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Lower or Higher Oxygenation Targets in ICU patients with COVID-19 - A secondary Bayesian analysis of the HOT-COVID trial. Chest (IF 9.5) Pub Date : 2024-09-18 Frederik M Nielsen,Thomas L Klitgaard,Anders Granholm,Theis Lange,Anders Perner,Olav L Schjørring,Bodil S Rasmussen
BACKGROUND In the Handling Oxygenation Targets in COVID-19 (HOT-COVID) trial, a partial pressure of arterial oxygen (PaO2) target of 60 mmHg compared to 90 mmHg resulted in more days alive without life support at 90 days in adult ICU patients with coronavirus disease 2019 (COVID-19) and hypoxemia. The trial was stopped after enrolling 726 of 780 planned patients due to slow recruitment. Here, we present
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Risk of pulmonary diseases in osteogenesis imperfecta in Denmark - A register-based cohort study. Chest (IF 9.5) Pub Date : 2024-09-17 Jane Dahl Andersen,Marie Louise Lyster,Mette Kathrine Holst,Daniel Pilsgaard Henriksen,Anders Christensen,Christian B Laursen,Antonella Forlino,Lars Folkestad
BACKGROUND Osteogenesis Imperfecta (OI) is a rare hereditary disease mainly resulting in reduced or altered collagen type I. Collagen type I is a major constituent of the respiratory system, and normal collagen type I is vital for the pulmonary tissue function. RESEARCH QUESTIONS Does patient with OI have increased admission rates due to pulmonary diseases compared to the general population? STUDY
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Physiological Comparison of Airway Pressure Release Ventilation and Low Tidal Volume Ventilation in Acute Respiratory Distress Syndrome: A Randomized Controlled Trial. Chest (IF 9.5) Pub Date : 2024-09-17 Hongling Zhang,Yongran Wu,Ruiting Li,Xuehui Gao,Azhen Wang,Xin Zhao,Xiaobo Yang,Huaqing Shu,Hong Qi,Zhaohui Fu,Shiying Yuan,Yilei Ma,Le Yang,Xiaojing Zou,You Shang,Zhanqi Zhao
BACKGROUND The physiological effects of different ventilation strategies on patients with acute respiratory distress syndrome (ARDS) need to be better understood. RESEARCH QUESTION In patients with ARDS under controlled mandatory ventilation, does airway pressure release ventilation (APRV) improve lung ventilation-perfusion matching and ventilation homogeneity compared to low tidal volume ventilation
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The Association between Air Pollution and Lung Function in Sarcoidosis and Implications for Health Disparities. Chest (IF 9.5) Pub Date : 2024-09-17 Ali M Mustafa,Kevin J Psoter,Kirsten Koehler,Nancy Lin,Meredith McCormack,Edward Chen,Robert A Wise,Michelle Sharp
BACKGROUND Sarcoidosis is a granulomatous disease with varying courses of disease progression. Environmental exposures are thought to be contributors to disease onset. Exposure to air pollutants such as fine particulate matter (PM2.5) and nitrogen dioxide (NO2) have been identified as contributors to health disparities in lung diseases; little is known about these environmental exposures' associations
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DIAGNOSIS AND PREVENTION OF INVASIVE FUNGAL INFECTIONS IN THE IMMUNOCOMPROMISED HOST. Chest (IF 9.5) Pub Date : 2024-09-06 Abdul Wahab,David Sanborn,Paschalis Vergidis,Raymund Razonable,Hemang Yadav,Kelly M Pennington
TOPIC IMPORTANCE The prevalence of invasive fungal infections (IFI) has risen in the past three decades, attributed to advancements in immune-modulatory therapies employed in transplantation, rheumatology, and oncology. REVIEW FINDINGS Organisms that cause IFI evade the host's natural defenses or at opportunities of immunologic weakness. Infections occur from inhalation of potentially pathogenic organisms
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How I do it. Choosing the right biologic for the right patient with severe asthma. Chest (IF 9.5) Pub Date : 2024-09-06 Simon Couillard,David J Jackson,Ian D Pavord,Michael E Wechsler
In this new instalment of the How I Do It: Severe Asthma series, we tackle the clinical conundrum of choosing the right biologic for the right patient with severe asthma. With 6 biologics now approved for use in this area comprising 4 different targeting strategies (anti-immunoglobulin E, omalizumab; anti-interleukin (IL)-5/5receptor, mepolizumab, reslizumab, and benralizumab; anti-IL-4receptor, dupilumab;
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Single Versus Double Lung Transplant in Older Adults: A Propensity-Matched Analysis. Chest (IF 9.5) Pub Date : 2024-09-05 Noah Weingarten,Atul C Mehta,Marie Budev,Usman Ahmad,James Yun,Kenneth McCurry,Haytham Elgharably
BACKGROUND Single lung transplantation (SLT) is associated with worse long-term outcomes than bilateral lung transplantation (BLT) but is often performed for older adults at risk of not tolerating BLT. RESEARCH QUESTION How do the outcomes of SLT and BLT compare among older adult recipients? STUDY DESIGN AND METHODS The Scientific Registry of Transplant Recipients database (2005-2022) was queried for
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Impact of Dyspnea on Adults With Respiratory Symptoms Without a Defined Diagnosis Chest (IF 9.5) Pub Date : 2024-09-04 Jared Bierbrier BSc, Emily Gerstein, G.A. Whitmore PhD, Katherine L. Vandemheen MScN, Celine Bergeron MD, Louis-Philippe Boulet MD, Andreanne Cote MD, Stephen K. Field MD, Erika Penz MD, R. Andrew McIvor MD, Catherine Lemière MD, Samir Gupta MD, Paul Hernandez MD, Irvin Mayers MD, Mohit Bhutani MD, M. Diane Lougheed MD, Christopher J. Licskai MD, Tanweer Azher MD, Nicole Ezer MD, Martha Ainslie MD
We investigated dyspnea, its associated risk factors, and its impact on health care utilization, quality of life, and work productivity in adults with undiagnosed respiratory symptoms.
