The effects of flow settings during high-flow nasal cannula oxygen therapy for neonates and young children
Conclusion Individualising flow settings in neonates and young children requires consideration of the patient's peak inspiratory flow, respiratory rate, heart rate, tolerance, work of breathing and lung aeration for optimal care. (Source: European Respiratory Review)
Source: European Respiratory Review - March 27, 2024 Category: Respiratory Medicine Authors: Li, J., Deng, N., He, W. J. A., Yang, C., Liu, P., Albuainain, F. A., Ring, B. J., Miller, A. G., Rotta, A. T., Guglielmo, R. D., Milesi, C. Tags: Paediatric pulmonology Reviews Source Type: research

Central sleep apnoea: not just one phenotype
Recent scientific findings in the field of sleep disordered breathing have characterised a variety of phenotypes in obstructive sleep apnoea. These findings have prompted investigations aiming to achieve a more precise differentiation and description of the entities of central sleep apnoea (CSA). There is increasing evidence for the heterogeneity of CSA in terms of underlying aetiology, pathophysiological concepts, treatment response and outcome. Assigning patients to these phenotypes allows for the selection of individualised therapies. Major pathophysiological characteristics include loop gain, apnoeic threshold, breathi...
Source: European Respiratory Review - March 27, 2024 Category: Respiratory Medicine Authors: Randerath, W., Baillieul, S., Tamisier, R. Tags: Sleep medicine Sleep and Breathing Conference Reviews Source Type: research

The persistent inflammation in COPD: is autoimmunity the core mechanism?
COPD poses a significant global public health challenge, primarily characterised by irreversible airflow restriction and persistent respiratory symptoms. The hallmark pathology of COPD includes sustained airway inflammation and the eventual destruction of lung tissue structure. While multiple risk factors are implicated in the disease's progression, the underlying mechanisms remain largely elusive. The perpetuation of inflammation is pivotal to the advancement of COPD, emphasising the importance of investigating these self-sustaining mechanisms for a deeper understanding of the pathogenesis. Autoimmune responses constitute...
Source: European Respiratory Review - March 27, 2024 Category: Respiratory Medicine Authors: Dong, L.-L., Liu, Z.-Y., Chen, K.-J., Li, Z.-Y., Zhou, J.-S., Shen, H.-H., Chen, Z.-H. Tags: COPD and smoking Reviews Source Type: research

Towards the adoption of quantitative computed tomography in the management of interstitial lung disease
The shortcomings of qualitative visual assessment have led to the development of computer-based tools to characterise and quantify disease on high-resolution computed tomography (HRCT) in patients with interstitial lung diseases (ILDs). Quantitative CT (QCT) software enables quantification of patterns on HRCT with results that are objective, reproducible, sensitive to change and predictive of disease progression. Applications developed to provide a diagnosis or pattern classification are mainly based on artificial intelligence. Deep learning, which identifies patterns in high-dimensional data and maps them to segmentations...
Source: European Respiratory Review - March 27, 2024 Category: Respiratory Medicine Authors: Walsh, S. L. F., De Backer, J., Prosch, H., Langs, G., Calandriello, L., Cottin, V., Brown, K. K., Inoue, Y., Tzilas, V., Estes, E., on behalf of the Open Source Imaging Consortium (OSIC) Tags: Interstitial and orphan lung disease, Lung imaging Reviews Source Type: research

"Phosphodiesterase 4B inhibition: a potential novel strategy for treating pulmonary fibrosis." M. Kolb, B. Crestani and T.M. Maher. Eur Respir Rev 2023; 32: 220206.
(Source: European Respiratory Review)
Source: European Respiratory Review - March 27, 2024 Category: Respiratory Medicine Tags: Author correction Source Type: research

