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Bronchoscopic detection of aspiration in patients with bronchiectasis and Mycobacterium avium complex pulmonary infection
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-03-11 DOI: 10.1016/j.resmer.2025.101166
Leah Lande , Spencer Whealon , Eden Singer , Lee W. Greenspon , Erin Rains , Rebecca Kwait , Meghan Buckley , Weidan Peng , Janet Sawicki , Joseph O. Falkinham III , Myra D. Williams , Donald D. Peterson
{"title":"Bronchoscopic detection of aspiration in patients with bronchiectasis and Mycobacterium avium complex pulmonary infection","authors":"Leah Lande ,&nbsp;Spencer Whealon ,&nbsp;Eden Singer ,&nbsp;Lee W. Greenspon ,&nbsp;Erin Rains ,&nbsp;Rebecca Kwait ,&nbsp;Meghan Buckley ,&nbsp;Weidan Peng ,&nbsp;Janet Sawicki ,&nbsp;Joseph O. Falkinham III ,&nbsp;Myra D. Williams ,&nbsp;Donald D. Peterson","doi":"10.1016/j.resmer.2025.101166","DOIUrl":"10.1016/j.resmer.2025.101166","url":null,"abstract":"<div><h3>Rationale</h3><div>To investigate whether gastroesophageal reflux with laryngopharyngeal reflux and aspiration play a role in the pathogenesis of bronchiectasis and <em>Mycobacterium avium</em> complex (MAC) pulmonary infection.</div></div><div><h3>Methods</h3><div>In this prospective case-control study, subjects included 31 patients with bronchiectasis undergoing bronchoscopy to investigate suspected MAC infection and 9 control subjects undergoing bronchoscopy for alternative reasons. Patients drank 45 mL of FD&amp;C Blue #1 mixed with 200 mL of tap water the night prior to bronchoscopy. During bronchoscopy, the bronchial mucosa was inspected for the presence of blue dye staining. Bronchoalveolar lavage (BAL) samples were obtained from the most affected segments on CT scan and were cultured for mycobacteria and assayed for pepsin and bile acids. Gastric aspirate samples were obtained for mycobacterial culture.</div></div><div><h3>Results</h3><div>93.8% of patients with confirmed pulmonary MAC infection and 91.7% of patients with evidence of bronchiectasis by CT scan, but negative mycobacterial cultures, had blue dye staining of the bronchial mucosa vs. 11.3% of control patients (<em>p</em> &lt; 0.001). Areas of abnormality on CT correlated with airways demonstrating blue staining by bronchoscopy in 100% of MAC patients and 90.9% of patients with bronchiectasis and negative mycobacterial cultures. MAC patients had higher median BAL pepsin levels compared to combined MAC negative patients (subjects with bronchiectasis and negative mycobacterial cultures and true controls), 5.4 ng/mL vs. 3.4 ng/mL (<em>p</em> = 0.019). 78.6% of MAC patients vs. 26.3% of combined MAC negative patients had BAL bile acid concentrations of &gt;/= 0.493 uM (<em>p</em> = 0.005). There was no significant difference in age, supraglottic index, reflux symptoms, gastric pH, or proton pump inhibitor use between the MAC positive vs. MAC negative patients. 42.8% of patients with growth of MAC on BAL also had growth of MAC in the gastric aspirate.</div></div><div><h3>Conclusions</h3><div>Reflux and aspiration of gastric contents into the airways show a strong association with bronchiectasis and may be associated with MAC pulmonary disease. The novel method introduced in this study of drinking blue dye the evening prior to bronchoscopy should be utilized in the evaluation of infectious and inflammatory lung diseases in which aspiration may play a role.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101166"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Update of guidelines for management of Community Acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF): Endorsed by the French intensive care society (SRLF), the French microbiology society (SFM), the French radiology society (SFR) and the French emergency society (SFMU).
