The lung microbiome in end-stage Lymphangioleiomyomatosis
Respir Res. 2021 Oct 26;22(1):277. doi: 10.1186/s12931-021-01873-y.ABSTRACTLymphangioleiomyomatosis (LAM) is a progressive cystic lung disease with mortality driven primarily by respiratory failure. Patients with LAM frequently have respiratory infections, suggestive of a dysregulated microbiome. Here we demonstrate that end-stage LAM patients have a distinct microbiome signature compared to patients with end-stage chronic obstructive pulmonary disease.PMID:34702264 | DOI:10.1186/s12931-021-01873-y (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Julie Ng Gustavo Pacheco-Rodriguez Lesa Begley Yvonne J Huang Sergio Poli Mark A Perrella Ivan O Rosas Joel Moss Souheil El-Chemaly Source Type: research

Central control malfunction in Wolfram syndrome: Report of one case of difficult weaning
CONCLUSION: While central apneas Wolfram syndrome remain rare, they should be systematically investigated due to their association with severe morbimortality.PMID:34702600 | DOI:10.1016/j.rmr.2021.09.007 (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: M Gauvrit S Jaffr é J Morin C Herv é H Alami F-X Blanc Source Type: research

< em > β < /em > Agonist Delivery by High-Flow Nasal Cannula During COPD Exacerbation: A Prospective Physiological Study
CONCLUSIONS: In subjects with severe exacerbation of COPD, salbutamol vibrating-mesh nebulization through HFNC induced a significant bronchodilator effect with volume and flow improvement.PMID:34702767 | DOI:10.4187/respcare.09242 (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Cl ément Beuvon R émi Coudroy Justine Bardin Nicolas Marjanovic Christophe Rault Vanessa Bironneau Xavier Drouot Ren é Robert Arnaud W Thille Jean-Pierre Frat Source Type: research

Reducing Device-Related Pressure Injuries Associated With Noninvasive Ventilation in the Neonatal Intensive Care Unit
CONCLUSIONS: A collaborative and multidisciplinary team approach was used to promote engagement with clinical staff to address a preventable harm. The implementation of a multifaceted PI prevention bundle contributed to reducing harm while permitting the continued use of appropriate respiratory support to a highly vulnerable patient population in the NICU.PMID:34702768 | DOI:10.4187/respcare.08850 (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: J Julia Krzyzewski Kristine K Rogers Andrea M Ritchey Connie R Farmer April S Harman Joana S Machry Source Type: research

Predicting Adverse Events Among Patients With COPD Exacerbations in the Emergency Department
CONCLUSIONS: The OCRS did not reliably predict SAEs in our population. We found 3 risk factors that were significantly associated with 30-d SAE in our United States ED population: triage PCO2 level, Charlson comorbidity index, and hospitalization within the previous year. Further studies are needed to develop generalizable decision tools to improve safety and resource utilization for this patient population.PMID:34702769 | DOI:10.4187/respcare.09013 (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Matthew E Doers Muhammad A Zafar Uwe Stolz Mark H Eckman Ralph J Panos Timothy M Loftus Source Type: research

Pediatric Tracheostomy Care Simulation: Real-Life Scenarios in a Safe Learning Environment
CONCLUSIONS: Caregiver knowledge, confidence, and comfort levels were increased after participation. Pediatric patients with a tracheostomy are medically fragile, therefore, it is important for caregivers to be aware of and prepared for common tracheostomy emergencies and to "experience" emergency situations firsthand.PMID:34702770 | DOI:10.4187/respcare.09201 (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Jennifer L McCoy Kathryn A Williams Janet L Senkinc Janalee Westerman Allison Bj Tobey Source Type: research

Influenza clinical testing and oseltamivir treatment in hospitalized children with acute respiratory illness, 2015-2016
Influenza Other Respir Viruses. 2021 Oct 26. doi: 10.1111/irv.12927. Online ahead of print.ABSTRACTBACKGROUND: Antiviral treatment is recommended for all hospitalized children with suspected or confirmed influenza, regardless of their risk profile. Few data exist on adherence to these recommendations, so we sought to determine factors associated with influenza testing and antiviral treatment in children.METHODS: Hospitalized children
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Lubna Hamdan Varvara Probst Zaid Haddadin Herdi Rahman Andrew J Spieker Simon Vandekar Laura S Stewart John V Williams Julie A Boom Flor Munoz Janet A Englund Rangaraj Selvarangan Mary A Staat Geoffrey A Weinberg Parvin H Azimi Eileen J Klein Monica McNea Source Type: research

