Abstract:
BACKGROUND:To improve communication and decision making related to cardiopulmonary resuscitation (CPR), a greater understanding of the perspectives of hospitalized patients with advanced diseases and their family members are needed. METHODS:In five Canadian hospitals, we administered a face-to-face questionnaire to older inpatients with end-stage cancer and advanced medical diseases and, where possible, to one of their family members, regarding information needs, the deliberation process, and their preferred decisional role. FINDINGS:A total of 440 of 569 patients (78%) and 160 of 176 available caregivers (91%) agreed to participate. Most patients (61%) had thought about what treatment they wanted if their heart stopped, few patients (11.3%) could describe more than two components of CPR, and only 2.7% of patients thought that the success rate of CPR was < 10%. A minority of patients (34%) had discussed CPR with their physician; 37% did not want to discuss their preferences with their doctor. Patients who felt that end-of-life issues were relevant to them were 5.5 times more likely to want a discussion with the physician regarding resuscitation (odds ratio, 5.5; 95% confidence interval, 2.5 to 12.0). The preferred role in decision making was variable, but most patients (59.7%) and family members (81.6%) preferred some degree of shared decision making that included the family member. There were no significant differences between cancer and medical patients in their preferred decisional role. INTERPRETATION:Seriously ill hospitalized patients have poor knowledge about CPR, and variable preferences for deliberation and their role in the decision-making process regarding their treatment. Strategies that improve understanding of CPR and foster discussions that involve patients, family members, and physicians in the decision-making process may improve the quantity and quality of communication and decision making about CPR.
journal_name
Chestjournal_title
Chestauthors
Heyland DK,Frank C,Groll D,Pichora D,Dodek P,Rocker G,Gafni Adoi
10.1378/chest.130.2.419subject
Has Abstractpub_date
2006-08-01 00:00:00pages
419-28issue
2eissn
0012-3692issn
1931-3543pii
S0012-3692(15)51856-4journal_volume
130pub_type
杂志文章,多中心研究相关文献
CHEST文献大全abstract::A 19-year-old man with untreated systemic lupus erythematosus had an acute myocardial infarction. A coronary arteriogram five hours after the onset of symptoms revealed total occlusion of the left anterior descending coronary artery. Reperfusion was achieved by coronary thrombolytic therapy with urokinase. Four weeks ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.88.1.147
更新日期:1985-07-01 00:00:00
abstract::Nodular opacities are a well-known pulmonary manifestation of rheumatoid arthritis (RA), occurring most often in seropositive men who smoke and have subcutaneous nodules. In the past 15 years two cases of lung carcinoma presenting as pulmonary nodules have been reported in patients with rheumatoid disease. We present ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.5.1022
更新日期:1989-11-01 00:00:00
abstract::Pulmonary infections, which frequently occur during the early and late period following bone marrow transplantation for hematologic malignancies, are associated with significant morbidity and mortality. In this study the incidence, the infectious causes of pneumonia and the mortality related to pneumonia in 130 alloge...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.2.371
更新日期:1993-08-01 00:00:00
abstract::A protocol was originally designed to study breathing control during and following cardiac arrest in humans, taking advantage of the period of pulseless ventricular fibrillation (PVF) produced while testing a newly implanted cardioverter-defibrillator device. A patient aged in his 60s with New York Heart Association c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-2950
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Pleuroparenchymal fibroelastosis (PPFE) is a rare form of interstitial pneumonia and sometimes coexists with a histologic usual interstitial pneumonia (UIP) pattern. This study aimed to describe the distinct clinical features of PPFE with UIP pattern compared with idiopathic pulmonary fibrosis (IPF). METHOD...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-2866
更新日期:2014-11-01 00:00:00
abstract:STUDY OBJECTIVE:Cysteinyl leukotrienes are important proinflammatory mediators in the pathogenesis of asthma. Since bronchial hyperresponsiveness is a noninvasive surrogate marker of asthmatic airway inflammation, we evaluated the bronchoprotection afforded by leukotriene receptor antagonists (LTRAs). DESIGN:Systemati...
