Measurement of blood (SpO2) and tissue (StO2) oxygenation is routinely performed in clinical practice. Arterial Blood Gas (ABG) analysis, though considered as the gold standard for SpO2 estimation, requires arterial puncture, trained personnel and laboratory back up. Currently, there is a lack of universally accepted and widely used method for StO2 measurement. Available non-invasive methods for SpO2 and StO2 estimation have several limitations. Many technologies are under development to address this unmet clinical need.

Nocturnal hypoxemia commonly affects people with pulmonary fibrosis (PF).

Insomnia and OSA, together known as comorbid insomnia and OSA (COMISA), are highly prevalent sleep disorders, each of which has the potential to impair treatment efficacy for the other.

Weight loss in patients with fibrotic interstitial lung disease (F-ILD) is associated with poor prognosis, yet the impact of dietary input is unknown.

A subgroup of patients with obesity exhibits hypoventilation as a result of, among other mechanisms, a narrow, collapsible upper airway (UA), a reduced ventilatory drive during both wakefulness and sleep, and the loss of pharyngeal muscle tone during sleep. These features characterize obesity-hypoventilation syndrome (OHS). If left untreated, OHS is associated with significant morbidity and mortality. Besides lifestyle modifications, positive airway pressure (PAP) is the only available treatment, and it is often not well tolerated. Drugs designed to activate UA muscles such as atomoxetine and to stimulate breathing such as acetazolamide represent a potential novel strategy for treating OHS.

The role of cannabis smoking in lung cancer has long been underexplored due to its historical illegality and frequent co-use with tobacco. As cannabis use increases globally, particularly among younger individuals, understanding its impact on lung cancer is critical.

Atelectasis frequently occurs in patients with impaired consciousness who are being treated with invasive mechanical ventilation. It is mainly caused by secretion accumulation, which can lead to longer durations of ventilation and ICU stay.

Olfaction may be associated with lung health because of the anatomic and functional connections between the upper and lower airways, but empirical evidence is lacking.

Interstitial lung disease (ILD) is a term encompassing a wide array of pulmonary conditions characterized by inflammation and fibrosis of the pulmonary parenchyma. Pulmonary hypertension (PH) is frequently encountered in patients with fibrotic ILDs and poses unique difficulties for both diagnosis and management. Patients with ILD-associated pulmonary hypertension (ILD-PH) are complex, often ailing and presenting with multiple comorbidities whose individual contributions to the underlying PH can be challenging to disentangle. Evidence supporting treatment with PH-specific medications in ILD-PH is limited. This edition of "How I Do It" presents a longitudinal case-based discussion of ILD-PH to address these challenges, highlight pearls and pitfalls in the diagnostic workup of these patients, and provide a framework for the practical evidence-based approach to accurate diagnosis and management of these challenging patients.

Air pollution and extreme temperatures exposure during pregnancy is associated with lung function in schoolchildren.

Breathlessness on exertion is a common, distressing, and limiting symptom that can be quantified on incremental cardiopulmonary exercise testing (CPET) using normative reference equations.

Uptake of evidence-based practices (EBPs) in pulmonary and critical care medicine is frequently incomplete. To address these gaps, implementation scientists seek to understand the clinical and societal contexts in which innovations and EBP are introduced. They also design and evaluate complex interventions to facilitate the adoption of an EBP in those contexts. We propose that well-established methods for analyzing hierarchical, observational data can complement and strengthen this process by identifying sources of practice variability. This paper reviews the dominant framework used to understand the clinical context of implementation programs, describes how measuring practice variability could help streamline this approach, and tests an assumption of the proposed combined methodology using observational data from a national study of patients on mechanical ventilation conducted by The Prevention and Early Treatment of Acute Lung Injury Network. We discuss how the combined approach can be used (1) to focus the search for determinants of practice, (2) to quantify the impact of evidence generation and evaluate the success of implementation projects, and (3) to facilitate comparisons between implementation strategies when multiple approaches are trialed simultaneously.

Nocturnal pulsed oxygen saturation (SpO2) monitoring is recommended for detecting residual sleep-disordered breathing, including nocturnal hypoventilation, in patients treated by noninvasive ventilation (NIV) or CPAP. It is a general assumption that different pulse oximetry devices will provide similar results. However, this may not be correct.

Trial participants typically are healthier than the general population. Differences in underlying characteristics between the population undergoing lung cancer screening (LCS) and LCS trial participants may alter the benefits of LCS.

Because of risk of severe asthma exacerbations, current Global Initiative for Asthma recommendations advise against use of short-acting beta-agonists (SABAs) alone as the first step in treating mild asthma. It is unclear if everyone with mild asthma carries equal risk for severe asthma exacerbations.

Malignant airway obstruction (MAO) is a common debilitating complication in advanced lung cancer. Therapeutic bronchoscopy is successfully applied to manage MAO. MAO recurs and requires repeat procedures.

There is substantial overlap between features of COPD, asthma, bronchiectasis (BE), and cystic fibrosis (CF). Each is characterized by inflammation and mucociliary dysfunction.