COVID-19-related ARDS Subphenotypes and Differential Response to Corticosteroids: Time for More Precision?
Am J Respir Crit Care Med. 2021 Oct 27. doi: 10.1164/rccm.202109-2213ED. Online ahead of print.NO ABSTRACTPMID:34705609 | DOI:10.1164/rccm.202109-2213ED (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Kiran Reddy Charles Corey Hardin Daniel Francis McAuley Source Type: research

New Insights into the Limitations of Host-Transcriptional Biomarkers of Tuberculosis
Am J Respir Crit Care Med. 2021 Oct 27. doi: 10.1164/rccm.202109-2146ED. Online ahead of print.NO ABSTRACTPMID:34705613 | DOI:10.1164/rccm.202109-2146ED (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2021 Category: Respiratory Medicine Authors: Mahdad Noursadeghi Rishi K Gupta Source Type: research

Serum tumor necrosis factor- α, interleukin-1β, interleukin-6, interleukin-17 relates to anxiety and depression risks to some extent in non-small cell lung cancer survivor
Clin Respir J. 2021 Oct 25. doi: 10.1111/crj.13457. Online ahead of print.ABSTRACTINTRODUCTION: Inflammatory cytokines are proposed as modulators for the pathogenesis of anxiety and depression (anxiety/depression), and anxiety/depression are frequent existed in non-small cell lung cancer (NSCLC) survivors. However, no published study has explored the association of inflammation cytokines with anxiety/depression in NSCLC survivors.OBJECTIVES: We aimed to evaluate serum tumor necrosis factor-α (TNF-α), interleukin -1 beta (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17) levels, and their correlations wi...
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Meifang Liu Xuesong Liu Yao Li Source Type: research

Using inpatient electronic medical records to study influenza for pandemic preparedness
CONCLUSIONS: We identified important trends in influenza severity related to treatment timing in a large inpatient dataset, laying the groundwork for the use of this and other inpatient EMR data for influenza and other respiratory virus surveillance.PMID:34697904 | DOI:10.1111/irv.12921 (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Candace C Fuller Austin Cosgrove Kenneth Sands Karla M Miller Russell E Poland Edward Rosen Alfred Sorbello Henry Francis Robert Orr Sarah K Dutcher Gregory T Measer Noelle M Cocoros Source Type: research

Recommended Reading from the Pulmonary and Critical Care Medicine Fellowship at University of Illinois
Am J Respir Crit Care Med. 2021 Oct 26. doi: 10.1164/rccm.202102-0293RR. Online ahead of print.NO ABSTRACTPMID:34699332 | DOI:10.1164/rccm.202102-0293RR (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Malvika Kaul Solomon Krow Ai-Yui M Tan Sunit Singla Source Type: research

Recommended Reading from Saint Louis University School of Medicine Fellows
Am J Respir Crit Care Med. 2021 Oct 26. doi: 10.1164/rccm.202103-0685RR. Online ahead of print.NO ABSTRACTPMID:34699334 | DOI:10.1164/rccm.202103-0685RR (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Rania Farhat Jennifer Minoff Shannon Burke Setu Patolia Source Type: research

Extracellular Vesicles Protect the Neonatal Lung from Hyperoxic Injury Through the Epigenetic and Transcriptomic Reprogramming of Myeloid Cells
CONCLUSION: MEx ameliorates hyperoxia-induced neonatal lung injury though epigenetic and phenotypic reprogramming of myeloid cells.PMID:34699335 | DOI:10.1164/rccm.202102-0329OC (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Gareth R Willis Monica Reis Ali Hashemi Gheinani Angeles Fernandez-Gonzalez Elizabeth S Taglauer Vincent Yeung Xianlan Liu Maria Ericsson Eric Haas S Alex Mitsialis Stella Kourembanas Source Type: research

