CHEST critical care最新文献

{"title":"Fluids in Septic Shock","authors":"Bram Rochwerg MD ,&nbsp;Diane Heels-Ansdell ,&nbsp;Peggy Austin ,&nbsp;Tina Millen ,&nbsp;Lisa Buckingham ,&nbsp;Frederick D’Aragon ,&nbsp;Lori Hand ,&nbsp;Gordon Guyatt ,&nbsp;Roman Jaeschke ,&nbsp;François Lamontagne ,&nbsp;Maureen Meade ,&nbsp;Sangeeta Mehta ,&nbsp;Michelle Zeller ,&nbsp;Deborah Cook ,&nbsp;Canadian Critical Care Trials Group","doi":"10.1016/j.chstcc.2025.100184","DOIUrl":"10.1016/j.chstcc.2025.100184","url":null,"abstract":"<div><h3>Background</h3><div>The Fluids in Septic Shock (FISSH) randomized controlled trial (RCT) aims to determine the impact of using Ringer’s lactate (RL) as compared with 0.9% normal saline (NS) on 30-day mortality and other end points in critically ill adults with septic shock.</div></div><div><h3>Research Question</h3><div>What are the rationale, methodology, ethics, implementation, and statistical analysis of the FISSH trial?</div></div><div><h3>Study Design and Methods</h3><div>The FISSH trial is an international, randomized, concealed allocation, masked, parallel-group, individual patient RCT. Eligible patients are critically ill adults aged ≥ 16 years who require fluid resuscitation for hypotension or organ hypoperfusion, have a clinical suspicion of infection, and are within 6 hours of emergency department presentation or within 6 hours of consultation by the critical care team for patients from the ward. Participants are randomized to receive either RL or NS for all maintenance and bolus fluids as needed throughout the ICU stay. The primary outcome is 30-day mortality. Secondary outcomes include acute kidney injury, length of ICU and hospital stays, and receipt of organ support.</div></div><div><h3>Results</h3><div>After an interim analysis of results from 548 patients (50% total), the data safety monitoring board recommended continuing the trial. The FISSH trial is conducted in collaboration with the Canadian Critical Care Trials Group. The FISSH trial was launched in October 2017. As of May 12, 2025, 1,019 patients (91.1%) of the target sample size of 1,118 patients have been recruited from 29 study centers. We anticipate recruitment to be complete by the end of 2025.</div></div><div><h3>Interpretation</h3><div>This protocol and statistical analysis plan outlines the design and conduct of the international FISSH randomized controlled trial. The FISSH trial may inform clinical practice guidelines worldwide.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT03677102; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333762","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":"Testing the Transportability of Sepsis Subtypes to Patients With ARDS for Postdischarge Outcomes","authors":"Robert J. Flick MD ,&nbsp;Thomas S. Valley MD ,&nbsp;Mari Armstrong-Hough MPH, PhD ,&nbsp;Theodore J. Iwashyna MD, PhD","doi":"10.1016/j.chstcc.2025.100203","DOIUrl":"10.1016/j.chstcc.2025.100203","url":null,"abstract":"<div><h3>Background</h3><div>Survivors of ARDS experience significant morbidity and mortality after hospital discharge. A latent class analysis (LCA) proposed 5 sepsis survivor subtypes that may be of use for patients with ARDS as well, but did not include an operationalization algorithm for assigning patients to subtypes.</div></div><div><h3>Research Question</h3><div>Can the Taylor et al sepsis survivor subtypes be operationalized in a population with ARDS, and do such operationalizations distinguish patients at varying risk of postdischarge mortality and readmission?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a secondary analysis of adults with ARDS requiring mechanical ventilation enrolled in the Reevaluation of Systemic Early Neuromuscular Blockade (ROSE) trial. We compared 2 methods of operationalizing subtype to develop an assignment rule: transported subtypes based on an algorithm developed using 5 variables from the previously published derivation cohort and de novo subtypes derived from a new LCA. Random-effect logit models were used to estimate the association between subtype and the primary outcome of mortality at 12 months.