CHEST critical care最新文献

{"title":"Post-COVID-19 Clinic Utilization Among Survivors of Critical Illness in Two Waves of SARS-CoV-2 Infection","authors":"Cher X. Huang MD ,&nbsp;Daniel Okin MD, PhD ,&nbsp;Emily E. Moin MD ,&nbsp;Sirus J. Jesudasen MD ,&nbsp;Nupur A. Dandawate MD ,&nbsp;Alexander Gavralidis MD ,&nbsp;Leslie L. Chang MD ,&nbsp;Alison S. Witkin MD ,&nbsp;Lucy B. Schulson MD, MPH ,&nbsp;Kathryn A. Hibbert MD ,&nbsp;Aran Kadar MD ,&nbsp;Patrick L. Gordan MD ,&nbsp;Lisa M. Bebell MD ,&nbsp;Peggy S. Lai MD, MPH ,&nbsp;George A. Alba MD","doi":"10.1016/j.chstcc.2024.100061","DOIUrl":"10.1016/j.chstcc.2024.100061","url":null,"abstract":"<div><h3>Background</h3><p>Post-COVID-19 clinics were implemented to improve postacute care for patients with COVID-19, including survivors of critical illness, many of whom experience post-intensive care syndrome (PICS). Whether postacute care changed over the course of the pandemic and if inequities in utilization exist remain unclear.</p></div><div><h3>Research Question</h3><p>Among survivors of COVID-19 critical illness, what were the patterns of postdischarge care during different pandemic waves, and are there inequities in outpatient utilization?</p></div><div><h3>Study Design and Methods</h3><p>In this retrospective cohort study, we describe sociodemographics, illness severity, outpatient utilization, and PICS burden up to 18 months after discharge for patients with COVID-19 admitted to an ICU at three Boston, Massachusetts, area hospitals during two waves (wave 1 and wave 2) of hospitalizations during the pandemic. Multivariable logistic regression models identified variables associated with follow-up in post-COVID-19 clinics and adverse postdischarge health care outcomes, including readmissions, ED visits, and all-cause postdischarge mortality.</p></div><div><h3>Results</h3><p>A total of 319 of 478 wave 1 patients (66.7%) and 80 of 187 wave 2 patients (42.8%) survived to hospital discharge. During wave 1, there was a higher proportion of patients with limited English proficiency (LEP) admitted to the ICU (45.5% vs 30.0%, <em>P</em> = .012) and a lower severity of illness on admission (Sequential Organ Failure Assessment score 4; interquartile range, 2-8 vs 6; interquartile range, 4-8; <em>P</em> = .013). PICS symptoms were common across both waves (80.6% vs 78.8%, <em>P</em> = .72). In multivariable analyses, LEP was associated with decreased odds of post-COVID-19 clinic follow-up (adjusted OR, 0.80; 95% CI, 0.70-0.92; <em>P</em> &lt; .01) and increased odds of adverse postdischarge health care outcomes (adjusted OR, 1.49; 95% CI, 1.11-2.0; <em>P</em> &lt; .01).</p></div><div><h3>Interpretation</h3><p>The overall burden of PICS was high across waves. LEP was associated with inequities in post-COVID-19 clinic follow-up and worse postdischarge outcomes, suggesting that language is an important target for further interventions to support equitable recovery after critical illness.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000157/pdfft?md5=390990559efd14e872acb2e5fd0df755&pid=1-s2.0-S2949788424000157-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile App-Based Mindfulness Intervention for Addressing Psychological Distress Among Survivors of Hospitalization for COVID-19 Infection","authors":"Christopher E. Cox MD, MPH ,&nbsp;John A. Gallis ScM ,&nbsp;Maren K. Olsen PhD ,&nbsp;Laura S. Porter PhD ,&nbsp;Tina M. Gremore PhD ,&nbsp;Theodore J. Iwashyna MD, PhD ,&nbsp;Ellen S. Caldwell MS ,&nbsp;Jeffrey M. Greeson PhD ,&nbsp;Marc Moss MD ,&nbsp;Catherine L. Hough MD","doi":"10.1016/j.chstcc.2024.100063","DOIUrl":"https://doi.org/10.1016/j.chstcc.2024.100063","url":null,"abstract":"<div><h3>Background</h3><p>Psychological distress symptoms are present and persistent among many patients who survive a critical illness like COVID-19.</p></div><div><h3>Research Question</h3><p>Could a self-directed mobile app-delivered mindfulness intervention be feasibly and rapidly implemented within a clinical trials network to reduce distress symptoms?