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-02-25 DOI: 10.1016/j.resmer.2025.101161
Aurélien Dinh, François Barbier, Jean-Pierre Bedos, Mathieu Blot, Vincent Cattoir, Yann-Erick Claessens, Xavier Duval, Pierre Fillâtre, Maxime Gautier, Yann Guegan, Sophie Jarraud, Alban Le Monnier, David Lebeaux, Paul Loubet, Constance de Margerie, Philippe Serayet, Yacine Tandjaoui-Lambotte, Emmanuelle Varon, Yves Welker, Damien Basille
{"title":"Update of guidelines for management of Community Acquired pneumonia in adults by the French Infectious Disease Society (SPILF) and the French-Speaking Society of Respiratory Diseases (SPLF): Endorsed by the French intensive care society (SRLF), the French microbiology society (SFM), the French radiology society (SFR) and the French emergency society (SFMU).","authors":"Aurélien Dinh, François Barbier, Jean-Pierre Bedos, Mathieu Blot, Vincent Cattoir, Yann-Erick Claessens, Xavier Duval, Pierre Fillâtre, Maxime Gautier, Yann Guegan, Sophie Jarraud, Alban Le Monnier, David Lebeaux, Paul Loubet, Constance de Margerie, Philippe Serayet, Yacine Tandjaoui-Lambotte, Emmanuelle Varon, Yves Welker, Damien Basille","doi":"10.1016/j.resmer.2025.101161","DOIUrl":"https://doi.org/10.1016/j.resmer.2025.101161","url":null,"abstract":"<p><p>Community-Acquired Pneumonia (CAP) of Presumed Bacterial Origin: Updated Management Guidelines Community-acquired pneumonia (CAP) of presumed bacterial origin is a common condition with varying severity, requiring either outpatient, hospital, or even critical care management. The French Infectious Diseases Society (SPILF) and the French Language Pulmonology Society (SPLF), in collaboration with the French Societies of Microbiology (SFM), Emergency Medicine (SFMU), Radiology (SFR), and Intensive Care Medicine (SRLF), along with representatives of general practice, have coordinated an update of the previous management guidelines, which dated back to 2010. From a therapeutic perspective, the updated recommendations define the choice of initial empiric antibiotic therapy, indications for combination therapy, the use of anti-Pseudomonas beta-lactams, antibiotic treatment duration, and the indications and modalities for prescribing systemic corticosteroids. On a biological level, indications for biomarkers and microbiological investigations have been refined. Regarding imaging, the role of different modalities in the diagnosis and follow-up of CAP has been reassessed, including chest X-ray, pleuropulmonary ultrasound, and thoracic CT scan.</p>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":" ","pages":"101161"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microbiological characteristics of pleural infection in adults: A 10-year retrospective study from a tertiary respiratory care hospital
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-02-21 DOI: 10.1016/j.resmer.2025.101164
Khouloud Ben Dhaou , Imen Bouzouita , Asma Ghariani , Emna Mehiri-Zeghal , Leila Slim-Saidi
{"title":"Microbiological characteristics of pleural infection in adults: A 10-year retrospective study from a tertiary respiratory care hospital","authors":"Khouloud Ben Dhaou ,&nbsp;Imen Bouzouita ,&nbsp;Asma Ghariani ,&nbsp;Emna Mehiri-Zeghal ,&nbsp;Leila Slim-Saidi","doi":"10.1016/j.resmer.2025.101164","DOIUrl":"10.1016/j.resmer.2025.101164","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleural infection is a high-mortality disease with a rising incidence in the past two decades. The knowledge of the main causative organisms is an important step for appropriate treatment. This study aims to describe etiologic and antibiotic resistance features of non-tuberculous pleural infections in adults in a tertiary care center specializing in the treatment of respiratory diseases.</div></div><div><h3>Methods</h3><div>This retrospective study was conducted at the microbiology laboratory of Abderrahmen Mami pneumology and phthisiology hospital, Ariana, Tunisia from January 2014 to December 2023. Pleural fluid samples were collected from adult patients with pleural effusion, from any cause, admitted to the different clinical services. Bacterial isolation and identification were performed by conventional techniques. The disk diffusion and the Vitek 2 methods were used for the susceptibility testing.