In a recent study, it was shown that metoprolol significantly decreased the risk of bucking during extubation in patients who underwent general anesthesia when compared to the placebo. This study’s findings were published in the Brazilian journal of anesthesiology (Elsevier).

This was a double-blind, placebo-controlled randomized trial that included 207 patients, comprising both males and females aged between 18 and 80 years, with an American Society of Anesthesiologists (ASA) physical status I–III. These patients were randomly allocated into two groups: one group received intravenous metoprolol 5 mg IV (n=102) while the other group received a placebo (n=105) post-surgery. The primary endpoint of the study was to assess the percentage of patients who exhibited bucking as a result of endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes evaluated included coughing, laryngospasm, bronchospasm, Heart Rate (HR) levels, and Mean Arterial Pressure (MAP).

At the end of the study, the incidence of bucking was significantly lower in patients who were received metoprolol (43.1% vs. 64.8%). In the metoprolol group, 6 (5.9%) patients experienced moderate/severe coughing, while 33 (31.4%) in the placebo group reported the same.

The above results demonstrated that in patients undergoing general anesthesia, metoprolol was found to significantly lower the risk of bucking during extubation when compared with the placebo.

 A study has shown that in  individuals undergoing lung resection with one-lung ventilation, individualised open-lung approach (iOLA) had a lower risk of severe postoperative pulmonary complications compared to conventional lung-protective ventilation. This study’s findings were published in the journal, Lancet Respiratory Medicine.

In this randomised controlled trial, patients aged 18 years and above were randomised into two groups: one receiving iOLA (n=670) and the other receiving standard lung-protective ventilation (n=638). The iOLA treatment involved an alveolar recruitment manoeuvre with an end-inspiratory pressure of 40 cm H₂O, followed by individualised positive end-expiratory pressure (PEEP) adjusted to achieve optimal respiratory system compliance. Additionally, participants in the iOLA group received personalised postoperative respiratory support through high-flow oxygen therapy. On the other hand, participants in the standard lung-protective ventilation group received 4 cm H₂O of PEEP during surgery and conventional oxygen therapy after surgery. The primary outcome measured was the occurrence of severe postoperative pulmonary complications within the first 7 days after surgery.

At the end of the study, patients in the iOLA group had a lower incidence of severe postoperative pulmonary complications within the first 7 days post-surgery compared to those in the standard lung-protective ventilation group [40 patients (6%) vs 97 patients (15%)].

According to the above study, in patients undergoing lung resection with one-lung ventilation, the utilization of iOLA was found to be linked to a decreased likelihood of experiencing severe postoperative pulmonary complications in comparison to the use of conventional lung-protective ventilation.

According to a recent study, respiratory syncytial virus prefusion F protein (RSVPreF3 OA) vaccine helps attenuate the severity of respiratory syncytial virus (RSV)-associated symptoms in acute respiratory infections (ARIs). This study was published in the journal, Influenza and Other Respiratory Viruses.

This phase 3 trial included adults aged ≥60 years who were randomized in a 1:1 ratio to receive either one dose of RSVPreF3 OA vaccine (N = 12,466) or placebo (N = 12,494). Patient-reported outcomes (PROs) were assessed using Short Form-12 (SF-12), InFLUenza Patient-Reported Outcome (FLU-PRO), and EuroQol-5 Dimension (EQ-5D) questionnaires. Wilcoxon test was used to compare the Peak FLU-PRO Chest/Respiratory scores during the first 7 days from ARI episode onset. Along with this, EQ-5D health utility scores and least squares mean (LSMean) of SF-12 physical functioning (PF) were estimated.

In the vaccine group, 27 first RSV-ARI episodes were observed, compared to 95 in the placebo group. For the RSVPreF3 OA group, median peak FLU-PRO Chest/Respiratory scores were lower (1.07) versus placebo group (1.86). The LSMean group differences for the EQ-5D health utility score and PF were 7.00.

From the above study, it can be concluded that RSVPreF3 OA vaccine may not only prevent infection but may also attenuate the severity of RSV-associated symptoms in breakthrough infections.

A recent study suggests that nintedanib reduces worsening of dyspnoea, fatigue and cough and the impacts of interstitial lung disease (ILD) over 52 weeks in patients with progressive pulmonary fibrosis (PPF). The findings of this study were published in the European Respiratory Journal.

The INBUILD trial included 663 patients with fibrosing interstitial lung disease (ILD) of >10% extent on high-resolution computed tomography (HRCT). These subjects met the criteria for ILD progression within the prior 24 months. The patients were randomized in a 1: 1 ratio to receive either nintedanib or placebo. The impact of pulmonary fibrosis in patients with progressive pulmonary fibrosis (PPF) was assessed using the Living with Pulmonary Fibrosis (L-PF) questionnaire.

At the end of the study (52 weeks), it was found that there was significantly smaller worsenings in adjusted mean L-PF questionnaire total scores in the nintedanib group when compared to the placebo (0.5 versus 5.1), symptoms (1.3 versus 5.3), fatigue (0.7 versus 4.0), and dyspnoea (4.3 versus 7.8). A decrease in the L-PF questionnaire cough score was observed in the nintedanib group, while an increase was noted in the placebo group (-1.8 versus 4.3). L-PF questionnaire impacts score also decreased slightly in the nintedanib group and increased in the placebo group (-0.2 versus 4.6).

Based on the above results, it can be concluded that changes in L-PF questionnaire scores may show that nintedanib reduces worsening of dyspnoea, fatigue, and cough and may also impact ILD over 52 weeks in patients with PPF.