle-income countries.</p><p><strong>Methods: </strong>A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included original research articles published in the last 10 years in indexed journals, written in Spanish and English, that focused on populations of healthcare students in low- and middle-income countries and provided information on the use of tobacco or nicotine delivery systems. Eleven databases were searched, and data were extracted using inductive analysis and thematic synthesis.</p><p><strong>Results: </strong>Thirty-four articles were reviewed. Asia was the continent that produced the most literature on the subject, and most studies had a quantitative cross-sectional methodological design. Information on social and cultural issues related to drug use, mental health, healthcare, smoking cessation, and policies and programs is presented in narrative form.</p><p><strong>Conclusions: </strong>Little information exists about the social and cultural aspects associated with the use of nicotine delivery systems, and the needs of health science students in this regard. This issue requires research through participatory, qualitative, or mixed-method approaches, focusing on analyzing participants' needs and identifying ways to transform their reality.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"206-217"},"PeriodicalIF":1.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of activation of different inspiratory muscles during incremental inspiratory loading in healthy adults: A cross-sectional study.","authors":"Umi Matsumura, Antenor Rodrigues, Tamires Mori, Peter Rassam, Marine Van Hollebeke, Dmitry Rozenberg, Laurent Brochard, Ewan C Goligher, Darren Roblyer, W Darlene Reid","doi":"10.29390/001c.143022","DOIUrl":"10.29390/001c.143022","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether the onset and duration of electromyography (EMG) activity of different inspiratory muscles vary during an incremental inspiratory threshold loading (ITL) in healthy adults and whether it is associated with dyspnea and inspiratory mouth pressure (Pm) at task failure.</p><p><strong>Methods: </strong>Twelve healthy adults (30 ± 7 years, six females) performed incremental ITL starting at warm-up (7.6 ± 1.7 cmH₂O), followed by 50 g increments every two minutes until task failure in this cross-sectional study. EMG onset (relative to inspiratory flow) and activity duration of the costal diaphragm/7th intercostal and extra-diaphragmatic inspiratory muscles (scalene, parasternal intercostal, sternocleidomastoid) were quantified using a validated algorithm. Ventilatory parameters, including Pm, were evaluated.</p><p><strong>Results: </strong>With increasing ITL, Pm increased (<i>p</i> ≤ 0.033), accompanied by increased EMG activity of extra-diaphragmatic muscles (<i>p</i> ≤ 0.016). Critically, the EMG onset of the sternocleidomastoid (<i>p</i> < 0.001), parasternal intercostal (<i>p =</i> 0.002), and scalene (<i>p</i> = 0.002) occurred earlier relative to inspiratory flow at task failure compared to lower loads. Earlier EMG onsets of these muscles were correlated with higher Pm at task failure (sternocleidomastoid: <i>r</i> = -0.65; parasternal intercostal: <i>r</i> = -0.45; scalene: <i>r</i> = -0.29; <i>p</i> ≤ 0.034). Notably, earlier EMG onsets of scalene at low loads were associated with higher Pm at task failure (<i>r</i> ≤ -0.75; <i>p</i> ≤ 0.026). Furthermore, an earlier EMG onset of the parasternal intercostal (<i>r</i> = -0.67; <i>p</i> = 0.023) and sternocleidomastoid (<i>r</i> = -0.65; <i>p</i> = 0.023) at task failure was associated with greater dyspnea intensity.</p><p><strong>Conclusion: </strong>Appreciation of timing of inspiratory muscle EMG may provide further insight into understanding the contributors to ventilatory task failure and dyspnea.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"191-205"},"PeriodicalIF":1.1,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot study of the impact of bacterial and fungal coinfections on mildly ill COVID-19 patients.","authors":"Anastasia Vaganova, Danial Djulanov, Marina Uvarova, Diana Zaitseva, Diana Safarova, Andrei Ivanov","doi":"10.29390/001c.142509","DOIUrl":"10.29390/001c.142509","url":null,"abstract":"<p><strong>Background: </strong>Coinfections and superinfections significantly impair prognosis in severely ill COVID-19 patients who may develop ventilator-associated pneumonia. However, the role of bacterial and fungal infections and/or lung colonization in patients with moderate COVID-19 who are not on mechanical ventilation remains controversial. Additionally, there is limited data on the impact of coinfections on pneumonia development in vaccinated subjects. To clarify this question, we summarize the data for patients treated in the single infectious department for a moderate form of COVID-19-associated pneumonia.</p><p><strong>Methods: </strong>We evaluated the association of the medical condition on hospital admission and disease duration with anti-<i>Chlamydophila pneumoniae</i> and anti-<i>Mycoplasma pneumoniae</i> quantitative IgM and sputum culture results in COVID-19 in patients (n=271).</p><p><strong>Results: </strong>Non-pneumococcal <i>Streptococci</i> were the most frequent bacteria isolated from sputum (70% of the population; only one case of St. <i>pneumoniae</i>), followed by <i>Candida albicans</i> (15.6% of the population) and Neisseria spp. (13% of the population). Airway colonization with <i>C. albicans</i> and anti-<i>M. pneumoniae</i> IgM seropositivity was significantly associated with a higher CT score, especially in vaccinated patients; meanwhile, fungal pathogen <i>C. albicans</i> colonization was associated with prolonged hospital duration. Airway colonization with <i>C. albicans</i> was associated with slightly longer disease duration.</p><p><strong>Conclusion: </strong>The results demonstrate that respiratory pathogens, at least <i>M. pneumoniae</i>, can contribute to the risk of COVID-19 onset and/or severity in the vaccinated population. Meanwhile, neither bacterial agents of atypical pneumonia nor lung colonization with opportunistic pathogens are essential for recovery in patients with moderate COVID-19 infection when appropriate treatment is provided.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"182-190"},"PeriodicalIF":1.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}