CHEST critical care最新文献

{"title":"Epidemiologic Characteristics and Management of Sepsis Among Previously Healthy Patients","authors":"Rachel K. Hechtman MD ,&nbsp;Megan E. Heath PhD ,&nbsp;Jennifer K. Horowitz MA ,&nbsp;Elizabeth McLaughlin MS, RN ,&nbsp;Patricia J. Posa RN, BSN, MSA, CCRN ,&nbsp;John Blamoun MD ,&nbsp;Paul Bozyk MD ,&nbsp;Megan Cahill DO, MBA, FACOEP ,&nbsp;Rania Esteitie MD, FCCP, ATSF ,&nbsp;Kevin Furlong DO ,&nbsp;Namita Jayaprakash MB, BcH BAO, MRCEM ,&nbsp;Jessica Jones PharmD ,&nbsp;Maximiliano Tamae-Kakazu MD ,&nbsp;Joan Nagelkirk MD ,&nbsp;Thomas Pfotenhauer DO ,&nbsp;Derek C. Angus MD, MPH, FRCP ,&nbsp;Scott A. Flanders MD ,&nbsp;Elizabeth S. Munroe MD ,&nbsp;Hallie C. Prescott MD","doi":"10.1016/j.chstcc.2025.100148","DOIUrl":"10.1016/j.chstcc.2025.100148","url":null,"abstract":"<div><h3>Background</h3><div>Most deaths resulting from sepsis occur among patients with advanced age, multiple morbidities, or frailty. It is unclear how many sepsis-related deaths truly are preventable. Previously healthy patients may provide insight into preventable sepsis mortality.</div></div><div><h3>Research Question</h3><div>What are the baseline characteristics, management, and outcomes associated with previously healthy patients with sepsis?</div></div><div><h3>Study Design and Methods</h3><div>This was a retrospective cohort of patients hospitalized for community-onset sepsis at 66 Michigan hospitals (November 2020-January 2024). We developed major and minor criteria to classify patients as previously healthy vs having significant comorbidities. We compared baseline characteristics, management, and outcomes of previously healthy patients vs patients with comorbid sepsis. Physicians reviewed charts of previously healthy patients with in-hospital death to evaluate baseline health status and rate preventability of death.</div></div><div><h3>Results</h3><div>Of 29,688 patients hospitalized for sepsis, 2,963 patients (10.0%) were classified as previously healthy. Previously healthy patients had median age of 53 years, a median of 2 minor comorbidities, and lower in-hospital mortality (5.8% vs 12.7%; <em>P</em> &lt; .01) vs comorbid patients. Delivery of guideline-recommended early sepsis management ranged from 56.8% to 80.9% across individual care practices. Several care practices were less common among previously healthy patients, including lactate measurement (67.5% vs 73.8%; <em>P</em> &lt; .01) and timely antibiotic administration (58.0% vs 66.3%; <em>P</em> &lt; .01), whereas some were more common, including ≥ 30 mL/kg fluid resuscitation (72.4% vs 55.3%; <em>P</em> &lt; .01). Among 48 charts of previously healthy decedents reviewed, 77.1% of patients were deemed to have life expectancy &gt; 5 years without sepsis. Most deaths were judged to be unpreventable because of severity of illness on presentation.</div></div><div><h3>Interpretation</h3><div>We found that 1 in 10 patients with community-onset sepsis was healthy previously. Although gaps in in-hospital management were identified, deaths among previously healthy patients generally were deemed unpreventable with better in-hospital management because of patients seeking treatment too late in the course of sepsis. This study highlights system-level opportunities for better recognition and triage of sepsis before hospitalization.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Mechanical Power Normalized to Predicted Body Weight on Outcomes in Pediatric ARDS","authors":"Herng Lee Tan MSc ,&nbsp;Rehena Sultana MSc(stat) ,&nbsp;Phuc Huu Phan MD ,&nbsp;Muralidharan Jayashree MD ,&nbsp;Hongxing Dang MD ,&nbsp;Soo Lin Chuah MBBS ,&nbsp;Chin Seng Gan MBBS ,&nbsp;Siew Wah Lee MD ,&nbsp;Karen Ka Yan Leung MBBS, MSc ,&nbsp;Ellis Kam Lun Hon MBBS, MD ,&nbsp;Xuemei Zhu MD ,&nbsp;Pei Chuen Lee MMed(Paeds) ,&nbsp;Chian Wern Tai MD ,&nbsp;Jacqueline Soo May Ong MB BChir ,&nbsp;Lijia Fan MD ,&nbsp;Kah Min Pon MD ,&nbsp;Li Huang MD ,&nbsp;Kazunori Aoki MD ,&nbsp;Hiroshi Kurosawa MD, PhD ,&nbsp;Rujipat Samransamruajkit MD ,&nbsp;Judith Ju Ming Wong MB BCh BAO","doi":"10.1016/j.chstcc.2025.100162","DOIUrl":"10.1016/j.chstcc.2025.100162","url":null,"abstract":"<div><h3>Background</h3><div>The topic of mechanical power (MP) in pediatric ARDS (PARDS) is not well explored in the current literature, limiting our understanding of its potentially detrimental effect.