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Respiration; International Review of Thoracic Diseases

Denise Mannée, Esther Vis, Aranka Hoekstra-Kuik, Jan van der Maten, Alex Jan van 't Hul, Hanneke van Helvoort
BACKGROUND: A simple technique to measure dynamic hyperinflation (DH) in patients with chronic obstructive pulmonary disease (COPD) is the metronome-paced tachypnea test (MPT). Earlier studies show conflicting results about the accuracy of the MPT compared to cardiopulmonary exercise testing (CPET). OBJECTIVES: The focus was to investigate the diagnostic accuracy of MPT to detect DH in a prospective and clinical study. METHODS: COPD patients were included; all underwent spirometry, CPET, and MPT...
March 14, 2019: Respiration; International Review of Thoracic Diseases
Felix J F Herth, Dirk-Jan Slebos, Gerard J Criner, Arschang Valipour, Frank Sciurba, Pallav L Shah
Endoscopic lung volume reduction (ELVR) therapies are gaining prominence as a treatment option with guideline recommendations by COPD GOLD and NICE and the recent FDA approval for endobronchial valves. The transition from an experiment-based therapy only to clinical care comes with new challenges. A significant volume of evidence-based data has been published; all data demonstrate consistent improvements in several aspects of patient outcomes. Patients suffering from severe air trapping and thoracic hyperinflation seem to benefit the most from ELVR...
March 5, 2019: Respiration; International Review of Thoracic Diseases
Pierre-Alexis Lépine, Rajesh Thomas, Sébastien Nguyen, Yves Lacasse, Hui Min Cheah, Jenette Creaney, Sanjeevan Muruganandan, Simon Martel, Y C Gary Lee, Antoine Delage
BACKGROUND: An important part of the investigation of pleural effusion is the identification of markers that help separate exudate from transudate. OBJECTIVES: The purposes of this study were to compare the accuracy of published and new sets of criteria to distinguish between exudative and transudative pleural effusions, and to determine whether serum biochemical analysis is necessary. METHODS: An externally validated cohort study was performed...
March 1, 2019: Respiration; International Review of Thoracic Diseases
Xiaoxuan Zheng, Chi Yang, Xueyan Zhang, Haibin Yuan, Fangfang Xie, Ying Li, Baikai Xu, Felix J F Herth, Jiayuan Sun
BACKGROUND: Percutaneous cryoablation has been used for the treatment of lung cancer and has been shown to be safe and effective. However, some lung cancer lesions cannot be reached by percutaneous puncture; using bronchoscopy cryoablation is necessary in these cases. PURPOSES: To examine the efficiency and security of a flexible cryoprobe, we measured the size and temperature distribution of the frozen area (ice ball) in ex vivo pig lung and liver and the temperature of the bronchoscope...
February 21, 2019: Respiration; International Review of Thoracic Diseases
Labib Debiane, Ruth Reitzel, Joel Rosenblatt, Mihai Gagea, Miguel A Chavez, Roberto Adachi, Horiana B Grosu, Ajay Sheshadri, Lori R Hill, Issam Raad, David E Ost
BACKGROUND: Granulation tissue is a common complication of airway stenting, but no published methods can quantify the volume and type of tissue that develops. OBJECTIVE: To use design-based stereology to quantify changes in tissue volume and type associated with airway stenting. METHODS: We compared drug-eluting stents (DES) filled with gendine to standard silicone stents in pigs in an assessor-blinded randomized trial. Tracheal stents were placed via rigid bronchoscopy...
February 20, 2019: Respiration; International Review of Thoracic Diseases
Jochen D Schipke, Frederic Lemaitre, Sinclair Cleveland, Kay Tetzlaff
This short review focuses on pulmonary injury in breath-hold (BH) divers. When practicing their extreme leisure sport, they are exposed to increased pressure on pulmonary gas volumes, hypoxia, and increased partial gas pressures. Increasing ambient pressures do present a serious problem to BH deep divers, because the semi-rigid thorax prevents the deformation required by the Boyle-Mariotte law. As a result, a negative-pressure barotrauma (lung squeeze) with acute hemoptysis is not uncommon. Respiratory maneuvers such as glossopharyngeal insufflation (GI) and glossopharyngeal exsufflation (GE) are practiced to prevent lung squeeze and to permit equalizing the paranasal sinuses and the middle ear...
February 15, 2019: Respiration; International Review of Thoracic Diseases
David Fielding, Andrew J Dalley, Farzad Bashirzadeh, Mahendra Singh, Lakshmy Nandakumar, Amy E McCart Reed, Debra Black, Stephen Kazakoff, John V Pearson, Katia Nones, Nicola Waddell, Sunil R Lakhani, Peter T Simpson
BACKGROUND: Next-generation sequencing (NGS) in lung cancer specimens from endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is usually performed on formalin-fixed paraffin-embedded cell block material. OBJECTIVES: Since DNA can be damaged by this process, we investigated the potential of using DNA extracted from Diff-Quik cytology smears made for rapid on-site evaluation during EBUS-TBNA. METHODS: In a prospective study, 67 patients undergoing diagnostic EBUS-TBNA were ana-lysed...
