Curr Opin Pulm Med [JOURNAL]
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200 papers
Pulmonary rehabilitation in adults with asthma.
Jarosch I, Schneeberger T, Gloeckl R … +1 more , Koczulla AR
Curr Opin Pulm Med · 2026 May · PMID 41631368 · Publisher ↗
PURPOSE OF REVIEW: Nonpharmacological strategies, including pulmonary rehabilitation (PR), are increasingly recognized as essential components of asthma management, particularly for individuals with persistent symptoms,...
PURPOSE OF REVIEW: Nonpharmacological strategies, including pulmonary rehabilitation (PR), are increasingly recognized as essential components of asthma management, particularly for individuals with persistent symptoms, poor asthma symptom control, or complex disease. This review summarize recent evidence on PR and related behavioural, lifestyle, and digital interventions, and explores emerging models to improve access and long-term effectiveness. RECENT FINDINGS: Current evidence demonstrate that PR improves asthma control, exercise capacity, quality of life, and several patient-reported outcomes across multiple asthma phenotypes. Benefits extend to those with obesity-associated asthma, elevated airway inflammation, and high psychosocial burden. Early data also suggest reductions in exacerbation frequency and steroid requirements. Nevertheless, PR remains markedly underutilized. Digital self-management interventions show promising, albeit inconsistent effects on asthma control, with adherence being a critical determinant of success. New models combining synchronous (real-time) supervision with modular digital components may address major access barriers and provide scalable support. SUMMARY: Although underutilized in routine care, PR and other structured nonpharmacological strategies offer clinically meaningful benefits for individuals with asthma. Flexible, digitally enabled delivery models aligned with disease complexity may help to expand reach, promote earlier intervention and support sustained behavioural change. Future work should prioritize phenotype-specific effectiveness, long-term outcomes and implementation frameworks.
Rethinking pneumonia in terms of the lung microbiome.
Gordon N, Segal LN, Wu BG
Curr Opin Pulm Med · 2026 May · PMID 41631341 · Publisher ↗
PURPOSE OF REVIEW: This review aggregates, analyzes, and summarizes the current understanding of the lung microbiome as it relates to pneumonia. We will review the composition and function of a healthy lung microbiome an...
PURPOSE OF REVIEW: This review aggregates, analyzes, and summarizes the current understanding of the lung microbiome as it relates to pneumonia. We will review the composition and function of a healthy lung microbiome and conceptualize dysbiosis associated with pneumonia. Finally, we discuss how the lung microbiome impacts the diagnosis, prognostication and pathogenesis, and recovery from pneumonia. RECENT FINDINGS: The most tangible benefit of studying the lung microbiome has been the identification of pathogenic organisms in suspected pneumonia; however, as there is a growing body of evidence that suggest the lung microbiome is critical to pneumonia. Generally, detection of potential pathogens such as Staphylococcus aureus , Pseudomonas aeruginosa , Streptococcus pneumoniae , and Escherichia coli can be found even when sampling the lung microbiome of healthy individuals, yet it is unclear what determines the transition from potential pathogens present as bystanders to pathogens driving the development of pneumonia. Analysis of the lung microbiome suggests that the loss of "oral commensals" (bacteria found in the oral microbiome) in the lower airways is associated with the development of pneumonia and may provide diagnostic and prognostic insights. SUMMARY: The lung microbiome is a rich and dynamic ecosystem comprised of numerous bacterial, fungal, and viral taxa that may contribute to pneumonia pathogenesis. There is increasing evidence that the lung microbiome may provide insight into factors that determine the pathogenicity of respiratory microbes and the susceptibility of individuals to those pathogens.
Advanced bronchoscopy therapies for emphysema: current state and future potentials.
Tana A, Shah PL
Curr Opin Pulm Med · 2026 Mar · PMID 41606822 · Publisher ↗
PURPOSE OF REVIEW: Emphysema is a phenotype of chronic obstructive pulmonary disease that is characterized by irreversible parenchyma destruction and loss of elastic recoil, resulting in air trapping and hyperinflation....