</div></div><div><h3>Results</h3><div>Five hundred eighty participants were assigned to 5 subtypes using the transported approach. In age-adjusted regression, transported subtype was associated significantly with mortality at 12 months (<em>P</em> = .027) and readmission at 3 months (<em>P</em> = .043). A de novo LCA identified 5 distinct subtypes as the optimal solution; subtypes were associated with mortality at 3, 6, and 12 months (<em>P</em> &lt; .001) and readmission at 3 months (<em>P</em> = .008). Agreement between the 2 assignment methods was 48% (κ = 0.361) and was concentrated in the lowest-risk (134/145 [92.4%]) and highest-risk (44/44 [100%]) groups.</div></div><div><h3>Interpretation</h3><div>Our results suggest that sepsis survivor subtypes can be transported and operationalized in patients with ARDS. Different approaches to operationalization were shown to yield similar, but not identical, subgroups classifications. Both approaches assigned individuals to groups that are associated significantly with patient-important outcomes among survivors of ARDS. Optimal strategies to transport externally derived subtypes, vs internally rederived subtypes, may depend on the specific use case.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578636","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":"Assessing Heterogeneity in the Treatment Effect of Neuromuscular Blockade According to Subphenotypes Determined by Clusters Derived From Clinical Characteristics of Patients With ARDS","authors":"Abhijit Duggal MD, MPH ,&nbsp;Heather Torbic PharmD, FCCM, BCPS, BCCCP ,&nbsp;Lucas Bulgarelli BS ,&nbsp;Wellington dos Reis Lucena BS ,&nbsp;Diego Ariel Rey PhD ,&nbsp;Rodrigo Octavio Deliberato MD, PhD ,&nbsp;Ary Serpa Neto MD, PhD","doi":"10.1016/j.chstcc.2025.100197","DOIUrl":"10.1016/j.chstcc.2025.100197","url":null,"abstract":"<div><h3>Background</h3><div>Two distinct subphenotypes (hyperinflammatory and hypoinflammatory) of ARDS have been identified. Neuromuscular blocking agents (NMBAs) are thought to provide benefit in ARDS by reducing inflammation. It is unclear whether ARDS subphenotypes respond differently to NMBAs.</div></div><div><h3>Research Question</h3><div>What is the heterogeneity of treatment effect (HTE) of NMBAs on 90-day mortality according to subphenotypes as determined by clinical variables in adult patients with ARDS using the data from the Reevaluation of Systemic Early Neuromuscular Blockade (ROSE) clinical trial?</div></div><div><h3>Study Design and Methods</h3><div>In this retrospective study of the de-identified data set from the ROSE trial, subphenotypes were determined by clusters derived from clinical variables. The HTE of NMBAs was assessed following a Bayesian hierarchical logistic model for the primary outcome.</div></div><div><h3>Results</h3><div>Of the 715 patients analyzed from the ROSE trial, 73% of patients were identified as having subphenotype B (hyperinflammatory) and 27% were identified as having subphenotype A (hypoinflammatory). Patients with subphenotype B showed higher 90-day mortality compared with patients with subphenotype A (248 patients [47.7%] vs 64 patients [32.8%]; <em>P</em> &lt; .001). Patients with subphenotype A receiving cisatracurium showed a lower 90-day mortality than those receiving usual care (31 patients [29.2%] vs 33 patients [37.1%]). In contrast, patients classified with subphenotype B showed a similar 90-day mortality independent of the treatment allocation arm (120 patients [48.2%] vs 128 patients [47.2%] for cisatracurium and usual care, respectively). The probability of lower 90-day mortality (benefit) with the use of cisatracurium compared with usual care was higher in patients with subphenotype A than in patients with subphenotype B (85.6% vs 44.2%; OR, 0.74 [95% credible interval, 0.42-1.30] vs OR, 1.03 [95% credible interval, 0.73-1.44], respectively).</div></div><div><h3>Interpretation</h3><div>At the time of enrollment into the ROSE trial, most patients had ARDS subphenotype B (hyperinflammatory), and based on the subsequent Bayesian analysis, NMBA use would not result in a mortality benefit in these patients.