Canadian Journal of Respiratory, Critical Care, and Sleep Medicine最新文献_第7页

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-07-04 DOI: 10.1080/24745332.2022.2096914

R. Leigh

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Among Canadian Pediatric respirologists, is there variability on decision to discontinue supplemental oxygen in premature patients with bronchopulmonary dysplasia? A cross-sectional survey study 在加拿大儿科呼吸科医生中，是否存在对支气管肺发育不良早产儿停止补充氧气的不同决定?横断面调查研究

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-07-01 DOI: 10.1080/24745332.2022.2087123

Nikytha Antony, K. Chaput, Mark Anselmo

{"title":"Among Canadian Pediatric respirologists, is there variability on decision to discontinue supplemental oxygen in premature patients with bronchopulmonary dysplasia? A cross-sectional survey study","authors":"Nikytha Antony, K. Chaput, Mark Anselmo","doi":"10.1080/24745332.2022.2087123","DOIUrl":"https://doi.org/10.1080/24745332.2022.2087123","url":null,"abstract":"Abstract RATIONALE AND OBJECTIVE: Bronchopulmonary dysplasia (BPD) is defined as the persistent need for oxygen at 36 weeks post menstrual age or 28 days of postnatal life in premature infants. Close to half of all premature infants with BPD are discharged from hospital with supplemental home oxygen and pediatric respirologists are commonly involved in the decision of discontinuing supplemental oxygen use. Our objective was to assess whether there is variability among Canadian pediatric respirologists on when to discontinue supplemental oxygen given the lack of evidence-based guidelines shaping this decision-making process. METHODS: Ethics approval was obtained and a cross sectional survey study was completed. Online and paper surveys included 4 oximetry test results and clinical vignettes provided in both English and French. Descriptive statistics were obtained for quantitative variables and data were analyzed for significance using the STATA statistical analysis software. RESULTS: The survey response rate was 27%. The decision to discontinue home oxygen did vary based on the province of current work; Alberta had the highest rate of respondents choosing to discontinue home oxygen (47.5%) in comparison to British Columbia and Quebec (18 and 20%, respectively; chi-square 3.97, p = 0.403). The years of experience of the physician was associated with a higher use of a guideline in making decisions on supplemental oxygen use (3.1 vs. 1.8, p = 0.167). CONCLUSION: This project allowed us to gather data on current decision making practices on home oxygen use among Canadian pediatric respirologists and informs that there is variability on care that patients receive across the country.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"19 1","pages":"265 - 269"},"PeriodicalIF":0.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75357034","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: 1

Autoimmune pulmonary alveolar proteinosis in an adolescent girl with rapidly progressive dyspnea 自身免疫性肺泡蛋白沉积症并发快速进行性呼吸困难的青春期女孩

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-07-01 DOI: 10.1080/24745332.2022.2086508

B. McLean, Kevan Mehta

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A moving target: Multiples occurrences of left lung torsion secondary to adenocarcinoma and pleural effusion 一个移动的目标:继发于腺癌和胸腔积液的左肺扭转的多次发生

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-06-13 DOI: 10.1080/24745332.2022.2081635

Charlenn Skead, K. Carle-Talbot, Diana Ochoa-Gomez, K. Amjadi, Ashish Gupta

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In memoriam of Dr. Joseph Milic-Emili 纪念约瑟夫·米利-埃米利博士

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-06-06 DOI: 10.1080/24745332.2022.2071071

B. Petrof

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Comparison of STOP-Bang and STOP-Bag questionnaires in stratifying risk of obstructive sleep apnea STOP-Bang和STOP-Bag问卷对阻塞性睡眠呼吸暂停风险分层的比较

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-05-24 DOI: 10.1080/24745332.2022.2057883