</div></div><div><h3>Research Question</h3><div>What is the association between MP and clinical outcomes, and does impairment in oxygenation mediate the association between MP and clinical outcomes?</div></div><div><h3>Study Design and Methods</h3><div>This post hoc causal mediation analysis of data from a before-and-after study recruited children with PARDS from 21 PICUs. We used a simplified MP calculation for pressure-controlled and volume-controlled ventilation normalized to predicted body weight. We identified low, moderate, and high MP cutoffs and used multivariable regression to determine the association between MP categories on ICU mortality, 28-day ventilator-free days (VFDs) and ICU-free days (IFDs), adjusting for the Pediatric Index of Mortality 3 score, Pediatric Logistic Organ Dysfunction 2 score, oxygenation index (OI), and age. Causal mediation analysis was performed to estimate the causal effect of MP on outcomes treating oxygenation impairment (represented by OI) as mediator and age as a confounder.</div></div><div><h3>Results</h3><div>A total of 466 patients were included for this analysis. Cutoffs for low, moderate, and high MP were &lt; 0.2262 J/min/kg, 0.2262 to 0.4487 J/min/kg, and &gt; 0.4487 J/min/kg, respectively. High vs low MP was associated with reduced VFDs (adjusted incidence rate ratio, –0.22 [95% CI, –0.35 to –0.10]; <em>P</em> &lt; .001) and IFDs (adjusted incidence rate ratio, –0.14 [95% CI, –0.27 to –0.01]; <em>P</em> = .034), but not ICU mortality. In the causal analysis, OI showed a significant indirect effect on the causal pathway of MP on VFDs (indirect effect, –4.30 [<em>P</em> &lt; .001]; direct effect, –1.17 [<em>P</em> = .635]; total effect, –5.47 [<em>P</em> = .024]) and IFDs [indirect effect, –3.13 [<em>P</em> &lt; .001]; direct effect, –0.72 [<em>P</em> = .635]; total effect, –3.84 [<em>P</em> = .024]), but not ICU mortality.</div></div><div><h3>Interpretation</h3><div>In this study, higher MP was associated with fewer VFDs and IFDs. The causal effect of MP on VFDs and IFDs was mediated fully by the impairment in oxygenation.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Delphi Consensus on Recommendations for Improving Research Processes and Infrastructure to Address Health Disparities","authors":"Amira Mohamed MD ,&nbsp;A. Adegunsoye MD, FACP, FCCP ,&nbsp;M. Armstrong-Hough MPH, PhD ,&nbsp;N. Ferguson-Myrthil PharmD, BCCCP ,&nbsp;I. Hassan MD ,&nbsp;F.B. Mayr MD, MPH ,&nbsp;T.S. Valley MD ,&nbsp;D.R. Winkfield PhD, RN, FNP-BC ,&nbsp;C.B. Walsh MD ,&nbsp;J.T. Chen MD","doi":"10.1016/j.chstcc.2025.100160","DOIUrl":"10.1016/j.chstcc.2025.100160","url":null,"abstract":"<div><h3>Background</h3><div>Racial and ethnic disparities in critical care medicine remain poorly understood, making them difficult to address. This initiative developed a thought leader consensus with recommendations for critical care research to document, assess, and understand potential disparities.</div></div><div><h3>Research Question</h3><div>What key areas should future critical care research focus on to better identify and address disparities related to race, ethnicity, and language?</div></div><div><h3>Study Design and Methods</h3><div>A modified Delphi-based method was used to form a consensus about addressing racial disparities through future critical care research. Nine thought leaders discussed aspects related to 4 topics: collection of race, ethnicity, and language variables; establishing recruitment plans for researchers from racial and ethnic minority groups; designating minority serving institutions; and health disparity education and community engagement. Consensus was reached when ≥ 80% of members agreed (answered with yes or with 4 to 5 points on a Likert scale).