Author: "Narongkorn Saiphoklang" - Searchworks@Jio Institute Digital Library Search Results

45 results on '"Narongkorn Saiphoklang"'

1. Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease

Author: Thanapon Keawon and Narongkorn Saiphoklang
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Background: Chronic obstructive pulmonary disease (COPD) is associated with airflow limitation resulting from a combination of small airway disease (SAD) and parenchymal destruction. Although various diagnostic methods for SAD exist, access to these tools can be limited. Objectives: This study aimed to explore the correlation between handgrip strength (HGS) and SAD in COPD patients. Design: Cross-sectional prospective study. Methods: HGS was measured using a hand dynamometer. SAD was evaluated using impulse oscillometry, with results reported as the difference between respiratory resistance at 5 and 20 Hz (R5–R20). SAD was defined as R5–R20 ⩾0.07 kPa/L/s. The receiver operator characteristic (ROC) curves, sensitivity, and specificity values were calculated to determine the optimal cutoff value of HGS for predicting SAD. Results: Sixty-four patients (90.6% male) were included. The average age was 72.1 ± 8.3 years, and body mass index was 23.4 ± 4.2 kg/m 2 . FEV 1 was 71.6 ± 21.3%, and HGS was 30.2 ± 8.1 kg. R5–R20 was 0.11 ± 0.08 kPa/L/s. SAD was found in 64.1% of patients. A negative correlation between HGS and R5–R20 was observed ( r = −0.332, p = 0.007). The best cutoff value for HGS in detecting SAD was determined to be 28.25 kg, with a sensitivity of 73.9%, specificity of 65.9%, and an area under ROC curve of 0.685 (95% CI 0.550–0.819, p = 0.015). Conclusion: SAD is common in COPD patients, and HGS is significantly negatively correlated with SAD. This tool might serve as an alternative or adjunctive assessment for small airway dysfunction in COPD patients. Registration: This study was registered with ClinicalTrials.gov with number NCT06223139.
Published: 2024
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2. Allergic rhinitis and other comorbidities associated with asthma control in Thailand

Author: Thitiwat Sriprasart, Narongkorn Saiphoklang, Theerasuk Kawamatawong, Watchara Boonsawat, Wat Mitthamsiri, Naricha Chirakalwasan, Chirawat Chiewchalermsri, Athipat Athipongarporn, Harutai Kamalaporn, Kumpol Kornthatchapong, Manaphol Kulpraneet, Mongkhon Sompornrattanaphan, Nittha Oer-Areemitr, Ticha Rerkpattanapipat, Santi Silairatana, Sarita Thawanaphong, Thanate Gaensan, Ketsupar Jirakran, and Orapan Poachanukoon
Subjects: ACT, asthma, asthma control test, allergic rhinitis, comorbidities, IgE, Medicine (General), R5-920
Abstract: BackgroundAsthma and allergic rhinitis (AR) can coexist and cause disabilities. This study aimed to assess the association between AR, asthma control, asthma-related quality of life, and other comorbidities.MethodsA cross-sectional study was conducted in adults with asthma in six hospitals in Thailand. The outcomes were association of asthma control assessed by the asthma control test (ACT), AR, and asthma comorbidities. Not-well-controlled asthma was defined as ACT scores ≤22. The severity of AR was determined by visual analog scale (VAS). Severe AR was defined as VAS ≥5. Asthma-related quality of life (AQLQ), comorbidities, and total IgE were recorded.ResultsA total of 682 asthmatic patients were included. Median (IQR) age was 58.0 (47.0–64.0) years. 69.9% were female. Not-well-controlled asthma was present in 44.7%. The prevalence of AR was 86.1%. Moderate/severe persistent AR was diagnosed in 21.7% and severe AR was diagnosed in 30.2% of the patients. Inhaled corticosteroid-containing regimens were prescribed in 97.7% of patients. Intranasal corticosteroid and antihistamine were prescribed in 65.7 and 31.7%, respectively. Patients with not-well-controlled asthma had higher body mass index, VAS scores, proportions of pollution exposure, aeroallergen sensitization, severe AR, nasal polyp, urticaria, food allergy, gastroesophageal reflux disease, depression and anxiety, peptic ulcer, and asthma exacerbations, but younger age, lower AQLQ scores, and lower FEV1. Correlation was found between AR severity and ACT (r = −0.461, p
Published: 2024
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3. Comparison of ROX, HROX, and delta-HR indices to predict successful weaning from high-flow oxygen therapy in hospitalized patients with COVID-19 pneumonia

Author: Pitchayapa Ruchiwit, Jaturong Madua, and Narongkorn Saiphoklang
Subjects: Medicine, Science
Published: 2024

4. dCROX and ROX Indices Predict Clinical Outcomes in Patients with COVID-19 Pneumonia Treated with High-Flow Nasal Cannula Oxygen Therapy

Author: Pitchayapa Ruchiwit, Kanpisut Pongtongkam, and Narongkorn Saiphoklang
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background. High-flow nasal cannula (HFNC) therapy is a common respiratory support in patients with COVID-19 pneumonia. Predictive tools for the evaluation of successful weaning from HFNC therapy for COVID-19 pneumonia have been limited. This study aimed to develop a new predictor for weaning success from HFNC treatment in patients with COVID-19 pneumonia. Methods. We conducted a retrospective cohort study at Thammasat University Hospital, Thailand. Patients with COVID-19 pneumonia requiring HFNC therapy from April 2020 to September 2021 were included. The ROX index was defined as the ratio of oxygen saturation (SpO2)/fraction of inspired oxygen (FiO2) to respiratory rate. The CROX index was defined as the ratio of C-reactive protein (CRP) to the ROX index. dCROX was defined as the difference in CROX index between 24 hours and 72 hours. Weaning success was defined as the ability to sustain spontaneous breathing after separation from HFNC without any invasive or noninvasive ventilatory support for ≥48 hours or death. Results. A total of 106 patients (49.1% male) were included. The mean age was 62.1 ± 16.2 years. Baseline SpO2/FiO2 was 276.1 ± 124.8. The rate of HFNC weaning success within 14 days was 61.3%. The best cutoff value of the dCROX index to predict HFNC weaning success was 3.15 with 66.2% sensitivity, 70.7% specificity, and an area under the ROC curve (AUC) of 0.71 (95% CI: 0.59–0.81, p
Published: 2024
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5. Factors influencing acceptance of influenza and pneumococcal vaccinations for patients with chronic obstructive pulmonary disease

Author: Narongkorn Saiphoklang and Jiranan Phadungwatthanachai
Subjects: chronic obstructive pulmonary disease, exacerbation, influenza vaccination, pneumococcal vaccination, pulmonary functions, Immunologic diseases. Allergy, RC581-607, Therapeutics. Pharmacology, RM1-950
Abstract: Chronic obstructive pulmonary disease (COPD), often complicated by influenza or pneumococcus, is a leading cause of mortality worldwide. Vaccinations against influenza and pneumococcus are, but vaccination coverage in Thailand has not been ascertained. This study aimed to determine the determinants of influenza and pneumococcal vaccination acceptance in COPD patients. A cross-sectional study of 210 COPD patients was conducted. Demographics, vaccinations, clinical outcomes (exacerbations and hospitalizations), and pulmonary functions were collected. A total of 134 COPD patients (91.0%male) were eligible for final analysis. Of these, 102 (76.1%) and 59 (44.0%) were vaccinated against influenza and pneumococcus, respectively. The influenza-vaccinated group had a higher rate of pneumococcal vaccination than the influenza-unvaccinated group (57.8% vs 0%, P
Published: 2022
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6. Prediction of optimal continuous positive airway pressure in Thai patients with obstructive sleep apnea

Author: Narongkorn Saiphoklang, Kanyada Leelasittikul, and Apiwat Pugongchai
Subjects: Medicine, Science
Abstract: Abstract Continuous positive airway pressure (CPAP) is simple and effective treatment for obstructive sleep apnea (OSA) patients. However, the CPAP prediction equation in each country is different. This study aimed to predict CPAP in Thai patients with OSA. A retrospective study was conducted in Thai patients, who OSA was confirmed by polysomnography and CPAP titration from January 2015 to December 2018. Demographics, body mass index (BMI), neck circumference (NC), Epworth sleepiness scale, apnea–hypopnea index (AHI), respiratory disturbance index (RDI), mean and lowest pulse oxygen saturation (SpO2), and optimal pressure were recorded. A total of 180 subjects were included: 72.8% men, age 48.7 ± 12.7 years, BMI 31.0 ± 6.3 kg/m2, NC 40.7 ± 4.1 cm, AHI 42.5 ± 33.0 per hour, RDI 47.1 ± 32.8 per hour, and lowest SpO2 77.1 ± 11.0%. Multiple linear regression analysis identified NC, BMI, RDI, and lowest SpO2. A final CPAP predictive equation was: optimal CPAP (cmH2O) = 4.614 + (0.173 × NC) + (0.067 × BMI) + (0.030 × RDI) − (0.076 × lowest SpO2). This model accounted for 50.0% of the variance in the optimal pressure (R2 = 0.50). In conclusion, a CPAP prediction equation can be used to explain a moderate proportion of the titrated CPAP in Thai patients with OSA. However, the CPAP predictive equation in each country may be different due to differences of ethnicity and physiology. Trial registration: TCTR20200108003.
Published: 2021
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7. Eosinophilia and parasitic infestations in patients with chronic obstructive pulmonary disease

Author: Narongkorn Saiphoklang and Chanya Chomchoey
Subjects: Medicine, Science
Abstract: Abstract Eosinophilia may guide response to inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease (COPD). This study aimed to determine prevalence of eosinophilia and parasitic infestations in these patients. We conducted a prospective cohort study between February 2019 and January 2020 and screened 107 stable COPD patients. A total of 77 subjects (84.4% men) were included. Age was 73.8 ± 8.9 years. Forced expiratory volume in 1 s was 66.5 ± 25.5%. Smoking history was 25.9 ± 18 pack-years. Comorbidities included cardiovascular disease (57.1%). Respiratory symptoms were assessed by modified Medical Research Council dyspnea score (1.6 ± 0.8), chronic obstructive pulmonary disease Assessment Test score (9.3 ± 4.9), and 6-min walking distance (317.2 ± 135.2 m). Patients with blood eosinophil count at least 100 cells/μL were 79.2% and at least 300 cells/μL were 33.8%. Intestinal parasites were not found. Significant positive correlations were found between high blood eosinophilia and some post-bronchodilator lung function parameters. In conclusion, eosinophilic COPD was not uncommon. No intestinal parasite was found in this population. This study suggests that stool parasite exam might be omitted for routine practice. Clinicaltrials.in.th Number: TCTR20191129002.
Published: 2020
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8. Comparison between 20 and 30 meters in walkway length affecting the 6-minute walk test in patients with chronic obstructive pulmonary disease: A randomized crossover study.

