Expert review of respiratory medicine最新文献_第3页

Imagining the severe asthma decision trees of the future. 畅想未来的重症哮喘决策树

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-20 DOI: 10.1080/17476348.2024.2390987

Arnaud Bourdin, Phil Bardin, Pascal Chanez

{"title":"Imagining the severe asthma decision trees of the future.","authors":"Arnaud Bourdin, Phil Bardin, Pascal Chanez","doi":"10.1080/17476348.2024.2390987","DOIUrl":"10.1080/17476348.2024.2390987","url":null,"abstract":"Introduction: There are no validated decision-making algorithms concerning severe asthma (SA) management. Future risks are crucial factors and can be derived from SA trajectories.Areas covered: The future severe asthma-decision trees should revisit current knowledge and gaps. A focused literature search has been conducted.Expert opinion: Asthma severity is currently defined a priori, thereby precluding a role for early interventions aiming to prevent outcomes such as exacerbations (systemic corticosteroids exposure) and lung function decline. Asthma 'at-risk' might represent the ultimate paradigm but merits longitudinal studies considering modern interventions. Real exacerbations, severe airway hyperresponsiveness, excessive T2-related biomarkers, noxious environments and patient behaviors, harms of OCS and high-doses inhaled corticosteroids (ICS), and low adherence-to-effectiveness ratios of ICS-containing inhalers are predictors of future risks. New tools such as imaging, genetic, and epigenetic signatures should be used. Logical and numerical artificial intelligence may be used to generate a consistent risk score. A pragmatic definition of response to treatments will allow development of a validated and applicable algorithm. Biologics have the best potential to minimize the risks, but cost remains an issue. We propose a simplified six-step algorithm for decision-making that is ultimately aiming to achieve asthma remission.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of ensifentrine on dyspnea in patients with moderate-to-severe chronic obstructive pulmonary disease: pooled analysis of the ENHANCE trials. 安思芬特林对中重度慢性阻塞性肺病患者呼吸困难的影响：ENHANCE 试验的汇总分析。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-08 DOI: 10.1080/17476348.2024.2389960

Donald A Mahler, Surya P Bhatt, Tara Rheault, Daniel Reyner, Thomas Bengtsson, Amy Dixon, Kathleen Rickard, Dave Singh

{"title":"Effect of ensifentrine on dyspnea in patients with moderate-to-severe chronic obstructive pulmonary disease: pooled analysis of the ENHANCE trials.","authors":"Donald A Mahler, Surya P Bhatt, Tara Rheault, Daniel Reyner, Thomas Bengtsson, Amy Dixon, Kathleen Rickard, Dave Singh","doi":"10.1080/17476348.2024.2389960","DOIUrl":"10.1080/17476348.2024.2389960","url":null,"abstract":"Background: Dyspnea is a critical component of chronic obstructive pulmonary disease (COPD). We report the effect of ensifentrine, a novel PDE3/PDE4 inhibitor, on dyspnea using pooled data from the Phase 3 ENHANCE-1/2 trials.Methods: The pooled population (ensifentrine, n = 975; placebo, n = 574) included patients aged 40-80 years with post-bronchodilator FEV1/FVC <0.7, FEV1 30-70% predicted, mMRC Dyspnea Scale score ≥2, and a smoking history ≥10 pack-years. Patients taking dual LAMA/LABA or LAMA/LABA/ICS triple therapy were excluded. Dyspnea measures included the Transition Dyspnea Index (TDI), Evaluating Respiratory Symptoms (E-RS), and rescue medication use.Results: After 24 weeks, ensifentrine significantly improved TDI scores (least-squares mean difference, 0.97; 95% CI, 0.64, 1.30; p < 0.001) and across all TDI subdomains. Ensifentrine-treated patients were more likely to be TDI responders at week 24 (p < 0.001), which was consistent across clinically relevant subgroups. Ensifentrine-treated patients had improved E-RS breathlessness subdomain scores (p = 0.053) and reduced rescue medication use (p = 0.002).Conclusion: Ensifentrine produced clinically meaningful improvements in multiple dyspnea measures in patients with symptomatic, moderate-to-severe COPD. A limitation of this study was the exclusion of patients taking dual LAMA/LABA and LAMA/LABA/ICS triple therapy.Clinical trial registration: www.clinicaltrials.gov identifiers are ENHANCE-1: NCT04535986; ENHANCE-2: NCT04542057.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-term effects of announcing spirometric lung-age on smokers' attitudes: results from a Tunisian real-life pilot study. 公布肺活量对吸烟者态度的短期影响：突尼斯一项真实试点研究的结果。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-18 DOI: 10.1080/17476348.2024.2390992

