Lancet Respiratory Medicine最新文献

{"title":"Endotracheal surfactant for infants with life-threatening bronchiolitis (BESS): a randomised, blinded, sham-controlled, phase 2 trial","authors":"Malcolm G Semple, Chloe Donohue, Laura Price, Rachael Cooper, Carly Vaughan, Tracy Moitt, Lynsey Finnetty, Paul C Ritson, Blessing Osaghae, Evette Allen, Clare Fowler, Rachel S Agbeko, Edgar Brincat, Jane V Cassidy, Patrick E Davies, Peter J Davis, Elisabeth Day, Constantinos Kanaris, Simona Lampariello, Richard Levin, Tsz-Yan Milly Lo, Kevin P Morris, Ahmed Osman, Stephen D Playfor, Julie Richardson, Gerri Sefton, Santosh Sundararajan, James Weitz, Annmarie Wherton-Whitehurst, Elizabeth Deja, Kerry Woolfall, Jens Madsen, Anthony D Postle, Catrin Barker, Carrol Gamble, Howard W Clark, John Pappachan, Kentigern Thorburn, Matthew Peak, Paul S McNamara, Mark A Turner, Ashley P Jones, Malcolm G Semple, Chloe Donohue, Laura Price, Rachael Cooper, Carly Vaughan, Tracy Moitt, Lynsey Finnetty, Paul C Ritson, Blessing Osaghae, Evette Allen, Clare Fowler, Rachel S Agbeko, Edgar Brincat, Jane V Cassidy, Patrick E Davies, Peter J Davis, Elisabeth Day, Constantinos Kanaris, Simona Lampariello, Richard Levin, Tsz-Yan Milly Lo, Kevin P Morris, Ahmed Osman, Stephen D Playfor, Julie Richardson, Gerri Sefton, Santosh Sundararajan, James Weitz, Annmarie Wherton-Whitehurst, Elizabeth Deja, Kerry Woolfall, Jens Madsen, Anthony Postle, Catrin Barker, Carrol Gamble, Howard W Clark, John Pappachan, Kentigern Thorburn, Matthew Peak, Paul S McNamara, Mark A Turner, Ashley P Jones, Helen Adamson, Cara Alexander, John Alexander, Laura Anderson, David Armstrong, Lydia Ashton, Judit Bak, Katherine Baptiste, Kirsten Beadon, Rebecca Beckley, Lynne Bell, Ashley Best, Amy Brammar, Wendy Browne, Lara T Bunni, Lisa-Marie Butt, Hilary Callaghan, Lorena Caruana, Tania Castillo Hernandez, Susanne Cathcart, Hannah Child, Bessie Cipriano, Hannah Clarke, Stephanie Clarke, Rob Claydon, Sophie Coles, Vanessa Compton, Amber Cook, Lindsay Crate, Tracey Curtis, Sarah Daggett, Anne Dawson, Laura Dodge, Rachael Dore, Sarah-Jayne Eames, Nichola Etherington, Samantha Finn, Sarah Fox, Crawford Fulton, Simon Gates, Bernadette C Gavin, Annabel Giddings, Jessica Green, Michael Griksaitis, Paris-Lucia Harrison, Ellen Haskins, Nadine Heenan, Elizabeth Henderson, Rebecca Hill, Sarah Hopton, Claire F Jennings, Rebecca Jennings, Petr Jirasek, Dawn Jones, Ebraheem Junaid, Nosheen Khalid, Tahmina Khatun, Ramiya Kirupananthan, Craig Knott, Ramesh Kumar, Samantha La Roche, Stephanie Laidlaw, Benjamin Lakin, Christopher Lamb, Flora Lewis, Christina Linton, Vicki Linton, Lisa Lucyk, Jeremy Lyons, Christine Mackerness, Dave Malabar, Michael Mander, Muhammed Pradhika Mapindra, Helen Marley, Ross Marscheider, Michael J Marsh, Rebecca Marshall, Lindy Martin, Shelley Mayor, Joseph McCann, Nicola McClelland, Laura McConaghy, Jenni McCorkell, Jackie McCormick, Liz McCullagh, Rachel McMinnis, Samantha Mead, Christie Mellish, Natalie Milburn, Bethany Millman, Philip Milner, Holly Minchin, Amisha Mistry, Sarah Mogan, Seana Molloy, Dave J Morgan, Tara Murray, Manoj Kumar Muthusamy, Clara Nelson, Katie M Neville, Bethan Newell, Heather Nicholls, Olivia Nugent, Laura O'Malley, Udeme Ohia, Zoe Oliver, Madhuri Panchal, Helen Parker, Holly Parkin, Roger Parslow, Rekha Patel, Simone Paulson, Harriet Payne, Rachael Percival, Nicolene Plaatjies, Jenny Pond, Catherine Postlethwaite, Jennifer Preston, Laura Rad, Raghu N Ramaiah, Pavanasam Ramesh, Maxine Ramsay, Samantha Reed, Kathryn Reeves, Emma K Riley, Laura Rimmer, Ceri Robbins, Natasha Roberts, Christa Ronan, Tomasz Rygielski, Avishay Sarfatti, Rohit Saxena, Alvin Schadenberg, Emily Scriven, Chidambaram Sethuraman, Chris Simons, Frances Sinfield, Anna Stancombe, John Stiven, Elizabeth Stoddart, Colin Summers, Laura J Sutton, Kate Teeley, Mark Terris, Carla Thomas, Charlotte Thompson, Clare Thompson, Natasha Thorn, Joanne Tomlinson, Patrick Tomlinson, Carly Tooke, Marie Turner, Clare van Miert, Anand Wagh, Laura Wallis, Penny Walsh, Marie Ward, Sophia Ward, Jacqueline Waters, Jack Watson, Grace Williamson, Helen Winmill, Andrea Wood, Laura Wooler","doi":"10.1016/s2213-2600(26)00008-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00008-1","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"118 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surfactant therapy in severe infant bronchiolitis: evidence from the BESS trial","authors":"Sailesh Kotecha","doi":"10.1016/s2213-2600(26)00043-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00043-3","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"92 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for caregivers: supporting invisible partners of the