The efficacy and safety of combined therapy with endobronchial tamponade and bronchial artery embolization for massive hemoptysis.

BACKGROUND: Massive hemoptysis is characterized by its life-threatening nature, potentially leading to airway obstruction and asphyxia. The objective of this study was to evaluate the clinical effectiveness of combining endobronchial tamponade with bronchial artery embolization (BAE) in the treatment of massive hemoptysis. METHODS: Between March 2018 and March 2022, a total of 67 patients with massive hemoptysis who underwent BAE were divided into two groups: the combination group (n = 26) and the BAE group (n = 41). Technical and clinical success rates were assessed, and adverse events were monitored following the treatment. Blood gas analysis and coagulation function indicators were collected before and after the treatment, and recurrence and survival rates were recorded during the follow-up period. RESULTS: All patients achieved technical success. There were no significant differences in the clinical success rate, recurrence rates at 3 and 6 months, and mortality rates at 3 months, 6 months, and 1 year between the combination group and the BAE group. However, the hemoptysis recurrence rate at 1 year was significantly lower in the combination group compared to the BAE group (15.4% vs. 39.0%, P = 0.039). No serious adverse events were reported in either group. After treatment, the combination group showed higher levels of arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), fibrinogen (FIB), and D-dimer (D-D) compared to the BAE group (P < 0.05). Multivariate regression analysis demonstrated a significant correlation between combined therapy and hemoptysis-free survival. CONCLUSION: Combination therapy, compared to embolization alone, exhibits superior efficacy in improving respiratory function, correcting hypoxia, stopping bleeding, and preventing recurrence. It is considered an effective and safe treatment for massive hemoptysis.

Temperature-Triggered Adhesive Bioelectric Electrodes with Long-Term Dynamic Stability and Reusability.

Bioelectric electrodes with low modulus and high adhesion have been intensively pursued, as they afford conformal and strong bonding at skin-electrode interface to improve the fidelity and stability of electrophysiological signals. However, during detachment, tough adhesion can cause pain or skin allergy; worse still, the soft electrodes can suffer damage due to excessive stretch/torsion, hampering long-term, dynamic, and multiple uses. Herein, a bioelectric electrode is proposed by transferring silver nanowires (AgNWs) network to the surface of bistable adhesive polymer (BAP). The phase transition temperature of BAP is tuned to be slightly below skin temperature at 30 °C. Triggered by skin heat, the BAP electrode achieves low modulus and high adhesion within seconds, allowing robust skin-electrode interface under dry, wet, and body-moving conditions. Ice bag treatment can dramatically stiffen the electrode and reduce the adhesion, which allows painless detachment and avoids electrode damage. Meanwhile, the AgNWs network with biaxial wrinkled microstructure remarkably promotes the electro-mechanical stability of the BAP electrode. The BAP electrode successfully combines long-term (7 days) and dynamic (body movements, sweat, underwater) stability, reusability (at least ten times), and minimized skin irritation during electrophysiological monitoring. The high signal-to-noise ratio and dynamic stability are demonstrated in the application of piano-playing training.