Author: Narongkorn Saiphoklang, Apiwat Pugongchai, and Kanyada Leelasittikul
Subjects: Medicine, Science
Abstract: BackgroundA 30-m walkway length for the 6-minute walk test (6MWT) is the standard recommendation established by the American Thoracic Society to assess patients with chronic obstructive pulmonary disease (COPD). This study aimed to compare between the distances of 20 and 30 m long corridor affecting 6MWT in COPD patients.MethodsA randomized crossover study was conducted with patients. COPD patients were randomized 1:1 to either a 20-m or a 30-m walkway in the first test, then switched to the other in the second test. Physiologic parameters and 6-minute walking distance (6MWD) were recorded.ResultsFifty subjects (92% men) were included: age 69.1±7.4 years, body mass index 22.9±5.5 kg/m2, FEV1 63.0±21.3%, and 50% having cardiovascular disease. The 6MWD in a 20-m and a 30-m walkway were 337.82±71.80 m and 359.85±77.25 m, respectively (PConclusionsThe walkway length had significant effect on walking distance in COPD patients. A 30-m walkway length should still be recommended in 6MWT for COPD assessment.Clinical trial registrationClinicaltrials.in.th number: TCTR20200206003.
Published: 2022
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9. The Effect of Nintedanib in Post-COVID-19 Lung Fibrosis: An Observational Study

Author: Narongkorn Saiphoklang, Pimchanok Patanayindee, and Pitchayapa Ruchiwit
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background. Lung fibrosis is a sequela of COVID-19 among patients with severe pneumonia. Idiopathic pulmonary fibrosis and lung fibrosis due to COVID-19 may share many similar features. There are limited data on effects of antifibrotic treatment of infection-related lung fibrosis. This study aimed to evaluate the effect of nintedanib on patients’ post-COVID-19 lung fibrosis. Methods. A retrospective, matched case-control study was performed on hospitalized patients with COVID-19 pneumonia. Patients who received nintedanib treatment for COVID-19 pulmonary fibrosis (nintedanib group) were compared to patients with standard treatment (control group). The primary outcome was oxygen improvement. The secondary outcomes were chest X-ray improvement, SpO2/FiO2 ratio improvement, mortality rates at 60 days, and adverse events. Results. A total of 42 patients with COVID-19 pneumonia were included (21 in each group). Mean age was 64.43 ± 14.59 years, and 54.8% were men. At baseline, SpO2/FiO2 ratio before treatment was 200.57 ± 105.77 in the nintedanib group and 326.90 ± 137.10 in the control group (P=0.002). Oxygen improvement and chest X-ray improvement were found in 71.4% and 71.4% in the nintedanib group and in 66.7% and 66.7% in the control group (P=0.739). The nintedanib group had more improvement in SpO2/FiO2 ratio than in the control group (144.38 ± 118.05 vs 55.67 ± 75.09, P=0.006). The 60-day mortality rates of the nintedanib and the control groups were 38.1% vs 23.8%, P=0.317. Hepatitis and loss of appetite were common adverse events (9.5% and 9.5%), while the incidence of diarrhea was 4.8%. Conclusions. Nintedanib as add-on treatment in post-COVID-19 lung fibrosis did not improve oxygenation, chest X-ray findings, or the 60-day mortality. However, this antifibrotic drug improved SpO2/FiO2 ratio in our patients. Further randomized controlled trials are needed to determine the efficacy of nintedanib for treatment of patients with post-COVID-19 lung fibrosis. Trial Registration. This study was registered in TCTR20220426001.
Published: 2022
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10. Correlation between Hand Grip Strength and Peak Inspiratory Flow Rate in Patients with Stable Chronic Obstructive Pulmonary Disease

Author: Apisara Suriyakul, Narongkorn Saiphoklang, Igor Barjaktarevic, and Christopher B. Cooper
Subjects: Accuhaler, dry powder inhalers, hand grip strength, peak inspiratory flow rate, Turbuhaler, Medicine (General), R5-920
Abstract: Optimal peak inspiratory flow rate (PIFR) is required for effective drug delivery to distal airways when using dry powder inhalers (DPIs). This study aimed to examine the association between PIFR and hand grip strength (HGS) in stable COPD patients. A cross-sectional study was conducted. PIFR was measured using the In-check DIAL to assess for Accuhaler and Turbuhaler DPIs. HGS was measured using a handheld dynamometer. A PIFR of 1 was 65.3 ± 23.7%. The prevalence of suboptimal PIFR was 38% and 59% for Accuhaler and Turbuhaler, respectively. HGS in the suboptimal PIFR group was lower than in the optimal PIFR group for Accuhaler (22.8 ± 4.7 vs. 33.2 ± 6.9 kg, p < 0.001) and for Turbuhaler (25.3 ± 6.4 vs. 35.1 ± 6.3 kg, p < 0.001). The equation for predicted Accuhaler PIFR (L/min) was −30.340 + (0.274 × hand grip strength) − (0.206 × age) + (0.219 × height) + (1.019 × FVC). The equation for predicted Turbuhaler PIFR (L/min) was 56.196 + (0.321 × hand grip strength) − (0.196 × female) − (0.224 × age) + (0.304 × FVC). The best cutoff values of HGS for predicting optimal PIFR in Accuhaler and Turbuhaler were 26.8 kg (with 82% sensitivity and 84% specificity) and 31.9 kg (with 79% sensitivity and 90% specificity), respectively. In conclusion, HGS correlated with PIFR in patients with clinically stable COPD, especially in the group with pronounced symptoms without frequent exacerbations. HGS threshold values associated with suboptimal PIFR were identified. HGS may be used as an alternative tool to assess an optimal inspiratory force for DPIs.
Published: 2022
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11. Handgrip strength cutoff value predicting successful extubation in mechanically ventilated patients.

Author: Narongkorn Saiphoklang and Nattawadee Mokkongphai
Subjects: Medicine, Science
Abstract: BackgroundHandgrip strength (HGS) is an alternative tool to evaluate respiratory muscle function. HGS cutoff value indicating extubation success or failure has not been investigated. This study aimed to determine HGS cutoff value to predict successful extubation.MethodsA prospective study was conducted. Patients requiring intubated mechanical ventilation with intubation ≥ 48 hours in medical wards were recruited. HGS test was performed at 10 minutes before and 30 minutes after spontaneous breathing trial (SBT). Rapid shallow breathing index (RSBI) was measured at 10 minutes before SBT.ResultsNinety-three patients (58% men) were included. Mean age was 71.6 ± 15.2 years. Weaning failure rate was 6.5%. The area under the ROC curve of 0.84 for the best HGS cutoff value at 10 minutes before SBT was 12.7 kg, with 75.9% sensitivity and 83.3% specificity (P = 0.005). The best HSG cutoff value at 30 minutes after SBT was 14.9 kg, with the area under the ROC curve of 0.82, with 58.6% sensitivity and 83.3% specificity (P = 0.009). The best RSBI cutoff value was 43.5 breaths/min/L, with the area under the ROC curve of 0.46, 33.3% sensitivity and 66.6% specificity (P = 0.737).ConclusionsHGS may be a predictive tool to guide extubation with better sensitivity and specificity than RSBI. A prospective study is needed to verify HGS test as adjunctive to RSBI in ventilator weaning protocol.
Published: 2021
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12. Correlation between Handgrip Strength and Rapid Shallow Breathing Index for Assessment of Weaning from Mechanical Ventilation

Author: Narongkorn Saiphoklang and Thanapon Keawon
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background. Assessment of weaning from mechanical ventilation (MV) is an important process. Rapid shallow breathing index (RSBI) is a standard tool to evaluate a patient’s readiness before the spontaneous breathing trial (SBT). Handgrip strength (HGS) is an alternative method for assessment of respiratory muscle strength. Relationship between HGS and RSBI has not been explored. This study aimed to determine the correlation between HGS and RSBI to predict successful extubation in mechanically ventilated patients. Methods. A prospective study was conducted in screened 120 patients requiring MV with tracheal intubation >48 h. HGS was performed at 48 h after intubation, 10 min before and 30 min after SBT, and 1 h after extubation. RSBI was performed at 10 min before SBT. Results. A total of 93 patients (58% men) were included in the final analysis. Mean age was 71.6 ± 15.2 years. Patients admitted in general medical wards were 84.9%. APACHE II score was 13.5 ± 4.7. Most patients were intubated from pneumonia (39.8%). Weaning failure was 6.5%. The main result shows that HGS was negatively correlated with RSBI (regression coefficient −0.571, P
Published: 2021
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13. Patient characteristics and outcomes of a home mechanical ventilation program in a developing country

Author: Narongkorn Saiphoklang, Apichart Kanitsap, Pitchayapa Ruchiwit, Pattarin Pirompanich, Thiti Sricharoenchai, and Christopher B Cooper
Subjects: Chronic obstructive pulmonary disease, complication, developing country, mechanical ventilation, ventilator-associated pneumonia, Diseases of the respiratory system, RC705-779
Abstract: Background: There are limited data on home mechanical ventilation (HMV) in developing countries. This study aimed to describe the patient characteristics, feasibility, and outcomes of an HMV program at a university hospital in Thailand. Materials and Methods: Data were collected on all patients who were discharged with HMV between October 2014 and August 2015 at Thammasat University Hospital. Results: Twelve patients (eight men and four women) underwent HMV. They were aged 71.5 ± 17.6 years; mean ± standard deviation. Indications for HMV were 6 neurologic diseases (4 amyotrophic lateral sclerosis, 1 multiple system atrophy, and 1 stroke), 2 chronic obstructive pulmonary disease (COPD), 1 tracheomalacia, and 3 combined neurologic diseases and respiratory diseases (2 stroke and COPD, 1 stroke and tracheomalacia). The duration of follow-up was 799.5 ± 780.5 days. The ratio of family income to cost of HMV usage was 77.2:1 ± 5.5:1. All patients had tracheostomies. Modes of HMV were biphasic positive airway pressure (66.7%), pressure-controlled ventilation (16.7%), pressure-support ventilation (8.3%), and volume-controlled ventilation (8.3%). Complications occurred in ten patients (83.3%), including tracheobronchitis (20 events) and ventilator-associated pneumonia (12 events). Overall mortality was 41.7% (5/12 patients), including two patients who died due to ventilator-associated pneumonia. There were no instances of ventilator malfunction. Conclusions: HMV is feasible for patients with neurological diseases and COPD in a developing country. The relatively high rate of complications indicates the need for more comprehensive clinical services for chronic ventilator-dependent patients in this setting.
Published: 2019
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14. Use of a Wearable Biosensor to Study Heart Rate Variability in Chronic Obstructive Pulmonary Disease and Its Relationship to Disease Severity

