Excited to share our summary on pulmonary rehabilitation, an underutilized and critically important treatment that can help our patients with chronic respiratory disease. Thanks to my coauthors Drs. Davis and @RestivoAnderson!
This JAMA Clinical Guidelines Synopsis summarizes the American Thoracic Society’s 2023 guidelines on pulmonary rehabilitation for adults with chronic respiratory disease.
https://t.co/9stV8lcIkB
@nickmmark In some cultures, especially those where people speak British-English (India and the likes..) the term that was learned and adopted is “expired”. It is interjected into non-English conversations in place of the non-English word for die, without malintent behind its use.
Congratulations to the presenters on fantastic work: Armaan Akbaar (JHU), Irene Bello (Hosp Clinic Barcelona), Sanjay Dutta (Sydney), Lucas Hoyos Mejia (Univ Hosp Zurich), Kevin Kulshrestha (Cincinnati Children’s)
🔎Conventional DBD v cDCD in🇨🇭: DBD correlated w/⬆️ ⏰ vent, ⬆️90d mortality. cDCD assoc w/⬆️LOS. BUT late outcomes w/o significant diff b/t groups (marginally superior 1yr mortality but early CLAD in cDCD cohort)
- Can we safely follow suit?
- Can this ⬆️access to pediatric pts?
🔎Extended criteria donors⬆️ pool, but significant regional variation in acceptable age. Single center eval don >68YO vs not. No difference in rates of post-op ECMO, LOS (ICU or hosp), or 30d mortality, overall death.
- So what’s stopping us?
🔎We use mechanical insufflation/exsufflation routinely for critically ill patients. One group performed blinded RCT of MIE on organ donors, which ⬆️ % of eligible lung donors!
- Can we use this to ⬆️ donor pool?
- What’s stopping us from universal implementation?
🔎Rates of intraop 🫁 turndown after initial acceptance have ⬆️ to up to 10% at some institutions in the last 20 yrs
- Can we improve communication b/t OPO & txp centers prior to transport/travel?
- What are the reasons behind 🫁decline?
- How will this change in the CAS era?