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333691","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":"Target for Anticoagulation in the Management of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock","authors":"Shingo Kazama MD, PhD ,&nbsp;Toru Kondo MD, PhD ,&nbsp;Hiraiwa Hiroaki MD, PhD ,&nbsp;Ryota Morimoto MD, PhD ,&nbsp;Takahiro Okumura MD, PhD ,&nbsp;Junta Honda MD ,&nbsp;Taku Tanaka MD, PhD ,&nbsp;Michiko Higashi MD ,&nbsp;Takanori Yamamoto MD, PhD ,&nbsp;Atsushi Numaguchi MD, PhD ,&nbsp;Yachiyo Kuwatsuka MD, PhD ,&nbsp;Masahiko Ando MD, PhD ,&nbsp;Shogo Yamaguchi MD, PhD ,&nbsp;Yusuke Uemura MD, PhD ,&nbsp;Akinori Sawamura MD, PhD ,&nbsp;Naoki Watanabe MD, PhD ,&nbsp;Itsuro Morishima MD, PhD ,&nbsp;Tomoaki Haga MD, PhD ,&nbsp;Masanori Shinoda MD, PhD ,&nbsp;Toyoaki Murohara MD, PhD ,&nbsp;Daisuke Kasugai MD, PhD","doi":"10.1016/j.chstcc.2025.100198","DOIUrl":"10.1016/j.chstcc.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Bleeding and thromboembolic complications are significant challenges in the treatment of patients with cardiogenic shock (CS) who require venoarterial extracorporeal membrane oxygenation (VA-ECMO). Anticoagulation strategies that target higher activated partial thromboplastin time (aPTT) may exacerbate bleeding and lead to poor outcomes. However, there is a lack of sufficient randomized trials to determine the optimal aPTT target for this patient population.</div></div><div><h3>Research Question</h3><div>Does anticoagulation management with a lower aPTT target range improve outcomes compared with a higher aPTT target range in patients with CS who are treated with VA-ECMO?</div></div><div><h3>Study Design and Methods</h3><div>The Target for Anticoagulation in the Management of Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock (TARGET-ECMO) trial is a multicenter, randomized controlled trial designed to evaluate the impact of different aPTT target ranges on outcomes in patients with CS who are treated with VA-ECMO. Patients are randomized into 1 of 2 groups: a lower aPTT target group (aPTT, 1.5 to1.8 times) or a higher aPTT target group (aPTT, 2.2 to 2.5 times).</div></div><div><h3>Results</h3><div>The primary end point is a hierarchic composite outcome assessed at 7 days that consists of (1) death from any cause, (2) major bleeding, (3) thromboembolic events, and (4) total transfusion of RBC concentrates, which are evaluated with the use of a win ratio.</div></div><div><h3>Interpretation</h3><div>Anticoagulation targets in VA-ECMO management typically are determined at the discretion of individual centers and clinicians. The Target for Anticoagulation in the Management of Venoarterial Extracorporeal Membrane Oxygenation for CS trial aims to improve the prognosis of patients with CS who are treated with VA-ECMO by exploring optimal aPTT target range for anticoagulation management.</div></div><div><h3>Clinical Trial Registration</h3><div>Certified Review Board of Nagoya University Hospital (approval number: 2024-0166) and the Japan Registry of Clinical Trials (jRCT1041240069).</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333759","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 Diagnostic Accuracy of Serum Procalcitonin for Sepsis in Adult Patients in the Emergency Department","authors":"Tanmoy Ghatak MD, PDCC, FACEE ,&nbsp;Syed Ammar Sajjad MSc ,&nbsp;Arnavjyoti Das MD ,&nbsp;Anup Kumar MSc, PhD ,&nbsp;Kurvatteppa Halemani MSc ,&nbsp;Bram Rochwerg MD, FRCPC","doi":"10.1016/j.chstcc.2025.100179","DOIUrl":"10.1016/j.chstcc.2025.100179","url":null,"abstract":"<div><h3>Background</h3><div>Procalcitonin, a precursor hormone of calcitonin, represents a promising marker of bacterial infections.</div></div><div><h3>Research Question</h3><div>What is the accuracy of procalcitonin for the diagnosis of sepsis in adult patients in the emergency department (ED)?</div></div><div><h3>Study Design and Methods</h3><div>In this this systematic review and meta-analysis, we searched 5 databases (PubMed, Google Scholar, Science Direct, Wiley, and the Cochrane database) from the inception of the Third International Consensus Definitions for Sepsis and Septic Shock diagnostic criteria (January 1, 2016) through December 31, 2024. We included studies that assessed the accuracy of procalcitonin for sepsis in adult patients admitted in the ED. We performed a random-effects meta-analysis, evaluated individual study risk of bias using Quality Assessment of Diagnostic Accuracy Studies 2 criteria and certainty of evidence using Grading of Recommendations, Assessment, Development, and Evaluations methodology.