European Respiratory Society International Congress Research Articles

ERS International Congress 2023: highlights from the Respiratory Clinical Care and Physiology Assembly.

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2023 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

ERS International Congress 2023: highlights from the Respiratory Intensive Care Assembly.

Early career members of Assembly 2 (Respiratory Intensive Care) attended the 2023 European Respiratory Society International Congress in Milan, Italy. The conference covered acute and chronic respiratory failure. Sessions of interest to our assembly members and to those interested in respiratory critical care are summarised in this article and include the latest updates in respiratory intensive care, in particular acute respiratory distress syndrome and mechanical ventilation.

ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly.

This article summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society International Congress. Two sessions from each Assembly group are outlined, covering the following topics: Group 9.01 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.02 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.03 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.04 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights article provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

ERS International Congress 2023: highlights from the Airway Diseases Assembly.

In this review, early career and senior members of Assembly 5 (Airway Diseases, Asthma, COPD and Chronic Cough) present key recent findings pertinent to airway diseases that were presented during the European Respiratory Society International Congress 2023 in Milan, Italy, with a particular focus on asthma, COPD, chronic cough and bronchiectasis. During the congress, an increased number of symposia, workshops and abstract presentations were organised. In total, 739 abstracts were submitted for Assembly 5 and the majority of these were presented by early career members. These data highlight the increased interest in this group of respiratory diseases.

ERS International Congress 2023: highlights from the Paediatrics Assembly.

Respiratory health in children is essential for general wellbeing and healthy development in the short and long term. It is well known that many respiratory diseases in adulthood have their origins in early life, and therefore research on prevention of respiratory diseases and management of children with respiratory diseases will benefit patients during the full life course. Scientific and clinical advances in the field of respiratory health are moving at a fast pace. This article summarises some of the highlights in paediatric respiratory medicine presented at the hybrid European Respiratory Society (ERS) International Congress 2023 which took place in Milan (Italy). Selected sessions are summarised by Early Career Members of the Paediatrics Assembly (Assembly 7) under the supervision of senior ERS officers, and cover a wide range of research areas in children, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology and bronchology.

ERS International Congress 2023: highlights from the Interstitial Lung Diseases Assembly.

This article summarises a selection of scientific highlights in the field of interstitial lung diseases (ILDs) presented at the International Congress of the European Respiratory Society in 2023. Translational and clinical studies focused on the whole spectrum of ILDs, from (ultra)rare ILDs to sarcoidosis, ILDs associated with connective tissue disease and idiopathic pulmonary fibrosis. The main topics of the 2023 Congress presentations were improving the diagnostic process of ILDs, better prediction of disease course and investigation of novel treatment options.

ERS International Congress 2023: highlights from the Pulmonary Vascular Diseases Assembly.

Pulmonary vascular diseases such as pulmonary embolism and pulmonary hypertension are important and frequently under-recognised conditions. This article provides an overview of key highlights in pulmonary vascular diseases from the European Respiratory Society International Congress 2023. This includes insights into disease modification in pulmonary arterial hypertension and novel therapies such as sotatercept and seralutinib. Exciting developments in our understanding of the mechanisms underpinning pulmonary hypertension associated with interstitial lung disease are also explored. A comprehensive overview of the complex relationship between acute pulmonary embolism and chronic thromboembolic pulmonary hypertension (CTEPH) is provided along with our current understanding of the molecular determinants of CTEPH. The importance of multidisciplinary and holistic care cannot be understated, and this article also addresses advances beyond medication, with a special focus on exercise training and rehabilitation.

ERS International Congress 2023: highlights from the Sleep Disordered Breathing Assembly.

The topic of sleep-related breathing disorders is always evolving, and during the European Respiratory Society (ERS) International Congress 2023 in Milan, Italy, the latest research and clinical topics in respiratory medicine were presented. The most interesting issues included new diagnostic tools, such as cardiovascular parameters and artificial intelligence, pathophysiological traits of sleep disordered breathing from routine polysomnography or polygraphy signals, and new biomarkers and the diagnostic approach in patients with excessive daytime sleepiness. This article summarises the most relevant studies and topics presented at the ERS International Congress 2023. Each section has been written by early career members of ERS Assembly 4.

