In March of 2020, Brigham and Women’s Hospital purchased four additional extracorporeal membrane oxygenation (ECMO) machines to prepare for a possible surge of COVID-19. It wasn’t yet clear if ECMO could support critically ill COVID-19 patients, but early reports from China had shown promise.
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.
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
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
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
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.
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.
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.
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.
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.