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 , Morgane Faure , Martin Dres , Nicolas Roche , Nicolas Terzi , Elise Morawiec , Julie Delemazure , Armand Mekontso-Dessap , Thomas Similowski , Maxens Decavèle , 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}
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 , 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","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}
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 , 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","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}
Damien Basille , Bénédicte Toublanc , Géraldine François , Isabelle Mayeux , Claire Poulet , Lola Soriot , Mélanie Drucbert , Nour Ahmad , Claire Andrejak , Daniel Rodenstein , Yazine Mahjoub , Vincent Jounieaux
{"title":"Role of narrow band imaging in assessing bronchial mucosal hypervascularization in COVID-19 patients","authors":"Damien Basille , Bénédicte Toublanc , Géraldine François , Isabelle Mayeux , Claire Poulet , Lola Soriot , Mélanie Drucbert , Nour Ahmad , Claire Andrejak , Daniel Rodenstein , Yazine Mahjoub , Vincent Jounieaux","doi":"10.1016/j.resmer.2025.101155","DOIUrl":"10.1016/j.resmer.2025.101155","url":null,"abstract":"<div><h3>Background</h3><div>SARS-CoV-2 virus which targets the lung vasculature is supposed to affect both pulmonary and bronchial arteries. This study evaluated the tracheobronchial vascularization density observed with narrow band imaging (NBI) in patients hospitalized for COVID-19 pneumonia. To determine if the observed changes were specific of COVID-19 patients, the procedure was also performed in non-COVID-19 patients.</div></div><div><h3>Methods</h3><div>Thirty patients included in this monocentric, prospective study underwent videobronchoscopy using both white light and NBI: 10 with a COVID-19 infection, 10 with a non-COVID-19 pulmonary infection and 10 with a peripheral pulmonary nodule. The tracheobronchial vascular density observed through NBI was rated by two blinded pneumologists at three levels (carina, right main bronchus and left main bronchus).</div></div><div><h3>Results</h3><div>When compared to the two other groups, a significant increase of the tracheobronchial vascularization was found in COVID-19 patients. The median tracheobronchial vascularization global score obtained with NBI (out of 15 points) was: 10 [9 – 13] in the COVID-19 group, 5 [4 – 10] in the non-COVID-19 group (<em>p</em> < 0.001) and 6 in the Nodule group [4 – 9] (<em>p</em> = 0.002). Using a weighted Cohen's Kappa coefficient, we observed a good agreement between the two raters for the evaluation of the tracheobronchial vascularization score (κ = 0.75 [0.65–0.83]); <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Videobronchoscopy with NBI in COVID-19 patients showed diffuse changes in tracheobronchial vascularization. We suggest that such bronchial hypervascularisation with dilated vessels contributes, at least in part, to the intrapulmonary right to left shunt that characterized the COVID-19 related Acute Vascular Distress Syndrome (AVDS).</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101155"},"PeriodicalIF":2.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025365","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}
{"title":"Constraints to the initiation of home non-invasive ventilation and short-term efficacy in different diagnostic groups (as a prelude to an ambulatory shift)","authors":"Claire Drouet , Pascaline Priou , Frédéric Gagnadoux , Wojciech Trzepizur","doi":"10.1016/j.resmer.2025.101154","DOIUrl":"10.1016/j.resmer.2025.101154","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-invasive ventilation (NIV) is the reference treatment for chronic respiratory failure (CRF) due to impairment of the ventilatory system. Home initiation is increasingly practiced. To better support this ambulatory shift, we aimed to assess the implementation constraints and short-term efficacy according to different aetiologies of CRF.