Expert review of respiratory medicine最新文献_第4页

Extreme temperature and airway dehydration: current understanding and integrative insights into respiratory vulnerability. 极端温度和气道脱水：目前对呼吸易感性的理解和综合见解。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1080/17476348.2026.2674958

Yu-Syuan Shih, Chia-Li Han, Yueh Lun Lee, Feng-Ming Yang, Yuan-Hung Wang, Shu-Chuan Ho, Kang-Yun Lee, Kian Fan Chung, Kin-Fai Ho, Kai-Jen Chuang, Jer-Hwa Chang, Hsiao-Chi Chuang

{"title":"Extreme temperature and airway dehydration: current understanding and integrative insights into respiratory vulnerability.","authors":"Yu-Syuan Shih, Chia-Li Han, Yueh Lun Lee, Feng-Ming Yang, Yuan-Hung Wang, Shu-Chuan Ho, Kang-Yun Lee, Kian Fan Chung, Kin-Fai Ho, Kai-Jen Chuang, Jer-Hwa Chang, Hsiao-Chi Chuang","doi":"10.1080/17476348.2026.2674958","DOIUrl":"10.1080/17476348.2026.2674958","url":null,"abstract":"Introduction: Climate change has significantly increased the frequency and intensity of extreme temperature events, posing growing threats to respiratory health. Among the underlying mechanisms, airway dehydration is a critical yet underrecognized pathway that disrupts the airway surface liquid (ASL), which is essential for mucociliary clearance, epithelial integrity, and immune defense.Areas covered: This article examines evidence linking airway dehydration to respiratory disease during temperature extremes. We discuss how hot, dry air and cold, low-humidity conditions disrupt airway hydration balance, leading to impaired mucociliary clearance and increased susceptibility to infection and inflammation. The review summarizes the impacts of airway dehydration on vulnerable populations, including individuals with pre-existing respiratory conditions (asthma, allergic rhinitis, chronic obstructive pulmonary disease (COPD), and cystic fibrosis), children, older adults, outdoor workers, and socioeconomically disadvantaged groups.Expert opinion: Airway dehydration represents a unifying mechanism linking climate extremes to respiratory vulnerability but remains underrepresented in clinical practice and public health strategies. We advocate for greater recognition of airway hydration in disease prevention, development of practical measurement tools, and targeted interventions for at-risk populations. Emphasizing airway dehydration as a key mediator offers opportunities to improve clinical management and develop effective climate adaptation strategies for respiratory health protection.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1055-1066"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936636","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

Sex differences in clinical and radiographic features of nontuberculous mycobacterial pulmonary disease in a Chinese population. 中国人群非结核性分枝杆菌肺病临床和影像学特征的性别差异

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-05-21 DOI: 10.1080/17476348.2026.2675633

LiHua Wu, JingXuan Xu, JunKai Qiao, ChunLong Fu, DongPing Hu, XinLing Pan, Li Hong, GongQiang Wu

{"title":"Sex differences in clinical and radiographic features of nontuberculous mycobacterial pulmonary disease in a Chinese population.","authors":"LiHua Wu, JingXuan Xu, JunKai Qiao, ChunLong Fu, DongPing Hu, XinLing Pan, Li Hong, GongQiang Wu","doi":"10.1080/17476348.2026.2675633","DOIUrl":"10.1080/17476348.2026.2675633","url":null,"abstract":"Background: Sex-related differences in nontuberculous mycobacterial pulmonary disease (NTM-PD) may influence both clinical presentation and radiographic phenotypes; however, evidence from Chinese populations remains limited.Research design and methods: This retrospective study included 218 patients with NTM-PD in China. Patients were stratified by sex. Clinical characteristics, comorbidities, laboratory parameters, and high-resolution computed tomography findings were compared. Logistic regression analyses were performed to evaluate the association between sex and specific radiographic manifestations.Results: Females had lower body mass index and higher rates of bronchiectasis and gastroesophageal reflux disease. The nodular bronchiectatic phenotype predominated in females (85.85%), with middle lobe/lingula involvement (71.70%). Female sex was independently associated with tree‑in‑bud opacities (p = 0.031). Males had higher rates of smoking, previous tuberculosis, and chronic obstructive pulmonary disease (COPD), and more fibrocavitary disease (25.00%), but cavitation was linked to smoking, tuberculosis, and COPD rather than sex (p = 0.118).Conclusions: Significant sex differences exist in the clinical and radiographic phenotypes of Chinese patients with NTM-PD. Limitations include the single-center retrospective design, relatively small sample size, lack of long-term follow-up data, and absence of sex hormone and environmental exposure assessments.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1119-1126"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944244","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

