Diagnostic Criteria for Idiopathic Pulmonary Fibrosis (IPF)

In 2000, IPF was defined as a specific form of chronic, progressive, fibrosing interstitial pneumonia of unknown cause, occurring primarily in older adults and limited to the lungs. Usual interstitial pneumonia (UIP) is the histopathological pattern of IPF. IPF is characterized by progressive worsening of dyspnea and lung function and is associated with a poor prognosis. Continue reading

Diagnosis of Obstructive Sleep Apnea (OSA) in Adults and Children

Obstructive sleep apnea syndrome (OSAS) is defined as repeated episodes of obstructive apneas and hypopneas during sleep, frequently followed by transient hemoglobin desaturation (hypoxemia) and unconscious (EEG) arousals.

Continue reading

Indications and Contraindications for Tube Thoracostomy

Indications for chest drain insertion

  • Pneumothorax
    • in any ventilated patient
    • tension pneumothorax after initial needle relief
    • persistent or recurrent pneumothorax after simple aspiration
    • large secondary spontaneous pneumothorax in patients over 50 years Continue reading

Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis

Wells Clinical Prediction Rule for Pulmonary Embolism (PE) Continue reading

Diagnosis, Clinical Characteristics, and Treatment of Sarcoidosis

Diagnosis

  • Diagnosis of sarcoidosis is firm when chest radiographic evidence is accompanied by compatible clinical features and noncaseating granulomas on biopsy, with all other causes of granulomas ruled out.
  • Biopsy is indicated for all patients presumed to have sarcoidosis, except those with Löfgren’s syndrome.

Continue reading

Criteria for Chronic Respiratory Failure in Infants and Children

Criteria for Chronic Respiratory Failure due to Cardiopulmonary Disorders in Infants and Children

Clinical criteria

  • Decreased inspiratory breath sounds
  • Increased retractions, use of accessory muscles
  • Cyanosis breathing room air
  • Decreased level of normal activity/function
  • Poor weight gain (mass) (IMPORTANT)

Continue reading

CURB-65 and CRB-65 Severity Scores for Community-Acquired Pneumonia (CAP)

CURB and CRB-65 scores can be used in the hospital and out-patients setting to assess pneumonia severity and the risk of death.

Continue reading

Tumor, Node, Metastasis International Staging System for Lung Cancer

The Tumor, Node, Metastasis (TNM) staging system for lung cancer is an internationally accepted system used to characterize the extent of disease. The TNM system combines features of the tumor into disease stage groups that correlate with survival and are linked to recommendations for treatment.

Continue reading

Diagnostic Criteria for the Hepatopulmonary Syndrome (HPS)

The hepatopulmonary syndrome is characterized as the triad of liver disease, pulmonary gas exchange abnormalities leading to arterial deoxygenation and evidence of intrapulmonary vascular dilatations.

Continue reading

ATS/ERS Criteria for Diagnosis of Idiopathic Pulmonary Fibrosis (IPF) in Absence of Surgical Lung Biopsy

Major Criteria

  1. Exclusion of other known causes of ILD such as certain drug toxicities, environmental exposures, and connective tissue diseases

  2. Abnormal pulmonary function studies that include evidence of restriction (reduced VC, often with an increased FEV1/FVC ratio) and impaired gas exchange [increased P(A–a)O2, decreased PaO2 with rest or exercise or decreased DLCO]

  3. Bibasilar reticular abnormalities with minimal ground glass opacities on HRCT scans

  4. Transbronchial lung biopsy or BAL showing no features to support an alternative diagnosis

    Continue reading