Directing therapy in pulmonary arterial hypertension using a target 6 min walk distance.

Background: The most effective approaches to escalating advanced therapies in pulmonary arterial hypertension (PAH) are controversial.

Objective: To compare outcomes before and after introducing a target 6 min walk distance (6MWD) treatment strategy in PAH using registry data.

Methods: From 2001 to 2005, WHO class II to IV patients were treated with bosentan or prostanoids.

Airway complications post lung transplantation.

Purpose Of Review: Advancements in surgical techniques, immunosuppression, graft retrieval, and postoperative care of lung transplant recipients has led to a decline in the incidence of airway complications since the first lung transplant was performed in 1963. Although improved, these complications remain a source of morbidity and mortality for lung transplant recipients.

Recent Findings: Identification and management of risk factors is ideal, although interventional bronchoscopy techniques have allowed management of many airway complications in a less invasive fashion.

Addition of sildenafil in patients with pulmonary arterial hypertension with inadequate response to bosentan monotherapy.

Background: Pulmonary arterial hypertension (PAH) remains a progressive disease despite improvement when using one of three medication classes: prostanoids, endothelin receptor antagonists or phosphodiesterase-5 inhibitors. Combination therapy has been proposed for patients with unsatisfactory response to monotherapy.

Objectives: To examine the effect of adding sildenafil to bosentan on 6 min walk distance (6MWD) and New York Heart Association (NYHA) classification in patients with PAH who achieved inadequate improvement with bosentan monotherapy.

Effect of maintenance azithromycin on established bronchiolitis obliterans syndrome in lung transplant patients.

Background: Bronchiolitis obliterans syndrome (BOS), the main cause of late mortality following lung transplantation, is defined as an irreversible decline in forced expiratory volume in 1 s (FEV1). Previous studies using azithromycin for BOS in lung transplant patients have demonstrated a potential reversibility of the decline in FEV1.

Objectives: To examine whether initiating azithromycin reverses decline in FEV1 in lung transplant recipients with established BOS of at least three months.