Canadian respiratory journal最新文献

{"title":"MicroRNA-101-3p Suppresses mTOR and Causes Mitochondrial Fragmentation and Cell Degeneration in COPD.","authors":"Lei Fang,&nbsp;Xinggang Wang,&nbsp;Ming Zhang,&nbsp;Petra Khan,&nbsp;Michael Tamm,&nbsp;Michael Roth","doi":"10.1155/2022/5933324","DOIUrl":"https://doi.org/10.1155/2022/5933324","url":null,"abstract":"<p><strong>Background: </strong>Cigarette smoke is assumed to cause the loss of airway wall structure in chronic obstructive pulmonary disease (COPD) by reducing airway smooth muscle cell (ASMC) function. It also modifies mTOR activity, microRNA (miR)-101-3p expression, and mitochondria function. Here, the link between miR-101-3p and mTOR-regulated mitochondria integrity and ASMC deterioration was assessed.</p><p><strong>Methods: </strong>Disease-specific miR-101-3p expression was determined by RT-PCR in primary ASMC (non-COPD smokers: <i>n</i> = 6; COPD: <i>n</i> = 8; healthy: <i>n</i> = 6). The regulatory effect of miR-101-3p modification on mTOR expression, mitochondrial fragmentation, and remodeling properties (<i>α</i>-SMA, fibronectin, MTCO2, and p70S6 kinase) was assessed in ASMC (healthy nonsmokers: <i>n</i> = 3; COPD: <i>n</i> = 3) by Western blotting and immunofluorescence microscopy. MiR-101-3p was modified by specific mimics or inhibitors, in ASMC stimulated with TNF-<i>α</i> (10 ng/ml) or cigarette smoke extract (CSE).</p><p><strong>Results: </strong>MiR-101-3p expression was significantly higher in ASMC of COPD patients, compared to ASMC of healthy or active smokers. MiR-101-3p expression was increased by TNF-<i>α</i> or CSE. TNF-<i>α</i> or miR-101-3p deteriorated ASMC and mitochondria, while decreasing mTOR signaling, <i>α</i>-SMA, fibronectin, and MTCO2. MiR-101-3p inhibition reduced ASMC deterioration and mitochondrial fragmentation.</p><p><strong>Conclusion: </strong>Constitutive high miR-101-3p expression characterizes COPD-ASMC, causing increased mitochondrial fragmentation and ASMC deterioration. Thus, reactivation mTOR or blocking miR-101-3p presents a potential new strategy for COPD therapy.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"5933324"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382012","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":"Effects of Different Intervention Factors on Vascular Endothelial Growth Factor-Induced Human Airway Smooth Muscle Cell Migration.","authors":"Chengtian Lv,&nbsp;Guangyuan Liao,&nbsp;Lichan Wu,&nbsp;Jing Li,&nbsp;Yuanmei Gao","doi":"10.1155/2022/6879539","DOIUrl":"https://doi.org/10.1155/2022/6879539","url":null,"abstract":"<p><strong>Background: </strong>Asthma airway remodeling is closely related to the abnormal migration of human airway smooth muscle cells (ASMCs), and vascular endothelial growth factor (VEGF) is involved in the pathophysiological process of asthma. This study aimed to investigate the effect of VEGF on ASMC migration through <i>in vitro</i> cell experiments and to intervene in ASMC migration with different asthma drugs and signaling pathway inhibitors to provide a basis for screening effective drugs for airway remodeling.</p><p><strong>Methods: </strong>The effect of VEGF on the proliferation of ASMCs was detected by the CCK-8 method, and the effect of VEGF on the migration of ASMCs was proven by scratch and transwell assays. Different asthma drugs and signaling pathway inhibitors were used to interfere with the migration of ASMCs. The number of migrating cells was compared between the intervention and nonintervention groups.</p><p><strong>Results: </strong>Our results showed that VEGF induction enhanced ASMC migration; pretreatment with the commonly used asthma drugs (salbutamol, budesonide, and ipratropium bromide) significantly attenuated VEGF-induced ASMC migration; and inhibitors SB203580, LY294002, and Y27632 blocked the VEGF-induced activation of p38 MAPK, PI3K, and ROCK signaling pathway targets in ASMCs and inhibited migration.</p><p><strong>Conclusion: </strong>This study shows that the current commonly used asthma drugs salbutamol, budesonide, and ipratropium have potential value in the treatment of airway remodeling, and the p38 MAPK, PI3K, and ROCK signaling pathway targets are involved in the VEGF-induced ASMC migration process. Signaling pathway inhibitor drugs may be a new way to treat asthma-induced airway remodeling in asthma patients in the future. However, the related mechanism and safety profile still need further research.