3541. Clinical Outcomes According to ECG Presentations in Infarct-Related Cardiogenic Shock in the Culprit Lesion Only PCI vs Multivessel PCI in Cardiogenic Shock Trial.
作者: Michel Zeitouni.;Ibrahim Akin.;Steffen Desch.;Olivier Barthélémy.;Delphine Brugier.;Jean-Philippe Collet.;Suzanne de Waha-Thiele.;John P Greenwood.;Paul Guedeney.;Georges Hage.;Marie Hauguel-Moreau.;Kurt Huber.;Mathieu Kerneis.;Marko Noc.;Keith G Oldroyd.;Jan J Piek.;Stéphanie Rouanet.;Stefano Savonitto.;Pranas Serpytis.;Johanne Silvain.;Janina Stepinska.;Eric Vicaut.;Christiaan J M Vrints.;Stephan Windecker.;Uwe Zeymer.;Holger Thiele.;Gilles Montalescot.; .
来源: Chest. 2021年159卷4期1415-1425页
The impact of ECG presentations of acute myocardial infarction (AMI) in cardiogenic shock is unknown.
3542. Interrelationships Among Small Airways Dysfunction, Neutrophilic Inflammation, and Exacerbation Frequency in COPD.
作者: Kerry Day.;Kristoffer Ostridge.;Joy Conway.;Doriana Cellura.;Alastair Watson.;Cosma Mirella Spalluto.;Karl J Staples.;Bruce Thompson.;Tom Wilkinson.
来源: Chest. 2021年159卷4期1391-1399页
Small airways disease (SAD) is a key component of COPD and is a main contributing factor to lung function decline.
3543. Providing Outpatient Telehealth Services in the United States: Before and During Coronavirus Disease 2019.
Before coronavirus disease 2019 (COVID-19), telehealth evaluation and management (E/M) services were not widely used in the United States and often were restricted to rural areas or locations with poor access to care. Most Medicare beneficiaries could not receive telehealth services in their homes. In response to the COVID-19 pandemic, Medicare, Medicaid, and commercial insurers relaxed restrictions on both coverage and reimbursement of telehealth services. These changes, together with the need for social distancing, transformed the delivery of outpatient E/M services through an increase in telehealth use. In some cases, the transition from in-person outpatient care to telehealth occurred overnight. Billing and claim submission for telehealth services is complicated; has changed over the course of the pandemic; and varies with each insurance carrier, making telehealth adoption burdensome. Despite these challenges, telehealth is beneficial for health-care providers and patients. Without additional legislation at the federal and state levels, it is likely that telehealth use will continue to decline after the COVID-19 public health emergency.
3544. Incidence and Impact of Swimming-Induced Pulmonary Edema on Navy SEAL Candidates.
作者: Charles Volk.;Jeffrey Spiro.;Gilbert Boswell.;Peter Lindholm.;Julia Schwartz.;Zenus Wilson.;Sara Burger.;Michael Tripp.
来源: Chest. 2021年159卷5期1934-1941页
Respiratory complications such as swimming-induced pulmonary edema (SIPE) are a common feature of United States Navy Special Warfare (NSW) training.
3545. Frequency, Risk Factors, Clinical Characteristics, and Outcomes of Spontaneous Pneumothorax in Patients With Coronavirus Disease 2019: A Case-Control, Emergency Medicine-Based Multicenter Study.
作者: Òscar Miró.;Pere Llorens.;Sònia Jiménez.;Pascual Piñera.;Guillermo Burillo-Putze.;Alfonso Martín.;Francisco Javier Martín-Sánchez.;Eric Jorge García-Lamberetchs.;Javier Jacob.;Aitor Alquézar-Arbé.;Josep Maria Mòdol.;María Pilar López-Díez.;Josep Maria Guardiola.;Carlos Cardozo.;Francisco Javier Lucas Imbernón.;Alfons Aguirre Tejedo.;Ángel García García.;Martín Ruiz Grinspan.;Ferran Llopis Roca.;Juan González Del Castillo.; .
来源: Chest. 2021年159卷3期1241-1255页
Recent reports of patients with coronavirus disease 2019 (COVID-19) developing pneumothorax correspond mainly to case reports describing mechanically ventilated patients. The real incidence, clinical characteristics, and outcome of spontaneous pneumothorax (SP) as a form of COVID-19 presentation remain to be defined.
3546. How Can I Survive This?: Coping During Coronavirus Disease 2019 Pandemic.
Worldwide, health-care professionals are experiencing unprecedented stress related to the coronavirus disease 2019 pandemic. Responding to a new virus for which there is no effective treatment yet and no vaccine is beyond challenging. Moral distress, which is experienced when clinicians are unable to act in the way that they believe they should, is often experienced when they are dealing with end-of-life care issues and insufficient resources. Both factors have been widespread during this pandemic, particularly when patients are dying alone and there is a lack of personal protection equipment that plagues many overburdened health-care systems. We explore here, guided by evidence, the concept and features of moral distress and individual resilience. Mitigation strategies involve individual and institutional responsibilities; the importance of solidarity, peer support, psychological first aid, and gratitude are highlighted.