</div></div><div><h3>Methods</h3><div>This retrospective study with cross-sectional and longitudinal analysis included patients initiated with NIV at Angers University Hospital. Patients were separated according to the following aetiologies: obesity hypoventilation syndrome (OHS), chronic obstruction pulmonary disease (COPD), amyotrophic lateral sclerosis (ALS), myopathy and chest wall disease. Implementation constraints were assessed by analysing the variability of NIV settings, the number of masks tried and the duration of hospitalisation. NIV effectiveness was assessed by measuring residual PaCO2 (arterial pressure in CO2), apnoea hypopnea index (AHI<sub>flow</sub>) and tidal volume (V<sub>T</sub>) (as displayed by the NIV software).</div></div><div><h3>Results</h3><div>Between October 2020 and May 2022, 102 patients were started with NIV, including a majority of ALS patients. We found a moderate variability in NIV settings (pressure, slope, triggers, etc.) within the different etiological groups, particularly in ALS. On the other hand, ALS patients required more interface trials than other groups and often had unmet efficacy criteria at hospital discharge. Interestingly, longitudinal follow-up showed a progressive improvement in efficacy criteria, particularly in patients who were initially inadequately ventilated.</div></div><div><h3>Conclusion</h3><div>Each aetiological group has specific constraints in the initiation of NIV that should be considered when initiating NIV in the outpatient setting.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101154"},"PeriodicalIF":2.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042395","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}
Claire Farkouh , Ari Chaouat , Anne Guillaumot , Bruno Ribeiro Baptista , François Chabot , Simon Valentin
{"title":"Pulmonary hypertension in patients with chronic obstructive pulmonary disease: Impact of lung hyperinflation on the response to pulmonary hypertension treatment","authors":"Claire Farkouh , Ari Chaouat , Anne Guillaumot , Bruno Ribeiro Baptista , François Chabot , Simon Valentin","doi":"10.1016/j.resmer.2024.101153","DOIUrl":"10.1016/j.resmer.2024.101153","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) is common during chronic obstructive pulmonary disease (COPD), particularly in patients with severe COPD. These patients can be classified into different PH groups due to frequent comorbidities. Emphysema is often associated with COPD and is responsible for lung hyperinflation, which may contribute to the development of PH. The treatment of PH in COPD is not well defined, and the response to treatment is variable depending on the phenotype of the patients. The aim of this study was to determine whether pulmonary hyperinflation in COPD patients predicts response to treatment.</div></div><div><h3>Methods</h3><div>This observational, retrospective, single-center study included COPD patients diagnosed with PH, treated with PH treatments. Patient were divided into two groups according to lung hyperinflation, judged on the ratio of residual volume to total lung capacity. Response to treatment was defined by an improvement of at least 30 m in the 6-minute walk test or a one-point improvement in World Health Organization functional class at the first reassessment performed at least three months after treatment initiation.</div></div><div><h3>Results</h3><div>Of the 47 patients included, 30 (63.8 %) were responders to PH treatments, with no significant difference between patients in the “lung hyperinflation” (HI) group and those in the “no lung hyperinflation” (NoHI) group (64.3 % vs. 63.2 %, <em>p</em> = 0.937). However, response to treatment was significantly lower in the most distended patients when compared to non-distended patients (<em>p</em> = 0.033). Mean overall survival was 59.1 months (95 % CI [47.4–70.7]) and was significantly better in responders, with a mean survival of 71.5 months (95 % CI [58.6–84.5]) vs. 35.4 months (95 % CI [17.3–53.4], <em>p</em> = 0.001). Mean survival did not differ according to lung hyperinflation, with a mean survival of 50.3 months (95 % CI [35.2–65.3]) for patients with HI, and 70.4 months (95 % CI [54.3–86.5], <em>p</em> = 0.105) for NoHI patients.</div></div><div><h3>Conclusions</h3><div>In COPD and PH patients eligible for PH treatments, the presence of lung hyperinflation did not predict response to treatment. However, patients with high degree of lung hyperinflation had a significantly poorer response to PAH treatment than patients without lung hyperinflation. Further studies are needed to confirm these results and to investigate other determinants of response in this population.</div></div><div><h3>Clinical Trial Registration</h3><div>The study design has been registered on ClinicalTrials (NCT06613321).</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101153"},"PeriodicalIF":2.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104863","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}