Ventilatory Drive Withdrawal Rather Than Reduced Genioglossus Compensation as a Mechanism of Obstructive Sleep Apnea in REM
Am J Respir Crit Care Med. 2021 Oct 26. doi: 10.1164/rccm.202101-0237OC. Online ahead of print.ABSTRACTRATIONALE: Rapid eye movement sleep (REM) is associated with reduced ventilation and greater obstructive sleep apnea (OSA) severity versus non-REM (nREM) for reasons not fully elucidated. Here we use direct physiological measurements to determine whether the pharyngeal compromise in REM OSA is most consistent with 1) withdrawal of neural ventilatory drive or 2) deficits in pharyngeal pathophysiology per se (i.e. increased collapsibility, decreased muscle responsiveness).METHODS: 63 OSA participants completed sleep studies...
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Ludovico Messineo Danny J Eckert Luigi Taranto-Montemurro Daniel Vena Ali Azarbarzin Lauren B Hess Nicole Calianese David P White Andrew Wellman Laura Gell Scott A Sands Source Type: research

Constant Tidal Volume Ventilation and Surfactant Dysfunction: An Overlooked Cause of Ventilator-Induced Lung Injury
Conclusions: The effect of CVTV on surfactant is complex. If attention is not paid to facilitating surfactant secretion and limiting its inactivation, depletion, desorption or displacement surface tension will increase and atelectasis and VILI will occur.PMID:34699343 | DOI:10.1164/rccm.202107-1690CP (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Richard K Albert Source Type: research

Serum tumor necrosis factor- α, interleukin-1β, interleukin-6, interleukin-17 relates to anxiety and depression risks to some extent in non-small cell lung cancer survivor
Clin Respir J. 2021 Oct 25. doi: 10.1111/crj.13457. Online ahead of print.ABSTRACTINTRODUCTION: Inflammatory cytokines are proposed as modulators for the pathogenesis of anxiety and depression (anxiety/depression), and anxiety/depression are frequent existed in non-small cell lung cancer (NSCLC) survivors. However, no published study has explored the association of inflammation cytokines with anxiety/depression in NSCLC survivors.OBJECTIVES: We aimed to evaluate serum tumor necrosis factor-α (TNF-α), interleukin -1 beta (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17) levels, and their correlations wi...
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Meifang Liu Xuesong Liu Yao Li Source Type: research

Using inpatient electronic medical records to study influenza for pandemic preparedness
CONCLUSIONS: We identified important trends in influenza severity related to treatment timing in a large inpatient dataset, laying the groundwork for the use of this and other inpatient EMR data for influenza and other respiratory virus surveillance.PMID:34697904 | DOI:10.1111/irv.12921 (Source: Respiratory Care)
Source: Respiratory Care - October 26, 2021 Category: Respiratory Medicine Authors: Candace C Fuller Austin Cosgrove Kenneth Sands Karla M Miller Russell E Poland Edward Rosen Alfred Sorbello Henry Francis Robert Orr Sarah K Dutcher Gregory T Measer Noelle M Cocoros Source Type: research

Interstitial lung abnormalities: What do we know and how do we manage?
Expert Rev Respir Med. 2021 Oct 23. doi: 10.1080/17476348.2021.1997598. Online ahead of print.ABSTRACTInterstitial lung abnormalities (ILAs), which refers to mild or subtle non-gravity dependent interstitial changes, may be neglected by some clinicians due to many reasons, such as lack of diagnostic criteria for ILAs, and absence of available treatments and surveillance strategies. However, without intervention, some ILAs may progress to interstitial lung disease (ILD). This review summarizes our current knowledge of this condition and ways of diagnosing it together with with current management. We hope that will lead to b...
Source: Respiratory Care - October 25, 2021 Category: Respiratory Medicine Authors: Qi Liu Hai Zhang Baohui Han Handong Jiang Kian Fan Chung Feng Li Source Type: research

