Search Results (4,001)

Background and Objectives: Comparisons of swallowing physiology between coronavirus disease 2019 (COVID-19) pneumonia and clinically diagnosed aspiration pneumonia (AP) have largely relied on ordinal scales, leaving etiology-specific biomechanical profiles unclear. We quantitatively compared videofluoroscopic swallowing study (VFSS) measures of pharyngeal residue and clearance mechanics to identify differential dysphagia phenotypes. Materials and Methods: This single-center retrospective cohort study included 50 adult inpatients with pneumonia (COVID-19, n = 25; AP, n = 25) who underwent VFSS for suspected dysphagia. COVID-19 pneumonia was laboratory-confirmed, and AP was clinically diagnosed after negative tests for severe acute respiratory syndrome coronavirus 2. Blinded ImageJ analysis examined the first standardized semisolid yogurt swallow (International Dysphagia Diet Standardisation Initiative level 4). Primary outcomes were Normalized Residue Ratio Scale values for the valleculae (NRRSv) and piriform sinuses (NRRSp); secondary outcomes were upper esophageal sphincter (UES) opening width and epiglottic rotation angle. Penetration–Aspiration Scale (PAS) score, hyoid displacement, and pharyngeal transit time were exploratory. Results: Baseline characteristics were comparable. COVID-19 pneumonia showed higher NRRSv (0.20 [0.12–0.56] vs. 0.13 [0.00–0.20]; p = 0.01). NRRSp was numerically higher but not statistically significant (0.12 [0.00–0.43] vs. 0.00 [0.00–0.17]; p = 0.07). COVID-19 pneumonia also showed smaller UES opening width (5.08 ± 2.48 vs. 6.50 ± 2.01 mm; p = 0.03) and reduced epiglottic rotation angle (66.0 [29.0–80.8] vs. 93.4 [74.2–100.4] degrees; p = 0.04). No statistically significant between-group difference was detected in PAS-defined airway invasion severity on the standardized semisolid task. Conclusions: These findings suggest an efficiency-predominant dysphagia phenotype in COVID-19 pneumonia, characterized by greater vallecular residue and restrictive clearance-related mechanics on a standardized semisolid task. The results indicate that PAS-defined safety metrics alone may underestimate residue-related dysphagia burden in this population. Full article

Background: Patients with prolonged mechanical ventilation (PMV) frequently require tracheostomy due to failure to wean, yet the pathway from ventilator dependence to successful decannulation remains complex and poorly standardised. Comprehensive respiratory rehabilitation is recognised as a core strategy for improving decannulation outcomes, but no unified, evidence-based guidelines currently exist for this population. This review addresses that gap by synthesising current evidence on respiratory rehabilitation and decannulation strategies for tracheostomized PMV patients. Methods: A narrative review was conducted through a systematic search of PubMed/MEDLINE covering publications indexed from May 2019 to February 2026, supplemented by targeted searches of Embase and the Cochrane Library. The search combined free-text keywords and Medical Subject Headings (MeSH) terms across eight search string combinations. Following title and abstract screening of 830 deduplicated records, 51 studies met eligibility criteria and were included in the final narrative synthesis. Results: Six core rehabilitation intervention domains were identified: respiratory muscle training, physical rehabilitation and nutritional optimisation, sedation and delirium management, speaking valve use, airway complication management, and ventilator mode optimisation. High-intensity inspiratory muscle training at no less than 50% of maximal inspiratory pressure is currently supported by the strongest available evidence among the interventions reviewed, although this threshold derives primarily from general ICU populations and has not been specifically validated in heterogeneous tracheostomized PMV cohorts. Decannulation readiness assessment may benefit from evaluating five core domains—neurological readiness, secretion management capacity (suctioning ≤ 4 times/24 h), cough efficacy (peak cough flow > 160 L/min), safe swallowing confirmed by instrumental assessment, and upper airway patency confirmed by fiberoptic bronchoscopy—using a structured multidisciplinary framework. Conclusions: Successful decannulation in tracheostomized PMV patients requires integration of evidence-based rehabilitation interventions, structured multidisciplinary assessment, and a patient-centred outcome framework that extends beyond physiological endpoints to encompass voice restoration, psychological well-being, and social reintegration. Significant evidence gaps remain—particularly for expiratory muscle training, population-specific decannulation protocols, and adapted rehabilitation models for resource-limited settings—representing priority areas for future research. Full article

