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14 pages, 2071 KiB

Open AccessArticle

Monitoring the Efficacy of High-Flow Nasal Cannula Oxygen Therapy in Patients with Acute Hypoxemic Respiratory Failure in the General Respiratory Ward: A Prospective Observational Study

by Zhanqi Zhao, Mei-Yun Chang, Tingting Zhang and Chien-Hung Gow

Biomedicines 2023, 11(11), 3067; https://doi.org/10.3390/biomedicines11113067 - 16 Nov 2023

Cited by 1 | Viewed by 2541

Abstract

High-flow nasal cannula (HFNC) is widely used to treat hypoxemic respiratory failure. The effectiveness of HFNC treatment and the methods for monitoring its efficacy in the general ward remain unclear. This prospective observational study enrolled 42 patients who had acute hypoxemic respiratory failure [...] Read more.

High-flow nasal cannula (HFNC) is widely used to treat hypoxemic respiratory failure. The effectiveness of HFNC treatment and the methods for monitoring its efficacy in the general ward remain unclear. This prospective observational study enrolled 42 patients who had acute hypoxemic respiratory failure requiring HFNC oxygen therapy in the general adult respiratory ward. The primary outcome was the all-cause in-hospital mortality. Secondary outcomes included the association between initial blood test results and HFNC outcomes. Regional ventilation distributions were monitored in 24 patients using electrical impedance tomography (EIT) after HFNC initiation. Patients with successful HFNC treatment had better in-hospital survival (94%) compared to those with failed HFNC treatment (0%, p < 0.001). Neutrophil-to-lymphocyte ratios of ≥9 were more common in patients with failed HFNC (70%) compared to those with successful HFNC (52%, p = 0.070), and these patients had shorter hospital survival rates after HFNC treatment (p = 0.046, Tarone-Ware test). Patients with successful HFNC treatment had a more central ventilation distribution compared to those with failed HFNC treatment (p < 0.05). Similarly, patients who survived HFNC treatment had a more central distribution compared to those who did not survive (p < 0.001). We concluded that HFNC in the general respiratory ward may be a potential rescue therapy for patients with respiratory failure. EIT can potentially monitor patients receiving HFNC therapy. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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23 pages, 3881 KiB

Open AccessArticle

Long-Term Radiological Pulmonary Changes in Mechanically Ventilated Patients with Respiratory Failure due to SARS-CoV-2 Infection

by Mircea Stoian, Adina Roman, Alina Boeriu, Danusia Onișor, Sergio Rareș Bandila, Dragoș Florin Babă, Iuliu Cocuz, Raluca Niculescu, Anamaria Costan, Sergiu Ștefan Laszlo, Dragoș Corău and Adina Stoian

Biomedicines 2023, 11(10), 2637; https://doi.org/10.3390/biomedicines11102637 - 26 Sep 2023

Cited by 3 | Viewed by 1999

Abstract

From the first reports of SARS-CoV-2, at the end of 2019 to the present, the global mortality associated with COVID-19 has reached 6,952,522 deaths as reported by the World Health Organization (WHO). Early intubation and mechanical ventilation can increase the survival rate of [...] Read more.

From the first reports of SARS-CoV-2, at the end of 2019 to the present, the global mortality associated with COVID-19 has reached 6,952,522 deaths as reported by the World Health Organization (WHO). Early intubation and mechanical ventilation can increase the survival rate of critically ill patients. This prospective study was carried out on 885 patients in the ICU of Mureș County Clinical Hospital, Romania. After applying inclusion and exclusion criteria, a total of 54 patients were included. Patients were monitored during hospitalization and at 6-month follow-up. We analyzed the relationship between invasive mechanical ventilation (IMV) and non-invasive mechanical ventilation (NIMV) and radiological changes on thoracic CT scans performed at 6-month follow-up and found no significant association. Regarding paraclinical analysis, there was a statistically significant association between patients grouped by IMV and ferritin level on day 1 of admission (p = 0.034), and between patients grouped by PaO₂/FiO₂ ratio with metabolic syndrome (p = 0.03) and the level of procalcitonin (p = 0.01). A significant proportion of patients with COVID-19 admitted to the ICU developed pulmonary fibrosis as observed at a 6-month evaluation. Patients with oxygen supplementation or mechanical ventilation require dynamic monitoring and radiological investigations, as there is a possibility of long-term pulmonary fibrosis that requires pharmacological interventions and finding new therapeutic alternatives. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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9 pages, 872 KiB

Open AccessArticle

Risk of Acute Myocardial Infarction in Pneumoconiosis: Results from a Retrospective Cohort Study

by Ju-Hsin Chang, Te-Chun Shen, Ke-Wei Chen, Cheng-Li Lin, Chung Y. Hsu, Yeong-Ray Wen and Kuan-Cheng Chang

Biomedicines 2023, 11(3), 897; https://doi.org/10.3390/biomedicines11030897 - 14 Mar 2023

Cited by 3 | Viewed by 1478

Abstract

Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a [...] Read more.

Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a retrospective cohort study design. Methods: This was a population-based, retrospective cohort study that used data from Taiwan’s National Health Insurance Database. A total of 7556 newly diagnosed patients with PCN and 7556 individuals without PCN were included in the PCN and comparison cohort (PC and CC), respectively, between 2008 and 2018, with propensity score matching for age, gender, comorbidity, medication, and date of PCN diagnosis. The occurrence of AMI was monitored until the end of 2019, and AMI risk was assessed using Cox proportional hazard regression models. Results: The overall incidence of AMI was 1.34-fold higher in the PC than in the CC (4.33 vs. 3.23 per 1000 person-years, respectively, p < 0.05), with an adjusted hazard ratio (aHR) of 1.36 (95% confidence interval (CI): 1.08–1.72) after controlling for age, gender, comorbidity, and medication. Further analyses showed a higher risk of AMI with increased annual number of emergency department visits among patients with PCN (aHR: 1.30, 95% CI: 1.01–1.66 (<1) and aHR: 1.68, 95% CI: 1.13–2.50 (≥1)). Conclusion: Patients with PCN had a significantly higher risk of developing AMI than those without PCN. Clinicians should pay more attention to prevent AMI episodes in patients with PCN. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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Review

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13 pages, 955 KiB

Open AccessReview

K_Ca2 and K_Ca3.1 Channels in the Airways: A New Therapeutic Target

by Razan Orfali, Ali AlFaiz, Mohammad Asikur Rahman, Liz Lau, Young-Woo Nam and Miao Zhang

Biomedicines 2023, 11(7), 1780; https://doi.org/10.3390/biomedicines11071780 - 21 Jun 2023

Cited by 4 | Viewed by 2873

Abstract

K⁺ channels are involved in many critical functions in lung physiology. Recently, the family of Ca²⁺-activated K⁺ channels (K_Ca) has received more attention, and a massive amount of effort has been devoted to developing selective medications targeting [...] Read more.

K⁺ channels are involved in many critical functions in lung physiology. Recently, the family of Ca²⁺-activated K⁺ channels (K_Ca) has received more attention, and a massive amount of effort has been devoted to developing selective medications targeting these channels. Within the family of K_Ca channels, three small-conductance Ca²⁺-activated K⁺ (K_Ca2) channel subtypes, together with the intermediate-conductance K_Ca3.1 channel, are voltage-independent K⁺ channels, and they mediate Ca²⁺-induced membrane hyperpolarization. Many K_Ca2 channel members are involved in crucial roles in physiological and pathological systems throughout the body. In this article, different subtypes of K_Ca2 and K_Ca3.1 channels and their functions in respiratory diseases are discussed. Additionally, the pharmacology of the K_Ca2 and K_Ca3.1 channels and the link between these channels and respiratory ciliary regulations will be explained in more detail. In the future, specific modulators for small or intermediate Ca²⁺-activated K⁺ channels may offer a unique therapeutic opportunity to treat muco-obstructive lung diseases. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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12 pages, 285 KiB

Open AccessReview

Better Safe than Sorry: Rheumatoid Arthritis, Interstitial Lung Disease, and Medication—A Narrative Review

by Iulia-Tania Andronache, Victoria-Cristina Şuţa, Maria Şuţa, Sabina-Livia Ciocodei, Liliana Vladareanu, Alina Doina Nicoara and Oana Cristina Arghir

Biomedicines 2023, 11(6), 1755; https://doi.org/10.3390/biomedicines11061755 - 19 Jun 2023

Cited by 1 | Viewed by 2578

Abstract

It is well known that rheumatoid arthritis (RA) patients are at an increased risk of developing non-infectious pulmonary complications, especially interstitial lung disease (ILD); however, the clinician must keep in mind that lung disease could not only be a manifestation of the underlying [...] Read more.

It is well known that rheumatoid arthritis (RA) patients are at an increased risk of developing non-infectious pulmonary complications, especially interstitial lung disease (ILD); however, the clinician must keep in mind that lung disease could not only be a manifestation of the underlying condition, but also a consequence of using disease-modifying therapies. New-onset ILD or ILD worsening has also been reported as a possible consequence of both conventional disease-modifying antirheumatic drugs (DMARDs) and biologic agents. This study is a narrative review of the current literature regarding the potential risk of developing interstitial lung disease along with the administration of specific drugs used in controlling rheumatoid arthritis. Its purpose is to fill knowledge gaps related to this challenging patient cohort by addressing various aspects of the disease, including prevalence, disease features, treatment strategies, and patient outcomes. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

