American journal of respiratory and critical care medicine最新文献

{"title":"Outcomes in Critically Ill Allogeneic Hematopoietic Stem-Cell Transplantation Recipients.","authors":"Antoine Lafarge, Thibault Dupont, Emmanuel Canet, Anne-Sophie Moreau, Muriel Picard, Djamel Mokart, Laura Platon, Julien Mayaux, Florent Wallet, Nahema Issa, Jean-Herlé Raphalen, Frédéric Pène, Anne Renault, Régis Peffault de la Tour, Christian Récher, Patrice Chevallier, Lara Zafrani, Michael Darmon, Naike Bigé, Elie Azoulay","doi":"10.1164/rccm.202401-0135OC","DOIUrl":"10.1164/rccm.202401-0135OC","url":null,"abstract":"<p><p><b>Rationale:</b> Allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) recipients are still believed to be poor candidates for ICU management. <b>Methods:</b> We investigated outcomes and determinants of mortality in a large multicenter retrospective cohort of Allo-HSCT patients admitted between January 1, 2015, and December 31, 2020, to 14 French ICUs. The primary endpoint was 90-day mortality. <b>Measurements and Main Results:</b> In total, 1,164 patients were admitted throughout the study period. At the time of ICU admission, 765 (66%) patients presented with multiple organ dysfunction, including acute respiratory failure in 40% (<i>n</i> = 461). The median sepsis-related organ failure assessment score was 6 (interquartile range, 4-8). Invasive mechanical ventilation, renal replacement therapy, and vasopressors were required in 438 (38%), 221 (19%), and 468 (41%) patients, respectively. ICU mortality was 26% (302 deaths). Ninety-day, 1-year, and 3-year mortality rates were 48%, 63%, and 70%, respectively. By multivariable analysis, age > 56 years (odds ratio [OR], 2.0 [95% confidence interval (CI), 1.53-2.60]; <i>P</i> < 0.001), time from Allo-HSCT to ICU admission between 30 and 90 days (OR, 1.68 [95% CI, 1.17-2.40]; <i>P</i> = 0.005), corticosteroid-refractory acute graft-versus-host disease (OR, 1.63 [95% CI, 1.38-1.93]; <i>P</i> < 0.001), need for vasopressors (OR, 1.9 [95% CI, 1.42-2.55]; <i>P</i> < 0.001), and mechanical ventilation (OR, 3.1 [95% CI, 2.29-4.18]; <i>P</i> < 0.001) were independently associated with 90-day mortality. In patients requiring mechanical ventilation, mortality rates ranged from 39% (no other risk factors for mortality) to 100% (four associated risk factors for mortality). <b>Conclusions:</b> Most critically ill Allo-HSCT recipients survive their ICU stays, including those requiring mechanical ventilation, with an overall 90-day survival rate reaching 51.8%. A careful assessment of goals of care is required in patients with two or more risk factors for mortality.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1017-1024"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632433","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":"Delayed Tuberculosis Paradoxical Reaction Associated with Tumor Necrosis Factor Inhibitors.","authors":"Suzanne M Roche, Ciara Ottewill, Rachel Mulpeter, Kevin Brown, Conor Grant, Daniel D Fraughen, Lorraine Dolan, Laura E Gleeson, Anne Marie McLaughlin, Joseph Keane","doi":"10.1164/rccm.202402-0464RL","DOIUrl":"10.1164/rccm.202402-0464RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1061-1065"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915902","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":"Nanoplastics in the Human Respiratory System.","authors":"Chenghui Zhong, Meiqi Lan, Changli Tu, Wenfeng Lu, Yuewei Liu, Xiaoliang Li, Cuiyan Tan, Jing Liu, Yun Zhou","doi":"10.1164/rccm.202403-0605RL","DOIUrl":"10.1164/rccm.202403-0605RL","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1059-1061"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974866","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":"October 15 Highlight.","authors":"","doi":"10.1164/rccm.210i8xxiv","DOIUrl":"https://doi.org/10.1164/rccm.210i8xxiv","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"210 8","pages":"xxiv-xxvi"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455981","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 Pollution and Bronchitis: Childhood Exposure, Lifelong Consequences.","authors":"Alessandro Marcon","doi":"10.1164/rccm.202407-1278ED","DOIUrl":"10.1164/rccm.202407-1278ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"973-975"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141915901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspergilloma in Cavity.","authors":"Minlong Zhang, Cuiping Yang, Yinghua Guo","doi":"10.1164/rccm.202312-2348IM","DOIUrl":"10.1164/rccm.202312-2348IM","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1057-1058"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183468","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 Glanville: The Emperor's New Clothes Revisited.","authors":"Michael B Keller, Xin Tian, Sean