CHEST Guidelines-Critical-Care-Echocardiography

Critical-Care-Echocardiography_chest

Pdf Summary

The letters to the editor address two distinct studies published in the journal "Chest." The first concerns the relationship between restrictive spirometry patterns (RSP) and arterial stiffness. Drs. I-Hsuan Wu and Jin-Shang Wu respond to Drs. Andreas and Reinhardt, clarifying that while their study found associations between reduced lung function and increased arterial stiffness potentially via systemic inflammation, causality cannot be concluded from their cross-sectional study. They agree that systemic inflammation and sympathetic activation may link RSP with arterial stiffness, but more research is needed.<br /><br />The second set of correspondences regards a study on advanced transesophageal echocardiography (TEE) conducted by pulmonary and critical care fellows. Drs. Paul A. Bergl, Jayshil J. Patel, and Rahul S. Nanchal express concerns about the study's lack of formal inclusion criteria, the potential influence of local culture, and the fellows’ desire to practice potentially skewing the assessment of TEE's true clinical utility. They highlight the importance of critical thinking skills alongside technological proficiency in medical training. In response, the original study authors explain that their simple criterion for performing TEE was based on inadequate transthoracic echocardiography (TTE) views to address clinical questions. They acknowledge limitations like the single-reviewer setup and the lack of direct evidence linking TEE management changes to improved patient outcomes, emphasizing the need for more extensive studies to fill these gaps.

Keywords

restrictive spirometry patterns

arterial stiffness

systemic inflammation

transesophageal echocardiography

critical care fellows

medical training

transthoracic echocardiography

clinical utility

cross-sectional study

causality