The annual meeting of the American College of Chest Physicians was held from Oct. 6 to 10 in San Antonio and attracted approximately 6,000 participants from around the world, including specialists and heath care professionals focused on pulmonary, critical care, and sleep medicine. The conference featured presentations focusing on clinical updates and advances in chest medicine.
In one study, Alexander Chen, M.D., of the Washington University School of Medicine in St. Louis, and colleagues performed a feasibility assessment of robotic technology in cadaver lungs to see if bronchoscopists using the system could precisely access and biopsy artificial tumor targets that had been placed to closely mimic pulmonary nodules.
“Using this cadaveric model, the robotic system was successful at biopsying 97 percent of nodules,” Chen said. “It is early to jump to conclusions about the impact on clinical practice since this study was performed in cadavers and not live humans. This was a necessary step moving this technology forward and the results are encouraging. We are in the process of performing additional studies in live human subjects to further explore this technology.”
In another study, Hira Iftikhar, M.D., of the Beaumont Health System in Royal Oak, Mich., and colleagues evaluated bacterial pathogens in patients with interstitial lung diseases (ILD).
“Infection has been theorized to play a part in not only the disease progression but also acute exacerbations in ILD patients,” Iftikhar said. “However, there is a scarcity of data regarding bacterial pathogens in ILD patients.”
The investigators found a majority of the respiratory isolates were gram-negative pathogens in ILD patients. Gram-negative pathogens were associated with worse outcomes, including worse mortality, higher vasopressor use, and intensive care unit (ICU) admission. These findings were in comparison with methicillin-resistant Staphylococcus aureus, pseudomonas, and other gram-positives.
“We also found that multidrug-resistant pathogens had worse outcomes. Patients who were on immunosuppressants, antifibrotics, or steroids did not have higher rates of multidrug-resistant pathogen isolation,” Iftikhar said. “Given that gram-negatives had worse outcomes in ILD patients, we should consider the type of bacteria while prognosticating patients with ILD.”
Bobbie Ann Adair White, Ed.D., of Texas A&M University in Temple, and colleagues created and implemented a conflict management education intervention for ICU workers (physicians, nurses, respiratory therapists, and advanced practitioners).
“The intervention’s objectives were around the ideas of ‘diagnosing’ conflict, recognizing internal dialogue, and building awareness through the use of the Thomas Kilmann Inventory, clinical cases, as well as a perception exercise,” White said.