February 7, 2019: Respiration; International Review of Thoracic Diseases
Claudia Crimi, Paola Pierucci, Annalisa Carlucci, Andrea Cortegiani, Cesare Gregoretti
BACKGROUND: Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. SUMMARY: NIV should be used early in the course of respiratory muscle involvement in NMD patients and its requirements may increase over time. Therefore, training on technical equipment at home and advice on problem solving are warranted. Remote monitoring of ventilator parameters using built-in ventilator software is recommended...
January 24, 2019: Respiration; International Review of Thoracic Diseases
Renaud Tamisier, Victor Bocquillon, Erika Treptow, Marie Destors, Muriel Salvat, Elisabeth Borrel, Jean Louis Pépin
BACKGROUND: Despite clinical optimization, many chronic heart failure (CHF) patients remain symptomatic with dyspnea and poor quality of life. STUDY OBJECTIVE: While oxygen therapy is prescribed in severe cases, the actual prevalence of different patterns of hypoxemia is unknown. METHODS: We analyzed 183 stable CHF patients with optimized medical treatment in the "MARS" database. The patients underwent cardiorespiratory sleep recording and complete daytime pulmonary function tests including arterial blood gases...
January 17, 2019: Respiration; International Review of Thoracic Diseases
Jean-Paul Janssens, Catherine Weber, François R Herrmann, Chloé Cantero, Aline Pessina, Caroline Matis, Roselyne Merlet Viollet, Ludivine Boiche-Brouillard, Jerôme Stirnemann, Sophie Pautex
BACKGROUND: Despite their poor prognosis, patients with severe chronic obstructive pulmonary disease (COPD) have little access to palliative care and tend to have a high rate of hospital and intensive care unit (ICU) admissions during their last year of life. OBJECTIVES: To determine the feasibility of a home palliative care intervention during 1 year versus usual care, and the possible impact of this intervention on emergency, hospital and ICU admissions, survival, mood, and health-related quality of life (HRQL)...
January 16, 2019: Respiration; International Review of Thoracic Diseases
Alexander Kogan, Michael J Segel, Eilon Ram, Ehud Raanani, Yael Peled-Potashnik, Shany Levin, Leonid Sternik
BACKGROUND: Lung injury with development of the acute respiratory distress syndrome (ARDS) is a serious complication which can occur after major surgery, including cardiac surgery. OBJECTIVE: The aim of our study was to compare the prevalence, risk factors, and mortality of ARDS following cardiac surgery according to the American-European Consensus Conference (AECC) definition and the new Berlin definition of ARDS. METHODS: We performed a retrospective, observational study that included prospectively collected data from consecutive adult patients, aged from 18 to 92 years, who had undergone cardiac surgery (both on and off pump) at a large tertiary university hospital over 5 years (from September 2012 to September 2017)...
January 16, 2019: Respiration; International Review of Thoracic Diseases
Hyewon Seo, Seung-Ick Cha, Kyung-Min Shin, Jae-Kwang Lim, Seung-Soo Yoo, Shin-Yup Lee, Jaehee Lee, Chang-Ho Kim, Jae-Yong Park
BACKGROUND: Data regarding community-acquired pneumonia (CAP) identified on chest computed tomography (CT) but not on chest radiography (CR) are limited. OBJECTIVES: The present study aimed to investigate the clinical and radiological features of these patients. METHODS: We retrospectively compared the clinical characteristics, etiological agents, treatment outcomes, and CT findings between CAP patients with negative CR and positive CT findings (negative CR group) and those with positive CR as well as CT findings (control group)...
January 9, 2019: Respiration; International Review of Thoracic Diseases
Kasper Møller Boje Rasmussen, Peter Hertz, Christian B Laursen, Arman Arshad, Zaigham Saghir, Paul Frost Clementsen, Lars Konge
BACKGROUND: Trocar pigtail catheter thoracentesis (TPCT) is a common procedure often performed by junior physicians. Simulation-based training may effectively train physicians in the procedure prior to performing it on patients. An assessment tool with solid validity evidence is necessary to ensure sufficient procedural competence. OBJECTIVES: Our study objectives were (1) to collect evidence of validity for a newly developed pigtail catheter assessment tool (Thoracentesis Assessment Tool [ThorAT]) developed for the evaluation of TPCT performance and (2) to establish a pass/fail score for summative assessment...
