November-December 2010 Plan Now to Contribute an Article to a 2011 Issue of the Bulletin
As the year winds down, section leaders are busy planning for 2011, and
one of the things that we’d like to boost next year is contributions
to our quarterly Bulletin. So if you have a topic that you’d like
to address, consider writing a short article on it (500-700 words) and
submitting it for publication to our editor, RICK
WEAVER.
Proposals for 2011 Congress Due Jan. 5
You have until Jan. 5 to submit a proposal for a presentation at the 2011
International Respiratory Congress in Tampa. The Program Committee will
review all submissions and make decisions early in February for the November
5-8 convention. READ
PROPOSAL INSTRUCTIONS
Bedside LUS Can Estimate PEEP-Induced Lung Recruitment
French investigators publishing in the Sept. 17 Epub edition of the American Journal of Respiratory and Critical Care Medicine find bedside lung ultrasound (LUS) can effectively estimate PEEP-induced lung recruitment. They arrived at that conclusion after comparing the pressure-volume (PV) curve method with LUS in 30 patients with acute respiratory distress syndrome and ten with acute lung injury. Among the results:
- A highly significant correlation was found between PEEP-induced lung recruitment measured by PV curves and the ultrasound reaeration score.
- An ultrasound reaeration score of ≥ + 8 was associated with a PEEP-induced lung recruitment > 600 ml.
- An ultrasound lung reaeration score of ≤ + 4 was associated with a PEEP-induced lung recruitment ranging from 75 to 450 ml.
- A statistically significant correlation was found between the lung ultrasound reaeration score and PEEP-induced increase in PaO2.
The authors conclude, “PEEP-induced lung recruitment can be adequately estimated with bedside LUS.” However, since LUS cannot assess PEEP-induced lung hyperinflation, they recommend against using it as the sole method for PEEP titration. READ ABSTRACT
Flexible Bronchoscopy in ECMO Patients
Michigan researchers who studied seven children undergoing extracorporeal membrane oxygenation (ECMO) for cardiac failure find flexible bronchoscopy is a safe and effective procedure in these patients. Overall, 17 flexible bronchoscopies were performed due to persistent atelectasis despite conventional ventilator adjustments. Activated clotting time during flexible bronchoscopy was maintained between 180 and 220 seconds in all patients, and no major complications occurred. In four patients, bronchus compression or narrowing was found. Mucous plugging was noted in three patients, and in two of these patients, serial bronchoscopies were accompanied by stepwise decreases in ECMO flow, thereby facilitating discontinuation from ECMO support. In three patients, bronchoalveolar lavage specimens identified new ventilator-associated infections. The research appeared in the Nov. 4 Epub edition of Pediatric Critical Care Medicine. READ ABSTRACT
FeNO Correlates Well with Clinical Control of Infant Wheeze
A new study out of France evaluated the feasibility and reproducibility of FeNO off-line measurement in very young children with recurrent wheeze and also assessed whether clinical control of infantile wheeze correlates with FeNO levels. Results showed an excellent reproducibility and a significant difference in FeNO levels between children with persistent wheeze and those whose wheeze was well controlled. The authors conclude, “Off-line assessment of FeNO is feasible, reproducible, and well accepted in wheezy very young children. Optimal clinical control of infantile wheeze appeared to be associated with the control of bronchial inflammation when evaluated by FeNO measurements.” The research was conducted among 80 infants, 40 with persistent wheeze and 40 with well controlled wheeze. The investigators published their findings in the Nov. issue of Pediatric Allergy and Immunology. READ ABSTRACT
Antioxidants and Pulmonary Function
Do antioxidants play a role in lung function? U.S. and Canadian researchers who examined dietary antioxidant intake and pulmonary function in 79 police officers believe the answer may be yes. They found better pulmonary function in officers with higher levels of vitamin A and magnesium, even after the results were adjusted to take other factors into account. For smokers/former smokers, vitamin E was also associated with better pulmonary function. The study appeared in the Nov. issue of the Journal of Occupational and Environmental Medicine. READ ABSTRACT |