</div></div><div><h3>Results</h3><div>During the study period, 5235 pleural fluid specimens were included. The sex ratio M/F was 2:1, and the median age was 57 years (interquartile range: 43–68 years). Culture was positive in 9.6 % of all cases, and in 31.4 % of purulent pleural fluids. The Gram stain had 41.5 % (95 % CI 35.6–47.6) sensitivity and 99.8 % (95 % CI 99.6–99.9) specificity in detecting microorganisms. A pleural fluid leukocyte count &gt;10,000/mL showed a sensitivity of 51.4 % (95 % CI 47.7–55.8) and a specificity of 91.7 % (95 % CI 90.8–92.4). A total of 544 microorganisms were isolated. The main causative microorganisms were viridans streptococci group (32.1 %), <em>Enterobacteriaceae</em> (25.3 %), <em>Staphylococcus aureus</em> (10.2 %), and anaerobes (9.3 %). Among Enterobacteriaceae, 19 % were resistant to third-generation cephalosporins and 6.4 % to carbapenems. The resistance to penicillin G was detected in 19 % of the <em>viridans streptococci</em> group. Methicilline Resistant <em>Staphylococcus aureus</em> percentage was 14.2 %.</div></div><div><h3>Conclusion</h3><div>Conventional culture yielded 31.4 % positivity in purulent pleural fluids, and Gram-positive organisms were the leading cause of non-tuberculous pleural infections in adults over the past ten years. These results highlight the need for new molecular methods to improve culture-negative empyema diagnosis.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101164"},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“Lung tensioning device” for emphysema: The comeback of the coil
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-02-20 DOI: 10.1016/j.resmer.2025.101163
Nicolas Guibert, Thomas Villeneuve, Juliette Edme, Julien Mazières, Gavin Plat, Valentin Héluain
{"title":"“Lung tensioning device” for emphysema: The comeback of the coil","authors":"Nicolas Guibert,&nbsp;Thomas Villeneuve,&nbsp;Juliette Edme,&nbsp;Julien Mazières,&nbsp;Gavin Plat,&nbsp;Valentin Héluain","doi":"10.1016/j.resmer.2025.101163","DOIUrl":"10.1016/j.resmer.2025.101163","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101163"},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The positional change in vital capacity as a tool to identify diaphragm dysfunction: A qualitative systematic review
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-02-07 DOI: 10.1016/j.resmer.2025.101162
Hendrik Kever , Giuseppe Liistro , Dominique Butenda Babapu , Gregory Reychler
{"title":"The positional change in vital capacity as a tool to identify diaphragm dysfunction: A qualitative systematic review","authors":"Hendrik Kever ,&nbsp;Giuseppe Liistro ,&nbsp;Dominique Butenda Babapu ,&nbsp;Gregory Reychler","doi":"10.1016/j.resmer.2025.101162","DOIUrl":"10.1016/j.resmer.2025.101162","url":null,"abstract":"<div><h3>Background</h3><div>Sitting to supine fall in vital capacity (∆VC) is commonly used to screen for diaphragmatic dysfunction (DD), but the predictive threshold value varies.</div><div>This systematic review aimed to compare the position-dependent change in vital capacity (VC) in patients with objectively confirmed DD.</div></div><div><h3>Research question</h3><div>What is the optimal predictive value of ∆VC to diagnose DD.</div></div><div><h3>Study design and methods</h3><div>We searched Medline/PubMed, Embase and Scopus, including backward citations, for studies from database inception to December 5, 2023. Included trials measured position change in VC in adult patients with DD, confirmed independently by a parameter other than ∆VC. Risk of bias was assessed using the Downs and Black checklist.</div></div><div><h3>Results</h3><div>Of 497 records identified, 10 studies were included, totalling 393 adults, of which 284 had DD. In patients with confirmed unilateral diaphragmatic paralysis, mean change in VC ranged from 7 to 23%, and in those with bilateral diaphragmatic paralysis, from 19 to 37%. In studies providing only values for DD without specifying unilateral or bilateral involvement, it ranged from 31 to 42%. In control groups, it ranged from 3 to 9%.</div></div><div><h3>Interpretation</h3><div>The change in VC appears to be a valid test for confirming DD when using a cut-off value of 20%, though this approach results in very low sensitivity.</div><div>A cut-off value of 15% should be used in a screening setting as an initial approach of a multimodal strategy, without being sensible enough to exclude milder forms of DD.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101162"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-acting muscarinic antagonists (LAMA) in asthma: What is the best strategy?
