RESPIRATORY Medicine / Pulmonology Updates

[Editorial] The far-reaching effects of wildfire smoke https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00256-0/fulltext?rss=yes The 2025 European State of the Climate report identified Europe as the world's fastest-warming continent, surpassed only by the Arctic region. In 2026, successive heatwaves have contributed to severe droughts and historic wildfires, with France and Spain battling huge blazes in July as more than 300 000 people were forced from their homes. As of Aug 5, 2026, more than 1500 landscape fires had been detected across the EU since the start of the year, with nearly 500 000 hectares burnt. Beyond the immediate dangers for people living and working close to the flames are the far-reaching effects of wildfire smoke.

[Articles] NEWS2 versus shock status to stratify antibiotic urgency in patients with suspected sepsis: a retrospective, multicentre cohort study https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00187-6/fulltext?rss=yes The NICE-defined high-risk NEWS2 category (scores ≥7) identified patients in whom each additional hour to antibiotic administration was associated with increased mortality, including many without shock, whereas no association was observed for lower NEWS2 scores. These findings suggest that NEWS2 might better target urgent antibiotic therapy beyond shock-based assessment alone.

[Comment] NEWS2 and the timing of antibiotics in suspected sepsis https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00202-X/fulltext?rss=yes The recognition of sepsis remains a challenge for emergency medicine: it requires deciding, at the bedside and with incomplete information, which patient with suspected infection is at high risk of mortality. From that decision follows another: the speed with which antibiotics should be administered. The 2026 Surviving Sepsis Campaign guidelines1 have made early antibiotic therapy a guiding principle, yet early should not mean indiscriminate antibiotic administration. The question is not only when to treat, but whom to treat first.