PURPOSE OF REVIEW: Emphysema is a phenotype of chronic obstructive pulmonary disease that is characterized by irreversible parenchyma destruction and loss of elastic recoil, resulting in air trapping and hyperinflation. Despite optimal medical management, many patients remain symptomatic. Bronchoscopic lung volume reduction (BLVR) techniques provide minimally invasive alternatives to surgery. This review summarizes the current role and future directions of advanced bronchoscopic therapies for emphysema. RECENT FINDINGS: Established BLVR approaches aim to induce atelectasis of diseased, hyperinflated lobes using endobronchial valves or thermal vapor ablation. Patient selection and clinical efficacy is critically influenced by emphysema distribution and the presence of collateral ventilation. To address these limitations, novel therapies are being developed. Sealants are under investigation as adjuncts to valve therapy to overcome collateral ventilation. Endobronchial coils mechanically re-tension the lung parenchyma, improving elastic recoil and airway patency. Airway stents and scaffolds are designed to facilitate expiratory flow by either bypassing or preventing closure of collapsible airways. These emerging modalities may extend treatment options to patients with homogeneous disease and those with significant collateral ventilation, groups traditionally with limited existing interventions. SUMMARY: Current BLVR therapies remain limited in homogeneous disease and collateral ventilation-positive patients. Research into novel treatments have shown promise in an expanding therapeutic landscape, though long-term safety, durability, and patient selection criteria require further study.
Water parks, vaping, COPD topics on team management, exacerbations, bronchoscopic therapies, lung transplantation, and artificial intelligence.
Joshi M, Varkey B
Curr Opin Pulm Med · 2026 Mar · PMID 41606821 · Publisher ↗
Abstract loading — click title to view on PubMed.
Recent advances in the diagnosis and management of community-acquired pneumonia.
Edland B, Waterer GW
Curr Opin Pulm Med · 2026 May · PMID 41603097 · Publisher ↗
PURPOSE OF REVIEW: To describe key studies on community-acquired pneumonia (CAP) published in the last 12-18 months including the new American Thoracic Society (ATS) Guideline update. RECENT FINDINGS: The new ATS guideli...
PURPOSE OF REVIEW: To describe key studies on community-acquired pneumonia (CAP) published in the last 12-18 months including the new American Thoracic Society (ATS) Guideline update. RECENT FINDINGS: The new ATS guidelines have recommendations regarding imaging, interpretation of viral detection in the upper airways, duration of antibiotics and corticosteroid therapy. Since publication, there have been key studies in several areas, particularly with corticosteroids and macrolides for therapy as well as the usefulness of diagnostic tests. SUMMARY: The use of corticosteroids has become less clear with the findings of the REMAP-CAP study and are probably only indicated in a very small subset of patients. New pathogen diagnostic tools find new pathogens, but do not seem to improve patient outcomes. Patients should not be put at risk by withholding empiric antibiotic therapy in the setting of detection of a virus in upper airways samples.
Integrated disease management in outpatient chronic obstructive pulmonary disease.
Deas S, Rao A, Raghavan D
Curr Opin Pulm Med · 2026 Mar · PMID 41527399 · Publisher ↗
PURPOSE OF REVIEW: There is an undisputable knowledge-to-care implementation gap in chronic obstructive pulmonary disease (COPD) management. Integrated disease management (IDM), a multidisciplinary approach to prevent an...
