Respiratory Medicine and Research最新文献

英文中文

Pulmonary vein stenosis: An unusual cause of hypoxemia after lung transplantation 肺静脉狭窄：肺移植术后低氧血症的异常原因

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-08-23 DOI: 10.1016/j.resmer.2023.101041

Margot Combet , Domitille Mouren , Justina Motiejunaite , Vincent Bunel , Pierre Mordant , Yves Castier , Aurélie Snauwaert , Philippe Montravers , Antoine Khalil , Sébastien Hascoet , Philippe Brenot , Jonathan Messika

引用次数: 0

Severe pre-capillary pulmonary hypertension associated with kyphoscoliosis: Description of 4 cases 重度毛细血管前肺动脉高压伴后凸畸形4例报告

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-08-23 DOI: 10.1016/j.resmer.2023.101034

Guillaume Martin, Matthieu Canuet, Mohamed Rahli, Armelle Schuller, Irina Enache, Romain Kessler, Marianne Riou

引用次数: 0

Comparative study of the two diagnostic criteria for idiopathic pleuroparenchymal fibroelastosis 两种诊断标准对特发性胸膜膜纤维弹性增生症的比较研究。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-08-18 DOI: 10.1016/j.resmer.2023.101046

Yoshiaki Kinoshita, Takuhide Utsunomiya, Kenji Wada, Shota Nakashima, Hisako Kushima, Hiroshi Ishii

引用次数: 0

Recovery of Endothelium-dependent vascular relaxation impairment in convalescent COVID-19 patients: Insight from a pilot study 新冠肺炎康复期患者内皮依赖性血管舒张损伤的恢复：一项试点研究的启示

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-08-04 DOI: 10.1016/j.resmer.2023.101044

Fares Gouzi , Aurélien Philippe , Jean Pastre , Bertrand Renaud , Nicolas Gendron , Marielle Subileau , Thông Hua-Huy , Benjamin Planquette , Olivier Sanchez , David M. Smadja , Sven Günther

Background

Endothelial dysfunction is a key-feature in acute COVID-19. However, follow-up data regarding endothelial dysfunction and injury after COVID-19 infection are lacking. We aimed to investigate the changes in endothelium-dependent vasorelaxation at baseline and four months after hospital discharge in COVID-19 patients.

Methods

Twenty COVID-19 patients were compared to 24 healthy controls. Clinical and morphological data were collected after hospital admission for SARS-CoV-2 infection and reactive hyperaemia index (RHI) measurement was performed with a delay between 24 and 48 h after hospital admission and four months after hospital discharge in the outpatient clinics. Blood tests including inflammatory markers and measurement of post-occlusive vasorelaxation by digital peripheral arterial tonometry were performed at both visits.

Results

At baseline, COVID-19 patients exhibited reduced RHI compared to controls (p < 0.001), in line with an endothelial dysfunction. At four months follow-up, there was a 51% increase in the RHI (1.69 ± 0.32 to 2.51 ± 0.91; p < 0.01) in favor of endothelium-dependent vascular relaxation recovery. RHI changes were positively correlated with baseline C-reactive protein (r = 0.68; p = 0.02). Compared to COVID-19 patients with a decrease in RHI, COVID-19 patients with an increase in RHI beyond the day-to-day variability (i.e. >11%) had less severe systemic inflammation at baseline.

Conclusion

Convalescent COVID-19 patients showed a recovery of systemic artery endothelial dysfunction, in particular patients with lower inflammation at baseline. Further studies are needed to decipher the interplay between inflammation and endothelial dysfunction in COVID-19 patients.

背景内皮功能障碍是急性新冠肺炎的关键因素。然而，缺乏新冠肺炎感染后内皮功能障碍和损伤的随访数据。我们旨在研究新冠肺炎患者在基线和出院后4个月内皮依赖性血管舒张的变化。方法将20例新冠肺炎患者与24例健康对照者进行比较。严重急性呼吸系统综合征冠状病毒2型感染入院后收集临床和形态学数据，并在入院后24至48小时和出院后4个月延迟在门诊进行反应性充血指数（RHI）测量。两次访视均进行了血液测试，包括炎症标志物和通过数字外周动脉眼压计测量闭塞后血管舒张。结果基线时，与对照组相比，新冠肺炎患者的RHI降低（p＜0.001），与内皮功能障碍一致。在四个月的随访中，RHI增加了51%（1.69±0.32至2.51±0.91；p＜0.01），有利于内皮依赖性血管舒张恢复。RHI变化与基线C反应蛋白呈正相关（r=0.68；p=0.02）。与RHI降低的新冠肺炎患者相比，RHI增加超过日常变异性（即>；11%）的新冠肺炎患者在基线时的全身炎症较轻。结论新冠肺炎康复患者全身动脉内皮功能障碍恢复，尤其是基线炎症较低的患者。需要进一步的研究来解读新冠肺炎患者炎症和内皮功能障碍之间的相互作用。

