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Mulryan K, Sorensen J, Waller D, Redmond K. Lung volume reduction surgery: a micro-costing analysis from a national tertiary referral centre. Eur J Cardiothorac Surg 2024; 65:ezae222. [PMID: 38833683 DOI: 10.1093/ejcts/ezae222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/26/2024] [Accepted: 06/01/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES Lung volume reduction surgery (LVRS) is a clinically effective palliation procedure for patients with chronic obstructive pulmonary disease. LVRS has recently been commissioned by the NHS England. In this study, a costing model was developed to analyse cost and resource implications of different LVRS procedures. METHODS Three pathways were defined by their surgical procedures: bronchoscopic endobronchial valve insertion (EBV-LVRS), video-assisted thoracic surgery LVRS and robotic-assisted thoracic surgery LVRS. The costing model considered use of hospital resources from the LVRS decision until 90 days after hospital admission. The model was calibrated with data obtained from an observational study, electronic health records and expert opinion. Unit costs were obtained from the hospital finance department and reported in 2021 Euros. RESULTS Video-assisted thoracic surgery LVRS was associated with the lowest cost at €12 896 per patient. This compares to the costs of EBV-LVRS at €15 598 per patient and €13 305 per patient for robotic-assisted thoracic surgery LVRS. A large component of EBV-LVRS costs were accrued secondary to complications, including revision EBV-LVRS. CONCLUSIONS This study presents a comprehensive model framework for the analysis of hospital-related resource use and costs for the 3 surgical modalities. In the future, service commissioning agencies, hospital management and clinicians can use this framework to determine their modifiable resource use (composition of surgical teams, use of staff and consumables, planned length of stay and revision rates for EBV-LVRS) and to assess the potential cost implications of changes in these parameters.
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Affiliation(s)
- Kathryn Mulryan
- School of Postgraduate Studies, Royal College of Surgeons in Ireland, Dublin, Ireland
- Professor Eoin O'Malley National Thoracic and Transplant Centre, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Cardiothoracic Surgery, Beacon Hospital, Dublin, Ireland
| | - Jan Sorensen
- Healthcare Outcome Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - David Waller
- Bart's Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Karen Redmond
- Professor Eoin O'Malley National Thoracic and Transplant Centre, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Cardiothoracic Surgery, Beacon Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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Carreto-Binaghi LE, Sartillo-Mendoza LG, Muñoz-Torrico M, Guzmán-Beltrán S, Carranza C, Torres M, González Y, Juárez E. Serum pro-inflammatory biomarkers associated with improvement in quality of life in pulmonary tuberculosis. Front Immunol 2023; 14:1241121. [PMID: 37753080 PMCID: PMC10518397 DOI: 10.3389/fimmu.2023.1241121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction Pulmonary dysfunction is an underestimated complication in tuberculosis (TB) infection, affecting quality of life (QoL). Although respiratory function tests objectively reflect lung disturbances in a specific moment, predictors of illness severity at the time of diagnosis are still lacking. Methods We measured serum pro-inflammatory cytokines (TNF-α and IL-8), eicosanoids (PGE2, LTB4, RvD1, Mar1, and LXA4), a marker of tissue damage (cell-free nucleosomes), and indicators of redox status (malonaldehyde, 8-isoprostane, total oxidants, and antioxidants), as well as a score of radiological abnormalities (SRA) and a QoL questionnaire, in 25 patients with pulmonary TB at the time of diagnosis (t0) and two months after the initiation of treatment (t2). Results We found higher antioxidant levels in the patients with the worst QoL at t0, and all the indicators of the prooxidant state were significantly reduced at t2, while the total antioxidant levels increased. LTB4, a pro-inflammatory eicosanoid, was diminished at t2, while all the pro-resolutory lipids decreased substantially. Significant correlations between the SRA and the QoL scores were observed, the latter showing a substantial reduction at t2, ranking it as a reliable tool for monitoring disease evolution during TB treatment. Discussion These results suggest that evaluating a combination of these markers might be a valuable predictor of QoL improvement and a treatment response indicator; in particular, the oxidation metabolites and eicosanoid ratios could also be proposed as a future target for adjuvant therapies to reduce inflammation-associated lung injury in TB disease.
