Hot in CHEST April 2017
By: Dr. Deep Ramachandran
April 25, 2017
Each month, we ask Drs. Chris Carroll and Deep Ramachandran, Social Media Co-Editors of CHEST, to weigh in on the hot topics in CHEST. It's April, so let's hear from Dr. Ramachandran as he outlines his highlights. After reviewing the issue, be sure to share your hot list on our Facebook wall, tweet with the hashtag #AprilCHEST, or discuss in the CHEST LinkedIn group.
High-flow Nasal Cannula
Lead author: liangbinmiao@163.com
“Mr. Jones, does the word “vomiting” have one T in it or 2 Ts in it?” said the second grader, his future as a CHEST Social Media Editor well beyond the horizon. “Well, Deep,” said Mr. Jones*. “It depends on how hard you’re vomiting.” Why do I tell you this story? Since the introduction of high-flow oxygen systems, it’s irked me that we spell normal and high-flow nasal cannula the same way. High-flow nasal cannulas deserve an extra “n.”
Not only because they blow air a lot harder, but that fact makes them a completely different animal from the old standby. In this study in CHEST the authors performed a meta-analysis to examine outcomes from the use of high-flow nasal cannula in the ICU. They found high-flow systems reduced the need for intubation and reintubation when compared with regular nasal cannula. Check out the results here, and feel free to join my campaign; #CaNNNula on Twitter!
*Mr. Jones is a figment of Dr. Ramachandran’s imagination and is in no way representative of the Connecticut Public School System.
CHEST Updates Guidelines on Cough Among Adults With Lung Cancer
Lead author: alex.molasiotis@polyu.edu.hk
In this CHEST Guideline and Expert Panel Report, the authors recommend that for lung cancer patients with cough who require pharmacological therapy “linctus” is suggested. Don’t worry if you’ve never heard of that, I had to Google it. And then when Google didn’t know what it was, I looked it up in the dictionary. The DICTIONARY people! Let’s pause to allow our younger readers to Google “what is a dictionary?” . . . ok they’re back.
As you’ve now learned, a linctus is simply a syrupy liquid that coats the throat and can be made of, well anything. Its presence in the guidelines serves not so much as to highlight the healing power of syrups but rather the relative lack of merit regarding other pharmacological cough therapies. Check out the rest of the recommendations.
CHEST Guideline: Management Pathways in Children With Chronic Cough
Lead author: annechang@ausdoctors.net
In this CHEST guideline, the authors review the systematic approach to chronic cough (>4 weeks) among children (</= 14 years old). Specifically, the authors used several key questions to help update recommendations from the 2006 CHEST guidelines on chronic cough in children. If you’re like me and you prefer the Cliff Notes version, check out the summary, which provides 11 recommendations.