Mathieu Marillier

Social media has become an integral component of modern medical practice, with most healthcare professionals engaging with it in some capacity. Its use has been associated with enhanced knowledge dissemination, professional networking, and increased visibility of research and clinical expertise. For respiratory healthcare professionals, social media offers particular value in navigating rapidly evolving evidence, technological innovation, establishing international collaborations and ongoing public health challenges. This article summarises current evidence and provides practical guidance on how to use social media to amplify professional impact in respiratory medicine, both in a professional context and in clinical practice with patients. We discuss key definitions, opportunities and limitations, with a focus on responsible and effective use to support collaboration, education and patient engagement.

Background: Intermittent hypoxic training aims to enhance exercise performance and health, commonly assessed through maximal oxygen uptake ( V O ₂ max). Currently applied methods are live-high train-low (LHTL), live-low train-high (LLTH) and passive hypoxic conditioning (PHC). However, within these methods, numerous modes of application exist, and effectiveness is debated. Objective: To determine the effect of LHTL, LLTH and PHC on V O ₂ max in healthy participants, and identify factors associated with the amplitude of change in V O ₂ max. Methods: We conducted a systematic review with random-effects meta-analysis and meta-regression. Studies were identified through PubMed, EMBASE and Web of Science. We included controlled studies, calculating between-group standardised mean differences. Athlete and non-athlete populations were analysed separately. RoB2 was used to assess study quality and publication bias was investigated with funnel plots and the Egger’s test. Results: Of the 5244 identified studies, 62 were included for analysis, resulting in a sample size of 1332 participants (610 athletes, 722 non-athletes). LHTL increased V O ₂ max significantly more than control in athletes (mean difference [MD] = 2.17; 95% CI = 0.77, 3.56) but not in non-athletes (MD = 3.1; 95% CI = − 0.23, 6.43). LLTH did not increase V O ₂ max significantly more than control in athletes (MD = 0.89; 95% CI = − 0.27, 2.05) but it did in non-athletes (MD = 1.70; 95% CI = 0.85, 2.54). PHC did not increase V O ₂ max significantly more than control in athletes (MD = − 1.07; 95% CI = − 3.51, 1.37) but it did in non-athletes (MD = 2.26; 95% CI = 1.00, 3.52). Multivariate meta-regressions identified the severity, duration, and frequency of hypoxic exposure to be significantly associated with the change in V O ₂ max. Conclusions: LHTL showed a significant effect on V O ₂ max in athletic populations while LLTH and PHC showed a significant effect on V O ₂ max in non-athletic populations only. Future studies should target investigating which characteristics (e.g. severity, duration) of the hypoxic exposure are most beneficial.

Shareable abstract An overview of some highlights of @ERSAssembly1 presented at the 2025 #ERSCongress in Amsterdam in line with the theme “Respiratory health around the globe” https://bit.ly/4srEJQ6

Background and Objective: Severe hypoxemia, heightened dyspnea, and exercise limitation are hallmarks of fibrotic interstitial lung disease ( f ‐ILD). Standard O ₂ therapy (nasal prongs) fails, however, to correct hypoxemia with limited symptomatic benefits due to inspiratory flow‐patient demand mismatch. Nasal high‐flow O ₂ therapy (NHFO ₂ ) is a promising alternative, but the respective contribution of high‐flow and supplemental O ₂ to improved dyspnea and exercise tolerance remains unknown in f ‐ILD. Methods: Sixteen patients performed, in a randomized order, endurance tests (70% peak power) under 4 conditions: air, supplemental O ₂ (face mask, 9–12 L·min ⁻¹ ), NHF _air [50–70 L·min ⁻¹ ; inspired fraction of O ₂ (FiO ₂ ) = 0.21], NHFO ₂ (50–70 L·min ⁻¹ ; FiO ₂ = 0.5). Endurance time and O ₂ saturation (SpO ₂ ), breathing pattern (respiratory plethysmography) and dyspnea (Borg CR‐10) were compared across conditions. Results: Supplemental O ₂ (98 [2]%) and NHFO ₂ (99 [3]%) increased isotime SpO ₂ vs air (87 [17]%, p < 0.001). Exercise time improved on O ₂ and NHFO ₂ vs air and NHF _air (683[903], 690[1338], 346[247], 319[415]s, respectively, p < 0.001; O ₂ vs NHFO ₂ , p = 0.117). Supplemental O ₂ and NHFO ₂ reduced isotime ventilation vs air (47 ± 22, 44 ± 20, 63 ± 29 L·min ⁻¹ , p < 0.001), driven by lower respiratory rates (36 ± 9, 37 ± 8, 44 ± 10 br·min ⁻¹ , p < 0.001). Supplemental O ₂ and NHFO ₂ reduced isotime dyspnea vs air (4[3.5], 3.5[2.5], 7 [3], p < 0.001) and NHFO ₂ vs NHF _air (3.5[2.5] vs 6[1.5], p = 0.016). NHF _air lowered isotime ventilation (9.0 ± 6.2 L·min ⁻¹ , p = 0.012) but did not improve dyspnea and exercise time vs air. Conclusion: Supplemental O ₂ and NHFO ₂ improved dyspnea and exercise time at “iso‐O ₂ saturation” in severely hypoxemic f ‐ILD. Physiological benefits from supplemental O ₂ (including lower ventilation) are thus likely primary drivers of dyspnea relief and improved exercise tolerance on NHFO ₂ vs air in f ‐ILD. Clinical Trial Registration: NCT07129707 (registered at ClinicalTrials.gov ). image