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-01-31 DOI: 10.1016/j.resmer.2025.101157
Guillaume Mahay , Maeva Zysman , Nicolas Guibert , Cindy Barnig , Laurent Guilleminault , Clairelyne Dupin
{"title":"Long-acting muscarinic antagonists (LAMA) in asthma: What is the best strategy?","authors":"Guillaume Mahay ,&nbsp;Maeva Zysman ,&nbsp;Nicolas Guibert ,&nbsp;Cindy Barnig ,&nbsp;Laurent Guilleminault ,&nbsp;Clairelyne Dupin","doi":"10.1016/j.resmer.2025.101157","DOIUrl":"10.1016/j.resmer.2025.101157","url":null,"abstract":"<div><div>The use of long-acting muscarinic antagonists (LAMA) in asthma is supported by their mechanism of action and evidence of drug synergy with inhaled corticosteroids ± long-acting β-agonists. This review discusses the scientific rationale, clinical data, and recommendations for the use of LAMA in the asthma therapeutic strategy. Adding a LAMA to a dual therapy with an inhaled corticosteroid and long-acting β-agonist has been shown to reduce exacerbations, increase asthma control, and improve quality of life, with a good safety profile. In addition, using a single inhaler device containing multiple drugs enhances patients’ adherence to therapy. Some predictive factors of the efficacy of this triple therapy have been suggested in the literature: patients with a history of at least one exacerbation within the past 12 months, male patients, those younger than 65 years, and non-smokers have been reported to have a greater improvement from baseline forced expiratory volume in 1 second (FEV1) compared with patients without these characteristics, while patients with high bronchial hyperresponsiveness and persistent airway limitations (PAL) seem to show better gains in the exacerbation rate. However, eosinophil levels do not seem to predict the efficacy of LAMA. The role and long-term benefits of LAMA combined with biologic therapy in severe asthma remain uncertain, with more clinical data needed.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101157"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of severe exacerbations of COPD by French intensivists and adherence to guidelines
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-01-31 DOI: 10.1016/j.resmer.2025.101159
Luc Haudebourg , Morgane Faure , Martin Dres , Nicolas Roche , Nicolas Terzi , Elise Morawiec , Julie Delemazure , Armand Mekontso-Dessap , Thomas Similowski , Maxens Decavèle , Alexandre Demoule
{"title":"Management of severe exacerbations of COPD by French intensivists and adherence to guidelines","authors":"Luc Haudebourg ,&nbsp;Morgane Faure ,&nbsp;Martin Dres ,&nbsp;Nicolas Roche ,&nbsp;Nicolas Terzi ,&nbsp;Elise Morawiec ,&nbsp;Julie Delemazure ,&nbsp;Armand Mekontso-Dessap ,&nbsp;Thomas Similowski ,&nbsp;Maxens Decavèle ,&nbsp;Alexandre Demoule","doi":"10.1016/j.resmer.2025.101159","DOIUrl":"10.1016/j.resmer.2025.101159","url":null,"abstract":"<div><h3>Background</h3><div>Severe exacerbations of chronic obstructive pulmonary disease (ECOPD) require hospitalization in intensive care unit (ICU) in 10 % of cases. This study aims to describe current practices for the management of severe ECOPD in the ICU and to evaluate adherence to the 2017 French guidelines.</div></div><div><h3>Methods</h3><div>From March to May 2019, we conducted a cross-sectional multicenter survey across 80 ICUs in France. A 9-item questionnaire exploring physicians practices in terms of diagnostic workup and management of severe ECOPD was sent to participating centers.</div></div><div><h3>Results</h3><div>Four hundred and thirty-eight physicians responded to the survey, 75 % were senior physicians, 39 % were certified medical intensivists and 67 % worked in a medical or respiratory ICU. Nebulized short-acting beta agonists prescription was mostly driven by the presence of wheezing, silent chest or respiratory failure, even though guidelines recommend them systematically for ECOPD (moderate adhesion to guidelines). Antibiotic prescription was mostly driven by increased sputum purulence and volume, fever, signs of respiratory distress or the severity of the underlying COPD, but was not deemed systematic in case of severity signs (poor adhesion to guidelines). Regarding the use of biomarkers for antibiotics prescription, adhesion to guidelines was moderate. The prescription of systemic corticosteroids was not deemed systematic but was rather considered if no improvement was observed 72 h after admission (good adhesion to guidelines).