R. Waseem, Yasser Salama, M. Baltzan, F. Chung

{"title":"Comparison of STOP-Bang and STOP-Bag questionnaires in stratifying risk of obstructive sleep apnea","authors":"R. Waseem, Yasser Salama, M. Baltzan, F. Chung","doi":"10.1080/24745332.2022.2057883","DOIUrl":"https://doi.org/10.1080/24745332.2022.2057883","url":null,"abstract":"Abstract RATIONALE AND OBJECTIVE: The snoring, tiredness, observed apnea, high BP, BMI, age, neck circumference, and male gender (STOP-Bang) questionnaire is used widely to screen individuals at high risk of OSA. The objective of the study is to examine the diagnostic performance of the STOP-Bang questionnaire versus the STOP-Bag (without neck circumference) questionnaire. We hypothesized that the diagnostic performance of the STOP-Bang questionnaire would be higher than STOP-Bag questionnaire. METHODS: A retrospective study was conducted that included patients from two preoperative clinics. All participants completed the STOP-Bang questionnaire and underwent polysomnography (PSG). The diagnostic parameters were calculated for the STOP-Bang questionnaire and the STOP-Bag questionnaire versus polysomnography as the reference standard. RESULTS: There were 203 patients with mean age of 57 ± 13 years and 51% were male. The STOP-Bang questionnaire had a significantly higher area under receiver operating curve than the STOP-Bag questionnaire (0.782 vs 0.758, P < 0.05) in detection of mild to severe OSA in surgical patients. Similarly, the STOP-Bang questionnaire had significantly higher sensitivity when compared to the STOP-Bag questionnaire (85.5% vs 81.3%, P < 0.05). The area under the curve for screening moderate-to-severe and severe OSA was not significantly different for STOP-Bang and STOP-Bag questionnaires. CONCLUSION: Compared to the STOP-Bag questionnaire, the STOP-Bang questionnaire has higher diagnostic performance in predicting all OSA, but the 2 questionnaires were similar for moderate-to-severe and severe OSA. The STOP-Bag questionnaire can be used for screening OSA when neck circumference measurement is not feasible.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"6 1","pages":"359 - 366"},"PeriodicalIF":0.8,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80760416","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 great masquerade: A rapidly growing pulmonary nodule 大假面舞会:一个快速生长的肺结节

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-05-23 DOI: 10.1080/24745332.2022.2068461

M. Mullin, A. Mehta, S. V. van Eeden, J. Leung

引用次数: 0

Rapid resolution of refractory hypoxemia and vascular spiders following liver transplantation 肝移植术后难治性低氧血症和血管蜘蛛的快速解决

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-05-23 DOI: 10.1080/24745332.2022.2063207

Alison V. Love, R. Jen, L. Van Tongeren, C. Ryan

{"title":"Rapid resolution of refractory hypoxemia and vascular spiders following liver transplantation","authors":"Alison V. Love, R. Jen, L. Van Tongeren, C. Ryan","doi":"10.1080/24745332.2022.2063207","DOIUrl":"https://doi.org/10.1080/24745332.2022.2063207","url":null,"abstract":"ABSTRACT The syndrome of platypnea-orthodeoxia is a rare disorder characterized by dyspnea and oxygen desaturation in the upright position that improve when supine. Excluding cardiac etiologies, the most common causes are intrapulmonary right-to-left shunt due to either abnormally dilated pulmonary blood vessels in hepatopulmonary syndrome (HPS) or pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia (HHT). Both conditions can cause cutaneous telangiectasia, and both are associated with pulmonary vascular abnormalities identifiable on chest computed tomographic (CT) imaging. Differentiating between them can be challenging, as there is overlap in their clinical and radiographic manifestations. We present a patient with severe refractory hypoxemia, platypnea, orthodeoxia and cutaneous telangiectasia whose subtle clinical and laboratory findings did not initially suggest significant liver disease. Also, refractory hypoxemia in response to a high fraction of inspired oxygen strongly suggested anatomical right-to-left shunt. Thus, the alternative diagnosis of diffuse microvascular pulmonary arteriovenous malformations as a rare manifestation of HHT was entertained. The patient was referred for possible lung transplantation. Further investigations revealed chronic liver disease, confirming the diagnosis of HPS. Liver transplantation resulted in rapid resolution of the severe refractory hypoxemia and disappearance of the cutaneous telangiectasia. Nine months post liver transplant, chest CT imaging showed marked improvement in the pulmonary vascular abnormalities. This patient’s clinical presentation and work-up illustrate: (i) the relevance of subtle clinical and chest CT findings to the differential diagnosis of intrapulmonary right-to-left shunt; and (ii) the importance of a thorough knowledge of the mechanisms of hypoxemia to understanding the pathophysiology of HPS.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"112 1","pages":"323 - 328"},"PeriodicalIF":0.8,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87749513","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: 1

Costs of oxygen therapy for interstitial lung disease and chronic obstructive pulmonary disease: A retrospective study from a universal healthcare system 间质性肺疾病和慢性阻塞性肺疾病的氧疗费用:一项来自全民医疗保健系统的回顾性研究

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-05-18 DOI: 10.1080/24745332.2022.2057882

Ferhan Saleem, S. Vahidy, J. Fleetham, Loretta Pavan, Claire Normandin, J. Guenette, Y. Khor, C. Ryerson

