CHEST Physician
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Implementing a critical care TEE program at your institution
Bedside-focused cardiac ultrasound assessment, or cardiac point-of-care ultrasound (POCUS), has become common in intensive care units throughout the US and the world. Many clinicians argue a POCUS cardiac assessment should be completed in most hypotensive patients and all cases of undifferentiated shock. However, obtaining images adequate for decision making via standard transthoracic echo (TTE) is…
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Emerging role of biologics in COPD: A new direction
Remodeling of airways and destruction of parenchyma by immune and inflammatory mechanisms are the leading cause of lung function decline in patients with COPD. Type 2 inflammation has been recognized as an important phenotypic pathway in asthma. However, its role in COPD has been much less clear, which had been largely associated with innate immune…
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Management of severe respiratory viruses in 2024
Viral infections frequently cause acute respiratory failure requiring ICU admission. In the United States, influenza causes over 50,000 deaths annually and SARS-CoV2 resulted in 170,000 hospitalizations in December 2023 alone.1 2 RSV lacks precise incidence data due to inconsistent testing but is increasingly implicated in respiratory failure. Patients with underlying pulmonary comorbidities are at increased…
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Leading with integrity: A values-driven year
As the President of the American College of Chest Physicians (CHEST), I have the privilege of regularly addressing CHEST members through a quarterly column where I can share updates and expand on topics that we hold in high regard. As such, I’d like to focus on the CHEST commitment to social responsibility and the work…
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Daylight Saving Time: Saving light but endangering health
The American Academy of Sleep Medicine recently published its position statement reaffirming its support of utilizing permanent Standard Time (ST) as opposed to Daylight Saving Time (DST).1 DST usually occurs on the second Sunday in March when we “spring forward” by advancing the clock by 1 hour. The analogous “fall back” on the first Sunday…
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The emergence of postgraduate training programs for APPs in pulmonary and critical care
Postgraduate training for advanced practice providers (APPs) has existed in one form or another since the genesis of the allied professions. They are typically referred to as residencies, fellowships, postgraduate programs, and transition-to-practice. The desire and necessity for these programs has increased in the past decade with workforce changes; namely the increasing number of nurse…
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Biomarker checklist seeks to expedite NSCLC diagnoses
Establishing a systematic biomarker testing program for patients with suspected non-small cell lung cancer (NSCLC) takes both time and collaboration across specialties. To standardize this process, the American College of Chest Physicians (CHEST) created two clinician checklists for use in practice. The case-by-case checklist helps guide physicians to ensure timely and comprehensive biomarker testing for…
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New age of CHEST philanthropy to focus on education, impact, community
In a time echoing with the constant call for transformation, CHEST delved deep into its essence, questioning its potential for impact. This pivotal introspection led to a crucial inquiry… Are we harnessing every opportunity to make a difference? It’s a familiar question, yet its resonance urged a deeper evaluation. Philanthropy has long been entwined in…
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Updates in evidence for rituximab in interstitial lung disease
Interstitial lung diseases (ILD) are a heterogeneous group of fibro-inflammatory disorders that can be progressive despite available therapies. The cornerstones of pharmacologic therapy include immunosuppression and antifibrotics. Data on the use of rituximab, a B-lymphocyte-depleting monoclonal antibody, often utilized as rescue therapy in progressive and severe ILD, was limited until recently. The RECITAL trial reported…
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Examining the past and looking toward the future: The need for quality data in interventional pulmonology
During the last decade, the explosion of technological advancements in the field of interventional pulmonary (IP) has afforded patients the opportunity to undergo novel, minimally invasive diagnostic and therapeutic procedures. However, these unprecedented technological advances have often been introduced without the support of high-quality research on safety and efficacy, and without evaluating their impact on…
