Overview

• Acute Respiratory Failure
  • Noninvasive Ventilation for ARF
• ARDS
  • Mechanical Ventilation in ARDS
  • ACURASYS: Neuromuscular blockade in 1^st 48hrs reduced 28- and 90-day mortality
  • PROSEVA: Proning in severe ARDS reduced 28- and 90-day mortality
• Asthma
  • Novel START: Prn Budesonide+formoterol reduced risk of exacerbations vs. Albuterol
  • AMAZES: Azithromycin reduced rate of asthma exacerbations, improved QOL in severe
• COPD
  • Treatment
    • Antibiotics
    • AECOPD
      • REDUCE: 5d is non-inferior to 14d for prevention of re-AECOPD
    • Pharmacotherapy
      • FLAME: LABA + LAMA > LABA + ICS if mMRC ≥2 for exacerbations
      • UPLIFT: Tiotropium associated with improvements in lung function, QOL, and exacerbations during 4-year period; did not reduce rate of FEV1 decline
• ICU
  • EMCRIT: Fluids/Electrolytes
  • 3SITES: Subclavian less CLABSIs and DVTs than jugular/femoral, more PTX
  • 65: MAP target 60-65 in pts ≥65 did not have mortality difference in vasodilatory shock
  • Routine vs. On-Demand CXR in MV pts in the ICU increases use 34%, no benefit
  • LACTATE: Decreased in-hospital mortality and shorter ICU stay with aim of 20% reduction q2hrs for the first 8 hours in ICU; guided group received more fluids and started vasopressors earlier but did not have faster rate of reduction in lactate
  • PRORATA: <10% increase in mortality at 30-60 days with procalcitonin-guided ABX
  • SPICE-III: Precedex had more ADE w/o improving mortality as primary sedative in MV
  • SOAP-II: Dopamine = NE for 1^st line; Dopamine has increased risk of arrhythmias
  • Septic Shock
    • Surviving Sepsis Campaign
• Interstitial Lung Disease (ILD)
  • IPF
  • Sarcoidosis
• Lung Cancer
  • National Lung Cancer Screening Trial
  • Early Palliative care in metastatic NSCLC improves QOL and improved survival
• Pleural Effusion
  • Lights Criteria for Pleural Effusions
  • Management
    • Management of infectious processes of the pleural space: a review
    • Malignant Pleural Effusions
• Sleep Apnea
  • Evaluation and Management of Obesity Hypoventilation Syndrome

Resources¶

• EMCrit IBCC
• CXR Atlas