Lungs of Deceased COVID-19 Patients Show Vascular Damage

Illustration of lungs with covid in them

SARS-CoV-2 and influenza A (H1N1) are in the same category of virus and both infect the respiratory tract. However, research has shown distinctive vascular changes in the lungs of patients with COVID-19 compared to those with H1N1.

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Proning Awake COVID-19 Patients in Early Stages of ARDS

Prone ventilation is well-established as an essential treatment for mechanically ventilated patients with moderate to severe acute respiratory distress syndrome (ARDS). Since the start of the COVID-19 pandemic, clinicians at Brigham and Women’s Hospital have been investigating the impact of proning awake individuals with ARDS before intubation.

Anthony Francis Massaro, MD, director of the Brigham’s Medical Intensive Care Unit, said that early initiation of prone ventilation in mechanically ventilated ARDS patients enhances oxygenation via several mechanisms. Read More

Preventing Two Potentially Fatal Complications of COVID-19

A decision by Brigham and Women’s Hospital in the early days of the COVID-19 pandemic is helping patients hospitalized with the virus avoid two potentially fatal complications: deep vein thrombosis (DVT) and pulmonary embolism (PE). The Brigham’s protocol to give all hospitalized patients a prophylactic anticoagulant dose of low-molecular-weight heparin (LMWH) addresses blood clot risk factors that are particularly acute in patients with COVID-19. Read More

Finding the Right Time for Tracheotomy in COVID-19 Patients

Dr. Matthew Rochefort and Dr. Anthony Coppolino performing a bedside percutaneous tracheostomy in a COVID positive patient.Dr. Matthew Rochefort and Dr. Anthony Coppolino prepared to perform a bedside percutaneous tracheostomy in a COVID+ patient.

How does one determine when to employ tracheotomy in COVID-19 patients requiring prolonged mechanical ventilation? It’s difficult to say given what relatively little we know about the disease at this point. Stephanie L. Nitzschke, MD, an acute care surgeon, trauma surgeon and surgical intensivist, is one of the clinicians developing guidelines on tracheotomy timing at Brigham and Women’s Hospital.

Dr. Nitzschke said that in order to balance the safety of patients and health care workers, the Brigham is delaying consideration of tracheotomy until 21 days after a positive test for COVID-19. But she stressed that all protocols related to this disease are subject to change. Read More

Early Disease Detection in Relatives of Patients With Pulmonary Fibrosis

lung scan

A soon-to-be published study reports a high prevalence of interstitial lung abnormalities (ILA) and undiagnosed interstitial lung disease (ILD) among first-degree relatives of patients with familial pulmonary fibrosis (FPF) and sporadic idiopathic pulmonary fibrosis (IPF). Results suggest screening might be warranted for undiagnosed relatives to facilitate early detection of PF.

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Bringing Screening—and a Brighter Outlook—to More Lung Cancer Patients

The landmark National Lung Screening Trial found that in high-risk individuals, low-dose CT (LDCT) screening reduced lung cancer mortality by 20 percent relative to chest X-ray. Nine years after those results were published, lung cancer remains by far the leading cause of cancer-related death. And yet, screening for this dangerous disease is lagging.
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Leading the Way in Applying Minimally Invasive Techniques in Thoracic Surgery

For years, general thoracic surgery was largely associated with open procedures such as thoracotomy, sternotomy and laparotomy. Minimally invasive techniques have steadily gained traction since the early 1990s, particularly for smaller procedures like wedge resection and pleural biopsy.

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Reevaluating Treatment Guidelines for Surgically Resected, N1-Positive Stage II NSCLC

doctor looking at imaging in computer

Stage II non-small cell lung cancer (NSCLC) represents less than 10 percent of the approximately 234,000 cases of lung cancer diagnosed each year in the United States. Due to its relatively low incidence, not many papers have been published on stage II NSCLC. Furthermore, few clinicians have extensive experience treating it.

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Using ECMO as a Bridging Strategy to Lung Transplant

working ecmo machine in intensive care department, closeup oxygenator

The Lung Center at Brigham and Women’s Hospital hosts the largest, and one of only two, lung transplant programs in New England. Through its use of extracorporeal membrane oxygenation (ECMO), the center is improving the outlook for patients with end-stage lung disease who otherwise would be considered too sick for transplant.

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A Multidisciplinary Approach to Controlling Severe Asthma

Senior woman on medical exam

About 24.7 million Americans live with asthma, according to the Centers for Disease Control and Prevention. Patients with severe asthma comprise 10 to 15 percent of this figure, said pulmonologist Elliot Israel, MD, co-director of the Severe Asthma Program at Brigham and Women’s Hospital. And yet, he added, caring for this segment of asthma patients accounts for over half the cost of asthma care.

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