Pulm PEEPS

“Plug” in! This prospective cohort study counted COPD patients’ mucus plugs on CTs and tracked exacerbations (AECOPD) over 2 years. Each mucus plug had an 8.3% increased risk of exacerbation, and a HR of 5.02 for >4 mucus plugs vs 0 mucus plugs. doi:10.1016/j.chest.2025.03.026

Difference between PA and AP chest radiograph 🫁
Cr. #shubham_arora

#radiology
#chestrad

@pulmpeeps.bsky.social
@nkagetsu.bsky.social

Lung cancer on CT 🫁
Cr. #Shubham_arora

#chestrad
#radiology

@laurengroner.bsky.social
@pulmpeeps.bsky.social
@gbama11.medsky.social

I have been amazed by the work of the Center for Humanizing the ICU. The center focuses on supporting patients and families with a sense of normalcy and compassion in the most abnormal and difficult times.

This Giving Tuesday consider donating!

tinyurl.com/jztcy97d

Frontal CXR lines and stripes 🫁
Cr. #Shubham_arora

#radiology
#chestrad

@pulmpeeps.bsky.social
@zahrashokrivarniab.bsky.social
@jordanchamberlinmd.bsky.social

📢 Calling all #MedEd interested Clinical Problems @atsearlycareer.bsky.social members!
Apply for the #ATS2026 Teaching Competition 🧑‍🏫
Submit an 8 minute presentation 📽️ teaching a CP topic of your choice! 🫁
Details and application: site.thoracic.org/membership/a...
Applications due February 2026

#Chestrad - lymphangitic carcinomatosis 🫁

For more information: radiopaedia.org/articles/lym...

#radiology
#thoracicthursday

@laurengroner.bsky.social
@gbama11.medsky.social
@pulmpeeps.bsky.social

New Pulm PEEPS Pearls episode out today about the use of methylene blue in septic shock!

Listen here: www.pulmpeeps.com/2025/11/25/1...

Episode from CHEST 2025 around an interesting case of bronchiectasis is out now! Listen in for many pearls including discussion of differential of bronchiectasis by location 👇

www.pulmpeeps.com/2025/11/11/1...

Types of emphysema 🫁
Cr. #devrad

#radiology
#chestrad

@gbama11.medsky.social
@drmonikaradike.bsky.social
@pulmpeeps.bsky.social

🗣️ new episode out today!

A patient is following with you for progressive dyspnea and cough and recurrent pneumonias. Here is there CT progression 👇

Listen to our episode today that was a live presentation at CHEST 2025 to work through the case!

#pulm
#pccm

www.pulmpeeps.com/2025/11/11/1...

New episode out today wrapping up our asthma guidelines series!

www.pulmpeeps.com/2025/10/28/1...

Infographics below 👇

Stay tuned for our next guidelines series about Pulmonary Hypertension!

#pulm
#pulmcrit
#meded

#Thoracicthursday: Amiodarone toxicity 🫁

For more information: radiopaedia.org/articles/ami...

#radiology
#chestrad

@pulmpeeps.bsky.social
@gbama11.medsky.social
@ctisus.bsky.social
@laurengroner.bsky.social

New episode out today!! We're back with BMJ Thorax to review high yield articles about bronchiectasis. We'll discuss new and emerging treatment options, and cohort studies on etiologies and quality of life. Listen wherever you get your podcasts or at www.pulmpeeps.com

Patterns of nodularity on CT from our most recent Fellows' Case Files from KUMC

www.pulmpeeps.com/2025/10/01/1...

Apple: podcasts.apple.com/us/podcast/f...

Spotify: open.spotify.com/episode/75Dx...

Amazon:
music.amazon.com/podcasts/913...

A 21-year-old woman who had presented to the pulmonary clinic with a 7-day history of sore throat and cough was noted to have a vertebral abnormality on chest radiograph. 1/2

#MedSky #PulmSky

🆕 Collaboration with RheumNow 🔵
*3-Part Series on Interstitial Lung Disease*

Part 3️⃣: Treatment of #ILD
💊 Medication Options for Rx of ILD
🫁 How to Treat Different ILD Subtypes
🚶🏻‍♀️Holistic Approach to Management ❌🚬

#RheumSky #PulmSky #IPF #Rheum #InterstitialLungDisease

Friendly reminder:

During an intra-arrest #POCUS, the finding of RV dilation alone is generally insufficient to conclude the presence of a pulmonary embolism & justify the administration of thrombolytics. After a few min of CPR, RV tends to dilate due to

#ARDS in pts with malignancies? Experience high mortality, irrespective of #ECMO. Nuanced ICU goals-of-care discussions needed, as caution when considering
#ECLS: general recommendations may not apply to this population
#FOAMcc @intenscaremed.bsky.social @schellongowski.bsky.social
🔓 rdcu.be/eI44I

Today's Paper of the Day is:

Management of Refractory Anaphylaxis: An Overview of Current Guidelines.

https://criticalcarereviews.com/latest-evidence/paper-of-the-day

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

A man in his 60s seeks the ED for chest pain starting a couple of hours before. ECG with lateral ST depression (almost painfree at this point). After #POCUS images the interventionalist agreed to take him. 100% LCX occlusion. Patient wins. #EMIMCC

This systematic review included 65 studies & 17,008 patients with #sepsis. The occurence rate of each one of the three #echocardiographic phenotypes, namely left ventricular systolic dysfunction (LVSD), LV diastolic dysfunction (LVDD), & RV dysfunction (RVD) peaked at 48h:

Some infographics applicable to yesterday's episode here. Listen in for some more pearls!

www.pulmpeeps.com/2025/10/01/1...

This was an unusual case, and thinking about tuberculosis first is the right diagnostic approach. However, this case does illustrate:
1) Not all miliary patterns are TB

2) The importance of maintaining a high index of suspicion, and confirming diagnoses

The patient was only getting worse after starting empiric TB treatment. A bronchoscopy with EBUS biopsy was pursued to get cultures, resistance pattern, and diagnostic clarity.

This showed metastatic pulmonary adenocarcinoma.

He was started on chemo with dramatic response 👇

Thanks for everyone who filled out our polls yesterday! The majority of you thought this was tuberculosis, and agree that the miliary pattern, young age, origin from a TB endemic area, and presence of CNS lesions all fits. BUT.....

For a reminder here was the original CT 👇

Listen to our latest episode to hear more about working through this differential, the ultimate diagnosis, and some clinical pearls along the way

www.pulmpeeps.com/2025/10/01/1...

@pulmcrit.bsky.social @pulmtoilet.bsky.social @atscommunity.bsky.social @lancetrespirmed.bsky.social

And some other imaging to help with your diagnostics.

What is on your differential for this patient?? What next steps are you taking?

🚨🔊 New episode out today! Case files at KUMC!

A 26 year old non-smoking man who immigrated from India and now lives in the mid-west US presents with a generalized tonic-clonic seizure in the setting of 6 months of cough and dyspnea. Here is the initial CT

#Pulmonary
#CriticalCare
#MedicalEducation

Use of Phenobarbital for Treating Alcohol Withdrawal This quality improvement study evaluates the implementation, clinical outcomes, and safety of an electronic health record order set for intravenous weight-based phenobarbital loading for treating alco...

New study supporting phenobarb monotherapy for EtOH withdrawal😍

We’ve been seeing more pts with *combined* withdrawal lately (eg opioid + EtOH)

IMHO phenobarb is esp useful in complex withdrawal to tx EtOH w/d, avoid delirium, and avoid excessive GABA #EMIMCC

#1/2

jamanetwork.com/journals/jam...