BMJ Open Respiratory Research最新文献

{"title":"Fissios and postoperative complications (FPoC trial): a multicentre, randomised, controlled clinical trial.","authors":"Carlos Alfredo Fraile Olivero, Lidia Sotillo Valenzuela, Verónica Albarrán Vidal, José Gabriel Barceló Cal, Verónica Alen Villamayor, Florentino Hernando Trancho, Elena Fernández Martín, Joaquín Calatayud Gastardi, Ana María Gómez Martínez, Pedro Daniel Arribas Manzanal, Passio Santos, Raquel Fernández Blanco, María Isabel Cal Vázquez, Lucia Milla Collado, María Rodríguez, Valerio Perna, Alejandra Romero Roman, Carlos Andrés Ordonez, José Ramón Jarabo Sarceda","doi":"10.1136/bmjresp-2025-003269","DOIUrl":"10.1136/bmjresp-2025-003269","url":null,"abstract":"<p><strong>Introduction: </strong>Respiratory physiotherapy as a part of a perioperative physical training programme may reduce the risk of developing postoperative complications in patients diagnosed with non-small cell lung carcinoma (NSCLC) scheduled for surgery. However, there is heterogeneity in the design, implementation and evaluation of respiratory physiotherapy programmes.Fissios App contains a standardised respiratory physiotherapy programme. Analysing the usage data, the patient's personal history, the surgical procedure and the postoperative course, we will establish the relationship between compliance with a standardised respiratory physiotherapy programme and the development of postoperative complications in a group of patients diagnosed with NSCLC who underwent lung resection surgery.</p><p><strong>Methods and analysis: </strong>The Fissios and postoperative complications trial is a multicentre, prospective, randomised, parallel two-group, controlled, open-label, superiority study of the use of only face-to-face respiratory physiotherapy or the use of Fissios App as a complement to respiratory physiotherapy. Based on the percentage of postoperative respiratory complications and the anticipated reduction, a total of 560 patients will be required. Patients will be electronically randomised to the intervention or control group before the surgery with a proportion of 1:1 in blocks of six for each centre.All patients will attend face-to-face respiratory physiotherapy sessions at the place and times established in each centre. In addition, patients in the intervention group will use the Fissios App freely and without restrictions in terms of hour of the day, usage time or location. The primary clinical endpoint is postoperative complications during hospital admission and the estimated duration of the study is 12 months.</p><p><strong>Ethics and dissemination: </strong>This protocol was reviewed and approved by the Clinical Research and Clinical Trials Unit of Hospital Clínico San Carlos (Madrid, Spain) and complies with the ethics principles for medical research on humans stipulated in the Declaration of Helsinki of the World Medical Association.</p><p><strong>Trial registration number: </strong>NCT06732193.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148263239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimated plasma volume for predicting sepsis-associated ARDS risk: a multicentre retrospective cohort study.","authors":"Lina Zhao, Lei Zong, Wei Wei, Yuehao Shen, Haiying Liu, Xuguang Li, Dongxue Huang, Daihua Yu, Fei Yang, Yunying Wang, Xiaopeng Shi, Yun Li, Yi Wang, Keliang Xie","doi":"10.1136/bmjresp-2025-003471","DOIUrl":"10.1136/bmjresp-2025-003471","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated acute respiratory distress syndrome (SA-ARDS) is a lethal complication demanding early predictors. This study assessed estimated plasma volume status (ePVS) for predicting SA-ARDS development.</p><p><strong>Methods: </strong>This multicentre cohort study analysed 3854 adult patients with sepsis 3.0 from China. The primary outcome was the incidence of SA-ARDS. Multivariate logistic regression, propensity score matching (PSM) and inverse probability weighting (IPW) were used to assess associations between ePVS and SA-ARDS.