Is Disease Stability an Attainable COPD Treatment Goal?

Chronic obstructive pulmonary disease (COPD) is a heterogenous lung condition characterized by progressive airflow obstruction. Despite advancements in diagnosis and treatment, the disease burden remains high; although clinical trials have shown improvements in outcomes such as exacerbations, quality of life, and lung function, improvement may not be attainable for many patients. For patients who do experience improvement, it is challenging to set management goals given the progressive nature of COPD.

Air Hunger Far Exceeds Dyspnea Sense of Effort During Mechanical Ventilation and a Weaning Trial.

Rationale: No systematic investigation into dyspnea in patients receiving prolonged ventilation (>21 days) after recovering from critical-illness has been published.

Objectives: To determine magnitude, nature and pathophysiological basis of dyspnea during an unassisted-breathing trial in prolonged-ventilation patients.

Methods: Dyspnea intensity and descriptor selection were investigated in 27 prolonged-ventilation patients during a 60-min unassisted-breathing trial.

Nasal High Flow to Modulate Dyspnea in Orally Intubated Patients.

Rationale: High flow therapy reduces dyspnea in acute respiratory failure but the underlying mechanisms are not fully elucidated.

Objectives: To compare dyspnea, airway occlusion pressure (P) and inspiratory work with and without nasal high flow (NHF, FiO 21%, temperature 31°C) in intubated patients under pressure support ventilation and during a spontaneous breathing trial (SBT).

Methods: Dyspnea (numerical rating scale, NRS and Mechanical Ventilation - Respiratory Distress Observational Scale, MV-RDOS), P, esophageal pressure, respiratory muscles EMG, arterial blood gas were compared in intubated patients on pressure support ventilation presenting a dyspnea-NRS > 3 during two sequences: 1) pressure support ventilation with NHF at 0 L/min followed by 30, 50 and 60 L/min (the last three were randomized) and 2) a SBT with NHF at 0 and 50 L/min (randomized).

Prevalence and Clinical Correlates of Radiologically Detected Coronary Artery Disease in COPD: A Cross-Sectional Observational Study.

Rationale: Unrecognised coronary artery disease (CAD) may contribute to adverse outcomes in chronic obstructive pulmonary disease (COPD). Improved identification of at-risk groups could inform better preventative care. We aimed to evaluate the burden and relationships of radiologically detectable CAD in COPD, establish frequency of occult disease, and examine potential cardiovascular screening methods.

C-reactive Protein-based Screening of People with Tuberculosis Symptoms: A Diagnostic Accuracy Study.

: C-reactive protein (CRP)-based tuberculosis (TB) screening is recommended for people with HIV (PWH). However, its performance among people without HIV and in diverse settings is unknown. : In a multi-country study, we aimed to determine whether CRP meets the minimum accuracy targets (sensitivity ≥90%, specificity ≥70%) for an effective TB screening test.