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Post Pulmonary Embolism Phenotypes Described by Invasive Cardiopulmonary Exercise Testing. Chest (IF 9.5) Pub Date : 2024-09-03 Michael Insel,Tammer El Aini,Gregory Woodhead,Rebecca Wig,Saad Kubba,Guido Claessen,Erin Howden,Franz Rischard
BACKGROUND Post pulmonary embolism (PE) dyspnea is common. Existing non-invasive studies have demonstrated that post PE dyspnea is associated with elevations in right ventricular afterload, dead space ventilation, and deconditioning. We aimed to use invasive cardiopulmonary exercise testing (iCPET) parameters in patients with post PE dyspnea to identify unique physiologic phenotypes. RESEARCH QUESTION
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Noninvasive Arterial Pressure Measurements at the Lower Leg: Evaluation of the Influence of Patient Position (Semi-Recumbent or Horizontal). A prospective study. Chest (IF 9.5) Pub Date : 2024-09-03 Karim Lakhal,Alexia Audran,Gurvan Normand,Bertrand Rozec,Thierry Boulain,Jérôme E Dauvergne
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Performance of Risk Assessment Models for VTE in Patients Who Are Critically Ill Receiving Pharmacologic Thromboprophylaxis: A Post Hoc Analysis of the Pneumatic Compression for Preventing VTE Trial Chest (IF 9.5) Pub Date : 2024-09-02 Hasan M. Al-Dorzi MD, Hatim Arishi MBBS, Fahad M. Al-Hameed MD, Karen E.A. Burns MD, Sangeeta Mehta MD, Jesna Jose MSc, Sami J. Alsolamy MD MPH, Sheryl Ann I. Abdukahil RN, Lara Y. Afesh MSN, Mohammed S. Alshahrani MD, Yasser Mandourah MD, Ghaleb A. Almekhlafi MD, Mohammed Almaani MD, Ali Al Bshabshe MD, Simon Finfer MD, Zia Arshad MD MBBS, Imran Khalid MD, Yatin Mehta MD, Atul Gaur MD, Hassan Hawa
The diagnostic performance of the available risk assessment models for VTE in patients who are critically ill receiving pharmacologic thromboprophylaxis is unclear.