</p><p><strong>Results: </strong>Elevated ePVS was independently associated with SA-ARDS incidence across all models (multivariate OR: 1.56, 95% CI 1.50 to 1.63; PSM OR: 1.72, 1.63 to 1.81; IPW OR: 1.58, 1.49 to 1.69; p<0.001). Receiver operating characteristic analysis demonstrated a strong discriminative ability of ePVS for SA-ARDS incidence (area under the curve (AUC): 0.772, 95% CI 0.757 to 0.788). SA-ARDS patients exhibited higher mortality (31.8% vs 23.1%, p<0.001), mechanical ventilation (MV) use (82.3% vs 48.4%, p<0.001) and continuous renal replacement therapy (CRRT) requirements (7.7% vs 4.7%, p<0.001). Generalised additive model analysis revealed a significant linear association between ePVS >8.0 dL/g and SA-ARDS mortality (p<0.001). Although ePVS >8.0 dL/g alone showed limited predictive value for in-hospital mortality in SA-ARDS patients (AUC: 0.549), its combination with acute physiology and chronic health evaluation II significantly improved discrimination (AUC: 0.823). This synergistic effect persisted even after excluding early deaths (≤72 hours), reinforcing ePVS's complementary role alongside established severity scores in mortality risk stratification. Stratified analysis revealed ePVS levels strongly correlated with acute respiratory distress syndrome (ARDS) severity (p<0.001), particularly distinguishing mild from moderate cases. Patients with pulmonary infections exhibited higher ePVS than non-pulmonary sources (p<0.001).</p><p><strong>Conclusions: </strong>These findings highlight ePVS is strongly associated with ARDS onset, disease severity and mortality risk, supporting its utility as a prognostic marker in risk stratification.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The <u>W</u>heezing, <u>A</u>sthma and <u>V</u>iral effects on the <u>E</u>pithelial <u>S</u>tructure and function (WAVES) birth cohort study: rationale, design and methods to understand airway development and the role of early-life respiratory viral infections on childhood asthma inception.","authors":"Tina Hartert, Christian Rosas-Salazar, Dawn C Newcomb, Brittney M Snyder, Sergejs Berdnikovs, Christopher McKennan, Sarah Osmundson, Zhouwen Liu, Erica Tafoya, Wais Folad, Pat Simon, Sara Reiss, Kadijah Poleon, Jacqueline-Yvonne Cephus, Shelby N Kuehnle, Kaitlin E McKernan, Siyuan Ma, Larry J Anderson, Tebeb Gebretsadik","doi":"10.1136/bmjresp-2025-004049","DOIUrl":"10.1136/bmjresp-2025-004049","url":null,"abstract":"<p><strong>Introduction: </strong>The airway epithelial barrier continues to develop during the first year of life, representing a critical time window of susceptibility to the effects of respiratory viruses that may contribute to the development of childhood asthma. This study specifically aimed to assess the impact of respiratory syncytial virus (RSV) infection on the longitudinal development of the airway epithelium, airway metabolism, DNA methylation and subsequent childhood asthma.</p><p><strong>Methods and analysis: </strong>The <u>W</u>heezing, <u>A</u>sthma and <u>V</u>iral effects on the <u>E</u>pithelial <u>S</u>tructure and function (WAVES) birth cohort study is a prospective, observational birth cohort that is enrolling mother-child dyads beginning in pregnancy and following children through age 5 years. It is designed as a quasi-natural randomisation of RSV infection in infancy, capturing the first RSV infection event during infancy and longitudinal nasal sampling from birth through age 5 years for multi-omic assays and assessment of clinical outcomes. The WAVES study protocol will enrol 250 pregnant women and their offspring (200 at high-risk for asthma and 50 at general-risk for asthma). The primary outcomes are pathways through which RSV infection intersects with airway epithelial development leading to asthma by age 5 years. We will employ a longitudinal systems biology approach to investigate the development of the airway epithelium following infant RSV infection in those who do and do not develop asthma. This approach will integrate single-cell and bulk RNA-sequencing gene expression, metabolomic and epigenetic data at the resolution of epithelial cell subsets.</p><p><strong>Ethics and dissemination: </strong>This study has been approved by the Vanderbilt University Medical Center IRB (#222277), and study results will be communicated in peer-reviewed publications and to the study participants and lay community. By analysing these longitudinal multi-omic datasets, we aim to uncover key mechanisms driving airway epithelial development and identify how these processes are altered by early-life RSV infection and contribute to the development of early-life respiratory morbidity and asthma.