</div></div><div><h3>Results</h3><div>Thought leaders arrived at a consensus agreement (100%) that improved data quality, achieved by more robust recruitment of research participants from racial and ethnic minority groups and standardization of race and ethnicity data, is crucial as the initial step of uncovering health disparities. They agreed that collection of language preferences should be part of all research studies to expose potential biases and disparities in non-English speakers (100% agreement). Engagement of racial and ethnic minority communities was agreed to be essential to obtain involvement of research participants from such minoritized groups (100%).</div></div><div><h3>Interpretation</h3><div>This consensus revealed the notable data deficiency impacting health disparities within critical care research especially when compared with other settings, highlighting the crucial need for comprehensive focus on this domain. Standardization of race, ethnicity, and language data collection, with the goal of increasing the number of research participants from racial and ethnic minority groups, is vital for understanding health disparities in critical care research and its potential causes.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Lightning Strikes the Heart","authors":"Abiodun Idowu MD ,&nbsp;Indiresha R. Iyer MD","doi":"10.1016/j.chstcc.2025.100157","DOIUrl":"10.1016/j.chstcc.2025.100157","url":null,"abstract":"<div><div>Cloud-to-ground lightning strikes are the second leading cause of weather-related deaths in the United States. Lightning strike injuries are more common in summer months, especially in the southeastern and southern parts of the United States. Deaths resulting from lightning strikes are 4 times more common in male patients. The average age of death is 37 years. Two-thirds of lightning-associated deaths occur in the first hour of injury and generally are the result of cardiorespiratory arrest. Lightning injuries occur through direct strike, indirect strike, side flash, ground current, upward streamers, and blast effects. Postulated mechanisms for cardiovascular damage include electroporation, myocardial hemorrhage and necrosis, contusion, induced electric currents, catecholaminergic surge, coronary vasospasm, blast injury, and corticomedullary brain dysfunction. Clinical cardiac manifestations include asystole; ventricular and atrial arrhythmias; hypotension; ventricular dysfunction; cardiomyopathy; cardiogenic shock; dynamic ST-segment and T-wave ECG changes, including ST-segment elevation myocardial infarction pattern; pericardial effusion; tamponade; and aortic injury. Immediate, sustained, and aggressive resuscitation efforts, so-called reverse triage, and rapid transportation to hospitals, even with prolonged asystole, often lead to complete recovery. Among hospitalized patients, cardiac arrest, ventricular arrhythmias, and an ECG pattern of ST-segment elevation myocardial infarction are associated with increased odds of mortality. Standard trauma, burn, and advanced cardiac life support protocols are recommended for management. Technological advances in weather forecasting, public awareness, and policies related to extreme weather are important in preventing lightning strike injuries.