21 pages, 5192 KiB

Open AccessReview

Clinicopathological Outlines of Post-COVID-19 Pulmonary Fibrosis Compared with Idiopathic Pulmonary Fibrosis

by Roxana-Elena Cîrjaliu, Mariana Deacu, Ioana Gherghișan, Angela-Ștefania Marghescu, Manuela Enciu, Gabriela Izabela Băltățescu, Antonela Anca Nicolau, Doina-Ecaterina Tofolean, Oana Cristina Arghir and Ariadna-Petronela Fildan

Biomedicines 2023, 11(6), 1739; https://doi.org/10.3390/biomedicines11061739 - 17 Jun 2023

Cited by 2 | Viewed by 3032

Abstract

This review brings together the current knowledge regarding the risk factors and the clinical, radiologic, and histological features of both post-COVID-19 pulmonary fibrosis (PCPF) and idiopathic pulmonary fibrosis (IPF), describing the similarities and the disparities between these two diseases, using numerous databases to [...] Read more.

This review brings together the current knowledge regarding the risk factors and the clinical, radiologic, and histological features of both post-COVID-19 pulmonary fibrosis (PCPF) and idiopathic pulmonary fibrosis (IPF), describing the similarities and the disparities between these two diseases, using numerous databases to identify relevant articles published in English through October 2022. This review would help clinicians, pathologists, and researchers make an accurate diagnosis, which can help identify the group of patients selected for anti-fibrotic therapies and future therapeutic perspectives. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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16 pages, 1815 KiB

Open AccessReview

Diagnosis and Treatment of Sleep Apnea in Children: A Future Perspective Is Needed

by Esther Solano-Pérez, Carlota Coso, María Castillo-García, Sofía Romero-Peralta, Sonia Lopez-Monzoni, Eduardo Laviña, Irene Cano-Pumarega, Manuel Sánchez-de-la-Torre, Francisco García-Río and Olga Mediano

Biomedicines 2023, 11(6), 1708; https://doi.org/10.3390/biomedicines11061708 - 14 Jun 2023

Cited by 6 | Viewed by 6006

Abstract

Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, [...] Read more.

Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, cardiovascular (CV), and neurological spheres. However, contrary to adults, advances in diagnostic and therapeutic management have been scarce in the last few years despite the increasing scientific evidence of the deleterious consequences of pediatric OSA. The problem of underdiagnosis and the lack of response to treatment in some groups make an update to the management of OSA in children necessary. Probably, the heterogeneity of OSA is not well represented by the classical clinical presentation and severity parameters (apnea/hypopnea index (AHI)), and new strategies are required. A specific and consensus definition should be established. Additionally, the role of simplified methods in the diagnosis algorithm should be considered. Finally, the search for new biomarkers for risk stratification is needed in this population. In conclusion, new paradigms based on personalized medicine should be implemented in this population. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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15 pages, 1852 KiB

Open AccessReview

Associated Factors of Pneumonia in Individuals with Chronic Obstructive Pulmonary Disease (COPD) Apart from the Use of Inhaled Corticosteroids

by Rosario Lineros, Lourdes Fernández-Delgado, Antonio Vega-Rioja, Pedro Chacón, Bouchra Doukkali, Javier Monteseirin and David Ribas-Pérez

Biomedicines 2023, 11(5), 1243; https://doi.org/10.3390/biomedicines11051243 - 22 Apr 2023

Cited by 4 | Viewed by 3045

Abstract

Inhaled corticosteroids (ICSs) are widely used in chronic obstructive pulmonary disease (COPD) and in combination with long-acting β2 agonists (LABAs) to reduce exacerbations and improve patient lung function and quality of life. However, ICSs have been associated with an increased risk of pneumonia [...] Read more.

Inhaled corticosteroids (ICSs) are widely used in chronic obstructive pulmonary disease (COPD) and in combination with long-acting β2 agonists (LABAs) to reduce exacerbations and improve patient lung function and quality of life. However, ICSs have been associated with an increased risk of pneumonia in individuals with COPD, although the magnitude of this risk remains unclear. Therefore, it is difficult to make informed clinical decisions that balance the benefits and adverse effects of ICSs in people with COPD. There may be other causes of pneumonia in patients with COPD, and these causes are not always considered in studies on the risks of using ICSs in COPD. We consider it very useful to clarify these aspects in assessing the influence of ICSs on the incidence of pneumonia and their role in the treatment of COPD. This issue has important implications for current practice and the evaluation and management of COPD, since COPD patients may benefit from specific ICS-based treatment strategies. Many of the potential causes of pneumonia in patients with COPD can act synergistically, so they can be included in more than one section. Full article

(This article belongs to the Special Issue Molecular Mechanisms, Diagnoses, and Treatments of Respiratory Diseases)

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