Managing Spontaneous Pneumothorax and Treating Severe Community-Acquired Pneumonia

THE FIRST European guidelines for the management of primary spontaneous pneumothorax (PSP) were presented in a symposium session delivered at the European Respiratory Society (ERS) International Congress 2023 on the 9th–13th of September in Milan, Italy. The novel guidelines covered new recommended approaches to acute pneumothorax, optimal management of persistent air leak (PAL), and analysed the evidence for the changing use of co-adjuvants in severe community-acquired pneumonia (SCAP).

Breathing New Life Into Acute Respiratory Care: Proactively Improving Long-Term Outcomes

Admissions due to asthma contribute substantially to the burden faced by emergency departments (ED) worldwide, with a considerable impact arising from the high number of readmissions among patients with severe asthma. Repeated ED readmittance not only places considerable demand on healthcare resources, but also increases the humanistic burden on patients through reduced lung function, decreased quality of life, and increased exposure to systemic corticosteroids (SCS) and oral corticosteroids (OCS). In addition, patients are subject to the increased morbidity and mortality risk, and quality of life deficit associated with repeated asthma exacerbations. Admission to the ED should be seen as an opportunity to break this readmission cycle and prevent further admissions, while offering patient-centric benefits, such as investigation into the underlying causes of disease, and optimisation of care to prevent further exacerbations. Actions that require no additional resource may be taken directly in the ED, including biomarker tests among routine blood tests, or teaching inhaler technique as part of patient education and safety-netting. In addition, patient discharge may be considered as an opportunity for improving guidance implementation and breaking the cycle of readmission. Unlike emergency cardiac care, where >90% of patients are discharged on secondary prevention drugs and 85% of patients are referred to follow-up rehabilitation, guidelines for care following an ED visit for asthma are not always followed. Furthermore, current tools designed to accelerate specialist referral are not always rigorously implemented following an ED visit, meaning that follow-up may be delayed. Finally, further efforts should be made to identify high-risk patients in the community earlier in the disease pathway, allowing timely intervention before further lung function impairment, or the onset of adverse events due to OCS over-exposure. This article summarises an AstraZeneca-sponsored symposium delivered on 12th September 2023, as part of the European Respiratory Society (ERS) International Congress in Milan, Italy. The faculty, consisting of David Price, Head of the Observational and Pragmatic Research Institute, Singapore; Mona Al-Ahmad, Consultant Allergist and Clinical Immunologist at the Ministry of Health in Kuwait; and Mohit Bhutani, Professor of Medicine at the University of Alberta, Edmonton, Canada, each gave a brief presentation on proactive strategies to improve long-term outcomes in acute respiratory care. During panel discussions following each presentation, Anne Marie Marley, Respiratory Nurse Consultant from Belfast Health and Social Care Trust, UK, provided examples of implementing transition of care by bridging hospital and community care settings.

Prioritising Patient Outcomes and Reducing Environmental Burden: How Both Are Achievable in Respiratory Care