Apnea of prematurity (AOP) remains a critical challenge in neonatal care, with caffeine citrate serving as the cornerstone of pharmacological intervention. However, the current standardized dosing schedule fails to account for significant inter-individual variability in caffeine pharmacokinetics and clinical response. This narrative review explores the transformative potential of integrating wearable sensor technologies and multi-modal data analytics into a closed-loop framework for personalized caffeine therapy. Based on a synthesis of current monitoring literature, we propose a theoretical, comprehensive monitoring system utilizing the area under the respiratory curve (rAUC) as a continuous proxy metric, alongside waveform amplitude analysis aligned with pediatric polysomnography standards. By incorporating emerging metrics such as respiratory rate variability (RRV) and hypoxic burden, the framework enables the objective quantification of respiratory stability. Furthermore, the integration of established neonatal intensive care unit (NICU) parameters for bradycardia and oxygen saturation detection provides a critical cross-validation layer to minimize artifact-induced false alarms. This conceptual model bridges the gap between advanced signal processing and clinical oversight, offering a scalable pathway toward precision dosing. By shifting from reactive to predictive neonatology, sensor-driven optimization can enhance therapeutic efficacy, reduce alarm fatigue, and ultimately improve developmental outcomes for preterm infants. Full article

Mucopolysaccharidosis (MPS) are a group of inherited lysosomal storage genetic disorders that affect the body’s ability to break down glycosaminoglycans (GAGs) due to the deficiency of required enzymes. This leads to depositions of these GAGs in various tissues and organs resulting in multi-systemic manifestations including pulmonary and sleep related issues. In recent years, there have been significant advancements in therapeutic options and supportive management which have led to the overall improvement in respiratory care, culminating in improved quality of life for MPS patients. Management of pulmonary and sleep disorders in mucopolysaccharidosis requires a multidisciplinary approach due to the multi-systemic affectation of the genetic disorders. Therapeutic options such as enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT) have yielded varying success in mitigating respiratory complications. Emerging treatments such as gene therapies have shown exciting and promising results thus far. Supportive therapies such as airway clearance, regular vaccination and use of positive airway pressure devices are also essential. Pre-operative airway and anesthesia planning is critical to mitigate peri-operative and post-operative complications. Early diagnosis, close monitoring and a patient focused individualized approach are essential for respiratory optimization and overall improvement in clinical outcomes. This review article aims to discuss these advancements in a comprehensive format, making it accessible to medical providers who care for this subset of patients. Full article

Background: Preterm premature rupture of membranes (PPROM) before 32 weeks of gestation with prolonged latency is associated with substantial neonatal morbidity, including Dry Lung Syndrome (DLS), pulmonary hypoplasia (PH), bronchopulmonary dysplasia (BPD), and death. Accurate individualized risk stratification remains elusive, as the interacting contributions of amniotic fluid dynamics, inflammatory status, and microbiological burden are inadequately captured by traditional statistical approaches. Methods: We performed a retrospective, exploratory–predictive analysis of 66 pregnancies complicated by second-trimester PPROM with latency exceeding 14 days. Elastic Net and Random Forest models were trained across six clinically defined predictor domains using a multi-stage block modelling strategy. To address the clinically relevant distinction between antenatal and postnatal information, results are reported separately for Model A—comprising exclusively antenatal predictors available during expectant management (gestational age at PPROM, latency, amniotic fluid trajectory, inflammatory status, vaginal microbiome at admission)—and Model B, which additionally incorporates postnatal variables and characterizes the full mechanistic perinatal risk trajectory. Binary and ordinal outcomes included DLS, PH, BPD, intraventricular hemorrhage (IVH), and neonatal death. Pairwise interaction models were additionally computed to identify cross-domain risk constellations. Results: Distinct predictor architectures emerged per outcome. Pulmonary hypoplasia was most strongly associated with temporal features of oligohydramnios—particularly the persistence and timing of SDP < 1 cm—rather than isolated measurements. For DLS, the antenatal model (Model A) achieved AUC 0.776, driven by gestational maturity and inflammatory status; surfactant administration—a postnatal variable reflecting therapeutic response rather than an antenatal risk factor—dominated only the mechanistic Model B. Neonatal death was driven by a combined profile of respiratory support burden, amniotic fluid persistence, and co-morbidity. IVH showed consistently high ordinal predictability (accuracy 0.863), with amniotic fluid dynamics and microbiological burden as leading contributors. BPD remained the least linearly separable endpoint across all configurations. Conclusions: Multi-domain machine learning reveals outcome-specific, cross-domain risk architectures following second-trimester PPROM that are invisible to conventional statistical models. Longitudinal amniotic fluid trajectory is the dominant antenatal determinant of structural pulmonary morbidity, while microbiological burden independently shapes neurological risk. These findings support prospective validation of integrated ML-based risk stratification tools for individualized antenatal counselling in this high-risk population. Full article