Management of acute chest syndrome in children with sickle cell disease: impact of vaccination and respiratory panels. 镰状细胞病儿童急性胸综合征的治疗：疫苗接种和呼吸系统检查的影响

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 DOI: 10.1080/17476348.2026.2725915

Yaoping Zhang, Susannah F Vanderpool, Margaret R Hammerschlag

{"title":"Management of acute chest syndrome in children with sickle cell disease: impact of vaccination and respiratory panels.","authors":"Yaoping Zhang, Susannah F Vanderpool, Margaret R Hammerschlag","doi":"10.1080/17476348.2026.2725915","DOIUrl":"https://doi.org/10.1080/17476348.2026.2725915","url":null,"abstract":"Introduction: Acute chest syndrome (ACS) is a common sickle cell disease (SCD) complication. Infectious pathogens are the most common causes of ACS followed by pulmonary infarction and fat embolism. Infectious pathogens responsible for ACS include viruses, atypical bacteria (Mycoplasma pneumoniae and Chlamydia pneumoniae), and bacteria.Areas covered: The introduction of conjugate pneumococcal and Hemophilus influenzae b vaccines and implementation of penicillin prophylaxis has significantly reduced, but not eliminated the risk of bacterial infections in this population. However, pneumococcal infections still occur but may further decline with the introduction of expanded conjugate vaccines such as PCV20. The introduction of multiplexed PCR respiratory panels in 2014 has enabled more accurate diagnosis of the infectious pathogens responsible for ACS in children with SCD. Recent studies using these panels have found that the majority of cases of ACS were associated with viral infections. M. pneumoniae and C. pneumoniae infections were uncommon.Expert opinion: We suggest that empiric antibiotics in children with SCD presenting with ACS be limited to ceftriaxone. Azithromycin should only be used if the respiratory pathogen panel is positive for M. pneumoniae or C. pneumoniae, as azithromycin will remain in the system for over 7-days even if discontinued after one dose.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868564","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

Impact of climate, air pollution, and urbanization on chronic respiratory infections. 气候、空气污染和城市化对慢性呼吸道感染的影响。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-05-25 DOI: 10.1080/17476348.2026.2675617

Paola Faverio, Veronica Capuano, Giovanni Franco, Antonio Morgante, Erika Panetta, Umberto Zanini, Enrico Cesare Maggioni, Paolo Pozzi, Lorenzo Del Castello, Stefano Aliberti, Fabrizio Luppi

{"title":"Impact of climate, air pollution, and urbanization on chronic respiratory infections.","authors":"Paola Faverio, Veronica Capuano, Giovanni Franco, Antonio Morgante, Erika Panetta, Umberto Zanini, Enrico Cesare Maggioni, Paolo Pozzi, Lorenzo Del Castello, Stefano Aliberti, Fabrizio Luppi","doi":"10.1080/17476348.2026.2675617","DOIUrl":"10.1080/17476348.2026.2675617","url":null,"abstract":"Introduction: chronic respiratory infections represent a significant source of global morbidity and mortality, especially among individuals with structural lung diseases or compromised defenses. Emerging evidence highlights the role of environmental factors, such as climate change, air pollution, and urbanization, in the epidemiology and progression of these infections.Areas covered: This review synthesizes current research on the interactions between climate conditions, pollution, and urbanization in bronchiectasis, cystic fibrosis, nontuberculous mycobacterial (NTM) pulmonary disease, and chronic pulmonary aspergillosis. A search of relevant medical literature in the English language was conducted in Medline/PubMed, EMBASE and Scopus up to January 2026.Increases in temperature, fluctuations in humidity, extreme weather events (e.g. heatwaves, floods, and cold spells), and elevated concentrations of particulate matter contribute to both pathogen proliferation and increased host susceptibility, which impact the severity and incidence of chronic respiratory infections, particularly those caused by environmental pathogens such as non-tuberculous mycobacteria and Aspergillus spp. respiratory infections. Higher urban density and changes in microbial ecosystems further enhance transmission and chronicity.Expert opinion: Understanding the complex interactions between environmental stressors and respiratory health and incorporating environmental risk assessment into clinical practice and public health policy is crucial for reducing disease burden in the context of accelerating climate change.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1083-1095"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978153","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

