Network News
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On thoughtful selection of medications in the acute critical care setting
As critical care medicine continues to advance understanding of ICU survivorship, thoughtful selection of medications in the acute setting can potentially mitigate long-term cognitive, physical, and affective effects. As of yet, no significant studies have linked opioid use in critical care to new diagnoses of opioid use disorder, but the opioid epidemic has taught us…
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Atypical pulmonary cysts: Why to care
Since the American College of Radiology (ACR) updated its Lung CT Screening Reporting & Data System (Lung-RADS) to include atypical pulmonary cysts in 2022, there has been little discussion among chest physicians regarding the significance of pulmonary cysts and why these changes were made. Lung-RADS 2022 defined atypical pulmonary cysts as single, unilocular cysts with…
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Trauma epidemiology and the organization of trauma care in the US
Patients who are injured do better when treated at trauma centers. During CHEST 2023 in Honolulu last year, the Disaster Response and Global Health Section hosted a presentation to a packed audience highlighting the history of the trauma model system in America. Attendees learned about the emergence of trauma systems in the US and the…
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Expanding recommendations for RSV vaccination
Respiratory syncytial virus (RSV) has been increasingly recognized as a prevalent cause of lower respiratory tract infection (LRTI) among adults in the United States. The risk of hospitalization and mortality from RSV-associated respiratory failure is higher in those with chronic lung disease. In adults aged 65 years or older, RSV has shown to cause up…
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Short telomere length and immunosuppression: Updates in nonidiopathic pulmonary fibrosis, interstitial lung disease
Interstitial lung diseases (ILDs) are a diverse group of relentlessly progressive fibroinflammatory disorders. Pharmacotherapy includes antifibrotics and immunosuppressants as foundational strategies to mitigate loss of lung function. There has been a growing interest in telomere length and its response to immunosuppression in the ILD community. Telomeres are repetitive nucleotide sequences that “cap” chromosomes and protect…
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Post-intensive care syndrome and insomnia
There has been a recent interest in post-intensive care syndrome (PICS), as an increasing number of patients are surviving critical illness. PICS is defined as “new onset or worsening of impairments in physical, cognitive, and/or mental health that arises after an ICU stay and persists beyond hospital discharge.1 We know that poor sleep is a…
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Diagnostic yield reporting of bronchoscopic peripheral pulmonary nodule biopsies: A call for standardization
More than 1.5 million Americans are diagnosed with an incidental CT scan-detected lung nodule annually. Advanced bronchoscopy, as a diagnostic tool for evaluation of these nodules, has evolved rapidly, incorporating a range of techniques and tools beyond CT scan-guided biopsies to assess peripheral lesions. The primary goal is to provide patients with accurate benign or…
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Severe early-life respiratory infections heighten pediatric OSA risk
Children with severe lower respiratory tract infections (LRTIs) within the first 2 years of life had a 2.06-fold increased risk of developing pediatric OSA by age 5, according to a study comparing patients hospitalized with LRTI to controls without severe LRTI.1 Prior studies linked LRTI and OSA, but the impact of LRTI severity was unknown.2…
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Machine learning meets cardiopulmonary exercise testing
Cardiopulmonary exercise testing (CPET) is a clinically useful modality to discriminate between cardiac, pulmonary, and musculoskeletal limitations to physical exertion. However, it is relatively underutilized due to the lack of local expertise necessary for accurate interpretation. Several studies have explored automation of CPET interpretation, the most notable of which utilized machine learning.1 Recently, Schwendinger et…
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Right heart catheterization practice patterns in pulmonary hypertension in the US
In the right clinical scenario, three key hemodynamic components obtained by right heart catheterization (RHC) define precapillary pulmonary hypertension (PH) warranting vasodilator treatment: mean pulmonary arterial pressure >20 mm Hg, pulmonary capillary wedge pressure (PCWP) ≤15 mm Hg, and pulmonary vascular resistance (PVR) >2Wood units.1 While these cutoffs are straightforward, a gap in practical application…