Background: Healthcare-associated bloodstream infections (HABSIs) are among the main categories of nosocomial infections. This analysis aims to identify the clinical characteristics of patients in the emergency department (ED) who will develop a HABSI during their hospital stay. Methods: Main outcome measures were HABSI and the cumulative survival rate at 30 days. The features tested in a logistic model were age, sex, vitals by the National Early Warning Score (NEWS), priority levels, main complaints, comorbidities by the Charlson Comorbidity Index (CCI), trauma-related disease, main diagnosis and ED length of stay. Results: In 414 (2.3%) out of 18,304 patients, aged 75 (16) years, mean (SD), a diagnosis of HABSI was recorded. HABSIs occurred in subjects with main diagnosis of diseases of the respiratory system (N = 116; 28.0%), digestive system (N = 72; 17.4%), and circulatory system (N = 68; 16.4%). The main key clinical features selected by the logistic model were: NEWS > 6, diagnosis of neoplasms, CCI > 4, and diagnosis of diseases of the digestive system. The ROC curve for the HABSI risk score was 0.703 ± 0.027 in predicting the outcome, (sensitivity 79%, specificity 51%, at optimal cut-off score). The overall hazard mortality risk was twofold higher in patients with HABSIs (hazard ratio: 2.319; 95% confidence interval: 1.871–2.875; p-value: <0.001). The overall 30-day survival rate was lower among patients with HABSIs (33%) vs. non-HABSI patients (62%). Conclusions: A group of main clinical features in subjects without suspect of infectious disease in the ED are associated with HABSIs. These features negatively impact survival rate during hospital stays. Full article

Background: Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep-related breathing disorder associated with significant systemic complications and reduced quality of life. Mandibular advancement devices (MADs) represent an established alternative therapy for patients who cannot tolerate continuous positive airway pressure (CPAP). However, concerns remain regarding their potential effects on temporomandibular disorders (TMD). Materials and Methods: This retrospective exploratory study analyzed clinical records of 26 patients (mean age 55.4 ± 5.8 years) with polysomnography-confirmed OSAS and baseline TMD-related symptoms treated with a custom-made monobloc MAD. Clinical parameters were evaluated at baseline (T0) and after approximately 6 months of therapy (T1). Outcomes included apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), Fonseca Anamnestic Index, and health-related quality of life assessed using the SF-36 questionnaire. Repeated measures ANOVA and linear regression analyses were performed. Results: After six months of MAD therapy, a significant reduction in AHI was observed (30 ± 13.76 vs. 10.87 ± 3.9; p < 0.00001). Daytime sleepiness significantly decreased (ESS: 9.31 ± 3.53 vs. 3.38 ± 1.77; p < 0.00001). TMD symptom severity also decreased significantly according to the Fonseca Index (33.85 ± 17.74 vs. 10.00 ± 8.94; p < 0.00001). Quality of life scores improved significantly (SF-36: 41.15 ± 9.52 vs. 65.38 ± 5.82; p < 0.00001). Linear regression analysis showed no significant association between changes in AHI and changes in TMD symptoms, ESS scores, or quality of life. Conclusions: Within the limitations of this retrospective study, MAD therapy was not associated with symptom aggravation of temporomandibular disorders in patients with pre-existing TMD symptoms. Significant improvements in respiratory parameters, daytime sleepiness, and quality of life were observed after six months of therapy. Full article