Author: Seon-Cheol Park, Narongkorn Saiphoklang, Donghyun Jung, David Gomez, Jonathan E. Phillips, Brett A. Dolezal, Donald P. Tashkin, Igor Barjaktarevic, and Christopher B. Cooper
Subjects: heart rate variability, wearable sensors, chronic obstructive pulmonary disease, bronchodilator, health, Chemical technology, TP1-1185
Abstract: The purpose of this study was to explore the relationships between heart rate variability (HRV) and various phenotypic measures that relate to health and functional status in chronic obstructive pulmonary disease (COPD), and secondly, to demonstrate the feasibility of ascertaining HRV via a chest-worn wearable biosensor in COPD patients. HRV analysis was performed using SDNN (standard deviation of the mean of all normal R-R intervals), low frequency (LF), high frequency (HF), and LF/HF ratio. We evaluated the associations between HRV and COPD severity, class of bronchodilator therapy prescribed, and patient reported outcomes. Seventy-nine participants with COPD were enrolled. There were no differences in SDNN, HF, and LF/HF ratio according to COPD severity. The SDNN in participants treated with concurrent beta-agonists and muscarinic antagonists was lower than that in other participants after adjusting heart rate (beta coefficient −3.980, p = 0.019). The SDNN was positively correlated with Veterans Specific Activity Questionnaire (VSAQ) score (r = 0.308, p = 0.006) and handgrip strength (r = 0.285, p = 0.011), and negatively correlated with dyspnea by modified Medical Research Council (mMRC) questionnaire (r = −0.234, p = 0.039), health status by Saint George’s Respiratory Questionnaire (SGRQ) (r = −0.298, p = 0.008), symptoms by COPD Assessment Test (CAT) (r = −0.280, p = 0.012), and BODE index (r = −0.269, p = 0.020). When measured by a chest-worn wearable device, reduced HRV was observed in COPD participants receiving inhaled beta-sympathomimetic agonist and muscarinic antagonists. HRV was also correlated with various health status and performance measures.
Published: 2022
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15. Incidence and outcome of weaning from mechanical ventilation in medical wards at Thammasat University Hospital.

Author: Narongkorn Saiphoklang and Jeerayuth Auttajaroon
Subjects: Medicine, Science
Abstract: BACKGROUND:Weaning from mechanical ventilation is classified as simple, difficult, or prolonged according to weaning process. Theoretically, simple weaning group usually has better clinical outcomes than non-simple group; however, the results of previous studies were still inconsistent. OBJECTIVES:The purpose of the study was to determine the incidence, predictors, and outcomes of ventilator weaning and causes of weaning failure. METHODS:A prospective observational study was performed between June and December 2013 in all patients (n = 164) who required mechanical ventilation with endotracheal intubation in medical wards at Thammasat University Hospital, Thailand. Duration of weaning, causes of weaning failure, extubation, reintubation, tracheostomy, number of ventilator-free days within 28 days, length of hospital stay, and hospital mortality were measured. RESULTS:103 patients were eligible for final analysis. Mean ± SD age was 65.1±17.5 years and 55.3% were males. The incidences of simple, difficult and prolonged weaning were 46.6%, 36.9% and 16.5%, respectively. The mortality rates for simple, difficult, and prolonged weaning were 0%, 10.5% and 23.5% (p = 0.006), respectively. The 3 causes of weaning failure in non-simple weaning were bronchospasm, pneumonia, and malnutrition. CONCLUSIONS:Non-simple weaning increased mortality. Bronchospasm, pneumonia, and malnutrition were key risk factors for weaning failure. Strategies are needed to minimize their effects.
Published: 2018
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16. The comparison study on accuracy of peak expiratory flow rate measurement by PRAAN, spirometry, and the mini-Wright peak flow meterÂ Â [version 1; peer review: awaiting peer review]

Author: Sirawich Chaiparnich, Orapan Poachanukoon, Natcha Manasilp, Narongkorn Saiphoklang, Charturong Tantibundhit, Pasitpon Vatcharavongvan, Pattapol Kunumpol, Phongpan Plienphanich, Apiwat Pugongchai, Kanyada Leelasittikul, and Nantavat Prompoom
Subjects: Research Article, Articles, agreement, asthma, Bland-Altman plots, correlation, digital peak flow meter, peak expiratory flow rate
Abstract: Background PRAAN, a digital peak flow meter, was developed to measure peak expiratory flow rate (PEFR) for asthma monitoring. This study aimed to compare PRAAN’s accuracy to that of spirometry and the mini-Wright peak flow meter for PEFR measurement. Methods Two cross-sectional studies were conducted in 106 healthy adult participants. Study A (n=56) compared PRAAN with spirometry, while study B (n=50) compared PRAAN with the mini-Wright peak flow meter. PEFR values were collected using crossover studies. Pearson’s correlation and Bland-Altman plots were used to report the relationship and agreement between two measurements, respectively. Results In study A, 51.8% were female, mean age was 24.3±5.6 years, and PEFR was 480.3±86.8 L/min. PEFR measured by PRAAN had very strongly positive correlation with spirometry (r=0.980, P Conclusions The accuracy of PRAAN is in the agreement with spirometry and the mini-Wright peak flow meter. The clinical application of PRAAN may potentially lead to a monitoring strategy that healthcare providers can use to improve the management of asthma.
Published: 2024
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17. Correlation of therapeutic pressure between home automatic positive airway pressure and in laboratory polysomnography manual titration in patients with obstructive sleep apnea [version 1; peer review: awaiting peer review]

Author: Apiwat Pugongchai, Kanyada Leelasittikul, and Narongkorn Saiphoklang
Subjects: Research Article, Articles, APAP, automatic positive airway pressure, continuous positive airway pressure, CPAP, obstructive sleep apnea, OSA
Abstract: Background Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea (OSA). Automatic positive airway pressure (APAP) at home might be an alternative choice to identify optimal treatment pressure for OSA patients requiring CPAP treatment. Data on the association of effective treatment pressure between laboratory polysomnography (in-lab PSG) and home APAP has been limited. The aim of this study was to determine the correlation of effective CPAP pressure between in-lab PSG and home APAP. Methods A prospective cohort study was conducted. OSA participants aged 18 years or older who required CPAP therapy were included. Patients underwent in-lab PSG with manual CPAP titration to identify an effective treatment pressure. Patients also underwent APAP at home for 2 weeks to identify 95 percentile treatment pressure as an effective pressure. Results Fifty OSA patients (82% male) were included. Mean age was 48.9±14.6 years. Body mass index was 28.7±6.1 kg/m 2. Polysomnographic data showed the effective treatment pressure of 10.4±2.9 cmH 2O and the apnea-hypopnea index was 55.1±29.0 events/hour. Severe OSA was 76%. Home APAP data showed effective treatment pressure of 10.8±1.8 cmH 2O. There was positive correlation of effective pressure between home APAP and in-lab PSG (r=0.472, P=0.001). The equation for predicting an in-lab effective pressure was: predicted pressure (cmH 2O) = 2 + (home APAP ⁎ 0.78). Bland-Altman analysis showed good agreement between them, with a low mean difference of -0.428 cmH 2O and 96% within the limit of agreement. Conclusions Home APAP pressure is moderately positively correlated with in-lab PSG effective pressure. The accuracy of home APAP is in agreement with in-lab PSG with manual CPAP titration. This APAP might be able to determine an effective therapeutic pressure in the sleep laboratory for OSA treatment.
Published: 2024
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18. Bronchodilator effect of oral doxofylline and procaterol in asthma: A randomized crossover study [version 1; peer review: awaiting peer review]

Author: Natthapon Noomon, Narongkorn Saiphoklang, Pimchanok Patanayindee, Kritti Tirakitpanich, Pitchayapa Ruchiwit, and Orapan Poachanukoon
Subjects: Research Article, Articles, asthma, Asthma Control Questionnaire-5, bronchodilator, doxofylline, procaterol, pulmonary function
Abstract: Background Oral bronchodilators may be used as an adjunctive treatment, especially in patients with uncontrolled asthma or poor inhaler technique. This study aimed to determine the differences in asthma symptoms and bronchodilator effect between oral doxofylline and oral procaterol in adults with asthma. Methods A crossover randomized controlled trial was conducted. Asthmatic patients aged 18 years or older with stable inhaled corticosteroids and long-acting beta2-agonists (ICS/LABA) treatment were included. Each patient received 2 weeks of treatment with either doxofylline or procaterol followed by a 1-week washout period and 2 weeks of treatment with the other drug. Asthma symptoms were assessed using the Asthma Control Questionnaire-5 (ACQ-5) scores, pulmonary function was assessed by spirometry with bronchodilator testing, and adverse events were recorded. Results A total of 21 patients were randomly allocated to either the doxofylline or procaterol groups. The mean age of the patients was 53.0±14.8 years. ACQ-5 scores were 1.4±1.1. After two weeks of treatment, the ACQ-5 scores and all pulmonary function parameters were not significantly different between the two groups ( P>0.05). However, significant improvements in ACQ-5 scores were found in both groups (mean change: -0.381± 0.740, P=0.029 and -0.476± 0.873, P=0.021 for the doxofylline and procaterol groups, respectively). None of the patients experienced asthma exacerbations. Conclusions Doxofylline and procaterol can improve asthma symptoms, although they cannot enhance lung function. These oral bronchodilators might be used as an add-on therapy in asthmatic patients with persistent symptoms despite treatment with an ICS/LABA combination.
Published: 2024
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19. Chronic cough management: Practical guidelines and PICO-based evidence for treatment.