ICU","authors":"","doi":"10.1016/s2213-2600(26)00090-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00090-1","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"12 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147478163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute respiratory failure in immunocompromised adults: the case for personalised care strategies","authors":"Carol L Hodgson, Richard A Greendyk","doi":"10.1016/s2213-2600(26)00075-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00075-5","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"213 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The host response in sepsis: can it be quantified?","authors":"Pratik Sinha, Nuala J Meyer","doi":"10.1016/s2213-2600(25)00465-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00465-5","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"282 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying immune dysregulation in pneumonia and sepsis with a parsimonious machine-learning model: a multicohort analysis across care settings and reanalysis of a hydrocortisone randomised controlled trial","authors":"Erik H A Michels, Pierre-François Dequin, Joe M Butler, Antoine Guillon, Bruno Evrard, Fleur P Paling, Tom D Y Reijnders, Alex R Schuurman, Tjitske S R van Engelen, Xanthe Brands, Bastiaan W Haak, Lieuwe D J Bos, Carolyn Leroux, Evangelos J Giamarellos-Bourboulis, Jaap Stoker, Jan M Prins, Daniël R Faber, Renée A Douma, Timothy E Sweeney, Surbhi Malhotra-Kumar, Tom van der Poll","doi":"10.1016/s2213-2600(25)00429-1","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00429-1","url":null,"abstract":"<h3>Background</h3>Sepsis is a dysregulated host response to infection resulting in life-threatening organ failure. Although immune dysregulation is central to the sepsis definition, immunomodulation trials enrol participants based on clinical severity, not the extent of dysregulation, which could contribute to treatment heterogeneity. A pragmatic way to quantify immune dysregulation could improve prognostication, help to evaluate treatment responses, and identify individuals most likely to benefit from immunomodulation. We aimed to construct a parsimonious machine-learning tool that defines and quantifies immune dysregulation, thereby supporting biologically informed immunomodulation.<h3>Methods</h3>In this multicohort analysis and reanalysis of a randomised controlled trial, the primary objective was to derive and validate a categorical and continuous immune dysregulation score that is independent of clinical presentation or outcome. We measured 35 plasma biomarkers reflecting key host response domains in individuals with community-acquired pneumonia (CAP) across different care settings (emergency department, general ward, and intensive care unit) and disease severities using data from three independent cohorts. We applied unsupervised trajectory inference analysis to identify an immune dysregulation gradient captured as discrete immune dysregulation stages (Dysregulated Immune Profile [DIP]) and a continuous score (cDIP; 0–1). We developed two parsimonious machine-learning models to predict the DIP stages and cDIP scores based on 35 biomarkers, and validated their ability to capture immune dysregulation and predict clinical outcomes in five independent cohorts. On the basis of our hypothesis that only individuals with severe immune dysregulation benefit from immunomodulation, we carried out a post-hoc analysis of a randomised trial evaluating hydrocortisone in severe CAP (CAPE COD trial, <span><span>NCT02517489</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>), assessing treatment effects across DIP stages and the cDIP continuum, and how hydrocortisone influenced dysregulation trajectories over time.<h3>Findings</h3>We organised 398 participants with CAP along a continuum of immune dysregulation from mild to severe on the basis of 35 plasma biomarkers, yielding three dysregulation stages (DIP1–3) and a continuous score (cDIP). Clinical severity proved to be an inadequate proxy for immune dysregulation. A three-biomarker machine-learning framework (procalcitonin, soluble TREM-1, and IL-6) accurately predicted the degree of dysregulation derived from 35 biomarkers (DIP stage accuracy 91·2%; cDIP root mean square error 0·056). Although the framework was not designed for outcome prediction, increased immune dysregulation—reflected in DIP and cDIP—was associated with a gradual rise in mor","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"31 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147465943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology, ventilation, and outcomes of acute respiratory failure in immunocompromised patients