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Role of Supplemental Oxygen in Intermediate Risk Pulmonary Embolism. Chest (IF 9.5) Pub Date : 2024-09-01 Ajay Kumar Jha
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Death and the Inescapability of Value Judgments. Chest (IF 9.5) Pub Date : 2024-09-01 Christos Lazaridis,Piotr G Nowak,John P Lizza
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A 76-Year-Old-Man With Dyspnea and Abnormal Oximetry Run. Chest (IF 9.5) Pub Date : 2024-09-01 Veronica Williams,Franck F Rahaghi,Ian R Drexler,Lewjain Sakr
A 76-year-old male Vietnam veteran with a medical history of OSA on CPAP, mild COPD, Parsonage-Turner syndrome (a rare neurologic syndrome manifesting with shoulder and arm pain), hypertension, gastroesophageal reflux, hiatal hernia, and prior endocarditis presented with 1 year duration progressive exertional dyspnea with minimal activity by referral from an outside pulmonologist. The patient reported
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Syncope in an Otherwise Healthy 74-Year-Old Woman. Chest (IF 9.5) Pub Date : 2024-09-01 Zein Kattih,Mateus Fernandes,Miguel A Alvarez Villela,Stephen Machnicki,Erica Altschul
A 74-year-old woman with a history of hypertension and peripheral artery disease and a reported diagnosis of sarcoidosis presents for an episode of syncope and shortness of breath. She had a history of sarcoidosis diagnosed on chest radiography that showed lymphadenopathy. There were no associated symptoms, and she was not previously treated for sarcoidosis. She previously smoked and had quit smoking
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Chylothorax in a Young Woman With Crohn Disease. Chest (IF 9.5) Pub Date : 2024-09-01 Daniel Ryan Brophy,Jeffrey Graham,Scott K Aberegg
Chylothorax, which accounts for 1% to 3% of pleural effusions, typically results from either surgery (traumatic) or underlying malignancy (nontraumatic). Less common causes of nontraumatic chylothorax are numerous and include congenital lymphatic abnormalities, connective tissue diseases, cirrhosis, and infection, among others.1 We describe what appears to be the first reported case of chylothorax
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Behind Bars at the Bedside: Navigating the Space Between Care and Criminalization as a Trainee. Chest (IF 9.5) Pub Date : 2024-09-01 Gwenyth L Day,Matthew F Griffith,Erin S DeMartino
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"Relative Value Units" Belie Real Value. Chest (IF 9.5) Pub Date : 2024-09-01 Rana Lee Adawi Awdish,Leonard L Berry,Gabriel T Bosslet
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A 70-Year-Old Man With an Encapsulated Mediastinal Fluid Collection. Chest (IF 9.5) Pub Date : 2024-09-01 Guoqing Zhang,Jindong Li,Xiangnan Li
A 70-year-old man was diagnosed with mid-thoracic esophageal squamous cell carcinoma (distance from incisors, 27-30 cm) because of progressive dysphagia and underwent thoracic laparoscopic esophagectomy at a local hospital. He was transferred from the ICU 4 days after surgery; however, a large amount of purulent fluid exuded from the neck incision after oral drinking, which was consistent with cervical
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Comparative Subgroup Analysis in Qualitative Interview Studies: Does Sample Size Matter? Chest (IF 9.5) Pub Date : 2024-09-01 Valerie Chepp
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Peeling Back the Onion: Kidney Disease Across Clinical Sepsis Phenotypes. Chest (IF 9.5) Pub Date : 2024-09-01 Alexander H Flannery,Javier A Neyra
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Multi-Cancer and Single-Cancer Early Detection Testing: Opportunities and Challenges. Chest (IF 9.5) Pub Date : 2024-09-01 Julie A Barta,Peter J Mazzone,Viswam S Nair
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No Set Rules: Variations in Decision-Making for Venovenous Extracorporeal Membrane Oxygenation Candidacy. Chest (IF 9.5) Pub Date : 2024-09-01 Catherine L Auriemma,Jacob Gutsche
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Risk Stratification in Pulmonary Hypertension: We Need to "GoDeeper"! Chest (IF 9.5) Pub Date : 2024-09-01 Charles Fauvel,Mardi Gomberg-Maitland,Raymond L Benza
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Lung Ultrasound in the ED: Will Death Do Us Part? Chest (IF 9.5) Pub Date : 2024-09-01 Ross Prager,Julian J Owen
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Strategies for Coping With Complicated Grief in Relatives of Patients Who Are Critically Ill: An Observational Single-Center Cohort Study Chest (IF 9.5) Pub Date : 2024-09-01 Livia B. Guntern BM, Katja Erne MscPsychol, Anaïs Achermann BPsychol, Martin Müller MD, Marie-Madlen Jeitziner PhD RN, Bjoern Zante MD MME
Relatives of patients who are critically ill who die are at high risk for symptoms of complicated grief (CG) with potential individual and social burdens. The prevalence and predictors of CG, and in particular the involvement of individual facets of relatives’ coping strategies, are not well understood.
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Sarcoidosis and Emergency Hospitalization Chest (IF 9.5) Pub Date : 2024-08-28 Pierre Gazengel MD, R. Hindre MD, F. Jeny MD PhD, S. Mendes, J. Caliez MD, O. Freynet MD, C. Rotenberg MD, M. Didier MD, R. Dhote MD PhD, Y. Cohen MD PhD, Y. Uzunhan MD PhD, D. Bouvry MD, H. Nunes MD PhD
Sarcoidosis is an idiopathic systemic granulomatosis whose evolution is self-limiting in most cases. However, it can progress to organ damage that menaces the vital or functional prognosis of patients. Sarcoidosis itself, but also its comorbidities, can pose a threat to the patient, require rapid initiation of treatment, and justify emergency hospitalization.
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No Evidence of Lung Pathology in Freedivers With History of Pulmonary Barotrauma Chest (IF 9.5) Pub Date : 2024-08-28 Tyler Grey MD, Goran Dujić MD, Peter Lindholm MD PhD, Ivan Drvis PhD, Otto Barak MD PhD, Željko Dujić MD PhD, Philip N. Ainslie PhD, Alexander Patrician PhD
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Does Reframing Do-Not-Resuscitate to Beneficial Care Only Increase Acceptance of No-CPR Orders? Chest (IF 9.5) Pub Date : 2024-08-28 Julie L. Campbell JD, Gina M. Piscitello MD
The terminology of a do not resuscitate (DNR) order can be confusing and controversial for patients at the end of life. We examined whether changing the name to beneficial care only (BCO) would increase patient acceptance.