Author: Dichapong Kanjanawasee, Orapan Poachanukoon, Thitiwat Sriprasart, Naricha Chirakalwasan, Narongkorn Saiphoklang, Athipat Athipongarporn, Anchalee Senavonge, Harutai Kamalaporn, Natthawan Sanguanwong, Wat Mitthamsiri, Chirawat Chiewchalermsri, Bandarn Suetrong, Aphichat Suwanchanratsamee, Pongsakorn Tantilipikorn, Monthira Maneerattanaporn, Pariyanan Jaruchinda, Theerasuk Kawamatawong, Varisara Luvira, Premsuda Sombuntham, and Mongkhon Sompornrattanaphan
Published: 2024
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20. Chronic cough management: Practical guidelines and PICO-based evidence for screening and investigation.

Author: Dichapong Kanjanawasee, Orapan Poachanukoon, Thitiwat Sriprasart, Naricha Chirakalwasan, Narongkorn Saiphoklang, Athipat Athipongarporn, Anchalee Senavonge, Harutai Kamalaporn, Natthawan Sanguanwong, Wat Mitthamsiri, Chirawat Chiewchalermsri, Bandarn Suetrong, Aphichat Suwanchanratsamee, Pongsakorn Tantilipikorn, Monthira Maneerattanaporn, Pariyanan Jaruchinda, Theerasuk Kawamatawong, Varisara Luvira, Premsuda Sombuntham, and Mongkhon Sompornrattanaphan
Published: 2024
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21. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Author: Tài, Pham, Leo, Heunk, Giacomo, Bellani, Fabiana, Madotto, Irene, Aragao, Gaëtan, Beduneau, Ewan C, Goligher, Giacomo, Grasselli, Jon Henrik, Laake, Jordi, Mancebo, Oscar, Peñuela, Lise, Piquilloud, Antonio, Pesenti, Hannah, Wunsch, Frank, van Haren, Laurent, Brochard, John G, Laffey, Abrough, Fekri, P Acharya, Subhash, Amin, Pravin, Arabi, Yaseen, Aragao, Irene, Bauer, Philippe, Beduneau, Gaëtan, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Grasselli, Giacomo, Gritsan, Alexey, Mohammadreza Hashemian, Seyed, Hermans, Greet, M Heunks, Leo, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Henrik Laake, Jon, Matamis, Dimitrio, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Piquilloud, Lise, Qiu, Haibo, Abdel Razek, Assem, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Ali Zeggwagh, Amine, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Kumar Agrawal, Vijay, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, Akbas, Türkay, Akker, Mustafa, Al Sadeh, Ghamdan, Alamri, Sultan, Algaba, Angela, Ali, Muneeb, Aliberti, Anna, Manuel Allegue, Jose, Alvarez, Diana, Amador, Joaquin, H Andersen, Finn, Ansari, Sharique, Apichatbutr, Yutthana, Apostolopoulou, Olympia, Arellano, Daniel, Arica, Mestanza, Arikan, Huseyin, Arinaga, Koichi, Arnal, Jean-Michel, Asano, Kengo, Asín-Corrochano, Marta, Milagrito Avalos Cabrera, Jesu, Avila Fuentes, Silvia, Aydemir, Semih, Aygencel, Gulbin, Azevedo, Luciano, Bacakoglu, Feza, Badie, Julio, Baedorf Kassis, Elia, Bai, Gabriela, Balaraj, Govindan, Ballico, Bruno, Banner-Goodspeed, Valerie, Banwarie, Preveen, Barbieri, Rosella, Baronia, Arvind, Barrett, Jonathan, Barrot, Loïc, Emilio Barrueco-Francioni, Jesu, Barry, Jeffrey, Bawangade, Harshal, Beavis, Sarah, Beck, Eduardo, Beehre, Nina, Belenguer Muncharaz, Alberto, Bellani, Giacomo, Belliato, Mirko, Bellissima, Agrippino, Beltramelli, Rodrigo, Ben Souissi, Asma, Benitez-Cano, Adela, Benlamin, Mohamed, Benslama, Abdellatif, Bento, Lui, Benvenuti, Daniela, Bernabe, Laura, Bersten, Andrew, Berta, Giacomo, Bertini, Pietro, Bertram-Ralph, Elliot, Besbes, Mohamed, Roberto Bettini, Lisandro, Beuret, Pascal, Bewley, Jeremy, Bezzi, Marco, Bhakhtiani, Lakshay, Bhandary, Rakesh, Bhowmick, Kaushik, Bihari, Shailesh, Bissett, Bernie, Blythe, David, Bocher, Simon, Boedjawan, Narain, M Bojanowski, Christine, Boni, Elisa, Boraso, Sabrina, Borelli, Massimo, Borello, Silvina, Borislavova, Margarita, J Bosma, Karen, Bottiroli, Maurizio, Boyd, Owen, Bozbay, Suha, Briva, Arturo, Brochard, Laurent, Bruel, Cédric, Bruni, Andrea, Buehner, Ulrike, Bulpa, Pierre, Burt, Karen, Buscot, Mathieu, Buttera, Stefania, Cabrera, 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Lynch, Ceri, Macheda, Sebastiano, Hugo Madrigal Robles, Victor, Maurizio Maggiore, Salvatore, Magret Iglesias, Mònica, Malaga, Peter, Mallapura Maheswarappa, Harish, Malpartida, Guillermo, Malyarchikov, Andrey, Mansson, Helena, Manzano, Anaid, Marey, Ismael, Marin, Nathalie, Del Carmen Marin, Maria, Markman, Eliana, Martin, Felix, Martin, Alex, Martin Dal Gesso, Cristina, Martinez, Felipe, Martínez-Fidalgo, Conchita, Martin-Loeches, Ignacio, Mas, Arantxa, Masaaki, Sakuraya, Maseda, Emilio, Massa, Eleni, Mattsson, Anna, Maugeri, Jessica, Mccredie, Victoria, Mccullough, Jame, Mcguinness, Shay, Mckown, Andrew, Medve, László, Mei, Chengqing, Mellado Artigas, Ricard, Mendes, Vitor, Khalaf Ebraheim Mervat, Mohamed, Michaux, Isabelle, Mikhaeil, Michael, Milagros, Olga, Milet, Igor, Teresa Millan, Maria, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, 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Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz 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Samantha, Hammel, Clare, Han Song, Joo, Hanlon, Gabrielle, Heines, Serge, Henriksson, Johanna, Herbrecht, Jean-Etienne, Omar Heredia Orbegoso, Gabriel, Hermon, Andrew, Hernandez, Rosana, Hernandez, Carmen, Herrera, Lui, Herrera-Gutierrez, Manuel, Heunks, Leo, Hidalgo, Juan, Hill, Dianne, Holmquist, Dagmar, Homez, Marcela, Hongtao, Xia, Hormis, Anil, Horner, Daniel, Carmen Hornos, M, Hou, Meihong, House, Stacy, Housni, Brahim, Hugill, Keith, Humphreys, Sally, Humbert, Loui, Hunter, Stephanie, Hwa Young, Lee, Iezzi, Nicola, Ilutovich, Santiago, Inal, Volkan, Innes, Richard, Ioannides, Panagioti, Antonio Iotti, Giorgio, Ippolito, Mariachiara, Irie, Hiromasa, Iriyama, Hiroki, Itagaki, Taiga, Izura, Javier, Izza, Santiago, Jabeen, Rakhshanda, Jamaati, Hamidreza, Jamadarkhana, Sunil, Jamoussi, Amira, Jankowski, Milosz, Alberto Jaramillo, Lui, Jeon, Kyeongman, Jeong Lee, Seok, Jeswani, Deepak, Jha, Simant, Jiang, Liangyan, Jing, Chen, Jochmans, Sébastien, Anders Johnstad, Bror, Jongmin, Lee, Joret, Aurélie, Junhasavasdikul, Detajin, Teresa Jurado, Maria, Kam, Elisa, Kamohara, Hidenobu, Kane, Caroline, Kara, Iskender, Karakurt, Sait, Karnjanarachata, Cherdkiat, Kataoka, Jun, Katayama, Shinshu, Kaushik, Shuchi, Kelebek Girgin, Nermin, Kerr, Kathryn, Kerslake, Ian, Khairnar, Prakash, Khalid, Abidi, Khan, Akram, K Khanna, Ashish, Khorasanee, Reza, Kienhorst, Dieneke, Kirakli, Cenk, Knafelj, Rihard, Kol Kol, Mark, Kongpolprom, Napplika, Kopitko, Csaba, Korkmaz Ekren, Pervin, Kubisz-Pudelko, Agnieszka, Kulcsar, Zoltan, Kumasawa, Junji, Kuriyama, Akira, Kutchak, Fernanda, Labarca, Eduardo, Labat, Françoise, Laborda, César, Alberto Laca Barrera, Manuel, Lagache, Laurie, Landaverde Lopez, Antonio, Lanspa, Michael, Lascari, Valeria, Le Meur, Matthieu, Hwan Lee, Su, Ju Lee, Young, Lee, Jinwoo, Lee, Won-Yeon, Lee, Jarone, Legernaes, Terje, Leiner, Tamaa, Lemiale, Virginie, Leonor, Tiago, M Lepper, Philipp, Li, Dahuan, Li, Hongbin, Li, Oleg, Raquel Lima, Ana, Lind, Dan, Litton, 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Michael, Milagros, Olga, Milet, Igor, Teresa Millan, Maria, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, Gianmario, Mora Aznar, Maria, Morakul, Sunthiti, Morales, Maria, Moreno Torres, Daniel, Rolando Morocho Tutillo, Diego, Motherway, Catherine, Mouhssine, Doumiri, Mouloudi, Eleni, Muñoz, Tapia, Munoz de Cabo, Carlo, Mustafa, Mohamed, Muthuchellappan, Radhakrishnan, Muthukrishnan, Muraleekrishnan, Muttini, Stefano, Nagata, Isao, Nahar, Dick, Nakanishi, Misuzu, Nakayama, Izumi, Antonio Namendys-Silva, Silvio, Nanchal, Rahul, Nandakumar, Sivakumar, Nasi, Alessandra, Nasir, Kamal, Navalesi, Paolo, Naz Aslam, Tayyba, Nga Phan, Thuy, Nichol, Alistair, Niiyama, Shuhei, Nikolakopoulou, Sofia, Nikolic, Elena, Nitta, Kenichi, Noc, Marko, Nonas, Stephanie, Nseir, Saad, Nur Soyturk, Ayse, Obata, Yukako, Oeckler, Richard, Oguchi, Moe, Ohshimo, 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Kol, Napplika Kongpolprom, Csaba Kopitko, Pervin Korkmaz Ekren, Agnieszka Kubisz-Pudelko, Zoltan Kulcsar, Junji Kumasawa, Akira Kuriyama, Fernanda Kutchak, Eduardo Labarca, Françoise Labat, César Laborda, Manuel Alberto Laca Barrera, Laurie Lagache, Antonio Landaverde Lopez, Michael Lanspa, Valeria Lascari, Matthieu