Patient outcomes must take precedence when considering environmental legislation related to the availability of inhaler devices, which are essential for the care of patients with respiratory diseases. This article reviews presentations and abstracts from the European Respiratory Society (ERS) International Congress 2023, held in Milan, Italy, in September 2023. The sessions focused on healthcare inequality and patient outcomes, highlighting the need for stakeholders to make patient-centric decisions in order to ensure access to essential inhaled medicines are prioritised. This is especially important during a period when there is an increasing need to reduce the carbon footprint associated with respiratory care. During a satellite symposium, co-chairs John Hurst, Professor of Respiratory Medicine at University College London (UCL), UK, and Helen Reddel, Research Leader at the Woolcock Institute of Medical Research, Sydney, Australia, emphasised the necessity of addressing environmentally sustainable respiratory care while prioritising patient outcomes. Christine Jenkins, Clinical Professor of Respiratory Medicine at the University of New South Wales (UNSW), Sydney, Australia, discussed the association between health inequity and uncontrolled chronic obstructive pulmonary disease (COPD) and asthma, and how that relates to the carbon footprint of treatment. Alberto Papi, Full Professor of Respiratory Medicine at the University of Ferrara, Italy, examined how implementing evidence-based guidelines can improve patient outcomes and reduce the carbon footprint of respiratory care, and the progress being made in the transition to near-zero propellants in pressurised metered-dose inhaler (pMDI) devices. Omar Usmani, Professor of Respiratory Medicine at the National Heart and Lung Institute (NHLI), Imperial College London, UK, stressed that pMDIs contain essential medicines, and inhaler regimens should not be considered readily interchangeable. He urged the respiratory community to ensure that their voice is heard in decisions where it relates to the environment regarding COPD and asthma care. The symposium emphasised the opportunities to reduce the environmental impact of respiratory care whilst prioritising patient outcomes. By supporting the transition to climate-friendly propellants in pMDI devices, and implementing guidelines to improve patient outcomes, the overall carbon footprint of respiratory care can be reduced. However, this must be done without limiting access to essential medicines, or increasing adverse health outcomes. The symposium identified pathways towards achieving patient-centric, sustainable respiratory care by improving outcomes, harnessing innovation, and promoting multi-stakeholder collaboration.

Shaping the Future in Rare Lung Diseases: From Imaging to Patient Management

This symposium was held during the 2023 European Respiratory Society (ERS) International Congress in Milan, Italy. The main objective was to discuss unmet needs in the diagnosis and management of rare lung diseases, with a particular emphasis on alpha 1 antitrypsin deficiency (AATD) and idiopathic pulmonary fibrosis (IPF). Presentations focused on promising approaches to meet these needs, including the feasibility of genomic diagnosis, the development of improved biomarkers of disease progression, such as quantitative CT and novel blood biomarkers, the use of digital lung auscultation, and increased screening for AATD in vulnerable populations. The overarching message from the symposium was that advancements in technology, multidisciplinary collaboration, and partnerships between academic institutions, patient associations, and industry are crucial to the continued improvement of patient management in rare diseases, and that the education of healthcare professionals is vital to enhance the understanding and awareness of these conditions.

ERS 2023 Abstract Highlights

The following highlights spotlight selected abstracts presented at the European Respiratory Society (ERS) International Congress 2023. They cover key topics, including persistent airflow limitation in paediatric severe asthma, pulmonary rehabilitation, health-related quality of life, chronic cough and obstructive sleep apnoea, paediatric lung transplantation, dead space ventilation in acute respiratory distress syndrome, and virtual wards for remote patient monitoring.

Precision Medicine in Airway Diseases: What Can We Offer in the Clinic?

AN EXCITING session, delivered at the European Respiratory Society (ERS) International Congress 2023, held in Milan, Italy, saw field experts present recent research surrounding precision medicine in airway diseases. Chaired by Apostolos Bossios, Karolinska University Hospital, Stockholm, Sweden; Emer Kelly, St. Vincent’s University Hospital, Dublin, Ireland; and Omar Usmani, National Heart and Lung Institute (NHLI), Imperial College London, UK, presentations discussed the value of ‘omics’, cellular signatures, novel chronic obstructive pulmonary disease (COPD) classifications, and the identification of treatable traits in improving patient care.

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly.

It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of the laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of Assembly 1 (Respiratory Clinical Care and Physiology). Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, mobile/electronic health (m-health/e-health), clinical respiratory physiology, exercise and functional imaging.

ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly.

