更新于：2024-05-01

Pulmonary Atelectasis

肺不张

更新于：2024-05-01

基本信息

别名

ATELECTASIS、Atelectases、Atelectases, Compression

+ [88]

简介

Absence of air in the entire or part of a lung, such as an incompletely inflated neonate lung or a collapsed adult lung. Pulmonary atelectasis can be caused by airway obstruction, lung compression, fibrotic contraction, or other factors.

关联

靶点-

作用机制

干细胞替代物

在研机构-

原研机构

Avicenna Research Institute

在研适应症-

非在研适应症

新型冠状病毒感染 [+4]

最高研发阶段无进展

首次获批国家/地区-

首次获批日期1800-01-20

AE-07

靶点-

作用机制-

在研机构-

原研机构

AETAS Pharma Co., Ltd.

在研适应症-

非在研适应症

肺不张 [+1]

最高研发阶段无进展

首次获批国家/地区-

首次获批日期1800-01-20

336

项与肺不张相关的临床试验

NCT04566172 / Not yet recruitingN/AIIT

Preoperative Optimization to Improve Functional Status

This is a pilot study to obtain preliminary information on the usability and efficacy of a pre-habilitation program. The investigators will recruit up to 100 patients.
The two specific aims of this study are to conduct an initial pilot study with the following goals:
1. To obtain information on feasibility and utilization of the program
2. To determine whether participation in the program improves a patient's Maximal Inspiratory Pressure

开始日期2024-11-01

申办/合作机构

The Johns Hopkins University

NCT06296173 / Not yet recruitingN/AIIT

Open Lung Protective Extubation Following General Anesthesia: the OLEXT-3 Trial

Perioperative respiratory complications are a major source of morbidity and mortality. Postoperative atelectasis plays a central role in their development. Protective "open lung" mechanical ventilation aims to minimize the occurrence of atelectasis during the perioperative period. Randomized controlled studies have been performed comparing various "open lung" ventilation protocols, but these studies report varying and conflicting effects. The interpretation of these studies is complicated by the absence of imagery supporting the pulmonary impact associated with the use of different ventilation strategies. Imaging studies suggest that the gain in pulmonary gas content in "open lung" ventilation regimens disappears within minutes after the extubation. Thus, the potential benefits of open-lung ventilation appear to be lost if, at the time of extubation, no measures are used to keep the lungs well aerated. Recent expert recommendations on good mechanical ventilation practices in the operating room conclude that there is actually no quality study on extubation.
Extubation is a very common practice for anesthesiologists as part of their daily clinical practice. It is therefore imperative to generate evidence on good clinical practice during anesthetic emergence in order to potentially identify an effective extubation strategy to reduce postoperative pulmonary complications.

开始日期2024-09-01

申办/合作机构

The Ottawa Hospital

[+2]

NCT02022969 / WithdrawnN/AIIT

Detection of SpO2-oscillations Caused by Cyclic Recruitment and Derecruitment of Low Ventilated Areas in the Lung (Atelectasis) During Mechanical Ventilation

Even though experimental lung injury in animal experiments is the best analogy for the changes in the patients, it has to be considered that kinetics may vary between species. An important question to answer is how common PaO2-oscillations occur in patients and how injurious they might be. A limitation to the detection of PaO2-oscillations is a sensing device that detects the oscillations at very high temporal resolution. In previous studies a fiberoptic probe was used, which was measuring PaO2 based on oxygen-sensitive fluorescence quenching with a time resolution up to 10 Hz (8, 13, 14). This method is not feasible in patients. Previous studies have shown that PaO2-oscillations are translated into the peripheral hemoglobin oxygen saturation (SpO2). Given a technology that has a time resolution that is high enough (i.e. >1 Hz), measurement of SpO2-oscillations would be a valid approach to detecting and quantifying cyclical recruitment and derecruitment in a non-invasive fashion in patients on the ICU. The Masimo Rad-8 pulse-oxymeter provides such a method. In the current study it is planned to deteted SpO2-oscillations in the post-operative patients on the ICU.