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引用次数: 0

Insight into the relationship between forced vital capacity and transfer of the lungs for carbon monoxide in patients with idiopathic pulmonary fibrosis 了解特发性肺纤维化患者的强迫肺活量与肺部一氧化碳转移之间的关系。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-07-14 DOI: 10.1016/j.resmer.2023.101042

Thibaud Soumagne , Sébastien Quétant , Alicia Guillien , Loïc Falque , David Hess , Bernard Aguilaniu , Bruno Degano

Background

Forced vital capacity (FVC) is routinely used to quantify the severity and identify the progression of idiopathic pulmonary fibrosis (IPF). Although less commonly used, lung transfer of carbon monoxide (TLCO) correlates better with the severity of IPF than does FVC.

Methods

Aiming at studying how FVC behaves in relation to TLCO, we analysed cross-sectional data from 430 IPF patients, of which 221 had at least 2 assessments (performed 2.4 ± 1.9 years apart) available for longitudinal analyses. Thresholds for identifying “abnormal” FVC and TLCO values were the statistically-defined lower limits of normal (LLN). For patients with longitudinal data, mean annual absolute declines of FVC and TLCO were calculated.

Results

The correlation between FVC and TLCO (%predicted) was weak (R²=0.21). FVC was “abnormal” (i.e., <LLN) in 38% of patients while 84% of patients had an “abnormal” TLCO. A large majority of the 268 patients with a “normal” FVC had nevertheless an “abnormal” TLCO (n = 209; 78%). On longitudinal analysis, 67/221 patients had an annual absolute decline in FVC≥5%, 34/221 had an annual absolute decline in TLCO ≥10%, and 22 had both.

Conclusion

In IPF, a “normal” FVC should be viewed with caution as it is most often associated with an “abnormal” TLCO, a parameter that is strongly correlated with the morphological extent of the disease. Only 1/3 of the patients with a FVC-based progression criterion also had a TLCO progression criterion. In contrast, 2/3 of patients with a TLCO progression criterion also had a FVC progression criterion.

背景：强迫肺活量（FVC）通常用于量化特发性肺纤维化（IPF）的严重程度和确定其进展。尽管不太常用，但与FVC相比，一氧化碳肺转移（TLCO）与IPF严重程度的相关性更好。方法：为了研究FVC与TLCO的关系，我们分析了430名IPF患者的横断面数据，其中221名患者至少有2项评估（间隔2.4±1.9年进行）可用于纵向分析。识别“异常”FVC和TLCO值的阈值是统计定义的正常下限（LLN）。对于有纵向数据的患者，计算FVC和TLCO的年平均绝对下降。结果：FVC和TLCO（预测百分比）之间的相关性较弱（R2=0.21）。FVC为“异常”（即，结论：在IPF中，应谨慎看待“正常”FVC，因为它最常与“异常”TLCO，一个与疾病的形态学程度密切相关的参数。在基于FVC的进展标准的患者中，只有1/3的患者也有TLCO进展标准。相反，2/3的TLCO进展标准患者也有FVC进展标准。

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引用次数: 0

Comparison of amikacin lung delivery between AKITA® and eFlow rapid® nebulizers in healthy controls and patients with CF: A randomized cross-over trial AKITA®和eFlow rapid®喷雾器在健康对照组和CF患者中阿米卡星肺部给药的比较：一项随机交叉试验。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-07-04 DOI: 10.1016/j.resmer.2023.101038

Anne-Sophie Aubriot , Guillaume Maerckx , Teresinha Leal , Sophie Gohy , Gregory Reychler

Introduction

Nebulization plays a key role in the treatment of cystic fibrosis. The Favorite function couple to jet nebulizers (AKITA®) emerged recently. The aim of this study was to assess the efficiency of the lung delivery by the AKITA® by comparing the urinary concentration of amikacin after nebulization with the AKITA® and the eFlow rapid®, in healthy subjects and patients with CF (PwCF).

Method

The two samples (healthy subjects and PwCF) were randomized (cross-over 1:1) for two nebulizations (500 mg of amikacin diluted in 4 mL of normal saline solution), with the AKITA® and with the eFlow rapid®. The primary endpoint was the amount of urinary excretion of amikacin over 24 h. The constant of elimination (Ke) was calculated based on the maximal cumulative urinary amikacin excretion plotted over time.

