Navigating Point-of-Care Reimbursement in Critical Care, Challenges and Current State
AbstractPurpose of ReviewPoint-of-care ultrasound (POCUS) use in the intensive care unit has continued to grow, year over year with more faculty having some training and many programs training fellows. This review is to help summarize recent publications related to credentialing, coding, and billing for POCUS studies.Recent FindingsWhile there have not been significant changes in advice from regulatory agencies related to POCUS billing and reimbursement, there has been more guidance on training, documentation, and coding issued by different specialty organizations.SummaryCredentialing for POCUS remains open for practitione...
Source: Current Respiratory Care Reports - April 19, 2024 Category: Respiratory Medicine Source Type: research
Novel Strategies for Optimization of the Pre-transplant Donor Lung
AbstractPurpose of ReviewWhile the number of lung transplants continues to increase, there remains an imbalance between potential lung transplant candidates and acceptable donor lungs resulting in excess mortality. We sought to describe the current state of donor acceptance practices and highlight novel approaches that have the potential to result in an increase in acceptable lungs available for transplant.Recent FindingsIncreased utilization of lungs from donors with positive nucleic acid amplification tests for hepatitis C, donation after circulatory death, lungs conditioned for transplant at Centralized Lung Evaluation ...
Source: Current Respiratory Care Reports - April 9, 2024 Category: Respiratory Medicine Source Type: research
Interstitial Lung Abnormalities (ILA) and Pulmonary Fibrosis
AbstractPurpose of ReviewThis review identifies the similarities and differences between interstitial lung abnormalities (ILA) and pulmonary fibrosis in terms of clinical relevance, radiological features, histological features, genetics, pathophysiology, and biomarkers, and presents clinical management with a focus on ILA and future perspectives.Recent FindingsILA and pulmonary fibrosis, especially idiopathic pulmonary fibrosis, may share common biological, radiological, and histopathological features and are increasingly understood as a spectrum of fibrotic interstitial lung diseases. ILA, especially subpleural fibrotic s...
Source: Current Respiratory Care Reports - April 2, 2024 Category: Respiratory Medicine Source Type: research
Surveillance Biopsy After Lung Transplantation — Is It Necessary?
This article w ill review available evidence and evolution in post-transplant care to evaluate the rationale, advantages, and drawbacks of these two practices. (Source: Current Respiratory Care Reports)
Source: Current Respiratory Care Reports - March 22, 2024 Category: Respiratory Medicine Source Type: research
Challenges in Grading the Severity of Right Ventricular Dysfunction via Point-of-Care Echocardiography
AbstractPurpose of ReviewThis review discusses the current limitations of assessing the right ventricle (RV) using Point-of-Care Ultrasound, explains the challenges in describing the complexity of the RV, and provides guidance on how to use Point-of-Care Ultrasound data in clinical practice.Recent FindingsAssessing the RV requires assessments from multiple views and parameters due to its complex shape. Combined use of multiple ultrasound-derived measures along with clinical information from other sources is recommended. Artificial intelligence is increasingly used in Point-of-Care Ultrasound and will help improve validity ...
Source: Current Respiratory Care Reports - March 18, 2024 Category: Respiratory Medicine Source Type: research
Artificial Intelligence in Lung Ultrasound
AbstractPurpose of ReviewWe summarize and review recent artificial intelligence (AI) and deep learning (DL) innovations within the field of lung point-of-care ultrasound (LUS).Recent FindingsMany recent DL models in LUS have been developed to aid in diagnosis of COVID-19 pneumonia, pulmonary edema, pneumothorax, and pediatric pneumonia. Publicly available data sets of patients with these pathologies have been curated, annotated, and developed to train DL models to not only detect these pathologies but also quantify severity, guide users, and act as a prognostic tool to risk stratify.SummaryThe increased use of AI in LUS ha...
Source: Current Respiratory Care Reports - March 6, 2024 Category: Respiratory Medicine Source Type: research
Training and Education in Point of Care Ultrasound in Critical Care: An Update
AbstractPurpose of ReviewTraining and education that culminate in the mastery of Critical Care Ultrasound (CCU) requires a complex systems based approach. We explore an update of the building blocks and barriers to CCU programs.Recent FindingsCritical Care Ultrasound training and education is competency based in order to assure it meets a high standard. Despite multiple CCU guidelines, implementation of a robust CCU training and education system continues to be challenging. Elements that are essential and are currently considered barriers for the implementation of effective CCU programs include a thorough evidenced based t...
Source: Current Respiratory Care Reports - March 2, 2024 Category: Respiratory Medicine Source Type: research
Management of SARS-CoV-2 and Persistent Viral Detection in Solid Organ Transplant Recipients
AbstractPurpose of ReviewWe explore the challenges of managing solid organ transplant recipients (SOTRs) during the COVID-19 pandemic, with a focus on prolonged viral detection in immunosuppressed individuals.Recent FindingsSOTR guidelines recommend three mRNA vaccine doses with additional booster dosing and continued protective post-vaccination measures. COVID-19 therapies are similar for SOTRs and non-SOTRs, although drug-drug interactions limit the use of some such as nirmatrelvir/ritonavir (NIM-RTV). Inpatient treatment options include remdesivir and steroids; outpatient antiviral options include NIM-RTV or remdesivir....