Le Meur, Su Hwan Lee, Young Ju Lee, Jinwoo Lee, Won-Yeon Lee, Jarone Lee, Terje Legernaes, Tamaas Leiner, Virginie Lemiale, Tiago Leonor, Philipp M Lepper, Dahuan Li, Hongbin Li, Oleg Li, Ana Raquel Lima, Dan Lind, Edward Litton, Ning Liu, Ling Liu, Jialin Liu, Jean-François Llitjos, Beatriz Llorente, Rodolfo Lopez, Claudia Elizabeth Lopez, Claudia Lopez Nava, Pablo Lovazzano, Min Lu, Francesca Lucchese, Manuela Lugano, Gustavo Lugo Goytia, Hua Luo, Ceri Lynch, Sebastiano Macheda, Victor Hugo Madrigal Robles, Salvatore Maurizio Maggiore, Mònica Magret Iglesias, Peter Malaga, Harish Mallapura Maheswarappa, Guillermo Malpartida, Andrey Malyarchikov, Helena Mansson, Anaid Manzano, Ismael Marey, Nathalie Marin, Maria Del Carmen Marin, Eliana Markman, Felix Martin, Alex Martin, Cristina Martin Dal Gesso, Felipe Martinez, Conchita Martínez-Fidalgo, Ignacio Martin-Loeches, Arantxa Mas, Sakuraya Masaaki, Emilio Maseda, Eleni Massa, Anna Mattsson, Jessica Maugeri, Victoria McCredie, James McCullough, Shay McGuinness, Andrew McKown, László Medve, Chengqing Mei, Ricard Mellado Artigas, Vitor Mendes, Mohamed Khalaf Ebraheim Mervat, Isabelle Michaux, Michael Mikhaeil, Olga Milagros, Igor Milet, Maria Teresa Millan, Zhang Minwei, Lucia Mirabella, Sanghamitra Mishra, Giovanni Mistraletti, Katsunori Mochizuki, Arif Moghal, Francesco Mojoli, Alexandre Molin, Raquel Montiel, Luca Montini (ORCID:0000-0003-4602-5134), Gianmario Monza, Maria Mora Aznar, Sunthiti Morakul, Maria Morales, Daniel Moreno Torres, Diego Rolando Morocho Tutillo, Catherine Motherway, Doumiri Mouhssine, Eleni Mouloudi, Tapia Muñoz, Carlos Munoz de Cabo, Mohamed Mustafa, Radhakrishnan Muthuchellappan, Muraleekrishnan Muthukrishnan, Stefano Muttini, Isao Nagata, Dick Nahar, Misuzu Nakanishi, Izumi Nakayama, Silvio Antonio Namendys-Silva, Rahul Nanchal, Sivakumar Nandakumar, Alessandra Nasi, Kamal Nasir, Paolo Navalesi, Tayyba Naz Aslam, Thuy Nga Phan, Alistair Nichol, Shuhei Niiyama, Sofia Nikolakopoulou, Elena Nikolic, Kenichi Nitta, Marko Noc, Stephanie Nonas, Saad Nseir, Ayse Nur Soyturk, Yukako Obata, Richard Oeckler, Moe Oguchi, Shinichiro Ohshimo, Marina Oikonomou, Agueda Ojados, Maria Teresa Oliveira, Wilson Oliveira Filho, Carlo Oliveri, Aitor Olmos, Kazuya Omura, Maria Cristina Orlandi, Francesca Orsenigo, Laura Ortiz-Ruiz De Gordoa, Kei Ota, Rainier Ovalle Olmos, Nándo Öveges, Peter Oziemski, Ozlem Ozkan Kuscu, Ezgi Özyilmaz, Fernando Pachas Alvarado, Gonzalo Pagella, Vijayanand Palaniswamy, Eugenio Luis Palazon Sanchez, Salvatore Palmese, Guojun Pan, Wensen Pan, Metaxia Papanikolaou, Theonymfi Papavasilopoulou, Ameet Parekh, Rachael Parke, Francisco J Parrilla, Dácil Parrilla, Taha Pasha, Laura Pasin, Luis Patão, Mayur Patel, Grisma Patel, Basanta Kumar Pati, Jayaprakash Patil, Saroj Pattnaik, Daniel Paul, Maurizio Pavesi, Vanesa Alejandra Pavlotsky, Graciela Paz, Enrique Paz, Elisabetta Pecci, Carlos Pellegrini, Andrea Gabriela Peña Padilla, Gaetano Perchiazzi, Tiago Pereira, Vera Pereira, Manuel Perez, Cesar Perez Calvo, Meisy Perez Cheng, Ronald Perez Maita, Rodrigo Pérez-Araos, Purificación Perez-Teran, David Perez-Torres, Gavin Perkins, Paolo Persona, Tananchai Petnak, Marina Petrova, Tai Pham, François Philippart, Edoardo Picetti, Elisabetta Pierucci, Edoardo Piervincenzi, Riccardo Pinciroli, Maria-Consuelo Pintado, Thomas Piraino, Stephanie Piras, Claudio Piras, Pattarin Pirompanich, Luigi Pisani, Enrique Platas, Gustavo Plotnikow, Willy Porras, Virginia Porta, Mariana Portilla, José Portugal, Pedro Povoa, Gwenael Prat, Romina Pratto, Gabriel Preda, Isidro Prieto, Estefania Prol-Silva, Richard Pugh, Yupeng Qi, Chuanyun Qian, Tiehe Qin, Hongping Qu, Teobaldo Quintana, Rosari Quispe Sierra, Rocio Quispe Soto, Raihan Rabbani, Mohamed Rabee, Ahmed Rabie, Maria Augusta Rahe Pereira, Ashish Rai, Sundar Raj Ashok, Mostafa Rajab, Navin Ramdhani, Elizabeth Ramey, Marco Ranieri, Darshana Rathod, Banambar Ray, Shihan Mahmud Redwanul Huq, Adrian Regli, Rosa Reina, Natalia Resano Sarmiento, Faustine Reynaud, Gemma Rialp, Pilar Ricart, Todd Rice, Angus Richardson, Marcelo Rieder, Martin Rinket, Fernando Rios, Alejandro Risso Vazquez, Ivano Riva, Monaly Rivette, Oriol Roca, Ferran Roche-Campo, Covadonga Rodriguez, Gabriel Rodriguez, Daniel Rodriguez Gonzalez, Xandra Yanina Rodriguez Tucto, Angela Rogers, María Elena Romano, Linda Rørtveit, Alastair Rose, Damien Roux, Anahita Rouze, Paolo Nahuel Rubatto Birri, Wang Ruilan, Aldana Ruiz Robledo, Antonio Luis Ruiz-Aguilar, Tomohito Sadahiro, Ignacio Saez, Judith Sagardia, Rajnish Saha, Rohit Saha, Narongkorn Saiphoklang, Shigeki Saito, Maie Salem, Gabriele Sales, Patricia Salgado, Srinivas Samavedam, Mhamed Sami Mebazaa, Line Samuelsson, Nandyelly San Juan Roman, Patricia Sanchez, Jesus Sanchez-Ballesteros, Yazcitk Sandoval, Emanuele Sani, Martin Santos, Carla Santos, Masamitsu Sanui, Lakshmikanthcharan Saravanabavan, Sema Sari, Agnes Sarkany, Bertrand Sauneuf, Monica Savioli, Hilal Sazak, Riccardo Scano, Francis Schneider, Frédérique Schortgen, Marcus J Schultz, Gabriele Leonie Schwarz, Faruk Seçkin Yücesoy, Andrew Seely, Frederik Seiler, Yasemin Seker Tekdos, Kim Seok Chan, Luca Serano, Wojciech Serednicki, Mariano Setten, Asim Shah, Bhagyesh Shah, You Shang, Pradeep Shanmugasundaram, Konstantin Shapovalov, Eman Shebl, Takuya Shiga, Nobuaki Shime, Phil Shin, Jack Short, Chen Shuhua, Sughrat Siddiqui, Juan Ignacio Silesky Jimenez, Daniel Silva, Betania Silva Sales, Koen Simons, Brit Ågot Sjøbø, David Slessor, Jakub Smiechowicz, Nathan Smischney, Paul Smith, Tim Smith, Mark Smith, Sarah Snape, Lindi Snyman, Filiep Soetens, Kyung Sook Hong, Miguel Ángel Sosa Medellin, Giovanna Soto, Xavier Souloy, Elsa Sousa, Stefania Sovatzis, Didem Sozutek, Savino Spadaro, Marco Spagnoli, Martin Spångfors, Nick Spittle, Mike Spivey, Andrew Stapleton, Branislava Stefanovic, Lorraine Stephenson, Elizabeth Stevenson, Kristian Strand, Maria Teresa Strano, Slavenka Straus, Chenliang Sun, Rongqing Sun, Venkat Sundaram, Tai SunPark, Elisabeth Surlemont, Yuda Sutherasan, Zsuzsanna Szabo, Christopher Tainter, Akihiro Takaba, Mandy Tallott, Tamasato Tamasato, Zhanhong Tang, Viratch Tangsujaritvijit, Leandro Taniguchi, Daisuke Taniguchi, Fabio Tarantino, Krittika Teerapuncharoen, Susana Temprano, Pierpaolo Terragni, Nicolas Terzi, Anand Thakur, Pongdhep Theerawit, Arnaud W Thille, Matt Thomas, Poungrat Thungtitigul, Martial Thyrault, Nejla Tilouch, Karina Timenetsky, Juna Tirapu, Manuel Todeschini, Roser Tomas, Christian Tomaszewski, Tommaso Tonetti, Alexandre Tonnelier, John Trinder, Konlawij Trongtrakul, Jonathon Truwit, Betty Tsuei, Aiman Tulaimat, Sema Turan, Melda Turkoglu, Sanjeev Tyagi, Alejandro Ubeda, Federica Vagginelli, María Florencia Valenti, Imma Vallverdu, Alisha Van Axel, Ingrid van den Hul, Hans van der Hoeven, Nardo Van Der Meer, Marc Vanhoof, Mónica Vargas-Ordoñez, Rosanna Vaschetto, Ettore Vascotto, Maria Vatsik, Ana Vaz, Antonia Vazquez-Sanchez, Sara Ventura, Jan Wytze Vermeijden, Anxela Vidal, Jocyelle Vieira, Bruno Vilela Costa Pinto, Ana Villagra, Cristina Villegas Succar, Ole Georg Vinorum, Giovanni Vitale, Ramesh Vj, Ana Vochin, Guillaume Voiriot, Carlo Alberto Volta, Magnus von Seth, Maazouzi Wajdi, Don Walsh, Shouhong Wang, Gabriel Wardi, Nils Christian Ween-Velken, Bi-Lin Wei, Dolf Weller, Deborah Welsh, Ingeborg Welters, Michael Wert, Simon Whiteley, Elizabeth Wilby, Erin Williams, Karen Williams, Antoinette Wilson, Jadwiga Wojtas, Jin Won Huh, David Wrathall, Christopher Wright, Jian-Feng Wu, Guo Xi, Zheng-Jiang Xing, Hongyang Xu, Kotaro Yamamoto, Jie Yan, Julio Yáñez, Xiaobo Yang, Elliot Yates, Ozlem Yazicioglu Mocin, Zhenglong Ye, Fatma Yildirim, Norifumi Yoshida, Hector Higo Leon Yoshido, Bo Young Lee, Rongguo Yu, Gong Yu, Tao Yu, Boyun Yuan, Nadwipa Yuangtrakul, Tetsuya Yumoto, Xie Yun, Graciela Zakalik, Ahmad Zaki, Begoña Zalba-Etayo, Massimo Zambon, Bin Zang, Gianluca Zani, Jonathan Zarka, Simone Maria Zerbi, Avsar Zerman, Harald Zetterquist, Jiuzhi Zhang, Hongwen Zhang, Wei Zhang, Guoxiu Zhang, Weixin Zhang, Hongsheng Zhao, Jia Zheng, Bin Zhu, and Ronald Zumaran
Abstract: Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 d
Published: 2023

