Expert review of respiratory medicine最新文献_第6页

An updated guide for clinicians: extracorporeal membrane oxygenation for pediatric patients with refractory acute respiratory failure. 临床医生更新指南：难治性急性呼吸衰竭患儿体外膜氧合。

Expert review of respiratory medicine Pub Date : 2025-07-24 DOI: 10.1080/17476348.2025.2536887

Makenzie Hamilton, Marybeth Burriss-West, Desiree Bonadonna, Caroline P Ozment, Kyle J Rehder

{"title":"An updated guide for clinicians: extracorporeal membrane oxygenation for pediatric patients with refractory acute respiratory failure.","authors":"Makenzie Hamilton, Marybeth Burriss-West, Desiree Bonadonna, Caroline P Ozment, Kyle J Rehder","doi":"10.1080/17476348.2025.2536887","DOIUrl":"10.1080/17476348.2025.2536887","url":null,"abstract":"Introduction: Extracorporeal membrane oxygenation (ECMO) remains a mainstay for refractory respiratory failure in select pediatric patients. Clinical practice surrounding its use continues to evolve, reflecting advances in technology, management strategies, and patient selection. Ongoing research and innovation are actively shaping VV-ECMO's future directions aimed at optimizing outcomes and increasing understanding of best practices.Areas covered: This review summarizes the fundamental concepts of VV-ECMO and highlights established practices and ongoing questions with a focus on indications/contraindications, cannulation, ventilator management, anticoagulation, fluid management, and weaning/decannulation. We also examine recent advancements and emerging technologies that are shaping the evolution of pediatric ECMO therapy. Narrative literature review of the PubMed central database was utilized to help inform this review.Expert opinion: Despite recent progress in pediatric VV-ECMO, substantial gaps remain in understanding optimal practices. And while there are many promising advances, there is a need for high-quality, collaborative research to further define best practices and guide ongoing future improvements for this life-sustaining therapy.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669143","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

Pneumonitis induced by immune checkpoint inhibitors: a systematic review. 免疫检查点抑制剂诱导的肺炎：一项系统综述。

Expert review of respiratory medicine Pub Date : 2025-07-24 DOI: 10.1080/17476348.2025.2538273

Ana Casal, Virginia Leiro, Laura Villar, Manuel Casal-Guisande, Cristina Pou, Mar Mosteiro, Maribel Botana, Tamara Lourido, María Castro, María Torres-Durán, Alberto Fernández-Villar

{"title":"Pneumonitis induced by immune checkpoint inhibitors: a systematic review.","authors":"Ana Casal, Virginia Leiro, Laura Villar, Manuel Casal-Guisande, Cristina Pou, Mar Mosteiro, Maribel Botana, Tamara Lourido, María Castro, María Torres-Durán, Alberto Fernández-Villar","doi":"10.1080/17476348.2025.2538273","DOIUrl":"10.1080/17476348.2025.2538273","url":null,"abstract":"Introduction: Pulmonary toxicity induced by immune checkpoint inhibitors (ICIs) has a variable incidence and a high index of suspicion is necessary in order to enable a timely approach. There are few studies on the actual epidemiology and specific outcomes of pulmonary toxicity associated with this treatment. The aim of this study is to assess the frequency, characteristics and outcomes of lung injury induced by ICIs.Methods: We conducted a systematic review applying predefined inclusion and exclusion criteria. A total of 7 studies were included.Results: ICI-induced pneumonitis is a relevant toxicity, with an incidence ranging from 1% to 7%. The risk is higher with anti-PD-1 than with anti-PD-L1 agents, with observed OR of 4.53 for Nivolumab, 3.56 for Pembrolizumab, 2.48 for Atezolizumab and 20.16 for Durvalumab. Pulmonary toxicity is more frequent in gastrointestinal, colorectal, breast, renal cancer and advanced-stage non-small cell lung cancer, particularly when histology is squamous, there is high PD-L1 expression and in patients without prior treatments.Conclusion: This systematic review provides an updated synthesis of the available evidence on ICI-associated pneumonitis, with particular attention to incidence, risk factors and progression. It contributes to outlining the profile of this adverse effect and identifying priority areas for future research.Prospero protocol registration identifier: CRD420251039825.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692830","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