Julie Tronchetti , Paul Habert , Thibault Agripnidis , Katia Chaumoitre , Noémie Resseguier , Anh Thu Nguyen , Jean-Yves Gaubert , Hervé Dutau , Philippe Astoul , Julien Guinde
{"title":"The effect of concurrent acetylsalicylic acid on hemorrhagic complications during percutaneous image-guided lung biopsy","authors":"Julie Tronchetti , Paul Habert , Thibault Agripnidis , Katia Chaumoitre , Noémie Resseguier , Anh Thu Nguyen , Jean-Yves Gaubert , Hervé Dutau , Philippe Astoul , Julien Guinde","doi":"10.1016/j.resmer.2024.101150","DOIUrl":"10.1016/j.resmer.2024.101150","url":null,"abstract":"<div><h3>Background</h3><div>CT-guided trans-thoracic lung biopsy (CT-TTLB) is efficient and widely used to diagnose pulmonary nodules. After pneumothorax, the second most frequent complication is hemoptysis, which can be life-threatening. These patients often have comorbidities and are on acetylsalicylic-acid (ASA) therapy. The aim of this study was to assess ASA as a risk factor for hemoptysis or severe hemoptysis following CT-TTLB.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed consecutive patients undergoing CT-TTLB from 2 centers between 01/2018 and 01/2021. Exclusion criteria were nodules with a pleural contact or a contraindication to lung puncture. Clinical and imaging data were recorded such as age, gender, comorbidities, hemoptysis (every blood spit), severe hemoptysis (>200 mL / oxygen need>10L/min / intervention or resuscitation / death), nodule size, puncture depth, emphysema, nodule location, patient position and histology. Lung parenchymal hemorrhage (LPH) was quantified in cm³ on CT after biopsy. Univariate and multivariate analysis were performed with a logistic regression model, without and with propensity match score, to identify variables associated with hemoptysis and severe hemoptysis.</div></div><div><h3>Results</h3><div>Four-hundred-and-one patients were analyzed, 106 and 295 in the ASA or the control group respectively. In multivariate analysis, ASA use was a risk factor for severe hemoptysis (OR=4.5; 95 %CI[1.3–15.9]) but not for hemoptysis (OR=1.7; 95 %CI[0.5–3.1]), persisting after matching. There was no difference for LPH between the ASA and the control sub-groups (median (IQR)) 5.2cm³ (15.3) vs 3.1cm³ (11.5) <em>p</em> = 0.2).</div></div><div><h3>Conclusions</h3><div>Treatment with ASA did not increase the risk of all hemoptysis occurrence after CT-TTLB but was a risk factor for severe hemoptysis.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101150"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104864","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}
Clémentine Bouchez , Chahine Medraoui , Aurélie Cazes , Antoine Khalil , Gilles Jebrak , Hervé Mal , Pierre Mordant , Yves Castier , Philippe Montravers , Marie-Pierre Debray , Gérard Zalcman , Jonathan Messika , Valérie Gounant , investigators of Bichat Lung Transplant Program
{"title":"Prognosis of incidental lung cancer in lung transplant candidates","authors":"Clémentine Bouchez , Chahine Medraoui , Aurélie Cazes , Antoine Khalil , Gilles Jebrak , Hervé Mal , Pierre Mordant , Yves Castier , Philippe Montravers , Marie-Pierre Debray , Gérard Zalcman , Jonathan Messika , Valérie Gounant , investigators of Bichat Lung Transplant Program","doi":"10.1016/j.resmer.2024.101146","DOIUrl":"10.1016/j.resmer.2024.101146","url":null,"abstract":"<div><h3>Background</h3><div>Incidental lung cancer, in the field of lung transplantation (LTx), is more often related to malignancies diagnosed in explants or transplanted organs. Little is known about cancer diagnosed during the medical evaluation of potential LTx candidates. What are the clinical, and prognostic differences between lung cancers diagnosed before or after transplantation in LTx candidates?