22. Prediction of optimal continuous positive airway pressure in Thai patients with obstructive sleep apnea

Author: Kanyada Leelasittikul, Apiwat Pugongchai, and Narongkorn Saiphoklang
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Polysomnography, Science, Article, 03 medical and health sciences, 0302 clinical medicine, Medical research, Internal medicine, Respiratory disturbance index, medicine, Pressure, Humans, Continuous positive airway pressure, Oxygen saturation (medicine), Sleep Apnea, Obstructive, Multidisciplinary, medicine.diagnostic_test, Anthropometry, Continuous Positive Airway Pressure, business.industry, Epworth Sleepiness Scale, Retrospective cohort study, Middle Aged, medicine.disease, Thailand, nervous system diseases, respiratory tract diseases, Obstructive sleep apnea, 030228 respiratory system, Risk factors, Cardiology, Medicine, Female, business, Body mass index, 030217 neurology & neurosurgery
Abstract: Continuous positive airway pressure (CPAP) is simple and effective treatment for obstructive sleep apnea (OSA) patients. However, the CPAP prediction equation in each country is different. This study aimed to predict CPAP in Thai patients with OSA. A retrospective study was conducted in Thai patients, who OSA was confirmed by polysomnography and CPAP titration from January 2015 to December 2018. Demographics, body mass index (BMI), neck circumference (NC), Epworth sleepiness scale, apnea–hypopnea index (AHI), respiratory disturbance index (RDI), mean and lowest pulse oxygen saturation (SpO2), and optimal pressure were recorded. A total of 180 subjects were included: 72.8% men, age 48.7 ± 12.7 years, BMI 31.0 ± 6.3 kg/m2, NC 40.7 ± 4.1 cm, AHI 42.5 ± 33.0 per hour, RDI 47.1 ± 32.8 per hour, and lowest SpO2 77.1 ± 11.0%. Multiple linear regression analysis identified NC, BMI, RDI, and lowest SpO2. A final CPAP predictive equation was: optimal CPAP (cmH2O) = 4.614 + (0.173 × NC) + (0.067 × BMI) + (0.030 × RDI) − (0.076 × lowest SpO2). This model accounted for 50.0% of the variance in the optimal pressure (R2 = 0.50). In conclusion, a CPAP prediction equation can be used to explain a moderate proportion of the titrated CPAP in Thai patients with OSA. However, the CPAP predictive equation in each country may be different due to differences of ethnicity and physiology.Trial registration: TCTR20200108003.
Published: 2021

23. Pulmonary function among rural residents in high air pollution area in northern Thailand

Author: Pitchayapa Ruchiwit, Narongkorn Saiphoklang, Kanyada Leelasittikul, Apiwat Pugongchai, and Orapan Poachanukoon
Abstract: BackgroundAir pollution has become a serious environmental and health issue in several countries. This condition leads to respiratory diseases, particularly asthma and chronic obstructive pulmonary disease (COPD). This study aimed to determine pulmonary functions and prevalence of respiratory diseases among rural residents in an area in northern Thailand with a high concentration of air pollution.MethodsA cross-sectional study was conducted in people aged 18 years or older, living in Lamphun, Thailand in December 2021. Demographics, pre-existing diseases, respiratory symptoms, and pulmonary functions by spirometry including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiration flow (PEF), forced expiration flow rate at 25-75% of FVC (FEF25-75), and bronchodilator responsiveness (BDR; FEV1 improvement after BDR test >12% and 200 mL) were collected.ResultsA total of 127 people (78.7%male) were included. Mean age was 43.76±11.32 years. Smoking was 52.0% and 4.44±5.45 pack-years. Self-reported respiratory diseases were allergic rhinitis (7.1%), asthma (0.8%), and COPD (0.8%). Respiratory symptoms were presented in 33.1% (14.2% runny nose, 10.2% nasal obstruction, 9.4% cough, 7.9% sputum production, and 6.3% breathlessness). Lung functions showed FVC in 96.74±12.91%, FEV1 in 97.52±12.99%, PEF in 102.46±19.18%, and FEF25-75 in 96.77±29.88%. Abnormal lung functions were found in 15.7%. Small airway disease (FEF25-751/FVCConclusionsAbnormal pulmonary functions, especially small airway disease, were relatively common in rural residents in a polluted air area in northern Thailand. These abnormal pulmonary functions were associated with more respiratory symptoms.Clinicaltrials.in.th numberTCTR20211223001
Published: 2022
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24. Guidelines for the management of asthma in adults: Evidence and recommendations

Author: Theerasuk, Kawamatawong, Atik, Sangasapaviriya, Narongkorn, Saiphoklang, Nittha, Oer-Areemitr, Thitiwat, Sriprasart, Harutai, Kamalaporn, Kumpol, Amnuaypattanapon, Ticha, Rerkpattanapipat, Naricha, Chirakalwasan, Manaphol, Kulpraneet, Chamard, Wongsa, Hiroshi, Chantaphakul, Santi, Silairatana, and Orapan, Poachanukoon
Subjects: Adult, Immunology, Immunology and Allergy, COVID-19, Humans, General Medicine, Thailand, Asthma
Abstract: The multidisciplinary experts in Thailand developed an asthma management recommendation that was relevant to low-middle income countries (LMICS). Populations level consideration about asthma management is emphasized. The healthcare systems, access to and availability of treatments as well as the asthma populations vary from country to country in LMICS. The feasibility in clinical practice for implementation is also a major issue. For these reasons, the practice guidelines that are relevant to local contexts are essential to improve better asthma control. Furthermore, integrative and collaboration between asthma experts and the public health sector to implement and discriminate such guidelines will help to achieve these challenging goals. The topics covered include the current asthma situation in Thailand and the Asia-Pacific region, the definition of asthma, asthma diagnosis, assessment of asthma patients, asthma treatment - both pharmacological and non-pharmacological, management of asthma exacerbation, management of asthma comorbidities, treatment of asthma in special conditions, severe and uncontrolled asthma, Thai alternative medicine and asthma, and asthma and coronavirus disease-19 (COVID-19).
Published: 2021

25. Handgrip strength cutoff value predicting successful extubation in mechanically ventilated patients

Author: Nattawadee Mokkongphai and Narongkorn Saiphoklang
Subjects: Male, medicine.medical_treatment, Science, Spontaneous breathing trial, Respiratory muscle, medicine, Cutoff, Intubation, Humans, Prospective Studies, Prospective cohort study, Lung, Aged, Mechanical ventilation, Aged, 80 and over, Multidisciplinary, Hand Strength, business.industry, Middle Aged, Prognosis, Respiration, Artificial, Respiratory Muscles, Anesthesia, Rapid shallow breathing index, Breathing, Airway Extubation, Medicine, Female, business, Ventilator Weaning, Biomarkers, Research Article
Abstract: Background Handgrip strength (HGS) is an alternative tool to evaluate respiratory muscle function. HGS cutoff value indicating extubation success or failure has not been investigated. This study aimed to determine HGS cutoff value to predict successful extubation. Methods A prospective study was conducted. Patients requiring intubated mechanical ventilation with intubation ≥ 48 hours in medical wards were recruited. HGS test was performed at 10 minutes before and 30 minutes after spontaneous breathing trial (SBT). Rapid shallow breathing index (RSBI) was measured at 10 minutes before SBT. Results Ninety-three patients (58% men) were included. Mean age was 71.6 ± 15.2 years. Weaning failure rate was 6.5%. The area under the ROC curve of 0.84 for the best HGS cutoff value at 10 minutes before SBT was 12.7 kg, with 75.9% sensitivity and 83.3% specificity (P = 0.005). The best HSG cutoff value at 30 minutes after SBT was 14.9 kg, with the area under the ROC curve of 0.82, with 58.6% sensitivity and 83.3% specificity (P = 0.009). The best RSBI cutoff value was 43.5 breaths/min/L, with the area under the ROC curve of 0.46, 33.3% sensitivity and 66.6% specificity (P = 0.737). Conclusions HGS may be a predictive tool to guide extubation with better sensitivity and specificity than RSBI. A prospective study is needed to verify HGS test as adjunctive to RSBI in ventilator weaning protocol.
Published: 2021

26. The Effect of Zingiber cassumunar (Phlai Capsule) on Bronchial Hyperresponsiveness in Asthmatic Patients: A Randomized Controlled Trial.

