Ultrasound-guided supraclavicular cannulation of the brachiocephalic vein (BCV) is a promising approach for neonatal central venous access, but multicenter data on feasibility, safety, and reproducibility remain limited.

Effective pulmonary nodule (PN) evaluation and management is essential to diagnosing early-stage lung cancers while avoiding unnecessary invasive procedures. Key knowledge gaps exist regarding how clinicians manage PNs and which opportunities for improvement should be prioritized.

The inherent false-positive rate of computed tomography (CT) necessitates efficient, non-invasive triage tools to distinguish lung cancer (LC) from benign mimics, thereby streamlining early detection and mitigating unnecessary invasive procedures.

Computed tomography imaging with machine learning can predict incident and prevalent chronic obstructive pulmonary disease (COPD), however, it is unknown if sex-specific models improve performance.

Up to 40% of patients with chronic obstructive pulmonary disease (COPD) have evidence of elevated eosinophil counts ≥ 300 cells/μL at some point during their disease. Blood eosinophil counts (BECs) are a biomarker that can identify patients with COPD and type 2 inflammation who are candidates for add-on inhaled corticosteroids (ICS) or biologic therapy. Evidence from real-world and clinical trial data shows variation in BECs over time in patients with COPD and type 2 inflammation.

Bronchiectasis is a chronic respiratory condition involving a cycle of impaired mucociliary clearance, chronic infections, inflammation, and progressive airway destruction, leading to persistent cough with sputum production, dyspnea, and fatigue. Without appropriate management, patients can experience increased exacerbations, reduced quality of life, declining lung function, and increased mortality risk. Variability exists in clinical practice regarding treatment selection, highlighting the need for evidence-based guidance to optimize patient outcomes and standardize care delivery across healthcare settings.

There is a growing body of evidence on the real-world effectiveness of adjuvanted respiratory syncytial virus (RSV) prefusion F3 (RSVPreF3) vaccination against RSV-related hospitalization among older adults. However, additional research is needed to further estimate vaccine effectiveness (VE) in subgroups at increased risk for severe RSV disease.

Lung cancer remains the leading cause of cancer deaths worldwide, and it has persistent disparities in detection, treatment, and survivorship. Navigators, including nurses, allied health professionals, and community health workers, are central to addressing these challenges by guiding patients through care pathways and improving access to timely, high-quality care. However, these navigators receive little lung cancer-specific training, leaving a gap in workforce preparation.

Pulmonary arterial hypertension therapies have not been systematically studied in early disease stages, despite potential benefit.

Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disorder with disparities in epidemiologic features, clinical outcomes, and health care access that disproportionately affect historically neglected populations, including Black Americans, Hispanic Americans, and American Indians.

To enhance biological understanding of ARDS, pneumonia, and sepsis and to accelerate therapeutic development in these areas, the National Institutes of Health developed the ARDS, Pneumonia, and Sepsis (APS) Consortium.

Pathologic cardiac findings have been described in case reports of patients with swimming-induced pulmonary edema (SIPE).

Bronchiectasis is a heterogeneous chronic lung disease marked by irreversible airway dilation and damage, instigating symptoms of chronic cough, dyspnea, and excessive mucus production. Recurrent exacerbations or infections with ongoing inflammation can lead to impaired quality of life, reduced ability to clear mucus, and even respiratory failure. Dozens of distinct conditions can contribute or coexist with bronchiectasis, often fueling a self-perpetuating vortex of inflammation, infection, and airway remodeling. Aspiration resulting in foreign particles into the airway can cause chemical pneumonitis from gastric contents, airway inflammation, and/or infection, with repeated exposures producing chronic injury. As clinical expertise has grown, aspiration-related pathology has acquired attention as a potential contributor to bronchiectasis and chronic lung infections, including nontuberculous mycobacteria, extrapolating from characterized relationships in other chronic lung diseases. Nonspecific symptoms, diagnostic challenges, and incomplete data characterizing the relationship have hindered the development of clear guidelines. In addition, the necessity for multidisciplinary care can delay timely management. Here, we assembled a multidisciplinary team of experts to evaluate retrograde and anterograde aspiration as modifiable comorbidities to bronchiectasis through case-based formatting. Using this framework and a narrative literature review, this How I Do It article provides clinical perspective on who, when, and how to test for aspiration from swallowing dysfunction and reflux disease. The study purpose was to raise awareness of aspiration, enhance evaluation by improving the pulmonologist's knowledge of test selection and interpretation, highlight the value of cross-disciplinary discussion, outline basic management strategies, and inspire further studies within bronchiectasis and chronic lung infection populations.

Biologic therapies targeting IL-5 or its receptor reduce eosinophilia and exacerbations in asthma. Breakthrough eosinophilic attacks are usually considered biologic failure. We report 2 patients with severe asthma receiving mepolizumab or benralizumab who developed relapsing hypereosinophilia associated with Pseudomonas aeruginosa airway infection. Case 1 was a 71-year-old woman in Canada with severe eosinophilic asthma and COPD overlap whose eosinophils suddenly rebounded to 1,400 cells/μL during an acute exacerbation while on mepolizumab, coinciding with P aeruginosa infection and resolving after antibiotic treatment. Case 2 was a 56-year-old woman in the United Kingdom with late-onset asthma who developed marked eosinophil rebound (1,690 cells/μL) during benralizumab therapy, again associated with Paeruginosa infection and resolving after antipseudomonal therapy. These cases suggest that P aeruginosa may drive eosinophilia through IL-5-independent mechanisms. Sputum cultures should be considered during exacerbations in patients treated with anti-IL-5 or IL-5R therapies, regardless of type 2 biomarkers.

Lung cancer is the leading cause of cancer mortality, yet lung cancer screening (LCS) remains underused. Centralizing LCS into dedicated teams with tracking systems (vs decentralized, individual provider-led screening) may improve LCS uptake, but effectiveness across diverse settings and populations is uncertain. Centralization also varies: hybrid programs share responsibilities with primary care clinicians, whereas fully centralized programs manage nearly all screening and patient navigation. Whether one model is more effective in enrolling patients remains unknown.

Interstitial lung disease encompasses > 200 disorders characterized by lung parenchymal inflammation and fibrosis, presenting significant diagnostic challenges that often require invasive procedures with substantial morbidity and mortality risks. Diagnostic approaches have traditionally relied on surgical lung biopsy for definitive histopathologic evaluation, a procedure carrying a 1.7% to 3.6% mortality rate; however, its use has declined recently. Bronchoscopy offers a safer alternative that provides direct access to the lung microenvironment through bronchoalveolar lavage, tissue sampling, and airway visualization.

Combined pulmonary fibrosis and emphysema (CPFE) is an important phenotype in patients with fibrotic interstitial lung disease (ILD).

High altitude may adversely affect patients with pulmonary vascular disease (PVD), but acute cardiopulmonary effects remain unclear.