PURPOSE OF REVIEW: There is an undisputable knowledge-to-care implementation gap in chronic obstructive pulmonary disease (COPD) management. Integrated disease management (IDM), a multidisciplinary approach to prevent and manage chronic diseases, has been identified as one potential solution to address this gap. The purpose of this review is to examine the recent evidence base and discuss the nuances of IDM in COPD care. RECENT FINDINGS: IDM in COPD has been implemented in the real world setting in diverse geospatial contexts in the last 5 years. IDM teams are predominantly embedded in primary care clinics and consist of 2-8 multidisciplinary team members. Interventions delivered by IDM COPD teams have been highly variable, making it difficult to definitively conclude 'how many' and 'which intervention' or 'combination of interventions' is needed to achieve positive clinical outcomes. Health service utilization and patient symptom scores are the common outcomes examined, and IDM COPD teams invariably achieved positive outcomes. SUMMARY: IDM represents a promising approach to the gaps in COPD guideline implementation and may help reduce care fragmentation. IDM teams have been shown to improve clinical outcomes, and also improve patient and provider satisfaction. A strong implementation plan that is theoretically grounded and considers all relevant contextual factors is more likely to result in successful implementation of an effective IDM team.
Respiratory health issues in indoor water parks: a review of noninfectious and infectious complications.
Ahluwalia V, Iyer VN
Curr Opin Pulm Med · 2026 Mar · PMID 41524091 · Publisher ↗
PURPOSE OF REVIEW: Indoor water parks, with over 1100 facilities in the United States, are popular recreational venues with an estimated 1.5 million visitors per year in North America. While generally well tolerated, the...
PURPOSE OF REVIEW: Indoor water parks, with over 1100 facilities in the United States, are popular recreational venues with an estimated 1.5 million visitors per year in North America. While generally well tolerated, they can be associated with significant respiratory and nonrespiratory health risks. This review focuses exclusively on the infectious and noninfectious respiratory health issues associated with indoor water park usage and is timely due to increasing popularity, evolving water-treatment practices, and the unique vulnerability of specific populations. RECENT FINDINGS: This review synthesizes peer-reviewed studies and institutional data from 2014 to 2024, detailing exposure mechanisms, health effects, mitigation strategies, and impacts on vulnerable populations such as children, asthmatic individuals, cystic fibrosis patients, immunocompromised individuals, and workers. Topics covered include disinfection by-products (DBPs), chloramine inhalation effects, asthma risks, hypersensitivity pneumonitis from nontuberculous mycobacteria, and occupational exposures. Emerging technologies in air and water quality management, alongside recent policy and facility-design developments, are also examined. SUMMARY: While indoor water parks remain a valued recreational resource, they pose significant and often under-recognized respiratory risks. Through better facility ventilation, hygiene education, disinfection innovation, and regulatory reform, these risks can be mitigated to protect both patrons and staff, particularly in vulnerable subpopulations.
Chronic obstructive pulmonary disease exacerbations for the academic hospitalist: an opportunity to learn and improve care.
Pruitt SE, Spradley TP, Bartter T
Curr Opin Pulm Med · 2026 Mar · PMID 41460068 · Publisher ↗
PURPOSE OF REVIEW: Hospitalists are at the forefront of managing chronic obstructive pulmonary disease (COPD) exacerbations. While patients may be followed by a pulmonologist outpatient, their care in the hospital is lar...
PURPOSE OF REVIEW: Hospitalists are at the forefront of managing chronic obstructive pulmonary disease (COPD) exacerbations. While patients may be followed by a pulmonologist outpatient, their care in the hospital is largely managed by internists. Our review addresses critical aspects of COPD care for the patient admitted to the hospital under the care of internal medicine. RECENT FINDINGS: When patients are hospitalized for COPD, the hospitalist has a critical opportunity to address tobacco cessation, vaccinations, and end-of-life issues. For hospitalists who are in academic medicine, teaching trainees the important mimickers of COPD exacerbations and how to establish the diagnosis are critical for their training. While these patients are hospitalized, ensuring adequate sleep and avoiding unnecessary night-time nebulizer use allows for patient recovery and wellbeing. SUMMARY: COPD exacerbations represent an opportunity for hospitalists to provide high-quality, comprehensive care for the patient and invaluable teaching for the trainee.