</p></div><div><h3>Study Design and Methods</h3><p>A randomized clinical trial was conducted between January 2021 and May 2022 at 29 US sites and included survivors of hospitalization due to COVID-19-related illness with elevated symptoms of depression at discharge. Participants were randomized to intervention or usual care control. The intervention consisted of four themed weeks of daily audio, video, and text content. All study procedures were virtual. The primary outcome was depression symptoms assessed with the Patient Health Questionnaire 9 at 3 months. Secondary outcomes included anxiety (Generalized Anxiety Disorder 7-item scale), quality of life (EQ-5D), and adherence. We used general linear models to estimate treatment arm differences in outcomes over time.</p></div><div><h3>Results</h3><p>Among 56 randomized participants (mean age ± SD, 51.0 ± 13.2 years; 38 female [67.9%]; 14 Black participants [25%]), 45 (intervention: n = 23 [79%]; control: n = 22 [81%]) were retained at 6 months. There was no difference in mean improvement between intervention and control participants at 3 months in Patient Health Questionnaire 9 (−0.5 vs 0.1), Generalized Anxiety Disorder 7-item scale (−0.3 vs 0.1), or EQ-5D (−0.03 vs 0.02) scores, respectively; 6-month results were similar. Only 15 participants (51.7%) initiated the intervention, whereas the mean number ± SD of the 56 prescribed intervention activities completed was 12.0 ± 15.2. Regulatory approvals delayed trial initiation by nearly a year.</p></div><div><h3>Interpretation</h3><p>Among survivors of COVID-19 hospitalization with elevated psychological distress symptoms, a self-directed mobile app-based mindfulness intervention had poor adherence. Future psychological distress interventions mobilized at broad scale should focus efforts on patient engagement and regulatory simplification to enhance success.</p></div><div><h3>Trial Registration</h3><p><span>ClinicalTrials.gov</span><svg><path></path></svg>; No.: <span>NCT04581200</span><svg><path></path></svg>; URL: <span>www.clinicaltrials.gov</span><svg><path></path></svg></p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000170/pdfft?md5=cf8d3aef90fa8920d9face6f4cab4bbd&pid=1-s2.0-S2949788424000170-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Mobilization in the ICU","authors":"Himanshu Rawal MD ,&nbsp;Rita N. Bakhru MD, MS","doi":"10.1016/j.chstcc.2023.100038","DOIUrl":"10.1016/j.chstcc.2023.100038","url":null,"abstract":"<div><p>ICU-acquired weakness (ICU-AW) impacts up to 40% of patients admitted to the ICU and can have long-lasting effects on those who survive an ICU stay. In the last decade, early mobilization (EM) has emerged as an intervention to help prevent or to mitigate ICU-AW, or both, and to improve functional outcomes for patients. Despite its feasibility, safety, and potential benefits, a large gap in implementation of EM in ICUs globally remains. The purpose of this article is to review ICU-AW, to discuss the evidence base and current guidelines about EM, and to offer a practical approach for EM implementation with an emphasis on patient safety and common barriers.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 1","pages":"Article 100038"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788423000382/pdfft?md5=a5cfb27df93fda155d93a6080da928c6&pid=1-s2.0-S2949788423000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers, Facilitators, and Trends in Prone Positioning for ARDS","authors":"Thomas F. Bodley MD, MSc ,&nbsp;Dominique Piquette MD, PhD ,&nbsp;Kaveh G. Shojania MD ,&nbsp;Ruxandra Pinto PhD ,&nbsp;Damon C. Scales MD, PhD ,&nbsp;Andre C.K.B. Amaral MD","doi":"10.1016/j.chstcc.2024.100059","DOIUrl":"10.1016/j.chstcc.2024.100059","url":null,"abstract":"<div><h3>Background</h3><p>Prone positioning is a historically underused evidence-based practice for ARDS. Despite increased prone positioning during the COVID-19 pandemic, some patients may remain at risk of nonuse.</p></div><div><h3>Research Question</h3><p>What is the current evidence-based gap for prone positioning in ARDS, how is use changing over time, and what are patient-level barriers and facilitators to prone positioning?