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1948. "Right" or Wrong Diagnosis? The Importance of Transesophageal Echocardiography to Assess the Etiology of Hypotension After Left Ventricular Assist Device Implantation.
作者: Karen H Katrivesis.;Jennifer Elia.;Diana Glovaci.;Dawn Lombardo.;Fabio Sagebin.;Sara Nikravan.;Kei Togashi.
来源: Chest. 2022年161卷2期e121-e125页 1950. ARDS With Pneumothorax in a Young Adult.
作者: Jonah Rubin.;Michelle L Chiu.;Mari Mino-Kenudson.;Amita Sharma.;Alison S Witkin.;Peter P Moschovis.;Yehuda Vogel.;Kenneth Shelton.;Jerome Crowley.;Yuval Raz.
来源: Chest. 2022年161卷2期e111-e116页
A 19-year-old, previously healthy man presented with 3 days of cough, high-grade fevers (40 °C), and dyspnea. Apart from a resolved history of seizures not requiring medications, he had no medical or surgical history. He had no known drug allergies. He took montelukast for allergies and trimethoprim-sulfamethoxazole (TMP-SMX) for 2 weeks before admission for acne, but no other medications, including over-the-counter medications and supplements. He had animal exposures to a new puppy and a friend's bird. He had no history of smoking, vaping, or recreational drug use. His paternal grandmother had rheumatoid arthritis.
1951. Recurrent Massive Hemothorax of Unknown Etiology in an 85-Year-Old Man.
作者: Yuki Okamatsu.;Kazuya Tsubouchi.;Takeshi Iwasaki.;Tomoya Nakamura.;Tadayuki Nakashima.;Kousei Nakatsuru.;Yuriko Takahata.;Taishi Harada.
来源: Chest. 2022年161卷2期e103-e110页
An 85-year-old Japanese man, who was taking aspirin and edoxaban for previous myocardial infarction and atrial fibrillation, came to our hospital with a chief complaint of dyspnea for 3 weeks. Chest radiography showed a massive left pleural effusion (Fig 1A). Analysis of pleural fluid showed an elevated hematocrit level at 32.8% (blood hematocrit level, 32.0%), and he was diagnosed with hemothorax. However, he had neither coagulation disorder nor thrombocytopenia, and the pleural effusion was negative for atypical cells. These findings suggested that the antithrombotic and anticoagulant medications might have induced the hemothorax.
1952. Correction to text in: Optimal NIV Medicare Access Promotion: Patients With OSA; A Technical Expert Panel Report From the American College of Chest Physicians, the American Association for Respiratory Care, the American Academy of Sleep Medicine, and the American Thoracic Society.
来源: Chest. 2022年161卷2期592页
1955. The Last Beat: Contemporary Ethical Controversies Surrounding Determination of Cardiopulmonary Death.
Part one of this series tracked the evolution of the death examination, noting its stability over the last century despite changing diagnostic and therapeutic technologies and social contexts. In part two, we discuss the practical and ethical debates surrounding the exact timing of death. Although the irreversible cessation of cardiopulmonary systems remains the most common criteria used for the determination of death, identification of the moment of irreversibility is imprecise. In most cases, this imprecision is not problematic, but, when the cessation of circulation is used to identify the time of organ procurement for transplantation, it becomes critical. The phenomenon of autoresuscitation highlights these issues because patients who meet all the criteria for circulatory death (sometimes for periods of observation well beyond the norm) apparently return to life. Were these patients resurrected (like Lazarus) or did we simply not wait long enough?
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