Impact of e-cigarettes and flavoured vapes on respiratory health: where are we now?
Omcikus M, Tashkin DP, Dimic-Janjic S … +1 more , Barjaktarevic I
Curr Opin Pulm Med · 2026 Mar · PMID 41403180 · Publisher ↗
PURPOSE OF REVIEW: The use of electronic cigarettes (e-cigarettes) for delivering nicotine has increased markedly in recent years, raising concerns regarding their long-term safety and their potential to sustain nicotine...
PURPOSE OF REVIEW: The use of electronic cigarettes (e-cigarettes) for delivering nicotine has increased markedly in recent years, raising concerns regarding their long-term safety and their potential to sustain nicotine dependence, particularly among adolescents and young adults. Marketed as safer alternatives to conventional cigarettes, e-cigarettes warrant careful evaluation of both their short-term and long-term health risks. RECENT FINDINGS: Evidence from systematic reviews suggests that e-cigarettes may serve as a tool for smoking reduction or cessation; however, available data indicate that usage often represents product switching rather than complete cessation. Given that e-cigarettes are not harmless, the advisability of recommending them as a smoking cessation aid remains controversial. Although long-term outcomes are not fully established, current research suggests that e-cigarettes could be responsible for acute lung injury, exacerbations of respiratory symptoms, chronic obstructive pulmonary disease progression, and various pathophysiological changes associated with cytotoxicity and airway dysfunction. SUMMARY: Considering the accumulating evidence of harm, e-cigarettes should be regulated similarly to conventional tobacco products, with strict restrictions on access for children and adolescents. Further longitudinal studies are needed to clarify their long-term health effects and to guide evidence-based public health policies.
Artificial intelligence in quantitative chest imaging analysis for occupational lung disease: appraisal of its current status.
Suganuma N, Tamura T, Eitoku M
Curr Opin Pulm Med · 2026 Mar · PMID 41376109 · Full text
PURPOSE OF REVIEW: The application of mathematical algorithms for detecting lung abnormalities has been a challenge for decades. Occupational lung diseases, which often present as diffuse abnormalities, are primarily scr...
PURPOSE OF REVIEW: The application of mathematical algorithms for detecting lung abnormalities has been a challenge for decades. Occupational lung diseases, which often present as diffuse abnormalities, are primarily screened and diagnosed using chest radiographs and computed tomography (CT). This article reviews recent algorithmic advancements applied to these diagnostic tasks. RECENT FINDINGS: Significant progress has been made in artificial intelligence (AI) technologies, particularly with three-dimensional deep learning models based on convolutional neural networks (CNNs). For chest radiographs, promising approaches include the "eTóraxLaboral" platform for pneumoconiosis detection, CNNs enhanced with dark channel prior-inspired lesion area enhancement, and CNNs paired with CycleGAN. For CT imaging, transformer-based factorized encoders (TBFE), various CNN architectures (often combined with other techniques), and the recently developed Kolmogorov-Arnold Networks (KANs) for binary classification have shown strong performance. However, both chest radiograph and CT studies commonly rely on the International Labour Organization (ILO) International Classification of Radiographs of Pneumoconioses system (ILO/ICRP) for pneumoconiosis as a reference, which may limit AI development for CT in particular. SUMMARY: Recent advancements offer strong promise for computer-assisted diagnosis of pneumoconiosis using chest radiographs and CT scans. The standardization and integration of these technologies - especially with support from international organizations and collaborative studies - will be critical to achieving accurate, implementable screening tools for occupational lung disease.
Health impacts of cannabis: focus on smoking vs. vaping effects on the respiratory and cardiovascular systems.
Chaiton M, Kundu A, Nathwani AA
Curr Opin Pulm Med · 2026 Mar · PMID 41355516 · Publisher ↗
PURPOSE OF REVIEW: The legalization of recreational and medical cannabis has shifted consumption patterns, with vaping emerging as a common alternative to smoking. This review summarizes recent evidence comparing the res...