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Epidemiologic Features of Endotracheal Tube Obstruction","authors":"Vimal Bhardwaj MD, FNB(Critical Care), EDIC ,&nbsp;Abhishek Samprathi MD, DrNB, EDIC ,&nbsp;Manu M.K. Varma MD, DM ,&nbsp;Kingshuk Saha MSc ,&nbsp;Ross Prager MD ,&nbsp;John Basmaji MD ,&nbsp;Nicolas Orozco MD ,&nbsp;Srirang Ramamoorthy MSc ,&nbsp;Jose Chacko MD, EDIC ,&nbsp;Arjun Alva MD","doi":"10.1016/j.chstcc.2025.100156","DOIUrl":"10.1016/j.chstcc.2025.100156","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal tube blockages (ETBs) are a common yet often overlooked cause of weaning failure, ventilator dyssynchrony, and hypoxia in the ICU, with limited studies on their prevalence, clinical factors, and outcomes.</div></div><div><h3>Research Question</h3><div>What are the incidence, risk factors, and associated clinical and ventilator factors of ETBs in ventilated patients in the ICU?</div></div><div><h3>Study Design and Methods</h3><div>We assessed 369 endotracheal tubes (ETTs) of mechanically ventilated patients after extubation. This prospective observational study was conducted at the tertiary cardiothoracic ICUs (CICUs) and medical ICUs (MICUs) of Narayana Health City, Bengaluru, India. Tubes were inspected visually and were cut at the point of maximum blockage, and cross-sectional images captured with a 12-megapixel camera were analyzed for ETB percentage using the SketchAndCalc algorithm.</div></div><div><h3>Results</h3><div>Of the 369 ETTs assessed, ETBs were categorized as showing low (0%-9%), moderate (10%-49%), and severe (&gt; 50%) occlusion. In the CICU, severe ETBs was observed in &lt; 2% of patients, compared with 4% of patients in the MICU, whereas moderate ETBs were present in 27.9% of patients in the CICU and 16.5% of patients in the MICU. On univariable analysis, suction type (β = 9.62 [95% CI, 5.27-13.98]; <em>P</em> &lt; .01), peak pressure (P_peak; β = 1.73 [95% CI, 1.38-2.08]; <em>P</em> &lt; .01), coagulopathy (β = 9.42 [95% CI, 4.22-14.62]; <em>P</em> &lt; .01), and ICU type (β = 9.62 [95% CI, 5.28-13.96]; <em>P</em> &lt; .01) were statistically significant. Multivariable regression analysis showed only P_peak (β = 1.65 [95% CI, 1.28-2.02]; <em>P</em> &lt; .01), coagulopathy (β = 8.02 [95% CI, 3.26-12.79]; <em>P</em> &lt; .01) and larger number of days receiving invasive mechanical ventilation (β = 0.02 [95% CI, 0.01-0.03]; <em>P</em> &lt; .01) to be significant factors associated with ETB percentage.</div></div><div><h3>Interpretation</h3><div>Moderate ETB was more prevalent in patients in the ICU, with significant factors including coagulopathy, closed suction practice, and mechanical ventilation duration. P_peak alarms lacked clinical impact, despite statistical significance.</div></div><div><h3>Clinical Trial Registry</h3><div>Clinical Trial Registry-India; No.: CTRI/2023/10/058184; URL: <span><span>www.ctri.nic.in</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Snapshot of the Central Nervous System","authors":"Christina Boncyk MD, MPH ,&nbsp;Christopher G. Hughes MD","doi":"10.1016/j.chstcc.2025.100159","DOIUrl":"10.1016/j.chstcc.2025.100159","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Attending Practice Variability in Prone Positioning Initiation","authors":"Anna K. Barker MD, PhD ,&nbsp;Emily A. Harlan MD ,&nbsp;Meeta Prasad Kerlin MD, MSCE ,&nbsp;Thomas S. Valley MD ,&nbsp;Michael W. Sjoding MD","doi":"10.1016/j.chstcc.2025.100158","DOIUrl":"10.1016/j.chstcc.2025.100158","url":null,"abstract":"<div><h3>Background</h3><div>Prone positioning is underused, despite mortality benefits. Prior studies highlight that patient-independent factors may influence prone positioning rates, but attending-specific contributions are unknown.</div></div><div><h3>Research Question</h3><div>Does significant variability in prone positioning rates exist among attending physicians?