ULTRASONOGRAPHY COULD REPLACE CHEST X-RAY FOR DETERMINING SOURCE OF ACUTE SHORTNESS OF BREATH
A new study suggests that ultrasonography could replace standard chest x-ray as the first choice of technique for imaging when rapid, accurate identification of the source of acute dyspnea is needed. Italian researchers studied 404 patients admitted to the emergency department and found strong agreement between the results of chest ultrasonography and x-ray for diagnosing the underlying pulmonary disease. Chest CT, long considered the gold standard for most pulmonary diseases, was used to determine accuracy when the results of the other modalities disagreed. Ultrasonography found reliable, faster results with fewer delays and less patient exposure to radiation. Considering these findings, ultrasonography could become the routine imaging modality for patients admitted to the emergency department with dyspnea. This article is published in the May issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2011;139(5):1140-1147.
RACE AND ETHNICITY CAN INFLUENCE END-OF-LIFE CARE IN THE ICU
A recent study shows a disparity in treatment choices for end-of-life care made by families for patients in the ICU based on race, ethnicity, and levels of understanding. Researchers from the University of California, San Francisco and the University of Washington compared race, ethnicity, and socioeconomic status of 3,138 patients who died in the ICU or within 30 hours of transfer from the ICU. Results showed that a number of ethnic and racial differences exist in end-of-life care in the ICU, such as those related to advance directives and family-clinician communication; however, socioeconomic status was not a consistent predictor of end-of-life care. Eliminating these disparities requires a more complete understanding of the specific cultural differences and a need to develop interventions to address them. This article is published in the May issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2011;139(5):1025-1033.
CHILDHOOD OBSTRUCTIVE SLEEP APNEA SYNDROME IMPROVED BY ADENOTONSILLECTOMY
A new study analyzed changes in heart rates in children with obstructive sleep apnea syndrome (OSAS) after having adenotonsillectomy (AT) and found evidence of improvement in OSAS. Researchers from Montefiore Children’s Hospital in New York studied 18 children with OSAS, a syndrome characterized by recurrent airway obstruction during sleep. OSAS disrupts normal breathing and sleep patterns and is linked to neurocognitive deficits and cardiovascular morbidities, with increased heart rate as a causative link. Age-, sex-, and BMI-matched children with primary snoring were compared with children with OSAS. Tests such as overnight polysomnography and electrocardiography were performed before and after AT. After AT, heart rate decreased and sleep-disordered breathing improved. This article is published in the May issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2011;139(5):1050-1059.