Impulse oscillometry indices are associated with functional impairment and progressive pulmonary fibrosis across interstitial lung diseases. 脉冲振荡指标与间质性肺疾病的功能损害和进行性肺纤维化相关。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-05-25 DOI: 10.1080/17476348.2026.2678615

Eyal Kleinhendler, Tomer Hasson, Doron Cohn-Schwartz, Ariel Melloul, Sharon Enghelberg, Inbal Friedman Regev, Nimrod Urtreger, Aviv Kupershmidet, Amir Bar-Shai, Boaz Tiran, Ophir Freund, Avraham Unterman

{"title":"Impulse oscillometry indices are associated with functional impairment and progressive pulmonary fibrosis across interstitial lung diseases.","authors":"Eyal Kleinhendler, Tomer Hasson, Doron Cohn-Schwartz, Ariel Melloul, Sharon Enghelberg, Inbal Friedman Regev, Nimrod Urtreger, Aviv Kupershmidet, Amir Bar-Shai, Boaz Tiran, Ophir Freund, Avraham Unterman","doi":"10.1080/17476348.2026.2678615","DOIUrl":"10.1080/17476348.2026.2678615","url":null,"abstract":"Background: Respiratory oscillometry provides effort-independent indices of airway heterogeneity (R5-20) and respiratory system stiffness (AX). Their clinical relevance in interstitial lung diseases (ILD) remains unclear and was the aim of our study.Research design and methods: A cross-sectional study including patients with ILD who underwent oscillometry, pulmonary function tests (PFTs), and six-minute walking distance (6MWD) at a single visit. R5-20 and AX were analyzed as continuous variables and as thresholds derived from receiver operating characteristic (ROC) analysis for progressive pulmonary fibrosis (PPF). Associations with clinical outcomes were assessed using multivariable regression models.Results: Ninety-four patients (median age 70y; 44% females) were included. Oscillometry parameters correlated with PFTs and 6MWD, and had a moderate discriminative ability for PPF (AUC 0.747-0.764). Abnormal oscillometry was identified in 46 patients (49%) and was not associated with any baseline characteristic or ILD subtype. However, it was linked to lower DLCO (48% vs. 54% predicted, p = 0.02) and reduced 6MWD (median [IQR] 413 [354-503] vs. 465 [425-533] meters, p = 0.024). R5-20 was higher in patients with air-trapping or mosaic attenuation in chest CT, although not in those with honeycombing or traction bronchiectasis.Conclusion: Oscillometric abnormalities are common in ILD and independently associated with disease severity.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1127-1136"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978160","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

Health disparities in cystic fibrosis in the context of the exposome: recent developments and future directions. 暴露背景下囊性纤维化的健康差异：最近的发展和未来方向。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-05-26 DOI: 10.1080/17476348.2026.2679780

Gabriela R Oates, Crystal Stephens, Michael S Schechter

引用次数: 0

Bovhyaluronidase azoximer for long-term pulmonary sequelae of COVID19: a multicenter, randomized, double-blind, placebo-controlled study. bovhyalonidase azoximer治疗covid - 19长期肺部后遗症：一项多中心、随机、双盲、安慰剂对照研究

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-06-10 DOI: 10.1080/17476348.2026.2684077

