A autoimmune Pulmonary Alveolar Proteinosis (PAP) patient with persistent disease underwent 3 Whole Lung Lavages (WLLs), 10 plasmapheresis sessions and further 3 WLL, from October 2004 to May 2007. Nevertheless HRTC and pulmonary function test (PFT) showed a persistent residual disease of mild degree. At the beginning of 2010, the patient was admitted to inhaled rGM-CSF (Sargramostim) therapy as compassionate treatment. GM-CSF was administered by Akita 2 nebulizer (Vectura), as follow: 250 mcg/day every other week for 12 weeks, then 250 mcg/day on 2 consecutive days every 2 weeks for 6 months. Follow up visits were scheduled at 3, 10, 18, 30 months and after that once a year. Functional and HRCT data and PaO2 were collected. Since the start of the inhaled GM-CSF therapy, the patient no more required WLL. Furthermore we found a significant increase in DLCO% (p=0.013) and FVC% (p=0.023) while %FEV1 show a positive trend. No substantial differences in blood gas analysis. The pulmonary involvement at HRCT shows a significant decrease of lung infiltrates (p=0.039) in terms of pathological segments. These data underscore the utility of inhaled GM-CSF not only in case of progressing disease but also in case of refractory patients with persistent lung infiltrates, in order to increase the response rate.

Objective: To evaluate the utility of inspiratory capacity (IC) measured by simple spirometry as an indirect measure of air trapping. Method: Functional residual capacity (FRC) and IC were determined, respectively, by a body plethysmography and by spirometry. Air trapping was defined by a FRC higher than 120%. Spearman’s rho between IC and FRC is determined and the receiver operating characteristic (ROC curve) is calculated as predictive of air trapping for IC. The best cutoff of the overall test is calculated.

Aim: To examine whether caloric intake during the first week of age influences the risk of Bronchopulmonary Dysplasia (BPD) in extremely preterm infants. Methods: In this retrospective cohort study, all infants born with gestational age < 29 weeks over 30 months period were eligible for the study. Infants with major congenital anomalies and those who died before 36 weeks postmenstrual age were excluded. We compared the nutritional characteristics between infants who developed BPD and those without BPD.

Background: Chronic Obstructive Pulmonary Disease (COPD) is characterized by a complex range of pathological changes including both pulmonary and systemic effects. Several mechanisms contribute to the variable intermediate and clinically relevant disease phenotypes, such as chronic bronchitis and emphysema, and systemic disease. The molecular mechanisms associated to the pathogenesis of COPD are not yet clearly understood.

Objective: Although, the use of humidification during non-invasive ventilation (NIV) is an important factor in decreasing nasal airway resistance and assuring patient’s comfort and adherence; many in-vitro studies recommend switching off the humidifier while delivering aerosol to NIV patients.