American journal of respiratory and critical care medicine最新文献

{"title":"A GOLD Science Committee Perspective on Exacerbations and Cardiovascular Risk In COPD.","authors":"Dave Singh, Alvar Agustí, Jean Bourbeau, Fernando J Martinez, David M G Halpin, Claus F Vogelmeier","doi":"10.1093/ajrccm/aamag231","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag231","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVDs) have shared risk factors and mechanisms. CVDs are highly prevalent in COPD patients. Additionally, the risk of suffering a cardiovascular (CV) event is increased following an exacerbation and remains elevated for months afterwards. This link between exacerbations and increased CV risk further highlights the importance of preventing exacerbations. Clinical management during and after exacerbations regarding the prevention of CV events remains to be optimised. CV events occur in patients with COPD who have not previously been diagnosed with CVD. Conventional CV risk tools have historically underestimated the risk of CV events in patients with COPD. All patients with COPD should be investigated for CVDs and markers of CV risk should be assessed at the time of COPD exacerbations. Improving survival in COPD depends on reducing the risk of exacerbations, particularly severe exacerbations, addressing identified CV risk factors and managing CVDs when identified according to guidelines.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Biomarker Results From a Phase 2 Study of Seralutinib in Pulmonary Arterial Hypertension.","authors":"Robin Osterhout, Athénaïs Boucly, Raymond L Benza, Richard N Channick, Kelly M Chin, Robert P Frantz, Anna R Hemnes, Luke S Howard, Vallerie V Mclaughlin, Olivier Sitbon, Jean-Luc Vachiéry, Roham T Zamanian, Richard Aranda, Matt Cravets, Zhaoqing Ding, Thao Duong-Verlé, David Mottola, Robert F Roscigno, Ravikumar Sitapara, Lawrence S Zisman, Jean-Marie Bruey, Hossein-Ardeschir Ghofrani","doi":"10.1093/ajrccm/aamag175","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag175","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of the Long-term Pneumonia Mortality Index in a Low- and Middle-Income Country.","authors":"Natalia Sanabria Herrera, Catia Cilloniz, Cristian C Serrano-Mayorga, Alirio Bastidas, Raúl Méndez, Luis Felipe Reyes","doi":"10.1093/ajrccm/aamag205","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag205","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indoor spaces as active protectors of respiratory health.","authors":"Brent Stephens, Kyle Bibby, Nadia N Hansel, Mohammad Heidarinejad, Kirsten Koehler, Linsey C Marr, Meredith C Mccormack, Robert A Wise, Jerry A Krishnan","doi":"10.1093/ajrccm/aamag230","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag230","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilatory efficiency during weaning from venovenous extracorporeal membrane oxygenation.","authors":"Lorenzo Giosa, Marta Lubian, Patrick D Collins, Stefano Lazzari, Mattia Busana, Barnaby Sanderson, Francesca Pugliese, Riccardo Del Signore, Michael Quintel, Luigi Camporota","doi":"10.1093/ajrccm/aamag145","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag145","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an early restrictive versus liberal fluid strategy on long-term patient-centered outcomes in sepsis-induced hypotension (SHAMROC): an open-label, randomized controlled trial.","authors":"Anselm Jorda, Georg Gelbenegger, Nathan I Shapiro, Ivor S Douglas, Casey Whitman, Zhe Chen, Joseph A Hippensteel, Lee A Kamphuis, Robert J Flick, Michael O Harhay, Ellen Caldwell, Markus Zeitlinger, Bernd Jilma, Theodore J Iwashyna, Catherine L Hough, Catherine L Auriemma","doi":"10.1093/ajrccm/aamag154","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag154","url":null,"abstract":"<p><strong>Rationale: </strong>The impact of fluid resuscitation strategies on patient-centered outcomes of sepsis survivors is unknown.</p><p><strong>Objectives: </strong>To assess the effect of an early restrictive or liberal fluid resuscitation strategy on long-term functional outcomes in patients with sepsis-induced hypotension.</p><p><strong>Methods: </strong>SHAMROC (Sepsis-induced Hypotension: Assessing effect of Method of Resuscitation On patient-Centered outcomes) prospectively assessed the impact of random assignment to a restrictive or liberal fluid resuscitation strategy for sepsis-induced hypotension outcomes at 6 and 12 months after randomization in the NIH NHLBI PETAL Network's CLOVERS trial (NCT03434028). The pre-specified analyses used trimmed means at 50% to prevent informative censoring of deceased patients.