Regional air trapping in acute exacerbation of obstructive lung diseases measured with electrical impedance tomography: a feasibility study.

Regional air trapping in acute exacerbation of obstructive lung diseases measured with electrical impedance tomography: a feasibility study. Minerva Anestesiol. 2019 Dec 04;: Authors: Zhao Z, Chang MY, Frerichs I, Zhang JH, Chang HT, Gow CH, Möller K Abstract BACKGROUND: Since bronchial abnormalities often exhibit spatial non-uniformity which may be not correctly assessed by conventional global lung function measures, regional information may help to characterize the disease progress. We hypothesized that regional air trapping during mechanical ventilation could be characterized by regional end-expiratory flow (EEF) derived from electrical impedance tomography (EIT). METHODS: Twenty-five patients suffering from chronic obstructive pulmonary disease (COPD grade 3 or 4) or severe asthma with acute exacerbation were examined prospectively. Patients were ventilated under assist-control mode. EIT measurements were conducted before and one hour after inhaled combined corticosteroid and long-acting β2 agonist, on two consecutive days. Regional EEF was calculated as derivative of relative impedance for every image pixel in the lung regions. The results were normalized to global flow values measured by the ventilator. RESULTS: Regional and global EEF were highly correlated (p
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research

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Publication date: Available online 15 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Yong Suk Jo, Yong Il Hwang, Kwang Ha Yoo, Tae-Hyung Kim, Myung Goo Lee, Sang Haak Lee, Kyeong-Cheol Shin, Kwang Ho In, Hyoung Kyu Yoon, Chin Kook Rhee, Korean Asthma Research Group &KOCOSS cohortAbstractBackgroundFew reports have investigated the efficacy of using inhaled corticosteroid (ICS)-containing inhalers to treat patients with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO).ObjectiveTo investigate the effect of ICS treatment on patients with ACO using five sets ...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
ConclusionThe use of ICS by the patients with CAP admitted to the hospital is not independently related with any radiological pattern, hospitalization duration and mortality. ICS usage may diminish fever response and may suppress the findings of crackles and/or bronchial sounds. This needs further confirmation.
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Purpose of review Asthma/chronic obstructive pulmonary disease overlap (ACO) continues to be a poorly understood condition. This review discusses newly proposed criteria and potential biomarkers in ACO, to aid in diagnosis and research studies, and prudent therapeutic approaches. Recent findings A global expert panel proposed an operational definition consisting of major and minor criteria as a step toward defining ACO. Serum periostin and YKL-40 may serve as biomarkers for ACO. Clinically, a reasonable therapeutic approach to ACO is the early addition of a long-acting β-agonist (LABA) and/or a long-acting muscar...
Source: Current Opinion in Allergy and Clinical Immunology - Category: Allergy & Immunology Tags: MECHANISMS OF ALLERGY AND ADULT ASTHMA: Edited by J. Andrew Grant and Enrico Heffler Source Type: research
Conclusions: In IDEAL, one-fifth of patients with SA were controlled, based on symptoms. Uncontrolled, exacerbating SA was associated with specific comorbidities, frequent exacerbations, lower lung function, and compromised HRQoL, although inference from this analysis is limited by the selective cross-sectional nature of the cohort. Nonetheless, these data highlight the need for more effective precision treatments in this population. PMID: 31874051 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Pneumonia is an important cause of morbidity and mortality. COPD patients using inhaled corticosteroids (ICS) have an increased risk of pneumonia, but less is known about whether ICS treatment in asthma also i...
Source: BMC Pulmonary Medicine - Category: Respiratory Medicine Authors: Tags: Research article Source Type: research
Conclusion: In this group of pulmonologists confirmed COPD or ACO patients, a substantial proportion would be considered to have signs of asthma. In the personalized approach of airway disease management, these patients might benefit from ICS containing treatment. Prospective studies are needed to guide personalized care in this patient group.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: General practice and primary care Source Type: research
Conclusions: The presence of a wheeze seems to be the only clinical indicator to predict physician decision to prescribe SCS at exacerbation.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
Conclusion: Further studies are needed to characterize this group of patients in order to improve our clinical practice.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Background: This real-world cohort study was performed in chronic obstructive pulmonary disease (COPD) patients to evaluate the status of inhaled corticosteroid (ICS) prescriptions following the 2017 revision of the GOLD guidelines.Methods: A total of 1144 patients from KOLD and KOCOSS cohorts, whose final follow-up visits were between 2017 and 2018, were analyzed. Features supporting ICS usage were: a history of asthma, blood eosinophils ≥300 cells/µl, or ≥2 exacerbations in the previous year. Among baseline ICS users, we compared annual total and severe exacerbation rates, based on ICS continuation or withdra...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
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