from 103 intensive care units in 26 countries: a retrospective observational study","authors":"Elie Azoulay, Colleen McEvoy, Pedro Castro, Ali Ait Hssain, Fabio Silvio Taccone, Sheila N Myatra, Guillaume Dumas, Jan-Hendrik Naendrup, Gaston Burghi, Cristina Gutiérrez, Joseph Nates, Ricard Ferrer, Laurent Argaud, Raphaël Clere-Jehl, Damien Vimpere, Huiqing Ge, Anne-Sophie Moreau, Yaseen M Arabi, Maria Theodorakopoulou, Christina-Chrysanthi Theocharidou, Manuel Perez Torres","doi":"10.1016/s2213-2600(26)00046-9","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00046-9","url":null,"abstract":"<h3>Background</h3>Acute hypoxaemic respiratory failure (ARF) is the leading cause of intensive care unit (ICU) admission among immunocompromised patients. However, contemporary data regarding the epidemiology, management, and outcomes of ARF in this population remain scarce. We aimed to identify predictors of mortality and intubation in immunocompromised patients admitted to the ICU with ARF.<h3>Methods</h3>This retrospective observational study was conducted in 103 ICUs in 26 countries. Adults (≥18 years) with ARF and immunodeficiency were eligible for inclusion. Patient data, including information on the nature of underlying immunosuppression, the cause of ARF, and the oxygenation strategy, were obtained from electronic medical records or medical charts. The primary outcome was to report 30-day mortality and identify associated factors in patients with complete data for all variables. Cox proportional hazards models were used to identify variables associated with mortality, and differences between groups were compared with χ<sup>2</sup> tests or two-sided Wilcoxon rank-sum tests, with p values of less than 0·05 considered significant.<h3>Findings</h3>9854 immunocompromised patients with ARF admitted to participating ICUs between Jan 1, 2017, and Dec 31, 2023, were included in the study. The median age was 64 years (IQR 54–71); 3941 (40·0%) patients were female and 5913 (60·0%) were male. The main causes of immunodeficiency were a haematological malignancy (4759 [48·3%] of 9854 patients) or solid malignancy (3818 [38·7%] patients). Infection was the leading cause of ARF (6610 [62·0%] of 9854 patients); 5288 (53·7%) patients had more than one contributing cause of ARF, and no cause was identified in 1490 (15·1%) patients. The median partial pressure of oxygen in arterial blood (PaO<sub>2</sub>)/fractional concentration of oxygen in inspired air (FiO<sub>2</sub>) ratio was 198 [IQR 141–208]. The 30-day mortality rate was 47·3% (4662 patients). Predictors of higher mortality were older age (hazard ratio 1·01 [IQR 1·00–1·02]), higher Charlson Comorbidity Index score (1·04 [1·01–1·07]), higher Frailty Index score (1·22 [1·16–1·28]), longer time from hospital to ICU admission (1·02 [1·01–1·03]), higher respiratory rate (1·02 [1·02–1·03]), coma at ICU admission (2·04 [1·72–2·43]), invasive fungal infection as cause of ARF (1·82 [1·45–2·28]), disease-specific infiltrates (1·73 [1·32–2·26]), unidentified cause of ARF (2·16 [1·74–2·68]), and use of vasoactive drugs (2·45 [2·10–2·86]) or renal replacement therapy (2·07 [1·74–2·48]). Protective factors included receipt of a solid organ transplant (0·62 [0·49–0·79]), systemic vasculitis or connective tissue disease (0·61 (0·47–0·78]), higher PaO<sub>2</sub>/FiO<sub>2</sub> ratio (0·78 [0·72–0·84]), receipt of high-flow nasal oxygen therapy (0·78 [0·64–0·95]), and cardiogenic pulmonary oedema (0·67 [0·51–0·89]).<h3>Interpretation</h3>In this large international cohort of immunocompromised patients with ARF, ","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"44 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten unanswered questions about dipeptidyl peptidase-1 inhibition in bronchiectasis","authors":"Jiahui He, Chloe Hughes, Merete B Long, James D Chalmers","doi":"10.1016/s2213-2600(26)00077-9","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00077-9","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"53 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UK trials AI and robotics to detect lung cancer earlier","authors":"Priya Venkatesan","doi":"10.1016/s2213-2600(26)00085-8","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00085-8","url":null,"abstract":"","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"59 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When evidence is not enough: making videolaryngoscopy the default for tracheal intubation","authors":"Manuel Ángel Gómez-Ríos, André A J Van Zundert","doi":"10.1016/s2213-2600(26)00048-2","DOIUrl":"https://doi.org/10.1016/s2213-2600(26)00048-2","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"49 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}