Soumaya Khaldi, Khansa Derbel, Ines Ghannouchi, Fatma Guezguez, Amani Sayhi, Wafa Benzarti, Balsam Barkous, Salsabil Bouafia, Fatma Zahra Dabbebi, Emna Charfedi, Helmi Ben Saad

{"title":"Short-term effects of announcing spirometric lung-age on smokers' attitudes: results from a Tunisian real-life pilot study.","authors":"Soumaya Khaldi, Khansa Derbel, Ines Ghannouchi, Fatma Guezguez, Amani Sayhi, Wafa Benzarti, Balsam Barkous, Salsabil Bouafia, Fatma Zahra Dabbebi, Emna Charfedi, Helmi Ben Saad","doi":"10.1080/17476348.2024.2390992","DOIUrl":"10.1080/17476348.2024.2390992","url":null,"abstract":"Background: To determine the effects of informing smokers of their spirometric lung-age (SLA) on smoking cessation (SC) rates and tobacco consumption.Research design and methods: An interventional study was conducted in real-life through a humanitarian event led by the Red Crescent on 9 January 2022, in Hammam-Sousse (Sousse, Tunisia). The study comprised four steps: i) Medical questionnaire (general questionnaire, Fagerström test for cigarette dependence, SC motivation questionnaire); ii) Measurement of spirometric data; iii) SLA estimation and its announcement to participants; and iv) Self-reported evaluation of smoking behavior three months later through telephonic recall. Smokers were divided into groups (nondependent vs. dependent groups and insufficient/moderate motivation vs. high/very high motivation groups) and categories (ceased smoking, reduced consumption, maintained stable or increased consumption).Results: Fifty-two smokers were included (94% were males). Three months after the event, i) 9 (17%) smokers ceased smoking, ii) 39 (75%) smokers reduced their daily smoking consumption by 12 ± 8 cigarettes/day, and iii) 4 (8%) smokers maintained stable (n = 3) or increased (n = 1) consumption.Conclusions: Informing smokers of their SLA led 92% of them to cease smoking or reduce their consumption. Announcing SLA could be an effective motivational tool and an easy-to-understand concept to help smokers cease their habit.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current perspective on e-cigarette use and respiratory outcomes: mechanisms and messaging. 电子烟使用与呼吸系统变量的当前视角：机制与信息传递。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-11 DOI: 10.1080/17476348.2024.2387090

Thomas A Wills, Wasim Maziak, Taghrid Asfar, Simanta Roy

{"title":"Current perspective on e-cigarette use and respiratory outcomes: mechanisms and messaging.","authors":"Thomas A Wills, Wasim Maziak, Taghrid Asfar, Simanta Roy","doi":"10.1080/17476348.2024.2387090","DOIUrl":"10.1080/17476348.2024.2387090","url":null,"abstract":"Introduction: There has been an increasing amount of research on the consequences of e-cigarette use for respiratory outcomes, which is significant for public health and respiratory medicine. We discuss recent findings and lay out implications for prevention and treatment.Areas covered: Based on literature searches using several databases (PubMed, Web of Science, Google Scholar) for keywords, including synonyms, 'e-cigarettes,' with 'pulmonary function,' 'oxidative stress,' and 'inflammation,' we review studies on acute effects of e-cigarette use for measures of pulmonary function and discuss selected laboratory studies on mechanisms of effect, focusing on processes with known relation to respiratory disease; oxidative stress and inflammation. We discuss available studies that have tested the effectiveness of communication strategies for prevention of e-cigarette use oriented to different audiences, including nonsmoking adolescents and adult smokers.Expert opinion: We conclude that the evidence presents a mixed picture. Evidence is found for adverse consequences of e-cigarette use on measures of lung function and two disease-related biological processes, sometimes but not always less than for cigarette smoking. How to best communicate these results to a complex audience of users, from younger susceptible adolescents to long-term adult smokers interested in quitting, is a question of significant interest and empirically validated communication strategies are greatly needed.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891359","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