PURPOSE OF REVIEW: The legalization of recreational and medical cannabis has shifted consumption patterns, with vaping emerging as a common alternative to smoking. This review summarizes recent evidence comparing the respiratory and cardiovascular health effects of these two modes of administration. RECENT FINDINGS: Vaping reduces exposure to combustion-related toxicants and allows modulation of Δ 9 -tetrahydrocannabinol (THC) bioavailability compared to smoking cannabis. However, both modes of consumption produce comparable physiological effects, including acute increases in heart rate and blood pressure, and altered immune responses in lung. There is clear association between THC vaping and e-cigarette or vaping associated lung injury. Vaping is also linked to increased risk of respiratory symptoms. Evidence regarding the long-term risks of vaping cannabis such as chronic obstructive pulmonary disease, lung cancer, myocardial infarction and stroke remains limited and inconclusive. SUMMARY: While vaping cannabis may mitigate some combustion-related harms compared to smoking, it introduces distinct respiratory and cardiovascular concerns. Evidence on long-term comparative safety remains limited, highlighting the need for longitudinal and experimental studies examining health outcomes across different modes of consumption, devices, temperatures and formulations.
Update on linear endobronchial ultrasound.
Awano N, Izumo T, Nakajima T
Curr Opin Pulm Med · 2026 Jan · PMID 41263057 · Publisher ↗
PURPOSE OF REVIEW: Linear endobronchial ultrasound (EBUS) plays a central role in the diagnosis and mediastinal staging of lung cancer. Recent advancements, including the 9th edition of the International Association for...
PURPOSE OF REVIEW: Linear endobronchial ultrasound (EBUS) plays a central role in the diagnosis and mediastinal staging of lung cancer. Recent advancements, including the 9th edition of the International Association for the Study of Lung Cancer (IASLC) TNM staging system and updated guidelines for neoadjuvant therapy, have significantly influenced its clinical utility. This review highlights these key developments and examines the expanding role of EBUS-guided tissue acquisition techniques and rapid on-site evaluation (ROSE). RECENT FINDINGS: The IASLC 9th edition offers a more nuanced nodal classification, reinforcing the importance of accurate EBUS-guided lymph node assessment. As neoadjuvant therapies become more common, precise pretreatment staging is critical for treatment planning. Emerging biopsy techniques, such as EBUS-guided intranodal forceps biopsy and cryobiopsy, yield larger tissue samples, improving diagnostic accuracy in complex cases, including lymphoma and benign diseases. Additionally, the integration of artificial intelligence into ROSE enhances the real-time diagnostic performance and mitigates the limitations of traditional cytopathology. SUMMARY: EBUS has evolved from diagnostic modality to a cornerstone of personalized lung cancer management. A clear understanding of updated staging systems, therapeutic guidelines, and biopsy strategies is essential. Future research should aim to establish evidence-based diagnostic algorithms incorporating these innovations to optimize patient care.
Diagnostic yield: what is sufficient?
Matsumoto Y, Gonzalez AV
Curr Opin Pulm Med · 2026 Jan · PMID 41221658 · Publisher ↗
PURPOSE OF REVIEW: Advances in diagnostic bronchoscopy seek to optimize diagnostic yield while maintaining the safety profile of conventional bronchoscopy. Despite rapid technological progress, inconsistent outcome defin...
