Canadian respiratory journal最新文献

{"title":"Palivizumab Prophylaxis among Infants at Increased Risk of Hospitalization due to Respiratory Syncytial Virus Infection in UAE: A Hospital-Based Study.","authors":"M Elhalik, K El-Atawi, S K Dash, A Faquih, A D Satyan, N Gourshettiwar, A Khan, S Varughese, A Ramesh, E Khamis","doi":"10.1155/2019/2986286","DOIUrl":"10.1155/2019/2986286","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) represents a significant public health burden and the leading cause of lower respiratory tract infections globally, and it is the major cause of hospitalization during the winter. We aimed to evaluate the effectiveness of palivizumab prophylaxis to reduce the hospitalization in children at high risk of RSV infection.</p><p><strong>Methods: </strong>We performed a retrospective observational single-arm hospital-based study including five RSV seasons (September to March) from 2012 to 2017. We retrospectively included premature infants born at less than 35 weeks of gestation with chronic lungs disease or hemodynamic significant congenital heart disease for palivizumab prophylaxis against RSV infection according to the criteria presented.</p><p><strong>Results: </strong>A total of 925 children were enrolled in the study over the five RSV seasons. Of them, 410 (44.3%) infants born at <32 weeks of gestation and 515 (55.6%) infants born at 32-35 weeks of gestation with mean (±SD) birth weight of 1104.8 ± 402.85 and 1842.5 ± 377.5, respectively. The compliance with the course of palivizumab was reported in 841 (90.9%) children. Of them, about 75 (8.9%) hospitalized children were reported, and 17 (2.02%) RSV positive children were detected. Hospitalization due to RSV infection was decreased from 9.23% in the 2012-2013 season to 0.67% in the 2016-2017 season.</p><p><strong>Conclusion: </strong>This study demonstrated that palivizumab prophylaxis in children at high risk of developing RSV infection was effective in reducing the risk of hospitalization with a high compliance rate over the five RSV seasons.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 ","pages":"2986286"},"PeriodicalIF":2.1,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Levels of Epithelial-Derived Cytokines as Interleukin-25 and Thymic Stromal Lymphopoietin after a Single Dose of Mepolizumab in Patients with Severe Non-Allergic Eosinophilic Asthma: A Short Report.","authors":"Virginija Kalinauskaite-Zukauske,&nbsp;Andrius Januskevicius,&nbsp;Ieva Janulaityte,&nbsp;Skaidrius Miliauskas,&nbsp;Kestutis Malakauskas","doi":"10.1155/2019/8607657","DOIUrl":"10.1155/2019/8607657","url":null,"abstract":"<p><p>The bronchial epithelium has continuous contact with environmental agents initiating and maintaining airway type 2 inflammation in asthma. However, there is a lack of data on whether reduced airway eosinophilic inflammation can affect the production of epithelial-derived mediators, such as interleukin-25 (IL-25) and thymic stromal lymphopoietin (TSLP). The aim of this study was to investigate the changes in serum levels of IL-25 and TSLP after a single dose of mepolizumab, a humanized monoclonal antibody to interleukin-5 (IL-5), in patients with severe non-allergic eosinophilic asthma (SNEA). We examined 9 SNEA patients before and four weeks after administration of 100 mg mepolizumab subcutaneously. The fractional exhaled nitric oxide (FeNO) level was analysed using an electrochemical assay (NIOX VERO®, Circassia, UK). Serum IL-25 and TSLP levels were measured by ELISA. Four weeks after the single dose of mepolizumab, blood eosinophil count significantly decreased from 0.55 ± 0.20 × 10⁹/l to 0.14 ± 0.04 × 10⁹/l (<i>p</i> = 0.01) and FEV₁ increased from 2.1 ± 0.5 l (65.4 ± 8.8% of predicted) to 2.6 ± 0.4 l (76.4 ± 9.1% of predicted) (<i>p</i> = 0.04), while FeNO level has not changed (32.3 ± 8.4 <i>vs</i> 42.9 ± 12.6 ppb). Serum IL-25 level significantly decreased from 48.0 ± 17.2 pg/mL to 34.8 ± 17.1 pg/mL (<i>p</i> = 0.02) with same tendency in TSLP level: from 359.8 ± 71.3 pg/mL to 275.6 ± 47.8 pg/mL (<i>p</i> = 0.02). It has also been noticed a significant relation between changes in the blood eosinophil count and serum IL-25 level (<i>r</i> = 0.81, <i>p</i> = 0.008), as well as between changes in serum IL-25 and TSLP levels (<i>r</i> = 0.93, <i>p</i> = 0.004) after a single dose of mepolizumab. Thus, anti-IL-5 treatment with mepolizumab might diminish the production of bronchial epithelial-derived cytokines IL-25 and TSLP in patients with SNEA which is potentially related to reduced eosinophilic inflammation. This trial is registered in ClinicalTrial.gov with identifier NCT03388359.