Chest journal news briefs -- June 2011 issue

(Press-News.org) NON-PHYSICIAN STAFFING MAY ADDRESS SHORTAGE IN THE ICU

Intensive care units are facing staffing shortages, which are predicted to worsen in the future. A recent study, conducted by physicians from Beth Israel Medical Center and Columbia University Medical Center in New York, NY, studying 590 daytime admissions in two intensive care units (ICUs) suggests that non-physician providers can help address these staff shortages. In the study, no significant differences in hospital mortality or other patient outcomes were found between high-acuity, adult ICU units staffed by nurse practitioners and physician assistants, and those staffed by intensivists or other physicians. This article is published in the June issue of Chest, the peer-review journal of the American College of Chest Physicians: Chest 2011; 139(6):1347-1353.

NEW STUDY SHOWS DVT PREVENTION LACKING FOR HIGH-RISK PATIENTS

Despite evidence-based guidelines for thrombosis prevention, such as those published by the American College of Chest Physicians, new research shows that efforts to prevent deep vein thrombosis (DVT) in high-risk patients are inadequate. Researchers from Michigan State University College of Osteopathic Medicine and the University of Arizona studied approximately 270,000 patient records covering 28 years. These records focused on patients admitted to hospitals because of a DVT or pulmonary embolism (PE) diagnosis and trends in those with DVT or PE that occurred during hospitalization. Between 1989 and 2006, the incidence of DVT increased 1.8 times due to an increase of secondary DVT, which increased 3.1 times, while the incidence of PE did not increase. Researchers concluded that efforts to prevent DVT in these high-risk hospitalized patients are inadequate, but the fact that secondary PE did not increase as the incidence of DVT increased suggests that therapy for DVT is being applied and is effective. This article is published in the June issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2011; 139(6):1317-1321.

NONINVASIVE APPROACH MAY BE SAFE ALTERNATIVE FOR PE DIAGNOSIS

A new study by French researchers determined that a combined strategy of clinical assessment, D-dimer, ultrasonography, and a lung scan provides a noninvasive alternative to diagnosing pulmonary embolism (PE) in the vast majority of outpatients with suspected PE. These researchers assessed 321 consecutive patients with clinically suspected PE and positive D-dimer or high clinical probability. Ultrasonography established the diagnosis of PE in 13% of these patients, and a lung scan associated with clinical probability was diagnostic in 76% of the patients, while chest multidetector CT (MDCT) scan was required in 11% of patients. Based on their findings, researchers conclude that this combination approach to diagnosing PE is a safe, noninvasive alternative to the more invasive technique of MDCT. This article is published in the June issue of Chest, the peer-reviewed journal of the American College of Chest Physicians: Chest 2011; 139(6):1294-1298.

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