Breathe最新文献 - Book学术

Lung cavitation and mediastinal lymphadenopathy in a patient with a positive tuberculin test: the role of mediastinal cryobiopsy. 结核菌素试验阳性患者的肺空化和纵隔淋巴结病：纵隔低温活检的作用。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0343-2025

Agamemnon Bakakos, Stavroula Zaneli, Evangelia Koukaki, Nektarios Anagnostopoulos, Grigorios Stratakos

引用次数: 0

Mechanical ventilation in acute brain injury. 机械通气在急性脑损伤中的应用。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0340-2025

Luca Ratibondi, Virginia Newcombe, Romit J Samanta

{"title":"Mechanical ventilation in acute brain injury.","authors":"Luca Ratibondi, Virginia Newcombe, Romit J Samanta","doi":"10.1183/20734735.0340-2025","DOIUrl":"https://doi.org/10.1183/20734735.0340-2025","url":null,"abstract":"Acute brain injury (ABI) includes traumatic brain injury, subarachnoid and intracerebral haemorrhage, ischaemic stroke and global hypoxic-ischaemic injury, and patients often require admission to intensive care. Although pathologically heterogeneous, they share common mechanisms of primary injury followed by secondary brain injury. Systemic derangements such as hypoxaemia, dysregulated carbon dioxide tension and elevated intracranial pressure (ICP) may exacerbate secondary injury and should be avoided. Patients with ABI often require invasive mechanical ventilation (IMV), and of these up to 19-22% may develop acute respiratory distress syndrome. Lung-protective ventilation (LPV) strategies using low tidal volumes and moderate positive end-expiratory pressure to minimise ventilator-induced lung injury are established practices in patients requiring IMV. However, strict application of LPV principles may conflict with neuro-protective goals, particularly carbon dioxide control to optimise cerebral blood flow and avoid rises in ICP. This review examines the physiological tension between lung and brain protection, focusing on neuro-respiratory interactions and brain-lung crosstalk. We synthesise the evidence on ventilatory strategies in the context of patients with ABI, discuss the implications for neurological and pulmonary outcomes, and highlight the need for an integrated, individualised approach to ventilation in these patients.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 4","pages":"250340"},"PeriodicalIF":4.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence and digital health in bronchoscopy: advances in diagnostic accuracy, real-time navigation and procedural skills training. 支气管镜检查中的人工智能和数字健康：诊断准确性、实时导航和程序技能培训方面的进展。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0051-2026

Zakaria Lahmar, Engi Ahmed, Quentin Wynands, Paul Reynaud, Arnaud Bourdin

{"title":"Artificial intelligence and digital health in bronchoscopy: advances in diagnostic accuracy, real-time navigation and procedural skills training.","authors":"Zakaria Lahmar, Engi Ahmed, Quentin Wynands, Paul Reynaud, Arnaud Bourdin","doi":"10.1183/20734735.0051-2026","DOIUrl":"https://doi.org/10.1183/20734735.0051-2026","url":null,"abstract":"Artificial intelligence (AI) and procedure-linked digital health technologies are beginning to transform bronchoscopy across three interconnected domains. In terms of diagnostic accuracy, deep learning models applied to endobronchial ultrasound images and bronchoscopic videos can match or exceed human readers in differentiating benign from malignant lesions, although nearly all evidence remains at the level of test-accuracy metrics rather than clinical outcomes. In real-time navigation, AI-augmented fluoroscopy and tomosynthesis platforms represent the clearest example of clinically deployed AI that improves lesion localisation and diagnostic yield for peripheral pulmonary nodules, while camera-based localisation and shared-control robotic systems remain largely preclinical. In training, multiple randomised controlled trials demonstrate that AI-guided simulators significantly improve performance across experience levels, and that AI-derived metrics can objectively assess competence, although the first attempt to show impact on real-world clinical performance was inconclusive. This review synthesises the current literature across these three domains, distinguishing technologies that are currently used in clinical practice with supportive published evidence from those that remain investigational. It provides practising bronchoscopists and trainees with a balanced appraisal of what AI can realistically offer today, what limitations persist, and what developments are likely over the coming decade.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 4","pages":"260051"},"PeriodicalIF":4.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to use social media to amplify your professional impact in respiratory medicine. 如何利用社交媒体扩大你在呼吸医学领域的专业影响力。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0151-2026

Ana Sofia Grave, Guido Marchi, Mathieu Marillier, Stefan Cristian Stanel, Marjolein A Heuvelmans

引用次数: 0

AI-augmented cardiopulmonary point-of-care ultrasound: a narrative review for pulmonary and critical care clinicians. 人工智能增强的心肺护理点超声：肺部和重症监护临床医生的叙述回顾。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0058-2026