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 ","pages":"8607657"},"PeriodicalIF":2.2,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8607657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Changes of Peripheral NK and T Cells in Pulmonary Interstitial Fibrosis of Patients with Rheumatoid Arthritis.","authors":"Na-Lin Lai,&nbsp;Wen Jia,&nbsp;Xia Wang,&nbsp;Jing Luo,&nbsp;Guang-Ying Liu,&nbsp;Chong Gao,&nbsp;Xiao-Feng Li,&nbsp;Jian-Fang Xie","doi":"10.1155/2019/7262065","DOIUrl":"https://doi.org/10.1155/2019/7262065","url":null,"abstract":"<p><strong>Objective: </strong>The absolute and relative changes of peripheral NK and T subsets are unclear in rheumatoid arthritis (RA) associated with pulmonary interstitial fibrosis (RA-ILD). To investigate the clinical risk factors, especially the changes of lymphocyte subsets, in RA-ILD in order to make early diagnosis and achieve prevention of the pulmonary interstitial lesions.</p><p><strong>Methods: </strong>A total of 100 RA and 100 RA-ILD patients were enrolled. Rheumatoid factor, anti-cyclic citrulline peptide antibody, erythrocyte sedimentation rate, immunoglobulin, and C-reactive protein were examined. The percentage and absolute number of NK, T, B, Treg, Th1, Th2, and Th17 cells in peripheral blood were determined by flow cytometry.</p><p><strong>Results: </strong>RA-ILD is more common in older and male RA patients and/or those with higher autoantibody titers. Flow cytometry showed that the absolute and relative numbers of CD56+ NK cells were significantly higher in RA-ILD (280.40 ± 180.51 cells/<i>μ</i>l vs. 207.66 ± 148.57 cells/<i>μ</i>l; 16.62 ± 8.56% vs. 12.11 ± 6.47%), whereas the proportion of T cells and CD4+ T cells was lower in peripheral blood of RA-ILD patients (69.82 ± 9.30%; 39.44 ± 9.87 cells/<i>μ</i>l) than that in RA patients (74.45 ± 8.72%; 43.29 ± 9.10 cells/<i>μ</i>l).</p><p><strong>Conclusions: </strong>The occurrence of RA-ILD is closely related to the older male patients with high titer of various self-antibodies. Imbalance of CD3-CD56+ NK cells and T cells with other subsets were found in RA-ILD patients, which, together with older age, male, and high levels of autoantibodies should be considered as risk factors of pulmonary interstitial lesions.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 ","pages":"7262065"},"PeriodicalIF":2.2,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7262065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circ_MDM2_000139, Circ_ATF2_001418, Circ_CDC25C_002079, and Circ_BIRC6_001271 Are Involved in the Functions of XAV939 in Non-Small Cell Lung Cancer.","authors":"Haixiang Yu,&nbsp;Lei Xu,&nbsp;Zhengjia Liu,&nbsp;Bo Guo,&nbsp;Zhifeng Han,&nbsp;Hua Xin","doi":"10.1155/2019/9107806","DOIUrl":"10.1155/2019/9107806","url":null,"abstract":"<p><strong>Background: </strong>The small molecule inhibitor XAV939 could inhibit the proliferation and promote the apoptosis of non-small cell lung cancer (<b>NSCLC</b>) cells. This study was conducted to identify the key circular RNAs (circRNAs) and microRNAs (miRNAs) in XAV939-treated NSCLC cells.</p><p><strong>Methods: </strong>After grouping, the NCL-H1299 cells in the treatment group were treated by 10 <i>μ</i>M XAV939 for 12 h. RNA-sequencing was performed, and then the differentially expressed circRNAs (DE-circRNAs) were analyzed by the edgeR package. Using the clusterprofiler package, enrichment analysis for the hosting genes of the DE-circRNAs was performed. Using Cytoscape software, the miRNA-circRNA regulatory network was built for the disease-associated miRNAs and the DE-circRNAs. The DE-circRNAs that could translate into proteins were predicted using circBank database and IRESfinder tool. Finally, the transcription factor (TF)-circRNA regulatory network was built by Cytoscape software. In addition, A549 and HCC-827 cell treatment with XAV939 were used to verify the relative expression levels of key DE-circRNAs.