Integrated plasma proteomics and lung transcriptomics reveal novel biomarkers in idiopathic pulmonary fibrosis
Respir Res. 2021 Oct 24;22(1):273. doi: 10.1186/s12931-021-01860-3.ABSTRACTBACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with a significant unmet medical need. Development of transformational therapies for IPF is challenging in part to due to lack of robust predictive biomarkers of prognosis and treatment response. Importantly, circulating biomarkers of IPF are limited and none are in clinical use.METHODS: We previously reported dysregulated pathways and new disease biomarkers in advanced IPF through RNA sequencing of lung tissues from a cohort of transplant-stage IPF patients (n = 36) in comparis...
Source: Respiratory Care - October 25, 2021 Category: Respiratory Medicine Authors: Pitchumani Sivakumar Ron Ammar John Ryan Thompson Yi Luo Denis Streltsov Mary Porteous Carly McCoubrey Edward Cantu Michael F Beers Gabor Jarai Jason D Christie Source Type: research

Role of the Emphysema Index Combined with the Chronic Obstructive Pulmonary Disease Assessment Test Score in the Evaluation of Chronic Obstructive Pulmonary Disease
This study aimed to evaluate the efficacy of the emphysema index (EI) in distinguishing chronic bronchitis (CB) from chronic obstructive pulmonary disease (COPD) and its role, combined with the COPD Assessment Test (CAT) score, in the evaluation of COPD.METHODS: A total of 92 patients with CB and 277 patients with COPD were enrolled in this study. Receiver operating characteristic (ROC) curves were analyzed to evaluate whether the EI can preliminarily distinguish chronic bronchitis from COPD. Considering the heterogeneity of COPD, there might be missed diagnosis of some patients with bronchitis type when differentiating CO...
Source: Respiratory Care - October 25, 2021 Category: Respiratory Medicine Authors: Qi Ding Xia Wei Jie Li Yan-Zhong Gao Shu-Di Xu Nan Yu Jiu-Yun Mi Bai-Bing Mi You-Min Guo Source Type: research

Does infection with or vaccination against SARS-CoV-2 lead to lasting immunity?
Lancet Respir Med. 2021 Oct 21:S2213-2600(21)00407-0. doi: 10.1016/S2213-2600(21)00407-0. Online ahead of print.ABSTRACTMany nations are pursuing the rollout of SARS-CoV-2 vaccines as an exit strategy from unprecedented COVID-19-related restrictions. However, the success of this strategy relies critically on the duration of protective immunity resulting from both natural infection and vaccination. SARS-CoV-2 infection elicits an adaptive immune response against a large breadth of viral epitopes, although the duration of the response varies with age and disease severity. Current evidence from case studies and large observat...
Source: Respiratory Care - October 24, 2021 Category: Respiratory Medicine Authors: Gregory Milne Thomas Hames Chris Scotton Nick Gent Alexander Johnsen Roy M Anderson Tom Ward Source Type: research

Long-acting antimuscarinic therapy in patients with chronic obstructive pulmonary disease receiving beta-blockers
CONCLUSIONS: This post hoc analysis supports long-acting anti-muscarinic use with concomitant beta-blockers in patients with moderate-to-very severe COPD and cardiovascular comorbidity.TRIAL REGISTRATION: ClinicalTrials.gov, NCT01966107, Registered 16 October 2013, https://clinicaltrials.gov/ct2/show/NCT01966107 .PMID:34686204 | PMC:PMC8532273 | DOI:10.1186/s12931-021-01861-2 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Kenneth R Chapman Robert A Wise Benjamin M Scirica Deepak L Bhatt Sami Z Daoud Dan Lythgoe Esther Garcia Gil Source Type: research

Issues affecting young people with asthma through the transition period to adult care
Paediatr Respir Rev. 2021 Sep 21:S1526-0542(21)00093-2. doi: 10.1016/j.prrv.2021.09.005. Online ahead of print.ABSTRACTAsthma is among the most common medical conditions affecting children and young people, with adolescence a recognised period of increased risk, overrepresented in analyses examining recent increasing asthma mortality rates. Asthma may change significantly during this period and management also occurs in the context of patients seeking increased autonomy and self-governance whilst navigating increasing academic and social demands. A number of disease factors can destabilise asthma during adolescence includi...
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Paul D Robinson Geshani Jayasuriya Stuart Haggie Ahmet Z Uluer Jonathan M Gaffin Louise Fleming Source Type: research

