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451. Sudden Right Lower Limb Paralysis: An Uncommon Presentation of Type A Aortic Dissection.
Acute aortic dissection is a rare and life-threatening emergency, with fatal outcomes often resulting from delayed or missed diagnoses. Type A aortic dissection, which typically presents with acute chest pain radiating to the back, is the most common cause of death associated with aortic lesions and requires urgent surgical intervention. We present an unusual case of type A aortic dissection that manifested solely with sudden paralysis and tingling of the right lower limb, without chest or back pain. Despite timely diagnosis in the emergency department, emergency surgical intervention failed to save the patient's life.
458. Low-Tidal-Volume Ventilation and Mortality in Patients With Acute Brain Injury: A Secondary Analysis of an International Observational Study.
作者: Julian F Daza.;Doulia M Hamad.;Martin Urner.;Kuan Liu.;Sarah Wahlster.;Chiara Robba.;Robert D Stevens.;Victoria A McCredie.;Raphael Cinotti.;Shaurya Taran.; .; .; .; .; .; .
来源: Chest. 2025年168卷5期1141-1151页
Low-tidal-volume ventilation (LTVV) improves outcomes in critically ill patients, but its impact in patients with acute brain injuries (ABIs) is less certain.
459. The Influence of Hospital Policies on Clinicians' Decisions to Withhold or Withdraw Life-Sustaining Treatment.
作者: Gina M Piscitello.;Edlyn Lopez Wolwowicz.;Michael T Huber.;Kelly C Vranas.;Donald R Sullivan.;Katrina E Hauschildt.;Patrick G Lyons.
来源: Chest. 2025年168卷6期1446-1458页
There is considerable variation in clinicians' approaches to decisions to withhold or withdraw life-sustaining treatment (LST) across US hospitals. These differences are not explained by patient preferences alone and are likely influenced by other factors (eg, hospital policies, hospital culture, state laws, medical society guidelines).
460. The Impact of the Unknown: Patient Experiences With Uncertainty in Sarcoidosis.
作者: Kristen R Mathias.;Michelle N Eakin.;Katrina E Hauschildt.;Edward S Chen.;Nisha A Gilotra.;Nancy W Lin.;Catherine A Bonham.;Michelle Sharp.
来源: Chest. 2025年168卷6期1395-1403页
Individuals with sarcoidosis face many sources of illness uncertainty, including diagnostic delays, unpredictable therapeutic efficacy and toxicity, and disease-associated morbidity and mortality. Patient perspectives on illness uncertainty in sarcoidosis have not been evaluated critically and offer an opportunity for providers to contextualize and prioritize gaps in care and patient support.
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