</div></div><div><h3>Study Design and Methods</h3><div>This is a retrospective cohort study of 514 adults receiving mechanical ventilation in a tertiary-care medical or surgical ICU from January 1, 2015, through June 30, 2024. Inclusion criteria included Pa<span>o</span>₂ to F<span>io</span>₂ ratio of ≤ 150 with F<span>io</span>₂ of ≥ 60% and positive end-expiratory pressure of ≥ 5 cm H₂O within 0 to 36 hours and 36 to 72 hours of intubation. The primary outcome was prone positioning within 72 hours of intubation or 24 hours of meeting prone positioning criteria. We hypothesized that attending variability was a significant predictor of prone positioning. We fit a mixed-effects logistic regression model to evaluate attending-level variability in prone positioning use, adjusting for 6 potential patient-centered prone positioning barriers and facilitators (age, BMI, COVID-19 status, code status, Pa<span>o</span>₂ to F<span>io</span>₂ ratio, and vasopressor use) and ICU location (medical or surgical).</div></div><div><h3>Results</h3><div>Among 514 patients eligible for prone positioning, 87 patients (17%) underwent prone positioning. Significant attending-level variability in prone positioning was noted among the 48 attendings included in the analysis, with risk- and reliability-adjusted rates ranging from 14.9% to 74.2% and a median OR among attending physicians of 2.6 (95% CI, 1.7-5.2). This effect size was associated more strongly with prone positioning than a 30-mm Hg decrease in Pa<span>o</span>₂ to F<span>io</span>₂ ratio. Even among patients with clinical documentation of ARDS on the day of prone positioning eligibility, the median OR among attending physicians was 2.4 (95% CI, 1.5-7.3). Additional patient factors predicting prone positioning included COVID-19 status, code status, and Pa<span>o</span>₂ to F<span>io</span>₂ ratio.</div></div><div><h3>Interpretation</h3><div>Our results show that large variation in prone positioning practices exists among attending providers, and future work should consider attending-focused and system-wide interventions as potential novel targets to improve prone positioning rates.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Intensive Care Rehabilitation","authors":"Laura Allum MRes ,&nbsp;Louise Rose PhD","doi":"10.1016/j.chstcc.2025.100154","DOIUrl":"10.1016/j.chstcc.2025.100154","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons From Gattinoni","authors":"Andrea Castellví-Font MD ,&nbsp;Tai Pham MD, PhD ,&nbsp;Bhakti Patel MD ,&nbsp;Eddy Fan MD, PhD","doi":"10.1016/j.chstcc.2025.100153","DOIUrl":"10.1016/j.chstcc.2025.100153","url":null,"abstract":"<div><div>Professor Luciano Gattinoni’s contributions to critical care medicine transformed the management of ARDS and mechanical ventilation, shaping the foundation of modern intensive care. Among his landmark achievements, the so-called baby lung concept redefined ARDS as a condition characterized by reduced functional lung volume, rather than lung stiffness, leading to the development of lung-protective ventilation strategies that prioritize minimizing ventilator-induced lung injury. His work on positive end-expiratory pressure advanced the understanding of lung aeration, atelectasis, and recruitment, highlighting the role of CT imaging in respiratory research. His research on prone positioning elucidated its physiologic benefits and demonstrated its lifesaving potential for patients with severe ARDS, culminating in its widespread adoption. Additionally, his work on mechanical power provided a unifying framework for assessing ventilator-induced lung injury risk, although challenges in its bedside application remain. Through his relentless pursuit of integrating respiratory physiology into clinical practice, Professor Gattinoni inspired generations of clinicians and researchers, leaving an indelible legacy that continues to guide advancements in critical care worldwide.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response","authors":"Tessa A. Mulder MD ,&nbsp;Linda Becude MD ,&nbsp;Jorge E. Lopez Matta MD ,&nbsp;Wilbert B. van den Hout PhD ,&nbsp;David J. van Westerloo MD, PhD ,&nbsp;Martijn P. Bauer MD, PhD","doi":"10.1016/j.chstcc.2025.100152","DOIUrl":"10.1016/j.chstcc.2025.100152","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}