</p></div><div><h3>Study Design and Methods</h3><p>This retrospective cohort included invasively ventilated adults with ARDS and who met prone positioning criteria from six hospitals. The rate of prone positioning among eligible patients was summarized from January 2018 through December 2021. Segmented Poisson regression was used to describe temporal trends. Logistic regression was used to identify patient-level barriers and facilitators to prone positioning.</p></div><div><h3>Results</h3><p>Seven hundred ninety-nine patients fulfilled criteria for prone positioning. The mean age was 57 years, 125 patients (15.6%) had COVID-19, mean ICU stay was 19.5 days, and the mortality rate was 50.1%. Prone positioning was used in 297 of 799 patients (37.2%). Prone positioning was increasing before the pandemic with a relative rate (RR) of 1.12 per quarter (95% CI, 1.03-1.22). Prone positioning increased during the pandemic vs before the pandemic (RR, 1.62; 95% CI, 1.02-2.61), but not for patients with nonrespiratory diagnoses causing ARDS (RR, 0.74; 95% CI, 0.22-2.52). Barriers to prone positioning included vasopressor use (OR for withholding prone positioning, 1.15 per 0.1 μm/kg/min norepinephrine equivalent; 95% CI, 1.06-1.26), age (OR, 1.12 per 5 years; 95% CI, 1.03-1.22), and having undergone surgery (OR, 2.41; 95% CI, 1.00-5.81). Facilitators included having COVID-19 (OR for withholding prone positioning, 0.10; 95% CI, 0.04-0.24) or another respiratory illness (OR, 0.42; 95% CI, 0.23-0.79), and receiving neuromuscular blockade (OR, 0.22; 95% CI, 0.13-0.38).</p></div><div><h3>Interpretation</h3><p>Despite increased prone positioning during the COVID-19 pandemic, an evidence-based gap persists, especially for patients with nonrespiratory causes of ARDS. Multiple barriers and facilitators must be targeted to increase prone positioning.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100059"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000133/pdfft?md5=76fd29a6380dd3123a2b912a03a6f74c&pid=1-s2.0-S2949788424000133-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhaled Corticosteroids Use Before Hospitalization May Be Protective in Children With Direct Lung Injury","authors":"Elizabeth Landzberg MD ,&nbsp;Garrett Keim MD, MSCE ,&nbsp;Nadir Yehya MD, MSCE","doi":"10.1016/j.chstcc.2024.100058","DOIUrl":"10.1016/j.chstcc.2024.100058","url":null,"abstract":"<div><h3>Background</h3><p>Systemic corticosteroid use in acute respiratory failure has yielded uncertain benefits, partially because of off-target side effects. Inhaled corticosteroids (ICSs) confer localized antiinflammatory benefits and may protect adults with direct lung injury (DLI) from developing respiratory failure. To our knowledge, this relationship has not been studied in children.</p></div><div><h3>Research Question</h3><p>Do children with DLI who are prescribed ICSs before hospitalization have lower odds of progressing to respiratory failure?</p></div><div><h3>Study Design and Methods</h3><p>This retrospective, single-center cohort identified children seeking treatment at the ED with DLI and medication records before hospitalization. The primary outcome was intubation; secondary outcomes included noninvasive respiratory support (NRS). We tested the association of ICSs with intubation and NRS, adjusting for confounders. We stratified analyses on history of asthma and performed a sensitivity analysis adjusting for systemic corticosteroid use to account for status asthmaticus.</p></div><div><h3>Results</h3><p>Of 35,220 patients, 17,649 patients (50%) were prescribed ICSs. Intubation occurred in 169 patients (73 patients receiving ICSs) and NRS was used in 3,582 patients (1,336 patients receiving ICS). ICS use was associated with lower intubation (adjusted OR, 0.46; 95% CI, 0.31-0.67) and NRS (aOR, 0.45; 95% CI, 0.40-0.49). The association between ICS and NRS differed according to history of asthma (<em>P</em> = .04 for interaction), with ICS exposure remaining protective only for patients with a history of asthma. Results held true in sensitivity analyses.