3547. A Cluster Analysis of Bronchiectasis Patients Based on the Airway Immune Profile.
作者: Lídia Perea.;Elisabet Cantó.;Guillermo Suarez-Cuartin.;Stefano Aliberti.;James D Chalmers.;Oriol Sibila.;Silvia Vidal.
来源: Chest. 2021年159卷5期1758-1767页
Clinical heterogeneity in bronchiectasis remains a challenge for improving the appropriate targeting of therapies and patient management. Antimicrobial peptides (AMPs) have been linked to disease severity and phenotype.
3548. Incidence of VTE and Bleeding Among Hospitalized Patients With Coronavirus Disease 2019: A Systematic Review and Meta-analysis.
作者: David Jiménez.;Aldara García-Sanchez.;Parth Rali.;Alfonso Muriel.;Behnood Bikdeli.;Pedro Ruiz-Artacho.;Raphael Le Mao.;Carmen Rodríguez.;Beverley J Hunt.;Manuel Monreal.
来源: Chest. 2021年159卷3期1182-1196页
Individual studies have reported widely variable rates for VTE and bleeding among hospitalized patients with coronavirus disease 2019 (COVID-19).
3549. Normative Cardiopulmonary Exercise Test Responses at the Ventilatory Threshold in Canadian Adults 40 to 80 Years of Age.
作者: Hayley Lewthwaite.;Omar Elsewify.;Frank Niro.;Jean Bourbeau.;Jordan A Guenette.;François Maltais.;Darcy D Marciniuk.;Denis E O'Donnell.;Benjamin M Smith.;Michael K Stickland.;Wan C Tan.;Dennis Jensen.; .; .
来源: Chest. 2021年159卷5期1922-1933页
Physiologic and symptom responses at the ventilatory threshold (Tvent) during incremental cardiopulmonary exercise testing (CPET) can provide important prognostic information.
3550. Added Diagnostic Utility of Clinical Metagenomics for the Diagnosis of Pneumonia in Immunocompromised Adults.
作者: Marwan M Azar.;Robert Schlaberg.;Maricar F Malinis.;Santos Bermejo.;Toni Schwarz.;Heng Xie.;Charles S Dela Cruz.
来源: Chest. 2021年159卷4期1356-1371页
In the evaluation of community-acquired pneumonia, 30% to 60% of cases remain undiagnosed, despite extensive conventional microbiologic testing (CMT). Clinical metagenomics (CM) is an unbiased pathogen detection method that can increase diagnostic yield.
3551. Lower Respiratory Tract Myeloid Cells Harbor SARS-Cov-2 and Display an Inflammatory Phenotype.
作者: William G Bain.;Hernán F Peñaloza.;Mark S Ladinsky.;Rick van der Geest.;Mara Sullivan.;Mark Ross.;Georgios D Kitsios.;Barbara A Methé.;Bryan J McVerry.;Alison Morris.;Alan M Watson.;Simon C Watkins.;Claudette M St Croix.;Donna B Stolz.;Pamela J Bjorkman.;Janet S Lee.
来源: Chest. 2021年159卷3期963-966页 3552. Low Tidal Volume Mechanical Ventilation Against No Ventilation During Cardiopulmonary Bypass in Heart Surgery (MECANO): A Randomized Controlled Trial.
作者: Lee S Nguyen.;Philippe Estagnasie.;Messaouda Merzoug.;Alain Brusset.;Jean-Dominique Law Koune.;Stephane Aubert.;Thierry Waldmann.;Cecile Naudin.;Jean-Michel Grinda.;Hadrien Gibert.;Pierre Squara.
来源: Chest. 2021年159卷5期1843-1853页
Postoperative pulmonary complications are common after cardiac surgery and have been related to lung collapse during cardiopulmonary bypass (CPB). No consensus exists regarding the effects of maintaining mechanical ventilation during CPB to decrease these complications.
3554. Sex and Survival After Surgery for Lung Cancer: A Swedish Nationwide Cohort.
Prior reports on a possible female survival advantage in both surgical and nonsurgical cohorts of patients with lung cancer are conflicting. Previously reported differences in survival after lung cancer surgery could be the result of insufficient control for disparities in risk factor profiles in men and women.
3555. Risk Factors for and Time to Recurrence of Symptomatic Malignant Pleural Effusion in Patients With Metastatic Non-Small Cell Lung Cancer with EGFR or ALK Mutations.
作者: Audra J Schwalk.;David E Ost.;Sahara N Saltijeral.;Henriette De La Garza.;Roberto F Casal.;Carlos A Jimenez.;Georgie A Eapen.;Jeff Lewis.;Waree Rinsurongkawong.;Vadeerat Rinsurongkawong.;Jack Lee.;Yasir Elamin.;Jianjun Zhang.;Jack A Roth.;Stephen Swisher.;John V Heymach.;Horiana B Grosu.