</div></div><div><h3>Conclusion</h3><div>Reported management of severe ECOPD does not follow all guidelines. Future works should focus on understanding barriers to clinical practice guidelines implementation.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101159"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tele-medicine experiences and expectations from patients with neuromuscular diseases treated with non-invasive ventilation
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-01-31 DOI: 10.1016/j.resmer.2025.101160
Sandrine Segovia-Kueny , Mathieu Delorme , Caroline Stalens , Julie Lejeune , Frédéric Lofaso , Hélène Prigent , Antoine Leotard
{"title":"Tele-medicine experiences and expectations from patients with neuromuscular diseases treated with non-invasive ventilation","authors":"Sandrine Segovia-Kueny ,&nbsp;Mathieu Delorme ,&nbsp;Caroline Stalens ,&nbsp;Julie Lejeune ,&nbsp;Frédéric Lofaso ,&nbsp;Hélène Prigent ,&nbsp;Antoine Leotard","doi":"10.1016/j.resmer.2025.101160","DOIUrl":"10.1016/j.resmer.2025.101160","url":null,"abstract":"","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101160"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143206498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Forced vital capacity reduction severity in pulmonary fibrosis and post-lung transplantation outcomes 肺纤维化和肺移植术后的强迫生命容量降低严重程度
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-01-25 DOI: 10.1016/j.resmer.2025.101158
Manon Levêque , Julien Bermudez , Ana Nieves , Florence Daviet , Antoine Roux , Xavier Demant , Benjamin Renaud-Picard , Jérôme Le Pavec , Hervé Mal , Thomas Villeneuve , Jean-François Mornex , Loïc Falque , Véronique Boussaud , Christiane Knoop , Adrien Tissot , Martine Reynaud-Gaubert , Benjamin Coiffard , the COLT consortium
{"title":"Forced vital capacity reduction severity in pulmonary fibrosis and post-lung transplantation outcomes","authors":"Manon Levêque ,&nbsp;Julien Bermudez ,&nbsp;Ana Nieves ,&nbsp;Florence Daviet ,&nbsp;Antoine Roux ,&nbsp;Xavier Demant ,&nbsp;Benjamin Renaud-Picard ,&nbsp;Jérôme Le Pavec ,&nbsp;Hervé Mal ,&nbsp;Thomas Villeneuve ,&nbsp;Jean-François Mornex ,&nbsp;Loïc Falque ,&nbsp;Véronique Boussaud ,&nbsp;Christiane Knoop ,&nbsp;Adrien Tissot ,&nbsp;Martine Reynaud-Gaubert ,&nbsp;Benjamin Coiffard ,&nbsp;the COLT consortium","doi":"10.1016/j.resmer.2025.101158","DOIUrl":"10.1016/j.resmer.2025.101158","url":null,"abstract":"<div><h3>Background</h3><div>The ISHLT guidelines recommend early referral to a lung transplantation (LTx) center for patients with interstitial lung disease (ILD) due to the unpredictable course. To our knowledge, no study has assessed the impact of forced vital capacity (FVC) reduction severity on LTx outcomes in ILD. This study aims to determine whether the severity of FVC reduction is associated with post-transplant outcomes in ILD.</div></div><div><h3>Methods and Results</h3><div>Recipients from the French multicentric COLT cohort who underwent lung transplantation for ILD were included in this study. FVC was assessed to determine if the severity of its reduction is associated with post-transplant outcomes. 311 recipients were included in the study. FVC was identified as a significant risk factor for mortality at one year in multivariate analysis (<em>p</em> = 0.003). The ROC curve for FVC estimated the probability of death at one year with an area under the curve of 64 % (95 % confidence interval 57–71 %) and defined an optimal FVC threshold of 46 %. Recipients with an FVC ≤46 % were more likely to be listed as emergency cases, had lower FVC at one year, and exhibited reduced short- and long-term survival.