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Association between peripheral blood/bronchoalveolar lavage eosinophilia and significant oxygen requirements in patients with acute eosinophilic pneumonia

急性嗜酸性粒细胞肺炎患者外周血/支气管肺泡灌洗嗜酸性粒细胞增多与显著氧需要量的相关性

  • 影响因子:2.40
  • DOI:10.1186/s12890-020-1056-7
  • 作者列表:"Joon Young Choi","Jeong Uk Lim","Ho Jung Jeong","Ji Eun Lee","Chin Kook Rhee
  • 发表时间:2020-02-02
Abstract

Abstract Background We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP). Methods We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2). Results Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements. Conclusions In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.

摘要

摘要: 背景: 我们研究了两种标志物的组合,外周 (PEC) 和支气管肺泡灌洗 (BAL) 嗜酸性粒细胞百分比 (BEP), 急性嗜酸性粒细胞性肺炎 (AEP) 患者的氧需要量。方法回顾性分析 2012年5月至 2017年5月首都人民医院收治的 AEP 患者的病历资料。我们使用相关性分析来评估 AEP 患者的 PEC/BEP 与临床结局之间的相关性。使用受试者工作特征 (ROC) 曲线分析计算 BEP 的临界值,对需要显著供氧的患者进行分类。引入 BAL/血嗜酸性粒细胞 (BBE) 评分,对外周嗜酸性粒细胞增多和 BEP 升高的患者进行分层。比较不同组之间的临床特征和结局。使用两种不同的模型,使用年龄、 C 反应蛋白 (CRP) 、吸烟持续时间和 BBE 评分 (模型 1) 以及年龄、 CRP 、 BEP 和 PEC (型号 2)。结果 338 例患者中,男性 99.7% 例,平均年龄 20.4 ± 1.4 岁。仅 0.6% 的患者从不吸烟,平均吸烟天数为 26.2 ± 25.4。相关性分析表明,PaO2/FiO2 比值和供氧时间均与 BEP 相关。ROC 曲线分析表明临界值为 41.5%。BBE 评分高的患者在低氧血症、住院天数、重症监护病房住院天数、供氧天数和类固醇治疗天数方面有良好的预后。多元 logistic 回归显示,BEP 和 BBE 评分往往与显著的氧需要量相关。结论在这项研究中,我们发现外周和 BAL 嗜酸性粒细胞增多与 AEP 患者的良好预后相关。

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影响因子:1.98
发表时间:2020-01-29
DOI:10.1080/02770903.2020.1723622
作者列表:["Parlar-Chun R","Arnold K"]

METHODS:INTRODUCTION:Continuous albuterol is a mainstay in management of pediatric status asthmaticus. While the National Heart Lung and Blood Institute Asthma Guidelines suggest 0.5 mg/kg/hr as the recommended dosage, there is a paucity of evidence comparing different weight based rates on hospital outcomes. METHODS:Patients requiring continuous albuterol for asthma exacerbation from January 2015 to December 2016 were identified using ICD codes. The concentration of albuterol (5 mg/h - 20 mg/h) and the duration of treatment were used to determine total albuterol administration. After dividing by patient weight, average weight based doses were divided into equal quintiles. Unadjusted and length of stay adjusted for age, initial asthma severity score, and administration of magnesium were compared among the quintiles. The same multivariate analysis was used for duration of continuous albuterol. RESULTS:533 hospitalizations for asthma were identified of which 289 received continuous albuterol. Weight based dosage quintiles ranged from lowest (0.07 - 0.29 mg/kg/hr) to the highest (>0.76 - 3.2 mg/kg/hr). Baseline characteristics were similar aside from age, race, and magnesium administration. There was no difference in adjusted length of stay or adjusted duration of continuous albuterol therapy among the five quintiles. CONCLUSION:No optimal weight based dose of continuous albuterol was found. Further investigation is needed to see if lower amounts of continuous albuterol may be as efficacious as higher doses. This could improve cost of status asthmaticus management and limit the number of adverse events associated with high exposure to continuous albuterol.

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影响因子:2.40
发表时间:2020-02-02
来源期刊:BMC Pulmonary Medicine
DOI:10.1186/s12890-020-1056-7
作者列表:["Joon Young Choi","Jeong Uk Lim","Ho Jung Jeong","Ji Eun Lee","Chin Kook Rhee"]

METHODS:Abstract Background We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP). Methods We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2). Results Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements. Conclusions In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.

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影响因子:2.41
发表时间:2020-01-22
DOI:10.1155/2020/9814916
作者列表:["Fei Zhao","Xuemei Guan","Jing Li","Liyong Liu","Jie Gong","Lihua He","Fanliang Meng","Jianzhong Zhang"]

METHODS:Background. Extensive studies have focused on the diagnosis and treatment of Mycoplasma pneumoniae infection; however, rare studies investigated the posttreatment conditions. We analyzed the carrying status of M. pneumoniae in the respiratory tract of children before and after treatment. Methods. Ninety-two children with M. pneumoniae pneumonia were included in this study. Clinical data were obtained from each patient, and pharyngeal swab sampling was performed at preliminary diagnosis and discharge. Real-time PCR and dilution quantitative culture were utilized to determine the DNA quantification and number of viable M. pneumoniae from samples collected upon preliminary diagnosis and discharge. Results. All the 92 cases showed DNA positivity upon preliminary diagnosis, serum IgM antibody was detected in 80 patients, and positivity of M. pneumoniae culture was observed in 82 cases. Upon discharge, the M. pneumoniae nucleotide and culture positivity were detected in 87 and 49 cases, respectively. The content of viable M. pneumoniae was 10–104 CCU/mL and 10–102 CCU/mL in the preliminary diagnosis samples and discharge samples, respectively. Conclusions. Real-time PCR was rapid and effective for the qualitative diagnosis of M. pneumoniae at the early stage, but it cannot be used to evaluate the prognosis of patients with M. pneumoniae infection. Quantitative analysis for M. pneumoniae DNA could not directly reflex the viable strain content.

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