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"6879539"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161854","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":"Efficacy of Intrapleural or Intrapericardial Injection of Single Bevacizumab in the Treatment of Lung Cancer-Mediated Malignant Effusion.","authors":"Dongyun He,&nbsp;Zhihua Guo,&nbsp;Zixian Xie,&nbsp;Yalei Zhang,&nbsp;Qiuhua Deng,&nbsp;Haihong Yang","doi":"10.1155/2022/6763625","DOIUrl":"https://doi.org/10.1155/2022/6763625","url":null,"abstract":"<p><p>The usage of bevacizumab for malignant pleural effusion (MPE) or malignant pericardial effusion (MPCE) has attracted increasing interest from researchers, but the precise ways of bevacizumab administration remain unknown. Patients with histologically or cytologically confirmed non-small-cell lung cancer (NSCLC) with MPE or MPCE were enrolled in the study and treated with a low dose of single bevacizumab (100 mg) intrapleurally or intrapericardially injected after the drainage of the effusions. The Lung Cancer Symptom Scale (LCSS), efficacy, and safety of drug administration were used as evaluation parameters in this study. The results indicated that lung cancer-related symptoms were significantly improved following treatment, compared with symptoms before the treatment (LCSS, score 494 ± 78 vs. score 377 ± 77, mean ± SD) (<i>P</i> < 0.001). Malignant effusions were well controlled, and the median time to progression (TTP) was 91 days and 111 days in MPE and MPCE, respectively. In addition, no severe side effects were observed, except in one patient with mild dizziness. In summary, the low dose of single bevacizumab (100 mg) with intrapleural or intrapericardial injection is effective and safe in the treatment of lung cancer-mediated malignant effusion, rapidly improving the malignant effusion-related symptoms and quality of life in patients with NSCLC.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"6763625"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9640233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10378454","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":"Chitosan-Coated Solid Lipid Nano-Encapsulation Improves the Therapeutic Antiairway Inflammation Effect of Berberine against COPD in Cigarette Smoke-Exposed Rats.","authors":"Hongxiang Liu,&nbsp;Yifan Li,&nbsp;Xiaoying Zhang,&nbsp;Man Shi,&nbsp;Dexu Li,&nbsp;Ying Wang","doi":"10.1155/2022/8509396","DOIUrl":"https://doi.org/10.1155/2022/8509396","url":null,"abstract":"<p><p>Berberine (Ber) is an isoquinoline alkaloid that has shown therapeutic potential in mice with chronic obstructive pulmonary disease (COPD). However, the therapeutic efficiency of Ber is restricted by its low aqueous solubility and bioavailability. Chitosan and solid lipid nanoparticles (SLNs) have demonstrated great abilities as delivery systems in enhancing the bioavailability of therapeutic compounds. The present study aimed to get together the biological features of SLNs with the advantages of chitosan to formulate an efficient nano-carrier platform for the oral delivery of Ber and evaluate the therapeutic effect of the prepared Ber-encapsulated nanoparticles on airway inflammation in cigarette smoke (CS)-induced COPD rats. The Ber-encapsulated SLE-chitosan formulation was manufactured using a modified solvent-injection method followed by a homogenization process. Physicochemical properties, encapsulation efficiency, in vitro stability and Ber release, and pharmacokinetics of the manufactured formulation were evaluated. The COPD rat model was developed by exposing animals to CS. To study the therapeutic efficiency of Ber-encapsulated SLE-chitosan nanoparticles and pure berberine, the histopathological changes of the lung tissues, levels of inflammatory cells and cytokines, and activities of myeloperoxidase (MPO) and superoxide dismutase (SOD) enzymes were evaluated in bronchoalveolar lavage fluid (BALF). Ber-encapsulated SLE-chitosan showed the particle size in nano-range with high stability and controlled slow-release profile <i>in vitro</i> in simulated gastric (pH 1.5) and intestinal (pH 6.8) fluids. Administration of Ber-loaded SLE-chitosan nanoparticles could significantly ameliorate inflammation scores in lung tissues and reduce levels of inflammatory cells (neutrophils and macrophages) and inflammatory cytokines (IL-1<i>β</i>, Il-6, Il-17, and TNF<i>α</i>) in BALF when compared with the pure Ber. SLE-chitosan-based nanoparticles can strongly improve the therapeutic anti-inflammatory impact of Ber against CS-induced airway inflammation in COPD rats, suggesting the promising application of Ber-encapsulated SLN-chitosan nanoparticles for treating COPD and other inflammation-mediated diseases.