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observational study of predictors and outcomes of lung cancer in never-smokers in the UK (OLIVE): study protocol.","authors":"Sindhu Bhaarrati Naidu, Gabrielle Guvensen, Honghan Wu, Rumana Z Omar, Usha Menon, Sanjay Popat, David A Moore, Yiwen Soo, Amyn Bhamani, Ricky Thakrar, Tanya Ahmad, Olive Ppi Group, Sam M Janes, Martin D Forster, Neal Navani","doi":"10.1136/bmjresp-2025-003966","DOIUrl":"10.1136/bmjresp-2025-003966","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is commonly associated with smoking. However, if considered separately, lung cancer in never-smokers (LCINS) is the seventh most common cause of cancer-related death worldwide. Expanding the limited understanding of LCINS, especially in the UK, is crucial to improving diagnosis.</p><p><strong>Methods and analysis: </strong>We will establish a retrospective and prospective UK multicentre observational cohort comprising never-smoking (lifetime use of <100 tobacco cigarettes) adults with lung cancer using routinely available primary and secondary care electronic health records (EHRs). Demographic data including occupation and ethnicity, exposures and lung cancer outcomes will be extracted. Deep learning-based natural language processing will be used to analyse free-text data. Quantitative or qualitative data collection for information not available in EHR may be initiated in the future. Follow-up will be until death, withdrawal or end of study (5 years from study activation date). Primary outcomes will be sociodemographic characteristics, comorbidities, environmental exposures, pathways to presentation and symptoms. A feasibility pilot of 225 patients (25 participants per year both retrospectively and prospectively) will be undertaken at one hospital before extending the study to multiple sites. Patient representatives have been involved in adapting the research protocol including the recruitment process and patient-facing materials.</p><p><strong>Ethics and dissemination: </strong>National ethical approval has been obtained from Health Research Authority (HRA) (24/YH/0147). Access to patient records without explicit consent, including deceased patient records, is legally supported by the Confidentiality Advisory Group and HRA. The study is sponsored by University College London Hospital.Data will be anonymised and analysed 2 years after the study start date and on study completion. Together with our patient representatives, we will disseminate data to the scientific and academic community and public through peer-reviewed publications, presentations at conferences, patient-facing charities and social media.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toll interacting protein (TOLLIP) serum concentration in patients with systemic sclerosis (SSc), with and without interstitial lung disease (ILD).","authors":"Niels Schröder, Jitka Andrä, Diana Knuth-Rehr, Silke Leja, Nicolas Hunzelmann, Eda Börner, Kimberly Barbet, Francesco Bonella","doi":"10.1136/bmjresp-2025-003962","DOIUrl":"10.1136/bmjresp-2025-003962","url":null,"abstract":"<p><strong>Background: </strong>Single nucleotide polymorphisms (SNPs) within Toll interacting protein (<i>TOLLIP</i>) coding gene have been associated with progression, prognosis and treatment response in idiopathic pulmonary fibrosis (IPF). These SNPs seem to influence mRNA expression and serum levels of TOLLIP. The aim of this study was to investigate <i>TOLLIP</i> serum concentrations in a previously genotyped cohort of patients with systemic sclerosis (SSc) with and without interstitial lung disease (ILD).</p><p><strong>Patients and methods: </strong>106 consecutive patients with SSc (77 female) with (n=53) and without ILD (n=53) and 60 healthy controls (HCs) were included. TOLLIP concentrations were measured using a commercially available ELISA kit (Cloud-Clone, USA) in serum samples from patients and HC previously genotyped for two SNPs within <i>TOLLIP</i> (rs3750920, rs5743890).</p><p><strong>Results: </strong>Patients with SSc had tendentially lower TOLLIP serum concentrations than HC (0.111 (95% CI 0.101 to 0.123) vs 0.141 (95% CI 0.104 to 0.191) ng/µL, p=0.076). Patients with SSc-ILD showed significantly higher TOLLIP levels than patients with SSc without ILD (0.126 (95% CI 0.106 to 0.151) vs 0.098 (95% CI 0.091 to 0.105) ng/µL, p=0.010). At a cut-off value of ≥0.1135 ng/µL serum TOLLIP yielded a 71% sensitivity and 74% specificity for identifying ILD (AUC=0.74, 95% CI 0.593 to 0.889, p=0.007). Serum TOLLIP concentrations did not differ significantly across rs3750920 or rs5743890 genotypes. TOLLIP concentration inversely correlated with age (r=-0.256, p<0.001), whereas no significant associations with gender, body mass index, C-reactive protein, forced vital capacity or diffusing capacity of the lung for carbon monoxide at time of sampling were observed.