Background: Frailty is associated with adverse postoperative outcomes and functional decline in older adults undergoing colorectal cancer (CRC) surgery. The long-term course of frailty and functional outcomes among patients undergoing prehabilitation before CRC surgery remains insufficiently investigated. Methods: This prospective observational cohort study evaluated long-term functional and physiological outcomes in older adults with frailty syndrome undergoing colorectal cancer (CRC) surgery who participated in a structured prehabilitation program. Forty-one patients aged >70 years were assessed before prehabilitation and at one-year follow-up. Frailty (the Clinical Frailty Scale [CFS] and the 5-item Frailty Index [5-FI]), physical activity, postural function, respiratory parameters, and functional performance (the 6 min walk test [6MWT] and the Timed Up and Go [TUG] test) were evaluated. Results: Of the 93 eligible patients, 41 completed the one-year follow-up and were therefore included in the final analysis. A small but statistically significant increase in frailty was observed using 5-FI (mean difference = 0.029, p = 0.012), with no significant change in CFS. Postural function improved (p = 0.031), while physical activity and functional performance remained stable (6MWT: 392.71 vs. 384.36 m, p = 0.885; TUG: 12.36 vs. 10.42 s, p = 0.051). A significant reduction in pre- and post-exercise oxygen saturation was observed; however, the magnitude of change (before: −1.25%, p = 0.006; after: −0.91%, p < 0.001) was small and of uncertain relevance. Conclusions: Over a one-year follow-up of prehabilitated CRC patients with frailty, their functional performance remained stable despite a subtle progression of frailty. These findings suggest a dissociation between physiological vulnerability and functional status. Due to the observational design of the study and the lack of a control group, the results should be interpreted as descriptive rather than causal. Full article

Background: Coronary artery disease (CAD) is an important comorbidity that may increase perioperative cardiovascular risk in major noncardiac surgery. However, data evaluating its impact on outcomes following pancreatic cancer surgery remain limited. This study evaluated inpatient outcomes among patients undergoing pancreatic cancer resection with versus without CAD in the United States. Methods: We performed a retrospective analysis using the National Inpatient Sample (2016–2022). Adult hospitalizations with ICD-10 diagnosis codes for pancreatic cancer and procedure codes for pancreatic resection were identified and stratified by the presence of CAD. The primary outcome was in-hospital mortality. Secondary outcomes included length of stay, hospitalization cost, and complications such as shock, respiratory failure, acute kidney injury, and transfusion. Results: A total of 49,395 hospitalizations were identified, including 6910 (14.0%) with CAD. Patients with CAD were older and had a greater comorbidity burden. In-hospital mortality was similar between groups (2.32% vs. 2.34%). Most complications were comparable, although shock was more frequent in CAD patients (6.66% vs. 5.44%). Length of stay was similar, while hospitalization costs were modestly higher in the CAD cohort. Conclusions: Pre-existing CAD was not associated with increased in-hospital mortality or longer hospitalization following pancreatic cancer surgery despite a greater comorbidity burden. Full article

Occupational lung diseases remain a significant public health concern in mining populations, particularly in high-exposure environments. This study examined occupational exposure profiles and respiratory health outcomes among surface and underground miners in Mpumalanga Province. A cross-sectional analytical design was employed among 239 mine workers. Data on socio-demographic characteristics, occupational exposures, behavioural factors, and respiratory outcomes were analysed using descriptive statistics, chi-square tests, and logistic regression models. Underground miners were significantly more likely to report high dust exposure (44.9% vs. 24.1%), poor ventilation (60.6% vs. 39.3%), and longer working hours (>8 h: 68.5% vs. 50.0%) compared to surface miners. They also reported a higher prevalence of respiratory symptoms, including chronic cough (45.7% vs. 25.9%), shortness of breath (41.7% vs. 23.2%), wheezing (34.6% vs. 18.8%), and diagnosed lung disease (23.6% vs. 9.8%). Multivariable analysis showed that underground mining (AOR = 1.92; 95% CI: 1.08–3.41), smoking (AOR = 1.78; 95% CI: 1.02–3.11), and high dust exposure (AOR = 2.89; 95% CI: 1.45–5.76) were independent predictors of chronic cough. A significant interaction between smoking and underground mining (AOR = 2.74; 95% CI: 1.32–5.68) further amplified respiratory risk. Additionally, underground miners demonstrated lower levels of knowledge (48.8% vs. 66.1%) and poorer preventive practices (44.1% vs. 64.3%). These findings highlight the combined influence of occupational and behavioural factors on respiratory health and highlight the need for integrated interventions to reduce the burden of occupational lung diseases. Full article

