April 2008 Press ReleaseNews Briefs From the Journal CHEST, April 2008HOW BEST TO PREDICT IN-FLIGHT HYPOXEMIAAir travel commonly causes significant hypoxia—or lack of oxygenation of the blood—in passengers with chronic obstructive pulmonary disease (COPD), and the hypoxia inhalation test (HIT) is widely used as a preflight evaluation. During the HIT test, patients inhale a gas mixture while their saturation is monitored. Despite its wide use, there have been concerns over the accuracy of the test. In response, researchers from New Zealand and Australia assessed the predictive capability of the HIT to in-flight hypoxemia in passengers with COPD. Preflight respiratory function tests were performed on 13 passengers with COPD. Pulse oximetery, cabin pressure, and dyspnea were recorded in-flight, and an HIT and 6-minute walk test were performed postflight. Researchers then compared the in-flight oxygenation response to the HIT and respiratory function parameters. Results showed that air travel caused significant desaturation, which was worsened by activity, with the HIT causing comparable desaturation to the air travel. The researchers concluded that the HIT is the best widely available test to predict in-flight hypoxemia. This study is published in the April issue of the journal CHEST. VENTILATOR SETTINGS MAY INFLUENCE DEVELOPMENT OF ARDSA new study reveals that ventilator settings may influence the development of acute respiratory distress syndrome (ARDS) in patients supported by mechanical ventilation. In a retrospective analysis of more than 2,500 patients, researchers from Harvard, Massachusetts Institute of Technology, and Beth Israel Deaconess Medical Center identified 789 patients who required more than 48 hours of ventilation but did not have ARDS at admission. After the test period, nearly 20% (152) of these patients went on to develop the syndrome. Results showed that peak pressure, high net fluid balance, transfusion of plasma, sepsis, and tidal volume were all significantly associated with the development of ARDS. Researchers suggest that by addressing these factors, ARDS may be a preventable complication in some cases. This study is published in the April issue of the journal CHEST. CHECKLIST HELPS DIAGNOSE TYPE OF DYSPNEANew research from China may help doctors better identify the symptomatic differences between dyspnea and medically unexplained dyspnea (MUD). Differentiating between the two conditions is often difficult; while patients with both dyspnea and MUD present with difficult or labored breathing, only those with dyspnea have cardiopulmonary explanations for their condition. To investigate the descriptors of each condition, researchers administered a symptom checklist to 291 patients, which included 61 spontaneously reported descriptors of dyspnea. A total of 96 were diagnosed with MUD after reporting factors such as “urge to breathe,” “affective dyspnea,” “anxiety,” and “tingling.” The remaining 195 patients reported “wheezing,” “cough and sputum,” and “palpitation,” which were indicative of cardiopulmonary disease and dyspnea. Researchers conclude that this method allows for a satisfactory separation of patients with MUD and cardiopulmonary disease. This study is published in the April issue of the journal CHEST. Contact:
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