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Misclassification of Pulmonary Hypertension With Current Hemodynamic Criteria Chest (IF 9.5) Pub Date : 2024-08-27 Maya Guglin MD, Kartik Munshi MPH, Elizabeth Volz MD, Mosi Bennett MD, Terrie Ann Benjamin MD, Kunjan Bhatt MD, Arvind Bhimaraj MD, Timothy Fendler MD, Marat Fudim MD, Ashrith Guha MD, James Thomas Heywood MD, Orvar Jonsson MD, Liviu Klein MD, Patrick McCann MD, Evan Muse MD, Monique Robinson MD, Andrew Sauer MD, Hirak Shah MD, Jacob Abraham MD
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Risk Factors, Morbidity, and Mortality in Association With Preserved Ratio Impaired Spirometry and Restrictive Spirometric Pattern: Clinical Relevance of Preserved Ratio Impaired Spirometry and Restrictive Spirometric Pattern Chest (IF 9.5) Pub Date : 2024-08-27 Lucia Cestelli MD, Ane Johannessen PhD, Amund Gulsvik MD PhD, Knut Stavem MD PhD, Rune Nielsen MD PhD
Preserved ratio impaired spirometry (PRISm) and restrictive spirometric pattern (RSP) are often considered interchangeable in identifying restrictive impairment in spirometry.
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Breathlessness, Frailty, and Sarcopenia in Older Adults Chest (IF 9.5) Pub Date : 2024-08-27 Tai Joon An MD PhD, Jihye Lim MD PhD, Heayon Lee MD PhD, Sunghwan Ji MD, Hee-Won Jung MD PhD, Ji Yeon Baek MD PhD, Eunju Lee MD PhD, Il-Young Jang MD PhD
Breathlessness shares aging mechanisms with frailty and sarcopenia.
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A 24/7 Pilot Remote Emergency Multidisciplinary Discussion for Rapidly Progressive Interstitial Lung Disease: A 2-Year Experience Chest (IF 9.5) Pub Date : 2024-08-27 Pierre Bay MD, Marc Pineton de Chambrun MD PhD, Yves Allenbach MD PhD, Jérôme Le Pavec MD PhD, Clément Picard MD, Benjamin Zuber MD, Vincent Bunel MD, Baptiste Hervier MD PhD, Alain Meyer MD PhD, Makoto Miyara MD PhD, Pierre-Yves Brillet MD PhD, Samia Boussouar MD, Christelle Declercq, Yacine Tandjaoui-Lambiotte MD, Hilario Nunes MD PhD, Vincent Cottin MD PhD, Eric Hachulla MD PhD, Yurdagül Uzunhan
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Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis Chest (IF 9.5) Pub Date : 2024-08-26 Ryota Sato MD MPH, Simone Messina MD, Daisuke Hasegawa MD PhD, Cristina Santonocito MD, Giulia Scimonello MD, Giulia Sanfilippo MD, Andrea Morelli MD, Siddharth Dugar MD, Filippo Sanfilippo MD PhD
The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs. Does the use of ultra-short-acting β-blockers (esmolol
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Dual Phosphodiesterase 3 and 4 Inhibitor Ensifentrine Reduces Exacerbation Rate and Risk in Patients With Moderate-to-Severe Chronic Obstructive Pulmonary Disease. Chest (IF 9.5) Pub Date : 2024-08-26 Frank C Sciurba,Stephanie A Christenson,Tara Rheault,Thomas Bengtsson,Kathleen Rickard,Igor Z Barjaktarevic
INTRODUCTION Exacerbations in chronic obstructive pulmonary disease (COPD) can be life-threatening and lead to irreversible declines in lung function and quality of life. Medications that reduce exacerbation burden are an unmet need, as exacerbations put patients at risk for more exacerbations and decrease quality of life. Ensifentrine is a novel, first-in-class, selective, dual inhibitor of phosphodiesterase
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“My Mom Is a Fighter”: A Qualitative Analysis of the Use of Combat Metaphors in ICU Clinician Notes Chest (IF 9.5) Pub Date : 2024-08-26 Shannen Kim MD, Hunter Mills MS, Teva Brender MD, Samuel McGowan MD, Eric Widera MD, Allyson C. Chapman MD, Krista L. Harrison PhD, Sei Lee MD, Alex K. Smith MD, David Bamman PhD, Oksana Gologorskaya MS, Julien Cobert MD
A metaphor conceptualizes one, typically abstract, experience in terms of another, more concrete, experience with the goal of making it easier to understand. Although combat metaphors have been well described in some health contexts, they have not been well characterized in the setting of critical illness. How do clinicians use combat metaphors when describing critically ill patients and families in
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Upper Airway and Translaryngeal Resistance During Mechanical Insufflation-Exsufflation Chest (IF 9.5) Pub Date : 2024-08-26 Tiina M. Andersen PT PhD, Anne Kristine Brekka PT MSc, Zoe Fretheim-Kelly PT PhD, Manel Lujan MD PhD, John-Helge Heimdal MD, Hege H. Clemm MD, Thomas Halvorsen MD, Ove Fondenes MD, Roy M. Nilsen PhD, Ola D. Røksund PT PhD, Maria Vollsæter MD PhD