Background: Surface electromyography is emerging as a noninvasive tool to examine neurogenic dysphagia in Parkinson’s disease (PD). This pilot study evaluated the feasibility of surface electromyography (sEMG) (acceptability, resource use, and safety), and explored changes in swallowing-related sEMG parameters following rehabilitation. Methods: Ten patients with mild to moderate PD (Hoehn Yahr 1–3) underwent clinical, respiratory, and swallowing assessments, including sEMG recordings of perioral (orbicularis oris), masticatory (masseter) and cervical muscles (submental/mylohyoid and infrahyoid group). Feasibility outcomes included recruitment, protocol completion, and adverse events. Exploratory sEMG measures comprised amplitude indices (root-mean-square, RMS; peak-to-peak, P2P range; area under curve, AUC) and activation time during saliva swallowing and continuous drinking tasks. Results: Nine out of 10 participants completed the protocol, and no adverse events were reported, indicating good acceptability and safety. Exploratory pre–post analyses showed reduced sEMG amplitude during saliva swallowing of orbicularis oris [median ΔP2P Range = −0.273 (p = 0.020), median ΔAUC = −0.145 (p = 0.027); RMS (median Δ = −0.427) (p = 0.074)] and a generalized prolongation of activation time during continuous sipping across recorded muscles. Conclusions: Multichannel sEMG assessment of swallowing muscles during speech therapy is feasible and safe in patients with PD. Exploratory signal changes warrant cautious interpretation and should be validated in larger rehabilitation-oriented studies. Full article

Background and Objectives: Postoperative pulmonary complications (PPCs) remain an important cause of morbidity after cardiac surgery. Driving pressure (DP), defined as the difference between plateau pressure and positive end-expiratory pressure, has been proposed as a bedside marker of respiratory system mechanics during lung-protective ventilation. However, its relationship with PPCs in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) remains uncertain. This study aimed to evaluate the association between intraoperative DP and PPCs following CPB-supported cardiac surgery. Materials and Methods: This single-center prospective observational study included 99 adult patients undergoing elective cardiac surgery with CPB. All patients were ventilated using a standardized lung-protective strategy with a tidal volume of 6 mL/kg predicted body weight and a fixed PEEP of 5 cmH₂O. Patients were categorized according to intraoperative DP as Group I (DP < 13 cmH₂O, n = 66) and Group II (DP ≥ 13 cmH₂O, n = 33). The primary outcome was a composite PPC endpoint, defined as the occurrence of at least one EPCO-defined pulmonary complication during the postoperative hospital stay. Multivariable logistic regression was performed to assess whether pre-CPB DP was independently associated with PPCs after adjustment for body mass index, CPB time, and age. Results: Patients with DP ≥13 cmH₂O had higher post-CPB and ICU-admission lactate concentrations. Pneumothorax, pleural effusion, atelectasis, CPAP requirement, and prolonged mechanical ventilation were more frequent in the elevated-DP group. Mechanical ventilation duration, ICU stay, and hospital stay were also longer in this group. Composite PPCs occurred in 41 patients (41.4%). Although higher pre-CPB DP showed a non-significant trend toward increased PPC risk in univariable analysis (OR 1.121, 95% CI 0.988–1.273; p = 0.077), it was not independently associated with the composite PPC endpoint after adjustment (adjusted OR 1.091, 95% CI 0.952–1.251; p = 0.212). In contrast, higher pre-CPB DP was significantly associated with prolonged postoperative ventilation and longer mechanical ventilation, ICU, and hospital stay durations. Conclusions: Elevated intraoperative DP was associated with a higher unadjusted burden of PPCs and delayed postoperative recovery after CPB-supported cardiac surgery. However, pre-CPB DP was not an independent predictor of the composite PPC endpoint after adjustment for relevant confounders. These findings suggest that DP may serve as a clinically useful marker of impaired respiratory mechanics and postoperative vulnerability rather than as an independent causal determinant of PPCs. Full article