</p><p><strong>Results: </strong>There were 106 DE-circRNAs (including 61 upregulated circRNAs and 45 downregulated circRNAs) between treatment and control groups. Enrichment analysis for the hosting genes of the DE-circRNAs showed that <i>ATF2</i> was enriched in the TNF signaling pathway. Disease association analysis indicated that 8 circRNAs (including circ_MDM2_000139, circ_ATF2_001418, circ_CDC25C_002079, and circ_BIRC6_001271) were correlated with NSCLC. In the miRNA-circRNA regulatory network, let-7 family members⟶circ_MDM2_000139, miR-16-5p/miR-134-5p⟶circ_ATF2_001418, miR-133b⟶circ_BIRC6_001271, and miR-221-3p/miR-222-3p⟶circ_CDC25C_002079 regulatory pairs were involved. A total of 47 DE-circRNAs could translate into proteins. Additionally, circ_MDM2_000139 was targeted by the TF <i>POLR2A</i>. The verification test showed that the relative expression levels of circ_MDM2_000139, circ_CDC25C_002079, circ_ATF2_001418, and circ_DICER1_000834 in A549 and HCC-827 cell treatment with XAV939 were downregulated comparing with the control.</p><p><strong>Conclusions: </strong>Let-7 family members and <i>POLR2A</i> targeting circ_MDM2_000139, miR-16-5p/miR-134-5p targeting circ_ATF2_001418, miR-133b targeting circ_BIRC6_001271, and miR-221-3p/miR-222-3p targeting circ_CDC25C_002079 might be related to the mechanism in the treatment of NSCLC by XAV939.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 ","pages":"9107806"},"PeriodicalIF":2.2,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9107806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37498799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tetrandrine Ameliorates Airway Remodeling of Chronic Asthma by Interfering TGF-β1/Nrf-2/HO-1 Signaling Pathway-Mediated Oxidative Stress","authors":"Yiping Lin, Jingchan Yao, Meiling Wu, Xiao-qian Ying, M. Ding, Yanli Wei, Xiao-Yan Fu, Wei Feng, Yunguang Wang","doi":"10.1155/2019/7930396","DOIUrl":"https://doi.org/10.1155/2019/7930396","url":null,"abstract":"Background Imbalanced oxidative stress and antioxidant defense are involved in airway remodeling in asthma. It has been demonstrated that Tetrandrine has a potent role in antioxidant defense in rheumatoid arthritis and hypertension. However, the correlation between Tetrandrine and oxidative stress in asthma is utterly blurry. This study aimed to investigate the role of Tetrandrine on oxidative stress-mediated airway remolding. Materials and Methods Chronic asthma was established by ovalbumin (OVA) administration in male Wistar rats. Histopathology was determined by HE staining. Immunofluorescence was employed to detect the expression of α-SMA and Nrf-2. Level of oxidative stress and matrix metalloproteinases were examined by ELISA kits. Cell viability and cell cycle of primary airway smooth muscle cells (ASMCs) were evaluated by CCK8 and flow cytometry, respectively. Signal molecules were detected using western blot. Results Tetrandrine effectively impairs OVA-induced airway inflammatory and airway remodeling by inhibiting the expression of CysLT1 and CysLTR1. The increase of oxidative stress and subsequent enhancement of MMP9 and TGF-β1 expression were rescued by the administration of Tetrandrine in the rat model of asthma. In in vitro experiments, Tetrandrine markedly suppressed TGF-β1-evoked cell viability and cell cycle promotion of ASMCs in a dose-dependent manner. Furthermore, Tetrandrine promoted Nrf-2 nuclear transcription and activated its downstream HO-1 in vivo and in vitro. Conclusion Tetrandrine attenuates airway inflammatory and airway remodeling in rat model of asthma and TGF-β1-induced cell proliferation of ASMCs by regulating oxidative stress in primary ASMCs, suggesting that Tetrandrine possibly is an effective candidate therapy for asthma.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7930396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41670927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Aspects of Interface Application in CPAP Treatment","authors":"A. Bachour, H. Avellan-Hietanen, Tuula Palotie, P. Virkkula","doi":"10.1155/2019/7215258","DOIUrl":"https://doi.org/10.1155/2019/7215258","url":null,"abstract":"While continuous positive airway pressure (CPAP) is an effective first-line therapy for sleep apnea, CPAP fails in one third of patients mainly due to poor adherence to the CPAP device and masks. The role of the medical team is to guide the patient in choosing the best mask, thus insuring good CPAP therapy adherence. Once a suitable mask is found, the brand of the mask does not affect patient satisfaction or CPAP adherence. For the majority of patients, nasal masks are by far more suitable than oronasal masks. Orosanal masks are indicated in case of nasal stuffiness or when an air leak manifests through the mouth. Re-evaluation of the efficacy of CPAP therapy is recommended when switching to oronasal masks.