Source: Current Respiratory Care Reports - February 24, 2024 Category: Respiratory Medicine Source Type: research
Evaluation of Candidates for Lung Transplant —A Review of Patient-Specific Risk Factors
AbstractPurpose of reviewThe purpose of this paper is to review the evaluation of patients who are potential candidates for a lung transplant. Attention is paid to patient-specific risk factors considered when determining if an individual is a candidate for a lung transplant.Recent findingsRecent consensus statements and a review of the literature support the notion that patient-specific risk factors associated with adverse outcomes following lung transplant should be identified and used to determine whether an individual patient is a candidate for lung transplant. The rationale for considering these risk factors is discus...
Source: Current Respiratory Care Reports - February 23, 2024 Category: Respiratory Medicine Source Type: research
Onco-Pulmonology: Exploring a New Frontier in Pulmonary Medicine
AbstractPurpose of ReviewTo detail the proposed skills and roles of an onco-pulmonologist.Recent FindingsLung cancer remains the leading cause of cancer-related death in the USA, and it requires a comprehensive multidisciplinary approach to care, which can be affected in some cases by an imbalance of patients and available providers. While pulmonologists traditionally have played an important role in screening, prevention, diagnosis, and palliation of symptoms, training in onco-pulmonology has been proposed to help bridge the gaps in lung cancer care.SummaryThe onco-pulmonologist should be well versed in advanced diagnosti...
Source: Current Respiratory Care Reports - February 21, 2024 Category: Respiratory Medicine Source Type: research
Airway Complications Related to Lung Transplantation
AbstractPurpose of ReviewThis review describes the pathophysiology and risk factors associated with airway complications post lung transplant. We discuss the different types of airway complications (AC) and their management based on recent literature reviews and institutional experience.Recent FindingsAC are now less frequent due to improvements in procurement, surgical techniques, and post-operative management of lung transplant. Risk factors for AC are well described and involve both donor and recipient factors. The management of airway complications is not universally agreed upon, and data regarding the efficacy of diff...
Source: Current Respiratory Care Reports - February 8, 2024 Category: Respiratory Medicine Source Type: research
Complications of Palliative Interventions for Malignant Pleural Effusions
AbstractPurpose of ReviewThis review summarizes the potential complications of interventions performed for palliation of symptoms related to malignant pleural effusion.Recent FindingsComplication rates, particularly the incidence of bleeding related events, have historically been reported much higher than in recent publications. Newer data suggests that many of the palliative interventions performed for the management of malignant pleural effusion may be safer than originally considered.SummaryA variety of palliative interventions are available for management of malignant pleural effusion and have been shown to improve sym...
Source: Current Respiratory Care Reports - February 8, 2024 Category: Respiratory Medicine Source Type: research
Artificial Intelligence in Chest Radiology: Advancements and Applications for Improved Global Health Outcomes
AbstractPurpose of ReviewIn this review, we explored the most recent innovations in artificial intelligence and their applications in chest radiology to promote population health.Recent FindingsAI algorithms have revolutionized imaging modalities essential for the diagnosis and management of thoracic pathologies such as pneumonia, lung cancer, interstitial lung disease, and cardiovascular disease. AI implementation in low- and middle-income countries has the potential to significantly improve chest radiology services but restricted access to adequate resources and infrastructure must be addressed to ensure globalization of...
Source: Current Respiratory Care Reports - January 18, 2024 Category: Respiratory Medicine Source Type: research
Primary Ciliary Dyskinesia: Integrating Genetics into Clinical Practice
AbstractPurpose of ReviewAdvances in molecular genetics have improved our understanding of primary ciliary dyskinesia. The purpose of this review is to describe the integration of genetics into clinical practice.Recent FindingsThis review describes > 50 genes which have been identified to cause multiple motile ciliopathies. Known genotype–phenotype relationships are explored, including genes associated with worse prognosis (CCDC39, CCDC40, CCNO). Features which indicate referral for genetic testing such as a family history, situs defects and lifelong chronic upper and lower respiratory tract disease are describe...
Source: Current Respiratory Care Reports - January 16, 2024 Category: Respiratory Medicine Source Type: research
Advances in Airway Stenting
AbstractPurpose of ReviewIn this review, we summarize the evolution of airway stents through the decades and address the various existing stent types along with some investigational stents, and the available data supporting their use. We also briefly discuss the most common complications, the process of removal, and controversies regarding follow-up.Recent FindingsStent technology continues to evolve in an ongoing effort to develop better stents with easier placement or removal, sustained clinical benefit, and the least number of complications. These improvements have allowed for the expansion of stent use from primarily p...
Source: Current Respiratory Care Reports - January 15, 2024 Category: Respiratory Medicine Source Type: research