开始日期2024-08-01

申办/合作机构

Medical University of Vienna

100 项与肺不张相关的临床结果

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100 项与肺不张相关的转化医学

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0 项与肺不张相关的专利（医药）

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10,263

项与肺不张相关的文献（医药）

2024-02-24·BMC pulmonary medicine

Primary endobronchial melanoma: a case report and clinical management indications.

Review

作者: Emanuela Barisione ; Andrea Boutros ; Marco Mora ; Francesco Spagnolo ; Enrica Teresa Tanda ; Carlo Genova ; Elena Tagliabue

BACKGROUND:

While cutaneous melanomas are well-documented, primary melanoma of the lung (PMML), particularly with endobronchial origin, remains rare and poorly characterized. This case report addresses gaps in understanding by presenting a comprehensive case of a 71-year-old male with primary endobronchial melanoma and conducting a systematic review of PMML cases.

CASE PRESENTATION:

The patient, a former smoker, presented with dyspnea, cough, and hemoptysis. Imaging revealed left lung atelectasis and a suspicious nodule. Bronchoscopy identified an endobronchial mass, subsequently treated with argon plasma coagulation and resection. Biopsy confirmed melanoma. Extensive examinations ruled out a primary skin lesion. Despite initial treatment, recurrence led to pneumonectomy. Histopathology confirmed melanoma. The patient received treatment with pembrolizumab and ipilimumab, but with poor clinical benefit.

CONCLUSIONS:

Primary endobronchial melanoma is a rare entity, comprising 0.01% of lung tumors. This case underscores diagnostic challenges and emphasizes histological criteria to distinguish primary from metastatic lesions. The pathogenesis remains unclear, with theories proposing foetal melanocyte migration or squamous metaplasia. Prognosis varies, necessitating radical surgical extirpation. A systematic review revealed diverse outcomes, supporting the need for further research. In conclusion, endobronchial melanoma involves an endoscopic and surgical management, but evolving therapies, such as immunotherapy, may reshape treatment paradigms. This case contributes to our understanding of PMML, guiding future research and clinical management. As therapeutic options evolve, continued research is crucial to refine our understanding and improve outcomes for this rare malignancy.

2024-02-22·JA clinical reports

Combination of high-flow nasal oxygen and ketamine/dexmedetomidine sedation for diagnostic catheterization in a child with pulmonary arterial hypertension: a case report.

Article

作者: Kaoru Tsuboi ; Misuzu Asai ; Toshiki Nakamura ; Jun Ninagawa ; Hiroshi Ono ; Shugo Kasuya

Pulmonary hypertension is associated with significant risk of perioperative life-threatening events. We present a case of a 12-year-old child with severe pulmonary arterial hypertension who successfully underwent diagnostic cardiac catheterization under ketamine and dexmedetomidine sedation with the support of high-flow nasal oxygen. Ketamine and dexmedetomidine are reported to have minimal effect on pulmonary vasculature in children with pulmonary hypertension and can be safely used in this population along with its lack of respiratory depression. Positive pressure generated by high-flow nasal oxygen improves upper airway patency, prevents micro-atelectasis, and is shown to improve the effectiveness of ventilation and oxygenation in patients under sedation breathing spontaneously. The presented strategy may contribute to enhancing the safety and effectiveness of procedural sedation for children with life-threatening pulmonary hypertension.

2024-02-21·BMC pulmonary medicine

Case report of a novel alpha1-antitrypsin null variant in Türkiye: Q0_RİZE.