Underrecognized and Facing Burnout: Promoting Resilience in Respiratory Therapy
Respir Care. 2021 Nov;66(11):1777-1778. doi: 10.4187/respcare.09659.NO ABSTRACTPMID:34686584 | DOI:10.4187/respcare.09659 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Heather Meissen Aimee Abide Vanessa Moll Source Type: research

Monitoring Spontaneous Effort During Mechanical Ventilation: Are Our Tools Good Enough?
Respir Care. 2021 Nov;66(11):1779-1782. doi: 10.4187/respcare.09567.NO ABSTRACTPMID:34686585 | DOI:10.4187/respcare.09567 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Glauco Cm Plens Eduardo Lv Costa Source Type: research

Exercise-Induced Desaturations and Functional Limitation in Post-COVID-19 Lung Disease: Cause or Correlate?
Respir Care. 2021 Nov;66(11):1783-1785. doi: 10.4187/respcare.09621.NO ABSTRACTPMID:34686586 | DOI:10.4187/respcare.09621 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Kai E Swenson Richard M Schwartzstein Source Type: research

Transpulmonary Pressure-Guided Lung-Protective Ventilation Improves Pulmonary Mechanics and Oxygenation Among Obese Subjects on Mechanical Ventilation
Respir Care. 2021 Nov;66(11):1786-1787. doi: 10.4187/respcare.09581.NO ABSTRACTPMID:34686587 | DOI:10.4187/respcare.09581 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Luigi G Grassi Lorenzo Berra Source Type: research

Editor's Commentary
Respir Care. 2021 Nov;66(11):i.NO ABSTRACTPMID:34686588 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Source Type: research

Long-term immunogenicity of BNT162b2 vaccination in older people and younger health-care workers
Lancet Respir Med. 2021 Oct 20:S2213-2600(21)00456-2. doi: 10.1016/S2213-2600(21)00456-2. Online ahead of print.NO ABSTRACTPMID:34687656 | PMC:PMC8528470 | DOI:10.1016/S2213-2600(21)00456-2 (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2021 Category: Respiratory Medicine Authors: Pinkus Tober-Lau Tatjana Schwarz Kanika Vanshylla David Hillus Henning Gruell EICOV/COVIM Study Group Norbert Suttorp Irmgard Landgraf Kai Kappert Joachim Seybold Christian Drosten Florian Klein Florian Kurth Leif Erik Sander Victor Max Corman Source Type: research

3TR: a pan-European cross-disease research consortium aimed at improving personalised biological treatment of asthma and COPD
Eur Respir J. 2021 Oct 21;58(4):2102168. doi: 10.1183/13993003.02168-2021. Print 2021 Oct.NO ABSTRACTPMID:34675035 | DOI:10.1183/13993003.02168-2021 (Source: Respiratory Care)
Source: Respiratory Care - October 22, 2021 Category: Respiratory Medicine Authors: Celeste Porsbjerg Anke H Maitland-van der Zee Guy Brusselle Giorgio Walter Canonica Alvar Agusti Rosa Faner Claus F Vogelmeier Martijn Nawijn Maarten van den Berge Franca Rusconi Charles Pilette Valeria Ramiconi Courtney Coleman Rekha Chaudhuri Kian Fan C Source Type: research

Temporal trends in pulmonary arterial hypertension: Results from the COMPERA registry
CONCLUSIONS: The use of combination therapy increased from 2010 to 2019, but most patients still received monotherapy. Survival rates at 1 year after diagnosis did not change over time. Future studies need to determine if the observed trend suggesting improved 3-year survival rates can be confirmed.PMID:34675047 | DOI:10.1183/13993003.02024-2021 (Source: Respiratory Care)
Source: Respiratory Care - October 22, 2021 Category: Respiratory Medicine Authors: Marius M Hoeper Christine Pausch Ekkehard Gr ünig Gerd Staehler Doerte Huscher David Pittrow Karen M Olsson Carmine Dario Vizza Henning Gall Oliver Distler Christian Opitz J Simon R Gibbs Marion Delcroix H Ardeschir Ghofrani Stephan Rosenkranz Da-Hee Par Source Type: research

Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care
Lancet Respir Med. 2021 Oct 19:S2213-2600(21)00385-4. doi: 10.1016/S2213-2600(21)00385-4. Online ahead of print.ABSTRACTAs of July 31, 2021, SARS-CoV-2 had infected almost 200 million people worldwide. The growing burden of survivorship is substantial in terms of the complexity of long-term health effects and the number of people affected. Persistent symptoms have been reported in patients with both mild and severe acute COVID-19, including those admitted to the intensive care unit (ICU). Early reports on the post-acute sequelae of SARS-CoV-2 infection (PASC) indicate that fatigue, dyspnoea, cough, headache, loss of taste ...
Source: Respiratory Care - October 22, 2021 Category: Respiratory Medicine Authors: Ann M Parker Emily Brigham Bronwen Connolly Joanne McPeake Anna V Agranovich Michael T Kenes Kelly Casey Cynthia Reynolds Konrad F R Schmidt Soo Yeon Kim Adam Kaplin Carla M Sevin Martin B Brodsky Alison E Turnbull Source Type: research

COVID-19 pneumonia: pathophysiology and management
Eur Respir Rev. 2021 Oct 20;30(162):210138. doi: 10.1183/16000617.0138-2021. Print 2021 Dec 31.ABSTRACTCoronavirus disease 2019 (COVID-19) pneumonia is an evolving disease. We will focus on the development of its pathophysiologic characteristics over time, and how these time-related changes determine modifications in treatment. In the emergency department: the peculiar characteristic is the coexistence, in a significant fraction of patients, of severe hypoxaemia, near-normal lung computed tomography imaging, lung gas volume and respiratory mechanics. Despite high respiratory drive, dyspnoea and respiratory rate are often n...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Luciano Gattinoni Simone Gattarello Irene Steinberg Mattia Busana Paola Palermo Stefano Lazzari Federica Romitti Michael Quintel Konrad Meissner John J Marini Davide Chiumello Luigi Camporota Source Type: research

Performance of Different Low-Flow Oxygen Delivery Systems in the Acute Emergency Setting
The objective of this study was to analyze the effective inspired oxygen concentration delivered by different low-flow oxygen therapy systems challenged with different oxygen flows and respiratory patterns in an experimental lung model.METHODS: An adult lung model ventilated in volume control mode simulated different respiratory patterns to obtain mean inspiratory flow of 22.5, 30.0, 37.5, or 45.0 L/min. The oxygen concentration sampled inside the lung model by nasal cannula, simple face mask, non-rebreather mask, and double-trunk mask above nasal cannula tested at oxygen flows of 10, 12.5, and 15 L/min was quantified. The...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Fr édéric Duprez Florence Dupriez Julien De Greef Julie Gabriel Arnaud Bruyneel Gr égory Reychler Christophe De Terwangne William Poncin Source Type: research

Health Care Use, Costs, and Survival Trajectory of Home Mechanical Insufflation-Exsufflation: Health Database Case Control Study
We examined the impact of provision of publicly funded MI-E devices on health care utilization, health care costs, and survival trajectory.METHODS: This is a retrospective pre/post cohort study linking data on prospectively recruited participants using MI-E to health administrative databases to quantify outcomes.RESULTS: We linked data from 106 participants (8 age
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Louise Rose Tom Fisher Regina Pizzuti Reshma Amin Ruth Croxford Craig M Dale Roger Goldstein Sherri Katz David Leasa Doug McKim Mika Nonoyama Anu Tandon Andrea Gershon Source Type: research

Impact of Airway Humidification Strategy in the Mechanically Ventilated COVID-19 Patients
CONCLUSIONS: The choice of the humidification device used in patients with COVID-19 has a relevant impact on ventilation efficiency (increased CO2 removal with lower dead space) and on complications related to low humidity, including ETOs that may be present with heated-wire HHs when used with high ambient temperatures.PMID:34670857 | DOI:10.4187/respcare.09314 (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Carole-Anne Lavoie-B érard Jean-Claude Lefebvre Pierre-Alexandre Bouchard Mathieu Simon Fran çois Lellouche Source Type: research

