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JOURNAL ARTICLE
Cristiana de Luca, Emanuela Gallo, Gabriella Tripepi, Ornella Leone
Lower respiratory tract infections (LRTI) are still burdened by considerable morbidity and mortality. Rapid and appropriate treatment imply knowledge of the underlying causative pathogen; while it is tempting to offer broad spectrum antibiotics, Antimicrobial Stewardship Practices invite a judicious use of the latter, especially when bacteria are not the cause. However, the epidemiology shifts to multidrug resistant (MDR) pathogens that require optimization of molecules in order to provide optimal treatment...
May 2024: New Microbiologica
#22
REVIEW
Kamini Jain, Claire E Wainwright, Alan R Smyth
BACKGROUND: Early diagnosis and treatment of lower respiratory tract infections is the mainstay of management of lung disease in cystic fibrosis (CF). When sputum samples are unavailable, diagnosis relies mainly on cultures from oropharyngeal specimens; however, there are concerns about whether this approach is sensitive enough to identify lower respiratory organisms. Bronchoscopy and related procedures such as bronchoalveolar lavage (BAL) are invasive but allow the collection of lower respiratory specimens from non-sputum producers...
May 3, 2024: Cochrane Database of Systematic Reviews
#23
JOURNAL ARTICLE
Thomas Leahy, Aneesha Chauhan, Victoria Nicholas, Pooja Patel, Alfred Wright, Samuel Miller, Geoff Ball, Christopher Remmington, Suveer Singh
Background and objective High-dose intravenous pulsed glucocorticosteroids (GCS) are not part of the standard treatment in acute respiratory distress syndrome (ARDS), and the evidence supporting their use is conflicting. In clinical practice, however, they are used in specialist settings when clinico-patho-radiological features suggest a potentially steroid-responsive pattern, or as a last resort in cases where patients are unable to be weaned off mechanical ventilation. This study aimed to investigate if an early objective response to high-dose GCS treatment in selected critically ill patients is predictive of survival in ARDS...
April 2024: Curēus
#24
JOURNAL ARTICLE
Irene Yuniar, Antonius Hocky Pudjiadi, Rismala Dewi, Yogi Prawira, Niken Wahyu Puspaningtyas, Tartila Tartila, Sharfina Fulki
BACKGROUND: High-flow nasal cannula (HFNC) is often used in pediatric populations with respiratory distress. In adults, the respiratory-rate oxygenation (ROX) index is used as a predictor of HFNC therapy; however, children have age-associated differences in respiratory rate, thus may not be applicable to children. This study aims to find the reliability of ROX index and modified P-ROX index as predictors of HFNC therapy failure in pediatric patients. METHODS: Subjects in this analytical cross-sectional study were taken from January 2023 until November 2023 in Cipto Mangunkusumo Hospital...
May 2, 2024: BMC Pulmonary Medicine
#25
RANDOMIZED CONTROLLED TRIAL
Keir E J Philip, Sara C Buttery, Sarah Bowen, Adam Lewis, Edmund Jeffery, Saeed M Alghamdi, Parris Williams, Ali M Alasmari, Abdullah S Alsulayyim, Christopher M Orton, Francesca Conway, Ley Chan, Bavithra Vijayakumar, Anand Tana, James Tonkin, Alexis Perkins, Justin L Garner, Karthikan Srikanthan, Ahmed Sadaka, Matthew J Pavitt, Winston Banya, Adam Lound, Sarah Elkin, Michael I Polkey, William D-C Man, Keir Lewis, Phoene Cave, Daisy Fancourt, Nicholas S Hopkinson
BACKGROUND: Singing for lung health (SLH) is an arts-based breathing control and movement intervention for people with long-term respiratory conditions, intended to improve symptoms and quality of life. Online, remotely delivered programmes might improve accessibility; however, no previous studies have assessed the effectiveness of this approach. METHODS: We conducted an assessor-blind randomised controlled trial comparing the impact of 12 weeks of once-weekly online SLH sessions against usual care on health-related quality of life, assessed using the RAND 36-Item Short Form Health Survey (SF-36) Mental Health Composite (MHC) and Physical Health Composite (PHC) scores...
