Publications by authors named "K M Van Nostrand"
Background And Objective: Diagnosis of pathology in the mediastinum has proven quite challenging, given the wide variability of both benign and malignant diseases that affect a diverse array of structures. This complexity has led to the development of many different non-invasive and invasive diagnostic modalities. Historically, diagnosis of the mediastinum has relied on different imaging modalities such as chest X-ray, computed tomography (CT), magnetic resonance imaging, and positron emission topography.
View Article and Find Full Text PDFBackground: CT-to-body divergence-described as the difference between preprocedural CT scans and intraprocedural lung architecture-is a significant barrier to improving diagnostic yield during navigational bronchoscopy. A major proposed contributor to CT-to-body divergence is the development of atelectasis, which can confound visualization of peripheral lung lesions via radial probe endobronchial ultrasound (RP-EBUS). High positive end-expiratory pressure (PEEP) ventilatory strategies have been used to decrease atelectasis, allowing the lesion to re-APPEAR on intraprocedure imaging.
View Article and Find Full Text PDFArticle Synopsis
- Current medical guidelines recommend specific procedural volumes for interventional pulmonology fellows to gain competency in electromagnetic navigational bronchoscopy (ENB), emphasizing the importance of structured training.
- A multicenter study involving 26 fellows showed that the median number of ENB procedures required to reach competency is 4, but it can range from 2 to 15, indicating substantial variability.
- The study identified six periprocedural complications, mostly occurring before fellows achieved competency, and highlighted the value of virtual assessments for determining competency, although further research is needed.
Objective: For the diagnosis of COVID-19, the yield of nasopharyngeal (NP) swabs is unclear, and bronchoalveolar lavage (BAL) is obtained to confirm the diagnosis. We assessed the utilisation of bronchoscopy for COVID-19 diagnosis in a multicenter study and compared the diagnostic yield of BAL versus NP swabs.
Methods: This retrospective study included all patients who were admitted with clinical presentation concerning for COVID-19 and underwent BAL from 1 March to 31 July 2020 at four tertiary care centres in North America.
Objective: The aim of this study was to assess the outcomes of tracheostomy in patients with COVID-19 respiratory failure.
Summary Background Data: Tracheostomy has an essential role in managing COVID-19 patients with respiratory failure who require prolonged mechanical ventilation. However, limited data are available on how tracheostomy affects COVID-19 outcomes, and uncertainty surrounding risk of infectious transmission has led to divergent recommendations and practices.