CHEST Guidelines-Lung-Fissures-Detection-With-Transthoracic-Ultraso

Lung-Fissures-Detection-With-Transthoracic-Ultraso

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The communication addresses the clinical practice guidelines related to sleep medicine and cardiovascular issues associated with obstructive sleep apnea (OSA) and acute coronary syndrome (ACS). The authors stress the significance of additional research into the effects of OSA-related preconditioning on ACS, due to limited literature available. Despite associations between sleep-disordered breathing and increased cardiovascular risk, outcomes in ACS patients with and without sleep-disordered breathing do not differ notably.<br /><br />Polysomnography is recommended for diagnosing OSA, but respiratory polygraphy is also viable. The study considered opioid use for ACS pain relief, noting their short half-life, and conducted sleep studies well after most opioids would metabolize. The authors reviewed patient charts to assess symptom onset relative to revascularization, highlighting the difficulty in obtaining accurate times due to vague patient reports and atypical symptoms like pain absence in diabetic patients.<br /><br />The initial analysis aimed to explore the relationship between OSA and peak troponin levels, with potential confounders analyzed and found statistically insignificant. The selection of patients was based on the Continuous Positive Airway Pressure (CPAP) in ACS and OSA study design limitations, which are acknowledged.<br /><br />Separately, the text criticizes a study on lung fissure detection using transthoracic ultrasound, focusing on methodological flaws related to ultrasound's acoustic impedance and artifacts. The response clarifies their study’s aim to estimate the detectable percentage of lung fissures via ultrasound in healthy individuals, noting the absence of artifacts in intraoperative ultrasound may relate to angle and parenchyma deflation effects.<br /><br />Overall, the writings emphasize the complexity of diagnosing and analyzing sleep-related and cardiac conditions, highlighting methodological considerations and the need for refined research approaches.

Keywords

sleep medicine

obstructive sleep apnea

acute coronary syndrome

polysomnography

respiratory polygraphy

opioid use

peak troponin levels

Continuous Positive Airway Pressure

transthoracic ultrasound

lung fissure detection