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RespiratoryRecon Respiratory Recon delivers insights on the future of lung health—tech, trends, and truths that matter. No fluff.

Sharp, frontline updates for RTs, clinicians, and changemakers. Like to stay informed, stay loud, and shape what’s next in respiratory care.

Over ten years, the rate of children with asthma ending up in intensive care rose sharply.A study in Ontario tracked nea...
10/18/2026

Over ten years, the rate of children with asthma ending up in intensive care rose sharply.

A study in Ontario tracked nearly 2 million people with asthma from 2013 to 2022. Among children, ICU admissions climbed from 0.64 to 1.67 per 1,000, with the steepest rise in kids younger than 6. Adult rates stayed about the same, but more adults needed ICU stays longer than 10 days.

This happened during a decade of better asthma medicines and clear treatment guidelines. Part of the rise may come from changes in when hospitals admit children or put them on breathing support. Either way, our youngest patients deserve a closer look.

Parents and clinicians, what changes have you seen in childhood asthma?

Two patients on the same ventilator settings may not face the same risk.New research in adults with ARDS, a severe form ...
10/17/2026

Two patients on the same ventilator settings may not face the same risk.

New research in adults with ARDS, a severe form of lung injury, found that high ventilator pressures were most strongly tied to death in the patients who looked less inflamed. In the most inflamed patients, failure of other organs, not the lungs, explained nearly half of the excess deaths.

A second study followed more than 1,400 ventilated children in 34 countries and found wide variation in care. About one in four received oxygen above 60%.

After four decades at the bedside, I keep coming back to the same lesson. The numbers we set every shift matter more or less depending on who is on the other end of the circuit.

Clinicians, how much does ventilator practice vary in your unit?

A normal-looking spirometry ratio doesn’t always mean normal lungs.PRISm (preserved ratio impaired spirometry) is a patt...
10/16/2026

A normal-looking spirometry ratio doesn’t always mean normal lungs.

PRISm (preserved ratio impaired spirometry) is a pattern where lung function is reduced, but the ratio used to diagnose COPD still looks fine. It often gets filed away as “borderline, recheck next year.”

A new study suggests that waiting has a cost. People with PRISm had breathlessness, overall muscle weakness and breathing muscle weakness much closer to people with COPD than to healthy adults. Breathing muscle endurance was among the hardest hit.

Referring these patients to pulmonary rehab earlier, with breathing muscle training built in, may catch the window that keeps getting missed.

Has anyone you know been told their breathing test was “borderline”?

When a heart failure patient stalls in cardiac rehab, the limit may not be the heart or the legs. It may be the breathin...
10/14/2026

When a heart failure patient stalls in cardiac rehab, the limit may not be the heart or the legs. It may be the breathing muscles.

Researchers in Japan looked back at the records of older adults hospitalized with heart failure. A simple bedside test of breathing muscle strength, called maximal inspiratory pressure, predicted how far patients could walk in six minutes, no matter how strong their legs were. Patients whose leg function was declining had much weaker breathing muscles: 30.7 versus 47.8 cmH2O.

The hopeful part is that these muscles can be trained. A plateau may not be a ceiling.

If you or someone you love is in cardiac rehab, has anyone checked breathing muscle strength?

A patient can be hospitalized for COPD and still leave with no maintenance prescription. Forty-one percent do. The devic...
10/11/2026

A patient can be hospitalized for COPD and still leave with no maintenance prescription. Forty-one percent do. The device gets dispensed. The technique never gets checked. If you prescribe inhaled therapy, dispense it, or build the devices that deliver it, this is the failure point nobody on your team is currently accountable for.

http://tiny.cc/TheLastMile

A home breathing test can catch a change in your lungs before you'd ever think to call the doctor. The harder question i...
10/10/2026

A home breathing test can catch a change in your lungs before you'd ever think to call the doctor. The harder question is who reads the results.

At this year's European Respiratory Society Congress in Barcelona, the message was consistent. AI-assisted spirometry, oscillometry (a gentle breathing test that picks up changes spirometry can miss), and digital inhalers are finding COPD and interstitial lung disease progression earlier than ever. But clinicians are stretched thin, and data nobody acts on doesn't change a single outcome.

The tools are here. The follow-through is still the work.

If you track your breathing at home, does anyone on your care team actually look at the numbers?

10/08/2026

Can a computer tell which COPD patient in the ICU won't make it through the month? Not yet.

Researchers tested 9 machine learning models on 715 adults admitted to the ICU for a COPD flare-up. 84 of them died within 28 days. The best models scored in the low-to-mid 0.70s on a scale where 0.5 is a coin flip and 1.0 is perfect. That's better than chance, but not good enough to make the call alone.

The clearest warning signs were ones bedside teams already watch: older age, a sicker start at admission, and a longer ICU stay. For now, these tools are a second opinion. The judgment still belongs to the people at the bedside.

If you've walked a family through a COPD admission, what helped you read the road ahead?

10/06/2026

Most of us only think about our breathing once something goes wrong.

Lung care still runs on snapshots: a breathing test at one visit, then months with little feedback until the next. Pulmonary rehab is one of the best-proven programs we have, and it still struggles to keep people coming back. Access isn't the only gap. The daily habit of paying attention is missing too.

Readiness means working on your breath before it becomes urgent. That applies whether you live with a chronic lung condition, walk into smoke for a living, or just want more in the tank. It doesn't replace clinical care. It gives that care something to build on.

What would help you stay connected to your breathing between appointments?

Twenty-five years after the towers fell, more than 600 FDNY members have died from 9/11-related illness, nearly twice th...
10/05/2026

Twenty-five years after the towers fell, more than 600 FDNY members have died from 9/11-related illness, nearly twice the 343 lost that day. This past week, New York City released 170,000 records showing officials knew the air was dangerous while telling the public otherwise. I wrote about what the data show now, and what it means for the next long-latency exposure.

http://tiny.cc/911Aftermath

10/04/2026

Knowing why a medicine matters and actually taking it every day are two different skills.

Most of us try to close that gap with more teaching. The research keeps pointing somewhere else: routine. Once a dose happens at the same time and in the same place every day, it stops depending on memory or motivation. In a year-long study of adults with cystic fibrosis, habit explained who took their inhaled medicines better than socioeconomic status, how complex the regimen was, or anything else the researchers measured.

For COPD and bronchiectasis, researchers have barely asked this question.

If you live with a lung condition, what keeps your treatment on track from day to day?

https://buckirrt.substack.com/p/the-habit-gap-in-respiratory-medicine?r=5ze1dc

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