BMC Pulmonary Medicine最新文献

{"title":"Association of blood eosinophil counts with pulmonary and extrapulmonary comorbidities in patients with chronic obstructive pulmonary disease: data from NHANES 2013-2018.","authors":"Hong Chen, Xiaobo Hu, Chenyun He, Yanmei Wen, Chunlan Ma, Yongsheng Wang","doi":"10.1186/s12890-025-03734-6","DOIUrl":"10.1186/s12890-025-03734-6","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) involves systemic inflammation and is often accompanied by comorbidities. Blood eosinophil count (BEC) is a key marker of airway inflammation, used for patient stratification and treatment guidance. However, the association between BEC (< 300 vs. ≥ 300 cells/µL) and pulmonary or extrapulmonary comorbidities in COPD remains unclear.</p><p><strong>Methods: </strong>This study analyzed COPD patients from the 2013-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multivariable logistic regression models examined associations between BEC and comorbidities, adjusting for potential confounders. Associations were quantified using odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 614 COPD patients were included (395 with BEC < 300 cells/µL, 219 with BEC ≥ 300 cells/µL). Patients with BEC ≥ 300 cells/µL had a higher prevalence of extrapulmonary comorbidities than those with BEC < 300 cells/µL (85.35% vs. 71.48%). Adjusted analysis showed that BEC ≥ 300 cells/µL was significantly associated with increased odds of any extrapulmonary comorbidity (OR = 2.03, 95% CI: 1.19-3.44, p = 0.009), congestive heart failure (OR = 1.69, 95% CI: 1.02-2.82, p = 0.043), and renal dysfunction (OR = 1.95, 95% CI: 1.01-3.79, p = 0.048), but not with pulmonary comorbidities. Sensitivity analyses using 3- and 4-level BEC categories revealed consistent trends, with higher BEC levels significantly associated with greater prevalence of at least one extrapulmonary comorbidity.</p><p><strong>Conclusions: </strong>In COPD, higher BEC (≥ 300 cells/µL) is significantly associated with extrapulmonary comorbidities, particularly congestive heart failure and renal dysfunction, but not pulmonary comorbidities.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"256"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131992","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":"Distance travelled in the six-minute walk test in patients with chronic obstructive pulmonary disease as a predictor of mortality.","authors":"Izadora Moraes Dourado, Cássia da Luz Goulart, Aldair Darlan Santos-de-Araújo, Renan Shida Marinho, Adriana Sanches Garcia-Araujo, Meliza Goi Roscani, Renata Trimer, Andrea Lucia Gonçalves da Silva, Renata Gonçalves Mendes, Audrey Borghi-Silva","doi":"10.1186/s12890-025-03721-x","DOIUrl":"10.1186/s12890-025-03721-x","url":null,"abstract":"<p><strong>Background: </strong>Exercise intolerance in patients with COPD has significant implications for quality of life, hospitalization rates, and survival.</p><p><strong>Objective: </strong>To assess functional capacity using the six-minute walk test (6MWT) by categorizing the distance walked in six minutes (6MWD) into tertiles and to assess the impact of this functional capacity on predictors of survival over a 24-month follow-up in patients with Chronic Obstructive Pulmonary Disease (COPD).</p><p><strong>Methods: </strong>This prospective cohort study followed 118 patients with COPD for 24 months. Participants were stratified based on the 6MWD: Group 1 (mean distance 590-424 m); Group 2 (mean distance 423-337 m); and Group 3 (mean distance < 336 m). Symptoms and disease severity were assessed using CAT scores. Kaplan-Meier was used to determine the association between 6MWD and all-cause mortality.</p><p><strong>Results: </strong>The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. The 6MWD, stratified by functional performance, was a significant predictor of survival in patients with COPD, despite heterogeneity in disease severity between groups. Furthermore, in regression analysis for mortality, it was identified for 6MWD (CI 0.994; p = 0.043) and peripheral oxygen saturation (SpO₂) (CI 0.735; p < 0.001). Kaplan-Meier survival analysis revealed that patients who walked less than 336 m in the 6MWD had the lowest probability of survival at 24 months (log-rank p < 0.05).</p><p><strong>Conclusion: </strong>The 6MWD is a robust predictor of mortality over a 2-year period in patients with COPD, reflecting a broad spectrum of disease severity. Poorer 6MWD performance is associated with increased desaturation, impaired heart rate recovery, and greater symptom burden during exercise, as indicated by CAT scores.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"258"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132052","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":"Association between CRP-Albumin-Lymphocyte (CALLY) index and Asthma-COPD overlap: analysis of NHANES 2015-2018 data.","authors":"Shasha Fu, Zongcun Chen, Hongchuan Wu","doi":"10.1186/s12890-025-03705-x","DOIUrl":"10.1186/s12890-025-03705-x","url":null,"abstract":"<p><strong>Background: </strong>The CRP-Albumin-Lymphocyte (CALLY) index, a novel inflammatory biomarker combining serum albumin, lymphocyte count, and C-reactive protein (CRP), has been proposed for clinical use. This study aimed to investigate the association between CALLY index and Asthma-COPD Overlap (ACO) in the general US population.