1776. Ventilatory Strategy to Prevent Atelectasis During Bronchoscopy Under General Anesthesia: A Multicenter Randomized Controlled Trial (Ventilatory Strategy to Prevent Atelectasis -VESPA- Trial).
作者: Moiz Salahuddin.;Mona Sarkiss.;Ala-Eddin S Sagar.;Ioannis Vlahos.;Christopher H Chang.;Archan Shah.;Bruce F Sabath.;Julie Lin.;Juhee Song.;Teresa Moon.;Peter H Norman.;George A Eapen.;Horiana B Grosu.;David E Ost.;Carlos A Jimenez.;Gouthami Chintalapani.;Roberto F Casal.
来源: Chest. 2022年162卷6期1393-1401页
Atelectasis negatively influences peripheral bronchoscopy, increasing CT scan-body divergence, obscuring targets, and creating false-positive radial-probe endobronchial ultrasound (RP-EBUS) images.
1777. Evaluation of Dyspnea and Exercise Intolerance After Acute Pulmonary Embolism.
Long-term dyspnea and exercise intolerance are common clinical problems after acute pulmonary embolism. Unfortunately, no single test can distinguish among the range of potential pathologic outcomes after pulmonary embolism. We illustrate a stepwise approach to post-pulmonary embolism evaluation that uses a hierarchic series of clinically validated diagnostic tests. The algorithm is represented by the acronym SEARCH, which stands for Symptom screening, Exercise testing, Arterial perfusion, Resting echocardiography, Confirmatory chest imaging, and Hemodynamics measured by right heart catheterization. We illustrate the algorithm with a patient whom we saw in our pulmonary embolism follow-up clinic. Patients are asked at least 6 months after pulmonary embolism whether they have returned to their baseline level of respiratory comfort and exercise tolerance. Patients with dyspnea and exercise intolerance undergo noninvasive cardiopulmonary exercise testing to identify elevated ventilatory dead space ratios, decreased stroke volume augmentation with exercise, and other physiologic abnormalities during exertion. Ventilation-perfusion scanning is performed on those patients with exercise-related physiologic findings to confirm the presence of residual pulmonary arterial obstruction or to suggest alternative diagnoses. Resting echocardiography may provide evidence of pulmonary hypertension; confirmatory imaging with pulmonary angiography or CT angiography may disclose findings characteristic of chronic pulmonary artery obstruction. Finally, right heart catheterization is performed to confirm chronic thromboembolic pulmonary hypertension; if resting pulmonary hemodynamics are normal, then invasive cardiopulmonary exercise testing may disclose exercise-induced defects.
1778. Clinical Characteristics, Treatment Persistence, and Outcomes Among Patients With COPD Treated With Single- or Multiple-Inhaler Triple Therapy: A Retrospective Analysis in Spain.
作者: Bernardino Alcázar-Navarrete.;Lucía Jamart.;Joaquín Sánchez-Covisa.;Mónica Juárez.;Ruth Graefenhain.;Antoni Sicras-Mainar.
来源: Chest. 2022年162卷5期1017-1029页
COPD is a leading cause of death and disability. COPD therapy goals include reducing exacerbations and improving symptom control. Single-inhaler triple therapy (SITT) or multiple-inhaler triple therapy (MITT) is indicated for patients with frequent exacerbations despite bronchodilator therapy. No available evidence compares SITT vs MITT in Spain in terms of treatment persistence, exacerbations, and other outcomes.
1779. Neutralizing COVID-19 Convalescent Plasma in Adults Hospitalized With COVID-19: A Blinded, Randomized, Placebo-Controlled Trial.
作者: Wesley H Self.;Allison P Wheeler.;Thomas G Stewart.;Harry Schrager.;Jason Mallada.;Christopher B Thomas.;Vince D Cataldo.;Hollis R O'Neal.;Nathan I Shapiro.;Conor Higgins.;Adit A Ginde.;Lakshmi Chauhan.;Nicholas J Johnson.;Daniel J Henning.;Stuti J Jaiswal.;Manoj J Mammen.;Estelle S Harris.;Sonal R Pannu.;Maryrose Laguio-Vila.;Wissam El Atrouni.;Marjolein de Wit.;Daanish Hoda.;Claudia S Cohn.;Carla McWilliams.;Carl Shanholtz.;Alan E Jones.;Jay S Raval.;Simon Mucha.;Tina S Ipe.;Xian Qiao.;Stephen J Schrantz.;Aarthi Shenoy.;Richard D Fremont.;Eric J Brady.;Robert H Carnahan.;James D Chappell.;James E Crowe.;Mark R Denison.;Pavlo Gilchuk.;Laura J Stevens.;Rachel E Sutton.;Isaac Thomsen.;Sandra M Yoder.;Amanda J Bistran-Hall.;Jonathan D Casey.;Christopher J Lindsell.;Li Wang.;Jill M Pulley.;Jillian P Rhoads.;Gordon R Bernard.;Todd W Rice.; .
来源: Chest. 2022年162卷5期982-994页
Convalescent plasma has been one of the most common treatments for COVID-19, but most clinical trial data to date have not supported its efficacy.
1780. Quantitative Interstitial Abnormality Progression and Outcomes in the Genetic Epidemiology of COPD and Pittsburgh Lung Screening Study Cohorts.
作者: Bina Choi.;Najma Adan.;Tracy J Doyle.;Ruben San José Estépar.;Rola Harmouche.;Stephen M Humphries.;Matthew Moll.;Michael H Cho.;Rachel K Putman.;Gary M Hunninghake.;Ravi Kalhan.;Gabrielle Y Liu.;Alejandro A Diaz.;Stefanie E Mason.;Farbod N Rahaghi.;Carrie L Pistenmaa.;Nicholas Enzer.;Clare Poynton.;Gonzalo Vegas Sánchez-Ferrero.;James C Ross.;David A Lynch.;Fernando J Martinez.;MeiLan K Han.;Russell P Bowler.;David O Wilson.;Ivan O Rosas.;George R Washko.;Raúl San José Estépar.;Samuel Y Ash.; .
来源: Chest. 2023年163卷1期164-175页
The risk factors and clinical outcomes of quantitative interstitial abnormality progression over time have not been characterized.
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