Resectable non-stage IV nonsmall cell lung cancer: the surgical perspective
Surgery remains an essential element of the multimodality radical treatment of patients with early-stage nonsmall cell lung cancer. In addition, thoracic surgery is one of the key specialties involved in the lung cancer tumour board. The importance of the surgeon in the setting of a multidisciplinary panel is ever-increasing in light of the crucial concept of resectability, which is at the base of patient selection for neoadjuvant/adjuvant treatments within trials and in real-world practice. This review covers some of the topics which are relevant in the daily practice of a thoracic oncological surgeon and should also be k...
Source: European Respiratory Review - March 20, 2024 Category: Respiratory Medicine Authors: Aigner, C., Batirel, H., Huber, R. M., Jones, D. R., Sihoe, A. D. L., Stupnik, T., Brunelli, A. Tags: Lung cancer Reviews Source Type: research

The nitric oxide-soluble guanylate cyclase-cGMP pathway in pulmonary hypertension: from PDE5 to soluble guanylate cyclase
The nitric oxide (NO)–soluble guanylate cyclase (sGC)–cyclic guanosine monophosphate (cGMP) pathway plays a key role in the pathogenesis of pulmonary hypertension (PH). Targeted treatments include phosphodiesterase type 5 inhibitors (PDE5i) and sGC stimulators. The sGC stimulator riociguat is approved for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). sGC stimulators have a dual mechanism of action, enhancing the sGC response to endogenous NO and directly stimulating sGC, independent of NO. This increase in cGMP production via a dual mechanism d...
Source: European Respiratory Review - March 20, 2024 Category: Respiratory Medicine Authors: Benza, R. L., Grünig, E., Sandner, P., Stasch, J.-P., Simonneau, G. Tags: Pulmonary pharmacology and therapeutics, Pulmonary vascular disease Reviews Source Type: research

Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis
Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the first-line treatment but is limited by poor adherence. Nocturnal oxygen therapy may be an alternative treatment for obstructive sleep apnoea but its effects remain unclear. This meta-analysis evaluates the effects of nocturnal oxygen therapy on both obstructive sleep apnoea severity and blood pressure. A literature search was performed based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed, randomised studies th...
Source: European Respiratory Review - March 20, 2024 Category: Respiratory Medicine Authors: Phyu, S. L., Ercan, S., Harriss, E., Turnbull, C. Tags: Sleep medicine Reviews Source Type: research

Inhaled versus systemic corticosteroids for acute exacerbations of COPD: a systematic review and meta-analysis
This meta-analysis compares the efficacy and safety of inhaled versus systemic corticosteroids for COPD exacerbations. Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology. We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations. All trials were at high risk of methodological...
Source: European Respiratory Review - March 20, 2024 Category: Respiratory Medicine Authors: Papadopoulou, E., Bin Safar, S., Khalil, A., Hansel, J., Wang, R., Corlateanu, A., Kostikas, K., Tryfon, S., Vestbo, J., Mathioudakis, A. G. Tags: COPD and smoking Reviews Source Type: research

20 years of neuromuscular electrical stimulation in COPD
Although a lung disease, COPD is also associated with extrapulmonary manifestations including, among others, limb muscle dysfunction. Limb muscle dysfunction is a key systemic consequence of COPD that impacts patients' physical activity, exercise tolerance, quality of life and survival. Deconditioning is the main mechanism underlying the development of limb muscle dysfunction in COPD, which can be partially improved with exercise. However, some patients may not be able to tolerate exercise because of incapacitating breathlessness or unwillingness to undertake whole-body exercise. Alternative training modalities that do not...
Source: European Respiratory Review - March 20, 2024 Category: Respiratory Medicine Authors: LoMauro, A., Gervasoni, F. Tags: COPD and smoking Reviews Source Type: research

Mitogen-activated protein kinase-guided drug discovery for post-viral and related types of lung disease
Respiratory viral infections are a major public health problem, with much of their morbidity and mortality due to post-viral lung diseases that progress and persist after the active infection is cleared. This paradigm is implicated in the most common forms of chronic lung disease, such as asthma and COPD, as well as other virus-linked diseases including progressive and long-term coronavirus disease 2019. Despite the impact of these diseases, there is a lack of small-molecule drugs available that can precisely modify this type of disease process. Here we will review current progress in understanding the pathogenesis of post...
Source: European Respiratory Review - February 28, 2024 Category: Respiratory Medicine Authors: Holtzman, M. J., Zhang, Y., Wu, K., Romero, A. G. Tags: Lung biology and experimental studies Lung Science Conference Reviews Source Type: research