</p><p><strong>Conclusion: </strong>Patients with SSc show lower TOLLIP serum concentrations than HC, while patients with SSc-ILD exhibit higher TOLLIP levels than those without. TOLLIP might serve as a biomarker of ILD in patients with SSc.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148209639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of non-traumatic chylothorax at a Singapore tertiary referral hospital.","authors":"Brian Lee Wei Chua, Si Ling Young, Qiao Li Tan, Carrie Kah-Lai Leong, Jane Jing Yi Wong, Ivana Gilcrist Chiew Sian Phua, Wen Ting Lim, Ken Junyang Goh","doi":"10.1136/bmjresp-2026-004142","DOIUrl":"10.1136/bmjresp-2026-004142","url":null,"abstract":"<p><strong>Background and objective: </strong>While the management of traumatic chylothorax has advanced over the past two decades, outcomes for non-traumatic chylothorax remain poor, with a paucity of data to guide management and prognostication.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients diagnosed with chylothorax between January 2020 and December 2024. Clinical data including interventions and clinical outcomes were recorded.</p><p><strong>Results: </strong>We evaluated 40 patients with a median age of 61 (IQR: 50-72) years. Cancer was the most common cause (67.5%), of which 18 (45%) patients had solid-organ malignancies and 9 (22.5%) had haematological malignancies. Other aetiologies included drug-induced (10%) and liver cirrhosis (7.5%). Despite dietary measures implemented in 65.0% of patients, 52.5% of patients required ≥2 pleural interventions, with chest drain and indwelling pleural catheter insertions performed in 32 (80.0%) and 8 (20.0%) patients, respectively. Lymphatic imaging was infrequently (20.0%) performed, with chyle leak identified in only one patient. The 90-day and 1-year mortality was 37.5% and 55.0%, respectively, with the highest 1-year mortality rates seen with solid organ cancers (83.3%) and liver cirrhosis (66.7%). Eighteen (45.0%) patients had clinical resolution of chylothorax, and this was highest in patients with drug-induced chylothorax (100.0%) followed by patients with haematological malignancies (66.7%).</p><p><strong>Conclusion: </strong>Non-traumatic chylothorax secondary to haematological malignancies and drugs have more favourable outcomes compared with solid organ cancers and liver cirrhosis. This highlights the need for a personalised and multidisciplinary approach to the management of chylothorax.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing the burden and characteristics of <i>Aspergillus</i>-related chronic lung disease at Imperial College Healthcare Trust: a 10-year retrospective study.","authors":"Tim Venkatesan, Navjeet Nagi, Lisa Nwankwo, Darius Armstrong-James, Meg Coleman","doi":"10.1136/bmjresp-2025-003997","DOIUrl":"10.1136/bmjresp-2025-003997","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of <i>Aspergillus</i>-related chronic lung disease remains poorly defined. We aimed to characterise the local burden at Imperial College Healthcare National Health Service Trust, London, across a 10-year period (2014-2024).</p><p><strong>Methods: </strong>Electronic health records were reviewed to identify individuals tested for serological markers of <i>Aspergillus</i> species infection after which thoracic CT scans were reviewed for features of <i>Aspergillus</i>-related chronic lung disease. Patients were classified into diagnostic categories based on definitions provided in the recent British Thoracic Society Clinical Statement.</p><p><strong>Results: </strong>In total, 334 individuals met criteria for serologic allergic bronchopulmonary aspergillosis (sABPA), 145 for ABPA, 74 for chronic pulmonary aspergillosis (CPA), 38 for simple aspergilloma and 11 with CPA-ABPA overlap. Serological responses varied: ABPA patients had higher median <i>Aspergillus fumigatus</i>-specific immunoglobulin (Ig)E titres (7.52 kUA/L, vs 1.94 kUA/L, p<0.05) and a greater proportion were positive for <i>Aspergillus</i> antibody (IgG) or precipitins (62.5% vs 32.9%, p<0.05) compared with sABPA. CPA patients had lower median total IgE (94 vs 1494 IU/mL, p<0.05) and <i>A. fumigatus</i>-specific IgE (2.24 vs 7.52 kUA/L, p<0.05) than ABPA patients. There was a wide spectrum of radiological presentations across diagnostic categories.