Results

The total amount of urinary amikacin excretion was greater when AKITA® was used in PwCF (11.7 mg (8.2–14.1) vs 6.1 mg (3.7–13.3); p = 0.02) but not different in healthy subjects (14.5 mg (11.7–18.5) vs 12.4 mg (8.0–17.1); p = 0.12). The duration of the nebulization was always shorter with eFlow rapid® than with AKITA® (PwCF: 6.5 ± 0.6 min vs 9.2 ± 1.8 min; p = 0.001 – Healthy: 4.7 ± 1.3 min vs 9.7 ± 1.6 min; p = 0.03). The constant of elimination was similar between the two modalities in CF subjects (0.153 (0.071–0.205) vs 0.149 (0.041–0.182); p = 0.26) and in healthy subjects (0.166 (0.130–0.218) vs 0.167 (0.119–0.210), p = 0.25).

Conclusion

the Favorite inhalation is better to deliver a specific amount of drug than a mesh nebulizer (eFlow rapid®) in PwCF but not in healthy subjects.

简介：雾化在囊性纤维化的治疗中起着关键作用。最近出现了最受欢迎的喷气式喷雾器功能组合（AKITA®）。本研究的目的是通过将雾化后阿米卡星的尿浓度与AKITA®和eFlow rapid®进行比较，来评估AKITA®的肺部输送效率，方法：将两个样本（健康受试者和慢性疲劳综合征患者）随机（交叉1:1）进行两次雾化（500 mg阿米卡星在4 mL生理盐水中稀释），分别使用AKITA®和eFlow rapid®。主要终点是24小时内阿米卡星的尿排泄量。消除常数（Ke）基于随时间绘制的最大累积尿阿米卡星排泄量来计算。结果：当AKITA®用于PwCF时，尿阿米卡星排泄总量更大（11.7 mg（8.2-14.1）vs 6.1 mg（3.7-13.3）；p=0.02），但在健康受试者中没有差异（14.5 mg（11.7-18.5）vs 12.4 mg（8.0-17.1）；p=0.12）。eFlow rapid®的雾化持续时间总是比AKITA®短（PwCF:6.5±0.6分钟vs 9.2±1.8分钟；p=0.001-健康：4.7±1.3分钟vs 9.7±1.6分钟；p=0.03）。CF受试者的两种模式的消除常数相似（0.153（0.071-0.205）vs 0.149（0.041-0.182）；p=0.26）和健康受试者（0.166（0.130-0.218）vs 0.167（0.119-0.210），p=0.25）。

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引用次数: 0

Intervening in primary spontaneous pneumothorax – Less is more 原发性自发性肺气肿的干预-少即是多。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-07-01 DOI: 10.1016/j.resmer.2023.101039

Steven Walker, Eleanor Barton, Nick Maskell

引用次数: 0

The evolution of management in Chronic Thromboembolic Pulmonary Hypertension in a non-Surgical/ Balloon Pulmonary Angioplasty center. 慢性血栓栓塞性肺动脉高压在非手术/球囊肺动脉成形术中心的治疗进展。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-07-01 DOI: 10.1016/j.resmer.2023.101043

M. Jevnikar, D. Montani, E. Fadel, X. Jais

引用次数: 0

Awake prone position in patients with acute hypoxic respiratory failure: A narrative review 急性缺氧性呼吸衰竭患者的俯卧位：叙述性综述

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-06-30 DOI: 10.1016/j.resmer.2023.101037

Zainab Al Duhailib, Ken Kuljit S. Parhar, Kevin Solverson, Waleed Alhazzani, Jason Weatherald

引用次数: 0

Education and implementation of home spirometry in an adolescent cystic fibrosis population 青少年囊性纤维化患者家庭肺活量测定的教育和实施。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Respiratory Medicine and Research

Pub Date : 2023-06-30 DOI: 10.1016/j.resmer.2023.101040

Sarah Schaffer, Abigail Strang, Ambika Shenoy, Dawn Selhorst, Aaron Chidekel

Background

Lung function in individuals with cystic fibrosis (CF) is closely monitored as an objective marker of clinical status. The COVID-19 pandemic shifted our ability to assess individuals from in-person to remote monitoring using telehealth. As part of efforts to monitor individuals remotely during this time, this study describes the process of education and implementation of home spirometry in an adolescent CF population at Nemours Children's Hospital in Wilmington, Delaware, USA. In addition, this study reviews the ability of adolescents with CF to produce reliable, consistent, and accurate results using home spirometry.

Methods

This was a quality-improvement study over a 9-month period at a single CF center. Home spirometers were supplied by the CF Foundation to 40 adolescents with CF. An educational curriculum was used for initial training on the device by a dedicated CF respiratory therapist. After training, participants reported spirometry results weekly until reliable technique was established. Once reliable technique was achieved, participants reported results monthly. Results were retrospectively reviewed to determine accuracy and consistency. The percentages of patients who were able to achieve reliable, consistent, and accurate results were recorded as well as the need for additional training or other reasons for inability to produce ongoing results.