{"title":"Costs of oxygen therapy for interstitial lung disease and chronic obstructive pulmonary disease: A retrospective study from a universal healthcare system","authors":"Ferhan Saleem, S. Vahidy, J. Fleetham, Loretta Pavan, Claire Normandin, J. Guenette, Y. Khor, C. Ryerson","doi":"10.1080/24745332.2022.2057882","DOIUrl":"https://doi.org/10.1080/24745332.2022.2057882","url":null,"abstract":"Abstract RATIONALE & OBJECTIVES: Oxygen is prescribed for patients with interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD). This study compared the per capita financial costs of home oxygen therapy in ILD and COPD. METHODS Adults with either ILD or COPD who initiated home oxygen between 2010-2017 at the Vancouver Coastal Health Home Oxygen Program were analyzed retrospectively using a chart review. The monthly cost of oxygen equipment, home visits by oxygen providers and respiratory therapists, as well as overnight oximetry studies, were collected for each year of oxygen utilization, adjusted to 2018 Canadian Dollars. The Wilcoxon Rank Sum Test was used to compare monthly oxygen costs and flow rates between the two diseases. MEASUREMENTS AND RESULTS: A total of 99 patients with ILD and 1017 with COPD initiated oxygen therapy between 2010-2017. Both cohorts had a higher per capita cost of home oxygen in month 1 compared to months 2-24 (ILD: ($202.57 ± $88.88 versus $142.21 ± $59.01, P < 0.001; COPD: $222.85 ± $102.52 versus $156.65 ± $60.50, P < 0.001). COPD was more costly after the initial month, corresponding to greater frequency of using continuous long-term oxygen compared to oxygen only with ambulation. Patients with ILD had higher mean ambulatory oxygen flow rate for all months (P < 0.001). CONCLUSION Per capita costs of home oxygen therapy were comparable between ILD and COPD, with the main difference in costs related to the use of ambulatory versus continuous long-term oxygen. These findings will aid healthcare budget planning for both ILD and COPD.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"12 1","pages":"351 - 358"},"PeriodicalIF":0.8,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73699043","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

Variability in pulmonary function test reporting: A survey of respirologists in Canada 肺功能测试报告的变异性:加拿大呼吸科医生的调查

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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Pub Date : 2022-05-12 DOI: 10.1080/24745332.2022.2048980

Kaitlin Sparrow, E. Wong, Lawrence Cheung, Melissa Wang, D. Vethanayagam, Pen Li

{"title":"Variability in pulmonary function test reporting: A survey of respirologists in Canada","authors":"Kaitlin Sparrow, E. Wong, Lawrence Cheung, Melissa Wang, D. Vethanayagam, Pen Li","doi":"10.1080/24745332.2022.2048980","DOIUrl":"https://doi.org/10.1080/24745332.2022.2048980","url":null,"abstract":"Abstract Rationale: The interpretation of pulmonary function tests (PFTs) is not standardized. Many guidelines exist, both disease specific and physiologically based, which lead to variability in PFT interpretations and may impact patient care. Objectives: We examine how respirologists in Canada interpret PFTs, what content they report and how this compares to current societal guidelines. Methods: An anonymous survey was sent to Canadian respirology training programs and forwarded to respirologists affiliated with their city. Comparisons were made using chi-square testing and variability measured using the index of qualitative variation (IQV). Results: There were 103 respondents; 78 (76%) were staff respirologists, representative of about 10% of practicing adult respirologists. The IQV ranged from 0.64 to 0.95 for defining obstruction and severity, bronchodilator response, lung volumes, and diffusion abnormalities and severity. No significant differences were detected between staff physicians and trainees or those in tertiary versus community practice, when defining obstruction, lung volumes and diffusion abnormalities. Pediatric respirologists were more likely (p < 0.001) to use Canadian Thoracic Society (CTS) asthma guidelines to define an obstructive defect. One specific diagnosis (p = 0.036) and a differential diagnosis (p = 0.027) were more likely to be included in a PFT summary if the ordering physician was a family physician compared to a respirologist or non-respirology specialist compared to a respirologist, respectively. Conclusions: There is large variability in how PFTs are interpreted and summarized by respirologists in Canada. Our study highlights the need for quality assurance and development of a national consensus of reporting PFTs.","PeriodicalId":9471,"journal":{"name":"Canadian Journal of Respiratory, Critical Care, and Sleep Medicine","volume":"41 1","pages":"344 - 350"},"PeriodicalIF":0.8,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80756173","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