</p><p><strong>Conclusions: </strong>While case numbers are likely underestimated, our findings highlight a substantial and heterogeneous local burden. This improved understanding of local epidemiology will inform our local service development.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the INterstitial lung Disease EXacerbations (INDEX) Study: a retrospective multicentre cohort study.","authors":"Amanda T Goodwin, Giles Dixon, Laura J White, Harvinder Virk, Iftikhar Nadeem, Gauri Saini, Fasihul Khan, Helen Parfrey, Chris J Scotton, Shaney L Barratt, Gordon Taylor, Michael Gibbons","doi":"10.1136/bmjresp-2025-003949","DOIUrl":"10.1136/bmjresp-2025-003949","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalisation for respiratory-related events is an important contributor to morbidity and mortality in individuals with fibrotic interstitial lung disease (fILD). Many such hospitalisations are due to acute exacerbations (AE-fILD), but AEs are poorly understood and there are limited evidence-based guidelines for their management. Most research in this area focuses on AEs of idiopathic pulmonary fibrosis (IPF), the commonest fILD and AEs of non-IPF fILD are less well studied. Furthermore, patients with fILD who are hospitalised with a respiratory-related event but do not meet the diagnostic criteria for AE are an important under-studied group. The INterstitial lung Disease EXacerbations (INDEX) study will describe in detail a large real-world population with fILD admitted to hospital for respiratory-related causes, including AE-fILD, as well as identify potential prognostic factors.</p><p><strong>Methods and analysis: </strong>This multicentre retrospective cohort study will analyse case notes for patients admitted to hospital between 1 September 2022 and 31 August 2023. Patient demographic data, clinical features on hospital admission, pre and postadmission investigation results, treatment approaches taken and mortality data will be collected. These data will be used to describe the patient population and to identify associations between patient, clinical presentation and treatment factors and outcomes. The primary outcome will be transplant-free survival at 90 days following the commencement of the index admission.</p><p><strong>Ethics and dissemination: </strong>The study has been approved by the Health Research Authority (HRA) (IRAS 317419) and has been prospectively registered on clinicaltrials.gov (NCT06685874). The HRA waivered the requirement for Research Ethics Committee approval due to only anonymised routinely collected clinical data being collected.</p><p><strong>Conclusion: </strong>This study will enhance our understanding of respiratory-related hospital admissions in fILD, including AE-fILD. The resulting data will describe a real-world patient population, define current standard care and may indicate prognostic and treatment factors to be assessed in future clinical trials.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13264910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Idiopathic Pulmonary Fibrosis Patient-Reported Outcome Measure (IPF-PROM) scale to a Greek IPF patient population and its interrelation with depressive symptoms and health-related quality of life.","authors":"Maria Tziraki, Andreas M Matthaiou, Manolis Linardakis, Eirini Vasarmidi, Aristea Zouraraki, Nikoleta Bizymi, Dimitrios Papagiannis, Ioannis Tomos, Foteini Malli, Zoe Daniil, Anne-Marie Russell, Katerina M Antoniou, Emmanouil K Symvoulakis","doi":"10.1136/bmjresp-2025-003482","DOIUrl":"10.1136/bmjresp-2025-003482","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive debilitating lung disease which affects physical and mental well-being. The IPF Patient-Reported Outcome Measure (IPF-PROM) scale is a validated and reliable tool for the self-report of physical and psychological well-being in IPF.</p><p><strong>Aims and objectives: </strong>This study aimed to validate a Greek version of the IPF-PROM scale and further investigate its correlation with clinical features of IPF patients and its interrelation with depressive symptoms and health-related quality of life (HRQoL).</p><p><strong>Methods: </strong>This was a two-centre, observational, cross-sectional study, in which IPF patients completed three scales: IPF-PROM, Patient Health Questionnaire-9 (PHQ-9), an index of depressive symptoms, and Health Survey Questionnaire Short Form-12 (SF-12), an index of HRQoL, at the IPF Outpatient Clinics of two University Hospitals in Greece during 2023-2024. Logistic regression analysis was conducted to assess severe status of IPF-PROM compared with mild/moderate status.