May 2, 2024: BMJ Open Respiratory Research
#26
JOURNAL ARTICLE
Julian Theuriet, Marion Masingue, Anthony Behin, Ana Ferreiro, Guillaume Bassez, Pauline Jaubert, Oriana Tarabay, Frédéric Fer, Antoine Pegat, Françoise Bouhour, Juliette Svahn, Philippe Petiot, Laurentiu Jomir, Guy Chauplannaz, Catherine Cornut-Chauvinc, Véronique Manel, Emmanuelle Salort-Campana, Shahram Attarian, Etienne Fortanier, Annie Verschueren, Ludivine Kouton, Jean-Philippe Camdessanché, Céline Tard, Armelle Magot, Yann Péréon, Jean-Baptiste Noury, Marie-Christine Minot-Myhie, Maud Perie, Frederic Taithe, Yacine Farhat, Anne-Laure Millet, Pascal Cintas, Guilhem Solé, Marco Spinazzi, Florence Esselin, Dimitri Renard, Sabrina Sacconi, Andra Ezaru, Edoardo Malfatti, Martial Mallaret, Laurent Magy, Eva Diab, Philippe Merle, Maud Michaud, Maxime Fournier, Aleksandra Nadaj Pakleza, Jean-Baptiste Chanson, Claire Lefeuvre, Pascal Laforet, Pascale Richard, Damien Sternberg, Rocio-Nur Villar-Quiles, Tanya Stojkovic, Bruno Eymard
Congenital myasthenic syndromes (CMS) are clinically and genetically heterogeneous diseases caused by mutations affecting neuromuscular transmission. Even if the first symptoms mainly occur during childhood, adult neurologists must confront this challenging diagnosis and manage these patients throughout their adulthood. However, long-term follow-up data from large cohorts of CMS patients are lacking and the long-term prognosis of these patients is largely unknown. We report the clinical features, diagnostic difficulties, and long-term prognosis of a French nationwide cohort of 235 adult patients with genetically confirmed CMS followed in 23 specialized neuromuscular centres...
May 2, 2024: Brain
#27
Alicia Mastrocco, Jennifer Prittie, Ann Marie Zollo
OBJECTIVE: To describe the successful conservative management of chemical pneumonitis and presumed acute respiratory distress syndrome in a cat secondary to inadvertent pulmonary polyethylene glycol-electrolyte solution (PEG-ELS) instillation. CASE SUMMARY: PEG-ELS is commonly used in small animals for bowel cleansing and to treat constipation. There have been several instances of aspiration or accidental instillation of this solution into the lungs of both people and dogs...
May 2, 2024: Journal of Veterinary Emergency and Critical Care
#28
Mohammad Milhem, Daleen Shehadeh, Yasmeen Abu Nawa, Roa Arman, Lara Masri, Zeena Salman, Mohammad Najajreh
INTRODUCTION AND IMPORTANCE: Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder impacting multiple organs. Characterized by renal dysfunction, retinal dystrophy, obesity, polydactyly, intellectual disability, and hypogonadism, it lacks targeted treatment. Diagnosis relies on clinical criteria, and management emphasizes early detection, complication screening, and genetic counselling. CASE PRESENTATION: A 4-year-old boy, born to first-cousin parents, presented with refractory iron-deficiency anaemia (IDA) and recurrent respiratory infections...
May 2024: Annals of Medicine and Surgery
#29
JOURNAL ARTICLE
Sarah Damery, Janet Jones, Elfatih Idris, Angela Cooper, Holly Minshall, Chris Clowes, Kate Jolly
Biologic treatments can alleviate severe asthma symptoms and reduce health service use. However, service capacity limits and low referral rates from primary care indicate unmet patient need. We report a mixed-methods evaluation of an enhanced severe asthma pathway implemented in Staffordshire and Stoke-on-Trent, UK which aimed to optimise primary care referrals through training/education, and increased capacity in specialist clinics. Quantitative analysis assessed patient wait times between pathway stages, prescribing changes, exacerbations, hospital admissions and asthma control...
