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  1. Article: Imaging in alpha-1 antitrypsin deficiency: a window into the disease.

    Huang, Yuh-Chin Tony / Wencker, Marion / Driehuys, Bastiaan

    Therapeutic advances in chronic disease

    2021  Volume 12_suppl, Page(s) 20406223211024523

    Abstract: Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the ... ...

    Abstract Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (
    Language English
    Publishing date 2021-07-29
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2554816-5
    ISSN 2040-6231 ; 2040-6223
    ISSN (online) 2040-6231
    ISSN 2040-6223
    DOI 10.1177/20406223211024523
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effect of tracheostomy delay time on outcome of patients with prolonged mechanical ventilation: A STROBE-compliant retrospective cohort study.

    Tai, Hsueh-Ping / Lee, David Lin / Chen, Chiu-Fan / Huang, Yuh-Chin Tony

    Medicine

    2019  Volume 98, Issue 35, Page(s) e16939

    Abstract: The tracheostomy timing for patients with prolonged mechanical ventilation (PMV) was usually delayed in our country. Both physician decision time and tracheostomy delay time (time from physician's suggestion of tracheostomy to procedure day) affect ... ...

    Abstract The tracheostomy timing for patients with prolonged mechanical ventilation (PMV) was usually delayed in our country. Both physician decision time and tracheostomy delay time (time from physician's suggestion of tracheostomy to procedure day) affect tracheostomy timing. The effect of tracheostomy delay time on outcome has not yet been evaluated before.Patients older than 18 years who underwent tracheostomy for PMV were retrospectively collected. The outcomes between different timing of tracheostomy (early: ≤14 days; late: >14 days of intubation) were compared. We also analyzed the effect of physician decision time, tracheostomy delay time, and procedure type on clinical outcomes.A total of 134 patients were included. There were 57 subjects in the early tracheostomy group and 77 in the late group. The early group had significantly shorter mechanical ventilation duration, shorter intensive care unit stays, and shorter hospital stays than late group. There was no difference in weaning rate, ventilator-associated pneumonia, and in-hospital mortality. The physician decision time (8.1 ± 3.4 vs 18.2 ± 8.1 days, P < .001) and tracheostomy delay time (2.1 ± 1.9 vs 6.1 ± 6.8 days, P < .001) were shorter in the early group than in the late group. The tracheostomy delay time [odds ratio (OR) = 0.908, 95% confidence interval (CI) = 0.832-0.991, P = .031) and procedure type (percutaneous dilatation, OR = 2.489, 95% CI = 1.057-5.864, P = .037) affected successful weaning. Platelet count of >150 × 10/μL (OR = 0.217, 95% CI = 0.051-0.933, P = .043) and procedure type (percutaneous dilatation, OR = 0.252, 95% CI = 0.069-0.912, P = .036) were associated with in-hospital mortality.Shorter tracheostomy delay time is associated with higher weaning success. Percutaneous dilatation tracheostomy is associated with both higher weaning success and lower in-hospital mortality.
    MeSH term(s) APACHE ; Aged ; Aged, 80 and over ; Comorbidity ; Female ; Hospital Mortality/trends ; Humans ; Intensive Care Units/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Odds Ratio ; Pneumonia, Ventilator-Associated/epidemiology ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; Taiwan/epidemiology ; Time Factors ; Tracheostomy/methods ; Ventilator Weaning/statistics & numerical data
    Language English
    Publishing date 2019-09-20
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000016939
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Lung compliance measurement in mice.

    Huang, Yuh-Chin Tony

    American journal of physiology. Lung cellular and molecular physiology

    2008  Volume 294, Issue 4, Page(s) L815; author reply L816

    MeSH term(s) Animals ; Bronchoalveolar Lavage Fluid/cytology ; Cell Count ; Lung Compliance/physiology ; Mice
    Language English
    Publishing date 2008-04-04
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 1013184-x
    ISSN 1522-1504 ; 1040-0605
    ISSN (online) 1522-1504
    ISSN 1040-0605
    DOI 10.1152/ajplung.00052.2008
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  4. Article ; Online: Executive Summary: Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report.

    Fernández Pérez, Evans R / Travis, William D / Lynch, David A / Brown, Kevin K / Johannson, Kerri A / Selman, Moisés / Ryu, Jay H / Wells, Athol U / Tony Huang, Yuh-Chin / Pereira, Carlos A C / Scholand, Mary-Beth / Villar, Ana / Inase, Naohiko / Evans, Richard B / Mette, Stephen A / Frazer-Green, Lindsy

    Chest

    2021  Volume 160, Issue 2, Page(s) 595–615

    Abstract: Background: The purpose of this summary is to provide a synopsis of evidence-based and consensus-derived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice ... ...