Agbor-Enoh","doi":"10.1164/rccm.202406-1139LE","DOIUrl":"10.1164/rccm.202406-1139LE","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1066-1067"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Syncytial Virus-related Community Chronic Obstructive Pulmonary Disease Exacerbations and Novel Diagnostics: A Binational Prospective Cohort Study.","authors":"Dexter J Wiseman, Ryan S Thwaites, Andrew I Ritchie, Lydia Finney, Mairi Macleod, Faisal Kamal, Hassan Shahbakhti, Lisa H van Smoorenburg, Hiub A M Kerstjens, Joanne Wildenbeest, Deniz Öner, Jeroen Aerssens, Guy Berbers, Rutger Schepp, Ashley Uruchurtu, Benedikt Ditz, Louis Bont, James P Allinson, Maarten van den Berge, Gavin C Donaldson, Peter J M Openshaw, Jadwiga Wedzicha","doi":"10.1164/rccm.202308-1320OC","DOIUrl":"10.1164/rccm.202308-1320OC","url":null,"abstract":"<p><p><b>Rationale:</b> Respiratory syncytial virus (RSV) is a common global respiratory virus that is increasingly recognized as a major pathogen in frail older adults and as a cause of chronic obstructive pulmonary disease (COPD) exacerbations. There is no single test for RSV in adults that has acceptable diagnostic accuracy. Trials of RSV vaccines have recently shown excellent safety and efficacy against RSV in older adults; defining the frequency of RSV-related community infections and COPD exacerbations is important for vaccine deployment decisions. <b>Objectives:</b> This prospective study aimed to establish the frequency of outpatient-managed RSV-related exacerbations of COPD in two well-characterized patient cohorts using a combination of diagnostic methods. <b>Methods:</b> Participants were recruited at specialist clinics in London, United Kingdom, and Groningen, the Netherlands, beginning in 2017 and observed for three consecutive RSV seasons, during exacerbations, and at least twice yearly. RSV infections were detected by RT-PCR and serologic testing. <b>Measurements and Main Results:</b> A total of 377 patients with COPD attended 1,999 clinic visits and reported 310 exacerbations. There were 27 RSV-related exacerbations (8.7% of the total); of these, seven were detected only by PCR, 16 only by serology, and four by both methods. Increases in RSV-specific Nucleoprotein antibody were as sensitive as those in the antibody to Pre-Fusion or Post-Fusion for serodiagnosis of RSV-related exacerbations. <b>Conclusions:</b> RSV is associated with 8.7% of outpatient-managed COPD exacerbations in this study. Antibodies to RSV Nucleoprotein may have diagnostic value and are potentially important in a vaccinated population. The introduction of vaccines that prevent RSV is expected to benefit patients with COPD.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"994-1001"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cough in Fibrotic Interstitial Lung Disease: Effects and Implications.","authors":"Jessica E Channick, Jeff Swigris","doi":"10.1164/rccm.202404-0683ED","DOIUrl":"10.1164/rccm.202404-0683ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"975-976"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis of Post-Tuberculosis Lung Disease: Defining Knowledge Gaps and Research Priorities at the Second International Post-Tuberculosis Symposium.","authors":"Sara C Auld, Amy K Barczak, William Bishai, Anna K Coussens, Intan M W Dewi, Steven C Mitini-Nkhoma, Caleb Muefong, Threnesan Naidoo, Anil Pooran, Cari Stek, Adrie J C Steyn, Liku Tezera, Naomi F Walker","doi":"10.1164/rccm.202402-0374SO","DOIUrl":"10.1164/rccm.202402-0374SO","url":null,"abstract":"<p><p>Post-tuberculosis (post-TB) lung disease is increasingly recognized as a major contributor to the global burden of chronic lung disease, with recent estimates indicating that over half of TB survivors have impaired lung function after successful completion of TB treatment. However, the pathologic mechanisms that contribute to post-TB lung disease are not well understood, thus limiting the development of therapeutic interventions to improve long-term outcomes after TB. This report summarizes the work of the Pathogenesis and Risk Factors Committee for the Second International Post-Tuberculosis Symposium, which took place in Stellenbosch, South Africa, in April 2023. The committee first identified six areas with high translational potential: <i>1</i>) tissue matrix destruction, including the role of matrix metalloproteinase dysregulation and neutrophil activity; <i>2</i>) fibroblasts and profibrotic activity; <i>3</i>) granuloma fate and cell death pathways; <i>4</i>) mycobacterial factors, including pathogen burden; <i>5</i>) animal models; and <i>6</i>) the impact of key clinical risk factors, including HIV, diabetes, smoking, malnutrition, and alcohol. We share the key findings from a literature review of those areas, highlighting knowledge gaps and areas where further research is needed.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"979-993"},"PeriodicalIF":19.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}