Efficacy and safety of bronchoscopic lung volume reduction for chronic obstructive pulmonary disease: a systematic review and network meta-analysis. 支气管镜肺容积缩小术治疗慢性阻塞性肺病的有效性和安全性：系统综述和网络荟萃分析。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-08 DOI: 10.1080/17476348.2024.2388293

Ranran Zhang, Ziwen Zheng, Yiding Bian, Mingming Deng, Felix F J Herth, Gang Hou

{"title":"Efficacy and safety of bronchoscopic lung volume reduction for chronic obstructive pulmonary disease: a systematic review and network meta-analysis.","authors":"Ranran Zhang, Ziwen Zheng, Yiding Bian, Mingming Deng, Felix F J Herth, Gang Hou","doi":"10.1080/17476348.2024.2388293","DOIUrl":"10.1080/17476348.2024.2388293","url":null,"abstract":"Background: Various bronchoscopic lung volume reduction (BLVR) methods have been developed to treat chronic obstructive pulmonary disease (COPD). The efficacy and safety of these interventions remain unclear. This study assessed the efficacy and safety of various BLVR interventions in COPD patients.Methods: PubMed and Embase were searched from inception to 21 October 2023. The primary outcomes assessed included the 6-min walking distance (6MWD), St. George Respiratory Questionnaire (SGRQ) score, lung function, and adverse events (AE). A frequentist approach with a random-effects model was used for a network meta-analysis.Results: Twelve randomized controlled trials (RCTs) with 1646 patients were included in this meta-analysis. Patients treated with an endobronchial valve (EBV) achieved a minimum clinically important difference (MCID) in 6MWD and SGRQ at 6 months. Patients treated with coils achieved MCID in the SGRQ score at 12 months. Patients with aspiration valve system and bronchoscopic thermal vapor ablation (BTVA) achieved MCID in the SGRQ score at 6 months.Conclusions: In COPD patients, EBV should be considered first, while being wary of pneumothorax. Coil and BTVA are potential therapeutic alternatives. Although BTVA demonstrates a safer procedural profile than coils, additional studies are imperative to clarify its efficacy.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141880021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improving diagnostic strategies in bronchoscopy for peripheral pulmonary lesions. 改进支气管镜检查周围肺部病变的诊断策略。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-11 DOI: 10.1080/17476348.2024.2387089

Yuji Matsumoto, Sze Shyang Kho, Hideaki Furuse

{"title":"Improving diagnostic strategies in bronchoscopy for peripheral pulmonary lesions.","authors":"Yuji Matsumoto, Sze Shyang Kho, Hideaki Furuse","doi":"10.1080/17476348.2024.2387089","DOIUrl":"10.1080/17476348.2024.2387089","url":null,"abstract":"Introduction: In the past two decades, bronchoscopy of peripheral pulmonary lesions (PPLs) has improved its diagnostic yield due to the combination of various instruments and devices. Meanwhile, the application is complex and intertwined.Areas covered: This review article outlines strategies in diagnostic bronchoscopy for PPLs. We summarize the utility and evidence of key instruments and devices based on the results of clinical trials. Future perspectives of bronchoscopy for PPLs are also discussed.Expert opinion: The accuracy of reaching PPLs by bronchoscopy has improved significantly with the introduction of combined instruments such as navigation, radial endobronchial ultrasound, digital tomosynthesis, and cone-beam computed tomography. It has been accelerated with the advent of approach tools such as newer ultrathin bronchoscopes and robotic-assisted bronchoscopy. In addition, needle aspiration and cryobiopsy provide further diagnostic opportunities beyond forceps biopsy. Rapid on-site evaluation may also play an important role in decision making during the procedures. As a result, the diagnostic yield of bronchoscopy for PPLs has improved to a level comparable to that of transthoracic needle biopsy. The techniques and technologies developed in the diagnosis will be carried over to the next step in the transbronchial treatment of PPLs in the future.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A clinician's guide to single vs multiple inhaler therapy for COPD. 慢性阻塞性肺病单吸入器疗法与多吸入器疗法的临床医师指南。

