Hot in CHEST: September 2017

Each month, my co-editor Deep Ramachandran and I select the hottest articles to blog about from that issue of CHEST.  This month it’s my turn! Enjoy!

A Medical Student Perspective on Physician-Assisted Suicide

Physician-assisted suicide is legal in five states in the U.S. 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 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 editorial 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

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 increased first attempt success rate compared to 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

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 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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