Asthma and COPD overlap: a challenging relationship. 哮喘和慢性阻塞性肺病重叠：一个具有挑战性的关系。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2538276

José Luis Lopez-Campos, Belen Muñoz-Sanchez, Esther Quintana-Gallego

引用次数: 0

Economic burdens of pediatric asthma in low and middle-income countries. 低收入和中等收入国家儿童哮喘的经济负担。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2536886

Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Jefferson Antonio Buendia

{"title":"Economic burdens of pediatric asthma in low and middle-income countries.","authors":"Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Jefferson Antonio Buendia","doi":"10.1080/17476348.2025.2536886","DOIUrl":"10.1080/17476348.2025.2536886","url":null,"abstract":"Introduction: Childhood asthma is a significant public health challenge in low- and middle-income countries (LMICs), with a high clinical and economic burden due to increased mortality, disability, and healthcare costs. Although numerous studies have been published assessing the economic burden of childhood asthma, most of these studies have focused on the financial burden of asthma in high-income countries.Areas covered: This narrative review aims to identify studies that report the economic burden of childhood asthma in LMICs. We extracted the reported asthma-related costs, the type of institution where the study was conducted, the method of cost calculation, the proportion of direct costs to total costs, the leading direct cost items, and the main cost drivers, if reported, from the identified studies.Expert opinion: This review highlights the high economic cost of childhood asthma in LMICs and provides an opportunity to rethink asthma management. Future strategies should prioritize prevention, ensure universal access to medicines, and incorporate cost assessment. A more proactive and integrated approach, combining a substantial primary care infrastructure, digital health interventions, and financial protection mechanisms, is crucial to reducing the economic burden of asthma and improving health outcomes for children in LMICs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669144","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

Telerehabilitation in lung transplant recipients and candidates - an exploratory systematic review and meta-analysis. 肺移植受者和候选者的远程康复——一项探索性系统综述和荟萃分析。

Expert review of respiratory medicine Pub Date : 2025-07-20 DOI: 10.1080/17476348.2025.2535760

Ulas Ar, Ebru Calik Kutukcu, Melda Saglam

{"title":"Telerehabilitation in lung transplant recipients and candidates - an exploratory systematic review and meta-analysis.","authors":"Ulas Ar, Ebru Calik Kutukcu, Melda Saglam","doi":"10.1080/17476348.2025.2535760","DOIUrl":"10.1080/17476348.2025.2535760","url":null,"abstract":"Introduction: Lung transplant candidates (LTC) and recipients (LTR) frequently suffer from impaired exercise capacity and reduced quality of life. Telerehabilitation (TR) offers a viable alternative for patients with limited access to center-based rehabilitation.Methods: This systematic review assessed TR's clinical efficacy in LTC and LTR populations. Methods: Eligible trials were identified by searching the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus databases. Continuous data were extracted for relevant outcomes and analyzed using the RevMan software as the pooled mean difference (PMD) and 95%CI in a fixed-effect meta-analysis model.Results: Seven studies (n = 230; mean age = 54.2 years) were included. TR significantly improved 6-minute walk distance in LTR (PMD:65.78 m [5.15-126.42], p = 0.03, I² = 0%).The Duke Activity Status Index scores showed significant improvement in LTC and LTR (PMD:-11.98 [-17.99-5.97], p < 0.0001, I² = 83%).Conclusion: Several telerehabilitation trials have suggested potential benefits in improving exercise capacity, physical fitness, and quality of life in LTC and LTR, both before and after transplantation. However, the overall quality of the evidence remains low. Further research is needed to evaluate the impact of telerehabilitation on clinical outcomes, and feasibility, and cost-effectiveness of these rehabilitation delivery model in this population.Registration: The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022378573).","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639063","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

Vitamin D deficiency and severity of non-cystic fibrosis bronchiectasis: a systematic review. 维生素D缺乏与非囊性纤维化支气管扩张的严重程度：一项系统综述。