Sergey N Avdeev, Galina L Ignatova, Oxana M Drapkina, Veronica B Popova, Ekaterina V Melnikova, Tatiana I Chudinovskikh, Olga V Ryabova, Natalia V Egorova, Tamara V Rubanik, Yury G Shvarts, Svetlana A Polyakova, Anna V Antonova, Dmitry A Zubkov, Mikhail S Khmelevskii, Nadezhda F Khomyakova, Mikhail A Tsyferov, Tim C Hardman, Anton A Tikhonov

{"title":"Bovhyaluronidase azoximer for long-term pulmonary sequelae of COVID19: a multicenter, randomized, double-blind, placebo-controlled study.","authors":"Sergey N Avdeev, Galina L Ignatova, Oxana M Drapkina, Veronica B Popova, Ekaterina V Melnikova, Tatiana I Chudinovskikh, Olga V Ryabova, Natalia V Egorova, Tamara V Rubanik, Yury G Shvarts, Svetlana A Polyakova, Anna V Antonova, Dmitry A Zubkov, Mikhail S Khmelevskii, Nadezhda F Khomyakova, Mikhail A Tsyferov, Tim C Hardman, Anton A Tikhonov","doi":"10.1080/17476348.2026.2684077","DOIUrl":"10.1080/17476348.2026.2684077","url":null,"abstract":"Background: Bovhyaluronidase azoximer (BA) has been reported to improve pulmonary function and exercise tolerance in patients with pulmonary sequelae of COVID-19. In this multicenter, randomized, double-blind, placebo-controlled study, we evaluated the effects of BA on patients with long-term (up to 12 months) pulmonary sequelae of COVID-19.Methods: Patients (n = 392) were randomized 1:1 to receive BA or placebo every 5 days for 71 days. Percent predicted forced vital capacity (ppFVC), respiratory symptoms, and exercise tolerance indicators were assessed at baseline and on Days 71 (Δ ppFVC was the primary endpoint) and 180.Results: The pre-specified primary endpoint (Δ ppFVC at Day 71) was negative (+0.30%, p = 0.817). Secondary endpoints showed reduced exertional desaturation (OR 0.36, p = 0.006) and dyspnea (OR 0.62, p = 0.040).Conclusion: While the primary objective yielded clinically insignificant results, patients treated with BA showed increased exercise tolerance although further investigations are required to confirm findings.Trial registration: The study is registered at ClinicalTrials.gov (NCT06383819).","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1137-1147"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207387","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

Delivery of care for pediatric laryngotracheal stenosis. 小儿喉气管狭窄的护理交付。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-09-01 Epub Date: 2026-06-03 DOI: 10.1080/17476348.2026.2676349

Anisha R Noble, Matthew M Smith

{"title":"Delivery of care for pediatric laryngotracheal stenosis.","authors":"Anisha R Noble, Matthew M Smith","doi":"10.1080/17476348.2026.2676349","DOIUrl":"10.1080/17476348.2026.2676349","url":null,"abstract":"Introduction: Management of pediatric laryngotracheal stenosis remains a complex and multidisciplinary process, with implications of surgery that extend far beyond the operating room. Ideal care for pediatric patients undergoing complex airway reconstruction requires a holistic approach that includes attention to patient and caregiver needs, quality of life measures, and the optimization of secondary outcomes of surgery, such as voicing and swallowing.Areas covered: This special report highlights the impact of non-surgical and secondary outcomes of complex airway reconstruction in pediatric patients with laryngotracheal stenosis. Articles queried from PubMed are reviewed in this report, with special attention to literature that focuses on quality-of-life metrics after pediatric airway reconstruction and that which examines post-operative dysphonia and dysphagia in this population. Additional insight and data from a high-volume pediatric airway reconstructive center are included in this discussion.Expert opinion: Comprehensive care of a pediatric patient with laryngotracheal stenosis extends beyond surgery and involves multidisciplinary management of long-term sequelae to truly improve the quality of life of patients and their caregivers.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1039-1043"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058952","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

Impact and management of biologic therapies on small airway dysfunction in severe asthma: a comprehensive review. 生物治疗对严重哮喘小气道功能障碍的影响和管理：一项全面的综述。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-08-30 DOI: 10.1080/17476348.2026.2727155