Background/objectives: Long COVID is associated with persistent, multi-system symptoms, yet little is known about how it affects individuals with intersecting vulnerabilities, such as a racialized identity and pre-existing mental health conditions. This study aimed to descriptively characterize the symptom burden, functional outcomes and mental health in this population. Methods: A cross-sectional, exploratory study was conducted among 51 adults in Canada who self-identified as racialized and as having a pre-existing mental health condition and reported long COVID symptoms. Participants completed an online survey, including validated measures of symptoms, fatigue, post-exertional malaise, cognitive function, mental health and disability. Descriptive statistics were used to summarize outcomes. Results: Participants reported a slight to moderate overall symptom burden, with the highest scores in respiratory and psychological domains. Functional impairment was moderate across work, social and daily activities (Work and Social Adjustment Scale mean = 17.35; World Health Organization Disability Assessment Schedule 2.0 mean = 16.61; Post COVID-19 Functional Status Scale mean = 2.20). Fatigue and post-exertional malaise were notable (Modified Fatigue Impact Scale mean = 43.39; DePaul Symptom Questionnaire—Post-Exertional Malaise mean = 22.47), and cognitive difficulties were commonly reported (Perceived Deficits Questionnaire mean = 33.43). Anxiety and depression scores were in the mild to moderate range respectively (General Anxiety Disorder-7 mean = 9.27; Patient Health Questionnaire-9 mean = 11.43). Conclusions: Clinically relevant fatigue, post-exertional malaise, and depression were found, alongside moderate functional limitations across life domains. The findings support the conceptualization of long COVID as a syndemic condition and underscore the need for equity-informed research, rehabilitation and public health strategies. Full article

Background: Weaning from mechanical ventilation remains a complex and failure-prone process, with extubation failure rates reaching up to 30%. Conventional indices inadequately capture the multifactorial physiology underlying weaning failure. This study aimed to evaluate whether a multimodal ultrasound approach could improve the identification of mechanisms and prediction of extubation outcomes. Methods: In this prospective pilot observational study, adult mechanically ventilated patients with preserved left ventricular ejection fraction (LVEF ≥ 50%) undergoing spontaneous breathing trials (SBT) were included. Multimodal ultrasound assessment—including transthoracic echocardiography (TTE), lung ultrasound (LUS), diaphragmatic ultrasound (DUS), and venous excess ultrasound (VExUS)—was performed at two predefined time points. Conventional respiratory mechanics parameters were recorded concurrently. The primary outcome was a composite of SBT failure (permanent weaning failure) or reintubation within 48 h. Results: A total of 27 patients were included, of whom 8 (29.6%) experienced extubation failure (5 permanent SBT failure, 3 post-extubation reintubation). Respiratory system compliance showed consistent associations with extubation failure across both ROC and regression analyses (AUC 0.806, 95% CI 0.611–1.000; cutoff ≤ 45 mL/cmH₂O; sensitivity 88%; specificity 74%; NPV 93%). Diaphragm excursion was significantly lower in the failure group (p = 0.042) and showed useful predictive performance (AUC 0.750, 95% CI 0.565–0.935; cutoff ≤ 24 mm; sensitivity 100%; specificity 58%; NPV 100%). Lung ultrasound, VExUS, and echocardiographic parameters did not demonstrate significant predictive value. Given the limited number of outcome events (n = 8) and events-per-variable ratio of 4.0 (EPV = 4.0), all multivariable findings are hypothesis-generating. Conclusions: In this prospective pilot study, respiratory system compliance and diaphragm excursion were associated with extubation failure in patients with preserved left ventricular function, while echocardiographic indices, LUS, and VExUS grading did not demonstrate significant predictive value. These hypothesis-generating findings suggest that impaired diaphragmatic function and reduced compliance may be more closely associated with weaning failure than cardiopulmonary congestion parameters. However, given the small sample size, low EPV, and single-centre design, all findings require validation in larger multicentre studies including patients with impaired systolic function. Full article

Chronic obstructive pulmonary disease (COPD) extends beyond the respiratory system and is closely linked to an increased risk of cardiovascular complications. Exacerbations represent critical periods of cardiovascular vulnerability, with a marked rise in major adverse cardiovascular events observed in the early post-exacerbation phase. This narrative review synthesizes current evidence on the epidemiology, pathophysiological mechanisms, and therapeutic implications of cardiovascular risk following COPD exacerbations. A structured literature search was conducted to identify relevant studies in this setting. Cardiovascular risk is elevated following exacerbations, particularly within the first weeks, and remains increased for months thereafter. Multiple pathophysiological mechanisms contribute to this vulnerable window. Systemic inflammation, marked by elevated cytokines such as IL-6, IL-8, and CRP, promotes endothelial dysfunction, vascular oxidative stress, and impaired nitric oxide bioavailability. Despite the well-established link, cardiovascular disease remains overlooked and undertreated in patients with COPD, and the use of guideline-directed cardiovascular therapies is suboptimal. A more systematic, integrated approach to cardiovascular assessment and management in patients with COPD is warranted to improve outcomes. Full article