</div></div><div><h3>Results</h3><div>We included 11 studies comprising 7,937 patients in the analysis. The pooled sensitivity of procalcitonin for sepsis in patients in the ED was 0.62 (95% CI, 0.60-0.64) and the pooled specificity was 0.80 (95% CI, 0.79-0.81); both were based on low certainty evidence. The pooled positive likelihood ratio was 2.80 (95% CI, 2.20-3.57), the negative likelihood ratio was 0.42 (95% CI, 0.32-0.55), and the pooled diagnostic OR was 6.83 (95% CI, 4.87-9.58). The area under the summary receiver operating characteristic curve for procalcitonin was 0.77 (95% CI, 0.7281-0.8309).</div></div><div><h3>Conclusions</h3><div>Based on pooled analysis, procalcitonin was shown to have reasonable specificity but poor sensitivity for diagnosis of sepsis in patients in the ED with suspected infection. Given that the results are based on low certainty of evidence, further high-quality data in this population are needed.</div></div><div><h3>Clinical Trial Registration</h3><div>International Prospective Register of Systematic Reviews; No.: CRD42024618786; URL: <span><span>https://www.crd.york.ac.uk/prospero/</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100179"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333761","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":"Addressing Language Barriers to ICU Delirium Detection","authors":"Ana Lucia Fuentes MD ,&nbsp;Charlotte C. Ellberg MD ,&nbsp;Guillermo Jimenez MD ,&nbsp;Paola Alicea Reyes MD ,&nbsp;Arianna Rodriguez MD ,&nbsp;Jorge A. Muñoz Pineda MD ,&nbsp;Humberto Parada Jr. PhD, MPH ,&nbsp;Robert L. Owens MD ,&nbsp;Atul Malhotra MD ,&nbsp;Biren B. Kamdar MD, MHS","doi":"10.1016/j.chstcc.2025.100192","DOIUrl":"10.1016/j.chstcc.2025.100192","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is a common and serious condition in the ICU associated with adverse outcomes. However, delirium can be challenging to detect, especially among patients with limited English language proficiency. Given the rise in the Spanish-speaking Hispanic and Latino population in the United States, we sought to translate into Spanish and culturally adapt for Hispanic and Latino adults an alternative delirium screening tool, the Family-Confusion Assessment Method for the ICU (Family-CAM).</div></div><div><h3>Research Question</h3><div>Our objective was to translate and culturally adapt the Family-CAM into Spanish (the Spanish-Language Family-Confusion Assessment Method for the ICU [Spanish-FAM]) and to evaluate its performance among Spanish-speaking patients in the ICU.</div></div><div><h3>Study Design and Methods</h3><div>The translation and cross-cultural adaptation process included double-forward and back translations and harmonization by a team of bilingual physicians representing multiple Spanish-speaking global regions. We then identified 20 Spanish-speaking patients in the ICU and their family caregivers (dyads) on admission. A trained bilingual assessor administered the validated Spanish-language Confusion Assessment Method for the ICU (Spanish-CAM), which served as the gold standard for delirium assessments. The performances of the Spanish-FAM (performed by family caregivers) and usual care (the Confusion Assessment Method for the ICU documented by bedside providers) then were compared with those of the Spanish-CAM using Cohen’s κ to assess for agreement between assessments.</div></div><div><h3>Results</h3><div>The Spanish-FAM maintained conceptual equivalence to the original English version. The Spanish-FAM demonstrated substantial agreement with the gold standard Spanish-CAM (κ = 0.68), with high sensitivity (91%) and specificity (85%). In contrast, usual care showed minimal agreement with the gold standard Spanish-CAM (κ = 0.16), with a sensitivity of only 18%.