Heart & Lung最新文献

{"title":"The influence of vigorous physical exertion on cardiac demand under conditions of daily living among firefighters with elevated blood pressure","authors":"Christina A. Day MSc ,&nbsp;Rachel S. Berkowsky MSc ,&nbsp;Amanda L. Zaleski PhD ,&nbsp;Ming-Hui Chen PhD ,&nbsp;Beth A. Taylor PhD, FACSM ,&nbsp;Yin Wu PhD ,&nbsp;Paul M. Parducci BSc ,&nbsp;Yiming Zhang PhD ,&nbsp;Bo Fernhall PhD, FACSM ,&nbsp;Antonio B. Fernandez MD ,&nbsp;Linda S. Pescatello PhD, FACSM","doi":"10.1016/j.hrtlng.2024.07.008","DOIUrl":"10.1016/j.hrtlng.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><p>Firefighters have a high prevalence of cardiovascular disease. The poor heart health of firefighters is implicated in their increased risk of sudden cardiac death (SCD). Exercise may be protective against SCD partially due to the immediate blood pressure (BP) reductions of 5–8 mmHg following exercise, termed <em>postexercise hypotension</em> (PEH)</p></div><div><h3>Objectives</h3><p>To examine PEH under ambulatory conditions after a maximal cardiopulmonary exercise test (CPET) among career firefighters</p></div><div><h3>Methods</h3><p>Firefighters (<em>n</em> = 19) completed a maximal CPET and non-exercise control (CONTROL) in random order on separate non-workdays and left the laboratory instrumented to an ambulatory BP (ABP) monitor. Ambulatory systolic BP (ASBP), diastolic BP (ADBP), and heart rate (AHR) were recorded at hourly intervals over 19hr. The ambulatory rate pressure product (ARPP) was calculated as ASBPxAHRx10^–3 at each hourly interval. Repeated measures ANCOVA tested if the ABP, AHR, and ARPP responses differed after CPET vs CONTROL over 19hr</p></div><div><h3>Results</h3><p>Firefighters were middle-aged (39.5 ± 8.9 yr), overweight (29.2 ± 4.0 kg/m²) men with elevated BP (123.1 ± 9.6/79.8 ± 10.4 mmHg), while resting HR (67.7 ± 11.3 bpm) and RPP (8.4 ± 1.7mmHg*bpm*10^–3) were in normal ranges. ASBP (16.6 ± 5.7 mmHg) and ADBP (3.1 ± 4.6 mmHg) increased after the CPET vs CONTROL over 19hr (ps&lt;0.01), as did AHR (9.4 ± 7.9 bpm, <em>p</em> = 0.02) and ARPP (2.5 ± 1.1mmHg*bpm*10^–3, <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Unexpectedly, the firefighters exhibited <em>postexercise hypertension</em> rather than PEH. The increases in ABP and AHR we observed indicated a sustained increase in cardiac demand. Further investigation is needed to confirm our findings and determine whether the adverse hemodynamic responses we observed contribute to the high prevalence of SCD that firefighters experience on the job.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 208-216"},"PeriodicalIF":2.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762773","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}

{"title":"Evaluation of staged autologous blood transfusion during extracorporeal membrane oxygenation decannulation: A retrospective study","authors":"Yun Gao ,&nbsp;Xufeng Chen ,&nbsp;Yong Mei,&nbsp;Tingting Yang,&nbsp;Xihua Huang,&nbsp;Hui Zhang,&nbsp;Yongxia Gao,&nbsp;Feng Sun,&nbsp;Huazhong Zhang,&nbsp;Xueli Ji,&nbsp;Juan Wu","doi":"10.1016/j.hrtlng.2024.07.009","DOIUrl":"10.1016/j.hrtlng.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><p>Clinical blood resources are scarce and autologous blood transfusion for extracorporeal membrane oxygenation (ECMO) withdrawal is less studied.</p></div><div><h3>Objectives</h3><p>To assess the use of staged autotransfusion during ECMO decannulation.</p></div><div><h3>Methods</h3><p>The study included ECMO withdrawal patients. Patients in the autologous transfusion group underwent staged transfusion during ECMO withdrawal, while those in the control group received 2.0 units of allogeneic packed red blood cells (RBCs) to increase hemoglobin (Hb). Parameters such as Hb, hematocrit (Hct), adverse events, decannulation success rate, volume of allogeneic RBC transfusions, and transfusion costs were compared.</p></div><div><h3>Results</h3><p>A total of 82 Chinese patients were enrolled, with a mean age of 46 years, 27 were female, and the top three primary diagnoses were cardiac arrest, acute myocarditis, and severe pneumonia. There were 41 individuals in the autologous blood transfusion group and 41 in the control group. No significant differences were observed in Hb, Hct, adverse events, and the success rate for decannulation between the two groups (all <em>P</em> &gt; 0.05). Compared with the control group, the volume of allogeneic RBC transfusions [0 (0∼1.50) U vs. 3.5 (1.88∼40) U, <em>P</em> &lt; 0.001] and the total cost [130 (130∼390) Chinese Yuan (CNY) vs. 910 (487.50, 1040) CNY, <em>P</em> = 0.002] were lower in the autologous transfusion group.