</p></div><div><h3>Interpretation</h3><p>ICS use prior to hospitalization may protect children with DLI from progressing to respiratory failure, with possible differential efficacy according to history of asthma.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100058"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000121/pdfft?md5=d8ad071e931858b9af20715a7b52195a&pid=1-s2.0-S2949788424000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Social Determinants of Health in Critical Care","authors":"Deepa Ramadurai MD ,&nbsp;Heta Patel BS ,&nbsp;Summer Peace BA ,&nbsp;Justin T. Clapp PhD, MPH ,&nbsp;Joanna L. Hart MD, MSHP","doi":"10.1016/j.chstcc.2024.100057","DOIUrl":"10.1016/j.chstcc.2024.100057","url":null,"abstract":"<div><h3>Background</h3><p>Social determinants of health (SDOHs) mediate outcomes of critical illness. Increasingly, professional organizations recommend screening for social risks. Yet, how clinicians should identify and then incorporate SDOHs into acute care practice is poorly defined.</p></div><div><h3>Research Question</h3><p>How do medical ICU clinicians currently operationalize SDOHs within patient care, given that SDOHs are known to mediate outcomes of critical illness?</p></div><div><h3>Study Design and Methods</h3><p>Using ethnographic methods, we observed clinical work rounds in three urban ICUs within a single academic health system to capture use of SDOHs during clinical care. Adults admitted to the medical ICU with respiratory failure were enrolled prospectively sequentially. Observers wrote field notes and narrative excerpts from rounding observations. We also reviewed electronic medical record documentation for up to 90 days after ICU admission. We then qualitatively coded and triangulated data using a constructivist grounded theory approach and the Centers for Disease Control and Prevention Healthy People SDOHs framework.</p></div><div><h3>Results</h3><p>Sixty-six patients were enrolled and &gt; 200 h of observation of clinical work rounds were included in the analysis. ICU clinicians infrequently integrated social structures of patients’ lives into their discussions. Social structures were invoked most frequently when related to: (1) causes of acute respiratory failure, (2) decisions regarding life-sustaining therapies, and (3) transitions of care. Data about common SDOHs were not collected in any systematic way (eg, food and housing insecurity), and some SDOHs were discussed rarely or never (eg, access to education, discrimination, and incarceration).</p></div><div><h3>Interpretation</h3><p>We found that clinicians do not incorporate many areas of known SDOHs into ICU rounds. Improvements in integration of SDOHs should leverage the multidisciplinary team, identifying who is best suited to collect information on SDOHs during different time points in critical illness. Next steps include clinician-focused, patient-focused, and caregiver-focused assessments of feasibility and acceptability of an ICU-based SDOHs assessment.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294978842400011X/pdfft?md5=43c7735b0fc3930b46dd348f980f579f&pid=1-s2.0-S294978842400011X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure Ascertainment of Alcohol Use in Critical Illness","authors":"Rachel M. Bennett MD ,&nbsp;John P. Reilly MD, MSCE","doi":"10.1016/j.chstcc.2024.100055","DOIUrl":"10.1016/j.chstcc.2024.100055","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100055"},"PeriodicalIF":0.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000091/pdfft?md5=38836744b234a6396e049e8d98e2722d&pid=1-s2.0-S2949788424000091-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139813528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Biomarkers of Endothelial Dysfunction Associated With Ventilatory Ratio and Mortality in ARDS Resulting From SARS-CoV-2 Infection Treated With Antiinflammatory Therapies","authors":"Jehan W. Alladina MD ,&nbsp;Francesca L. Giacona BA ,&nbsp;Alexis M. Haring BA ,&nbsp;Kathryn A. Hibbert MD ,&nbsp;Benjamin D. Medoff MD ,&nbsp;Eric P. Schmidt MD ,&nbsp;Taylor Thompson MD ,&nbsp;Bradley A. Maron MD ,&nbsp;George A. Alba MD","doi":"10.1016/j.chstcc.2024.100054","DOIUrl":"10.1016/j.chstcc.2024.100054","url":null,"abstract":"<div><h3>Background</h3><p>The association of plasma biomarkers and clinical outcomes in ARDS resulting from SARS-CoV-2 infection predate the evidence-based use of immunomodulators.