CHEST Physician
-
Mechanical power: A missing piece in lung-protective ventilation?
The ARDSNet trial demonstrated the importance of low tidal volume ventilation in patients with ARDS, and we have learned to monitor parameters such as plateau pressure and driving pressure (DP) to ensure lung-protective ventilation. However, severe hypercapnia can occur with low tidal volume ventilation and respiratory rate would often need to be increased. What role does the…
-
AI applications in pediatric pulmonary, sleep, and critical care medicine
Artificial intelligence (AI) refers to the science and engineering of making intelligent machines that mimic human cognitive functions, such as learning and problem solving.1AI tools are being increasingly utilized in pediatric pulmonary disease management to analyze the tremendous amount of patient data on environmental and physiological variables and compliance with therapy. Asthma exacerbations in young children…
-
Revival of the aspiration vs chest tube debate for PSP
Considerable heterogeneity exists in the management of primary spontaneous pneumothorax (PSP). American and European guidelines have been grappling with this question for decades: What is the best way to manage PSP? A 2023 randomized, controlled trial (Marx et al. AJRCCM) sought to answer this. The study recruited 379 adults aged 18 to 55 years between…
-
Advocating for diversity in medical education
Earlier this year, Representative Greg Murphy, MD, along with several cosponsors, introduced H.R. 7725, the Embracing Anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act. If enacted, the EDUCATE Act would cut off federal funding to medical schools that force students or faculty to adopt specific beliefs; discriminate based on race or ethnicity; or…
-
Top reads from the CHEST journal portfolio – October 2024
Explore articles on PAP adherence, plasma biomarkers in ARDS, and airways disorders hospitalizations during wildfire season
-
Pseudomonas infection in patients with noncystic fibrosis bronchiectasis
Pseudomonas aeruginosa is a clinically important organism that infects patients with noncystic fibrosis bronchiectasis (NCFB). In the United States, the estimated prevalence of NCFB is 213 per 100,000 across all age groups and 813 per 100,000 in the over 65 age group.1 A retrospective cohort study suggests the incidence of NCFB as ascertained from International…
-
Prediction models in sepsis
Early recognition is the linchpin of sepsis management, as mortality from sepsis increases by 4% to 9% for every hour that diagnosis and treatment are delayed.1 2 Artificial intelligence (AI) and machine learning (ML) are increasingly featured in discussions and publications about sepsis care. Already ML models are embedded in electronic medical records (EMR), driving…
-
The gas stove: Friend or foe?
The kitchen is considered the heart of the home, but recent discoveries have raised concerns about whether this beloved space might also pose hidden health risks. Gas stoves, present in 38% of U.S. homes, generate multiple pollutants including nitrogen dioxide (NO₂), a known respiratory irritant.1 Studies have identified a correlation between NO₂ levels and respiratory…
-
Sleep and athletic performance
Considering the recent Olympics, it is timely to review the importance of sleep for optimal athletic performance. When surveyed, 20% to 50% of athletes report poor or insufficient sleep, with consequences across four categories.1 2 Athletic performance: Objective measures of athletic performance, such as oxygen-carrying capacity during cardiopulmonary exercise and even sport-specific accuracy measures, like…
-
Lung ultrasound: An indispensable yet underutilized tool
An assessment using bedside thoracic ultrasound (TUS) improves diagnostic evaluation and therapeutic management in critically ill patients without undue risk. With changes in diagnosis occurring in 23% of cases and alterations in management in 39% of critically ill patients, TUS can improve length of stay, reduce complications, minimize delays in therapy, and lower hospitalization costs.1…