James Mattson, Kaivalya Deshpande, Deepak Pradhan

{"title":"AI-augmented cardiopulmonary point-of-care ultrasound: a narrative review for pulmonary and critical care clinicians.","authors":"James Mattson, Kaivalya Deshpande, Deepak Pradhan","doi":"10.1183/20734735.0058-2026","DOIUrl":"https://doi.org/10.1183/20734735.0058-2026","url":null,"abstract":"Point-of-care ultrasound (POCUS) is an increasingly utilised tool in pulmonary and critical care medicine, yet its effectiveness remains limited by operator dependency and the required cognitive demands of real-time image acquisition and interpretation. Artificial intelligence (AI) has emerged as a promising approach to augment POCUS by supporting image acquisition, interpretation and quantitative analysis. Given the rapid evolution of this field, clinicians must understand both the capabilities and limitations of AI-enabled POCUS. However, prior reviews have largely catalogued applications without focusing on how these tools integrate into bedside workflows. This narrative review examines AI in cardiopulmonary POCUS through a workflow-based lens relevant to pulmonologists and intensivists. We discuss the role of AI as a bedside coach, interpreter and quantifier, highlighting applications in lung and focused cardiac ultrasound, including pneumothorax detection, B-line analysis, left ventricular function assessment, and identification of other cardiopulmonary pathologies. Across domains, AI demonstrates strong performance in controlled settings, although variability persists in real-world environments due to differences in image quality, patient factors and dataset limitations. Future directions include interactive, clinician-in-the-loop systems, protocol-driven integration, and multimodal data synthesis. A clear understanding of these developments will be essential for clinicians as AI becomes increasingly embedded within bedside patient care.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 4","pages":"260058"},"PeriodicalIF":4.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Digital health and artificial intelligence in paediatric respiratory medicine: what clinicians need to know and what is coming next. 儿科呼吸医学中的数字健康和人工智能：临床医生需要知道什么以及接下来会发生什么。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0045-2026

Mirèse Christine Lilian Kleuskens, Amy Hai Yan Chan, David Drummond

{"title":"Digital health and artificial intelligence in paediatric respiratory medicine: what clinicians need to know and what is coming next.","authors":"Mirèse Christine Lilian Kleuskens, Amy Hai Yan Chan, David Drummond","doi":"10.1183/20734735.0045-2026","DOIUrl":"https://doi.org/10.1183/20734735.0045-2026","url":null,"abstract":"Digital health and artificial intelligence (AI) are increasingly part of paediatric respiratory clinics, from home-based symptom monitoring and remote consultations to AI-supported test interpretation and large language model (LLM)-supported communication. These tools promise to capture real-world disease and treatment patterns, support self-management, and enhance clinical decisions. Yet for most of these tools, the paediatric evidence base remains limited and fragmented, and the clinical benefit observed in practice is often modest. What has emerged is that effectiveness depends less on the technology itself than on how it fits into the child-parent-clinician triad, on its usability in daily family life, and on its impact on clinical workflow and on equity. Paediatric datasets remain small, heterogeneous and developmental, making extrapolation from adult evidence risky. Over the next 3 years, progress is likely to consolidate rather than expand, with paediatric-specific validation, regulation and routine integration. Clinicians will play a central role: deciding what to adopt, what to question, and what to govern.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 4","pages":"260045"},"PeriodicalIF":4.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical performance and practical limitations of large language models in respiratory medicine. 呼吸医学中大型语言模型的临床表现和实际限制。

IF 4.5

Breathe Pub Date : 2026-10-13 eCollection Date: 2026-10-01 DOI: 10.1183/20734735.0125-2026

Simon Høj, Casper Jensen, Howraman Meteran

{"title":"Clinical performance and practical limitations of large language models in respiratory medicine.","authors":"Simon Høj, Casper Jensen, Howraman Meteran","doi":"10.1183/20734735.0125-2026","DOIUrl":"https://doi.org/10.1183/20734735.0125-2026","url":null,"abstract":"This Journal club discusses three recent studies evaluating large language models (LLMs) in respiratory medicine and allergy. In COPD, ChatGPT-3.5 was rated higher than Bing Chat by respiratory specialists for accuracy, completeness, clarity and safety, although clinically important omissions remained. In asthma, 13 out of 14 models exceeded 85% accuracy on multiple-choice questions and five exceeded 95%, but performance was lower and more variable in objective structured clinical examinations. In allergen immunotherapy, ChatGPT-4 achieved fair overall DISCERN quality, but showed insufficient Journal of the American Medical Association (JAMA) benchmark reliability and produced responses that were often difficult to read. Together, these studies show that LLMs perform best on structured and familiar knowledge tasks, while weaknesses persist in completeness, transparency, readability and clinically nuanced application. Current evidence supports supervised educational use in respiratory medicine and allergy, but not unsupervised patient counselling or autonomous clinical deployment.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 4","pages":"260125"},"PeriodicalIF":4.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimising respiratory health in children with neurodevelopmental impairment. 优化神经发育障碍儿童的呼吸健康。

IF 4.5

Breathe Pub Date : 2026-09-15 eCollection Date: 2026-07-01 DOI: 10.1183/20734735.0325-2025