Mechanical insufflation-exsufflation (MI-E) uses positive and negative pressures to assist weak cough and to help clear airway secretions. Laryngeal visualization during MI-E has revealed that inappropriate upper airway responses can impede its efficacy. However, the dynamics of pressure transmission in the upper airways during MI-E are unclear, as are the relationships among anatomic structure, pressure
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Differences in Health Care and Palliative Care Use at the End of Life: A Comparison Study Among Lung Cancer, COPD, and Idiopathic Pulmonary Fibrosis Chest (IF 9.5) Pub Date : 2024-08-24 Angela O. Suen MD, Kara Bischoff MD, Anand S. Iyer MD MSPH, Keerthana Radhakrishnan MS, Cynthia Fenton MD, Jonathan P. Singer MD, Rebecca L. Sudore MD, Ashwin Kotwal MD, Erica Farrand MD
Patients with lung cancer, idiopathic pulmonary fibrosis (IPF), and COPD have high symptom burden, poor quality of life, and high health care use at the end of life. Although proactive integration of palliative care in lung cancer can improve outcomes, it is unclear whether similar practices have been adopted in COPD and IPF care. Do patients with COPD and IPF have different patterns of health care
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Incidence, risk factors and long-term outcomes for extubation failure in intensive care unit in patients with obesity A retrospective analysis of a multicenter prospective observational study. Chest (IF 9.5) Pub Date : 2024-08-23 Audrey De Jong,Mathieu Capdevila,Yassir Aarab,Matthieu Cros,Joris Pensier,Ines Lakbar,Clément Monet,Hervé Quintard,Raphael Cinotti,Karim Asehnoune,Jean-Michel Arnal,Christophe Guitton,Catherine Paugam-Burtz,Paer Abback,Armand Mekontso-Dessap,Karim Lakhal,Sigismond Lasocki,Gaetan Plantefeve,Bernard Claud,Julien Pottecher,Philippe Corne,Carole Ichai,Nicolas Molinari,Gerald Chanques,Laurent Papazian,Elie
BACKGROUND No large observational study has compared the incidence and risk factors for extubation failure within 48 hours and during intensive care unit (ICU) stay in the same cohort of unselected critically ill patients with and without obesity. RESEARCH QUESTION Which are the incidence and risk factors of extubation failure in patients with and without obesity? STUDY DESIGN AND METHODS In this prospective
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Phosphodiesterase-5 Inhibitor Treatment is Associated with Improved Survival in Pulmonary Hypertension Associated with COPD in the PVRI GoDeep Meta-Registry. Chest (IF 9.5) Pub Date : 2024-08-23 Khodr Tello,Athiththan Yogeswaran,Raphael W Majeed,David G Kiely,Allan Lawrie,Evan Brittain,Jeffrey S Annis,Horst Olschewski,Gabor Kovacs,Paul M Hassoun,Aparna Balasubramanian,Ziad Konswa,Andrew J Sweatt,Roham T Zamanian,Martin R Wilkins,Luke Howard,Alexandra Arvanitaki,George Giannakoulas,Hector R Cajigas,Robert Frantz,Paul G Williams,Marlize Frauendorf,Kurt Marquardt,Tobiah Antoine,Meike Fuenderich
BACKGROUND Patients with COPD frequently develop pulmonary hypertension (PH-COPD). Severe PH-COPD, identified by a pulmonary vascular resistance (PVR) >5 Wood Units (WU), is closely linked to impaired transplant-free survival. The impact of PH-targeting pharmacotherapy in this context remains unclear. RESEARCH QUESTION Is PH-targeted therapy associated with improved transplant-free survival in PH-COPD
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Advancing Point of Care Testing by Application of Machine Learning Techniques and Artificial Intelligence. Chest (IF 9.5) Pub Date : 2024-08-23 Craig M Lilly,Apurv V Soni,Denise Dunlap,Nathaniel Hafer,Mary Ann Picard,Bryan Buchholz,David D McManus
The promise of artificial intelligence (AI) has generated enthusiasm among patients, healthcare professionals, and technology developers who seek to leverage its potential to enhance the diagnosis and management of an increasing number of chronic and acute conditions. Point-of-care testing (POCT) increases access to care because it enables care outside of traditional medical settings. Collaboration
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Inpatient Complication Rates of Bronchoscopic Lung Volume Reduction in the United States Chest (IF 9.5) Pub Date : 2024-08-23 Francisco F. Costa Filho MD PhD, Jonh D. Buckley MD MPH, Alan Furlan MD, Samantha Campbell MD, Kirsten Hickok MSc, Philip J. Kroth MD
