Manual of clinical ProblEMS in PulMonary MEdicinE Seventh Edition Manual of clinical ProblEMS in PulMonary MEdicinE Seventh Edition Editors Timothy a. Morris, MD, FCCP Professor of Medicine and Clinical Service Chief, Division of Pulmonary and Critical Care Medicine, University of California, San Diego School of Medicine, La Jolla, California; Medical Director of Respiratory Care and Pulmonary Function Laboratory, University of California, San Diego Medical Center, San Diego, California andrew l. ries, Md, MPH Associate Vice Chancellor for Academic Affairs, Professor of Medicine and Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California; Director of Pulmonary Rehabilitation, University of California, San Diego Medical Center, San Diego, California richard a. bordow, Md Associate Director, Pulmonary Function Laboratory, Doctors’ Hospital, San Pablo, California Executive Editor: Rebecca Gaertner Senior Product Development Editor: Kristina Oberle Production Project Manager: Bridgett Dougherty Senior Manufacturing Manager: Beth Welsh Design Coordinator: Holly McLaughlin Compositor: S4Carlisle Publishing Services © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins 2001 Market Street Philadelphia, PA 19103 USA LWW.com 6th edition, © 2005 by Lippincott Williams & Wilkins 5th edition, © 2000 by Lippincott Williams & Wilkins 4th edition, © 1996 by Churchill Livingstone 3rd edition, © 1991 by Little Brown & Co. 2nd edition, © 1985 by Little Brown & Co. 1st edition, © 1980 by Time Warner Books All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form or by any means, including photocopy, recording, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copy- right. The views expressed in such chapters are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. Printed in China Library of Congress Cataloging-in-Publication Data Manual of clinical problems in pulmonary medicine / editors, Timothy A. Morris, Andrew L. Ries, Richard A. Bordow. — Seventh edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4511-1658-8 (alk. paper) I. Morris, Timothy A., editor of compilation. II. Ries, Andrew L., editor of compilation. III. Bordow, Richard A., editor of compilation. [DNLM: 1. Lung Diseases—Handbooks. WF 39] RC756 616.2'4—dc23 2013050544 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional respon- sibility of the practitioner. The authors and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publica- tion. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. 10 9 8 7 6 5 4 3 2 1 To Prudy Who remains optimistic, cheerful, and courageous in the midst of life’s adversity. You are loved more than you will ever know. (TM) To Vivian and the ucSd Pulmonary family We could not have done this without you. (AR) To liz Who has encouraged, supported, and sustained me for the last forty years and seven editions. It has been a truly wonderful journey! (RB) And To Kenneth Moser (i.e., KM) A gifted physician and teacher. He was the common thread among the three of us as well as the inspiration for creating and perpetuating this manual. contributing authors Dennis E. Amundson, DO David M. Burns, MD Staff Physician Professor Emeritus Scripps Clinic Family and Preventive Medicine Encinitas, California UCSD School of Medicine San Diego, California William R. Auger, MD Professor of Clinical Medicine J. Jonas Carmichael, MD Pulmonary and Critical Care Fellow Medicine Department of Pulmonary/Critical Care Medicine University of California, San Diego Naval Medical Center San Diego San Diego, California San Diego, California Frank D. Bender, MD Antonino Catanzaro, MD Staff Physician Professor of Medicine Escondido Pulmonary Pulmonary and Critical Care Medicine Medicine Group University of California, San Diego Escondido, California San Diego, California Jonathan L. Benumof, MD Henri G. Colt, MD Professor of Anesthesia Professor of Medicine Department of Anesthesiology Pulmonary & Critical Care UCSD School of Medicine University of California, Irvine San Diego, California Orange, California Douglas J. Conrad, MD Robert Bercovitch, MD Professor of Medicine Staff Physician Pulmonary and Critical Care Medicine Yale–New Haven Hospital University of California, San Diego New Haven, Connecticut San Diego, California Timothy D. Bigby, MD Director, UCSD Adult Cystic Fibrosis Professor of Medicine Clinic Pulmonary & Critical Department of Medicine Care Medicine UCSD Medical Center University of California, San Diego La Jolla, California La Jolla, California Laura E. Crotty Alexander, MD Section Chief, Pulmonary and Critical Care Assistant Professor of Medicine Medicine Service Pulmonary and Critical Care Medicine VA San Diego Healthcare System University of California, San Diego San Diego, California San Diego, California Jennifer Blanchard, MD Konrad L. Davis, MD Assistant Professor Staff Physician Department of Medicine Pulmonary Department University of California, San Diego Naval Medical Center San Diego San Diego, California San Diego, California Richard A. Bordow, MD David J. De La Zerda, MD Associate Director Fellow Pulmonary Function Laboratory Division of Pulmonary and Critical Care Doctors’ Hospital Medicine San Pablo, California University of California, San Diego San Diego, California Shari A. Brazinsky, MD Staff Physician Asha Devereaux, MD, MPH Alvarado Hospital Medical