Results

Home spirometers were distributed to 40 adolescents. Out of these 40 participants, 35 (88%) completed initial training; 29 (83%) sent at least one set of results, and 24 (60%) established reliable technique after an average of 5 weekly attempts. When home spirometer results were retrospectively reviewed, 83% (20/24) were deemed accurate in comparison to spirometry completed in clinic, and 83% (20/24) showed consistency between efforts sent.

Conclusion

Home spirometry, when properly implemented with structured education and active participant engagement, has potential to provide meaningful data and feedback to CF care teams. Implementation of this process requires substantial resources and active participation from an adolescent population who are at higher risk for non-adherence. Future studies are needed to determine the impact of home spirometry on clinical outcomes and reliability over time and to address barriers to consistent and enduring engagement in the adolescent population.

背景：囊性纤维化（CF）患者的肺功能作为临床状态的客观标志物受到密切监测。新冠肺炎大流行将我们评估个人的能力从住院转变为使用远程医疗进行远程监测。作为在此期间远程监测个体的努力的一部分，本研究描述了美国特拉华州威尔明顿Nemours儿童医院青少年CF人群中家庭肺活量测定的教育和实施过程。此外，本研究还回顾了CF青少年使用家庭肺活计得出可靠、一致和准确结果的能力。方法：这是一项在单个CF中心进行的为期9个月的质量改进研究。CF基金会为40名CF青少年提供了家庭肺活量计。专门的CF呼吸治疗师使用教育课程对该设备进行了初步培训。训练后，参与者每周报告肺活量测定结果，直到建立可靠的技术。一旦实现了可靠的技术，参与者每月报告结果。对结果进行回顾性审查，以确定准确性和一致性。记录了能够获得可靠、一致和准确结果的患者百分比，以及需要额外培训或其他无法产生持续结果的原因。结果：家庭肺活量计被分配给40名青少年。在这40名参与者中，35人（88%）完成了初步培训；29人（83%）发送了至少一组结果，24人（60%）在平均每周5次尝试后建立了可靠的技术。当对家庭肺活量计的结果进行回顾性审查时，与临床完成的肺活量测定相比，83%（20/24）的结果被认为是准确的，83%（2000/24）的结果显示所做努力的一致性。结论：如果通过结构化的教育和积极的参与者参与正确实施家庭肺活量测定，有可能为CF护理团队提供有意义的数据和反馈。这一进程的实施需要大量资源和不遵守的风险较高的青少年群体的积极参与。未来的研究需要确定家庭肺活量测定对临床结果和可靠性的影响，并解决青少年群体持续和持久参与的障碍。

{"title":"Education and implementation of home spirometry in an adolescent cystic fibrosis population","authors":"Sarah Schaffer, Abigail Strang, Ambika Shenoy, Dawn Selhorst, Aaron Chidekel","doi":"10.1016/j.resmer.2023.101040","DOIUrl":"10.1016/j.resmer.2023.101040","url":null,"abstract":"<div><h3>Background</h3><p>Lung function in individuals with cystic fibrosis (CF) is closely monitored as an objective marker of clinical status. The COVID-19 pandemic shifted our ability to assess individuals from in-person to remote monitoring using telehealth. As part of efforts to monitor individuals remotely during this time, this study describes the process of education and implementation of home spirometry in an adolescent CF population at Nemours Children's Hospital in Wilmington, Delaware, USA. In addition, this study reviews the ability of adolescents with CF to produce reliable, consistent, and accurate results using home spirometry.</p></div><div><h3>Methods</h3><p>This was a quality-improvement study over a 9-month period at a single CF center. Home spirometers were supplied by the CF Foundation to 40 adolescents with CF. An educational curriculum was used for initial training on the device by a dedicated CF respiratory therapist. After training, participants reported spirometry results weekly until reliable technique was established. Once reliable technique was achieved, participants reported results monthly. Results were retrospectively reviewed to determine accuracy and consistency. The percentages of patients who were able to achieve reliable, consistent, and accurate results were recorded as well as the need for additional training or other reasons for inability to produce ongoing results.</p></div><div><h3>Results</h3><p>Home spirometers were distributed to 40 adolescents. Out of these 40 participants, 35 (88%) completed initial training; 29 (83%) sent at least one set of results, and 24 (60%) established reliable technique after an average of 5 weekly attempts. When home spirometer results were retrospectively reviewed, 83% (20/24) were deemed accurate in comparison to spirometry completed in clinic, and 83% (20/24) showed consistency between efforts sent.</p></div><div><h3>Conclusion</h3><p>Home spirometry, when properly implemented with structured education and active participant engagement, has potential to provide meaningful data and feedback to CF care teams. Implementation of this process requires substantial resources and active participation from an adolescent population who are at higher risk for non-adherence. Future studies are needed to determine the impact of home spirometry on clinical outcomes and reliability over time and to address barriers to consistent and enduring engagement in the adolescent population.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"84 ","pages":"Article 101040"},"PeriodicalIF":2.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169673","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}

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