Article

作者: Dilek Karadoğan ; Ünal Şahin ; Bettina Dreger ; Laura Grandoso ; Lourdes Osaba

BACKGROUND:

Alpha1-antitrypsin (AAT) is a serine protease inhibitor that serves as a counterbalance to the activity of elastases, e.g., neutrophil elastase in lung tissue. AAT deficiency (AATD) is a rare disorder usually arising from mutations to the SERPINA1 gene that codes for AAT. The most common AATD alleles are S and Z which produce ~ 40% and ~ 90% reductions in serum AAT, respectively. Rare genetic variants (> 500 identified) can also be associated with mild to severe AATD.

RESULTS:

This report describes a novel mutation of SERPINA1 producing AATD, which we have designated, Q0_RİZE. This mutation was identified in a 44-year-old woman admitted with massive hemoptysis and treated with bronchial artery embolization. Computed tomography revealed centriacinar and panacinar emphysema with prominent air entrapment, atelectasis, and localized bronchiectasis. Serum AAT was < 0.27 g/L (below detection limit). Genetic analysis showed homozygous deletion of exons I to III.

CONCLUSIONS:

Although many SERPINA1 variants have been identified, variants with large deletions and identified in a homozygous individual, as seen in this case with Q0_RIZE, are uncommon. AATD is an underdiagnosed and undertreated disease. Wider screening of COPD patients could result in earlier diagnosis and treatment that could preserve lung function.

项与肺不张相关的新闻（医药）

2024-02-28

·PRNewswire

Actress Jane Seymour and Insmed Raise Awareness of "Unseenism" and Empower People to Speak Up When It Comes to Their Health

— New survey reveals the prevalence of "Unseenism," which can be described as a social phenomenon where gender and age biases can leave some patients feeling overlooked or unheard, in healthcare — — 58% of women who chose not to speak up during a visit with their doctor said it was because their health concerns were previously ignored — — Insmed's educational initiative "Speak Up in BE" aims to bring hope, education, and a sense of belonging to bronchiectasis (BE) patients who are feeling unseen — BRIDGEWATER, N.J., Feb. 28, 2024 Insmed Incorporated (Nasdaq: INSM), a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases, today announced its involvement with award-winning actress Jane Seymour to raise awareness of gender and age biases in healthcare. Insmed conducted a nationally representative survey to reveal how these unconscious and often enduring biases leave some people feeling overlooked, unheard, or ignored, a societal phenomenon that can be described as "Unseenism." Survey data found that this phenomenon is especially prevalent for those with chronic conditions like bronchiectasis (BE). "In both my television and film roles and in real life, I've always tried to push back against the typical notions of aging and feeling unseen. Being older shouldn't mean you are no longer valuable or relevant," said Seymour. "I am thrilled to work with Insmed to lend a voice to this all-too-familiar topic and encourage others to speak up and advocate for themselves, particularly when it comes to their health, regardless of age or gender." The survey of over 2,000 participants, conducted by Insmed, aimed to uncover how "Unseenism" can shape the health decisions of people aged 40+ years. Key insights from the survey indicate that: 62% of women surveyed stated they feel more overlooked or believe they will feel more overlooked as they age. 82% of respondents said they leave a doctor's appointment without getting all their questions answered and understanding all that was discussed. 