May 1, 2024: NPJ Primary Care Respiratory Medicine
#30
MULTICENTER STUDY
Panagis Galiatsatos, Brian Garibaldi, Dapeng Yao, Yanxun Xu, Jamie Perin, Andi Shahu, John W Jackson, Damani Piggott, Oluwaseun Falade-Nwulia, Jocelyn Shubella, Henry Michtalik, Harolyn M E Belcher, Nadia N Hansel, Sherita Golden
INTRODUCTION: In the USA, minoritised communities (racial and ethnic) have suffered disproportionately from COVID-19 compared with non-Hispanic white communities. In a large cohort of patients hospitalised for COVID-19 in a healthcare system spanning five adult hospitals, we analysed outcomes of patients based on race and ethnicity. METHODS: This was a retrospective cohort analysis of patients 18 years or older admitted to five hospitals in the mid-Atlantic area between 4 March 2020 and 27 May 2022 with confirmed COVID-19...
May 1, 2024: BMJ Open Respiratory Research
#31
JOURNAL ARTICLE
Nikita Simms-Williams, Prasad Nagakumar, Rasiah Thayakaran, Nicola J Adderley, Richard Hotham, Adel H Mansur, Krishnarajah Nirantharakumar, Shamil Haroon
BACKGROUND: Asthma remains a common cause of hospital admissions across the life course. We estimated the contribution of key risk factors to asthma-related hospital and intensive care unit (ICU) admissions in children, adolescents and adults. METHODS: This was a UK-based cohort study using linked primary care (Clinical Practice Research Datalink Aurum) and secondary care (Hospital Episode Statistics Admitted Patient Care) data. Patients were eligible if they were aged 5 years and older and had been diagnosed with asthma...
May 1, 2024: BMJ Open Respiratory Research
#32
JOURNAL ARTICLE
Amanda K Johnson, Sinziana Cornea, Samuel Goldfarb, Qing Cao, Julia A Heneghan, Ashish O Gupta
Hematopoietic cell transplant (HCT) is a curative treatment for multiple malignant and non-malignant disorders. While morbidity and mortality have decreased significantly over the years, some patients still require management in the pediatric intensive care unit (PICU) during their HCT course for additional respiratory, cardiovascular, and/or renal support. We retrospectively reviewed pediatric patients (0-18 years) who underwent HCT from January 2015-December 2020 at our institution to determine risk factors for PICU care and evaluate PICU utilization and outcomes...
2024: Frontiers in Pediatrics
#33
JOURNAL ARTICLE
Amanda Grant-Orser, Charlotte Pooler, Nathan Archibald, Charlene Fell, Giovanni Ferrara, Kerri A Johannson, Meena Kalluri
OBJECTIVES: The diagnostic process for patients with interstitial lung diseases (ILD) remains complex. The aim of this study was to characterise the diagnostic care pathway and identify barriers and potential solutions to access a timely and accurate ILD diagnosis. DESIGN: This mixed-method study was comprised of a quantitative chart review, patient and physician surveys and focus groups. RESULTS: Chart review was completed for 97 patients...
April 30, 2024: BMJ Open Respiratory Research
#34
MULTICENTER STUDY
Boris Lacarra, Aurélie Hayotte, Jérôme Naudin, Arielle Maroni, Guillaume Geslain, Géraldine Poncelet, Michael Levy, Matthieu Resche-Rigon, Stéphane Dauger
INTRODUCTION: In children, respiratory distress due to upper airway obstruction (UAO) is a common complication of extubation. The quantitative cuff-leak test (qtCLT) is a simple, rapid and non-invasive test that has not been extensively studied in children. The objective of the ongoing study whose protocol is reported here is to investigate how well the qtCLT predicts UAO-related postextubation respiratory distress in paediatric intensive care unit (PICU) patients. METHODS AND ANALYSIS: Air Leak Test in the Paediatric Intensive Care Unit is a multicentre, prospective, observational study that will recruit 900 patients who are aged 2 days post-term to 17 years and ventilated through a cuffed endotracheal tube for at least 24 hours in any of 19 French PICUs...