</div></div><div><h3>Methods</h3><div>We performed a retrospective, observational, single-center study to describe the characteristics of lung malignancies first discovered during the pre-transplant assessment and then identified in lung explants, over the same period.</div></div><div><h3>Results</h3><div>From 1630 consecutive patients referred to Paris-Bichat Lung Transplant Program from 2006 to 2022, 288 were deemed not suitable for transplantation. The reason was lung malignancy in 20 patients (15 non-small cell lung cancer (NSCLC) proved). The one-year survival rate was 55 %. Seven died from their respiratory insufficiency, and six died from lung cancer progression. Over the same period, 611 patients received LTx. NSCLC were identified in six explants (1 %). One-year survival was 66.7 % in these transplanted patients.</div></div><div><h3>Conclusions</h3><div>Lung cancer diagnosed during the medical evaluation of potential LTx candidates is rare. However, this represents a critical issue because it contraindicates LTx and leads to a non-optimal management of both lung cancer and of end-stage lung disease. We report an encouraging one-year survival rate in transplanted patients with a pathological lung malignancy diagnosis in lung explant, compared to their counterpart in whom lung cancer discovery contraindicated LTx. A multicenter observational study is mandatory in order to confirm such observation, as it might change current standard to deny LTx in patients with incidental localized NSCLC.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101146"},"PeriodicalIF":2.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848017","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}
Abouzar Chaudhry , Floriane Gallais , Pierre-Emmanuel Falcoz , Sylvie Colin De Verdiere , Thomas Villeneuve , Delphine Horeau , Eva Chatron , Elodie Blanchard , Olivier Collange , Benjamin Renaud-Picard
{"title":"Efficacy of convalescent plasma for the treatment of COVID-19 in lung transplant recipients: A multicenter French study","authors":"Abouzar Chaudhry , Floriane Gallais , Pierre-Emmanuel Falcoz , Sylvie Colin De Verdiere , Thomas Villeneuve , Delphine Horeau , Eva Chatron , Elodie Blanchard , Olivier Collange , Benjamin Renaud-Picard","doi":"10.1016/j.resmer.2024.101145","DOIUrl":"10.1016/j.resmer.2024.101145","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung transplant (LT) recipients are at greater risk of complications from COVID-19. Treatment options are limited partly due to interactions with immunosuppressive agents. Convalescent plasma (CP) is a potential treatment option, but it has not been extensively studied in LT patients. We aimed to assess the efficacy and safety of CP use in France for COVID-19 infected LT patients.</div></div><div><h3>Material and methods</h3><div>We retrospectively recruited LT patients followed up in the 10 French LT centers, older than 18 years, infected with SARS-CoV-2 between the pandemic onset and July 1, 2023, and treated with high-titer CP.</div></div><div><h3>Results</h3><div>We collected the data from 27 patients who received CP for a COVID-19 infection in six out of the 10 French LT centers. The average delay between symptom onset and CP administration was 19.5 days, and 51.8 % of patients received four units. In patients treated within the first 9 days of infection, the survival rate was 100 % at one and three months vs. 75 % (<em>p</em> = 0.28) for late administration patients. Average loss of forced expiratory volume in 1 second at three months was 10.5 % in the early group vs. 3.3 % in the late group (<em>p</em> = 0.58). The average length of hospital stay was 18 and 24 days respectively (<em>p</em> = 0.07). Early use of CP was also more frequent in 2023.</div></div><div><h3>Discussion</h3><div>In this study highlighting the French experience for the use of CP in LT patients, we observed a limited, heterogenous but well-tolerated use of this therapy.</div></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"87 ","pages":"Article 101145"},"PeriodicalIF":2.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848010","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}