</p><p><strong>Methods: </strong>We analyzed data from 6,797 participants aged ≥ 40 years from the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into quartiles based on natural logarithmic transformed (ln) CALLY index. ACO was defined as self-reported physician-diagnosed asthma and COPD. Logistic regression models were used to examine the association between ln CALLY and ACO, adjusting for potential confounders across three models. Generalized additive models, subgroup analyses, and receiver operating characteristic (ROC) curve analysis were also performed.</p><p><strong>Results: </strong>The prevalence of ACO across the four CALLY quartiles was 5.56%, 1.89%, 1.54%, and 0.66%. In the fully adjusted model, for each 1-unit increase in ln CALLY, the risk of ACO decreased by 43% (OR = 0.57, 95% CI: 0.44-0.73, P = 0.001). Compared with Q1, the risk of ACO in Q2, Q3, and Q4 was reduced by 63% (OR = 0.37), 66% (OR = 0.34), and 87% (OR = 0.13), respectively (P for trend = 0.003). Generalized additive models showed a non-linear negative relationship (P < 0.001). Subgroup analysis revealed that the association remained consistent across different sexes, age groups, races, smoking status, and disease statuses (arthritis, DM, and hypertension). ROC curve analysis indicated moderate predictive ability of ln CALLY for ACO (AUC = 0.675, 95% CI: 0.636-0.714), with an optimal cutoff value of 8.007 (sensitivity 0.669, specificity 0.598).</p><p><strong>Conclusion: </strong>Higher CALLY index is independently associated with lower risk of ACO, suggesting its potential value as a biomarker for ACO risk assessment in clinical practice. By integrating inflammation, immune, and nutritional status evaluation, the CALLY index offers a novel perspective for early identification of high-risk individuals in clinical practice.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"257"},"PeriodicalIF":2.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131886","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":"Nocturnal desaturation in patients with non-operable chronic thromboembolic pulmonary hypertension.","authors":"Yu Taniguchi, Miki Sakamoto, Hiroyuki Fujii, Keisuke Miwa, Yasunori Tsuboi, Kenichi Yanaka, Noriaki Emoto, Hiromasa Otake","doi":"10.1186/s12890-025-03712-y","DOIUrl":"10.1186/s12890-025-03712-y","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal desaturation is occasionally observed in patients with chronic thromboembolic pulmonary hypertension (CTEPH) despite the absence of parenchymal lung disease; however, the underlying mechanism remains unclear. This study aimed to clarify the clinical features of nocturnal desaturation in patients with CTEPH.</p><p><strong>Methods: </strong>Data of 163 patients with CTEPH who underwent balloon pulmonary angioplasty (BPA) between March 2011 and December 2022 were retrospectively analyzed. We evaluated their hemodynamics using right heart catheterization, arterial blood gas examination, respiratory function tests, nocturnal oximetry, and cardiopulmonary exercise testing, which were routinely performed at baseline and after BPA.</p><p><strong>Results: </strong>A higher ratio of dead space to tidal volume (VD/VT) (p < 0.001) and higher alveolar-arterial oxygen difference (A-aDO2) (p = 0.026) at baseline were associated with greater nocturnal desaturation in the multivariable linear analysis. After BPA, nearly normal hemodynamics was achieved (mean pulmonary arterial pressure: 37.5 ± 10.0 to 20.2 ± 4.9 mmHg, p < 0.01). Nocturnal desaturation also improved from - 13.3 ± 5.8% at baseline to -10.3 ± 5.4% after BPA (p < 0.01). Improvement in VD/VT correlated well with improvement in nocturnal desaturation after BPA (p < 0.001, R² linear = 0.18).</p><p><strong>Conclusions: </strong>Nocturnal desaturation often coexists with CTEPH. VD/VT, a marker of physiologic dead-space fraction, A-aDO2, a marker of ventilation-perfusion mismatch, and lung diffusing capacity were strongly associated. Nocturnal desaturation improved slightly after BPA, which was associated with a decrease in the physiological dead- space fraction. Our study emphasizes the importance of including nocturnal oximetry in routine evaluations and continuation of nocturnal oxygen therapy, if necessary, in patients with CTEPH.