</p></div><div><h3>Conclusion</h3><p>In comparison with allogeneic RBC transfusion, staged autotransfusion during ECMO decannulation not only effectively maintained Hb levels but also reduced the requirement for allogeneic RBC transfusions. In addition, this approach decreased the associated costs and did not increase the risk of clinical adverse events.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 202-207"},"PeriodicalIF":2.4,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001365/pdfft?md5=8f5a1e0161368b525b44fefdc95d25dc&pid=1-s2.0-S0147956324001365-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753416","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":"Risk factors for readmission after sepsis and its association with mortality","authors":"Milo Engoren MD ,&nbsp;Cynthia Arslanian-Engoren PhD, RN","doi":"10.1016/j.hrtlng.2024.07.007","DOIUrl":"10.1016/j.hrtlng.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><p>Sepsis is associated with an approximately 20 % 30-day readmission rate and with subsequent mortality.</p></div><div><h3>Objectives</h3><p>To determine the demographics, comorbidities that had been documented prior to sepsis onset, processes of care, commonly administered laboratory tests measured near discharge, and post-sepsis infections that may be associated with readmission and, secondarily, whether readmission is an independent risk factor for 90-day mortality.</p></div><div><h3>Methods</h3><p>Using a database of patients who met Sepsis-3 criteria divided into Construction and Validation groups, we used logistic regression to estimate the factors independently associated with readmission within 30 days after discharge and proportional hazard regression to estimate the factors independently associated with 90-day mortality.</p></div><div><h3>Results</h3><p>Of the 30,798 patients ≥ 18 years at our combined referral and community hospital and were discharged alive who met Sepsis-3 criteria between July 10, 2009 and September 7, 2019, 5943 (19 %) were readmitted within 30 days. Thirteen thousand, four hundred forty-four (44 %) of the patients were female, 25,293 (82 %) White, 3523 (11 %) Black, and the mean age was 59 ± 17 years. Among the readmitted patients, 894 (15 %) died within 90 days from the original discharge compared to 11 % (<em>p</em> &lt; 0.001) who had not been readmitted. Seven comorbidities, five processes of care (presepsis platelet transfusion, postsepsis platelet transfusion, operation, ICU length of stay, and hospital length of stay), five culture results, two discharge laboratory values, and discharge location were associated with readmission. The model had good discrimination, 0.770 ± 0.004 (Construction Group) and 0.748 ± 0.006 (Validation Group) and good relevancy (area under the precision recall curve), 0.390 ± 0.004 (Construction group) and 0.476 ± 0.005 (Validation group). Readmission within 30 days was independently associated with a 56 % higher risk of death (HR=1.562, 95 % CI=1.434, 1.703, <em>p</em> &lt; 0.001) within 90 days from discharge.</p></div><div><h3>Conclusions</h3><p>Comorbidities, abnormal laboratory values, processes of care, and post-sepsis onset culture results, but not demographic characteristics, were associated with 30-day readmission. Readmission was associated with 90-day mortality.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 195-201"},"PeriodicalIF":2.4,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729735","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}