PURPOSE OF REVIEW: Advances in diagnostic bronchoscopy seek to optimize diagnostic yield while maintaining the safety profile of conventional bronchoscopy. Despite rapid technological progress, inconsistent outcome definitions have hindered pooling of data across studies and comparisons across technologies. This review aims to clarify how a standardized definition of diagnostic yield can enhance comparability and clinical interpretation in advanced diagnostic bronchoscopy. RECENT FINDINGS: The recent ATS/CHEST consensus statement provides a rigorous framework for defining and reporting diagnostic yield, enabling meaningful cross-study comparisons. Beyond definitions of diagnostic outcome measures, optimization of tissue acquisition and processing through close collaboration between bronchoscopists and pathologists is critical. Current evidence supports the use of coordinated sampling strategies to secure sufficient, high-quality material for molecular testing, particularly for large-panel next-generation sequencing (NGS). Advances in EBUS-TBNA, cryobiopsy, and robotic bronchoscopy have improved sample yield and quality for genomic profiling. In parallel, liquid biopsy using circulating tumor DNA provides a minimally invasive adjunct, particularly valuable when tissue is limited, exhausted, or longitudinal monitoring is required; however, its sensitivity remains constrained in low-shedding diseases. SUMMARY: Adherence to a strict definition of diagnostic yield, combined with optimized sampling and integrated molecular testing, ensures that technological innovation in bronchoscopy translates into clinically meaningful, precise, and patient-centered diagnosis of lung cancer.
Aerodigestive fistulas in adults: a focus on airway interventions and review of recent literature.
Leong CK, Hsu AAL, Lee P
Curr Opin Pulm Med · 2026 Jan · PMID 41208247 · Publisher ↗
PURPOSE OF REVIEW: Aerodigestive fistulas (ADFs) cause significant morbidity and mortality, especially in advanced malignancies. This review summarizes current knowledge on etiology, diagnostic, and management strategies...
PURPOSE OF REVIEW: Aerodigestive fistulas (ADFs) cause significant morbidity and mortality, especially in advanced malignancies. This review summarizes current knowledge on etiology, diagnostic, and management strategies. RECENT FINDINGS: Esophageal carcinoma is the predominant cause of malignant ADFs with their development influenced by tumor location, most often involving the upper and middle thirds of the esophagus, and by prior interventions such as radiotherapy or esophageal stenting.Benign acquired ADFs typically result from iatrogenic injuries including pressure necrosis from cuffed tubes, stent erosion, endoscopy, and surgery. Diagnosis often is delayed by nonspecific symptoms, requiring combined imaging and endoscopic evaluation. Benign ADFs are typically amenable to surgical repair, whereas malignant fistulas usually require individualized palliation, notably airway and esophageal stenting. Dual airway-esophageal stenting has advantages over single stenting for malignant ADFs due to superior quality of life and survival outcomes. Emerging minimally invasive techniques include endoscopic clips, occluder devices, and tissue adhesives. SUMMARY: Optimal management of ADFs requires high clinical vigilance, timely diagnostic evaluation, and individualized multidisciplinary approaches. Further research into emerging therapies and standardized management algorithms is essential for improving patient outcomes and guiding evidence-based clinical practice.
Artificial intelligence in chronic obstructive pulmonary disease: recent advances in imaging and physiological monitoring.
Zhou CY, Restko M, Freije B … +1 more , Burkes RM
Curr Opin Pulm Med · 2026 Mar · PMID 41208246 · Publisher ↗
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a leading cause of worldwide morbidity and mortality, yet significant barriers in its diagnosis and management persist. Artificial intelligence is rapidl...
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a leading cause of worldwide morbidity and mortality, yet significant barriers in its diagnosis and management persist. Artificial intelligence is rapidly emerging as a powerful tool to address these challenges. This review summarizes recent trends in its application to advance the care of patients with COPD, focusing on imaging and physiologic parameters. RECENT FINDINGS: Recent literature demonstrates significant progress in artificial intelligence enhanced imaging, with deep learning models applied to chest radiographs and computed tomography showing high accuracy in detecting COPD, quantifying disease features, and predicting clinical outcomes including exacerbations and mortality. Machine learning algorithms are improving the interpretation of pulmonary function tests and leveraging novel data streams from cough sounds and wearable smart devices for noninvasive diagnosis, severity assessment, and the prediction of acute exacerbations. SUMMARY: While artificial intelligence holds immense potential to shift COPD care toward a more proactive and personalized model, most applications remain in early developmental stages, with critical challenges including the need for rigorous clinical validation, addressing algorithmic bias, and establishing standardized evaluation metrics.