Early randomized controlled trials (RCTs) of bronchoscopic lung volume reduction (BLVR) have shown clinically meaningful benefits in lung function, dyspnea, and quality of life in patients with severe emphysema. Safety outcome data obtained after BLVR in the United States are scarce outside the RCTs. What is the rate of inpatient complications after BLVR in the real world in the United States? We used
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Ethnic Variation in Asthma Prevalence across Childhood in the Asian American and Pacific Islander Population. Chest (IF 9.5) Pub Date : 2024-08-22 Julia G Costantini,Joan C Lo,Jimmy Ko,Malini Chandra,Polly Huang,Jeanne A Darbinian,Anna Chen Arroyo
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Association of Cardiopulmonary Hemodynamics and Outcomes in Pulmonary Hypertension Following Kidney Transplant: A Multicenter Retrospective Cohort Study. Chest (IF 9.5) Pub Date : 2024-08-22 Arun Jose,Sathish S Kumar,Leonid Gorelik,Samuel H Friedman,Antolin S Flores,Denise Sese,Michael Vinzani,Nicholas J Douville,Akshar Patel,Rahul G Argula,Courtney Jones,Nicole M Bhave,Jean M Elwing
BACKGROUND Pulmonary Hypertension (PH) frequently complicates the evaluation of kidney transplant (KT) candidates, and is associated with increased adverse outcomes (mortality, delayed graft function (DGF), and major adverse cardiovascular events (MACE)) following KT. RESEARCH QUESTION What is the relationship between cardiopulmonary hemodynamics and post-KT outcomes? STUDY DESIGN AND METHODS We conducted
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Bronchoalveolar Lavage Fluid Cellular Analysis and Radiologic Patterns in Patients With Fibrotic Interstitial Lung Disease Chest (IF 9.5) Pub Date : 2024-08-22 Amanda Grant-Orser MBBCh, Michael Asmussen PhD, Daniel-Costin Marinescu, Cameron J. Hague MD, Nestor L. Muller MD, Darra T. Murphy MBBCh, Andrew Churg MD, Joanne L. Wright MD, Amna Al-Arnawoot MD, Ana-Maria Bilawich MD, Patrick Bourgouin MD, Gerald Cox MD, Celine Durand MD, Tracy Elliot MD, Jennifer Ellis MD, Jolene H. Fisher MD, Derek Fladeland MD, Gillian C. Goobie MD, Zachary Guenther MD, Ehsan
Bronchoalveolar lavage (BAL) cellular analysis is often recommended during the initial diagnostic evaluation of fibrotic interstitial lung disease (ILD). Despite recommendation for its use, between-center heterogeneity exists and supportive data concerning the clinical utility and correlation of BAL findings with radiologic features or patterns remain sparse. In patients with fibrotic ILD, are BAL
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The Responsiveness of Exercise Tests in COPD: A Randomized Controlled Trial Chest (IF 9.5) Pub Date : 2024-08-21 Theresa C. Harvey-Dunstan PhD, M.M. Baldwin, R. Tal-Singer PhD, M. Allinder, M.I. Polkey PhD, A. Hamilton PhD, M. Richardson PhD, S.A. Edwards BSc, M.C. Steiner MD, M.D. Morgan MD, S.J. Singh PhD, COPD/MAP Consortium
COPD is characterized by reduced exercise tolerance, and improving physical performance is an important therapeutic goal. A variety of exercise tests commonly are used to assess exercise tolerance, including laboratory and field-based tests. The responsiveness of these tests to common COPD interventions is yet to be compared, but the results may inform test selection in clinical and research settings
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Nocturnal Cardiac Arrhythmias in Heart Failure With Obstructive and Central Sleep Apnea Chest (IF 9.5) Pub Date : 2024-08-20 Christian M. Horvath MD, Christoph Fisser MD, John S. Floras MD DPhil, Samuel Sossalla MD, Stella Wang MSc, George Tomlinson PhD, Fiona Rankin BSc, Shoichiro Yatsu MD PhD, Clodagh M. Ryan MD, T. Douglas Bradley MD, Michael Arzt MD, ADVENT-HF Investigators
Both OSA and central sleep apnea (CSA) may contribute to nocturnal cardiac arrhythmias (NCAs). Data are scarce regarding the prevalence of clinically important nocturnal atrial and ventricular arrythmias in patients with heart failure with reduced ejection fraction (HFrEF) and OSA or CSA. In a cohort of patients with HFrEF, how does the prevalence of NCA compare among those with OSA, CSA, and those
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Diffuse Cystic Lung Disease: A Clinical Guide to Recognition and Management Chest (IF 9.5) Pub Date : 2024-08-19 Alessandro N. Franciosi PhD, Nishant Gupta MD, David J. Murphy MD, Kathryn A. Wikenheiser-Brokamp PhD, Cormac McCarthy PhD
