Canadian Thoracic Society Position Statement Research Articles

Canadian Thoracic Society Position Statement on Climate Change and Choice of Inhalers for Patients with Respiratory Disease

Canadian Thoracic Society Position Statement on Climate Change and Choice of Inhalers for Patients with Respiratory Disease

Bronchoscopy during the COVID-19 pandemic: A Canadian Thoracic Society Position Statement update

Bronchoscopy during the COVID-19 pandemic: A Canadian Thoracic Society Position Statement update

Canadian Thoracic Society position statement on rehabilitation for COVID-19 and implications for pulmonary rehabilitation

This position statement aims to provide rapid guidance for pulmonary rehabilitation in adults with COVID-19 illness. These recommendations are based on the consensus of the authors, who are members...

Bronchoscopy during the COVID-19 pandemic: A Canadian Thoracic Society position statement

This position statement aims to provide rapid guidance for those performing bronchoscopy in the pediatric and adult populations during the COVID-19 pandemic. These recommendations are based on the consensus of the authors, who are members of the Canadian Thoracic Society (CTS) Chest Procedures Assembly, and on the information available at the time this document was written, including guidance from other organizations. Changes in our understanding of COVID-19 and the course of the pandemic may affect the recommendations in this statement. Guidance from local public health authorities and from institutional infection prevention and control departments should be considered when assessing information in this document. Readers should consult these resources as they adapt plans for bronchoscopy during the pandemic. We plan to update this guidance regularly as new information becomes available, and recommend periodically checking the Canadian Thoracic Society website (https://cts-sct.ca/covid-19/) for updates.

Mechanical insufflation-exsufflation and available funding for Canadian adult patients. A Canadian Thoracic Society Position Statement

Many neuromuscular disease patient populations suffer from a weak, inadequate cough, which may lead to respiratory tract infections, respiratory failure, and increased mortality. Hospitalized neuromuscular disease patients are often treated with a mechanical insufflation-exsufflation (MI-E) machine to improve lung volume, promote mucociliary clearance and improve their respiratory health. Many of these patients require MI-E within their homes to maintain the benefits achieved in hospitals. Currently, a resource paper that outlines provincial funding avenues for home MI-E machines does not exist. Accordingly, Canadian Respiratory Health Professionals (CRHP) Leadership Council members formed a working group to propose and collate recommendations and resources for using MI-E in neuromuscular populations at home.

Considerations regarding school return for children and adolescents with asthma: A Canadian Thoracic Society position statement

Version 1.0 – September 9, 2020 This document complements the Canadian Thoracic Society (CTS) Position Statement on “Addressing therapeutic questions to help Canadian physicians optimize asthma man...

Delivering pulmonary rehabilitation during the COVID-19 pandemic: A Canadian Thoracic Society position statement

This position statement aims to provide guidance for resumption of pulmonary rehabilitation (PR) services during the post-peak phase of the COVID-19 pandemic (ie, period of low community prevalence...

Long-term monitoring of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society Position Statement

Longitudinal monitoring of patients with fibrotic interstitial lung disease (ILD) is essential to identifying disease progression and guiding management decisions. There are no evidence-based clinical practice guidelines to inform decision-making for the appropriate components and frequency of monitoring patients with fibrotic ILD. This position statement summarizes the key components of long-term monitoring of fibrotic ILD, including the appropriate frequency of monitoring, specific symptoms and comorbidities to consider, and the objective testing that should be routinely performed. Key messages based on scientific literature review and consensus from a panel of ILD experts are provided to guide clinical practice.

Alpha-1 Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Clinical Practice Guideline

Alpha-1 antitrypsin (A1AT) functions primarily to inhibit neutrophil elastase, and deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD). Severe A1AT deficiency occurs in one in 5000 to one in 5500 of the North American population. While the exact prevalence of A1AT deficiency in patients with diagnosed COPD is not known, results from small studies provide estimates of 1% to 5%. The present document updates a previous Canadian Thoracic Society position statement from 2001, and was initiated because of lack of consensus and understanding of appropriate patients suitable for targeted testing for A1AT deficiency, and for the use of A1AT augmentation therapy. Using revised guideline development methodology, the present clinical practice guideline document systematically reviews the published literature and provides an evidence-based update. The evidence supports the practice that targeted testing for A1AT deficiency be considered in individuals with COPD diagnosed before 65 years of age or with a smoking history of <20 pack years. The evidence also supports consideration of A1AT augmentation therapy in nonsmoking or exsmoking patients with COPD (forced expiratory volume in 1 s of 25% to 80% predicted) attributable to emphysema and documented A1AT deficiency (level ≤11 µmol⁄L) who are receiving optimal pharmacological and nonpharmacological therapies (including comprehensive case management and pulmonary rehabilitation) because of benefits in computed tomography scan lung density and mortality.

Canadian Cardiovascular Society and Canadian Thoracic Society Position Statement on Pulmonary Arterial Hypertension

The Canadian Cardiovascular Society and the Canadian Thoracic Society requested a position statement on pulmonary arterial hypertension from leading Canadian experts. The present document is intended to act as an update for the clinician, to provide a template for the initial evaluation of patients, to enable the understanding of current therapeutic paradigms based on approved indications for Canada, to highlight new therapies on the horizon, and to state the positions of the Canadian Cardiovascular Society and the Canadian Thoracic Society on resource management for pulmonary arterial hypertension in Canada.