</div></div><div><h3>Interpretation</h3><div>These findings suggest that usual care may be unreliable in Spanish-speaking patients in the ICU, whereas the Spanish-FAM may be a strong alternative tool for more accurate delirium assessments in this population.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269885","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":"Needs of Acute Respiratory Failure Survivors Throughout 1 Year of Recovery","authors":"Jasmine A. Silvestri MPH ,&nbsp;Craig Kwiatkowski BA ,&nbsp;Erich M. Dress MPH, MBE ,&nbsp;Taara V. Prasad MPH, MBE ,&nbsp;Eric Ryu ,&nbsp;Meeta Prasad Kerlin MD, MSCE ,&nbsp;Michael O. Harhay PhD ,&nbsp;Tamar Klaiman PhD, MPH ,&nbsp;Rachel Kohn MD, MSCE","doi":"10.1016/j.chstcc.2025.100185","DOIUrl":"10.1016/j.chstcc.2025.100185","url":null,"abstract":"<div><h3>Background</h3><div>Although ICU mortality is declining for the &gt; 1 million Americans with acute respiratory failure (ARF) annually, little evidence exists to guide care after hospital discharge, and few studies have explored longitudinal care needs among survivors.</div></div><div><h3>Research Question</h3><div>To ultimately develop dynamic, adaptable care plans across recovery trajectories, what are the barriers and facilitators to ARF survivor recovery?</div></div><div><h3>Study Design and Methods</h3><div>After hospital discharge, we enrolled survivors of ARF discharged from 4 University of Pennsylvania Health System hospitals from June 2022 through April 2023 who underwent mechanical ventilation for ≥ 24 hours into a longitudinal cohort study. We enrolled a subset of this cohort to conduct qualitative structured phone interviews at 3, 6, and 12 months regarding barriers and facilitators to recovery using the Timing It Right (TIR) framework, which identifies longitudinal changing needs. We coded interview data and performed thematic analysis to identify unmet and met needs. Using TIR framework recovery constructs, we sequentially mapped needs categorically and then across time points.</div></div><div><h3>Results</h3><div>Thirty-two patients participated in 59 interviews. Themes mapped to informational, instrumental, and emotional TIR framework recovery aspects across discharge preparation, transition to community, and long-term adjustment recovery phases. During discharge preparation, patients required rapport with inpatient clinicians and comprehensive information about the rehabilitation process. During transition to community, patients needed instrumental support, including increased touchpoints from health care professionals. As recovery continued, the mental and emotional burden of recovery became prominent.</div></div><div><h3>Interpretation</h3><div>Survivors of ARF encountered evolving support needs throughout the recovery trajectory from informational needs during discharge preparation to instrumental needs during transition to community and emotional needs during long-term adjustment. Understanding needs trajectories is a critical first step toward developing guidance to mitigate unmet needs and developing dynamic, adaptable care plans across recovery trajectories among survivors of ARF.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363108","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":"What Is the Optimal Reintubation Rate?","authors":"Yuki Arita MD ,&nbsp;Daisuke Kawakami MD, PhD ,&nbsp;Hidenobu Koga MT, MMSc ,&nbsp;Shumpei Yoshino MD","doi":"10.1016/j.chstcc.2025.100210","DOIUrl":"10.1016/j.chstcc.2025.100210","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528278","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":"Sarah N. Obeidalla MEd ,&nbsp;Gordon R. Bernard MD ,&nbsp;Lorraine B. Ware MD ,&nbsp;V. Eric Kerchberger MD","doi":"10.1016/j.chstcc.2025.100189","DOIUrl":"10.1016/j.chstcc.2025.100189","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108981","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":"ICU Reintubation Rates","authors":"Akram Khan MBBS,&nbsp;Shewit P. Giovanni MD","doi":"10.1016/j.chstcc.2025.100219","DOIUrl":"10.1016/j.chstcc.2025.100219","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 4","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528277","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}