{"title":"Reaching Deeper into Remission in Severe Asthma: Broadening the Lens Beyond Type 2 Inflammation.","authors":"Yen-Fu Chen,Jung-Yien Chien,Hao-Chien Wang,Chong-Jen Yu","doi":"10.1164/rccm.202507-1654le","DOIUrl":"https://doi.org/10.1164/rccm.202507-1654le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"101 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339141","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202506-1440le
Zhican Liu,Lingling Zhang,Mingyan Jiang
{"title":"Considerations on Stratified Analysis and Biomarker Use in CAD Detection in COPD.","authors":"Zhican Liu,Lingling Zhang,Mingyan Jiang","doi":"10.1164/rccm.202506-1440le","DOIUrl":"https://doi.org/10.1164/rccm.202506-1440le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"160 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339074","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202508-1873le
Erik H A Michels,Hessel Peters-Sengers,Tom van der Poll
{"title":"Reply to Feng et al.: Potential Pitfalls in Proteomic Risk Assessment for Community-acquired Pneumonia.","authors":"Erik H A Michels,Hessel Peters-Sengers,Tom van der Poll","doi":"10.1164/rccm.202508-1873le","DOIUrl":"https://doi.org/10.1164/rccm.202508-1873le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"39 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338833","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202508-2055st
Reshma Amin,Amit Agarwal,Jackie Chiang,Joseph M Collaco,A Ioana Cristea,Evan L Propst,Sarah A Sobotka,Karthik Balakrishnan,Dan Benscoter,Michael J Brenner,Maria L Castro-Codesal,Milenka Cuevas Guaman,Cori L Daines,Jessica A Dawson,Jeffrey D Edwards,Robert J Graham,Jennifer K Henningfeld,Nadia E Hoekstra,Arwen J Jackson,Romaine F Johnson,Karen Kam,Sheila S Kun,Natalie Napolitano,Alvaro Pacheco,Howard B Panitch,Jeremy D Prager,Jenny Y Shi,Marlene Soma,Aaron St-Laurent,Faiza Syed,Karen F Watters,David Zielinski,An Thi Nhat Ho,Ravi Kanth Velagapudi,Fatima Zeba,Shandra L Knight,Narayan Iyer,Christopher D Baker
BACKGROUNDThe increase in tracheostomies among infants and children, driven by medical advances and evolving family preferences, underscores the need for standardized, evidence-based guidelines. This guideline outlines management recommendations for these medically complex and resource-intensive children with tracheostomies, incorporating best evidence on diagnostic tools and streamlined care protocols.METHODSThis Clinical Practice Guideline adheres to American Thoracic Society policies and procedures, utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to form clinical questions, summarize evidence, and develop recommendations with a health equity perspective. A multidisciplinary panel with expertise in pediatric tracheostomy care contributed to recommendations for ethical considerations, discharge processes, in-home caregiver requirements, and diagnostic tools (tracheal aspirate cultures, bronchoscopy, and polysomnography).RESULTSThe panel recommends applying ethical principles to guide shared decision-making about tracheostomy placement (strong recommendation). We also recommend a standardized discharge process involving comprehensive family caregiver training for safe transitions from hospital-to-home (conditional recommendation). A continuously awake, trained caregiver to manage emergencies is also recommended for high-risk patients (strong recommendation). The panel recommends tracheal aspirate cultures during acute respiratory episodes to guide antibiotic therapy, but not for routine surveillance (conditional recommendation), bronchoscopy for thorough airway examination before tracheostomy decannulation (strong recommendation), and polysomnography before decannulation to ensure respiratory stability (conditional recommendation).CONCLUSIONSThese guidelines aim to standardize and improve the management of pediatric patients with tracheostomies by providing evidence-based recommendations for ethical considerations, discharge planning, and diagnostic assessments. Implementing these guidelines aims to enhance patient safety and quality of life through a structured and patient-centered approach.