40% of people surveyed said they have previously chosen not to speak up to their doctor even though they had something to say. Reasons cited for not speaking up included their health concerns were previously ignored (58%), they feared their concerns wouldn't be addressed (44%), or they didn't want to burden their doctor (41%). For those suffering from chronic conditions, the experience of feeling unseen can be magnified, including in patients with BE, a respiratory disease that causes permanent widening of the airways, which can make it difficult to clear mucus and bacteria. BE is underrecognized and its diagnosis is often missed or delayed. Approximately two-thirds of patients diagnosed with BE are women and the average age of patients is 68. Over time, patients may experience worsening symptoms or flares – which can contribute to irreversible lung damage. This is why it is critical to ensure patients receive timely and proper care. The survey also included a subset of BE patients. Among those respondents (n=83): 57% cited illness as the factor that has contributed most to them ever feeling unseen; 35% noted that their diagnosis made them feel more unseen. 79% said they have felt more unseen as they age. 72% said being knowledgeable about their health makes them feel empowered to speak up with healthcare providers. "These findings highlight the urgent need to bridge communication gaps and amplify health education initiatives for patients who feel unseen," said Alana Clemens-Saliba, Executive Director, Patient Advocacy & Professional Society Engagement at Insmed. "That's why we're proud of the Speak Up in BE campaign, an educational initiative dedicated to providing information and resources on BE to help patients feel understood, supported, and empowered to raise their voices." Living with BE can be challenging, but patients are not alone in their journey. Speak Up in BE provides resources for patients, including questions that can start conversations with a doctor, ways to connect with others in the community, and a limited-edition book full of stories, articles, and tips from real people living with BE to help patients who are feeling unseen. To learn more about BE, please visit SpeakUpInBronchiectasis.com. About Bronchiectasis Bronchiectasis is a serious, chronic lung disease in which the bronchi become permanently dilated due to a cycle of infection, inflammation, and lung tissue damage. The condition is marked by frequent pulmonary exacerbations requiring antibiotic therapy and/or hospitalizations. Symptoms include chronic cough, excessive sputum production, shortness of breath, and repeated respiratory infections, which can worsen the underlying condition. Bronchiectasis affects approximately 340,000 to 520,000 patients in the U.S. About Insmed Insmed Incorporated is a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases. We seek to bring forward therapies that address patients' most urgent unmet needs by leveraging cutting-edge technologies and employing new modes of drug discovery, delivery, and development. Insmed is headquartered in Bridgewater, New Jersey, with additional offices and research locations throughout the United States, Europe, and Japan. Visit to learn more. Contact: Investors: Bryan Dunn Executive Director, Investor Relations Insmed (646) 812-4030 [email protected] Eleanor Barisser Associate Director, Investor Relations Insmed (718) 594-5332 [email protected] Media: Mandy Fahey Executive Director, Corporate Communications Insmed (732) 718-3621 [email protected] SOURCE Insmed Incorporated