April 30, 2024: BMJ Open
#35
JOURNAL ARTICLE
Chen Yun Goh, Herng Lee Tan, Yi-Jyun Ma, Apollo Bugarin Aguilan, Wen Cong Lee, Anuradha P Menon, Yee Hui Mok, Judith Ju-Ming Wong
BACKGROUND: A protocolized extubation readiness test (ERT), including a spontaneous breathing trial (SBT), is recommended for patients who are intubated. This quality-improvement project aimed to improve peri-extubation outcomes by using a high-risk ERT protocol in intubated cardiac patients in addition to a standard-risk protocol. METHODS: After baseline data collection, we implemented a standard-risk ERT protocol (pressure support plus PEEP), followed by a high-risk ERT protocol (PEEP alone) in cardiac subjects who were intubated...
April 30, 2024: Respiratory Care
#36
JOURNAL ARTICLE
Chris Garvey
Pulmonary rehabilitation (PR) is a highly effective intervention for persons with chronic respiratory diseases, resulting in improvement in exercise capacity, dyspnea, health-related quality of life, mood, reduced hospitalization, and improved survival and cost savings post-COPD hospitalization. Despite demonstrated effectiveness, PR is underutilized in part due to lack of awareness, limited access, and inadequate PR reimbursement. Poor payment is a long-standing barrier to PR's financial stability and access...
April 30, 2024: Respiratory Care
#37
JOURNAL ARTICLE
Abebaw Mengistu Yohannes
Pulmonary rehabilitation (PR) improves exercise capacity and quality of life (QOL) while reducing dyspnea in patients with COPD. However, little is known about the efficacy of PR, cognitive behavioral therapy (CBT), or antidepressant drug therapy on psychosocial factors in patients with COPD. Knowledge gaps include which therapy is most efficacious, what barriers exist for each treatment, and the optimal duration of each intervention. Potential barriers to antidepressant therapy include patient fears of potential adverse effects, apprehension and misconception, and stigma related to depression...
April 30, 2024: Respiratory Care
#38
REVIEW
Bruna M F Silveira, Hugo L A Pereira, Gabriela Chaves, Daniel G C Ho, Verônica F Parreira
BACKGROUND: Maximal respiratory pressure is used to assess the inspiratory and expiratory muscles strength by using maximal inspiratory pressure (PImax ) and maximal expiratory pressure (PEmax ). This study aimed to summarize and evaluate the reliability and validity of maximal respiratory pressure measurements. METHODS: This systematic review followed the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations and was reported by using the PRISMA checklist...
April 30, 2024: Respiratory Care
#39
JOURNAL ARTICLE
Vaishali Mehta, Najia Sayedy, Joshua Fogel, Eric Lam, Pratap Upadrista, Bruno Okoro, Hira Tahir, Jagadish Akella
BACKGROUND: Inhaler education for patients with asthma and patients with COPD is typically provided by non-pulmonologists. We studied inhaler education by pulmonologists to determine changes in clinical outcomes and inhaler use. METHODS: This was a retrospective study of 296 subjects diagnosed with asthma, COPD, or both that evaluated use of inhaler technique education and its impact on (1) inhaler/dosage change consisting of dosage change in the same class of inhaler and/or change in number of inhalers, (2) forced expiratory volume in one second/forced vital capacity (FEV1 /FVC%), (3) disease symptom control, (4) out-patient visits, (5) urgent care visits (6) emergency department visits, and (7) hospital admissions...
April 30, 2024: Respiratory Care
#40
JOURNAL ARTICLE
Joshua M Justice, Arthur S Slutsky, Nathan Stanford, Christopher Isennock, Sameer Siddiqui, Hamza Zamir, J Richard Walker, Mark F Brady
BACKGROUND: The bag-valve-mask (BVM) or manual resuscitator bag is used as a first-line technique to ventilate patients with respiratory failure. Volume-restricted manual resuscitator bags (eg, pediatric bags) have been suggested to minimize overventilation and associated complications. There are studies that both support and caution against the use of a pediatric resuscitator bag to ventilate an adult patient. In this study, we evaluated the ability of pre-hospital clinicians to adequately ventilate an adult manikin with both an adult- and pediatric-size manual resuscitator bag without the assistance of an advanced airway or airway adjunct device...
April 30, 2024: Respiratory Care
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