Pulmonary Medicine Center Sharp-Coronado Hospital San Diego, California Coronado, California v i Contributing Authors v i i Jeffrey R. Dichter, MD Patricia W. Finn, MD Medical Director Professor and Head, Department of Medicine Unity Hospital Intensive Care University of Illinois College of Medicine at Chicago Allina Health Chicago, Illinois Minneapolis, Minnesota Amy L. Firth, PhD David Wayne Dockweiler, MD Research Scientist Medical Director, Surgical Services Salk Institute Staff Physician Laboratory of Genetics Scripps Memorial Hospital, La Jolla La Jolla, California La Jolla, California Richard Ford, BS, RRT, FAARC Administrative Director Richard D. Drucker, MD Respiratory Care Department Staff Physician University of California, San Diego Health System Kaiser Permanente San Diego, California Woodland Hills, California Michael J. Freudiger, PharmD Wael ElMaraachli, MD Clinical Pharmacist Assistant Professor of Medicine Saint Agnes Medical Center Pulmonary and Critical Care Medicine Fresno, California University of California, San Diego San Diego, California Mark M. Fuster, MD Assistant Professor of Medicine Mary Elmasri, MD Pulmonary and Critical Care Medicine Fellow University of California, San Diego Pulmonary and Critical Care Medicine Staff Physician University of California, San Diego Pulmonary & Critical Care Section San Diego, California VA San Diego Healthcare System Steven J. Escobar, MD, FCCP, FACP San Diego, California Assistant Professor Eugene M. Golts, MD Internal Medicine Assistant Clinical Professor of Surgery Uniformed Services University Department of Surgery of the Health Sciences Division of Cardiothoracic Surgery Bethesda, Maryland University of California, San Diego Head San Diego, California Pulmonary Medicine Naval Medical Center Ian R. Grover, MD San Diego, California Associate Clinical Professor of Medicine Emergency Medicine Garner G. Faulkner, RRT Medical Director Manager Hyperabaric Medicine Center Respiratory Care Department University of California, San Diego University of California, San Diego Medical Center Health System San Diego, California San Diego, California Tony S. Han, MD Peter F. Fedullo, MD Staff Physician Clinical Professor of Medicine Department of Pulmonary/Critical Pulmonary and Critical Care Medicine Care Medicine University of California, San Diego Naval Medical Center San Diego San Diego, California San Diego, California Timothy M. Fernandes, MD Carl K. Hoh, MD Associate Physician Professor of Radiology Pulmonary and Critical Care Medicine Division Chief, Nuclear Medicine University of California, San Diego University of California, San Diego San Diego, California San Diego, California v i i i Contributing Authors William G. Hughson, MD, DPhil David H. Kupferberg, MD, MPH Clinical Professor of Medicine Staff Physician Director, Center for Occupational & Pulmonary & Critical Care Division Environmental Medicine Physician Lead, Health Connect Optimization, University of California, San Diego San Diego San Diego, California San Diego Medical Center–Zion Southern California Permanente Medical Group Tristan J. Huie, MD San Diego, California Instructor Medicine Judd W. Landsberg, MD University of Colorado, Denver Assistant Professor of Medicine Aurora, Colorado Pulmonary and Critical Care Medicine Instructor University of California, San Diego Medicine San Diego, California National Jewish Health Staff Physician Denver, Colorado Pulmonary & Critical Care Section VA San Diego Healthcare System Shazia M. Jamil, MD, FCCP, FAASM San Diego, California Assistant Clinical Professor Department of Medicine Deneen A. LeBlanc, RRT, NPS, AE-C University of California, San Diego School Practice Manager of Medicine Mercy Health Physician Partners Southeast Attending Physician Kentwood, Michigan Pulmonary and Critical Care Medicine Stephen H. Lee, MD Scripps Clinic, Scripps Green Hospital Staff Physician La Jolla, California Sharp Rees-Stealy Medical Group Lindsay G. Jensen, BA San Diego, California Research Fellow Andrew D. Lerner, MD Department of Radiation Oncology Fellow Moores Cancer Center Pulmonary and Critical Care Medicine University of California, San Diego University of California, San Diego La Jolla, California San Diego, California Kim M. Kerr, MD Clinical Professor of Medicine Julian P. Lichter, MD, FCCP Director, Medical Intensive Care Associate Clinical Professor Unit–Thornton Department of Medicine Pulmonary and Critical Care Medicine University of California, San Diego University of California, San Diego Director of ICU and Respiratory San Diego, California Department of Medicine Scripps Mercy Hospital Erik B. Kistler, MD, PhD San Diego, California Assistant Professor of Anesthesiology Department of Anesthesiology & Thuy K. Lin, MD Critical Care Staff Physician University of California, San Diego, & VA Department of Pulmonary/Critical Care Medicine San Diego Healthcare System Naval Medical Center San Diego San Diego, California San Diego, California Andrew Kitcher, MD Philip A. LoBue, MD Fellow Associate Director for Science Pulmonary and Critical Care Medicine Division of Tuberculosis Elimination University of California, San Diego Centers for Disease Control and Prevention San Diego, California Atlanta, Georgia Contributing Authors i x José S. Loredo, MD, MS, MPH Timothy A. Morris, MD, FCCP Professor