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"254"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126706","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":"Machine learning prediction model with shap interpretation for chronic bronchitis risk assessment based on heavy metal exposure: a nationally representative study.","authors":"Tiansheng Xia, Kaiyu Han","doi":"10.1186/s12890-025-03724-8","DOIUrl":"10.1186/s12890-025-03724-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic bronchitis (CB), as a core precursor of Chronic Obstructive Pulmonary Disease (COPD), is crucial for global disease burden prevention and control. Although the association between heavy metal exposure and respiratory damage has been preliminarily demonstrated, traditional linear models are difficult to resolve the nonlinear interactions and dose-response heterogeneity. The aim of this study was to construct the first heavy metal exposure-chronic bronchitis risk prediction model by integrating exposureomics data through machine learning (ML).</p><p><strong>Methods: </strong>Weighted logistic regression was used to assess the association of 14 blood and urine heavy metals with CB based on nationally representative samples from the 2005-2015 National Health and Nutrition Examination Survey (NHANES). The Boruta algorithm was further applied to screen the characteristic variables and construct 10 ML models. The best model was selected by four evaluation metrics: accuracy, specificity, sensitivity, and area under the ROC curve (AUC), and the best model was visually interpreted using Shapley's additive interpretation (SHAP).</p><p><strong>Results: </strong>The multifactorial logistic regression model showed that urinary cadmium (OR = 1.53, 95% CI = 1.17-1.98) versus blood cadmium (OR = 1.36, 1.13-1.65) was an independent risk factor for CB. The CatBoost model had the best predictive performance (AUC = 0.805), with smoking as the most significant predictor, followed by blood cadmium concentration and gender.</p><p><strong>Conclusion: </strong>In this research, the first risk prediction diagnostic model for heavy metal-chronic bronchitis was developed, in which CatBoost model had the best performance, and it provides a referenceable prediction model for the screening of high-risk groups.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"252"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126704","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":"Patient characteristics and pharmacologic treatment patterns in antifibrotic-treated patients with fibrosing interstitial lung diseases: real-world results from a claims database.","authors":"Yasuhiro Kondoh, Tomohiro Ito, Hana Kimura, Haikun Bao, Masataka Kuwana","doi":"10.1186/s12890-025-03713-x","DOIUrl":"10.1186/s12890-025-03713-x","url":null,"abstract":"<p><strong>Background: </strong>Antifibrotics have been approved for use in many countries, including Japan, based on the results of several phase III clinical trials in patients with IPF, SSc-ILD, and PPF, which showed slower lung function decline with antifibrotic treatment. There is a paucity of information on the real-world use of antifibrotics in clinical practice.</p><p><strong>Methods: </strong>Baseline characteristics, comorbidities, and drugs used prior to and concomitant with antifibrotics were collected for patients with IPF, SSc-ILD, and PPF using a health insurance claims database in Japan from 1 January 2013 to 30 June 2023. Descriptive statistics were generated for all study variables.</p><p><strong>Results: </strong>This study included 657 nintedanib users with IPF; 418 pirfenidone users with IPF; 4160 nintedanib users with PPF; 18,403 users of glucocorticoids/immunosuppressants for ILD treatment with PPF; 676 nintedanib users with SSc-ILD; and 698 users of glucocorticoids/immunosuppressants for ILD treatment with SSc-ILD. At index, pirfenidone users with IPF were the oldest (mean [SD] 74.8 [7.3] years), and nintedanib users with SSc-ILD were the youngest (mean [SD] 65.6 [11.7] years). In nintedanib users with IPF, 76.7% were prescribed nintedanib as monotherapy, and 75.6% of pirfenidone users were prescribed pirfenidone, as monotherapy. In patients with IPF, 75.2% were prescribed nintedanib, and 76.1% were prescribed pirfenidone, as first-line therapy. In patients with SSc-ILD, 34.9% were prescribed nintedanib as monotherapy for ILD treatment, and 38.6% as first-line therapy. Approximately half of patients with PPF were prescribed nintedanib concomitantly with other glucocorticoids/immunosuppressant drugs, and after one or more glucocorticoids/immunosuppressant drugs. The most common concomitant drug in all patient groups was glucocorticoids. In patients with IPF, 18.6% of nintedanib users and 18.2% of pirfenidone users were prescribed glucocorticoids concomitantly. Concomitant glucocorticoid use was 52.7% for nintedanib users with SSc-ILD, and 44.1% for nintedanib users with PPF.</p><p><strong>Conclusions: </strong>These results provide real-world evidence of antifibrotic use in clinical practice. Most patients with IPF were prescribed antifibrotics as monotherapy for ILD treatment whereas antifibrotics were used concomitantly with glucocorticoids/immunosuppressants in many patients with SSc-ILD and PPF. While most patients with IPF were prescribed antifibrotics as first-line therapy, patients with SSc-ILD and PPF were more likely to be prescribed nintedanib as second-line or later-line treatment after glucocorticoids/immunosuppressants.