</p><p><strong>Measurements and main results: </strong>Of the 1563 participants included in the CLOVERS trial, 898 (57%) were included in the SHAMROC trial. As 196 were lost to follow-up, 702 participants were analyzed at 6 months (431 survivors and 271 non-survivors). Baseline characteristics were similar between the groups. At 6 months, no group differences were observed in cognitive function (restrictive versus liberal; trimmed mean difference in Montreal Cognitive Assessment-Blind Score, 0.11, 95% CI -1.44-1.70), executive function (trimmed mean difference in Hayling Sentence Completion Test, 0.38, 95% CI -0.97-1.76), disability status (trimmed mean difference in Activity of Daily Living Score, 0.03, 95% CI -0.84-0.90), mobility (trimmed mean difference in PROMIS Mobility Score, 0.72, 95% CI -2.20-3.64), and health-related quality of life (trimmed mean difference in EQ-5D-5L, -0.01, 95% CI -0.07-0.06). Outcomes also did not differ at 12 months.</p><p><strong>Conclusions: </strong>In this long-term follow-up of a randomized controlled trial of patients with sepsis-induced hypotension, the restrictive fluid strategy used in this study resulted in similar cognitive and physical function at 6 and 12 months, compared to a liberal fluid strategy.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation without invasive mechanical ventilation for acute respiratory distress syndrome: an international cohort study.","authors":"Roberto Roncon-Albuquerque, Matthieu Petit, Tiago Veiga, Sérgio Gaião, Jeannine L Kühnle, João Ribeiro, Micha Landoll, Philip Fortuna, Christoph Fisser, Benjamin Seeliger, Marina P R Fantini, Peter Schellongowski, Giacomo Grasselli, Konstanty Szuldrzynski, Juan I Chico, Hadrien Winiszewski, José Artur Paiva, Alain Combes, Christian Karagiannidis, Matthieu Schmidt","doi":"10.1093/ajrccm/aamag219","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag219","url":null,"abstract":"<p><strong>Rationale: </strong>In acute respiratory distress syndrome (ARDS), extracorporeal membrane oxygenation (ECMO) without invasive mechanical ventilation (IMV) is particularly challenging.</p><p><strong>Objectives: </strong>To study ARDS patients treated with ECMO to avoid IMV-'primary awake ECMO'-or with extubation during ECMO support - 'extubated ECMO'.</p><p><strong>Methods: </strong>International retrospective cohort of adult ARDS patients treated with ECMO without IMV at 14 centers in 8 countries (2015-2024). The primary outcome was mortality 90 days after ECMO initiation.</p><p><strong>Measurements and main results: </strong>Among 307 adult patients with ARDS, 113 received 'primary awake ECMO' and 194 were extubated on ECMO. Ninety-day mortality was 30.1% in the 'primary awake ECMO' group and 14.9% in the 'extubated ECMO'. Strategy failure occurred in 46 patients (40.7%) and 47 patients (24.2%), respectively, most frequently within the first 10 days. In multivariate analysis, strategy failure was associated with 90-day mortality (hazard ratio 7.67 (3.44-17.11); P < .001 in 'extubated ECMO'; hazard ratio 5.95 (2.63-13.46); P < .001 in 'primary awake ECMO'), while higher age and longer time from ICU admission to ECMO cannulation were associated with 90-day mortality in 'extubated ECMO' and 'primary awake ECMO', respectively. The leading cause of strategy failure was worsening of respiratory failure, followed by agitation/delirium in 'primary awake ECMO' and inability to clear secretions in 'extubated ECMO'.</p><p><strong>Conclusions: </strong>Patients selected for 'primary awake ECMO' and 'extubated ECMO' presented different baseline characteristics, strategy failure, and 90-day mortality rates. However, strategy failure was consistently associated with 90-day mortality in both groups.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Qian et al.: Toward Noninvasive ARDS Phenotyping: Bridging Pulmonary Transcriptomics to Bedside Tools.","authors":"Aartik Sarma, Charles R Langelier, Carolyn S Calfee","doi":"10.1093/ajrccm/aamag161","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag161","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Noninvasive ARDS Phenotyping: Bridging Pulmonary Transcriptomics to Bedside Tools.","authors":"Mingcheng Qian, Yan Xia, Yong Zhang, Yan Li","doi":"10.1093/ajrccm/aamag160","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag160","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal gray matter volume changes associated with obstructive sleep apnea are age-dependent.","authors":"Marie-Ève Martineau-Dussault, Claire André, Véronique Daneault, Andrée-Ann Baril, Hélène Blais, Dominique Lorrain, Carol Hudon, Célyne H Bastien, Cynthia Thompson, Danielle Gilbert, Chantal Lafond, Julie Carrier, Nadia Gosselin","doi":"10.1093/ajrccm/aamag218","DOIUrl":"https://doi.org/10.1093/ajrccm/aamag218","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}