Chez l'homme, l'hypoxie correspond à une inadéquation entre les besoins tissulaires et les apports en oxygène. Cet état est une caractéristique commune à l'exposition à l'altitude et au syndrome d'apnées obstructives du sommeil (SAOS), bien que celle-ci soit continue dans le premier cas et intermittente et nocturne dans le second.L'hypoxie d'altitude entraine une altération des performances cognitives et motrices. La réduction de la performance à l'exercice en altitude a longtemps été attribuée à une altération du métabolisme musculaire du fait d'une réduction de l'apport en oxygène. Les perturbations cérébrales induites par l'hypoxie pourraient également avoir un rôle majeur dans cette limitation.Le SAOS, véritable enjeu de santé publique, est associé à des troubles cognitifs pouvant ainsi influencer le fonctionnement quotidien des patients souffrant de ce syndrome et résulter en une somnolence diurne excessive, une baisse de la qualité de vie ou encore une réduction de la productivité au travail et des performances scolaires. Le fait que ces altérations cérébrales puissent influencer les capacités motrices et à l'effort des patients atteints d’apnées obstructives du sommeil reste en revanche à investiguer.Au cours de ce travail de thèse, nous nous sommes intéressés à deux modèles d’exposition hypoxique et à leurs conséquences cérébrales et neuromusculaires. Nous avons tout d’abord étudié l'effet d'une exposition à l'hypoxie d'altitude aigue (quelques heures) et prolongée (plusieurs jours) sur la fonction neuromusculaire et ses répercussions à l'exercice chez le sujet sain. Nous avons ensuite étudié l'influence du modèle d'hypoxie intermittente associé au SAOS sur la fonction neuromusculaire et la tolérance à l'exercice de ces patients. Nous avons ainsi cherché à caractériser les altérations cérébrales à l'exercice en lien avec ce syndrome et leur réversibilité suite à un traitement en ventilation par pression positive continue.Chez le sujet sain, nous avons démontré que la performance à l'exercice impliquant une masse musculaire réduite (fléchisseurs du coude) n'était pas limitée par une fatigue centrale accrue après 1 et 5 jours d'exposition à une altitude de 4350 m. Nous avons mis en évidence que la dysfonction musculaire (force et endurance réduites) observée chez le patient SAOS est associée à un déficit d'activation supraspinal et une augmentation de l'inhibition intracorticale. De plus, nos résultats suggèrent qu'une altération de la réponse cérébrovasculaire à l'exercice puissent impacter négativement la tolérance à l'exercice des patients souffrant d'un SAOS sévère. Ces altérations neuromusculaires et cérébrovasculaires n'étaient pas corrigées après un traitement de huit semaines par ventilation nocturne en pression positive continue soulignant la nature persistante de ces altérations cérébrales.

In moderately hypoxemic, naive individuals with fibrotic interstitial lung disease, nasal high flow (regardless of O ₂ enrichment) lessened resting ventilatory requirements versus room air but increased dyspnea intensity versus conventional O ₂ therapy, suggesting dissociation between physiological and perceptual responses in this population. Our findings thus highlight the need for individualized strategies when implementing nasal high flow O ₂ therapy in these patients.

Work–life balance is a real challenge for early career respiratory professionals striving to manage clinical responsibilities, research, teaching and professional commitments. In this collective reflection by members of the European Respiratory Society Early Career Member Committee, we openly explore our own experiences, struggles and lessons learned in the pursuit of balance. While some of us feel we have found a rhythm that works, many are still navigating fluctuating demands, blurred boundaries and long hours that spill into evenings, weekends and even holidays. Parenthood, changing roles and growing responsibilities have reshaped our priorities and tested our limits. Still, we remain deeply passionate about our work. Through honest discussion, we share personal strategies such as setting boundaries, using time-management tools and leaning on support networks, and highlight the emotional toll when the balance is lost. We also recognise that systemic change is needed: fairer compensation, cultural shifts around overwork, and structural support for young professionals. This article is both a reflection and a call to action: to take care of ourselves, to support one another and to shape a professional culture where wellbeing is valued as much as productivity. We hope our shared experiences resonate and offer encouragement to other early career respiratory professionals.

It is well‐established that functional electrical stimulation (FES) can enhance physical function, but little is known regarding its acute impact on cerebral blood perfusion and its possible acute repercussions on cognition in comparison to a conventional cycling exercise. Thirteen young healthy participants (1 female, 12 males) underwent two testing sessions (25 min of FES‐assisted cycling and cycling control) applied in a randomized order and separated by at least 1 week of recovery. Cerebral blood velocity (CBFv) in the middle (right MCAv) and posterior cerebral arteries (left PCAv), cerebrovascular conductance (CVCi) and resistance index (CVRi), cerebral oxygenation (O ₂ Hb), cardiac output (CO), mean arterial pressure (MAP), and heart rate (HR) were measured continuously throughout the sessions. Cognitive tests (Stroop, RAVLT, and Trail Making Test) were performed before and after each experimental condition to assess the acute effect of FES and cycling on inhibitory control, attention, short‐term memory, and mental flexibility. MCAv, PCAv, CO, MAP, HR, and O ₂ Hb increased similarly throughout both sessions ( p < 0.001). An interaction between condition and time ( p = 0.034) was observed, indicating that FES‐assisted cycling induced greater improvements on the congruent Stroop task. A condition effect ( p = 0.023) reported that the RAVLT‐A performance was enhanced in control cycling. In conclusion, the present findings reveal that cerebral blood perfusion increases during exercise irrespective of its modalities. Thus, FES‐assisted cycling could be explored as a potential strategy to enhance cerebrovascular perfusion, particularly in individuals with marked physical limitations who are unable to engage in voluntary exercise.