{"title":"The role of Sodium-Glucose Transporter-2 Inhibitors (SGLT-2i) in preventing chronic obstructive disease exacerbation in patients with diabetes and COPD: An electronic health database analysis","authors":"Sushan Gupta ,&nbsp;Avani Mohta ,&nbsp;Alexa Lauinger ,&nbsp;Danish Thameem","doi":"10.1016/j.hrtlng.2024.07.003","DOIUrl":"10.1016/j.hrtlng.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><p>Sodium Glucose Transporter 2 inhibitor (SGLT-2i) medications reduce inflammation, improve glycemic control, and impart weight loss, all of which may play a role in chronic obstructive pulmonary disease (COPD) pathophysiology.</p></div><div><h3>Objectives</h3><p>The primary objective of our study was to explore the incidence of COPD exacerbation in patients with diabetes and COPD on SGLT-2i medications. The secondary objective was to assess the impact of SGLT-2i medications on COPD exacerbations needing hospitalization, ICU admission, and mechanical ventilation.</p></div><div><h3>Methods</h3><p>This was a retrospective cohort analysis of COPD patients with diabetes enrolled in the COPD registry at a Mid-west Tertiary care teaching hospital from January 1, 2022, to December 31, 2022. We used Slicer-Dicer, a self-service cohort exploration tool embedded in EPIC for data extraction.</p></div><div><h3>Results</h3><p>We had 31,411 patients registered with the COPD registry during the study period. Of these, 18,713 had diabetes, and 1295 patients were on SGLT-2i medication. The incidence of COPD exacerbation, including severe COPD exacerbation needing hospitalization, was significantly lower in the SGLT-2i medication group (3.16% vs 18.3%, <em>p</em> &lt; 0.05; 1.2% vs 5.04%, <em>p</em> &lt; 0.05). Also, there was a non-significant trend suggesting that the incidence of COPD exacerbation needing intensive care unit admission and intubation was lower in the SGLT-2i medication group (0.07% vs 3.4%; 0 vs 0.04%). SGLT-2i medication use was associated with reduced incidence of COPD exacerbation irrespective of underlying control of diabetes.</p></div><div><h3>Conclusions</h3><p>Our study suggests possible role of SGLT-2i in preventing COPD exacerbation. Randomized trials are needed in the future to confirm or refute these findings.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 191-194"},"PeriodicalIF":2.4,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728360","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}

{"title":"Communication intervention for families in adult intensive care units during COVID-19 pandemic: A systematic review","authors":"Eun Ju Park MSN, RN ,&nbsp;Jooyeon Seong MSN, RN ,&nbsp;Ji Won Shin PhD, RN ,&nbsp;Judith A. Tate PhD, RN, FAAN, ATSF ,&nbsp;JiYeon Choi PhD, RN, ATSF","doi":"10.1016/j.hrtlng.2024.07.004","DOIUrl":"10.1016/j.hrtlng.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Restrictions on ICU family visitation during COVID-19 pandemic posed communication challenges for families, patients, and healthcare teams. Diverse approaches were used to overcome communication barriers. As ICUs begin to reinstate family visitation, it is timely to review the lessons learned from these interventions during the pandemic.</p></div><div><h3>Objectives</h3><p>To identify and evaluate content and qualities of the studies that describe communication interventions for families of adult ICU patients during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>Following the PRISMA guidelines, we searched PubMed, Embase, CINAHL, and Web of Science for studies that (1) involved communication intervention for families in adult ICU settings, (2) were published between January 2020 and September 2022, and (3) were published in English. We excluded studies that were not from peer-reviewed journal articles or in English.</p></div><div><h3>Results</h3><p>Of 2,628 articles initially identified, we reviewed the 23 selected studies (20 non-experimental and 3 experimental studies). Most of the studies were published in 2022 (<em>n</em> = 14, 60.9 %) and conducted in Europe (<em>n</em> = 13, 56.5 %). Various communication methods (e.g., video calls, telephone, applications) were used to provide information, emotional support, and virtual access to patients and their families. Video calls were the most frequently used intervention. Many interventions included healthcare teams providing updates on the patient's condition or treatment to the family.</p></div><div><h3>Conclusions</h3><p>The COVID-19 pandemic prompted the adoption of diverse communication approaches for families in ICU settings, despite many limitations, including technical challenges. Insights gained from this experience will help expedite flexibility and diversity in designing communication interventions for ICU family members.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 175-190"},"PeriodicalIF":2.4,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636736","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}