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"8509396"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9771348","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":"Clinical Outcome Discrimination in Pediatric ARDS by Chest Radiograph Severity Scoring.","authors":"Yu-Chun Yan,&nbsp;Wen-Han Hao,&nbsp;Feng-Sen Bai,&nbsp;Shuang Liu,&nbsp;Dong Qu,&nbsp;Xin-Yu Yuan","doi":"10.1155/2022/9309611","DOIUrl":"https://doi.org/10.1155/2022/9309611","url":null,"abstract":"<p><strong>Background: </strong>There is no accurate radiological measurement to estimate the severity of pediatrics acute respiratory distress syndrome (PARDS). We validated the effectiveness of an adult radiographic assessment of lung edema (RALE) score in PARDS.</p><p><strong>Aim: </strong>To assess the severity and prognosis of PARDS based on a chest radiograph (CXR) RALE scoring method.</p><p><strong>Methods: </strong>Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria were used to diagnose PARDS. General demographics, pulmonary complications, and 28-day mortality of the patients were recorded. Subgroups were compared by prognosis (survive and death) and etiology (infection and noninfection). Two observers calculated RALE independently. Each quadrant of CXR was scored by consolidation scores 0 (none alveolar opacity), 1 (extent <25%), 2 (extent 25%-50%), 3 (50%-75%), and 4 (>75%) and density scores 1 (hazy), 2 (moderate), and 3 (dense). Quadrant score equals consolidation score times density score. Total score equals to the sum of four quadrants scores. The ROC curve and survival curve were established, and the optimal cutoff score for discrimination prognosis was set.</p><p><strong>Results: </strong>116 PARDS (72 boys and 44 girls) and 463 CXRs were enrolled. The median age was 25 months (5 months, 60.8 months) and with a mortality of 37.9% (44/116). The agreement between two independent observers was excellent (ICC = 0.98, 95% CI: 0.97-0.99). Day 3 score was independently associated with better survival (<i>p</i> < 0.001). The area under the curve of ROC was 0.773 (95% CI: 0.709-0.838). The cutoff score was 21 (sensitivity 71.7%, specificity 76.5%), and the hazard ratio (HR) was 9.268 (95% CI: 1.257-68.320). The pulmonary complication showed an HR of 3.678 (95% CI: 1.174-11.521) for the discrimination.</p><p><strong>Conclusion: </strong>CXR RALE score can be used in PARDS for discriminating the prognosis and has a better agreement among radiologist and pediatrician. PARDS with pulmonary complications, day 3 score whether greater than 21 points, have a better predictive effectiveness.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"9309611"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306431","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":"Characteristics, Management, and Outcomes of Community-Acquired Pneumonia Due to Human Rhinovirus-A Retrospective Study.","authors":"Ibrahim Bahabri,&nbsp;Abdulaziz Abdulaal,&nbsp;Thamer Alanazi,&nbsp;Sultan Alenazy,&nbsp;Yasser Alrumih,&nbsp;Rakan Alqahtani,&nbsp;Mohammad Bosaeed,&nbsp;Hasan M Al-Dorzi","doi":"10.1155/2022/1349994","DOIUrl":"https://doi.org/10.1155/2022/1349994","url":null,"abstract":"<p><strong>Introduction: </strong>Human rhinovirus (HRV) can lead to a variety of respiratory illnesses; it is also an uncommon cause of community-acquired pneumonia (CAP). We described the characteristics and outcomes of patients hospitalized for CAP due to HRV.</p><p><strong>Methods: </strong>We retrospectively studied consecutive adult patients admitted to King Abdulaziz Medical City-Riyadh with CAP due to HRV between 2016 and 2019. The diagnosis was made by respiratory multiplex PCR within 48 hours of hospitalization. We compared patients requiring ICU admission to those who did not.