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"253"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126722","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":"Characteristics of folic acid metabolism-related genes unveil prognosis and treatment strategy in lung adenocarcinoma.","authors":"Yanting Dong, Xiaoyan Wang, Chuanchuan Dong, Peiqi Li, Zhuola Liu, Xinrui Tian","doi":"10.1186/s12890-025-03694-x","DOIUrl":"10.1186/s12890-025-03694-x","url":null,"abstract":"<p><strong>Background: </strong>Lung adenocarcinoma (LUAD) is the most common subtype of lung cancer. Folic acid metabolism-related genes (FAMGs) have received increased attention because of their distinct role in DNA synthesis and repair. Nevertheless, the function of FAMGs in LUAD remains ambiguous.</p><p><strong>Methods: </strong>LUAD transcriptome data from GEO and TCGA were analyzed. Patients were classified into two clusters based on gene expression levels, revealing distinct overall survival (OS) outcomes. Common differentially expressed genes (DEGs) were identified between LUAD and normal tissues, as well as between the two clusters. A prognostic risk model was established using Cox regression analysis to predict outcomes of LUAD patients and was validated with Kaplan-Meier and ROC curve analysis. Clinical correlations and enrichment analyses were carried out to explore the functions of DEGs and their associations with clinical characteristics of LUAD patients. The tumor microenvironment and drug sensitivity were evaluated between two risk subgroups. Moreover, expression levels of prognostic genes were validated across datasets using the Wilcoxon-test.</p><p><strong>Results: </strong>The study identified seventy-seven common DEGs and nine prognostic genes (ANLN, PLK1, DLGAP5, PRC1, CYP4B1, MKI67, KIF23, BIRC5, TK1). The risk model could effectively predict the prognosis of LUAD patients. Clinical correlation analysis revealed that age, pathologic-T, pathologic-N, and tumor stage were significantly correlated with the risk score. Enrichment analysis showed that DEGs between the two risk subgroups were predominantly enriched in cell cycle and cellular senescence pathways. Differences in immune cell infiltration and immunotherapy markers were markedly noted between the two risk subgroups. Drug sensitivity analysis disclosed significantly diverse responses to sixty-eight drugs between the two risk subgroups. Consistent expression tendencies of prognostic genes were observed across datasets.</p><p><strong>Conclusion: </strong>The prognostic model based on FAMGs demonstrates considerable potential for guiding diagnosis and clinical management of LUAD patients.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"255"},"PeriodicalIF":2.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126701","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":"Effects of pulmonary rehabilitation program in a community based hospital in California.","authors":"Baljit Ubhi, Razaz Shaheen, Kristin Ireland, Abdullah Alismail","doi":"10.1186/s12890-025-03714-w","DOIUrl":"10.1186/s12890-025-03714-w","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to evaluate the effectiveness of a community based pulmonary rehabilitation program in central California.</p><p><strong>Method: </strong>This was a retrospective study approved by the institutional review board at Community Regional Medical Centers Fresno. Data were extracted from a pulmonary rehabilitation clinic at a Community Based Hospital in Fresno, CA, USA from 2016 to 2023. The program was designed as follows: patients completed a six-week program, two hours, twice/week. The program included the following: stretching, breathing, and personalized training/exercise. Main outcomes were the following data: six-minute walk tests (6MWT), shortness of breath questionnaire (SOB-Q), Patient Health Questionnaire (PHQ-9), quality of life (QoL), and satisfaction level.</p><p><strong>Results: </strong>The study included 381 participants, comprising 186 males and 195 females. Our findings demonstrated significant improvements post-program, including increased six-minute walk test (6MWT) distances (633 ± 316 to 925 ± 311 m, p < 0.001), reduced shortness of breath scores (52.28 ± 22.36 to 41.87 ± 20.9, p < 0.001), improved PHQ-9 depression scores (7.83 ± 5.46 to 4.70 ± 4.42, p < 0.001), and higher quality of life scores (16.0 ± 5.88 to 19.00 ± 6.15, p < 0.001). Patient satisfaction was high, with consistent positive feedback on program design and delivery.</p><p><strong>Conclusion: </strong>Our results showed that the program was effective in improving patients' quality of life, shortness of breath, and 6MWT. In addition, patients were satisfied with the program upon completion. Further longitudinal studies in different regions are strongly recommended to confirm and validate our findings.