{"title":"Weight-adjusted waist index is an independent predictor of all-cause and cause-specific mortality in patients with asthma","authors":"Shidong Wang ,&nbsp;Dai Li ,&nbsp;Liping Sun","doi":"10.1016/j.hrtlng.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><p>There is a close relationship between obesity and the occurrence of asthma.The weight-adjusted waist index (WWI) is a relatively novel anthropometric parameter that reflects obesity.</p></div><div><h3>Objective</h3><p>We aimed to explore the association between WWI and mortality in the asthma population.</p></div><div><h3>Methods</h3><p>We included adult with asthma from NHANES 1999–2018. WWI = Waist circumference (cm)/square root of body weight (kg). Current asthma was determined by the participant's responses in standardized questionnaires. All-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality information was obtained by prospectively matching these data to the National Death Index. Multivariate-adjusted Cox proportional hazards regression analyses, Kaplan Meier survival analyses, restricted cubic spline (RCS) analyses, stratified analyses, and sensitivity analyses were used to clarify these associations.</p></div><div><h3>Results</h3><p>A total of 101,316 participants were included in the study, and 3223 were diagnosed with asthma.WWI was independently and positively associated with all-cause and all factor-specific mortality in asthma. In fully adjusted models, each unit increase in WWI was associated with 43 % (hazard ratio [HR] and 95 % confidence interval [CI] = 1.43 [1.25,1.64], <em>p</em> &lt; 0.0001), 58 % (1.58 [1.25, 1.99], <em>p</em> &lt; 0.001), 50 % (1.50 [1.19, 1.90], <em>p</em> &lt; 0.001), and 79 % (1.79 [1.34, 2.39], <em>p</em> &lt; 0.0001) increased all-cause, CVD, cancer, and respiratory disease mortality, respectively. RCS analyses showed largely linear associations between WWI and all mortality risks. Stratified analyses indicated that these associations were influenced by multiple factors, and that age was consistently the effect modifier across all associations.</p></div><div><h3>Conclusions</h3><p>WWI is an independent predictor of all-cause, CVD, cancer, and respiratory-related mortality in the adult asthma population. These findings highlight that WWI may have novel prognostic value as a simple and easily accessible obesity parameter in asthma patients.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 166-174"},"PeriodicalIF":2.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147956324001304/pdfft?md5=5770841dbe3d791cb8c7312877be1328&pid=1-s2.0-S0147956324001304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605277","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":"Impact of the COVID-19 pandemic on mechanical ventilation cases and mortality rates in non-SARS-CoV-2 patients: A nationwide analysis in Spain","authors":"Javier Muñoz MDPhD","doi":"10.1016/j.hrtlng.2024.06.017","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.06.017","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has presented unprecedented challenges for healthcare systems globally, impacting critical care resources and patient outcomes. Understanding its multifaceted effects is crucial for future crisis response.</p></div><div><h3>Objective</h3><p>Analyze the repercussions of the COVID-19 pandemic on mechanical ventilation cases and mortality among non-SARS-CoV-2 patients.</p></div><div><h3>Methods</h3><p>A nationwide database encompassing all patients receiving mechanical ventilation in Spain was used to compare the number of cases and clinical outcomes during COVID-19 (March 2020 - December 2021) to pre-pandemic cases (May 2018 - February 2020). Univariate and multivariate analyses were employed.</p></div><div><h3>Results</h3><p>COVID-19 significantly reduced access to ventilation for non-COVID-19 patients. A 16 % decrease (12,099 fewer patients) was observed during the pandemic compared to pre-pandemic times. This reduction affected all analyzed conditions except self-inflicted injuries, coinciding with a rise in overall mortality risk (34.5% vs 35.6 %, OR 1.09, 95 %CI 1.06–1.12). The increased mortality was consistent across diverse admission types, including cancer (37.1% vs. 41.5 %, OR 1.18, 95 %CI 1.09–1.29), hemorrhagic strokes (55.4% vs. 56.6 %, OR 1.07, 95 %CI 1.02–1.20), acute myocardial infarction (35.6% vs. 38 %, OR 1.11, 95 %CI 1.01–1.21), non-SARS-CoV-2 pneumonia (44.5% vs. 45.8 %, OR 1.12, 95 %CI 1.02–1.24), septic shock (54.7% vs. 56.3 %, OR 1.10, 95 %CI 1.06–1.15), and prolonged ventilation (≥96 h) (37% vs. 38.2 %, OR 1.10, 95 %CI 1.06–1.10).