</p></div><div><h3>Research Question</h3><p>Which plasma biomarkers are associated with clinical outcomes in patients with ARDS resulting from SARS-CoV-2 infection treated routinely with immunomodulators?</p></div><div><h3>Study Design and Methods</h3><p>We collected plasma from patients with ARDS resulting from SARS-CoV-2 infection within 24 h of admission to the ICU between December 2020 and March 2021 (N = 69). We associated 16 total biomarkers of inflammation (eg, IL-6), coagulation (eg, D-dimer), epithelial injury (eg, surfactant protein D), and endothelial injury (eg, angiopoietin-2) with the primary outcome of in-hospital mortality and secondary outcome of ventilatory ratio (at baseline and day 3).</p></div><div><h3>Results</h3><p>Thirty patients (43.5%) died within 60 days. All patients received corticosteroids and 6% also received tocilizumab. Compared with survivors, nonsurvivors demonstrated a higher baseline modified Sequential Organ Failure Assessment score (median, 8.5 [interquartile range (IQR), 7-9] vs 7 [IQR, 5-8]); <em>P</em> = .004), lower Pa<span>o</span>₂ to F<span>io</span>₂ ratio (median, 153 [IQR, 118-182] vs 184 [IQR, 142-247]; <em>P</em> = .04), and higher ventilatory ratio (median, 2.0 [IQR, 1.9-2.3] vs 1.5 [IQR, 1.4-1.9]; <em>P</em> &lt; .001). No difference was found in inflammatory, coagulation, or epithelial biomarkers between groups. Nonsurvivors showed higher median neural precursor cell expressed, developmentally down-regulated 9 (NEDD9) levels (median, 8.4 ng/mL [IQR, 7.0-11.2 ng/mL] vs 6.9 ng/mL [IQR, 5.5-8.0 ng/mL]; <em>P</em> = .0025), von Willebrand factor domain A2 levels (8.7 ng/mL [IQR, 7.9-9.7 ng/mL] vs 6.5 ng/mL [IQR, 5.7-8.7 ng/mL]; <em>P</em> = .007), angiopoietin-2 levels (9.0 ng/mL [IQR, 7.9-14.1 ng/mL] vs 7.0 ng/mL [IQR, 5.6-10.6 ng/mL]; <em>P</em> = .01), and syndecan-1 levels (15.9 ng/mL [IQR, 14.5-17.5 ng/mL] vs 12.6 ng/mL [IQR, 10.5-16.1 ng/mL]; <em>P</em> = .01). Only NEDD9 level met the adjusted threshold for significance (<em>P</em> &lt; .003). Plasma NEDD9 level was associated with 60-day mortality (adjusted OR, 9.7; 95% CI, 1.6-60.4; <em>P</em> = .015). Syndecan-1 level correlated with both baseline (ρ = 0.4; <em>P</em> = .001) and day 3 ventilatory ratio (ρ = 0.5; <em>P</em> &lt; .001).</p></div><div><h3>Interpretation</h3><p>Biomarkers of inflammation, coagulation, and epithelial injury were not associated with clinical outcomes in a small cohort of patients with ARDS uniformly treated with immunomodulators. However, endothelial biomarkers, including plasma NEDD9, were associated with 60-day mortality.</p></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294978842400008X/pdfft?md5=35b37476cd22672e512be05ff829f5de&pid=1-s2.0-S294978842400008X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139816672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzodiazepines and Hospital-Level Sedation Practices Continue to Impact Outcomes","authors":"Christina S. Boncyk MD, MPH,&nbsp;Christopher G. Hughes MD","doi":"10.1016/j.chstcc.2024.100052","DOIUrl":"10.1016/j.chstcc.2024.100052","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"2 2","pages":"Article 100052"},"PeriodicalIF":0.0,"publicationDate":"2024-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949788424000066/pdfft?md5=e5d8ca1f7136d5593539fd57334b4d21&pid=1-s2.0-S2949788424000066-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzodiazepines and Hospital-Level Sedation Practices Continue to Impact Outcomes","authors":"C. Boncyk, Christopher G. Hughes","doi":"10.1016/j.chstcc.2024.100052","DOIUrl":"https://doi.org/10.1016/j.chstcc.2024.100052","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"59 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139828233","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}