January 9, 2019: Respiration; International Review of Thoracic Diseases
Núria Bruguera-Àvila, Ignasi Garcia-Olive, Alicia Marin, Cristina Prat, Alicia Lacoma, Montserrat Gil, Jorge Abad Capa
BACKGROUND: Inhaled antibiotics allow the delivery of higher drug concentrations at the site of infection without the systemic adverse effects observed with the use of parenteral or oral antibiotics. These antibiotics have shown to decrease the number of exacerbations, reduce bacterial load or improve pulmonary function in several chronic respiratory conditions. OBJECTIVES: The aim of this study was to describe changes in the bacteriology of sputum in patients with chronic bronchial infection with Pseudomonas aeruginosa treated with nebulised colistin...
January 3, 2019: Respiration; International Review of Thoracic Diseases
Heather E Elphick, Abdulkadir Hamidu Alkali, Ruth K Kingshott, Derek Burke, Reza Saatchi
BACKGROUND: Respiratory rate is a vital physiological measurement used in the immediate assessment of unwell children and adults. Convenient electronic devices exist for the measurement of pulse, blood pressure, oxygen saturation, and temperature. Although devices which measure respiratory rate exist, none have entered everyday clinical practice for acute assessment of children and adults. An accurate and practical device which has no physical contact with the patient is important to ensure readings are not affected by distress caused by the assessment method...
January 3, 2019: Respiration; International Review of Thoracic Diseases
Marta Diez-Ferrer, Arturo Morales, Cristian Tebé, Noelia Cubero, Rosa López-Lisbona, Susana Padrones, Samantha Aso, Jordi Dorca, Debora Gil, Antoni Rosell
BACKGROUND: Bronchoscopy is a safe technique for diagnosing peripheral pulmonary lesions (PPLs), and virtual bronchoscopic navigation (VBN) helps guide the bronchoscope to PPLs. OBJECTIVES: We aimed to compare the diagnostic yield of VBN-guided and unguided ultrathin bronchoscopy (UTB) and explore clinical and technical factors associated with better results. We developed a diagnostic algorithm for deciding whether to use VBN to reach PPLs or choose an alternative diagnostic approach...
December 21, 2018: Respiration; International Review of Thoracic Diseases
Elisabeth Bendstrup, Wim Wuyts, Tiago Alfaro, Nazia Chaudhuri, Robin Cornelissen, Michael Kreuter, Kirsten Melgaard Nielsen, Anna-Marie B Münster, Marjukka Myllärniemi, Claudia Ravaglia, Tim Vanuytsel, Marlies Wijsenbeek
Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with a dismal survival rate of only 3 years and no curative pharmacological therapy. The recent approval of 2 anti-fibrotic drugs (nintedanib and pirfenidone) that slow disease progression has provided some hope for patients. However, effectively managing anti-fibrotic treatment can be a challenge due to tolerability issues, the presence of pulmonary and extra-pulmonary comorbidities, and the need for concomitant medications in many patients. In general, making clear evidence-based decisions can be difficult for physicians because patients with comorbidities are often excluded from clinical trials...
2019: Respiration; International Review of Thoracic Diseases
Dan Adler, Jean-Paul Janssens
The purpose of this review is to provide an overview on how interactions between control of breathing, respiratory load, and muscle function may lead to respiratory failure. The mechanisms involved vary according to the underlying pathology, but respiratory failure is most often the result of an imbalance between the muscular pump and the mechanical load placed upon it. Changes in respiratory drive and response to CO2 seem to be important contributors to the pathophysiology of respiratory failure. Inspiratory muscle dysfunction is also frequent but is not a mandatory prerequisite to respiratory failure since increased load may also be sufficient to precipitate it...
2019: Respiration; International Review of Thoracic Diseases
Yiming Zeng, Hong-Zhi Gao, Xiao-Bin Zhang, Hui-Huang Lin
Closure of bronchopleural fistula remains a difficult challenge for clinicians. Although several therapeutic approaches have been proposed, the clinical results are commonly unsatisfactory. Previous reports have indicated that autologous mesenchymal stem cells (MSCs) are useful for aiding treatment of bronchopleural fistula. We report here the use of umbilical cord MSCs to effect the successful closure of a bronchopleural fistula (5 mm) in a 33-year-old woman 6 months after a lobectomy. A review of the relevant literature is included...
2019: Respiration; International Review of Thoracic Diseases
Roel L J Verhoeven, Chris L de Korte, Erik H F M van der Heijden
BACKGROUND: In lung cancer staging, mediastinal lymph nodes are currently aspirated using endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) based on size and FDG-PET avidity. EBUS strain elastography (SE) is a new technique that may help predict the presence of malignancy. However, a standardized assessment strategy for EBUS-SE measurement is lacking. OBJECTIVES: The aim of this study was to determine the optimal assessment strategy for investigating the predictive value of EBUS-SE in mediastinal lymph nodes...
December 14, 2018: Respiration; International Review of Thoracic Diseases
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