Chest
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Multicenter Study
Patterns and impact of arterial CO2 management in patients with Acute Respiratory Distress Syndrome: Insights from the LUNG SAFE study.
Considerable variability exists regarding CO2 management in early ARDS, with the impact of arterial CO2 tension on management and outcomes poorly understood. ⋯ No evidence was found for benefit or harm with hypercapnia. Of concern, ICU mortality was higher with sustained hypocapnia in mild to moderate ARDS.
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Meta Analysis
High flow nasal cannula in the immediate post-operative period: a systematic review and meta-analysis.
Studies have demonstrated that high-flow nasal cannula (HFNC) prevents intubation in acute hypoxic respiratory failure when compared with conventional oxygen therapy (COT). However, the data examining routine HFNC use in the immediate postoperative period are less clear. ⋯ With evidence of moderate certainty, prophylactic HFNC reduces reintubation and escalation of respiratory support compared with COT in the immediate postoperative period after cardiothoracic surgery. This effect is likely driven by patients who are at high risk and/or obese. These findings support postoperative prophylactic HFNC use in the patients who are at high risk and/or obese undergoing cardiothoracic surgery.
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Ultrasound examination of the thorax is superior to chest radiograph or physical examination for diagnosing common conditions such as pneumonia, pulmonary edema, pleural effusion, and pneumothorax. The basic skill set is straightforward to learn, quick to perform, repeatable, and does not involve patient transport, harmful ionizing radiation, or waiting time. This paper outlines the basic building blocks that makeup a thoracic ultrasound examination, regardless of which specific scanning protocol is performed. Narrative videos and illustrative figures demonstrating these techniques are included.
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Multicenter Study Observational Study
Standardized reporting and management of suspicious findings on chest computed tomography is associated with improved lung cancer diagnosis in an observational study.
Follow-up of chest CT scan findings suspicious for lung cancer may be delayed because of inadequate documentation. Standardized reporting and follow-up may reduce time to diagnosis and care for lung cancer. ⋯ In this large quasi-experimental community-based observational study, implementation of a system that combines standardized tagging of chest CT scan reports with clinical navigation was effective for increasing the diagnosis of early-stage lung cancer.
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Multicenter Study
Association of Cigarette Type and Nicotine Dependence in Patients Presenting for Lung Cancer Screening.
Over decades, there have been several alterations to cigarettes, including the addition of filters and flavoring. However, lung cancer remains the leading cause of cancer-related death in the United States. ⋯ In a screening population, the type of cigarette smoked is associated with different levels of dependence. Eliciting type of cigarette and time to first cigarette has the potential to allow for tailored tobacco treatment interventions within this context.