We are excited to start the month off with a new #RadiologyRounds 🫁 A young adult man in his 20s presents with dyspnea on exertion, productive cough, intermittent wheezing and general fatigue. A chest x-ray was obtained as part of his work-up.

You can identify hyperinflation, interstitial changes and bronchial wall thickening on this image with concern for associated bronchiectasis

You should have Sarcoidosis, Cystic Fibrosis (CF), Hypersensitivity Pneumonitis (HP) and Lymphangioleiomyomatosis (LAM) on the differential

A CT chest is obtained given his abnormal chest x-ray and representative images are shown below

Given upper lobe bronchiectasis you are concerned for cystic fibrosis. A sweat chloride test is obtained and was elevated suggesting CF and further genetic testing was sent to confirm the diagnosis.

🔑 points from Fatimah Alkhunaizi, @nikolhaustweets, S Brusca, & David Furfaro’s ⭐️⭐️⭐️⭐️⭐️ #journal_CHESTCritCare Review on ❤️⚡️ chestcc.org/article/S2949-… Thanks, as always, Brooke Barlow of Ashley & Brooke Barlow PharmD fame for the 🏆 infographic:

Time for another #RadiologyRounds! This case is brought to you by our Associate Editor nick pulmcrit ! A 55 year old man presents to the hospital with progressive dyspnea and a chronic cough. Here is his initial CXR. How would you describe it (let us know in the comments!!)

Further history and exam is taken 🩺 *⃣ Progressive dyspnea, especially with exertion *⃣ Has received courses of steroids and antibiotics in the past *⃣ Breeds pigeons *⃣ Tachypneic on exam, scattered rales, and rare faint wheeze

A high resolution, thin cut, CT w/out contrast insp exp and prone and supine is performed. Here are some key images Remember to apply Pulm PEEPs' LAMBS approach to reading CTs with diffuse parenchymal findings 🐏 Lobes Area Morphology Bronchial abnormalities Septal abnormalities

The CT scan shows an example of Triple Density Sign (formerly Headcheese Sign). This finding of areas of normal lung, high attenuation GGOs, and lucent regions of air trapping scattered throughout the lung is a specific, but not sensitive sign for fibrotic HP

📢🗣️🚨 In honor of July Pulm PEEPs is embarking on an ARDS literature journey! Throughout the summer we will release Rapid Fire Journal Club Luke Padgett Hedrick, MD episodes on landmark ARDS trials. These are key reading for all critical care providers! Tune in! First episode tomorrow!

Positive end-expiratory pressure management in patients with severe ARDS: implications of prone positioning and ECMO CCR Journal Watch criticalcarereviews.com/latest-evidenc… Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/su…

Today, in the penultimate episode in our RFJC Summer Series on ARDS we are discussing the DEXA-ARDS trial examining the impact of dexamethasone on mortality and duration of MV in patients with ARDS. You can listen now! pulmpeeps.com/2024/08/27/83-… 👇 key points

Great work @MdSonnick and Luke Benvenuto on this paper examining the secondary pulmonary hypertension designation in patients awaiting lung transplant. sciencedirect.com/science/articl… Take away: secondary PH is not a useful designation for lung allocation

#CHEST2024 is just around the corner!! This week we sat down with Gabriel Bosslet and Sandy Khurana the conference chairs, and Huzaifah to talk about all the amazing features (old and new!). Listen today to plan your conference and see you all soon! pulmpeeps.com/2024/09/27/86-…

Humbled to meet one of my fav podcasts hosts 😍 at #CHEST2024 Pulm PEEPs David Furfaro Kristina Montemayor #CHESTSoMe CHEST

Really enjoyed working on this perspective article with this crew! Check it out @FrontiersinArtificialIntelligence - "AI-assisted human clinical reasoning in the ICU: beyond "to err is human". Khalil El Gharib David Furfaro Raja-Elie Abdulnour

After a January hiatus we’re excited to be coming back next week with a first episode of a new series breaking down the most up to date guidelines in pulmonary and critical care!! Stay tuned for this coming Tuesday when we kick it off looking at the GINA guidelines for asthma!

Today's Paper of the Day is current perspectives in the management of sepsis and septic shock criticalcarereviews.com/latest-evidenc… Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

Want to learn more about right heart cathterizations?? Sign up for this fantastic post-graduate course at ATS 2025!! We'll cover wave form interpretations, swan trouble shooting, exercise RHCs, and review real cases with a panel of fantastic experts! ats2025.d365.events/directory/sess…