Chest
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The optimal target for partial pressure of arterial carbon dioxide (PaCO₂) remains uncertain in patients undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) following out-of-hospital cardiac arrest (OHCA). ⋯ In non-traumatic adult OHCA patients on VA-ECMO, high normocapnia was associated with better functional outcomes than low normocapnia in both initial and 24-hour PaCO₂ analyses. These findings suggest a hypothesis that maintaining high normocapnia levels, irrespective of initial PaCO2, may improve functional outcomes for patients on VA-ECMO after OHCA.
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Although small airway disease has been recognized as a major contributor to obstructive respiratory diseases, the association between occupational endotoxin exposure and small airway disease, as characterized by CT scans, requires further investigation. ⋯ We found that occupational endotoxin exposure was significantly associated with small airway disease and lower FEV1. We identified Residual-856 and E/I MLA as the imaging biomarkers for early detection of small airway dysfunction in pre-clinical individuals (FEV1/FVC ≥ 0.70). These findings have important implications for identifying early-stage SAD and airflow obstruction with CT imaging biomarkers.
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Education and psychosocial support are essential components of pulmonary rehabilitation (PR). However, the delivery of education often follows a one-size-fits-all approach, with individual factors that influence learning rarely considered. Moreover, education-related outcomes are frequently overlooked in PR assessments, and inconsistent use of these outcomes has limited our understanding of the impact of education on people with chronic respiratory diseases. There is a clear need for practical guidance to identify key learning determinants and define which education-related outcomes in PR should be targeted to optimize the intervention and establish quality standards. ⋯ This review emphasizes the importance of person-centered education in PR, provides a framework for understanding which education-related outcomes to target, and highlights the need for future research to enhance this essential component.
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Pulmonary rehabilitation (PR) is a beneficial intervention for people with interstitial lung disease (ILD), however the effect of PR on survival is unclear. This study compared the survival outcomes in people with ILD who were allocated to PR versus those who were allocated to control in two published randomised controlled trials (RCTs). ⋯ Participation in PR among people with ILD may impact survival at 5 years. Along with clinical improvements following PR, the potential for a survival benefit further strengthens the importance of PR in the standard care of people with ILD.