American Thoracic Society

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What's it doing for you and what's the strategy in ARDS?

Yeah, I think current ATS or American Thoracic Society guidance conditionally favors a higher PEEP strategy without prolonged recruitment maneuvers, which we used to do quite commonly back when I was a fellow.

And that's in moderate to severe ARDS.

If you look at the ARDS net PEEP/FiO2 tables, I think that's a reasonable and very good starting framework.

And so you missed three articles from this past week.

What were those articles about that you missed? Well, we looked at guidelines from the American Thoracic Society for non-invasive ventilation.

And then we looked at whether or not you should be giving rest bure cases early as possible for tumor lysis syndrome.

And then finally, hey, whatever happens to those PE patients that we send home.

From my perspective, we've got hormonal rhinitis.

So we know the American Thoracic Society produced a workshop report.

So this was CPAP experts, either the prescribers or the people that deliver CPAP.

And they said mouth breathing and nasal symptoms are common in those with obstructive sleep apnea and interfere with treatment.

mouth tape okay so um sleep medicine sleep conditions are very concerned about mouth tape because if somebody has obstructive sleep apnea and um seals their lips that they are concerned that that's going to be a problem um i think again nuance and i think um Clearly, if somebody cannot breathe through their nose, then there is an issue and putting mouth tape on would mean that that person can't breathe at all.

But

as I said, that American Thoracic Society report said that the two things that are common and interfere with treatment are nasal symptoms and mouth breathing.

So by definition in sleep medicine, we want to eradicate nasal symptoms and we want to reestablish nasal breathing.

You're listening to the ATS Breathe Easy podcast brought to you by the American Thoracic Society.

Welcome to the ATS Breathe Easy podcast.

I'm your host, Dr. Erica Moseson, a pulmonary critical care medicine physician in Portland, Oregon, and host of the Air Health, Our Health podcast.

We are here today to discuss strategies to meaningfully reduce healthcare sector emissions in pulmonary critical care and sleep practice, an official American Thoracic Society workshop report.

I am joined by two of the three authors that led this project, Dr. Radbell and Dr. Brigham.

Why don't you introduce yourselves?

I work at Mass General.

As a background, I have done internal medicine, then moved to do my pulmonary and the critical care at Tulane University in New Orleans, where also I did my master's in clinical research and minor in medical education, as well as a certificate with ATS, or American Thoracic Society, for guideline methodology training.

After that, I did my interventional pulmonary fellowship in the combined fellowship at Mass General as well as Beth Israel DeConis.

That was back in 2016, almost now 10 plus years ago.

Lundy and Aaron were both invited to join the country's leading experts on lung health to review pulmonary function testing.

The American Thoracic Society debated for two years whether to remove race from the test's algorithms.

And in 2023, the group finally came out with new recommendations.

Doctors and hospitals should use race-neutral tests.

You know, we know these guidelines were, you know, designed for the United States.

We are an American thoracic society.

IDSA is, you know, particularly focused on the United States, but we recognize that they are used by the global community.

And when you've got, you know, up to two thirds of the world's population not having access to radiology.