</p><p><strong>Results: </strong>One-hundred-and-six patients were studied (peak hospitalization between November and January, median age 71.5 years, hypertension 59%, diabetes 50%, and chronic respiratory disease 44.3%); 16 (15.1%) patients required ICU admission. The median pneumonia severity index score (PSI) was 107, with no significant difference between ICU and nonICU patients. ICU patients had a higher prevalence of tachypnea (62.5% vs. 26.7%, <i>p</i>=0.005), hemoptysis (12.5% vs 0%, <i>p</i>=0.001), and lymphopenia (71.4% vs 26.3%, <i>p</i>=0.01). Chest X-ray on presentation showed bilateral infiltrates in 47/101 (46.5%) patients and unilateral infiltrates in 26/101 (25.7%) patients. Systemic corticosteroids were used in 54.7% of patients (the median initial dose was 120 mg of prednisone equivalent and was higher in nonICU patients). Most (69.2%) ICU patients received mechanical ventilation (median duration of 8 days). Bacterial coinfection (6.6%) and superinfection (3.8%) were rare. The overall hospital mortality was 9.4% (higher for ICU patients: 37.5% vs. 4.4%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Most patients with CAP due to HRV were elderly and had significant comorbidities. ICU admission was required in almost one in six patients and was associated with higher mortality.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"1349994"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10392071","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":"Promising Therapeutic Functions of Bone Marrow Mesenchymal Stem Cells Derived-Exosome in Asthma.","authors":"Jia-Ying Yuan,&nbsp;Xiang-Yun Wang,&nbsp;Zhi-Ying Tong,&nbsp;Yu-Chao Dong,&nbsp;Jia-Yi Zhao,&nbsp;Yi Zhang,&nbsp;Yan Shang","doi":"10.1155/2022/1485719","DOIUrl":"https://doi.org/10.1155/2022/1485719","url":null,"abstract":"<p><p>Asthma is a chronic inflammatory disturbance of the airways in which many cells and cellular elements are involved. Wheezing, breathlessness, chest tightness, and coughing, especially at night or in the early morning, are typical symptoms of asthma. At present, inhaled corticosteroid (ICS) and long-acting <i>β</i>-agonists (LABAs) are standard treatments for regular management. Oral corticosteroids (OCSs) were recommended for controlling asthma exacerbation but only for a short-term treatment because of the side effects on organs. Biologic therapies have achieved exciting and notable effects in clinical treatment but are not applicable for all phenotypes of asthma. At present, some new approaches are under exploration to lessen side effects and improve curative effects. Studies have revealed that bone marrow mesenchymal stem cells (BMMSCs) hold various curative effects in asthma and may benefit in the long term with high safety. Extracellular vesicles (EVs) enriched in body fluid were characterized as subcomponents of extracellular vesicles and delivered carriers combined with genetic messages in vivo. The therapeutic potential of exosomes has become a research hotspot in many diseases. BMMSC-derived exosomes were considered as the dominant part of BMMSCs in cell-to-cell communications and playing curative effects. Points also hold that BMMSC-Exo could interfere with airway inflammation and airway remolding in asthma via modulating the immune response, regulating gene expression, adjusting the phenotype of macrophage, etc. However, BMMSC-Exo still lacked more clinical trials for evaluating the effects on asthma, and the technology of extraction and purification still needs to be improved for wide use. This review aims to draw the relationship among asthma, BMMSC, and exosome, which may provide innovate ideas for treatment of asthma, and arouse attention about the curative potential of BMMSC-Exo.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"1485719"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10519185","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":"A Nomogram Model for Mortality Risk Prediction in Pulmonary Tuberculosis Patients Subjected to Directly Observed Treatment Shortcourse (DOTS).","authors":"Yi Xie,&nbsp;Jing Han,&nbsp;Weili Yu,&nbsp;Zhili Hou,&nbsp;Zhen Wan","doi":"10.1155/2022/1449751","DOIUrl":"https://doi.org/10.1155/2022/1449751","url":null,"abstract":"<p><p>We analyzed the risk factors of mortality for patients with pulmonary tuberculosis under the Directly Observed Treatment Shortcourse (DOTS) and established a predictive nomogram for the risk of mortality. The retrospective