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7215258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41774099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explorating the Involvement of Plasma Sestrin2 in Obstructive Sleep Apnea","authors":"Rong Jiang, Qiru Wang, Huifen Zhai, Xiaohua Du, Shibo Sun, Haoyan Wang","doi":"10.1155/2019/2047674","DOIUrl":"https://doi.org/10.1155/2019/2047674","url":null,"abstract":"Obstructive sleep apnea (OSA) can lead to serious complications such as coronary heart disease and hypertension due to oxidative stress. Sestrin2 expression is upregulated under conditions of oxidative stress. This study aimed to explore whether Sestrin2 was involved in OSA. OSA and healthy control subjects were recruited and matched with age, gender, and body mass index (BMI). Plasma Sestrin2 levels were measured and compared. A multivariate stepwise regression model was used to detect the relationship between Sestrin2 and other variable factors. The Sestrin2 levels were compared between before and after four weeks treatment by nasal continuous positive airway pressure (nCPAP) in severe OSA patients. Fifty-seven subjects were divided into two groups: control group (39.33 ± 9.40 years, n = 21) and OSA group (38.81 ± 7.84 years, n = 36). Plasma Sestrin2 levels increased in the OSA group (control group 2.06 ± 1.76 ng/mL, OSA group 4.16 ± 2.37 ng/mL; P = 0.001). Sestrin2 levels decreased after four-week nCPAP treatment (pre-nCPAP 5.21 ± 2.32 ng/mL, post-nCPAP 4.01 ± 1.54 ng/mL; P = 0.004). Sestrin2 was positively correlated with apnea/hypopnea index (AHI) oxygen desaturation index, while negatively correlated with mean oxygen saturation. Moreover, these correlations remained unchanged after adjusting for gender, age, waist-to-hip ratio, and body mass index. Multiple regression analysis showed that there was an association between Sestrin2 and AHI. Our findings suggest that Sestrin2 is involved in OSA. The increase of plasma Sestrin2 is directly related to the severity of OSA. To some extent, Sestrin2 may be useful for determining the severity of OSA and monitoring the effect of CPAP. In addition, since some complications of OSA such as coronary heart disease and diabetes are usually related with oxidative stress, the role of Sestrin2 in those OSA complications needs further study.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2047674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46347054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Comment on \"Noninvasive Ventilation Weaning in Acute Hypercapnic Respiratory Failure due to COPD Exacerbation: A Real-Life Observational Study\".","authors":"Paola Faverio, Anna Stainer, Federica De Giacomi, Grazia Messinesi, Valentina Paolini, Anna Monzani, Paolo Sioli, Irdi Memaj, Oriol Sibila, Paolo Mazzola, Alberto Pesci","doi":"10.1155/2019/4897045","DOIUrl":"https://doi.org/10.1155/2019/4897045","url":null,"abstract":"","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2019 ","pages":"4897045"},"PeriodicalIF":2.1,"publicationDate":"2019-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Group Asthma Education on Asthma Control and Emergency Room Visits in an Underserved New York Community","authors":"Asghar Ali, S. G. Pena, C. Huggins, F. Lugo, M. Khaja, G. Díaz-Fuentes","doi":"10.1155/2019/5165189","DOIUrl":"https://doi.org/10.1155/2019/5165189","url":null,"abstract":"Objective Asthma education programs have been shown to be effective in decreasing health care utilization and improving disease control and management. However, there are few studies evaluating the outcomes of group asthma education. The aim of this study was to assess the impact of an outpatient adult group asthma education program in an inner-city-based hospital caring for an underserved population. Methods We conducted a pre- and poststudy of all patients with asthma who participated in two structured group asthma education sessions led