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Background and Objective: Respiratory muscle activity is increased in patients with chronic respiratory disease. 18F‐FDG‐PET/CT can assess respiratory muscle activity. We hypothesized that respiratory muscles metabolism was correlated to lung function impairment and was associated to prognosis in patients undergoing lung cancer surgery based on the research question whether respiratory muscle metabolism quantitatively correlates with the severity of lung function impairment in patients? Does respiratory muscle hypermetabolism have prognostic value? Methods: Patients undergoing 18F‐FDG‐PET/CT and pulmonary function tests prior to lung cancer surgery were identified. Maximum Standardized Uptake Value (SUVm) were measured in each respiratory muscle group (sternocleidomastoid, scalene, intercostal, diaphragm), normalized against deltoid SUVm. Respiratory muscle hypermetabolism was defined as SUVm >90th centile in any respiratory muscle group. Clinical outcomes were collected from a prospective cohort. Results: One hundred fifty‐six patients were included, mostly male [110 (71%)], 53 (34%) with previous diagnosis of COPD. Respiratory muscle SUVm were: scalene: 1.84 [1.51–2.25], sternocleidomastoid 1.64 [1.34–1.95], intercostal 1.01 [0.84–1.16], diaphragm 1.79 [1.41–2.27]. Tracer uptake was inversely correlated to FEV1 for the scalene (r = −0.29, p < 0.001) and SCM (r = −0.17, p = 0.03) respiratory muscle groups and positively correlated to TLC for the scalene (r = 0.17, p = 0.04). Respiratory muscle hypermetabolism was found in 45 patients (28.8%), who had a lower VO2 max (15.4 [14.2–17.5] vs. 17.2 mL/kg/min [15.2–21.1], p = 0.07) and poorer overall survival when adjusting to FEV1% (p < 0.01). Conclusion: Our findings show respiratory muscle hypermetabolism is associated with lung function impairment and has prognostic significance. 18F‐FDG/PET‐CT should be considered as a tool for assessing respiratory muscle activity and to identify high‐risk patients. [ABSTRACT FROM AUTHOR]

Background: In patients with chronic respiratory failure, home non-invasive ventilation (NIV) is delivered through nasal or oronasal masks. Masks are a cornerstone for NIV success but can be associated with side effects. However, the type, the frequency and the consequences of these side effects are unknown. Here, we aimed to study the prevalence, nature, and impact of mask-related adverse events in a cohort of stable patients. We then investigated differences between oronasal and nasal masks both in our cohort and in a bench study., Methods: Prospective observational cohort including patients established on long-term non-invasive ventilation admitted for their elective review. Data regarding mask-related side effects were assessed using a structured questionnaire. Our bench study was performed using a 3-D printed head connected to an artificial lung., Results: Eight hundred patients were included of whom, 84% had a oronasal mask. Moderate to very severe mask-related side effects occurred in 47% of patients and severe to very severe side effects occurred in 18%. Side effects were associated to a poorer daytime PaCO 2 (p=0.005), poorer subjective sleep quality (p=0.003), poorer quality of life (p<0.001). Mask-related side effects were more frequently reported with the use of oronasal masks as compared to nasal masks (p=0.023). Our bench study showed that nasal masks were more stable than oronasal masks (p<0.001)., Conclusion: Mask-related side effects are frequent and associated with poorer outcome. Our data suggest that nasal masks may have a better tolerance profile and should be used as a first-line interface., (Copyright ©The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org.)

Pulmonary complications after allogeneic hematopoietic stem cell transplantation occur frequently (30-75%), vary in severity, and sometimes prove lethal. They may occur at an early stage post-transplant before D100 but may also surface later. Etiological support for these complications has shown a beneficial impact on survival. When faced with early complications, non-invasive tests, scans, and microbiological tests must be rapidly implemented. In the majority of cases, these tests facilitate diagnosis. In cases where microbiological non-invasive tests are negative, and the patient shows a steady respiratory condition, bronchoalveolar lavage can be effective if it is implemented in the first four days following the onset of pulmonary symptoms. This diagnostic approach should in no way occlude the introduction of broad-spectrum antibiotics in these profoundly immunocompromised patients. Later pulmonary complications are the most often not infectious. They include different anatomo-clinical conditions: cryptogenic organizing pneumonia; interstitial lung disease; idiopathic pleuroparenchymal fibroelastosis. Vascular disorders may include hypertension, thrombotic microangiopathy, venous thromboembolism, and pleural effusions. These conditions must be monitored using RFE (respiratory functional exploration) which allows early detection and therapeutic intervention. A combination of RFE and thoracic radiology scans will provide diagnostic assessment. Bronchoalveolar lavage is indicated when an infection is suspected or before systemic corticosteroid therapy. A lung biopsy should be discussed on a case-by-case basis, such as in cases of interstitial pulmonary disorders., (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)