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.
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.
Adding to the care options for patients with advanced emphysema, the Lung Center at Brigham and Women’s Hospital now offers a new procedure to place one-way endobronchial valves into the airways of a diseased lobe. The valves offer the symptom relief of lung reduction without the risks of surgery.
Edwin Silverman, MD, PhD, is a pioneer in studying how genetics impact COPD risk. His team, which includes leading researchers such as Craig Hersh, MD, MPH; Dawn DeMeo, MD, MPH; Michael Cho, MD, MPH; Peter Castaldi, MD; and Xiaobo Zhou, PhD, generated findings that could have profound implications for the future of COPD treatment.