Expert review of respiratory medicine Pub Date : 2025-07-20 DOI: 10.1080/17476348.2025.2535764

Dafni Moriki, Despoina Koumpagioti, Michalis Kalogiannis, Maria Tsouprou, Konstantinos Douros

{"title":"Vitamin D deficiency and severity of non-cystic fibrosis bronchiectasis: a systematic review.","authors":"Dafni Moriki, Despoina Koumpagioti, Michalis Kalogiannis, Maria Tsouprou, Konstantinos Douros","doi":"10.1080/17476348.2025.2535764","DOIUrl":"10.1080/17476348.2025.2535764","url":null,"abstract":"Introduction: Vitamin D deficiency is common in cystic fibrosis (CF) and may be linked to disease severity. We aimed to investigate the association between vitamin D deficiency and severity in non-CF bronchiectasis.Methods: A systematic search of PubMed and Scopus (up to December 2024) identified relevant studies. After screening 170 articles, seven met the inclusion criteria. Study quality was assessed using NIH tools.Results: Patients with non-CF bronchiectasis had significantly lower serum 25-hydroxyvitamin D (25OHD) levels compared to healthy controls. In one study, median 25OHD was 24.7 nmol/L in patients vs. 45.3 nmol/L in controls. Another reported mean levels of 14.7 ± 9.6 ng/mL vs. 19.8 ± 6.9 ng/mL, respectively. Disease severity was assessed using validated and semi-structured measures, including the bronchiectasis severity index (BSI), number of exacerbations, pulmonary function tests (PFTs), radiological scores (Bhalla, modified Reiff), and health-related quality-of-life (HRQL) tools. Most studies reported worse severity outcomes in vitamin D-deficient patients.Conclusions: Although vitamin D deficiency appears to be associated with more severe non-CF bronchiectasis, heterogeneity between studies limits definitive conclusions. Future studies should incorporate standardized tools such as the eFACED score to better characterize disease severity.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639064","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

Hospital discharge protocol for patients with chronic obstructive pulmonary disease: expert consensus from India. 慢性阻塞性肺疾病患者的出院协议：来自印度的专家共识。

Expert review of respiratory medicine Pub Date : 2025-07-15 DOI: 10.1080/17476348.2025.2527963

Harjit Dumra, Sanjay Mittal, Devasahayam J Christopher, Sushmita Roy Chowdhury, Lancelot Pinto, P Arjun, Arjun Khanna

{"title":"Hospital discharge protocol for patients with chronic obstructive pulmonary disease: expert consensus from India.","authors":"Harjit Dumra, Sanjay Mittal, Devasahayam J Christopher, Sushmita Roy Chowdhury, Lancelot Pinto, P Arjun, Arjun Khanna","doi":"10.1080/17476348.2025.2527963","DOIUrl":"10.1080/17476348.2025.2527963","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disorder (COPD) is a significant health challenge in India, mainly attributed to smoking, air pollution, and biomass fuel exposure. Severe COPD is associated with frequent hospitalization due to recurring exacerbations, leading to increased healthcare utilization and economic burden, and a higher risk of cardiovascular events and mortality. Preventing exacerbations is key to slowing disease progression, as each exacerbation worsens lung function and increases the risk of future exacerbations. Evidence suggests that implementing evidence-based discharge care bundles may reduce hospital readmissions and improve patient outcomes. A virtual advisory board meeting involving 7 leading experts from pulmonary medicine and cardiology specialties was convened in June 2024 to gain insights into the current unmet needs in managing COPD exacerbations, particularly focused on discharge protocols.Areas covered: Targeted, nonsystematic literature searches using MEDLINE databases focused on local or national discharge protocols/guidelines for COPD patients' post-exacerbation, their clinical implementation, and identified challenges and gaps encountered following hospital discharge.Expert opinion: The panel proposed a standardized COPD discharge protocol based on local clinical practices for uniform implementation and uptake across all healthcare settings in India. Experts recommended prioritizing the accessible and affordable interventions including smoking cessation, education of patients and caregivers, medication reconciliation, and referral to home-based pulmonary rehabilitation programs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562412","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 COPD exacerbations in hospital emergency departments. 医院急诊科慢性阻塞性肺病加重的管理。