Modified Medical Research Council and COPD Assessment Test Cutoff Points
This study aimed to identify mMRC and CAT cutoff points to discriminate sedentary behavior and PADL level of subjects with COPD and verify whether these cutoff points differentiate pulmonary function, health-related quality of life (HRQOL), functional status, and mortality index in subjects with COPD.METHODS: Subjects (N = 131, FEV1: 36.7 ± 16.1% predicted) were assessed for lung function, mMRC, CAT, HRQOL, functional status, and mortality index. PADL was monitored using a triaxial accelerometer, and subjects were classified as sedentary/nonsedentary (cutoff point of 8.5 h/d in PADL
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Anelise Bauer Munari Aline Almeida Gulart Juliana Ara újo J úlia Zanotto Luiza Minato Sagrillo Manuela Karloh Anamaria Fleig Mayer Source Type: research

The Impact of High-Flow Nasal Cannula Device, Nebulizer Type, and Placement on Trans-Nasal Aerosol Drug Delivery: An In Vitro Study
Respir Care. 2021 Oct 20:respcare.09133. doi: 10.4187/respcare.09133. Online ahead of print.ABSTRACTBACKGROUND: Aerosol delivery via high-flow nasal cannula (HFNC) has been increasingly used in recent years. However, the effects of different HFNC devices, nebulizer types, and placement on aerosol deposition remain largely unknown.METHODS: An adult manikin with anatomically correct upper airway was used with a collection filter placed between the manikin's trachea and a breathing simulator, composed of a dual-chamber model lung driven by a critical care ventilator. Three HFNC device configurations were compared, with vibrat...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Jie Li Lucas Williams James B Fink Source Type: research

Improvement of Pediatric Advanced Airway Management in General Emergency Departments After a Collaborative Intervention Program
CONCLUSIONS: A simulation-based collaborative intervention program led to improvement in pediatric airway management and subject outcomes in general emergency departments. This model demonstrated the transfer of improvement from a simulated setting to a clinical setting and may be targeted in other clinical settings.PMID:34670860 | DOI:10.4187/respcare.09250 (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Manahil Mustafa Riad Lutfi Hani Alsaedi Peter Castelluccio Kellie J Pearson Erin E Montgomery Mara E Nitu Kamal Abulebda Samer Abu-Sultaneh Source Type: research

Initial Triple Combination Therapy for Intermediate and High-Risk Pulmonary Arterial Hypertension: Standard of Care or Still too Soon to Tell?
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202107-1622LE. Online ahead of print.NO ABSTRACTPMID:34672865 | DOI:10.1164/rccm.202107-1622LE (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Qi Jin Lihua Guan Wenzhi Pan Daxin Zhou Source Type: research

Treatment of Pulmonary Hypertension: Is Triple Therapy Necessarily Better than Monotherapy?
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202108-1965LE. Online ahead of print.NO ABSTRACTPMID:34672866 | DOI:10.1164/rccm.202108-1965LE (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Xishi Sun Riken Chen Xiaoyun Yao Zhenzhen Zheng Manxia Wang Chaoyu Wang Junfen Cheng Source Type: research

Reply to: Jin et al. and Sun et al
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202107-1725LE. Online ahead of print.NO ABSTRACTPMID:34672868 | DOI:10.1164/rccm.202107-1725LE (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Ath énaïs Boucly Jason Weatherald Laurent Savale Xavier Ja ïs David Montani Marc Humbert Olivier Sitbon Source Type: research

Treatment Trials in Pre-COPD and Young COPD: Time to Move Forward
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202107-1663SO. Online ahead of print.ABSTRACTChronic Obstructive Pulmonary Disease is the end-result of a series of dynamic and cumulative gene-environment interactions over a lifetime. The evolving understanding of COPD biology provides novel opportunities for prevention, early diagnosis, and intervention. To advance these concepts we propose therapeutic trials in two major groups of subjects: those "young" individuals with COPD and those with pre-COPD. Given that lungs grow to about 20 years of age and begin to age at approximately 50 years, we consider ...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Fernando J Martinez Alvar Agusti Bartolome R Celli MeiLan K Han James Allinson Surya P Bhatt Peter Calverley Sanjay H Chotirmall Badrul Chowdhury Patrick Darken Carla A Da Silva Gavin Donaldson Paul Dorinsky Mark Dransfield Rosa Faner David M Halpin Paul Source Type: research