{"title":"Care of Infants and Children with Tracheostomies. An Official American Thoracic Society Clinical Practice Guideline.","authors":"Reshma Amin,Amit Agarwal,Jackie Chiang,Joseph M Collaco,A Ioana Cristea,Evan L Propst,Sarah A Sobotka,Karthik Balakrishnan,Dan Benscoter,Michael J Brenner,Maria L Castro-Codesal,Milenka Cuevas Guaman,Cori L Daines,Jessica A Dawson,Jeffrey D Edwards,Robert J Graham,Jennifer K Henningfeld,Nadia E Hoekstra,Arwen J Jackson,Romaine F Johnson,Karen Kam,Sheila S Kun,Natalie Napolitano,Alvaro Pacheco,Howard B Panitch,Jeremy D Prager,Jenny Y Shi,Marlene Soma,Aaron St-Laurent,Faiza Syed,Karen F Watters,David Zielinski,An Thi Nhat Ho,Ravi Kanth Velagapudi,Fatima Zeba,Shandra L Knight,Narayan Iyer,Christopher D Baker","doi":"10.1164/rccm.202508-2055st","DOIUrl":"https://doi.org/10.1164/rccm.202508-2055st","url":null,"abstract":"BACKGROUNDThe increase in tracheostomies among infants and children, driven by medical advances and evolving family preferences, underscores the need for standardized, evidence-based guidelines. This guideline outlines management recommendations for these medically complex and resource-intensive children with tracheostomies, incorporating best evidence on diagnostic tools and streamlined care protocols.METHODSThis Clinical Practice Guideline adheres to American Thoracic Society policies and procedures, utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to form clinical questions, summarize evidence, and develop recommendations with a health equity perspective. A multidisciplinary panel with expertise in pediatric tracheostomy care contributed to recommendations for ethical considerations, discharge processes, in-home caregiver requirements, and diagnostic tools (tracheal aspirate cultures, bronchoscopy, and polysomnography).RESULTSThe panel recommends applying ethical principles to guide shared decision-making about tracheostomy placement (strong recommendation). We also recommend a standardized discharge process involving comprehensive family caregiver training for safe transitions from hospital-to-home (conditional recommendation). A continuously awake, trained caregiver to manage emergencies is also recommended for high-risk patients (strong recommendation). The panel recommends tracheal aspirate cultures during acute respiratory episodes to guide antibiotic therapy, but not for routine surveillance (conditional recommendation), bronchoscopy for thorough airway examination before tracheostomy decannulation (strong recommendation), and polysomnography before decannulation to ensure respiratory stability (conditional recommendation).CONCLUSIONSThese guidelines aim to standardize and improve the management of pediatric patients with tracheostomies by providing evidence-based recommendations for ethical considerations, discharge planning, and diagnostic assessments. Implementing these guidelines aims to enhance patient safety and quality of life through a structured and patient-centered approach.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"129 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338836","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202508-1911ed
Melinda L Jackson,Ivana Rosenzweig
{"title":"Perivascular Dynamics, Sleep Apnoea, and Memory: Interpreting a Moving Target.","authors":"Melinda L Jackson,Ivana Rosenzweig","doi":"10.1164/rccm.202508-1911ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-1911ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"1 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338843","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202508-2000ed
Franz P Rischard,Anna R Hemnes
{"title":"Inflammation, Obesity, and Outcomes in Pulmonary Arterial Hypertension: Toward Precision-driven Care.","authors":"Franz P Rischard,Anna R Hemnes","doi":"10.1164/rccm.202508-2000ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-2000ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"2 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338827","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202507-1748le
Xujun Feng,Jiadi Gan,Yuan Shi,Lingling Cao
{"title":"Potential Pitfalls in Proteomic Risk Assessment for Community-acquired Pneumonia.","authors":"Xujun Feng,Jiadi Gan,Yuan Shi,Lingling Cao","doi":"10.1164/rccm.202507-1748le","DOIUrl":"https://doi.org/10.1164/rccm.202507-1748le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"17 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338832","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202508-1925ed
Duncan J Stewart,Dean Fergusson
{"title":"MSC Therapy for ARDS: End of the Line or a Bump in the Road?","authors":"Duncan J Stewart,Dean Fergusson","doi":"10.1164/rccm.202508-1925ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-1925ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"44 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338829","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202507-1814ed
Lise Piquilloud,Alexandre Demoule
{"title":"P-SILI and the Dangers of the Transition Phase.","authors":"Lise Piquilloud,Alexandre Demoule","doi":"10.1164/rccm.202507-1814ed","DOIUrl":"https://doi.org/10.1164/rccm.202507-1814ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"139 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338835","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}
Pub Date : 2025-10-22DOI: 10.1164/rccm.202507-1661le
Mairi A MacLeod,Kristopher D Knott,Edward D Nicol,Jadwiga A Wedzicha
{"title":"Reply to Liu et al.: Considerations on Stratified Analysis and Biomarker Use in CAD Detection in COPD.","authors":"Mairi A MacLeod,Kristopher D Knott,Edward D Nicol,Jadwiga A Wedzicha","doi":"10.1164/rccm.202507-1661le","DOIUrl":"https://doi.org/10.1164/rccm.202507-1661le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"51 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145339073","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}
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