American journal of respiratory and critical care medicine最新文献

{"title":"Leveraging Peer-driven Social Support to Improve Care Delivery and Outcomes in Obstructive Sleep Apnea.","authors":"Emerson M Wickwire, Amy M Sawyer","doi":"10.1164/rccm.202411-2117ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2117ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862895","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":"Atorvastatin in Severity-stratified Pulmonary Sarcoidosis: A Phase II Randomized Controlled Trial.","authors":"Joseph R Fontana, Joel Moss, Dong-Yun Kim, Mario Stylianou, Stewart J Levine, Amisha V Barochia, Nargues Weir, Les R Folio, Huy Michael Do, Vincent Manganiello","doi":"10.1164/rccm.202403-0526RL","DOIUrl":"https://doi.org/10.1164/rccm.202403-0526RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862742","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":"Diaphragm Pacing in Early Critical Illness? A Plea for a Super-relaxed Approach.","authors":"Leo Heunks, Dirk W Donker, Eline Oppersma, Coen A C Ottenheijm, Jonne Doorduin","doi":"10.1164/rccm.202408-1642VP","DOIUrl":"https://doi.org/10.1164/rccm.202408-1642VP","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862743","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":"Timing for Initiating Home Noninvasive Ventilation in Italy: Beyond Clinical Parameters.","authors":"Claudia Crimi, Annalisa Carlucci","doi":"10.1164/rccm.202411-2119LE","DOIUrl":"https://doi.org/10.1164/rccm.202411-2119LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862900","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":"Ferroptosis Inhibition Combats Metabolic Derangements and Improves Cardiac Function in Pulmonary Artery Banded Pigs.","authors":"Felipe Kazmirczak, Ryan Moon, Neal T Vogel, Walt Tollison, Matt T Lahti, John P Carney, Jenna B Mendelson, Todd Markowski, LeeAnn Higgins, Kevin Murray, Candace Guerrero, Kurt W Prins","doi":"10.1164/rccm.202406-1197RL","DOIUrl":"https://doi.org/10.1164/rccm.202406-1197RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862762","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":"In Asthma, Change Is the Only Constant.","authors":"Karl J Staples","doi":"10.1164/rccm.202411-2290ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2290ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862773","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":"Prophylactic Noninvasive Ventilation after Extubation of Obese Patients.","authors":"Arnaud W Thille, Sylvain Le Pape","doi":"10.1164/rccm.202411-2199ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2199ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862898","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":"\"Probable Chronic Lung Allograft Dysfunction\" Is Definitely Good Enough.","authors":"Michael P Combs, Daniel F Dilling","doi":"10.1164/rccm.202411-2191ED","DOIUrl":"https://doi.org/10.1164/rccm.202411-2191ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862570","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":"Air Hunger Far Exceeds Dyspnea Sense of Effort During Mechanical Ventilation and a Weaning Trial.","authors":"Amal Jubran, Franco Laghi, Brydon J B Grant, Martin J Tobin","doi":"10.1164/rccm.202406-1243OC","DOIUrl":"https://doi.org/10.1164/rccm.202406-1243OC","url":null,"abstract":"<p><strong>Rationale: </strong>No systematic investigation into dyspnea in patients receiving prolonged ventilation (>21 days) after recovering from critical-illness has been published.</p><p><strong>Objectives: </strong>To determine magnitude, nature and pathophysiological basis of dyspnea during an unassisted-breathing trial in prolonged-ventilation patients.</p><p><strong>Methods: </strong>Dyspnea intensity and descriptor selection were investigated in 27 prolonged-ventilation patients during a 60-min unassisted-breathing trial. Pressure-time product (PTP), respiratory mechanics, and transcutaneous PCO₂ (PtcCO₂) were also measured.</p><p><strong>Measurements and main results: </strong>Of 10 patients who reported dyspnea during assist-control ventilation, 9 (90.0%) selected \"<i>Not getting enough air</i>\" to characterize dyspnea. Tidal-volume setting was lower in dyspneic than non-dyspneic patients: 480.0 versus 559.4 ml (p<0.046). During the unassisted-breathing trial (n=26), patients developed increases in dyspnea (p<0.01) and PtcCO2 (p<0.01), but no change in minute ventilation. Dyspnea score was strongly linked to PtcCO2 (p<0.012) and airway resistance (p<0.013) but not respiratory work (although PTP was almost 3 times higher than normal). At 60 min into the trial, 83.3% of patients selected \"<i>Not getting enough air</i>\" on its own or in combination with \"<i>Too much effort</i>\" to describe discomfort whereas only 16.7% selected \"<i>Too much effort</i>\" on its own (p<0.001). Across the dyspnea spectrum, patients chose \"<i>Not getting enough air</i>\" overwhelmingly over other descriptor options (p<0.001).</p><p><strong>Conclusions: </strong>Patients developed increases in dyspnea and PtcCO₂ but unchanged minute ventilation and work of breathing during an unassisted-breathing trial; patients selected air-hunger descriptors overwhelmingly over excessive effort; the observations support the belief that air hunger results from heightened respiratory-center stimulation combined with incapacity to increase minute ventilation.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833462","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":"Nasal High Flow to Modulate Dyspnea in Orally Intubated Patients.","authors":"Valentine Le Stang, Mélodie Graverot, Antoine Kimmoun, Marie-Cécile Niérat, Maxens Decavèle, Thomas Similowski, Alexandre Demoule, Martin Dres","doi":"10.1164/rccm.202405-1057OC","DOIUrl":"https://doi.org/10.1164/rccm.202405-1057OC","url":null,"abstract":"<p><strong>Rationale: </strong>High flow therapy reduces dyspnea in acute respiratory failure but the underlying mechanisms are not fully elucidated.</p><p><strong>Objectives: </strong>To compare dyspnea, airway occlusion pressure (P_0.1) and inspiratory work with and without nasal high flow (NHF, FiO₂ 21%, temperature 31°C) in intubated patients under pressure support ventilation and during a spontaneous breathing trial (SBT).</p><p><strong>Methods: </strong>Dyspnea (numerical rating scale, NRS and Mechanical Ventilation - Respiratory Distress Observational Scale, MV-RDOS), P_0.1, esophageal pressure, respiratory muscles EMG, arterial blood gas were compared in intubated patients on pressure support ventilation presenting a dyspnea-NRS > 3 during two sequences: 1) pressure support ventilation with NHF at 0 L/min followed by 30, 50 and 60 L/min (the last three were randomized) and 2) a SBT with NHF at 0 and 50 L/min (randomized).</p><p><strong>Measurements and main results: </strong>Twenty patients were included. During pressure support ventilation, as compared to dyspnea-NRS that was 5 (4 - 6) at NHF 0 L/min, dyspnea-NRS was 3 (2 - 6) and 3 (2 - 5) at NHF 30L/min and NHF 50L/min, respectively (p<0.05). However, there was no change in MV-RDOS, P_0.1, esophageal pressure, respiratory muscles EMG and gas exchange. During the SBT, at NHF 50 L/min, dyspnea-NRS and P_0.1 were lower than during the SBT at NHF 0 L/min (p<0.01 and p=0.04 respectively) whereas MV-RDOS, esophageal pressure, respiratory muscles EMG did not change as compared to SBT with NHF 0 L/min.</p><p><strong>Conclusions: </strong>In orally intubated patients, nasal high flow was associated with lower dyspnea and lower respiratory drive without affecting the inspiratory work.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833496","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}