ARDS and High Blood Endocan Profile During COVID‑19

ARDS and High Blood Endocan Profile During COVID‑19

With great interest, we read the recently published paper by Pascreau et al. concluding that a high blood endocan profile during COVID‑19 distinguishes moderate from severe acute respiratory distress syndrome (ARDS). In... read more

Oxidized DNA Precursors Cleanup by NUDT1 Contributes to Vascular Remodeling in Pulmonary Arterial Hypertension

Oxidized DNA Precursors Cleanup by NUDT1 Contributes to Vascular Remodeling in Pulmonary Arterial Hypertension

By overexpressing NUDT1, PAH-PASMCs hijack persistent oxidative stress in preventing incorporation of oxidized nucleotides into DNA, thus allowing the cell to escape apoptosis and proliferate. Given that NUDT1 inhibitors... read more

Mitochondrial Damage-Associated Molecular Patterns Exacerbate Lung Fluid Imbalance Via the Formyl Peptide Receptor-1 Signaling Pathway in Acute Lung Injury

Mitochondrial Damage-Associated Molecular Patterns Exacerbate Lung Fluid Imbalance Via the Formyl Peptide Receptor-1 Signaling Pathway in Acute Lung Injury

Mitochondrial damage–associated molecular patterns exacerbate lung fluid imbalance in the experimental acute lung injury model through formyl peptide receptor-1 signaling, the inhibition of which may prevent exacerbation... read more

Doppler Echocardiographic Indices in Critically Ill Patients Under Mechanical Ventilation

Doppler Echocardiographic Indices in Critically Ill Patients Under Mechanical Ventilation

Doppler Echocardiographic Indices Are Specific But Not Sensitive to Predict Pulmonary Artery Occlusion Pressure in Critically Ill Patients Under Mechanical Ventilation. The objective of this study was to prospectively... read more

The voice of people living with COPD: what I learned from doing qualitative research

The voice of people living with COPD: what I learned from doing qualitative research

As a general respiratory physician, schooled in the clinical world of evidence-based medicine (EBM), I shared a common view that qualitative research was, well, flaky. Where was the science? The statistical significance?... read more

Epidemiology of Invasive Pulmonary Aspergillosis Among COVID-19 Intubated Patients

Epidemiology of Invasive Pulmonary Aspergillosis Among COVID-19 Intubated Patients

We found a high incidence of CAPA among critically ill COVID-19 patients and that its occurrence seems to change the natural history of disease. A total of 108 patients were enrolled. Prospective, multicentre study... read more

Inhaled Pulmonary Vasodilators

Inhaled Pulmonary Vasodilators

Confusion between inhaled versus intravenous routes for pulmonary vasodilators. For optimal clinical benefit (especially regarding oxygenation), these agents must be given via an inhaled route. The misconception that inhaled... read more

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

Rapid Advancement in Enteral Nutrition Does Not Affect Systemic Inflammation and Insulin Homeostasis Following Pediatric Cardiopulmonary Bypass Surgery

A FF strategy was not associated with changes to early enteral nutrition delivery. Inflammation, insulin resistance, and morbidity were similar, but FF may modify the relationship between inflammation and adverse event. Multicenter... read more

COVID-19: A Hypothesis Regarding the Ventilation-Perfusion Mismatch

COVID-19: A Hypothesis Regarding the Ventilation-Perfusion Mismatch

We believe that a severe V/Q mismatch underlies the pathophysiology of moderate to severe COVID-19 cases, in which downregulation of ACE2 secondary to viral endocytosis plays a key role. There is low V/Q ratio in areas of... read more

COVID-19: Thrombosis and Anticoagulation

COVID-19: Thrombosis and Anticoagulation

Early reports have shown that COVID-19 is most likely causing a hypercoagulable state, however the prevalence of acute VTE and exactly how to treat it is an evolving area. Limited data suggest pulmonary microvascular thrombosis... read more

Leading EHR System Adopts Bundle to Prevent ICU Delirium

Leading EHR System Adopts Bundle to Prevent ICU Delirium

Seminal studies at Vanderbilt University Medical Center over the past two decades by pulmonary and critical care specialist Wes Ely, M.D. and colleagues have spurred ICU delirium research, and the resulting body of evidence... read more

Artificial Intelligence or Merely a Symptom of a Broken Healthcare System?

Artificial Intelligence or Merely a Symptom of a Broken Healthcare System?

We are constantly hunting for newer and better sources of information. This leads to a perpetual generation of newer lab tests, different hemodynamic gizmos, and fresh decision tools. Some of these pan out. Most don't. Why... read more

Harrison’s Pulmonary and Critical Care Medicine

Harrison’s Pulmonary and Critical Care Medicine

Featuring a superb compilation of chapters related to pulmonary and critical care topics, this concise, full-color clinical companion delivers the latest knowledge in the field backed by the scientific rigor and authority... read more

Recommendations for a Standardized Pulmonary Function Report

Recommendations for a Standardized Pulmonary Function Report

The American Thoracic Society committee on Proficiency Standards for Pulmonary Function Laboratories has recognized the need for a standardized reporting format for pulmonary function tests. Although prior documents have... read more

Building Critical Care Community Through Twitter Chat

Building Critical Care Community Through Twitter Chat

Twitter chats can be a powerful tool for the widespread engagement of a medical audience. Social media sites such as Twitter can significantly enhance education and advocacy efforts. In 2013, the American College of Chest... read more

COPD Patients Who Live Alone are Less Active

COPD Patients Who Live Alone are Less Active

Patients with chronic obstructive pulmonary disease (COPD) who live with a spouse, partner, or other caregiver are more active than patients who live alone, and are also more likely to participate in pulmonary rehabilitation... read more

PaCO2 Equation

PaCO2 Equation

I've previously written about the alveolar gas equation and oxygen delivery equation, both of which deal with the physiologic process of oxygenation. Now I want to discuss the important relationship between alveolar... read more