by a respiratory therapist, clinical pharmacist, and pulmonologist. The study period (January 2016 to April 2018) included the year before group education and the year after education. The primary outcomes were the number of patients requiring emergency room visits and hospital admission. The secondary outcomes included asthma control as assessed by Asthma Control Test scores, use of systemic corticosteroids, and change in test scores postintervention. Results Eighty-eight patients received group education during the study period; 82 attended 2/2 sessions, and 6 attended 1/2 sessions. The study population was largely Hispanic (73%) or African American (25%) and had a mean age of 58 years. Most had moderate (57%) or severe (25%) persistent asthma. Significantly, fewer patients required emergency room visits in the postintervention period than in the preintervention period (20 visits vs. 42 visits, p=0.0002). Group education was also associated with increased asthma control (p=0.0043), decreased use of systemic corticosteroids (p=0.0005), and higher postintervention test scores (p=0.0001). Conclusions Group asthma education provided by a multidisciplinary team in an inner-city hospital clinic caring for underserved and minority populations is feasible and may decrease utilization of health care resources when patients are educated and empowered to participate in their asthma management.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5165189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43724661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Noninvasive Ventilation Weaning in Acute Hypercapnic Respiratory Failure due to COPD Exacerbation: A Real-Life Observational Study”","authors":"Habib Md Reazaul Karim, A. Esquinas","doi":"10.1155/2019/5490510","DOIUrl":"https://doi.org/10.1155/2019/5490510","url":null,"abstract":"We have read with great interest the article by P. Faverio et al. published in this journal [1]. We thank the authors for being able to establish an adequate strategy of weaning from noninvasive ventilation (NIV) incorporating interruption of ventilation. *e article also rightly highlights the lack of consensus and studies in this regard. Although the study has a retrospective design, the hypothesis tested and evidence provided are compelling. Yet, we consider that some interesting practical aspects are worth mentioning. While the authors have tested the methodology of NIV interruption well, the number of days at each stage of weaning, NIV during afternoon and night or nocturnal NIV only, was at physician discretion. *is is an exciting aspect and confusing as well because, eventually, the criteria may be influenced by wide individual variability, which may make it impossible to extrapolate the results. Good numbers (39%) of the patients in the chronic domiciliary NIV group were not able to be weaned by the new method and continued to be in the domiciliary NIV settings. As there are no clear criteria for such patients, it will be worth knowing the settings, whether these patients were finally stabilized, and if yes, “how.” *ese aspects will help readers in better application or exclusion of the new interruption-based weaning in this subgroup of patients in the future. Pneumothorax due to severe bullous emphysema is considered by the authors as a risk factor for not weaning. While we agree that such patients are prone to not weaning, pneumothorax it is more related to the selected positive inspiratory and end-expiratory pressure levels selected [2]. However, the positive pressure used by the authors was not so high, so this association was not much clear from this study. All these aspects lead us to believe that if these patients were taken into account, the results might have been different. We again thank the authors for another interesting observation of no recurrence of AHRF during hospitalization after weaning by the new method. *is is interesting and raises speculation whether this can be considered as a protective aspect of the NIV. A prospective randomized study will give us more evidence on these aspects, especially which subgroup of patients will be benefited by this new technique.","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5490510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49494542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}