    Abstract Background: The purpose of this summary is to provide a synopsis of evidence-based and consensus-derived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.
    Study design and methods: Approved panelists developed key questions regarding the diagnosis of HP using the PICO (Population, Intervention, Comparator, and Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. The quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus.
    Results: The systematic review of the literature based on 14 PICO questions resulted in 14 key action statements: 12 evidence-based, graded recommendations, and 2 ungraded consensus-based statements. All evidence was of very low quality.
    Interpretation: Diagnosis of HP should employ a patient-centered approach and include a multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence prior to considering BAL and/or lung biopsy. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.
    MeSH term(s) Alveolitis, Extrinsic Allergic/diagnosis ; Clinical Decision-Making ; Diagnosis, Differential ; Evidence-Based Medicine ; Humans
    Language English
    Publishing date 2021-04-15
    Publishing country United States
    Document type Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2021.03.067
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report.

    Fernández Pérez, Evans R / Travis, William D / Lynch, David A / Brown, Kevin K / Johannson, Kerri A / Selman, Moisés / Ryu, Jay H / Wells, Athol U / Tony Huang, Yuh-Chin / Pereira, Carlos A C / Scholand, Mary-Beth / Villar, Ana / Inase, Naohiko / Evans, Richard B / Mette, Stephen A / Frazer-Green, Lindsy

    Chest

    2021  Volume 160, Issue 2, Page(s) e97–e156

    Abstract: Background: The purpose of this analysis is to provide evidence-based and consensus-derived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.: ... ...

    Abstract Background: The purpose of this analysis is to provide evidence-based and consensus-derived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.
    Study design and methods: Approved panelists developed key questions regarding the diagnosis of HP using the PICO (Population, Intervention, Comparator, Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. The quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. A diagnostic algorithm is provided, using supporting data from the recommendations where possible, along with expert consensus to help physicians gauge the probability of HP.
    Results: The systematic review of the literature based on 14 PICO questions resulted in 14 key action statements: 12 evidence-based, graded recommendations and 2 ungraded consensus-based statements. All evidence was of very low quality.
    Interpretation: Diagnosis of HP should employ a patient-centered approach and include a multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence prior to considering BAL and/or lung biopsy. Criteria are presented to facilitate diagnosis of HP. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.
    MeSH term(s) Alveolitis, Extrinsic Allergic/diagnosis ; Evidence-Based Medicine ; Humans
    Language English
    Publishing date 2021-04-20
    Publishing country United States
    Document type Journal Article ; Practice Guideline ; Research Support, Non-U.S. Gov't
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2021.03.066
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  6. Article: Monitoring oxygen delivery in the critically ill.

    Huang, Yuh-Chin Tony

    Chest

    2005  Volume 128, Issue 5 Suppl 2, Page(s) 554S–560S

    Abstract: An accurate assessment of regional tissue oxygen delivery (DO(2)) may help the intensivist to attenuate end-organ damage in critically ill patients. Transport of oxygen from the ambient air to the mitochondria occurs by convection and diffusion, and is ... ...

    Abstract An accurate assessment of regional tissue oxygen delivery (DO(2)) may help the intensivist to attenuate end-organ damage in critically ill patients. Transport of oxygen from the ambient air to the mitochondria occurs by convection and diffusion, and is tightly regulated by neural and humoral factors. This article reviews the basic principles of DO(2) and the abnormal oxygen supply-demand relationship seen in patients with shock. It also discusses approaches to monitoring DO(2), including clinical symptoms/signs, acid-base status, and gas exchange, which provide global assessment, as well as gastric tonometry, which may reflect regional DO(2). Some new experimental methods, such as near-infrared spectroscopy and positron emission tomography, are still in development but may in the future provide useful clinical devices for quantifying the adequacy of regional tissue oxygenation in critically ill patients.
    MeSH term(s) Acid-Base Equilibrium ; Critical Illness ; Humans ; Hypoxia/physiopathology ; Oxygen/blood ; Oxygen/metabolism ; Oxygen Consumption ; Pulmonary Gas Exchange ; Tissue Distribution
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2005-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.128.5_suppl_2.554S
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  7. Article: Pharmacologic Adjuncts During Mechanical Ventilation

    Que, Loretta G. / Tony Huang, Yuh-Chin

    Seminars in Respiratory and Critical Care Medicine

    2000  Volume 21, Issue 03, Page(s) 223–232

    Abstract: Despite recent advances in technology, the mortality rate for patients suffering from adult respiratory distress syndrome remains in the range of 40-50%. This high mortality rate may be in part related to complications from ventilator management, such as ...

    Abstract Despite recent advances in technology, the mortality rate for patients suffering from adult respiratory distress syndrome remains in the range of 40-50%. This high mortality rate may be in part related to complications from ventilator management, such as ventilator-induced lung injury. In these patients, adjunct therapies aiming at ameliorating ventilator-induced lung injury are being developed. This article discusses the rationale for use of pharmacologic adjunct therapies, including inhaled nitric oxide, surfactant replacement therapy, antioxidants, prostaglandins, and corticosteroids, in patients with acute lung injury, and reviews the effectiveness of these agents in human clinical trials to date.
    Keywords Antioxidants ; corticosteroids ; nitric oxide ; prostaglandins ; surfactant
    Language English
    Publishing date 2000-01-01
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-2000-9848
    Database Thieme publisher's database

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