In this article, we provide a brief overview of some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2022 European Respiratory Society International Congress, which was held in a hybrid format. Early Career Members from Assembly 9 summarised the content of the sessions, with the support of the Officers from the four Assembly groups: Respiratory Function Technologists and Scientists (Group 9.01); Physiotherapists (Group 9.02); Nurses (Group 9.03); and Psychologists and Behavioural Scientists (Group 9.04). The sessions covered the following topics: recent advances in cardiopulmonary exercise and challenge testing; the role and new trends in physiotherapy, exercise and physical activity promotion interventions in chronic respiratory diseases; development of the international curriculum for respiratory nurses and nursing aspects in disease management; and treatment adherence, e-health interventions and post-coronavirus disease 2019 challenges. This Highlights article targets delegates who attended the Congress sessions, as well as those who were unable to attend, and provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

ERS International Congress 2022: highlights from the Sleep Disordered Breathing Assembly.

During the European Respiratory Society (ERS) International Congress 2022 in Barcelona, Spain, the latest research and clinical topics in respiratory medicine were presented. The sleep medicine-focused presentations and symposia provided novel insights into the pathophysiology of sleep disordered breathing, its diagnostics, and new trends in translational research and clinical applications. The presented research trends focused mainly on the assessment of sleep disordered breathing-related intermittent hypoxia, inflammation and sleep fragmentation, and their implications, especially cardiovascular. The most promising methods for assessing these aspects encompass genomics, proteomics and cluster analysis. The currently available options include positive airway pressure and a combination of it and pharmacological agents (e.g. sulthiame). This article summarises the most relevant studies and topics on these subjects presented at the ERS International Congress 2022. Each section has been written by Early Career Members of the ERS Assembly 4.

ERS International Congress 2022: highlights from the Epidemiology and Environment Assembly.

In this article, early career members of the Epidemiology and Environment Assembly of the European Respiratory Society summarise a selection of five sessions from the Society's 2022 International Congress, with a focus on areas of specific interest for the Assembly, i.e. epidemiology and risk factors of respiratory diseases in both children and adults. Topics covered include the characterisation of obstructive respiratory diseases, their comorbidities and their evolution, with novel insight from large cohorts. The importance of early-life factors in respiratory health was also emphasised, including maternal exposures and habits during pregnancy. As smoking behaviours have changed following the introduction of e-cigarettes and heated tobacco products, research remains very active to determine the health consequences and predictors of these novel uses, especially in teenagers. The impact of environmental and occupational exposures on respiratory health remained a major topic of the congress, with a focus on emerging risk factors such as landscape fire smoke, non-exhaust particles and nanoparticles. Regarding workplace exposures, old and novel causes of occupational asthma and rhinitis were discussed.

ERS International Congress 2022: highlights from the Respiratory Intensive Care Assembly.

Early Career Members of Assembly 2 (Respiratory Intensive Care) attended the 2022 European Respiratory Society (ERS) International Congress in Barcelona, Spain. The conference covered acute and chronic respiratory failure. Sessions of interest to our Assembly members and to those interested in respiratory critical care included the state-of-the-art session on respiratory critical care, the journal session (ERS/Lancet) on acute respiratory distress syndrome (ARDS) phenotyping into precision medicine, and sessions on specificity of coronavirus disease 2019 ARDS and its post-critical care. A symposium on treatment of acute respiratory failure in patients with COPD and innovations in mechanical ventilation either in the intensive care unit or at home were also reported upon. These sessions are summarised in this article.

ERS International Congress 2022: highlights from the Interstitial Lung Diseases Assembly.

This article contains a selection of scientific highlights in the field of interstitial lung diseases (ILDs) presented at the hybrid European Respiratory Society International Congress 2022. Early Career Members of Assembly 12 summarise recent advances in translational and clinical research in idiopathic interstitial pneumonias, ILDs of known origin, sarcoidosis and other granulomatous diseases, and rare ILDs. Many studies focused on evaluation of diagnostic and prognostic (bio)markers, and novel pharmacological and nonpharmacological treatment options for different ILDs. In addition, new insights in clinical, physiological and radiological features of various rare ILDs were presented.