Diffuse cystic lung diseases (DCLDs) represent a group of pathophysiologically heterogeneous entities that share a common radiologic phenotype of multiple thin-walled pulmonary cysts. DCLDs differ from the typical fibroinflammatory interstitial lung diseases in their epidemiology, clinical presentation, molecular pathogenesis, and therapeutic approaches, making them worthy of a distinct classification
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Quantitative Imaging Methods in Combined Pulmonary Fibrosis and Emphysema Chest (IF 9.5) Pub Date : 2024-08-16 Jennifer M. Wang MD, Tetsuro Araki MD PhD, Vincent Cottin MD PhD, MeiLan K. Han MD, Justin M. Oldham MD
Combined pulmonary fibrosis and emphysema (CPFE) is an underdiagnosed syndrome in which individuals have variable degrees of pulmonary fibrosis and emphysema. Patients with CPFE have high morbidity, including poor exercise tolerance and increased development of comorbidities. CPFE mortality also seems to outpace that of lone emphysema and pulmonary fibrosis. A major limitation to rigorous, large-scale
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Unveiling Hidden Disparities: Evaluating US Multiple Listing Practices in Lung Transplantation Chest (IF 9.5) Pub Date : 2024-08-16 Adora N. Moneme BS, Mallory Hunt MD, Jacqueline Friskey BA, Madeline McCurry BA, Dun Jin BA, Joshua M. Diamond MD MSCE, Michaela R. Anderson MD, Emily Clausen MD, Aya Saleh BA, Allie Raevsky BA, Jason D. Christie MD MSCE, Douglas Schaubel PhD, Jesse Hsu PhD, A. Russell Localio PhD, Robert Gallop PhD, Edward Cantu MD MSCE
Multiple listing (ML) is a practice used to increase the potential for transplant but is controversial due to concerns that it disproportionately benefits patients with greater access to health care resources. Is there disparity in ML practices based on social deprivation in the United States and does ML lead to quicker time to transplant? A retrospective cohort study of adult (≥ 18 years of age) lung
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Extracellular Vesicle-Encapsulated microRNAs and Respiratory Health Among American Indians in the Strong Heart Study Chest (IF 9.5) Pub Date : 2024-08-16 Christina M. Eckhardt MD, Haotian Wu PhD, Gabriela Jackson, Marisa H. Sobel, Tessa Bloomquist, Adnan Divjan, Hadler da Silva, Lyle G. Best MD, Shelley Cole PhD, Jason Umans MD PhD, Ying Zhang PhD, Peter de Hoff PhD, Louise C. Laurent MD PhD, Matthew S. Perzanowski PhD MPH, Ke Cheng PhD, Andrea A. Baccarelli MD PhD, Tiffany R. Sanchez PhD
American Indian populations have experienced marked disparities in respiratory disease burden. Extracellular vesicle-encapsulated microRNAs (EV-miRNAs) are a novel class of biomarkers that may improve recognition of lung damage in indigenous populations. Are plasma EV-miRNAs viable biomarkers of respiratory health in American Indian populations? The Strong Heart Study (SHS) is a prospective cohort
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Multiple biomarkers are equivalent to clinical pulmonary arterial hypertension survival risk models. Chest (IF 9.5) Pub Date : 2024-08-16 Megan Griffiths,Catherine E Simpson,Jun Yang,Dhananjay Vaidya,Melanie K Nies,Stephanie Brandal,Rachel Damico,Paul Hassoun,Dunbar D Ivy,Eric D Austin,Michael W Pauciulo,Katie A Lutz,Lisa J Martin,Erika B Rosenzweig,Raymond L Benza,William C Nichols,Cedric Manlhiot,Allen D Everett
BACKGROUND Risk assessment in pulmonary arterial hypertension (PAH) is fundamental to guiding treatment and improved outcomes. Clinical models are excellent at identifying high-risk patients but leave uncertainty amongst moderate risk patients. RESEARCH QUESTION Can a multiple blood biomarker model of PAH, using previously described biomarkers, improve risk discrimination over current models? STUDY
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Biomarker Testing for Guiding Precision Medicine for Patients with Non-Small Cell Lung Cancer Chest (IF 9.5) Pub Date : 2024-08-14 Adam H. Fox MD, Mariam Alexander MD PhD, Jessica A. Forcucci MD, Gerard A. Silvestri MD
The initial management of patients with lung cancer is growing more complex in the context of an expanding number of precision medicine treatments. These challenges are accompanied by opportunities to deliver more efficacious and less toxic treatments to patients. Indications for these treatments are also expanding, and patients with lung cancer across multiple stages now require biomarker testing