Sara Kussad, Matthew Hurley

{"title":"Optimising respiratory health in children with neurodevelopmental impairment.","authors":"Sara Kussad, Matthew Hurley","doi":"10.1183/20734735.0325-2025","DOIUrl":"https://doi.org/10.1183/20734735.0325-2025","url":null,"abstract":"Respiratory complications represent a major cause of morbidity and mortality in children with neurodisability. Neurodisability includes those with neurological impairment (cerebral palsy), neuromuscular impairment (muscular dystrophies) and developmental impairment (global developmental impairment, genetic syndromes). Respiratory complications arise from a complex interplay of factors including bulbar dysfunction, impaired airway clearance, recurrent aspiration, respiratory muscle weakness, and progressive chest wall restriction. Children with neurodevelopmental conditions (e.g. cerebral palsy, developmental disorders) are particularly vulnerable, with respiratory disease accounting for a substantial proportion of hospital admissions and premature deaths. This review provides an overview of the pathophysiological mechanisms underlying respiratory dysfunction in children with neurodevelopmental conditions, outlines assessment strategies, and evaluates current interventions aimed at optimising respiratory health. Key management approaches include airway clearance techniques, secretion management and nutritional optimisation. A multidisciplinary approach incorporating regular surveillance, prevention strategies, and individualised care planning is essential. Despite growing clinical experience, randomised controlled trials remain limited, and significant research gaps persist.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 3","pages":"250325"},"PeriodicalIF":4.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Molecules of lung cancer - fusion alterations in nonsmall cell lung cancer: biology and diagnostic considerations. 非小细胞肺癌的分子融合改变：生物学和诊断考虑。

IF 4.5

Breathe Pub Date : 2026-09-15 eCollection Date: 2026-07-01 DOI: 10.1183/20734735.0259-2025

Marie Talty, David O'Reilly, Jasmine Dunne, Jarushka Naidoo

{"title":"Molecules of lung cancer - fusion alterations in nonsmall cell lung cancer: biology and diagnostic considerations.","authors":"Marie Talty, David O'Reilly, Jasmine Dunne, Jarushka Naidoo","doi":"10.1183/20734735.0259-2025","DOIUrl":"https://doi.org/10.1183/20734735.0259-2025","url":null,"abstract":"Fusion alterations have transformed outcomes for a subset of patients with nonsmall cell lung cancer (NSCLC), as part of the evolution of precision oncology. While the role of molecular pathology in the diagnosis and treatment of NSCLC has rapidly evolved, it remains the responsibility of the pulmonologist to coordinate the diagnostic evaluation of patients with lung cancer, including clinical assessment, obtaining a histological diagnosis and coordination of staging procedures. This review focuses on the biology, clinical significance and diagnostic considerations of fusion alterations in NSCLC. We summarise current knowledge regarding the role of actionable gene fusion translocations, including anaplastic lymphoma kinase (ALK), ros-protooncogene 1 (ROS1), retinoblastoma rearranged during transfection (RET) and neurotrophic tyrosine receptor kinase (NTRK) fusions, while outlining clinical decision-making considerations and testing frameworks. For respiratory physicians, it is essential to prioritise suitable diagnostic modalities by taking into account tissue availability, turnaround time, and consideration of next generation sampling methods and noninvasive sampling such as blood-based circulating tumour DNA assays.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 3","pages":"250259"},"PeriodicalIF":4.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory consequences of cervical spinal cord injury: insights from preclinical models. 颈脊髓损伤的呼吸后果：来自临床前模型的见解。

IF 4.5

Breathe Pub Date : 2026-09-15 eCollection Date: 2026-07-01 DOI: 10.1183/20734735.0348-2025

Wei Chen, Enora Chaib, Pauline Michel-Flutot, Stéphane Vinit, Isabelle Vivodtzev

{"title":"Respiratory consequences of cervical spinal cord injury: insights from preclinical models.","authors":"Wei Chen, Enora Chaib, Pauline Michel-Flutot, Stéphane Vinit, Isabelle Vivodtzev","doi":"10.1183/20734735.0348-2025","DOIUrl":"https://doi.org/10.1183/20734735.0348-2025","url":null,"abstract":"Respiratory dysfunction is one of the most common acute medical issues after cervical spinal cord injury (cSCI) and is considered a leading cause of reduced quality of life for long-term survivors. After cSCI, disruption of descending respiratory drive, impairment of respiratory muscle recruitment and altered airway protection combine to reduce ventilatory capacity and cough effectiveness, increasing the risk of atelectasis, pneumonia and ventilator dependence. Although modern intensive care and pulmonary rehabilitation have improved survival, respiratory complications remain a leading driver of hospitalisation, long-term disability and healthcare costs after cSCI. These clinical limitations highlight the need to explore novel therapeutic strategies and mechanistic targets that cannot be systematically tested in human studies and therefore require rigorous evaluation in preclinical models. This review synthesises clinical and preclinical evidence on how cervical injury compromises breathing, with emphasis on insights from experimental models that permit controlled manipulation of lesion level, severity and laterality to link specific injury characteristics to respiratory dysfunction. In particular, we outline the neural control of respiration (highlighting autonomous and volitional pathways linked to spinal respiratory motor pools), summarise the clinical trajectory of respiratory impairment and, finally, provide a comparison of widely used preclinical models, from their typical characteristic patterns of respiratory dysfunction to the lesion pathology that shapes recovery and interpretation of therapeutic studies.","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"22 3","pages":"250348"},"PeriodicalIF":4.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0