</p></div><div><h3>Conclusions</h3><p>The findings underscore the profound impact of the COVID-19 pandemic on critical care utilization and patient outcomes among non-SARS-CoV-2 patients. As healthcare systems strive to mitigate future crises, these insights emphasize adaptable strategies for equitable access to life-saving treatments.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 154-159"},"PeriodicalIF":2.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605278","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}

{"title":"Exercise intolerance, oxidative stress, and irisin in pediatric cystic fibrosis: Can telehealth-based exercise training make a difference?","authors":"Kubra Kilic ,&nbsp;Naciye Vardar-Yagli ,&nbsp;Halime Nayir-Buyuksahin ,&nbsp;Ismail Guzelkas ,&nbsp;Deniz Dogru ,&nbsp;Melda Saglam ,&nbsp;Ebru Calik-Kutukcu ,&nbsp;Deniz Inal-Ince ,&nbsp;Nagehan Emiralioglu ,&nbsp;Ebru Yalcin ,&nbsp;Ugur Ozcelik ,&nbsp;Nural Kiper","doi":"10.1016/j.hrtlng.2024.06.016","DOIUrl":"10.1016/j.hrtlng.2024.06.016","url":null,"abstract":"<div><h3>Background</h3><p>Patients with cystic fibrosis (CF) experience increased oxidative stress. Tele-exercise can be a new method to improve exercise in CF.</p></div><div><h3>Objective</h3><p>This study aimed to investigate the effect of telehealth-based exercise training using different modalities (combined exercise training group, CombG, core stabilization exercise group, SG), in comparison with control group (CG), on exercise capacity, oxidative stress, and irisin in children with CF.</p></div><div><h3>Methods</h3><p>Thirty-nine children with CF (mean age=11.41±2.18 years, mean FEV₁(z-score)=-0.66±1.96) were included in the study. The children were randomly allocated to groups. The CombG and SG performed core stabilization exercises (CS) 3 days per week for 8 weeks. The CombG also performed aerobic exercises 3 days per week in addition to CS. Physical activity (PA) recommendations were provided to the CG. Exercise capacity was evaluated using the Modified Shuttle Test (MST). Oxidative stress was assessed using total antioxidant status (TAS), total oxidant status (TOS), Oxidative Stress Index (OSI), malondialdehyde (MDA), and superoxide dismutase (SOD). The irisin level was also measured.</p></div><div><h3>Results</h3><p>Children's baseline sex, age, BMI, and FEV₁ z-scores were similar (<em>p</em> &gt; 0.05). The MST distance (<em>p</em> = 0.047,np²=0.157) and%MST distance (<em>p</em> = 0.045, np²=0.159) significantly improved in the CombG compared with the SG and CG. Although TAS and SOD decreased over time (<em>p</em> &lt; 0.05), no significant changes were observed for TAS, TOS, OSI, MDA, SOD, and irisin parameters between the groups after training (<em>p</em> &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Combining aerobic exercise training with core stabilization applied using telehealth improved exercise capacity more than core stabilitation training only or PA recommendations in children with CF.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 145-153"},"PeriodicalIF":2.4,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565156","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}

{"title":"Stroke in critically ill patients with respiratory failure due to COVID-19: Disparities between low-middle and high-income countries","authors":"Denise Battaglini MD, PhD ,&nbsp;Thu-Lan Kelly PhD ,&nbsp;Matthew Griffee MD, PhD ,&nbsp;Jonathon Fanning MD, PhD ,&nbsp;Lavienraj Premraj Ms ,&nbsp;Glenn Whitman MD ,&nbsp;Diego Bastos Porto MD, PhD ,&nbsp;Rakesh Arora MD, PhD ,&nbsp;David Thomson MD, PhD ,&nbsp;Paolo Pelosi MD, FERS, FESAIC ,&nbsp;Nicole M. White PhD ,&nbsp;Gianluigi Li Bassi MD, PhD ,&nbsp;Jacky Suen MD, PhD ,&nbsp;John F. Fraser MD, PhD ,&nbsp;Chiara Robba MD, PhD ,&nbsp;Sung-Min Cho DO, MHS","doi":"10.1016/j.hrtlng.2024.06.015","DOIUrl":"10.1016/j.hrtlng.2024.06.015","url":null,"abstract":"<div><h3>Purpose</h3><p>We aimed to compare the incidence of stroke in low-and middle-income countries (LMICs) versus high-income countries (HICs) in critically ill patients with COVID-19 and its impact on in-hospital mortality.