2023-12-27

·生物探索

JCI | 西南医科大学曾博团队发现机械敏感通道TMEM63A和TMEM63B介导肺扩张诱导的表面活性剂分泌

肺表面活性物质是一种附着在肺泡表面的脂蛋白复合物，其作用是降低肺泡表面张力，促进吸气。表面活性物质缺乏常见于早产儿，也见于呼吸窘迫综合征的儿童和成人。肺泡2型上皮(AT2)细胞在肺扩张过程中的机械拉伸是刺激表面活性剂分泌的主要生理因素；然而，目前尚不清楚是否有专门用于这一过程的机械传感器。2023年12月21日，西南医科大学曾博团队在Journal of Clinical Investigation 在线发表题为“Mechanosensitive channels TMEM63A and TMEM63B mediate lung inflation-induced surfactant secretion”的研究论文，该研究表明机械敏感通道TMEM63A和TMEM63B的缺失导致小鼠由于表面活性剂分泌不足而导致肺不张和呼吸衰竭。TMEM63A/B主要定位于板层体的限制膜，这是一种溶酶体相关的细胞器，在AT2细胞中储存肺表面活性物质和ATP。在细胞拉伸过程中，TMEM63A/B通道被激活，促进了与质膜融合的片状体释放表面活性剂和ATP。释放的ATP在AT2细胞中激活Ca2+信号，并增强更多板层体的胞外融合。该研究揭示了TMEM机械敏感通道的重要生理功能，使肺部为出生时的第一次呼吸做好准备，并在一生中维持呼吸。肺表面活性物质是降低肺泡衬里液体表面张力和有效吸气所必需的。肺表面活性物质缺乏导致早产儿新生儿呼吸窘迫综合征，并涉及成人各种肺部疾病，包括急性呼吸窘迫综合征、阻塞性肺疾病、急性呼吸窘迫综合征。众所周知，肺泡上皮细胞(AECs)通过机械敏感的ATP释放和Ca2+依赖途径刺激肺表面活性剂的分泌。AECs由大而薄的肺泡1型(AT1)细胞组成，用于气体交换，立方肺泡2型(AT2)细胞用于合成和分泌肺表面活性剂。在AT2细胞中，肺表面活性剂和ATP储存在板层体(LBs)中，这是一种与溶酶体相关的特化细胞器。肺扩张诱导表面活性剂分泌的一个普遍接受的机制是，AECs的拉伸引起ATP释放到肺泡表面，然后这些释放的ATP在AT2细胞中引起Ca2+信号，促进LBs与质膜的融合和表面活性剂的胞外分泌。然而，仍有几个关键问题尚未解决：(i)机械拉伸如何诱导ATP释放？体外研究表明AT1和AT2细胞都是ATP的来源，ATP释放的途径尚未得到一致的说明。(ii)为什么ATP处理可以有效地刺激LB与质膜融合，但在促进表面活性剂释放方面却远不如细胞拉伸？目前尚不清楚的是，拉伸诱导的Ca2+信号仅仅是P2嘌呤能受体对细胞外ATP的反应，还是含有由细胞拉伸直接激活的Ca2+可渗透机械敏感通道所贡献的成分。机理模式图（图源自Journal of Clinical Investigation ）为了解决这些问题，最重要的问题是了解机械拉伸是如何在AECs中感知和转导的。尚不清楚AECs中是否有一个主要的机械传感器来启动或控制ATP和表面活性剂的释放。在各种能够感知机械力的细胞结构和蛋白质中，机械敏感离子通道与Ca2+信号传导和胞吐作用最为相关。目前，只有四种类型的哺乳动物离子通道通常被认为是真正的机械激活通道，包括Piezo1/2，双孔域K+通道(K2P, TREK/TRAAK)，跨膜通道样TMC1/2和跨膜63 (TMEM63)通道。尽管在AT1细胞系中发现Piezo1可以调节ATP释放，但在小鼠肺中未检测到其在AECs中的功能表达。K2P通道广泛表达，但由于其复极化作用，与Ca2+信号没有直接关系。TMC1/2在耳蜗毛细胞中形成机械转导通道，其突变仅导致听力损失。作为最近发现的机械敏感通道，TMEM63B在毛细胞存活中起关键作用，对听力至关重要，但TMEM63A/B/C在其他系统中的生理功能尚不清楚。综上所述，该研究发现AT2细胞中的TMEM63A/B机械敏感通道通过感知和转导肺泡扩张过程中LBs所受的机械力来控制肺表面活性剂和ATP的释放。TMEM63A/B 缺乏导致肺泡表面活性物质不足，进而引起肺不张和呼吸衰竭。该研究证明了机械敏感通道TMEM63A和TMEM63B是AECs中的机械传感器，介导肺扩张诱导的表面活性剂和ATP的释放，并在维持呼吸功能中发挥重要作用。参考文献:Chen GL, Li JY, Chen X, Liu JW, et al. Mechanosensitive channels TMEM63A and TMEM63B mediate lung inflation-induced surfactant secretion. J Clin Invest. 2023 Dec 21:e174508. doi: 10.1172/JCI174508. Epub ahead of print. PMID: 38127458.文章来源：“iNature”责编|探索君排版|探索君End往期精选围观王晓红教授团队：绘制单次冷冻囊胚移植成功的女性植入期外周血microRNA动态表达谱，开拓领域创新研究热文维生素B12在细胞重编程与组织再生中发挥关键作用！热文不孕症治疗新方向！又一导致女性不孕的关键因素被发现热文Let-7家族miRNA或为癌症潜在免疫治疗靶点热文一项最新发现或可用于阿尔茨海默病药物开发点击“阅读原文”，了解更多~