Author: Junprateepsuda Dulpinijthamma, Narongkorn Saiphoklang, Sira Nanthapisal, Prapasri Kulalert, and Orapan Poachanukoon
Subjects: BRONCHIAL spasm, RANDOMIZED controlled trials, ZINGIBER, ALLERGIC rhinitis
Abstract: Background: Bronchial hyperresponsiveness (BHR) is a key feature of asthma. Compound D, an active compound in Phlai, can bind cysteinyl leukotrienes receptors that play a role for asthma treatment. Objective: To determine the effect of Phlai capsules on BHR measured by the methacholine challenge test. Materials and Methods: A randomized, double-blind, placebo-controlled, crossover study was conducted in adult asthmatic patients with partly controlled symptoms. Each patient received four weeks of treatment with either Phlai or placebo separated by a 2-week washout period. The main outcome was provocative concentration of methacholine causing a 20% drop in FEV₁ (PC₂₀). Asthma control test (ACT) scores, and fractional exhaled nitric oxide (FeNO) levels were secondary end points. Results: Thirty patients were randomly allocated to either the Phlai or the placebo group. All patients had allergic rhinitis and received inhaled corticosteroid and long-acting beta2-agonist (ICS/LABA) or ICS alone. Four weeks after treatment, mean PC₂₀ in the Phlai group was higher than in the placebo group at 9.76±1.56 mg/mL versus 6.05±1.65 mg/mL (p=0.151). The improvement of ACT scores in the Phlai group was significantly higher than in the placebo group. FeNO levels decreased after treatment in the Phlai group. All patients tolerated the treatment well and had no side effects. Conclusion: In adult asthmatic patients with partly controlled symptoms, concomitant treatment with Phlai capsules tended to decrease BHR and significantly improve symptom scores. [ABSTRACT FROM AUTHOR]
Published: 2023
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27. COVID-19 and Pulmonary Involvement

Author: Narongkorn Saiphoklang
Subjects: Ground-glass opacity, Acute respiratory distress syndrome, education, COVID-19, Pneumonia, health care economics and organizations, humanities
Abstract: Asian Medical Journal and Alternative Medicine, 21, Supplement 1, S81
Published: 2021
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28. Smoking characteristics and lung functions among university athletes

Author: Orapan Poachanukoon, Suchada Soorapan, and Narongkorn Saiphoklang
Subjects: Male, medicine.medical_specialty, Adolescent, Universities, lcsh:Medicine, Cigarette use, Article, Cigarette Smoking, 03 medical and health sciences, FEV1/FVC ratio, Young Adult, 0302 clinical medicine, Medical research, Internal medicine, medicine, Prevalence, Tobacco Smoking, Humans, 030212 general & internal medicine, lcsh:Science, Exercise, Lung function, Asthma, Smoke, Multidisciplinary, Lung, biology, Athletes, business.industry, Respiration, lcsh:R, Health care, 030229 sport sciences, Tobacco Use Disorder, medicine.disease, biology.organism_classification, Thailand, Nicotine Addiction, Respiratory Function Tests, Family member, medicine.anatomical_structure, Cross-Sectional Studies, lcsh:Q, Female, business
Abstract: Cigarette smoking has negative effects on the respiratory system, particularly pulmonary functions. This study aimed to determine smoking prevalence and characteristics among university athletes. We conducted a cross-sectional study of Thammasat University athletes in Thailand from July to October 2018. Demographic and smoking data were recorded. Exhaled carbon monoxide (CO) levels and lung function data were analysed. A total of 433 subjects (56% men) were included. Mean age was 19.8 ± 1.3 years. Asthma was reported in 5.5%. The prevalence of current cigarette smoking was 23.8%. Tobacco use was 3.0 ± 3.2 cigarettes per day. The Fagerstrom score for nicotine dependence was 0.76 ± 1.47. Compared to non-smokers, smokers were predominately males (70.6% vs 29.4%, P P P = 0.001), higher FEV1 (92.60 ± 15.36% vs 87.77 ± 11.23%, P = 0.002), but lower FEV1/FVC (78.21 ± 5.38% vs 79.70 ± 5.60%, P = 0.015). Moreover, athletes who smoke, were more likely to: drink alcohol, have a family member who smokes, have a friend who smokes or have a university instructor who smokes. In conclusion, smoking prevalence among university athletes was relatively high, although low nicotine addiction level and good lung functions were found. Home and institute environments had important influences on cigarette use in students.Trial registration: TCTR20180917001
Published: 2020

29. Comparison Between 20 and 30 Meters in Walkway Length Affecting the 6-Minute Walk Test in COPD Patients

Author: K. Leelasittikul, Narongkorn Saiphoklang, and A. Pugongchai
Subjects: medicine.medical_specialty, business.industry, Copd patients, Physical therapy, Medicine, 6-minute walk test, business
Published: 2020
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30. Patient characteristics and outcomes of a home mechanical ventilation program in a developing country

Author: Apichart Kanitsap, Pitchayapa Ruchiwit, Thiti Sricharoenchai, Pattarin Pirompanich, Christopher B. Cooper, and Narongkorn Saiphoklang
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, complication, mechanical ventilation, 03 medical and health sciences, ventilator-associated pneumonia, 0302 clinical medicine, medicine, 030212 general & internal medicine, Stroke, Mechanical ventilation, lcsh:RC705-779, COPD, business.industry, Chronic obstructive pulmonary disease, Ventilator-associated pneumonia, developing country, lcsh:Diseases of the respiratory system, medicine.disease, Pneumonia, 030228 respiratory system, Tracheomalacia, Emergency medicine, Breathing, Original Article, Complication, business
Abstract: Background: There are limited data on home mechanical ventilation (HMV) in developing countries. This study aimed to describe the patient characteristics, feasibility, and outcomes of an HMV program at a university hospital in Thailand. Materials and Methods: Data were collected on all patients who were discharged with HMV between October 2014 and August 2015 at Thammasat University Hospital. Results: Twelve patients (eight men and four women) underwent HMV. They were aged 71.5 ± 17.6 years; mean ± standard deviation. Indications for HMV were 6 neurologic diseases (4 amyotrophic lateral sclerosis, 1 multiple system atrophy, and 1 stroke), 2 chronic obstructive pulmonary disease (COPD), 1 tracheomalacia, and 3 combined neurologic diseases and respiratory diseases (2 stroke and COPD, 1 stroke and tracheomalacia). The duration of follow-up was 799.5 ± 780.5 days. The ratio of family income to cost of HMV usage was 77.2:1 ± 5.5:1. All patients had tracheostomies. Modes of HMV were biphasic positive airway pressure (66.7%), pressure-controlled ventilation (16.7%), pressure-support ventilation (8.3%), and volume-controlled ventilation (8.3%). Complications occurred in ten patients (83.3%), including tracheobronchitis (20 events) and ventilator-associated pneumonia (12 events). Overall mortality was 41.7% (5/12 patients), including two patients who died due to ventilator-associated pneumonia. There were no instances of ventilator malfunction. Conclusions: HMV is feasible for patients with neurological diseases and COPD in a developing country. The relatively high rate of complications indicates the need for more comprehensive clinical services for chronic ventilator-dependent patients in this setting.
Published: 2019

31. Interest of hand grip strength to predict outcome in mechanically ventilated patients

Author: Chatkarin Tepwimonpetkun and Narongkorn Saiphoklang
Subjects: Pulmonary and Respiratory Medicine, Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Spontaneous breathing trial, 03 medical and health sciences, Grip strength, 0302 clinical medicine, Intensive care, medicine, Respiratory muscle, Weaning, Humans, Prospective Studies, Prospective cohort study, Mechanical ventilation, Hand Strength, business.industry, Tracheal intubation, Respiration, Artificial, Intensive Care Units, 030228 respiratory system, Anesthesia, Airway Extubation, Female, Cardiology and Cardiovascular Medicine, business, Ventilator Weaning
Abstract: Background Weaning from mechanical ventilation is a crucial process for critically ill patients. Hand grip strength (HGS) is an assessment tool for respiratory muscle function to assist guidance of extubation. Objective To evaluate HGS as a predictor for in-hospital clinical outcomes in mechanically ventilated patients. Methods A prospective study was conducted. Patients requiring mechanical ventilation with tracheal intubation in medical wards and intensive care units were recruited. HGS, reintubation, number of ventilator-free days and mortality were recorded. Results A total of 34 patients (52.9% men) were included. When compared to the non re-intubation group, the re-intubation group had significantly lower HGS at 10 min and 30 min after starting spontaneous breathing trial (7.6 ± 4.8 kg Vs 13.4 ± 6.5 kg, P = 0.045, and 8 ± 5.1 kg Vs 13.2 ± 5.7 kg, P = 0.047). Moreover, at 1 h and 48 h of post extubation, the re-intubation group had lower HGS than the non re-intubation group. HGS at 1 h of post extubation was positively correlated with ventilator-free day at 28 days (r = 0.34, P = 0.05). HGS did not differ between survival group and death group in hospital over time. Conclusions Hand grip strength may be a predictive tool for extubation failure in mechanically ventilated patients. Low strength corresponded to significantly increased re-intubation rate. Furthermore, this measurement could not predict in-hospital mortality.
Published: 2020

32. Hand Grip Strength Predicts In-hospital Clinical Outcomes in Mechanically Ventilated Patients

Author: Chatkarin Tepwimonpetkun and Narongkorn Saiphoklang
Subjects: Mechanical ventilation, Grip strength, Extubation failure, Respiratory failure, business.industry, medicine.medical_treatment, Anesthesia, Respiratory muscle, Medicine, Weaning, business, Prospective cohort study, Spontaneous breathing trial
Abstract: Background: Respiratory failure is a common indication for mechanical ventilation. Evaluation of weaning from the ventilator is important to reduce morbidity and mortality. Previous studies showed the correlation between handgrip strength (HGS) and respiratory muscle power. This study aimed to evaluate the HGS test as a predictor for in-hospital clinical outcomes. Methods: A prospective study was conducted between January 2018 and January 2019. Patients required mechanical ventilation for at least 48 hours. HGS, duration of ventilator weaning, extubation, reintubation, number of ventilator-free days within 28 days and in-hospital mortality were recorded. Results: A total of 34 patients (52.9% men) were included. When compared to the non-reintubation group, the re-intubation group had significantly lower maximal HGS at 10 minutes and 30 minutes after starting spontaneous breathing trial(SBT)(7.6 ± 4.8 kg Vs 13.4 ± 6.5 kg, P=0.045 and 8.0 ± 5.1 kg Vs 13.2 ± 5.7 kg, P = 0.047). Moreover, at 1 hour and 48 hours of post-extubation, the reintubation group had lower maximal HGS than non-reintubation group(8.0 ± 5.2 kg Vs 14.0 ± 5.6 kg, P = 0.023 and 4.2 ± 0.2 kg Vs 14.3 ± 6.0 kg, P = 0.018). Significant positive correlation was found between ventilator free day within 28 days and maximal HGS at 1 hour of post extubation(r = 0.34, P = 0.05). However, there was no difference in HGS between survival group and death group over time. Conclusions: HGS was the predictive tool for extubation failure in mechanically ventilated patients. Lower strength significantly increased reintubation rate. However, this measurement could not predict on 28-day in-hospital mortality.
Published: 2019
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33. Heart Rate Variability in COPD Patients Differs with Chronic Bronchitic and Bronchiectatic Phenotypes