Robotic assisted bronchoscopy for peripheral pulmonary nodules - data review.
Fielding D, Gildea TR, Ntiamoah P … +1 more , Saghaie T
Curr Opin Pulm Med · 2026 Jan · PMID 41208244 · Publisher ↗
PURPOSE OF REVIEW: Robotic Assisted bronchoscopy has emerged as an important tool in diagnosing small peripheral lung nodules in the era of CT screening. This paper reviews results from recent publications. RECENT FINDIN...
PURPOSE OF REVIEW: Robotic Assisted bronchoscopy has emerged as an important tool in diagnosing small peripheral lung nodules in the era of CT screening. This paper reviews results from recent publications. RECENT FINDINGS: Three meta -analyses have now been reported. Diagnostic yields reported in studies must be considered in terms of the study prevalence of malignancy, which if high tends to give higher overall diagnostic yield. Diagnostic yields are consistently an improvement on earlier technologies, particularly for lesions <20 mm in size. A range of imaging modalities have emerged as significant ways to improve diagnostic yield in Robotic procedures. These may be "stand alone" or integrated into the robotic systems. Robotic procedures may be performed under a single anaesthetic with planned surgical excision, the latter being guided by rapid on-site assessment or frozen section. Learning curve appears to be short and high levels of diagnostic performance with good safety profile have been reported. SUMMARY: Ongoing clinical study with robotic nodule biopsy will continue given the significant advance it has provided to clinicians in the first 5 years of its introduction.
Peripheral bronchoscopy: back to basics.
Quah P, Lee P
Curr Opin Pulm Med · 2026 Jan · PMID 41175036 · Publisher ↗
PURPOSE OF REVIEW: Peripheral bronchoscopy is increasingly practiced to gain access to peripheral pulmonary lesions (PPLs). Lung cancer screening with low-dose computed tomography (CT) is fuelling the need for superior n...
PURPOSE OF REVIEW: Peripheral bronchoscopy is increasingly practiced to gain access to peripheral pulmonary lesions (PPLs). Lung cancer screening with low-dose computed tomography (CT) is fuelling the need for superior navigational tools such as robot-assisted bronchoscopy to target screen-detected pulmonary nodules which may be as small as 6 mm. RECENT FINDINGS: It is an opportune moment to return to the basics of performing peripheral bronchoscopy through revising airway mapping with CT imaging. Virtual bronchoscopy, electromagnetic navigation bronchoscopy (ENB) and robot-assisted bronchoscopy (RAB) have yet to supplant the accuracy of manual airway mapping achieved simply by CT reading. The technique of airway mapping should be consistently utilised for airway navigation as it is complementary to technologies such as virtual bronchoscopy, ENB or RAB. In this review, we share the technique of performing airway mapping with a case illustration, and our approach to peripheral bronchoscopy. SUMMARY: Airway mapping is a foundational skill that must be preserved, practiced and perfected in our bronchoscopic approach to a PPL. In the absence of advanced navigational tools, peripheral bronchoscopy can be performed in combination with readily available tools to obtain a high diagnostic yield.
Strategies to decrease exacerbations of chronic obstructive pulmonary disease: can they impact disease progression?
Hatipoğlu U
Curr Opin Pulm Med · 2026 Mar · PMID 41165487 · Publisher ↗
PURPOSE OF REVIEW: Preventing disease progression is a key element of chronic obstructive pulmonary disease (COPD) management. COPD exacerbations are adverse events that can result in a decline of lung function that can...
