Atelectasis frequently occurs in patients with impaired consciousness who are being treated with invasive mechanical ventilation. It is mainly caused by secretion accumulation, which can lead to longer durations of ventilation and ICU stay.

Olfaction may be associated with lung health because of the anatomic and functional connections between the upper and lower airways, but empirical evidence is lacking.

Interstitial lung disease (ILD) is a term encompassing a wide array of pulmonary conditions characterized by inflammation and fibrosis of the pulmonary parenchyma. Pulmonary hypertension (PH) is frequently encountered in patients with fibrotic ILDs and poses unique difficulties for both diagnosis and management. Patients with ILD-associated pulmonary hypertension (ILD-PH) are complex, often ailing and presenting with multiple comorbidities whose individual contributions to the underlying PH can be challenging to disentangle. Evidence supporting treatment with PH-specific medications in ILD-PH is limited. This edition of "How I Do It" presents a longitudinal case-based discussion of ILD-PH to address these challenges, highlight pearls and pitfalls in the diagnostic workup of these patients, and provide a framework for the practical evidence-based approach to accurate diagnosis and management of these challenging patients.

Air pollution and extreme temperatures exposure during pregnancy is associated with lung function in schoolchildren.

Breathlessness on exertion is a common, distressing, and limiting symptom that can be quantified on incremental cardiopulmonary exercise testing (CPET) using normative reference equations.

Uptake of evidence-based practices (EBPs) in pulmonary and critical care medicine is frequently incomplete. To address these gaps, implementation scientists seek to understand the clinical and societal contexts in which innovations and EBP are introduced. They also design and evaluate complex interventions to facilitate the adoption of an EBP in those contexts. We propose that well-established methods for analyzing hierarchical, observational data can complement and strengthen this process by identifying sources of practice variability. This paper reviews the dominant framework used to understand the clinical context of implementation programs, describes how measuring practice variability could help streamline this approach, and tests an assumption of the proposed combined methodology using observational data from a national study of patients on mechanical ventilation conducted by The Prevention and Early Treatment of Acute Lung Injury Network. We discuss how the combined approach can be used (1) to focus the search for determinants of practice, (2) to quantify the impact of evidence generation and evaluate the success of implementation projects, and (3) to facilitate comparisons between implementation strategies when multiple approaches are trialed simultaneously.

Nocturnal pulsed oxygen saturation (SpO2) monitoring is recommended for detecting residual sleep-disordered breathing, including nocturnal hypoventilation, in patients treated by noninvasive ventilation (NIV) or CPAP. It is a general assumption that different pulse oximetry devices will provide similar results. However, this may not be correct.

Trial participants typically are healthier than the general population. Differences in underlying characteristics between the population undergoing lung cancer screening (LCS) and LCS trial participants may alter the benefits of LCS.

Because of risk of severe asthma exacerbations, current Global Initiative for Asthma recommendations advise against use of short-acting beta-agonists (SABAs) alone as the first step in treating mild asthma. It is unclear if everyone with mild asthma carries equal risk for severe asthma exacerbations.

Malignant airway obstruction (MAO) is a common debilitating complication in advanced lung cancer. Therapeutic bronchoscopy is successfully applied to manage MAO. MAO recurs and requires repeat procedures.

There is substantial overlap between features of COPD, asthma, bronchiectasis (BE), and cystic fibrosis (CF). Each is characterized by inflammation and mucociliary dysfunction.

The apnea-hypopnea index (AHI), the standard measure of OSA, has limitations in reflecting disease severity.

Angiotensin-converting enzyme (ACE) inhibitors are widely used antihypertensive agents with proven cardioprotective effects. Previous mechanistic and clinical studies have suggested that ACE inhibitor therapy may slow disease progression and reduce mortality in idiopathic pulmonary fibrosis (IPF).

Thoracoscopy guidelines recommend inducing artificial pneumothorax before medical thoracoscopy in patients with minimal or absent pleural effusion. Single-arm studies have demonstrated that nonartificial pneumothorax approaches reduce operative time and complication rates compared with artificial pneumothorax techniques in these patients. However, there is a lack of trials comparing the effectiveness and safety of performing artificial pneumothorax vs not performing it in these cases.

Chronic cough (CC) is one of the most common symptoms reported to primary care and to respiratory outpatient clinics. The Triggers and Sensations Provoking Coughing (TOPIC) questionnaire is a 15-item questionnaire designed to capture sensations and triggers associated with CC in a fashion that discriminates between refractory CC (RCC) and other causes of CC.

Development of persistent critical illness (PerCI) necessitating prolonged ICU stays varies across hospitals. Specialty palliative care consultation may mitigate PerCI development by influencing the transition to comfort-directed care when appropriate.

Long COVID or a post-COVID condition, defined as the persistence of symptoms at least 3 months after acute COVID-19 infection, is a novel condition in which a definitive diagnostic marker and treatment have yet to be found. This condition, which has been estimated to impact > 65 million individuals worldwide, manifests with multisystem involvement, most commonly presenting with fatigue, brain fog, dyspnea, cough, or a combination thereof. The burden of these symptoms can range from mild to severe, with many patients reporting an inability to return to usual activities. Herein, we present several hypothetical but clinically representative case reports to allow discussion around how we approach the diagnosis of respiratory symptoms of long COVID in those with and without chronic lung disease.