Author: Matthew Flynn, William LeMaster, M. Villarreal, Roslynn Marzan-McGill, Brett A. Dolezal, Christopher B. Cooper, M. Dembek, John A. Belperio, Russell G. Buhr, Igor Barjaktarevic, and Narongkorn Saiphoklang
Subjects: medicine.medical_specialty, business.industry, Copd patients, Internal medicine, medicine, Cardiology, Heart rate variability, business, Phenotype
Published: 2019
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34. Diagnostic Value of Pleural Fluid Adenosine Deaminase in Tuberculous Pleuritis at Thammasat University Hospital

Author: Narongkorn, Saiphoklang, Apichart, Kanitsap, and Pitchayapa, Ruchiwit
Subjects: Adult, Male, Adenosine Deaminase, Exudates and Transudates, Mycobacterium tuberculosis, Tuberculosis, Pleural, Middle Aged, Sensitivity and Specificity, Hospitals, University, Pleural Effusion, ROC Curve, Humans, Female, Prospective Studies, Pleurisy, Biomarkers, Aged
Abstract: Pleural fluid adenosine deaminase (ADAPF) is a diagnostic test for diagnosing the early tuberculous pleuritis (TBP). However, cutoff values vary widely in many studies.To determine the optimal diagnostic value of ADAPF.A prospective study was performed between August 2012 and August 2014. One hundred seventyeight patients with pleural effusions; 29 TBPs, 63 malignant pleural effusions (MPEs), 40 parapneumonic effusions (PARAEs), 18 transudates, 5 empyemas, 19 other exudates, and 4 unknown causes, were investigated.Mean + SD of ADAPF was 60.0+25.6 U/L with TBPs, 15.6+11.1 U/L with MPEs, 15.8+9.9 U/L with PARAEs, 6.6+5.7 U/L with transudates, 13.8+7.7 U/L with empyemas, 14.5+7.1 U/L with other exudates, and 17.8+4.6 U/L with unknown causes. The area under the ROC curve was 0.983 (95% CI: 0.969-0.998) for the best ADAPF cutoff value of 33.5 U/L, with 93.1% sensitivity, 94.6 % specificity, 77.1% positive predictive value, and 98.6% negative predictive. ADAPF level30.5 U/L suggests that a TBP is highly unlikely.Pleural fluid ADA assay is a helpful diagnostic tool with high sensitivity and specificity for the rapid diagnosis of TBP.
Published: 2018

35. Anaesthetic Management for Caesarean Delivery Patient with Obstructed Superior Vena Cava by Mediastinal Mass

Author: Vanda, Pattaratuma, Theerada, Chandee, and Narongkorn, Saiphoklang
Subjects: Adult, Pregnancy Complications, Superior Vena Cava Syndrome, Treatment Outcome, Cesarean Section, Pregnancy, Humans, Female, Thailand, Anesthesia, Spinal, Hodgkin Disease, Mediastinal Neoplasms
Abstract: Maternal anatomical and physiological changes occur during pregnancy, particularly with cardiovascular and respiratory systems. Pregnant women with large mediastinal mass additionally have an increased risk of cardiopulmonary compromise. We report a 31-year-old patient at 30 weeks of gestation with a large anterior mediastinal tumour with superior vena cava obstruction. Her presenting symptom was progressive and severe dyspnea due to the large mediastinal mass. An ultrasound-guided biopsy was performed and the pathologic result was Hodgkin’s lymphoma. Termination of pregnancy and delivery of the neonate were performed using a Caesarean delivery under spinal anesthesia in the sitting position. The perioperative anaesthetic management was successful without any serious complications, and the postoperative outcomes were very impressive.
Published: 2018

36. ASSESSMENT OF A NEW SMOKING CESSATION PROGRAM AT THAMMASAT UNIVERSITY HOSPITAL, PATHUM THANI, THAILAND

Author: Pattarin, Pirompanich, Tawanchai, Jirapramukpitak, Narongkorn, Saiphoklang, Thiti, Sricharoenchai, Pichayapa, Ruchiwit, Narit, Sennoi, and Apichart, Kanitsap
Subjects: Adult, Hospitals, University, Male, Treatment Outcome, Smoking, Humans, Female, Smoking Cessation, Prospective Studies, Middle Aged, Thailand, Aged
Abstract: The Smoking Cessation Clinic (SCC) at Thammasat University Hospital had only 27 patients from October 2013 to September 2014 and a quit rate of only 3.7%. A new smoking cessation program was implemented at the end of 2014 to improve success rates. This new program is an interdisciplinary program that includes several health care specialists. The study aimed to examine the characteristics of the smokers and the outcomes after implementing the new program with an interdisciplinary approach at the SCC in order to gain data to improve the efficacy of the SCC. This prospective descriptive study was conducted by the SCC from December 2014 to December 2015. During the study period 111 patients attended the SCC under the new program and all were included in the survey; 100 (90.1%) were men. The mean (±SD) age of these patients was 56.5±13.5 years. The mean (±SD) age of onset of smoking was 18.5±5.5 years. Smoking cessation in the program was checked by measuring the exhaled carbon monoxide levels at 6 months after reporting smoking cessation. A level less than 10 parts per million was considered not to be a smoker. Of the 111 patients, 14 (12.6%) had reported smoking cessation and had an exhaled carbon monoxide level less than 10 parts per million. The new smoking cessation program was attended by more patients and had a higher success rate than the previous smoking cessation program, although the smoking cessation success rate was still low. Further studies are needed to determine which factors improved cessation rates and to determine other factors associated with successful smoking cessation in the study population.
Published: 2018

37. Correlations between functional performance, health status and inflammatory biomarkers in stable COPD

Author: Brett A. Dolezal, Igor Barjaktarevic, Roslynn Marzan-McGill, Narongkorn Saiphoklang, John A. Belperio, and Christopher B. Cooper
Subjects: Spirometry, medicine.medical_specialty, COPD, medicine.diagnostic_test, Exacerbation, business.industry, Cancer, Disease, Fibrinogen, medicine.disease, respiratory tract diseases, Internal medicine, Medicine, Observational study, business, medicine.drug, Asthma
Abstract: Background: Progressive of COPD is associated with reduced functional performance, impaired health status, and comorbidities. Inflammatory biomarkers are thought to reflect systemic effects. Aim: To explore correlations between functional performance, health status and inflammatory biomarkers in stable COPD patients. Methods: We analysed data from an ongoing observational study of stable COPD patients without exacerbation history within 3 months of enrolment. Demographics, clinical characteristics, spirometry and comorbidities were recorded. Functional performance was assessed by 6-minute walking distance (6MWD), handgrip strength, modified MRC dyspnea scale (mMRC), and Veteran9s Specific Activity Questionnaire (VSAQ). Health status was evaluated by CAT, SGRQ-C, and SF12 Health Survey. Biomarkers measured were ESR, CRP, fibrinogen, and WBC. Results: Twenty-one subjects (18 men) were included: Age 70.8±5.7 years, FEV1 59.5±21.4%, smoking history 49.0 ± 30.8 pack-years, exacerbation history 43%, cardiovascular disease 45%, asthma 20%, and cancer 20%. We found negative correlations between 6MWD and mMRC (r=-0.74, p Conclusions: Functional performance in stable COPD is significantly associated with health status and systemic inflammatory biomarkers. These measures should be included in routine COPD assessment.
Published: 2017
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38. The effect of Zingiber cassumunar (Phlai capsule) on bronchial hyperresponsiveness in asthmatic patients

Author: Orapan Poachanukoon, Junprateepsuda Dulpinijthamma, and Narongkorn Saiphoklang
Subjects: biology, Zingiber cassumunar, Bronchial hyperresponsiveness, business.industry, Immunology, medicine, Immunology and Allergy, Asthmatic patient, Capsule, Pharmacology, biology.organism_classification, medicine.disease, business
Published: 2020
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39. DIFFERENCES IN CLINICAL MANIFESTATIONS AND PLEURAL FLUID CHARATERISTICS BETWEEN TUBERCULOUS AND MALIGNANT PLEURAL EFFUSIONS

Author: Narongkorn, Saiphoklang, Apichart, Kanitsap, and Andanake, Nambunchu
Subjects: Adult, Male, Chest Pain, Lung Neoplasms, Fever, Lymphoma, Adenosine Deaminase, Breast Neoplasms, Exudates and Transudates, Middle Aged, Pleural Effusion, Malignant, Pleural Effusion, Radiography, Dyspnea, Logistic Models, Neoplasms, Multivariate Analysis, Humans, Female, Tuberculosis, Pulmonary, Aged, Retrospective Studies
Abstract: Tuberculous and malignant pleural effusions share similar clinical and radiographic findings and both may produce lymphocytic-predominant exudative effusions. This study aimed to determine distinguishing clinical features between the two diseases. We conducted a retrospective study among 47 patients with tuberculous pleural effusions (TBPE) and 73 with malignant pleural effusions (MPE). Demographic data, clinical features, pleural fluid characteristics, and radiographic findings were obtained for each patient and the 2 groups were compared. Sixty-nine (57.5%) patients were males. The mean (+/- SD, range) age was 60.2 (+/- 16.9, 19-94) years. Mean (+/- SD) symptom duration was 31.6 (+/- 51.6) days. Univariate analysis identified 20 clinical, pleural fluid and radiological differences between the two groups. Multivariate logistic regression analysis revealed 3 independent predictors of TBPE: fever (OR=8.2; 95% CI: 1.9 - 35.9; p=0.005), having a non-serosanguinous effusion (OR=6.1; 95% CI: 1.1 - 33.6; p=0.038), and a fluid adenosine deaminase level30 U/I (OR=86.7; 95% CI: 4.3 - 1735; p=0.004). Fever, non-serosanguinous pleural effusions and high adenosine deaminase levels were suggestive of a TBPE and could be clinically useful when evaluating a pleural effusion of unknown etiology.
Published: 2015