Francesco Menzella, Rory Chan, Marcello Cottini, Claudio Micheletto

{"title":"Impact and management of biologic therapies on small airway dysfunction in severe asthma: a comprehensive review.","authors":"Francesco Menzella, Rory Chan, Marcello Cottini, Claudio Micheletto","doi":"10.1080/17476348.2026.2727155","DOIUrl":"https://doi.org/10.1080/17476348.2026.2727155","url":null,"abstract":"Introduction: Despite significant advances in precision medicine, managing severe asthma remains a major clinical challenge. Small airway dysfunction (SAD) is a crucial determinant of poor symptom control, airway remodeling, and frequent exacerbations. While conventional spirometry primarily assesses large airway mechanics, airway oscillometry (AO) provides a highly sensitive, effort-independent evaluation of peripheral resistance and reactance during normal breathing.Areas covered: This review synthesizes current evidence from major biomedical databases (PubMed, Embase, Scopus, and Web of Science; 2000-2026) regarding the physiological role of SAD across severe asthma phenotypes (eosinophilic vs. non-eosinophilic). Furthermore, it systematically evaluates the specific impact of targeted biological therapies (anti-IgE, anti-IL-5/IL-5 R, anti-IL-4/13 Rα, and anti-TSLP) on distal respiratory mechanics.Expert opinion: SAD represents a vital treatable trait in severe asthma. Biologics exert distinct physiological effects on peripheral parameters, with upstream modulators such as dupilumab and tezepelumab demonstrating superior efficacy in reversing distal mucus plugging and frequency-dependent resistance abnormalities. Incorporating AO into routine clinical algorithms alongside T2 inflammatory biomarkers is essential to refine endophenotyping, improve overall risk stratification, guide personalized biologic selection, and accurately monitor functional therapeutic responses in patients with severe refractory asthma.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868610","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 effect of the respiratory rate on mechanical power and patient outcomes - a systematic review. 呼吸频率对机械动力和患者预后的影响——一项系统综述。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-08-28 DOI: 10.1080/17476348.2026.2724585

Jan Willem H J Geerts, Bibi Bosman, M H G Papenhuijzen, Juliana Ferreira, David van Meenen, Frederique Paulus, Marcus J Schultz, Kanwalpreet Sodhi, Louise Urlings-Strop, Laura A Buiteman-Kruizinga

{"title":"The effect of the respiratory rate on mechanical power and patient outcomes - a systematic review.","authors":"Jan Willem H J Geerts, Bibi Bosman, M H G Papenhuijzen, Juliana Ferreira, David van Meenen, Frederique Paulus, Marcus J Schultz, Kanwalpreet Sodhi, Louise Urlings-Strop, Laura A Buiteman-Kruizinga","doi":"10.1080/17476348.2026.2724585","DOIUrl":"10.1080/17476348.2026.2724585","url":null,"abstract":"Introduction: Mechanical power (MP) is associated with worse clinical outcomes. Respiratory rate (RR) is a key component of MP. The aim of this systematic review was to assess whether, among mechanically ventilated adult ICU patients, a low versus high RR is associated with differences in MP, clinical outcomes and ventilation parameters.Methods: A comprehensive systematic search in PubMed, Embase, Cochrane Central Register of Controlled Trials and Google Scholar was performed in January 2026. Studies were included if they reported on invasively ventilated adult patients in the ICU and evaluated RR in relation to MP or patient outcomes.Results: 12 studies were included. Most studies involved patients with ARDS or COVID-19. Lower RR was associated with reduced MP across most studies. Studies using automated ventilation or protocolized RR adjustments showed the largest reductions in MP. Higher RR was associated with increased mortality in three studies. Reducing RR did not lead to significant changes in other ventilation parameters or gas exchange.Conclusion: Lowering RR is a promising strategy to reduce MP with minimal effects on gas exchange over short durations. RR may represent an underrecognized setting in lung-protective ventilation, but prospective studies are needed to confirm effects on clinical outcomes.Study registration: The search strategy was registered at PROSPERO (registration number CRD420251240779).","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835785","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