Liberation from mechanical ventilation
Common misconceptions and mistakes • Labeling a patient as “failure to wean” because of a rapid shallow breathing pattern (ie, increased rapid shallow breathing index [RSBI]) during spontaneous breathing trial…
RESPIRATORY
Noninvasive ventilatory support with bilevel positive pressure ventilation
Common misconceptions and mistakes • Believing that somnolence makes a trial of bilevel positive pressure ventilation (BiPAP) unsafe • Believing that any hemoptysis, regardless of the volume or context, makes…
Diffuse parenchymal lung disease and its mimics
Common misconceptions and mistakes • Bronchoscopy with transbronchial biopsies are usually indicated and helpful in the evaluation of diffuse parenchymal lung disease • Video-assisted thoracoscopic surgery (VATS) lung biopsy is…
Lung cancer
Common misconceptions and mistakes • Believing that IV contrast is required to screen for pathologic mediastinal adenopathy • Being reassured about a lesion that has demonstrated growth over time because…
Acute venous thromboembolic disease
Common misconceptions and mistakes • Believing that the target of heparin is the already embolized clot (preventing its extension in the pulmonary vasculature) • Missing the most common abnormal chest…
Oral anaerobic lung infection, aspiration pneumonia, lung abscess, and empyema
Common misconceptions and mistakes • Using the term “aspiration” without clearly defining the clinical aspiration syndrome you are concerned with • Believing that aspiration pneumonia is solely a disease of…
Invasive mechanical ventilation
Common misconceptions and mistakes • Believing that patients with acute respiratory distress syndrome (ARDS) require advanced modes of mechanical ventilation (eg, airway pressure release ventilation [APRV]) • Changing the ventilator…
Sarcoidosis
Common misconceptions and mistakes • The stages of sarcoid reflect disease progression (stage 1, early disease; stage 4, late disease) • Pulmonary sarcoidosis is a steroid-responsive disease • Believing that…
Pneumothorax and bronchopleural fistulas: air in the pleural space
Common misconceptions and mistakes • The proper way to screen for a pneumothorax (PTX) is by looking for areas on the chest x-ray (CXR) that do not have lung markings…