Preclinical models of maternal asthma and progeny outcomes: a scoping review
There is an increased risk of adverse perinatal outcomes in the ~17% of women with asthma during pregnancy. The mechanisms linking maternal asthma and adverse outcomes are largely unknown, but reflect joint effects of genetics and prenatal exposure to maternal asthma. Animal models are essential to understand the underlying mechanisms independent of genetics and comorbidities, and enable safe testing of interventions. This scoping review aimed to explore the methodology, phenotype, characteristics, outcomes and quality of published studies using preclinical maternal asthma models. MEDLINE (PubMed), Embase (Elsevier) and We...
Source: European Respiratory Review - February 28, 2024 Category: Respiratory Medicine Authors: Robinson, J. L., Gatford, K. L., Bailey, D. N., Roff, A. J., Clifton, V. L., Morrison, J. L., Stark, M. J. Tags: Asthma and allergy Reviews Source Type: research

Clinical-imaging-pathological correlation in pulmonary hypertension associated with left heart disease
Pulmonary hypertension (PH) is highly prevalent in patients with left heart disease (LHD) and negatively impacts prognosis. The most common causes of PH associated with LHD (PH-LHD) are left heart failure and valvular heart disease. In LHD, passive backward transmission of increased left-sided filling pressures leads to isolated post-capillary PH. Additional pulmonary vasoconstriction and remodelling lead to a higher vascular load and combined pre- and post-capillary PH. The increased afterload leads to right ventricular dysfunction and failure. Multimodality imaging of the heart plays a central role in the diagnostic work...
Source: European Respiratory Review - February 28, 2024 Category: Respiratory Medicine Authors: van de Veerdonk, M. C., Roosma, L., Trip, P., Gopalan, D., Vonk Noordegraaf, A., Dorfmüller, P., Nossent, E. J. Tags: Lung imaging, Pulmonary vascular disease Clinical-radiological-pathological correlation in pulmonary hypertension Source Type: research

Lung cancer risk and occupational pulmonary fibrosis: systematic review and meta-analysis
Background: Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary fibrosis and lung cancer. Research question: Is pulmonary fibrosis from exposure to occupational carcinogens an independent risk factor for lung cancer? Study design and methods: A comprehensive search of PubMed, Embase, Web of Science and Cochrane databases with over 100 search terms regarding occupational hazards causing pulmonary fibrosis was conducted. After screening and extraction, quality of evidence and eligibility criteria for meta-analysi...
Source: European Respiratory Review - February 14, 2024 Category: Respiratory Medicine Authors: Krabbe, J., Steffens, K. M., Driessen, S., Kraus, T. Tags: Lung cancer Reviews Source Type: research

REM sleep obstructive sleep apnoea
Obstructive sleep apnoea (OSA) can occur in both rapid eye movement (REM) and non-REM sleep or be limited to REM sleep, when the upper airway is most prone to collapse due to REM sleep atonia. Respiratory events are usually longer and more desaturating in REM than in NREM sleep. The prevalence of REM OSA is higher in women than in men and REM OSA usually occurs in the context of mild–moderate OSA based on the apnoea–hypopnoea index calculated for the entire sleep study. Studies have highlighted some detrimental consequences of REM OSA; for example, its frequent association with systemic hypertension and a degre...
Source: European Respiratory Review - February 14, 2024 Category: Respiratory Medicine Authors: Bonsignore, M. R., Mazzuca, E., Baiamonte, P., Bouckaert, B., Verbeke, W., Pevernagie, D. A. Tags: Sleep medicine Sleep and Breathing Conference Reviews Source Type: research