of Clinical Medicine Professor of Medicine and Clinical Service Chief Pulmonary and Critical Care Medicine Division of Pulmonary and Critical Care Medicine University of California, San Diego University of California, San Diego School of San Diego, California Medicine La Jolla, California Bao Q. Luu, MD Medical Director of Respiratory Care and Staff Physician P ulmonary Function Laboratory Scripps Clinic University of California, San Diego Medical Center San Diego, California San Diego, California Marisa Magaña, MD Dominic A. Munafo Jr., MD Assistant Clinical Professor Assistant Clinical Professor Pulmonary and Critical Care Medicine Internal Medicine University of California, San Diego University of California San Diego, California Medical Director Sleep Data, Inc. Samir S. Makani, MD San Diego, California Associate Clinical Professor Pulmonary and Critical Care Medicine Jennifer M. Namba, PharmD, BCPS University of California, San Diego Assistant Professor of Clinical Pharmacy San Diego, California Skaggs School of Pharmacy San Diego, California Jess Mandel, MD Associate Professor of Medicine John Scott Parrish, MD Pulmonary and Critical Care Medicine Associate Fellowship Program Director University of California, San Diego Department of Pulmonary/Critical San Diego, California Care Medicine Naval Medical Center San Diego Gregory Matwiyoff, MD San Diego, California Fellowship Program Director Department of Pulmonary/Critical Care Medicine David Poch, MD Naval Medical Center San Diego Assistant Clinical Professor San Diego, California Pulmonary and Critical Care Medicine University of California, San Diego Russell J. Miller, MD San Diego, California Fellow Department of Pulmonary/Critical Care Medicine Bruce M. Potenza, MD, FACS Naval Medical Center San Diego Clinical Professor San Diego, California Department of Surgery UCSD School of Medicine Omar H. Mohamedaly, MD San Diego, California Fellow Pulmonary and Critical Care Medicine Frank L. Powell, PhD University of California, San Diego Professor of Medicine and Chief San Diego, California Division of Physiology University of California, San Diego Philippe R. Montgrain, MD La Jolla, California Assistant Professor Pulmonary and Critical Care Medicine Jennifer M. Radin, MPH University of California, San Diego Graduate Student Staff Physician University of California, San Diego/San Diego Medicine Service State University Joint Doctoral Program in VA San Diego Healthcare System P ublic Health (Epidemiology) San Diego, California San Diego, California x Contributing Authors Charles A. Read, MD Kathleen Sarmiento, MD, MPH Professor of Medicine and Surgery Assistant Professor Division of Pulmonary, Critical Care, Pulmonary and Critical Care Medicine and Sleep Medicine University of California, San Diego Vice Chairman, Inpatient Medicine Staff Physician Director, Adult Critical Care Medicine Service Director, Pulmonary Fellowship Program VA San Diego Healthcare System Georgetown University Medical Center San Diego, California Washington, D.C. Gregory B. Seymann, MD, SFHM Justin C. Reis, MD Clinical Professor of Medicine Pulmonary Fellow Division of Hospital Medicine Department of Pulmonary/Critical UCSD School of Medicine Care Medicine San Diego, California Naval Medical Center San Diego Kevin D. Shaw, MD San Diego, California Assistant Clinical Professor Andrew L. Ries, MD, MPH Pulmonary and Critical Care Medicine Associate Vice Chancellor for Academic Affairs University of California, San Diego Professor of Medicine and Family and Preventive San Diego, California Medicine Cecilia M. Smith, DO, FACP, FCCP University of California, San Diego School of Clinical Professor of Medicine Medicine Department of Medicine La Jolla, California Jefferson Medical College Director of Pulmonary Rehabilitation Philadelphia, Pennsylvania University of California, San Diego Medical Center Chair San Diego, California Department of Medicine David R. Riker, MD The Reading Hospital and Director, Interventional Pulmonology/Critical Care Medical Center San Diego Interventional Procedures & Complex West Reading, Pennsylvania Airway Center Robert M. Smith, MD San Diego, California Professor of Medicine William L. Ring, MD Pulmonary and Critical Care Medicine Pulmonary and Critical Care Medicine University of California, San Diego Scripps Clinic Torrey Pines Associate Chief of Staff for Research and Co-Director, Intensive Care Unit Development Pulmonary and Critical Care Medicine Chief of Staff/Medical Director, VA San Diego Green Hospital of Scripps Clinic Healthcare Systems La Jolla, California San Diego, California Omar Saeed, MD Maida V. Soghikian, MD Staff Physician Staff Physician Department of Pulmonary/Critical Pulmonary and Critical Care Medicine Care Medicine Scripps Clinic Torrey Pines Naval Medical Center San Diego Co-director of Respiratory Care San Diego, California Scripps Green Hospital Co-chair, Scripps Health Respiratory and Critical Ajay P. Sandhu, MD, DMRT Care Co-management Group Clinical Professor La Jolla, California Department of Radiation Oncology University of California, San Diego Xavier Soler, MD, PhD Medical Director Assistant Professor of Clinical Medicine Department of Radiation Oncology Department of Medicine Moores Cancer Center University of California, San Diego La Jolla, California San Diego, California