272. Demystifying Volume Status: An Ultrasound-Guided Physiologic Framework.
Accurate assessment of a patient's volume status is crucial in many conditions, informing decisions on fluid prescribing, vasoactive agents, and decongestive therapies. Determining a patient's volume status is challenging because of limitations in examination and investigations and the complexities of fluid homeostasis in disease states. Point-of-care ultrasound (POCUS) is useful in assessing hemodynamic parameters related to volume status, fluid responsiveness, and fluid tolerance. It requires understanding several physiologic concepts to interpret and integrate POCUS findings accurately into volume-related clinical decision-making.
273. Association of Lung Function With Visceral Adiposity and Skeletal Muscle Mass Considering Myosteatosis.
作者: Young Ju Jung.;Min Jung Lee.;Eun Hee Kim.;Sung-Jin Bae.;Hong-Kyu Kim.
来源: Chest. 2025年167卷6期1714-1726页
Changes in body composition, including loss of muscle mass and obesity, adversely affect lung function.
274. Effect of Famotidine on Outcomes in Pulmonary Arterial Hypertension: A Randomized Controlled Trial.
作者: Peter J Leary.;Samuel G Rayner.;Kelley R H Branch.;Laurie Hogl.;Nancy M Liston.;Lia M Barros.;Jessi Prout.;Stephanie Nolley.;Jonathan Buber.;David D Ralph.;Jeffrey L Probstfield.
来源: Chest. 2025年
Adaptation of the right ventricle is a key determinant of outcomes in pulmonary arterial hypertension (PAH). Despite a compelling rationale to develop targeted therapies for the right ventricle in PAH, no such treatments exist. H2-receptor antagonism is a potential myocardial-focused paradigm in heart failure.
275. Pulmonary Subsolid Nodules: Upfront Surgery or Watchful Waiting?
作者: Fenglan Li.;Linlin Qi.;Changfa Xia.;Jianing Liu.;Jiaqi Chen.;Shulei Cui.;Liyan Xue.;Sainan Cheng.;Xu Jiang.;Jianwei Wang.
来源: Chest. 2025年167卷6期1764-1777页
Patients with pulmonary subsolid nodules (SSNs) of ≤ 2 cm in diameter and a consolidation to tumor ratio (CTR) of ≤ 0.25 have good postoperative prognoses, but their management remains controversial.
276. The Role of Bronchial Biopsy in the Prediction of Response to Biologic Therapy in Severe Uncontrolled Asthma: A Prospective Study.
作者: Borja G Cosío.;Amanda Iglesias.;Hanaa Shafiek.;Mar Mosteiro.;Inés Escribano.;Nuria Toledo-Pons.;Jose Luis Valera.;Cristina Gómez Bellvert.;Luis Pérez de Llano.
来源: Chest. 2025年167卷4期945-955页
Up to two-thirds of patients with severe uncontrolled asthma (SUA) who received biologic therapy do not have a complete response.
277. Effect of Flow Rates of High-Flow Nasal Cannula on Extubation Outcomes: A Randomized Controlled Trial.
作者: Sheng-Yuan Ruan.;Yao-Wen Kuo.;Chun-Ta Huang.;Ying-Chun Chien.;Chun-Kai Huang.;Lu-Cheng Kuo.;Jerry Shu-Hung Kuo.;Kuei-Pin Chung.;Shih-Chi Ku.;Jung-Yien Chien.; .
来源: Chest. 2025年167卷5期1388-1396页
High-flow nasal cannula (HFNC) has emerged as a promising intervention for postextubation oxygen therapy, with the potential to reduce the need for reintubation. However, it remains unclear whether using a higher flow setting provides better outcomes than the commonly used flow rate of 30 to 50 L/min.
278. Preserved Ratio Impaired Spirometry Prevalence, Risk Factors, and Outcomes: A Systematic Review and Meta-Analysis.
作者: Nicole M Robertson.;Connor S Centner.;Vickram Tejwani.;Shakir Hossen.;Dipan Karmali.;Sibei Liu.;Trishul Siddharthan.
来源: Chest. 2025年167卷6期1591-1614页
The prevalence of chronic respiratory diseases is increasing globally. There is evidence that those with spirometric impairment and no signs of obstruction (termed preserved ratio impaired spirometry [PRISm]) have an increased risk of morbidity and mortality compared with those with normal lung function. Several gaps remain in characterizing PRISm.
279. Verifying Eligibility for Lung Cancer Screening via TiMeToAct Text Message Intervention: A Quality Improvement Initiative.
作者: F Alonso Camacho.;Gayatri Gujar.;Arlette Chávez-Iñiguez.;Francisco Cartujano-Barrera.;Kevin Fiscella.;A Paula Cupertino.;David H Adler.;M Patricia Rivera.
来源: Chest. 2025年167卷5期1509-1513页 280. Ascertainment of Small Airways Dysfunction Using Oscillometry to Better Define Asthma Control and Future Risk: Are We Ready to Implement It in Clinical Practice?
作者: Rory Chan.;Laura Gochicoa-Rangel.;Marcello Cottini.;Pasquale Comberiati.;Erol A Gaillard.;Francine M Ducharme.;Stanley P Galant.
来源: Chest. 2025年167卷5期1287-1296页
The small airways comprise generations 8 to 23 of the bronchial tree, consist of airways with an internal diameter < 2 mm, and are classically difficult to assess and treat in persistent asthma. Small airways dysfunction (SAD) is integral to the asthma management paradigm because it is associated with poorer symptom control and greater levels of type 2 inflammation, and it has been proposed as a potentially treatable asthma trait. Although identification of SAD based on oscillometry has been found to be clinically useful in managing asthma, very few physicians, including specialists, use this technique as part of standard or adjunct evaluation of lung function to diagnose asthma, grade severity of airway obstruction, ascertain disease control or the risk for future exacerbations, or to make management decisions. To rectify the unrecognized value of oscillometry in the asthma community, a consortium of authors who are investigators with knowledge and experience of oscillometry wished to address the most important clinical questions raised by our colleagues who are considering using this technique, including its clinical utility. In this article, we discuss integral concepts, including applicability of oscillometry as a predictive tool for asthma exacerbations and disease control, adequacy of spirometry and oscillometry in assessing SAD, potential limitations of oscillometry, and treatment options for SAD.
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