Expert review of respiratory medicine Pub Date : 2024-07-01 Epub Date: 2024-07-27 DOI: 10.1080/17476348.2024.2384702

Mario Cazzola, Josuel Ora, Mauro Maniscalco, Paola Rogliani

{"title":"A clinician's guide to single vs multiple inhaler therapy for COPD.","authors":"Mario Cazzola, Josuel Ora, Mauro Maniscalco, Paola Rogliani","doi":"10.1080/17476348.2024.2384702","DOIUrl":"10.1080/17476348.2024.2384702","url":null,"abstract":"Introduction: In the management of chronic obstructive pulmonary disease (COPD), inhalation therapy plays a pivotal role. However, clinicians often face the dilemma of choosing between single and multiple inhaler therapies for their patients. This choice is critical because it can affect treatment efficacy, patient adherence, and overall disease management.Areas covered: This article examines the advantages and factors to be taken into consideration when selecting between single and multiple inhaler therapies for COPD.Expert opinion: Both single and multiple inhaler therapies must be considered in COPD management. While single inhaler therapy offers simplicity and convenience, multiple inhaler therapy provides greater flexibility and customization. Clinicians must carefully evaluate individual patient needs and preferences to determine the most appropriate inhaler therapy regimen. Through personalized treatment approaches and shared decision-making, clinicians can optimize COPD management and improve patient well-being. Nevertheless, further research is required to compare the effectiveness of single versus multiple inhaler strategies through rigorous clinical trials, free from industry bias, to determine the optimal inhaler strategy. Smart inhaler technology appears to have the potential to enhance adherence and personalized management, but the relative merits of smart inhalers in single inhaler regimens versus multiple inhaler regimens remain to be determined.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The benefits and drawbacks of home oxygen therapy for COPD: what's next? 慢性阻塞性肺病家庭氧疗的利弊：下一步该怎么办？

Expert review of respiratory medicine Pub Date : 2024-07-01 Epub Date: 2024-07-15 DOI: 10.1080/17476348.2024.2379459

Yet H Khor, Magnus Ekström

{"title":"The benefits and drawbacks of home oxygen therapy for COPD: what's next?","authors":"Yet H Khor, Magnus Ekström","doi":"10.1080/17476348.2024.2379459","DOIUrl":"10.1080/17476348.2024.2379459","url":null,"abstract":"Introduction: Home oxygen therapy is one of the few interventions that can improve survival in patients with chronic obstructive pulmonary disease (COPD) when administered appropriately, although it may cause side effects and be an unnecessary burden for some patients.Areas covered: This narrative review summarizes the current literature on the assessment of hypoxemia, different types of home oxygen therapy, potential beneficial and adverse effects, and emerging research on home oxygen therapy in COPD. A literature search was performed using MEDLINE and EMBASE up to January 2024, with additional articles being identified through clinical guidelines.Expert opinion: Hypoxemia is common in patients with more severe COPD. Long-term oxygen therapy is established to prolong survival in patients with chronic severe resting hypoxemia. Conversely, in the absence of chronic severe resting hypoxemia, home oxygen therapy has an unclear or conflicting evidence base, including for palliation of breathlessness, and is generally not recommended. However, beneficial effects in some patients cannot be precluded. Evidence is emerging on the optimal daily duration of oxygen use, the role of high-flow and auto-titrated oxygen therapy, improved informed decision-making, and telemonitoring. Further research is needed to validate novel oxygen delivery systems and monitoring tools and establish long-term effects of ambulatory oxygen therapy in COPD.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Small airways disease in chronic obstructive pulmonary disease. 慢性阻塞性肺病中的小气道疾病。

