PulmCCM

The PulmCCM team writes the posts under this moniker. Read the About page for more of the PulmCCM story.

Apr 072011
 

In 173 patients free of bronchiolitis obliterans syndrome at least 6 months post-transplant, having 10 or more colony-forming units of mesenchymal cells in bronchoalveolar lavage fluid carried a >5.0 hazard ratio for subsequently developing BOS. The relation persisted after multivariate analysis, report Badri et al. AJRCCM 2011;183:1062-1070.

Apr 062011
 

Fang et al prospectively observed 126 patients undergoing lung transplant at 9 U.S. centers. PA pressure was obtained invasively in the OR just after transplant. Those who developed grade 3 primary graft dysfunction at 72 hours (1′ endpoint) had mPAP of 38.5 mm Hg, compared to 29.6 for those who did not; the relationship persisted [… read more]

Apr 052011
 

Analyzing 50,481 victims of prolonged mechanical ventilation in Taiwan 1997-2007, Hung et al report outcomes were frankly terrible, with median survival of about 4 months. Those with a primary indication of neurologic damage fared significantly better. Those with a PMV indication of COPD, younger than 85, had 6-18 months median survival. Authors take the additional [… read more]

Apr 032011
 

Lettieri et al prospectively observed 210 patients with obstructive sleep apnea, who were diagnosed & titrated in-lab or at home. Those who were diagnosed and titrated at home and managed through their primary care clinic had equivalent adherence with CPAP therapy (~70% of nights; ~4.5 hrs/night; regular use ~52%) to those diagnosed and titrated in-lab [… read more]

Apr 032011
 

Workshop on molecular diagnostics for respiratory tract infections: Procalcitonin shows promise as a biomarker for differentiating bacterial from viral pneumonias, and to assess response to therapy. Rapid PCR for MRSA in sputum may become available after further development & testing. Molecular tests for S. pneumonia in respiratory secretions currently are uninterpretable in practice, due to [… read more]

Mar 312011
 

An excess amount of the chaos and stress endemic to ICUs is due to poor systems engineering (think alarm fatigue); a rational, integrated approach to design & technology selection is needed to make ICUs more effective and safer for patients, argue Mathews & Pronovost. Academic health systems should fill the leadership vacuum, organize stakeholders and [… read more]