</p><p><strong>Results: </strong>The study involved 136 IPF patients (87.9% males) with a mean age of 73.5±7.9 years. Patients were classified overall with moderate disease according to IPF-PROM mean scores (41.7±31.3), particularly in the combined Breathlessness/Fatigue and the Psychological well-being components (40.1 and 43.8, respectively, p>0.050). Patients with severe symptoms, as measured by IPF-PROM, scored higher levels of depressive symptoms on PHQ-9 compared with those with moderate or mild symptoms (17.1, 12.3 and 1.4, respectively, p<0.001) and lower levels of HRQoL in physical (32.6, 34.7 and 47.9, p<0.001) and mental health on SF-12 (23.9, 34.5 and 50.3, p<0.001). Patients with incrementally higher levels of oxygen saturation had lower odds for severe health status according to IPF-PROM (OR=0.83, p=0.018).</p><p><strong>Conclusions: </strong>A significant percentage of IPF patients present with impaired health status and symptoms suggestive of depression. The IPF-PROM scale represents a useful tool that may predict impairment of mental health and HRQoL in IPF, with potential utility for clinical practice and research.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time spent within the SpO₂ target range during nasal CPAP therapy with different backup modes in extremely preterm infants: a randomised cross-over trial.","authors":"Stephanie Ströbele, Tibor Jung, Dominik Kraft, Eva-Maria Mair, Sophie Kiener, Katharina Hofmann, Markus Waitz, Vanessa Linhoff, Antje Westhoff, Jens Dreyhaupt, Keywan Sohrabi, Harald Ehrhardt","doi":"10.1136/bmjresp-2025-003530","DOIUrl":"10.1136/bmjresp-2025-003530","url":null,"abstract":"<p><strong>Objectives: </strong>To study the efficacy of different modes of backup nasal intermittent positive pressure ventilation (NIPPV) during nasal continuous positive airway pressure (nCPAP) therapy to keep extremely preterm (EPT) infants within the oxygen saturation (SpO₂) target range.</p><p><strong>Design: </strong>Single-centre randomised cross-over trial.</p><p><strong>Setting: </strong>Level 3 neonatal intensive care unit.</p><p><strong>Participants: </strong>24 EPT infants (median gestational age of 24+1 and median postnatal age of 43 days).</p><p><strong>Interventions: </strong>EPT infants on nCPAP therapy with backup NIPPV during apnoea >4 s were assigned in random sequence to immediate cessation of backup NIPPV or to stepwise reduction of backup NIPPV support on restart of spontaneous respiration.</p><p><strong>Main outcome measures: </strong>Primary outcome was time spent within the SpO₂ target range (88%-95%). Secondary outcomes included frequency and duration of hypoxaemic and hyperoxaemic episodes, impact on cerebral tissue oxygenation, parameters of gas exchange and vital signs.</p><p><strong>Results: </strong>The mean percentage of time spent within the SpO₂ target range did not differ between immediate cessation of backup NIPPV on restart of spontaneous respiration compared with the stepwise reduction of backup NIPPV (61.1% vs 64.7%, p=0.15). There were no differences in the time spent below or above the SpO₂ target range, the number of prolonged (>30 s) and severe (<80% and <70%) desaturations and in the parameters of cerebral tissue oxygenation. The stepwise reduction of backup NIPPV resulted in a significant increase in mean airway pressure (7.2 cm H₂0 vs 5.6 cm H₂0, p<0.01) and reduction in respiratory frequency (60.1 vs 63.8, p=0.02) compared with the immediate cessation of backup NIPPV on restart of spontaneous respiration, while mean fraction of inspired oxygen, transcutaneous carbon dioxide pressure and heart rate did not vary between the two interventions.</p><p><strong>Conclusion: </strong>Our findings underpin that new sophisticated ventilation modes like stepwise reduction of backup NIPPV do not necessarily provide a clinical benefit compared with the standard mode. For this, technological advances require robust evaluation within well-designed clinical trials demonstrating the safety and efficacy before being used in everyday clinical practice.</p><p><strong>Trial registration: </strong>German Clinical Trials Register; registration number: DRKS00031956 (https://drks.de/search/en/trial/DRKS00031956), date of registration: 26 May 2023.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}