Chest
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Comparative Study
Is direct collection of pleural fluid into a heparinized syringe important for determination of pleural pH? A brief report.
It has long been believed that pleural fluid must be directly aspirated into a heparinized syringe to obtain an accurate value. Many operators aspirate 30 to 60 mL of pleural fluid into a syringe without heparin, and then place 1 mL into a heparinized syringe from which the pH is determined. We postulated that this technique does not cause a clinically significant difference in pleural pH values. ⋯ Pleural fluid can be collected in a large syringe and then placed into a heparinized syringe to assess pH. This is useful information because the use of just one syringe saves time and reduces the risk of iatrogenic complications.
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Comparative Study
Noninvasive diagnosis of suspected severe pulmonary embolism: transesophageal echocardiography vs spiral CT.
Patients with pulmonary embolism (PE) and echocardiographic signs of right ventricular overload have worse prognosis and may require aggressive therapy. Unequivocal confirmation of PE is required before thrombolysis or embolectomy. This study compares the value of transesophageal echocardiography (TEE) and spiral CT (sCT) in direct visualization of pulmonary artery thromboemboli in patients with suspected PE and echocardiographic signs of right ventricular overload. ⋯ Because of high prevalence of bilateral central pulmonary thromboemboli in patients with hemodynamically significant PE, both sCT and TEE allow its definitive confirmation in most cases. Thrombi reported by sCT distally to lobar arteries should be interpreted with caution.
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Multicenter Study Comparative Study
A new self-administered questionnaire to monitor health-related quality of life in patients with COPD. Ambulatory Care Quality Improvement Project (ACQUIP) Investigators.
To develop and validate a brief, computer-scannable, self-administered questionnaire to monitor health-related quality of life in patients with COPD. The Seattle Obstructive Lung Disease Questionnaire (SOLQ) consists of 29 items measuring four health dimensions: physical function, emotional function, coping skills, and treatment satisfaction. ⋯ The SOLQ is a reliable, valid, and responsive measure of physical and emotional function, coping skills, and treatment satisfaction. Brief, self-administered, and computer scannable, it is useful in monitoring long-term outcomes among large groups of COPD patients.
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We sought to determine the current practice habits among clinicians treating spontaneous pneumothorax and bronchopleural fistula. ⋯ Marked practice variation exists in clinicians' approaches to the management of spontaneous pneumothorax and bronchopleural fistulas that is partially explained by differences between pulmonologists and thoracic surgeons. A national consensus statement is needed to guide randomized studies in pneumothorax management.