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Longitudinal Changes in Maximal Forced Inspiratory Flow and Clinical Outcomes in Patients With COPD Chest (IF 9.5) Pub Date : 2024-08-14 Dong Hyun Kim MD, Eun-Tae Jeon PhD, Hyo Jin Lee MD, Heemoon Park MD, Jung-Kyu Lee MD, Eun Young Heo MD, Deog Kyeom Kim MD, Hyun Woo Lee MD
COPD primarily impairs expiratory flow due to progressive airflow obstruction and reduced lung elasticity. Increasing evidence underlines the importance of inspiratory flow as a biomarker for selecting inhaler devices and providing ancillary aerodynamic information. Does the longitudinal changes in maximum forced inspiratory flow (FIFmax) influence acute exacerbations and lung function decline in patients
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Occupational Exposure to Charcoal Smoke and Dust, a Major Risk Factor for COPD: A Multiregional Cross-sectional Study in the Democratic Republic of Congo Chest (IF 9.5) Pub Date : 2024-08-13 Pierre Vuvu Olenga Lofuta MSc MPH, Malgorzata Klass PhD, Nathalie Pauwen MPH, Augustin Mboko Kipula PhD, Philippe van de Borne MD PhD, Alain van Muylem MPH PhD, Silvia Perez-Bogerd MD, Gael Deboeck PhD
Occupational exposure to charcoal smoke and dust is a threat to workers’ respiratory systems. What is the prevalence of COPD in charcoal workers as compared with farmers in rural areas of Democratic Republic of Congo (DRC)? This cross-sectional, comparative, and multisite study was performed in the charcoal-producing provinces of southwestern DRC. We randomly included charcoal workers and compared
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Identifying risk of postoperative cardiorespiratory complications in obstructive sleep apnea. Chest (IF 9.5) Pub Date : 2024-08-10 Maree Azzopardi,Richard Parsons,Gemma Cadby,Stuart King,Nigel McArdle,Bhajan Singh,David R Hillman
BACKGROUND Patients with obstructive sleep apnea (OSA) are at increased risk of postoperative cardiorespiratory complications and death. Attempts to stratify this risk have been inadequate, and predictors from large well-characterized cohort studies are needed. RESEARCH QUESTION What is the relationship between OSA severity, defined by various polysomnography-derived metrics, and risk of postoperative
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Decídetexto: Mobile Cessation Support for Latino Adults Who Smoke: A Randomized Clinical Trial Chest (IF 9.5) Pub Date : 2024-08-10 Francisco Cartujano-Barrera MD, Lisa Sanderson Cox PhD, Delwyn Catley PhD, Xueya Cai PhD, Francisco J. Diaz PhD, Evelyn Arana-Chicas DrPH, Arlette Chávez-Iñiguez MD, Chinwe Ogedegbe MD, Kristi D. Graves PhD, M. Patricia Rivera MD, Arturo Ponce, Edward F. Ellerbeck MD, Ana Paula Cupertino PhD
Latino adults experience multiple barriers to health care access and treatment that result in tobacco-related disparities. Mobile interventions have the potential to deliver smoking cessation treatment among Latino adults, the highest users of mobile technologies. Is , a culturally accommodated mobile health intervention, more effective for smoking cessation compared with standard care among Latinx
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Sexual Dysfunction in Patients With Sarcoidosis Chest (IF 9.5) Pub Date : 2024-08-10 Catharina C. Moor MD PhD, Yasmin Gur-Demirel MSc, Thomas Koudstaal MD PhD, Jelle R. Miedema MD
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Longitudinal Assessment of Communication with Patient-Reported Outcomes During Lung Cancer Screening. Chest (IF 9.5) Pub Date : 2024-08-10 Christopher G Slatore,Sara E Golden,Liana Schweiger,Ian Ilea,Donald R Sullivan,Sean P M Rice,Renda Soylemez Wiener,Santanu Datta,James M Davis,Anne C Melzer
BACKGROUND Many organizations recommend clinicians use structured communication processes, referred to as "shared decision making," to improve patient-reported outcomes for patients considering lung cancer screening (LCS). RESEARCH QUESTION Which components of high-quality patient-centered communication are associated with decision regret and distress? STUDY DESIGN AND METHODS We conducted a prospective
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Health Care Provider Practices and Perceptions of Biomarker Testing in US Veterans With Non-Small Cell Lung Cancer Chest (IF 9.5) Pub Date : 2024-08-02 Elena Vlachos DO, Adam Fox MD, John Dell’Italia PhD, Nicholas Maurice MD, Israel Rubinstein MD, Nichole T. Tanner MD MSCR