PURPOSE OF REVIEW: Preventing disease progression is a key element of chronic obstructive pulmonary disease (COPD) management. COPD exacerbations are adverse events that can result in a decline of lung function that can persevere. Therefore, reducing exacerbation frequency has the potential to affect disease progression and improve health status of COPD patients. This narrative review explores monitoring for disease progression in COPD and its potential association with COPD exacerbations. RECENT FINDINGS: Pharmacotherapy can slow down disease progression, but the effect is mediated only in part by reducing exacerbations. While disease progression is continuous, patients with established airflow obstruction in early stages appear more vulnerable to faster declines in lung function. Longitudinal monitoring of lung function and structure is necessary to identify patients with disease progression. SUMMARY: Pharmacotherapy is an effective option for preventing disease progression. A holistic approach including longitudinal pulmonary function testing, clinical symptoms and imaging may be necessary to detect disease progression for early intervention.
Foreign body removal.
Goyal R, Sehgal IS, Agarwal R
Curr Opin Pulm Med · 2026 Jan · PMID 41076577 · Publisher ↗
PURPOSE OF REVIEW: Airway foreign body aspiration remains a potentially life-threatening emergency, predominantly affecting children under 5 years and adults over 65 years. This review synthesizes current evidence on dia...
PURPOSE OF REVIEW: Airway foreign body aspiration remains a potentially life-threatening emergency, predominantly affecting children under 5 years and adults over 65 years. This review synthesizes current evidence on diagnostic strategies, bronchoscopic extraction techniques, procedural outcomes, complication management, and emerging technologies in airway foreign body management. RECENT FINDINGS: Multidetector computed tomography with three-dimensional reconstruction has significantly improved diagnostic accuracy, achieving sensitivity of 98-99% for radiopaque objects and 85-92% for radiolucent materials. Flexible bronchoscopy has evolved from a diagnostic tool to a first-line therapeutic modality, with recent pediatric meta-analyses demonstrating 87% success rates and adult series showing comparable outcomes to rigid bronchoscopy for appropriately selected cases. Rigid bronchoscopy maintains superiority in asphyxiating presentations, and for large (>1.5 cm), sharp, or severely impacted foreign bodies. Technological innovations including robotic-assisted bronchoscopy, electromagnetic navigation systems, and artificial intelligence-powered imaging analysis are enhancing procedural precision and safety. SUMMARY: Successful airway foreign body management requires individualized, multidisciplinary approaches integrating patient clinical status, foreign body characteristics, and institutional expertise. Success depends on appropriate bronchoscopic modality selection, comprehensive preprocedural planning, availability of specialized retrieval instruments, and readiness to manage potential complications. Integration of advanced imaging, simulation-based training protocols, and telemedicine consultation are becoming essential components of contemporary practice.
History of bronchoscopy: from inception to the modern era of interventional pulmonology.
Ntiamoah P, Shirakawa T, Mehta AC
Curr Opin Pulm Med · 2026 Jan · PMID 41065578 · Publisher ↗
PURPOSE OF REVIEW: This review traces the historical evolution of bronchoscopy, from its origins in the late nineteenth century to its current role as a central tool in interventional pulmonology. It highlights major tec...
PURPOSE OF REVIEW: This review traces the historical evolution of bronchoscopy, from its origins in the late nineteenth century to its current role as a central tool in interventional pulmonology. It highlights major technological and clinical milestones and considers how early innovations continue to shape modern practices. As bronchoscopy enters the era of robotics and artificial intelligence, this reflection offers a timely perspective on its future trajectory. RECENT FINDINGS: Advances in both rigid and flexible bronchoscopy have enhanced visualization, navigation, and therapeutic precision. Interventions such as airway stenting, cryotherapy, endobronchial valve placement, and nonthermal ablation are now routine. These developments build on historical foundations and support a more targeted, minimally invasive approach to pulmonary intervention. SUMMARY: The evolution of bronchoscopy reflects a legacy of innovation driven by clinical need and technological advancement. Rigid and flexible techniques remain vital, while recent advances in robotics, artificial intelligence navigation, and image-guided interventions signal a new era. A deep appreciation of its historical development informs current practice and shapes the integration of emerging technologies into the future of interventional pulmonology.
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