</p></div><div><h3>Methods</h3><p>International observational study conducted in 43 countries. Stroke and mortality incidence rates and rate ratios (IRR) were calculated per admitted days using Poisson regression. Inverse probability weighting (IPW) was used to address the HICs vs. LMICs imbalance for confounders.</p></div><div><h3>Results</h3><p>23,738 patients [20,511(86.4 %) HICs vs. 3,227(13.6 %) LMICs] were included. The incidence stroke/1000 admitted-days was 35.7 (95 %CI = 28.4–44.9) LMICs and 17.6 (95 %CI = 15.8–19.7) HICs; ischemic 9.47 (95 %CI = 6.57–13.7) LMICs, 1.97 (95 %CI = 1.53, 2.55) HICs; hemorrhagic, 7.18 (95 %CI = 4.73–10.9) LMICs, and 2.52 (95 %CI = 2.00–3.16) HICs; unspecified stroke type 11.6 (95 %CI = 7.75–17.3) LMICs, 8.99 (95 %CI = 7.70–10.5) HICs. In regression with IPW, LMICs vs. HICs had IRR = 1.78 (95 %CI = 1.31–2.42, <em>p</em> &lt; 0.001). Patients from LMICs were more likely to die than those from HICs [43.6% vs 29.2 %; Relative Risk (RR) = 2.59 (95 %CI = 2.29–2.93), <em>p</em> &lt; 0.001)]. Patients with stroke were more likely to die than those without stroke [RR = 1.43 (95 %CI = 1.19–1.72), <em>p</em> &lt; 0.001)].</p></div><div><h3>Conclusions</h3><p>Stroke incidence was low in HICs and LMICs although the stroke risk was higher in LMICs. Both LMIC status and stroke increased the risk of death. Improving early diagnosis of stroke and redistribution of healthcare resources should be a priority.</p></div><div><h3>Trial registration</h3><p>ACTRN12620000421932 registered on 30/03/2020.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 131-144"},"PeriodicalIF":2.4,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538967","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}

{"title":"SARS-CoV-2 and RSV bronchiolitis outcomes","authors":"Donna R. Mendez MD, EdD ,&nbsp;Krishna Paul ,&nbsp;Joan Richardson ,&nbsp;Dietrich Jehle MD","doi":"10.1016/j.hrtlng.2024.06.005","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2024.06.005","url":null,"abstract":"<div><h3>Background</h3><p>Severe acute respiratory syndrome related coronavirus (SARS-CoV-2) bronchiolitis has arisen with the SARS-CoV-2 pandemic. There is a paucity of literature on SARS-CoV-2 bronchiolitis.</p></div><div><h3>Objective</h3><p>The purpose of our paper was to review and compare outcomes in bronchiolitis due to severe acute respiratory syndrome related coronavirus 2 (SARS- CoV-2) and Respiratory Syncytial Virus (RSV). We also performed a subgroup analysis of two disrupted RSV seasons during the pandemic.</p></div><div><h3>Methods</h3><p>This was a retrospective study from a US TriNetX database from March 1, 2020-January 1, 2023. Propensity matching was utilized for confounders.</p></div><div><h3>Results</h3><p>There was a total of 3,592 patients (1,796 in each group) after propensity matching.</p><p>There was an increased risk of oxygen saturation ≤95 % (RR=1.50 95 % CI 1.58–1.94, <em>p</em> = 0.002) and ICU admission (RR=1.44 95 % CI 1.06–1.94, <em>p</em> = 0.02) in those with SARS- CoV-2 but not for oxygen saturation ≤90 % (RR=1.03 95 %CI 0.75–1.42, <em>p</em> = 0.85) or intubation (RR=0.73 95 % CI 0.35–1.47, <em>p</em> = 0.37). There was a decreased risk of a patient with SARS- CoV-2 bronchiolitis being hospitalized (RR=0.65 95 % CI 0.57–0.74, <em>p</em> &lt; 0.0001), respiratory rate ≥60 (RR=0.64 95 % CI 0.48–0.88, <em>p</em> &lt; 0.001) or ≥70 (RR=0.64 95 % CI 0.43–0.96, <em>p</em> = 0.03) when compared to RSV bronchiolitis. Specifically examining SARS- CoV-2 versus RSV bronchiolitis during the delayed RSV seasons, during the first season both infections were not severe, but during the second RSV bronchiolitis season, patients infected with RSV had less risk of ICU admission compared to those infected with SARS- CoV-2.</p></div><div><h3>Conclusion</h3><p>SARS- CoV-2 bronchiolitis patients appeared to have more severe outcomes since the risk of ICU admission was higher for these patients. Also, during the second delayed RSV season, SARS- CoV-2 bronchiolitis was more severe than RSV bronchiolitis.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"68 ","pages":"Pages 126-130"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486978","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}