Transpulmonary Pressure to Guide Mechanical Ventilation: Art or Science?
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202109-2116ED. Online ahead of print.NO ABSTRACTPMID:34672875 | DOI:10.1164/rccm.202109-2116ED (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: V Marco Ranieri Tommaso Tonetti Stefano Nava Source Type: research

Reducing Ventilation Associated Brain Injury by Diaphragm Neurostimulation : Racking the Diaphragm to Protect the Brain?
Am J Respir Crit Care Med. 2021 Oct 21. doi: 10.1164/rccm.202110-2312ED. Online ahead of print.NO ABSTRACTPMID:34672876 | DOI:10.1164/rccm.202110-2312ED (Source: Respiratory Care)
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Martin Dres Gianluigi Li Bassi Source Type: research

Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial
Lancet Respir Med. 2021 Oct 18:S2213-2600(21)00384-2. doi: 10.1016/S2213-2600(21)00384-2. Online ahead of print.ABSTRACTBACKGROUND: Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19.METHODS: We did a double-blind, randomised, placebo-controlled trial at 63 hospitals across five countries (Japan, Mexico, Singapore, South Korea, and the USA). Eligible patients were hospita...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Andre C Kalil Aneesh K Mehta Thomas F Patterson Nathaniel Erdmann Carlos A Gomez Mamta K Jain Cameron R Wolfe Guillermo M Ruiz-Palacios Susan Kline Justino Regalado Pineda Anne F Luetkemeyer Michelle S Harkins Patrick E H Jackson Nicole M Iovine Victor F Source Type: research

Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial
Lancet Respir Med. 2021 Oct 18:S2213-2600(21)00435-5. doi: 10.1016/S2213-2600(21)00435-5. Online ahead of print.ABSTRACTBACKGROUND: Colchicine has been proposed as a treatment for COVID-19 based on its anti-inflammatory actions. We aimed to evaluate the efficacy and safety of colchicine in patients admitted to hospital with COVID-19.METHODS: In this streamlined, randomised, controlled, open-label trial, underway at 177 hospitals in the UK, two hospitals in Indonesia, and two hospitals in Nepal, several possible treatments were compared with usual care in patients hospitalised with COVID-19. Patients were eligible for inclu...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: RECOVERY Collaborative Group Source Type: research

SARS-Cov-2 and Lung Injury: Dysregulation of Immune Response, But Not Hyperimmune Response as in "Cytokine Storm Syndrome"
Clin Respir J. 2021 Oct 21. doi: 10.1111/crj.13455. Online ahead of print.ABSTRACTSARS-CoV-2 infection can present either an asymptomatic or symptomatic; the spectrum of symptomatic infection ranges from mild to critical. A majority of patients have experienced mild symptoms with a good prognosis. But, approximately 14% of them have severe infection presenting with hypoxemia and extensive lung involvement. The current mini-review describes the dysregulation of immune response for SARS-CoV-2 viral pneumonia and virus-induced lung injury. Also, many confounding factors can increase lung injury, in addition to virus-induced l...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Serpil Öcal Source Type: research

COVID-19 pneumonia: pathophysiology and management
Eur Respir Rev. 2021 Oct 20;30(162):210138. doi: 10.1183/16000617.0138-2021. Print 2021 Dec 31.ABSTRACTCoronavirus disease 2019 (COVID-19) pneumonia is an evolving disease. We will focus on the development of its pathophysiologic characteristics over time, and how these time-related changes determine modifications in treatment. In the emergency department: the peculiar characteristic is the coexistence, in a significant fraction of patients, of severe hypoxaemia, near-normal lung computed tomography imaging, lung gas volume and respiratory mechanics. Despite high respiratory drive, dyspnoea and respiratory rate are often n...
Source: Respiratory Care - October 21, 2021 Category: Respiratory Medicine Authors: Luciano Gattinoni Simone Gattarello Irene Steinberg Mattia Busana Paola Palermo Stefano Lazzari Federica Romitti Michael Quintel Konrad Meissner John J Marini Davide Chiumello Luigi Camporota Source Type: research