New research presented at CHEST 2011, the 77th annual meeting of the American College of Chest Physicians, from October 22-26 in Honolulu addressed many important topics in pulmonary, critical care, and sleep medicine. The features below highlight just some of the studies that emerged from the meeting.

» Pain Common for Pulmonologists Performing Bronchoscopy
» Guideline Effects on CRBSI 
» An Effective Computer Model for Smoking Cessation 

Pain Common for Pulmonologists Performing Bronchoscopy

The Particulars: Much attention has been paid to ergonomics and overuse injury in gastroenterology and surgery settings. However, little attention has been paid on other medical specialties, such as bronchoscopy.

Data Breakdown: Researchers in New York gave an online questionnaire to 132 pulmonologists to assess pain and injury while performing bronchoscopy. Nearly 40% reported experiencing pain while operating a bronchoscope. Among this group, 22% reported recurring pain, which mostly occurred in the shoulder, back, wrist, neck, and thumb. This pain appeared to be associated with overuse and height less than 5’7″. Only 38% of pulmonologists who felt pain attempted to modify their workspace.

Take Home Pearl: Interventions may be needed to prevent musculoskeletal injuries among pulmonologists who perform bronchoscopies.

Guideline Effects on CRBSI [back to top]

The Particulars: The Institute of Health Improvement Bundle was created in 2006 as a guideline to help hospitals reduce catheter-related bloodstream infection (CRBSI) rates. Whether this goal has been achieved remains uncertain.

Data Breakdown: An investigation from researchers in Tampa retrospectively reviewed 895 patient charts for people admitted to two hospitals who required a central venous catheter (CVC) between 2007, when the guidelines were first released, and 2010. The rate of CRBSIs decreased from 4.38 per 1,000 CVC line days in 2007 to 0.32 infections per 1,000 CVC line days in 2010.

Take Home Pearl: Implementing evidence-based practice guidelines in the care of patients requiring CVCs appears to reduce CRBSI rates, particularly when components of guidelines are bundled and executed simultaneously.

An Effective Computer Model for Smoking Cessation [back to top]

The Particulars: Researchers at Clemson and the University of North Carolina, Chapel Hill recently developed a computer-aided model to evaluate the cost-effectiveness of several smoking cessation treatments.

Data Breakdown: The model showed an 87% tendency to relapse at 1 year for patients who received nicotine replacement therapy. These individuals also had a 93% chance to relapse at 30 years. For patients receiving other therapies, such as bupropion and varenicline, 78% were still smoking at 1 year, and 89% still smoked at 30 years. Most patients who quit smoking unassisted tended to return to prior behaviors at 1 year and 30 years (95% and 98%, respectively).

Take Home Pearl: Smoking cessation treatments appear to increase the probability that patients will quit smoking.