Chest
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High-flow nasal cannula (HFNC) has emerged as a promising intervention for post-extubation oxygen therapy, with the potential to reduce the need for reintubation. However, it remains unclear whether using a higher flow setting provides better outcomes than the commonly used flow rate of 30-50 L/min. ⋯ ClinicalTrials.gov; No.: NCT04934163.
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Up to two thirds of patients with severe uncontrolled asthma (SUA) who received biological therapy do not have a complete response. ⋯ BB is more precise in the prediction of response to biological therapy than the T2 score, especially in those requiring OCS or receiving anti-IL5/5R . Tissue eosinophilia is the main driver of this predictive capacity, but there are other items in the PS related to bronchial remodeling that might be contributing to the identification of response to biological therapy.
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The prevalence of chronic respiratory diseases is increasing globally. There is evidence that those with spirometric impairment, and no evidence of obstruction, termed preserved ratio impaired spirometry (PRISm), have increased risk of morbidity and mortality, compared to those with normal lung function. There remain several gaps in characterizing PRISm. ⋯ Individuals with PRISm have increased risk of all-cause, cardiovascular, and respiratory mortality. Recognizing and targeting modifiable PRISm risk factors may reduce the growing burden of PRISm and transition to obstructive lung disease globally. Additional studies are needed in LMICs that have unique risk factors a disease trajectory.
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The small airways comprise generations 8 to 23 of the bronchial tree, consist of airways with an internal diameter <2mm, and are classically difficult to assess and treat in persistent asthma. Small airways dysfunction (SAD) is integral to the asthma management paradigm as it is associated with poorer symptom control, greater levels of type 2 inflammation, and has been proposed as a potential treatable asthma trait. ⋯ To rectify the unrecognized value of oscillometry in the asthma community, a consortium of authors who are investigators with knowledge and experience of oscillometry wished to address the most important clinical questions raised by our colleagues who are considering using this technique, including its clinical utility. In this article, we discuss integral concepts including applicability of oscillometry as a predictive tool for asthma exacerbations and disease control; adequacy of spirometry and oscillometry in assessing SAD; potential limitations of oscillometry; as well as treatment options for SAD.