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Affiliation(s)
- Laura E. Carreto-Binaghi
- Laboratorio de Inmunobiología de la Tuberculosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Luis Gustavo Sartillo-Mendoza
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla (BUAP), Puebla, Mexico
- Becario de la Dirección General de Calidad y Educación en Salud, Secretaría de Salud, Mexico, Mexico
| | - Marcela Muñoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Silvia Guzmán-Beltrán
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Claudia Carranza
- Laboratorio de Inmunobiología de la Tuberculosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Martha Torres
- Laboratorio de Inmunobiología de la Tuberculosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Yolanda González
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
| | - Esmeralda Juárez
- Departamento de Investigación en Microbiología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico, Mexico
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Mesquita R, da Silva GPF, do Nascimento FAB, Holanda MA, Mont'Alverne DGB, de Oliveira Junior PV, Janssen DJA, Pereira EDB. Religiosity and Religious Coping in Patients with COPD: A Cross-Sectional Comparison Between Brazil and the Netherlands and Associations with Physical and Psychological Health. JOURNAL OF RELIGION AND HEALTH 2022; 61:4039-4050. [PMID: 34291424 DOI: 10.1007/s10943-021-01341-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to compare religiosity and religious coping (RC) between Brazilian and Dutch patients with chronic obstructive pulmonary disease (COPD) and to examine associations with physical and psychological health. Religiosity, RC, and physical and psychological health were cross-sectionally assessed in 161 patients with COPD (74 from Brazil and 87 from the Netherlands). Brazilian participants showed the greatest religiosity (p < 0.05), and weak correlations were observed between religiosity/RC and exercise capacity and quality of life (p < 0.05 for all analyses). Brazilian patients with COPD had higher religiosity than Dutch patients, and religiosity correlated with functional exercise capacity and quality of life.
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Affiliation(s)
- Rafael Mesquita
- Department of Physiotherapy, Federal University of Ceara, Rua Major Weyne, 1440 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-450, Brazil.
- Masters Programme in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceará, Brazil.
- Masters Programme in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceará, Brazil.
| | - Guilherme P F da Silva
- Department of Physiotherapy, Health Sciences Centre, University of Fortaleza, Fortaleza, Ceará, Brazil
- Masters and Doctoral Programmes in Medical Sciences, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | - Marcelo Alcantara Holanda
- Respiration Laboratory (RespLab), Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | - Daniela Gardano Bucharles Mont'Alverne
- Department of Physiotherapy, Federal University of Ceara, Rua Major Weyne, 1440 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-450, Brazil
- Masters Programme in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | - Daisy J A Janssen
- Department of Research & Development, CIRO, Horn, Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Steinbeis F, Knape P, Mittermaier M, Helbig ET, Tober-Lau P, Thibeault C, Lippert LJ, Xiang W, Müller-Plathe M, Steinbrecher S, Meyer HJ, Ring RM, Ruwwe-Glösenkamp C, Alius F, Li Y, Müller-Redetzky H, Uhrig A, Lingscheid T, Grund D, Temmesfeld-Wollbrück B, Suttorp N, Sander LE, Kurth F, Witzenrath M, Zoller T. Functional limitations 12 months after SARS-CoV-2 infection correlate with initial disease severity: An observational study of cardiopulmonary exercise capacity testing in COVID-19 convalescents. Respir Med 2022; 202:106968. [PMID: 36081267 PMCID: PMC9420203 DOI: 10.1016/j.rmed.2022.106968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
Background Cardiopulmonary Exercise Testing (CPET) provides a comprehensive assessment of pulmonary, cardiovascular and musculosceletal function. Reduced CPET performance could be an indicator for chronic morbidity after COVID-19. Methods Patients ≥18 years with confirmed PCR positive SARS-CoV-2 infection were offered to participate in a prospective observational study of clinical course and outcomes of COVID-19. 54 patients completed CPET, questionnaires on respiratory quality of life and performed pulmonary function tests 12 months after SARS-CoV-2 infection. Results At 12 months after SARS-CoV-2 infection, 46.3% of participants had a peak performance and 33.3% a peak oxygen uptake of <80% of the predicted values, respectively. Further impairments were observed in diffusion capacity and ventilatory efficiency. Functional limitations were particularly pronounced in patients after invasive mechanical ventilation and extracorporeal membrane oxygenation treatment. Ventilatory capacity was reduced <80% of predicted values in 55.6% of participants, independent from initial clinical severity. Patient reported dyspnea and respiratory quality of life after COVID-19 correlated with CPET performance and parameters of gas exchange. Risk factors for reduced CPET performance 12 months after COVID-19 were prior intensive care treatment (OR 5.58, p = 0.004), SGRQ outcome >25 points (OR 3.48, p = 0.03) and reduced DLCO (OR 3.01, p = 0.054). Conclusions Functional limitations causing chronic morbidity in COVID-19 survivors persist over 12 months after SARS-CoV-2 infection. These limitations were particularly seen in parameters of overall performance and gas exchange resulting from muscular deconditioning and lung parenchymal changes. Patient reported reduced respiratory quality of life was a risk factor for adverse CPET performance.
