Publications by authors named "Kuang-Yao Yang"

Background: The latest guidelines discourage the use of long-acting beta-agonists/inhaled corticosteroids (LABA/ICS) for chronic obstructive pulmonary disease (COPD). However, there is a lack of evidence regarding the optimal subsequent treatment after discontinuing LABA/ICS.

Objectives: To compare the effectiveness and safety of switching from LABA/ICS to triple therapy (LABA/long-acting muscarinic antagonists (LAMA)/ICS) or to dual bronchodilators (LABA/LAMA) in COPD patients.

View Article and Find Full Text PDF
Article Synopsis
  • The study compared ICU outcomes of COVID-19 patients during the Alpha and Omicron periods, analyzing data from 231 patients in Northern Taiwan.
  • Patients during the Omicron period were found to be older, had more comorbidities, and demonstrated a higher 28-day mortality rate (26.4% vs. 13.9%) compared to the Alpha period, although the variant itself was not an independent factor for increased mortality.
  • Key factors associated with higher mortality included a low PF ratio, septic shock, and not receiving remdesivir, but when matched for other variables, mortality rates between the two periods were comparable (12.1% vs. 18.2%).
View Article and Find Full Text PDF

Infection-related lipopolysaccharide (LPS) release causes cytokine storm and acute lung injury. Emerging data show that the interleukin 6 (IL-6) inhibitor tocilizumab can improve lung damage in patients with sepsis. This study aimed to investigate the therapeutic effect of tocilizumab on acute lung injury in cirrhotic rats.

View Article and Find Full Text PDF

Background: Carbapenem-resistant gram-negative bacteria (CRGNB) present a considerable global threat due to their challenging treatment and increased mortality rates, with bloodstream infection (BSI) having the highest mortality rate. Patients with end-stage renal disease (ESRD) undergoing renal replacement therapy (RRT) face an increased risk of BSI. Limited data are available regarding the prognosis and treatment outcomes of CRGNB-BSI in patients with ESRD in intensive care units (ICUs).

View Article and Find Full Text PDF

Introduction: This study endeavors to decipher the association between Activin A and PRISm, thereby addressing the potential of Activin A as a serum biomarker for early detection and long-term clinical outcome prediction of PRISm and subsequent all-cause mortality.

Methods: The study sample comprised middle-aged and older adults from the I-Lan Longitudinal Aging Study. Pulmonary function including forced vital capacity (FVC) and forced expiratory volume in one second (FEV) were measured.

View Article and Find Full Text PDF

Objectives: The link between aging and pulmonary function decline is well-established, but the underlying mechanisms have yet to be fully revealed. Serum follistatin, a myokine implicated in muscle degeneration, may play a role in age-related pulmonary changes. This study aims to investigate the relationship between serum follistatin levels and pulmonary function decline in community-dwelling older adults, and evaluate their combined association with all-cause mortality.

View Article and Find Full Text PDF
Article Synopsis
  • This study looked at how getting a serious blood infection called bacteremia affects patients with a type of pneumonia in the ICU.
  • They found that patients with bacteremia had a higher chance of dying in the hospital (around 68.3%) compared to those without it (about 45.9%).
  • The study also showed that waiting too long from when patients got to the ICU to when they developed pneumonia increased their risk of getting bacteremia, especially if they were on a ventilator for a long time.
View Article and Find Full Text PDF

Background: Despite vaccines' effectiveness in reducing COVID-19 infection rates and disease severity, their impact on critical patients presenting with acute respiratory failure is elusive. The aim of this study was to further investigate the influence of vaccination on mortality rates among severely ill COVID-19 patients experiencing acute respiratory failure.

Methods: This retrospective cohort study was carried out at a tertiary medical center in Taiwan.

View Article and Find Full Text PDF

Background: Coronavirus disease 2019 (COVID-19) has affected individuals worldwide, and patients with cancer are particularly vulnerable to COVID-19-related severe illness, respiratory failure, and mortality. The relationship between COVID-19 and cancer remains a critical concern, and a comprehensive investigation of the factors affecting survival among patients with cancer who develop COVID-19-related respiratory failure is warranted. We aim to compare the characteristics and outcomes of COVID-19-related acute respiratory failure in patients with and without underlying cancer, while analyzing factors affecting in-hospital survival among cancer patients.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzes patients with influenza-related acute respiratory distress syndrome (ARDS) who required prolonged mechanical ventilation (PMV), identifying factors that contribute to PMV and challenges in weaning off ventilation.
  • - Conducted at eight medical centers in Taiwan, the research involved 263 patients, revealing that 78 experienced PMV, with a mortality rate of 39.7% and a weaning rate of 68.8% during a 60-day observation period.
  • - Key risk factors for PMV included a body mass index (BMI) over 25, the use of extracorporeal membrane oxygenation (ECMO), bacterial pneumonia, and prolonged neuromuscular blockade; while ECMO usage and bacteremia were linked
View Article and Find Full Text PDF

Background: Acute respiratory distress syndrome (ARDS) is a common life-threatening condition in critically ill patients. Itis also an important public health issue because it can cause substantial mortality and health care burden worldwide. The objective of this study was to investigate therisk factors that impact ARDS mortality in a medical center in Taiwan.

View Article and Find Full Text PDF

Influenza virus infection leads to acute pulmonary injury and acute respiratory distress syndrome (ARDS). The Radiographic Assessment of Lung Edema (RALE) score has been proposed as a reliable tool for the evaluation of the opacity of chest X-rays (CXRs). This study aimed to examine the RALE scores and outcomes in patients with influenza-associated ARDS.

