Hot in CHEST September 2017

By: Chris Caroll, MD, FCCP

September 7, 2017

Dr. Chris CarrollEach 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 September, so let's hear from Dr. Carroll as he outlines his highlights. After reviewing the issue, be sure to share your hot list on our Facebook wall, tweet with the hashtag #journalCHEST, or discuss in the CHEST LinkedIn group.

A Medical Student Perspective on Physician-Assisted Suicide

Lead author: John Y. Rhee, MPH

Physician-assisted suicide is legal in five states in the US. Although advocates praise the autonomy of these laws, increasingly, some physicians are pushing back against these laws based on ethical and practical issues. In the ICU, these issues are even murkier. In January, the Society of Critical Care Medicine hosted “Hot Topics” debate on the core ethical issues in a session hosted by Dr. Wes Ely. In August, the New York Times published a moving editorial of a physician wrestling with both the moral and practical aspects of these laws. And most recently, in the September CHEST, a group of medical students have published an article on the medical student perspective. This thoughtful article is a must read for providers interested in the core issues related to physician-assisted suicide.

Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults: A Systemic Review and Meta-Analysis

Co-author: Bin Du, MD

One of the most controversial topics on Medical Social Media is the most appropriate way to intubate a patient. Don’t believe me? Search “DL vs VL” on Twitter. Or better yet, post a poll or a comment advocating for direct laryngoscopy and watch the sparks fly. In this month’s CHEST, a meta-analysis and systemic review by Dr. Huang and colleagues adds even more fuel to this fire. In the analysis, the authors found that video laryngoscopy did not increase first attempt success rate compared with direct laryngoscopy and concluded that the routine use of video laryngoscopy is not supported in the ICU (ducks!).

Extracorporeal Membrane Oxygenation for Adult Respiratory Failure: 2017 Update

Co-author: Daniel Brodie, MD

ECMO (or extracorporeal membrane oxygenation) provides rescue support for oxygenation and ventilation during severe episodes of respiratory failure. Widely used in neonates and in children, this therapy has saved thousands of lives. Recently, there has been increasing use of ECMO in adults. In a Contemporary Review in this month’s CHEST, Drs. Abrams & Brodie provide an excellent review of the physiology, mechanics, evidence, and ethical concerns. Check it out!

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