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Barman A, Sinha MK, Sahoo J, Jena D, Patel V. Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis. Heart Lung 2022; 53:11-24. [PMID: 35108624 PMCID: PMC8758335 DOI: 10.1016/j.hrtlng.2022.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/29/2021] [Accepted: 01/10/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND With an increase in published reports on respiratory rehabilitation (RR) in severe acute respiratory syndrome (SARS), there is a need for a meta-analysis and systematic review to measure the effects of the RR in SARS. OBJECTIVE Objective of the review was to evaluate the efficacy and safety of RR in patients recovering from SARS. METHODS PubMed/ MEDLINE, CENTRAL, EMBASE, and Clinical Trial Registries were systematically searched (between January 1, 2003, to July 31, 2021) to identify all patients who received RR, at least for six days, following SARS. The primary outcome was exercise capacity [6-meter walking distance (6-MWD)], and secondary outcomes were change in pulmonary function test (PFT) parameters, activities in daily livings (ADLs), and quality of life (QoL). Meta-analysis was performed by using RevMan 5.4. RESULTS Twenty-one observational studies, including eight comparative studies, were included. Eight comparative studies participated in quantitative meta-analysis. The intervention group, who received RR, improved significantly in exercise capacity (6-MWD) [mean difference (MD):45.79, (95% CI:31.66-59.92)] and PFT parameters, especially in forced vital capacity (FVC%) [MD:4.38, (95% CI:0.15-8.60)], and diffusion lung capacity for carbon monoxide (DLCO%) [MD:11.78, (95% CI:5.10-18.46)]. The intervention group failed to demonstrate significant improvement in ADLs and QoL outcomes. No significant adverse events were reported during the intervention. CONCLUSION Respiratory rehabilitation can improve exercise capacity and PFT parameters in patients recovering from SARS infection. The RR does not cause serious adverse events. Clinical trials to determine the best RR program (in terms of initiation, duration, and components) in SARS and its treatment efficacy, both in the short and long- term are needed.
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Affiliation(s)
- Apurba Barman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Mithilesh K Sinha
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jagannatha Sahoo
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Debasish Jena
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Vikas Patel
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Bhubaneswar, India
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Steinbeis F, Thibeault C, Doellinger F, Ring RM, Mittermaier M, Ruwwe-Glösenkamp C, Alius F, Knape P, Meyer HJ, Lippert LJ, Helbig ET, Grund D, Temmesfeld-Wollbrück B, Suttorp N, Sander LE, Kurth F, Penzkofer T, Witzenrath M, Zoller T. Severity of respiratory failure and computed chest tomography in acute COVID-19 correlates with pulmonary function and respiratory symptoms after infection with SARS-CoV-2: An observational longitudinal study over 12 months. Respir Med 2021; 191:106709. [PMID: 34871947 PMCID: PMC8632363 DOI: 10.1016/j.rmed.2021.106709] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/11/2021] [Accepted: 11/29/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Prospective and longitudinal data on pulmonary injury over one year after acute coronavirus disease 2019 (COVID-19) are sparse. We aim to determine reductions in pulmonary function and respiratory related quality of life up to 12 months after acute COVID-19. METHODS Patients with acute COVID-19 were enrolled into an ongoing single-centre, prospective observational study and prospectively examined 6 weeks, 3, 6 and 12 months after onset of COVID-19 symptoms. Chest CT-scans, pulmonary function and symptoms assessed by St. Georges Respiratory Questionnaire were used to evaluate respiratory limitations. Patients were stratified according to severity of acute COVID-19. RESULTS Median age of all patients was 57 years, 37.8% were female. Higher age, male sex and higher BMI were associated with acute-COVID-19 severity (p < 0.0001, 0.001 and 0.004 respectively). Also, pulmonary restriction and reduced carbon monoxide diffusion capacity was associated with disease severity. In patients with restriction and impaired diffusion capacity, FVC improved over 12 months from 61.32 to 71.82, TLC from 68.92 to 76.95, DLCO from 60.18 to 68.98 and KCO from 81.28 to 87.80 (percent predicted values; p = 0.002, 0.045, 0.0002 and 0.0005). The CT-score of lung involvement in the acute phase was associated with restriction and reduction in diffusion capacity in follow-up. Respiratory symptoms improved for patients in higher severity groups during follow-up, but not for patients with initially mild disease. CONCLUSION Severity of respiratory failure during COVID-19 correlates with the degree of pulmonary function impairment and respiratory quality of life in the year after acute infection.
