CHEST Guidelines-Pleural-Manometry--Response

Pleural-Manometry--Response_chest

Pdf Summary

The document is a series of correspondence and article reactions published in medical journals by various professionals in pulmonary medicine. The first part of the document is a response to a letter from Drs Khosla and Kistler, discussing the role of pleural manometry during thoracentesis. Drs Fabien Maldonado and John J. Mullon from the Mayo Clinic address concerns related to pleural manometry, acknowledging its potential but emphasizing the lack of definitive data supporting its routine use. They advocate for outcomes-based research and stress that widespread adoption should be supported by strong evidence. Manometry is used by a minority for specific suspicions like unexpandable lung but is not mandated for all procedures. The response notes the importance of training, competency, and ultrasonography in reducing procedural risks such as iatrogenic pneumothorax.<br /><br />The second part is a letter from Dr. Jan Poelaert, related to a review on ventilator-associated pneumonia prevention (VAP), commenting on endotracheal tubes. Dr. Poelaert clarifies the difference in outcomes when using a barrel-shaped, rather than tapered-shaped, endotracheal tube, discussing how these differences were not stated correctly in an earlier review. This distinction could influence VAP prevention strategies, particularly concerning the cuff material and design.<br /><br />Both responses stress the importance of evidence-based practice in clinical decisions and underline the significance of detailed reporting in studies to ensure accurate representation and application of research findings in clinical settings. The document highlights ongoing discussions and clarifications around current practices and the need for further studies in specific medical procedures.

Keywords

pleural manometry

thoracentesis

pulmonary medicine

unexpandable lung

iatrogenic pneumothorax

ventilator-associated pneumonia

endotracheal tubes

evidence-based practice

clinical decisions

medical procedures