cohort analysis was conducted on the treatment outcomes of 11207 tuberculosis patients in the tuberculosis management information system in Tianjin from 2014 to 2019. Based on the multivariable unconditional logistic regression, we analyzed the risk factors of mortality in patients with pulmonary TB and established the death risk prediction nomogram. We further applied cross-validation and the receiver operating characteristic (ROC) curve to explore the efficiency of the nomogram. There were 10,697 patients in the survival group and 510 in the mortality group who had successfully initiated DOTS, and the mortality rate was 4.55%. Multivariable logistic regression analysis showed that age, male, relapse cases, first sputum positivity, patient delay, and HIV-positive were independent risk factors for pulmonary TB death. The calibration curve shows that the average absolute error between the predicted mortality risk and the actual death risk is 0.003. The ROC curve shows that the area under the curve where the line-up model predicts the risk of death is 0.816 (95% CI: 0.799∼0.832). The nomogram model based on independent risk factors of mortality in TB patients shows good discrimination and accuracy, with potentially high clinical value in screening patients with a high risk of death, which could be useful for setting the interventional strategies in patients with tuberculosis who had successfully initiated DOTS.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"1449751"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9788877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10809664","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":"Comment on \"Effects of Waterpipe Tobacco Smoking on the Spirometric Profile of University Students in Palestine: A Cross-Sectional Study\".","authors":"Helmi Ben Saad","doi":"10.1155/2022/9831574","DOIUrl":"https://doi.org/10.1155/2022/9831574","url":null,"abstract":"<jats:p />","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2022 ","pages":"9831574"},"PeriodicalIF":2.2,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10495950","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":"Obesity as a Risk Factor for Failure to Wean from ECMO: A Systematic Review and Meta-Analysis.","authors":"Syed Arsalan A Zaidi, Kainat Saleem","doi":"10.1155/2021/9967357","DOIUrl":"10.1155/2021/9967357","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity has been associated with an increased risk of respiratory complications and other systemic illnesses. Respiratory dynamics in an obese patient, combined with modified lung physiology of ARDS, present a significant challenge in managing obese patients with ARDS. Many physicians think of obesity as a relative contraindication to ECMO. We performed a meta-analysis to see the effect of obesity on weaning from ECMO and survival to hospital discharge.</p><p><strong>Methods: </strong>We searched online databases for studies on ECMO and obesity. The search yielded 49 citations in total; after extensive review, six studies were assessed and qualified to be included in the final analysis. Patients were stratified into BMI >30 kg/m² (obese) and BMI < 30 kg/m² (nonobese).</p><p><strong>Results: </strong>In meta-analysis, there was a total sample population of 1285 patients, with 466 in the obese group and 819 in the nonobese group. There was no significant difference in weaning from ECMO when compared between obese and nonobese patients, with a risk ratio of 1.03 and 95% confidence interval (CI) of 0.94-1.13 (heterogeneity: chi² = 7.44, df = 4 (<i>p</i>=0.11), <i>I</i> ² = 46%). There was no significant difference in survival rates between obese and nonobese patients who were treated with ECMO during hospitalization, with a risk ratio of 1.04 and 95% CI of 0.86-1.25 (heterogeneity: Tau² 0.03, chi² = 14.61, df = 5 (<i>p</i>=0.01), <i>I</i> ² = 66%).</p><p><strong>Conclusion: </strong>Our findings show no significant difference in survival and weaning from ECMO in obese vs. nonobese patients. ECMO therapy should not be withheld from obese patients, as obesity is not a contraindication to ECMO.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2021 ","pages":"9967357"},"PeriodicalIF":2.2,"publicationDate":"2021-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10030328","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}