IF 2.7

Expert review of respiratory medicine Pub Date : 2025-07-12 DOI: 10.1080/17476348.2025.2530207

Pascual Piñera Salmerón, Esther Pulido Herrero, Raúl Perales Muñoz, Arturo Huerta García, Raúl Alonso Avilés, Cesar Cinesi Gómez, Juan González Del Castillo

{"title":"Management of COPD exacerbations in hospital emergency departments.","authors":"Pascual Piñera Salmerón, Esther Pulido Herrero, Raúl Perales Muñoz, Arturo Huerta García, Raúl Alonso Avilés, Cesar Cinesi Gómez, Juan González Del Castillo","doi":"10.1080/17476348.2025.2530207","DOIUrl":"10.1080/17476348.2025.2530207","url":null,"abstract":"Introduction: Emergency departments (EDs) play a crucial role in managing exacerbation of COPD (ECOPD). However, there is currently no standardization of management criteria for ECOPD within the Spanish healthcare system. This document aims to outline the management of ECOPD in EDs in the context of 2025, serving as a guide for healthcare professionals working in emergency services.Areas covered: Various aspects of the management of ECOPD in EDs are covered in this article, including severity classification, treatments (both pharmacological and nonpharmacological), criteria for hospital admission and discharge from the ED, treatment at discharge, palliative care, and management of frail patients.Expert opinion: The authors, who are members of the Spanish Society of Emergency Medicine (SEMES), emphasize the importance of classifying the severity of the episode and the patient characteristics to tailor care to each individual. The authors also highlight the value of biomarkers, the appropriate use of ventilatory therapies for ECOPD patients, the importance of proper antibiotic management, and the establishment of clear referral protocols to prevent patients from feeling lost in the healthcare system. Finally, the need to personalize post-discharge treatments is underscored to enhance continuity of care and improve health outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602638","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 emerging role of hyperpolarized ¹²⁹Xe MRI in pulmonary hypertension. 超极化129Xe MRI在肺动脉高压中的新作用。

Expert review of respiratory medicine Pub Date : 2025-07-10 DOI: 10.1080/17476348.2025.2529543

Fawaz Alenezi, Anna Costelle, Seth Lee, Bastiaan Driehuys, Sudarshan Rajagopal

引用次数: 0

Addressing advance care planning for idiopathic pulmonary fibrosis: a call to action. 解决特发性肺纤维化的预先护理计划：行动呼吁。

Expert review of respiratory medicine Pub Date : 2025-07-10 DOI: 10.1080/17476348.2025.2528947

Annlise Calypso, Sonye K Danoff, Rebecca Anna Gersten

{"title":"Addressing advance care planning for idiopathic pulmonary fibrosis: a call to action.","authors":"Annlise Calypso, Sonye K Danoff, Rebecca Anna Gersten","doi":"10.1080/17476348.2025.2528947","DOIUrl":"https://doi.org/10.1080/17476348.2025.2528947","url":null,"abstract":"Introduction: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by relentless parenchymal scarring, deteriorating pulmonary function, and unpredictable exacerbations. The prognosis remains poor, despite antifibrotic and other therapies. Patients with IPF experience a high symptom burden, frequent hospitalizations, and uncertainty regarding disease progression. Advance care planning (ACP), the process of defining patients' preferences for medical care, is inconsistently implemented in IPF care. This often leads to end-of-life care unaligned with the patient's wishes and increased distress amongst patients and their care partners.Areas covered: In this perspective, we argue for the early and routine integration of ACP into IPF management. We review the multifaceted patient-, provider-, and system-level barriers to ACP and propose actionable strategies to normalize, document, and operationalize patient-centered ACP across the IPF disease trajectory. We highlight the critical need for an interdisciplinary team to best address ACP.Expert opinion: While IPF research has resulted in huge progress in the understanding of disease pathobiology and the expansion of treatment options, perhaps the most patient-centered portion of care remains under-studied. We must prioritize research to better understand an interdisciplinary system of iterative ACP that gives IPF patients a clear voice until the last moment of life.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610695","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