</div></div><div><h3>Conclusions</h3><div>The severity of pre-transplant FVC reduction is a risk factor for poorer post-transplant outcomes. The findings should stimulate discussion about benefits of LTx for patients with lower FVC. An FVC threshold of ≤46 % should be considered in discussions about lung transplantation indications, decisions regarding single lung transplantation, and the selection of smaller donor lungs. Respirologists managing patients with ILD should consider early referral to a LTx center.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101158"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of high flow nasal oxygen therapy in acute hypoxemic respiratory failure due to COVID-19 pneumonia
IF 2.2 4区 医学
Respiratory Medicine and Research Pub Date : 2025-01-24 DOI: 10.1016/j.resmer.2025.101156
Asma Tariq , Maher Ghamloush , Greg Schumaker , Anthony Faugno , Lori Lyn Price , Leslie Lussier , Anjan Devaraj , Amrita Karambelkar , Beverly Wong , Elizabeth Han , Lydia Ran , Edward Shi , Alison Travers , Suma Gondi , Derek Lejeune , Gizem Koybasi , Nicholas S. Hill
{"title":"The role of high flow nasal oxygen therapy in acute hypoxemic respiratory failure due to COVID-19 pneumonia","authors":"Asma Tariq ,&nbsp;Maher Ghamloush ,&nbsp;Greg Schumaker ,&nbsp;Anthony Faugno ,&nbsp;Lori Lyn Price ,&nbsp;Leslie Lussier ,&nbsp;Anjan Devaraj ,&nbsp;Amrita Karambelkar ,&nbsp;Beverly Wong ,&nbsp;Elizabeth Han ,&nbsp;Lydia Ran ,&nbsp;Edward Shi ,&nbsp;Alison Travers ,&nbsp;Suma Gondi ,&nbsp;Derek Lejeune ,&nbsp;Gizem Koybasi ,&nbsp;Nicholas S. Hill","doi":"10.1016/j.resmer.2025.101156","DOIUrl":"10.1016/j.resmer.2025.101156","url":null,"abstract":"<div><h3>Background</h3><div>The use of high flow nasal oxygen therapy (HFNO) may improve clinical outcomes in acute hypoxemic respiratory failure (AHRF) compared to conventional oxygen. However, whether the use of HFNO improves clinical outcomes in COVID-19 pneumonia remains unclear. In this study, we describe the use of HFNO, as compared to conventional oxygen therapy (COT), in moderate to severe COVID-19 pneumonia.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study conducted at one academic medical center and one community hospital between March 1, 2020 and July 14, 2020. The primary purpose of the study was to determine the success of HFNO in preventing the composite outcome of invasive mechanical ventilation (IMV) or in-hospital death compared to COT. Secondary objectives included determining the predictors of this composite outcome, rate of endotracheal intubation, hospital mortality and outcomes of early versus late HFNO failure. Logistic and quantile regression were used to test for associations.</div></div><div><h3>Results</h3><div>A total of 197 patients were included<strong>,</strong> 166 in the HFNO and 31 in the COT group. There was no significant difference between the groups in the composite outcome of IMV or death, odds ratio (OR) = 0.36, <em>p</em> = 0.08. Use of HFNO as opposed to COT was associated with a significant reduction in the rate of IMV (64 % versus 87 %, <em>p</em> = 0.03). Older age and coronary artery disease were associated with HFNO failure. There was no significant mortality difference between early and late IMV.</div></div><div><h3>Conclusion</h3><div>In our study, HFNO did not reduce our primary composite outcome of IMV or death in moderate to severe AHRF, although we found that HFNO was associated with lower rate of intubation compared to COT. We detected no benefit of early vs late IMV. Utilizing HFNO in COVID-19 patients with AHRF may be a reasonable initial respiratory support strategy with close monitoring. Additional studies are needed to determine subset(s) of such patients that would benefit the most from HFNO use.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101156"},"PeriodicalIF":2.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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