Expert review of respiratory medicine Pub Date : 2024-07-01 Epub Date: 2024-07-24 DOI: 10.1080/17476348.2024.2380070

Nikolaos Lazarinis, Evangelia Fouka, Anders Linden, Apostolos Bossios

{"title":"Small airways disease in chronic obstructive pulmonary disease.","authors":"Nikolaos Lazarinis, Evangelia Fouka, Anders Linden, Apostolos Bossios","doi":"10.1080/17476348.2024.2380070","DOIUrl":"10.1080/17476348.2024.2380070","url":null,"abstract":"Introduction: Small airway disease (SAD) represents a common and critical feature of Chronic Obstructive Pulmonary Disease (COPD). Introduced in the '60s, SAD has gradually gained increasing interest as assessment methodologies have improved. Chronic exposure to smoking and noxious particles or gases induces inflammation and remodeling, leading to airway obstruction and SAD, eventually resulting in complete airway loss.Areas covered: A literature search up to June 2024 was performed in PubMed to identify articles on SAD and airway diseases mainly COPD, but also to the extent that it seemed relevant in the uncontrolled/severe asthma field, where SAD is better studied. We provide clinicians and translational scientists with a comprehensive analysis of the existing literature on SAD in COPD, concentrating on the underlying pathophysiological mechanisms, diagnostic techniques, and current pharmacological approaches targeting airflow obstruction in small airways.Expert opinion: Small airways are the primary site for the onset and progression of airflow obstruction in patients with COPD, with significant clinical consequences associated with poor lung function, hyperinflation, and impaired quality of life. The early identification of individuals with subclinical SAD may allow us to prevent its further progress from airway loss and potential development of emphysema and choose the appropriate therapeutic approach.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical evidence and technical aspects of innovative technology and monitoring of chronic NIV in COPD: a narrative review. 慢性阻塞性肺疾病慢性 NIV 监测创新技术的临床证据和技术方面：叙述性综述。

Expert review of respiratory medicine Pub Date : 2024-07-01 Epub Date: 2024-08-13 DOI: 10.1080/17476348.2024.2384024

F Soleimani, D W Donker, E Oppersma, M L Duiverman

{"title":"Clinical evidence and technical aspects of innovative technology and monitoring of chronic NIV in COPD: a narrative review.","authors":"F Soleimani, D W Donker, E Oppersma, M L Duiverman","doi":"10.1080/17476348.2024.2384024","DOIUrl":"10.1080/17476348.2024.2384024","url":null,"abstract":"Introduction: Chronic nocturnal noninvasive ventilation (NIV) improves outcomes in COPD patients with chronic hypercapnic respiratory failure. The aim of chronic NIV in COPD is to control chronic hypercapnic respiratory insufficiency and reduce symptoms of nocturnal hypoventilation, thereby improving quality of life. Chronic NIV care is more and more offered exclusively at home, enabling promising outcomes in terms of patient and caregiver satisfaction, hospital care consumption and cost reduction. Yet, to achieve and maintain optimal ventilation, during adaptation and follow-up, effective feasible (home) monitoring poses a significant challenge.Areas covered: Comprehensive monitoring of COPD patients receiving chronic NIV requires integrating data from ventilators and assessment of the patient's status including gas exchange, sleep quality, and patient-reported outcomes. The present article describes the physiological background of monitoring during NIV and aims to provide an overview of existing methods for monitoring, assessing their reliability and clinical relevance.Expert opinion: Patients on chronic NIV are 'ideal' candidates for home monitoring; the advantages of transforming hospital to home care are huge for patients and caregivers and for healthcare systems facing increasing patient numbers. Despite the multitude of available monitoring methods, identifying and characterizing the most relevant parameters associated with optimal patient well-being remains unclear.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0