临床结果临床1期

2023-11-13

·PRNewswire

MONARCH Platform for Bronchoscopy Receives Regulatory License for China

The MONARCH™ Platform is the first minimally invasive, robotic-assisted technology approved for bronchoscopy in a country with significant burden of lung cancer. REDWOOD CITY, Calif., Nov. 13, 2023 /PRNewswire/ -- Johnson & Johnson MedTech* today announced that the MONARCH Platform and MONARCH Bronchoscope have obtained regulatory approval in China. The platform is the first minimally invasive, robotic-assisted technology approved for peripheral lung procedures in China and the first J&J MedTech robotic-assisted technology approved in China. This also marks the first regulatory approval of the MONARCH Platform outside of the United States. The MONARCH Platform, used with the MONARCH Bronchoscope, is intended to provide bronchoscopic visualization of and access to adult patient airways for diagnostic and therapeutic procedures. The device enables physicians to use minimally invasive, robotic-assisted technology for peripheral lung procedures. The ability to reach small, hard-to-reach peripheral lung nodules at an earlier stage and with greater precision is helping to transform the future of interventional care for patients because nodules from lung cancer are typically small, deep in the lungs and difficult to reach, making early-stage diagnosis and treatment difficult. Lung cancer is the leading cause of cancer deaths worldwide, and early detection has been shown to increase survival rates if the disease is caught at a stage when it is more likely to be treated successfullyi. "There are more than two million patients diagnosed with lung cancer each year around the world, and nearly 40% of them are in Chinaii," said Will Song, President, Johnson & Johnson MedTech China. "With this approval, MONARCH is poised to aid physicians in China as they work with patients to fight one of the most prevalent and deadly diseases in the country." "The MONARCH team is committed to driving meaningful innovation that changes the way patients experience healthcare," said Adrian Whitford, President, MONARCH. "Expanding the reach of flexible robotic-assisted devices for lung procedures to countries around the world is part of our vision to deliver breakthrough technology that improves clinical outcomes for patients fighting diseases like lung cancer." To date, The MONARCH platform has been used in more than 35,000 cases in the United States. About Johnson & Johnson MedTech At Johnson & Johnson MedTech, we unleash diverse healthcare expertise, purposeful technology, and a passion for people to transform the future of medical intervention and empower everyone to live their best life possible. For more than a century, we have driven breakthrough scientific innovation to address unmet needs and reimagine health. In surgery, orthopaedics, vision and interventional solutions, we continue to help save lives and create a future where healthcare solutions are smarter, less invasive and more personalized. To learn more, visit * Comprising the surgery, orthopaedics, vision and interventional solutions businesses within Johnson & Johnson's MedTech segment. Indications for Use (United States) The MONARCH™ Bronchoscope and the MONARCH™ Platform and its accessories are intended to provide bronchoscopic visualization of and access to patient airways for diagnostic and therapeutic procedures. Important Safety Information Complications from bronchoscopy may include breathing difficulty, vocal cord spasm, hoarseness, slight fever, vomiting, dizziness, bronchial spasm, infection, low blood oxygen, bleeding from biopsied site, or an allergic reaction to medications. More serious complications from bronchoscopy may include collapsed lung, respiratory failure, hemorrhage, burns, heart attack, or cardiac arrhythmia. Cautions Concerning Forward-Looking Statements This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding Johnson & Johnson MedTech, the MONARCH Platform and MONARCH Bronchoscope. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Auris Health, Inc., Johnson & Johnson Medical (Shanghai) Ltd. and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended January 1, 2023, including in the sections captioned "Cautionary Note Regarding Forward-Looking Statements" and "Item 1A. Risk Factors," and in Johnson & Johnson's subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at , or on request from Johnson & Johnson. None of Auris Health, Inc., Johnson & Johnson Medical (Shanghai) Ltd. nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments. Media Contact: Ryan Carbain [email protected] Investor Relations Sarah Wood [email protected] SOURCE Johnson & Johnson MedTech