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Affiliation(s)
- Fridolin Steinbeis
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Charlotte Thibeault
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Felix Doellinger
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Raphaela Maria Ring
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Mirja Mittermaier
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christoph Ruwwe-Glösenkamp
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Florian Alius
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Philipp Knape
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Hans-Jakob Meyer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Lena Johanna Lippert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Elisa Theresa Helbig
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Daniel Grund
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Bettina Temmesfeld-Wollbrück
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany
| | - Norbert Suttorp
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; German Center for Lung Research (DZL), Berlin, Germany
| | - Leif Erik Sander
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; German Center for Lung Research (DZL), Berlin, Germany
| | - Florian Kurth
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, And Department of Medicine I, University Medical Centre Hamburg-Eppendorf, 20359, Hamburg, Germany
| | - Tobias Penzkofer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Augustenburger Platz 1, 13353, Berlin, Germany; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Martin Witzenrath
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; German Center for Lung Research (DZL), Berlin, Germany
| | - Thomas Zoller
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117, Berlin, Germany; Swiss Tropical and Public Health Institute, Basel, Switzerland.
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Majorski DS, Duiverman ML, Windisch W, Schwarz SB. Long-term noninvasive ventilation in COPD: current evidence and future directions. Expert Rev Respir Med 2021; 15:89-101. [PMID: 33245003 DOI: 10.1080/17476348.2021.1851601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: Long-term noninvasive ventilation (NIV) is an established treatment for end-stage COPD patients suffering from chronic hypercapnic respiratory failure. This is reflected by its prominent position in national and international medical guidelines. Areas covered: In recent years, novel developments in technology such as auto-titrating machines and hybrid modes have emerged, and when combined with advances in information and communication technologies, these developments have served to improve the level of NIV-based care. Such progress has largely been instigated by the fact that healthcare systems are now confronted with an increase in the number of patients, which has led to the need for a change in current infrastructures. This article discusses the current practices and recent trends, and offers a glimpse into the future possibilities and requirements associated with this form of ventilation therapy. Expert opinion: Noninvasive ventilation is an established and increasingly used treatment option for patients with chronic hypercapnic COPD and those with persistent hypercapnia following acute hypercapnic lung failure. The main target is to augment alveolar hypoventilation by reducing PaCO2 to relieve symptoms. Nevertheless, when dealing with severely impaired patients, it appears necessary to switch the focus to patient-related outcomes such as health-related quality of life.
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Affiliation(s)
- Daniel S Majorski
- Department of Pneumology, Cologne Merheim Hospital , Cologne, Germany.,Faculty of Health/School of Medicine, Witten/Herdecke University , Witten, Germany
| | - Marieke L Duiverman
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands.,Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen , Groningen, The Netherlands
| | - Wolfram Windisch
- Department of Pneumology, Cologne Merheim Hospital , Cologne, Germany.,Faculty of Health/School of Medicine, Witten/Herdecke University , Witten, Germany
| | - Sarah B Schwarz
- Department of Pneumology, Cologne Merheim Hospital , Cologne, Germany.,Faculty of Health/School of Medicine, Witten/Herdecke University , Witten, Germany
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Ronit A, Gelpi M, Argentiero J, Mathiesen I, Nielsen SD, Pressler T, Quittner AL. Electronic applications for the CFQ-R scoring. Respir Res 2017; 18:108. [PMID: 28558706 PMCID: PMC5450183 DOI: 10.1186/s12931-017-0592-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 05/18/2017] [Indexed: 11/10/2022] Open
Abstract
Patient reported outcomes (PROs) have become widely accepted outcome measures in cystic fibrosis (CF) and other respiratory diseases. The Cystic Fibrosis-Questionnaire-Revised (CFQ-R) is the best validated and most widely used PRO for CF. Data collection can be time-intensive, and electronic platforms would greatly facilitate the feasibility, utility and accuracy of administration of the CFQ-R. Given that the CFQ-R is utilized in virtually all clinical trials worldwide and is increasingly integrated into clinical practice, we developed a software application that will help users to administer, score and save CFQ-R data for all versions. All codes are open access, which will enable other PRO users to design similar applications for other respiratory diseases, such as primary ciliary dyskinesia and non-CF bronchiectasis.
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Affiliation(s)
- Andreas Ronit
- Department of Infectious Diseases 8632, University Hospital of Copenhagen, Copenhagen, Denmark.
| | - Marco Gelpi
- Department of Infectious Diseases 8632, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Jonathan Argentiero
- Copenhagen Cystic Fibrosis Center, Department of Infectious Diseases, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Inger Mathiesen
- Copenhagen Cystic Fibrosis Center, Department of Infectious Diseases, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Susanne D Nielsen
- Department of Infectious Diseases 8632, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Tanja Pressler
- Copenhagen Cystic Fibrosis Center, Department of Infectious Diseases, University Hospital of Copenhagen, Copenhagen, Denmark
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Ronit A, Mathiesen IH, Gelpi M, Benfield T, Gerstoft J, Pressler T, Christiansen A, Lundgren J, Vestbo J, Dam Nielsen S. Small airway dysfunction in well-treated never-smoking HIV-infected individuals. Eur Respir J 2017; 49:49/3/1602186. [DOI: 10.1183/13993003.02186-2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 11/30/2016] [Indexed: 12/29/2022]
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