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"249"},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118825","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":"Safety and efficacy of pulmonary surfactant therapy for acute respiratory distress syndrome in children: a systematic review and meta-analysis.","authors":"Xuesong Ren, Qi Jiang, Lin Wang, Xia Yuan, Dan Chen, Guo Xu","doi":"10.1186/s12890-025-03728-4","DOIUrl":"10.1186/s12890-025-03728-4","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary surfactants (PSs) are generally known to be effective in treating newborns with acute respiratory distress syndrome (ARDS). However, their effectiveness in children remains controversial. The purpose of the current systematic review and meta-analysis was to assess the effectiveness and safety of PS in children.</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, EMBASE, Cochrane, CNKI, and Wanfang databases was conducted to identify publications up to December 2024. Only multicenter, randomized controlled trials involving children aged between 1 month and 18 years with acute lung injury or ARDS were included. The intervention group received PS treatment, whereas the control group received a placebo. The primary outcome measure was mortality rate, and secondary outcomes included days without mechanical ventilation, duration of mechanical ventilation, incidence of adverse events, and oxygenation index (OI).</p><p><strong>Results: </strong>Seven articles met the inclusion criteria. The use of PS was associated with a significant reduction in the mortality rate (relative risk [RR] = 1.50, 95% confidence interval [CI] = 1.11-2.01, p = 0.008). In terms of secondary outcomes, there was an increase in the number of days without mechanical ventilation (mean difference = 1.20, 95% CI = 0.24-2.15, p = 0.01) and a lower incidence of adverse events (RR = 1.76, 95% CI = 1.14 to 2.71, p = 0.01) in the intervention group than in the control group, with no significant difference in mechanical ventilation duration (MD = -1.06, 95% CI = -3.47 to -1.35, p = 0.39) or OI (MD = -0.65, 95% CI = -3.48 to -2.19, p = 0.66).</p><p><strong>Conclusion: </strong>PS treatment was associated with a reduction in the mortality rate and incidence of adverse events in critically ill children with ARDS; however, the clinical impact of PS treatment warrants further research.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"250"},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118864","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":"Case report: refractory atelectasis after infection of adenovirus and Mycoplasma Pneumoniae in an immunocompetent patient.","authors":"Xuehua Xu, Hui Xu, Xiaoyun Jia, Huifeng Fan, Diyuan Yang, Dongwei Zhang, Gen Lu","doi":"10.1186/s12890-025-03652-7","DOIUrl":"10.1186/s12890-025-03652-7","url":null,"abstract":"<p><strong>Background: </strong>Atelectasis is defined as collapse of alveolar spaces due to a variety of reasons. Most atelectasis could improve after removing the cause by chest physiotherapy, medical treatment, therapeutic bronchoscopy and so on. However, some atelectasis cannot be cleared with above treatments, resulting in long-term atelectasis, also called as refractory atelectasis. It easily leads to recurrent infection, bronchiectasis, bronchiolitis obliterans, and lung necrosis. So, it is important to identify causal mechanism of refractory atelectasis, which may contribute to explore effective approach and reducing complications.</p><p><strong>Case presentation: </strong>We present the case of a 4-years-old girl admitted to hospital with fever and cough for 6 days, who had pulmonary consolidation in left lower lobe due to human adenovirus-7 and Mycoplasma pneumoniae. Although the patient did not have inborn errors of immunity, neuromuscular disease or inherited metabolic diseases through medical history and laboratory examination, the consolidation of the left lower lung still existed after a series of treatments, including mechanical ventilation, intravenous immunoglobulin, systemic corticosteroid, azithromycin and bronchoalveolar lavage. Even, chest HRCT showed left lung atelectasis one month after discharge. In the follow-up 1 years, she was hospitalized for respiratory infections and wheezing 4 times. In consideration of refractory atelectasis and recurrent infections, left lung was resected by thoracoscopy and postoperative pathology confirmed bronchiolitis obliterans. Specific antibodies was utilized to identify type I and II alveolar epithelial cells, club cells, ionocytes and ciliated cells respectively, which show a selective reduction in type I alveolar epithelial cells.</p><p><strong>Conclusion: </strong>It is rare that a previously healthy child developed to refractory atelectasis after an infection which ultimately resulted in a lobectomy. The cellular analysis of the atrophic lung tissue showed a selective reduction in type I alveolar epithelial cells.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"251"},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118820","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}