View Article and Find Full Text PDF

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is common worldwide. Despite carbapenem resistance, standard-dose carbapenems are still used in clinical practice. Hence in this study, we aimed to compare the efficacy and outcomes of a regimen containing standard-dose carbapenems with those of a regimen lacking carbapenems during the treatment of critically ill patients with CRAB nosocomial pneumonia in the intensive care unit (ICU).

View Article and Find Full Text PDF

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a pandemic that has resulted in millions of deaths worldwide. Critically ill COVID-19 patients who require intubation and develop nosocomial pneumonia, commonly caused by gram-negative bacilli, have a higher mortality rate than those without nosocomial pneumonia.

Objectives: The aim of this study is to compare the clinical characteristics and outcomes and associated risk factors of Alpha and Omicron SARS-CoV-2 variants in critically ill patients on mechanical ventilation (MV) with nosocomial pneumonia.

View Article and Find Full Text PDF

Idiopathic pulmonary fibrosis has poor clinical outcomes despite antifibrotic treatment. The nucleotide-binding domain leucine-rich repeat-containing receptor, pyrin domain-containing-3 (NLRP3) inflammasome and endothelial-to-mesenchymal transition (EndoMT) were shown to be involved in the pathogenesis of pulmonary fibrosis. However, the detailed mechanism is unknown.

View Article and Find Full Text PDF

Background: Coronavirus disease 2019 (COVID-19) is a global outbreak disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cytomegalovirus (CMV) infection can occur in critical COVID-19 patients and is associated with adverse clinical outcomes.

Objective: The aim of this study was to explore the clinical characteristics and outcome of CMV infection in critical COVID-19 patients.

View Article and Find Full Text PDF

Since the coronavirus disease 2019 (COVID-19) pandemic, millions of people worldwide have passed away due to critical illness. Intensive care for severe COVID-19 infection remains one of the most important ways to save patients' lives. In Taiwan, the government-led critical care model and COVID-19 clinical rounds, grand rounds, and chief rounds by experts; critical care guidelines established by the Taiwan Centers for Disease Control and major professional societies; consensus and management recommendations among medical institutes; and research works in the field of critical care constitute the concrete basis of intensive care.

View Article and Find Full Text PDF

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a key pathogen associated with ventilator-associated pneumonia (VAP). Research on treatment outcomes, especially ventilator dependence, in patients with VAP caused by CRAB remains limited.

Methods: This retrospective multicenter study included ICU-admitted patients with VAP caused by CRAB.

View Article and Find Full Text PDF

We investigated the effects of vegetable glycerin (VG), a main e-cigarette constituent, on endotoxin-induced acute lung injury (ALI). Mice received intratracheal administration of 30% VG in phosphate buffered saline (PBS) vehicle or only PBS (control) for 4 days. On Day 5, mice received an intratracheal instillation of lipopolysaccharide (LPS) (LPS group and VG + LPS group) or PBS (VG group and control group).

View Article and Find Full Text PDF

Background: Adverse reactions, especially nephrotoxicity, are great concerns of intravenous colistin treatment. The role of substitutive nebulized colistin in treating nosocomial pneumonia caused by carbapenem-resistant Gram-negative bacterial (CR-GNB) in critically ill patients remains unknown.

Methods: This retrospective study enrolled patients with nosocomial pneumonia caused by colistin-susceptible CRGNB in the intensive care unit (ICU) without intravenous colistin treatment.

View Article and Find Full Text PDF

Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) are both associated with significant morbidity and mortality in daily clinical practice, as well as in a critical care setting. It is unclear whether colistin susceptible-only Acinetobacter baumannii (CSO AB) is a unique phenotype separate from or a subset of CRAB-associated pneumonia. The aim of this study is to investigate the prevalence of CSO AB pneumonia and compare the presentation and outcome between CSO AB and CRAB-associated pneumonia in critically ill patients.

View Article and Find Full Text PDF
Article Synopsis
  • Tigecycline is a type of antibiotic that can fight off certain hard-to-treat bacteria known as carbapenem-resistant Gram-negative bacteria (CR-GNB), often causing pneumonia in hospitalized patients.
  • A study looked at ICU patients with pneumonia from CR-GNB to see if adding tigecycline to their treatment would help them recover better.
  • Results showed that patients who got tigecycline had lower death rates and a better chance of getting better compared to those who didn't, especially after 28 days of treatment.
View Article and Find Full Text PDF

Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia.

Methods: This was a retrospective study conducted in a medical center in Taiwan. From May to September 2021, patients from four intensive care units were enrolled after SARS-CoV-2 was confirmed through quantitative polymerase chain reaction and all cases were compatible with the definitions of severe COVID-19 infection.

View Article and Find Full Text PDF

Background/purpose: Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is common in critically ill patients with COVID-19 and is associated with worse outcomes. However, reports on CAPA and its impact on treatment outcomes in Asian populations are limited.

Methods: Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction-confirmed COVID-19 admitted to intensive care units (ICUs) were retrospectively enrolled in this observational study.

View Article and Find Full Text PDF

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease (ILD). Pulmonary fibroblasts play an important role in the development of IPF. Emerging evidence indicates that pulmonary endothelial cells could be the source of pulmonary fibroblasts through endothelial mesenchymal transition (EndoMT), which contributes to pulmonary fibrosis.

View Article and Find Full Text PDF