来源: Chest. 2021年159卷3期1256-1264页
The main goal of management in patients with non-small cell lung cancer (NSCLC) and malignant pleural effusion (MPE) is palliation. Patients with MPE and actionable mutations, because their disease is expected to respond quickly and markedly to targeted therapy, are less likely than those without actionable mutations to receive definitive MPE management. Whether such management is indicated in these patients is unclear.
3556. Assessing Patients for Air Travel.
Advising patients before air travel is a frequently overlooked, but important, role of the physician, particularly primary care providers and pulmonary specialists. Although physiologic changes occur in all individuals during air travel, those with underlying pulmonary disease are at increased risk of serious complications and require a specific approach to risk stratification. We discuss the available tools for assessment of preflight risk and strategies to minimize potential harm. We also present a case discussion to illustrate our approach to assessing patients for air travel and discuss the specific conditions that should prompt a more thorough preflight workup.
3557. Sepsis, the Administration of IV Fluids, and Respiratory Failure: A Retrospective Analysis-SAIFR Study.
作者: Nikhil Jagan.;Lee E Morrow.;Ryan W Walters.;Robert W Plambeck.;Tej M Patel.;Karson F Kalian.;Jeffrey C Macaraeg.;Emily D Dyer.;Adam A Bergh.;Aaron J Fried.;Douglas R Moore.;Mark A Malesker.
来源: Chest. 2021年159卷4期1437-1444页
Although resuscitation with IV fluids is the cornerstone of sepsis management, consensus regarding their association with improvement in clinical outcomes is lacking.
3558. Excellent Prognosis of Patients With Invasive Lung Adenocarcinomas During Surgery Misdiagnosed as Atypical Adenomatous Hyperplasia, Adenocarcinoma In Situ, or Minimally Invasive Adenocarcinoma by Frozen Section.
作者: Yang Zhang.;Chaoqiang Deng.;Fangqiu Fu.;Zelin Ma.;Zhexu Wen.;Xiangyi Ma.;Shengping Wang.;Yuan Li.;Haiquan Chen.
来源: Chest. 2021年159卷3期1265-1272页
Our previous study revealed that intraoperative frozen section (FS) analysis could differentiate invasive lung adenocarcinoma (LUAD) accurately from preinvasive lesions. However, few articles have analyzed the clinical impact of FS errors such as underestimation of invasive adenocarcinomas (IACs), and whether complementary therapy is needed remains controversial.
3559. Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS: The PROTECTION Pilot Randomized Clinical Trial.
作者: Tommaso Mauri.;Giuseppe Foti.;Carla Fornari.;Giacomo Grasselli.;Riccardo Pinciroli.;Federica Lovisari.;Daniela Tubiolo.;Carlo Alberto Volta.;Savino Spadaro.;Roberto Rona.;Egle Rondelli.;Paolo Navalesi.;Eugenio Garofalo.;Rihard Knafelj.;Vojka Gorjup.;Riccardo Colombo.;Andrea Cortegiani.;Jian-Xin Zhou.;Rocco D'Andrea.;Italo Calamai.;Ánxela Vidal González.;Oriol Roca.;Domenico Luca Grieco.;Tomas Jovaisa.;Dimitrios Bampalis.;Tobias Becher.;Denise Battaglini.;Huiqing Ge.;Mariana Luz.;Jean-Michel Constantin.;Marco Ranieri.;Claude Guerin.;Jordi Mancebo.;Paolo Pelosi.;Roberto Fumagalli.;Laurent Brochard.;Antonio Pesenti.; .
来源: Chest. 2021年159卷4期1426-1436页
Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant.
3560. Restarting Respiratory Clinical Research in the Era of the Coronavirus Disease 2019 Pandemic.
作者: Jennifer L Taylor-Cousar.;Lisa Maier.;Gregory P Downey.;Michael E Wechsler.
来源: Chest. 2021年159卷3期1173-1181页
The clinical research we do to improve our understanding of disease and to develop new therapies has temporarily been delayed as the global health-care enterprise has focused its attention on those impacted by coronavirus disease 2019 (COVID-19). Although rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are decreasing in many areas, many locations continue to have a high prevalence of infection. Nonetheless, research must continue and institutions are considering approaches to restarting non-COVID-related clinical investigation. Those restarting respiratory research must navigate the added planning challenges that take into account outcome measures that require aerosol-generating procedures. Such procedures potentially increase risk of transmission of SARS-CoV-2 to research staff, use limited personal protective equipment, and require conduct in negative-pressure rooms. One must also be prepared to address the potential for COVID-19 resurgence. With research subject and staff safety and maintenance of clinical trial data integrity as the guiding principles, here we review key considerations and suggest a step-wise approach for resuming respiratory clinical research.
|