journal_title:Chest
pub_type: 杂志文章,meta分析
doi:10.1378/chest.122.1.146
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:There is a need for a more complete classification system of lung cancer. To address this issue, we assessed whether the new staging could differentiate patients with early-stage cancers who have poorer prognosis and improve the unbalanced patient numbers with overlapping prognoses arising from the current T...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-1950
更新日期:2007-07-01 00:00:00
abstract:STUDY OBJECTIVES:Solitary fibrous tumors of the pleura (SFTPs) are slow-growing neoplasms. Approximately 800 cases have been reported in the literature to date. The aim of this study was to address our experience with the management of SFTPs and to evaluate the advantage of video-assisted thoracoscopic surgery (VATS) i...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.3.1144
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Although diaphragmatic motion is readily studied by ultrasonography, the procedure remains poorly codified. The aim of this prospective study was to determine the reference values for diaphragmatic motion as recorded by M-mode ultrasonography. METHODS:Two hundred ten healthy adult subjects (150 men, 60 wome...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1541
更新日期:2009-02-01 00:00:00
abstract::The association between pulmonary impairment and all-cause mortality was investigated among white subjects in a follow-up study of a large national cohort. Pulmonary function was measured during the National Health and Nutrition Examination Survey (NHANESI) (1971 to 1975); subsequent mortality information was obtained...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.2.536
更新日期:1993-02-01 00:00:00
abstract::Human leukocyte antigen (HLA) tissue-typing studies on patients with genetically transmitted hypertrophic cardiomyopathy have demonstrated an HLA linkage in a Caucasian and black patient group and an HLA-DR locus association in a Japanese population sample. To confirm whether a specific HLA antigen(s) might serve as a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.81.4.466
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Airway inflammation is important in the development and progression of asthma. Activation of inflammatory cells induces a respiratory burst resulting in the production of reactive oxygen species, such as H(2)O(2). The aim of this study was to measure the concentration of H(2)O(2) in exhaled breath condensate...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.120.4.1136
更新日期:2001-10-01 00:00:00
abstract::A 41-year-old woman had progressive shortness of breath. Cerebrotendinous xanthomatosis was diagnosed 4 years before. An open-lung biopsy showed the simultaneous presence of cerebrotendinous xanthomatosis and pulmonary lymphangioleiomyomatosis. This is perhaps the first time the coincidental occurrence of these two di...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.112.1.273
更新日期:1997-07-01 00:00:00
abstract::An unruptured aneurysm of the left sinus of Valsalva was diagnosed by angiography in a 16-year-old male subject 19 years ago. A recent repeated angiographic study documented no change in the aneurysm over the 19-year interval, and the patient has remained asymptomatic. We are aware of no other long-term follow-up repo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.1.143
更新日期:1986-07-01 00:00:00
abstract::There is increasing clinical, radiologic, and pathologic recognition of the coexistence of emphysema and pulmonary fibrosis in the same patient, resulting in a clinical syndrome known as combined pulmonary fibrosis and emphysema (CPFE) that is characterized by dyspnea, upper-lobe emphysema, lower-lobe fibrosis, and ab...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.11-1062
更新日期:2012-01-01 00:00:00
abstract::Pulmonary torsion is very rare, and usually occurs following lung resection. We report a case of spontaneous middle lobe torsion in a patient presenting with a right pleural effusion. The condition was treated by lobectomy through a totally thoracoscopic approach. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-2373
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Early-life stress is becoming an important determinant of immune system programming. Maternal prenatal distress is found to be associated with atopic disease in offspring but the separate effects of postnatal distress are not well-studied. RESEARCH QUESTION:Does the likelihood of asthma and atopic dermatiti...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2020.01.052
更新日期:2020-07-01 00:00:00
abstract::We report the clinical history, laboratory findings, and imaging features of coronavirus disease 2019 (COVID-19) in a neonate whose mother was also a patient. The newborn was the youngest patient with COVID-19 in the world at the time he was diagnosed. This case has brought more attention and understanding to the epid...
journal_title:Chest
pub_type:
doi:10.1016/j.chest.2020.03.018
更新日期:2020-07-01 00:00:00
abstract:STUDY OBJECTIVE:To examine if the perception of dyspnea during normal pregnancy may be related to an inappropriate ventilatory response to the increased metabolic rate, due to a higher chemosensitivity. PATIENTS AND INTERVENTIONS:At weeks 12, 24, and 36 of gestation and 4 months after delivery, 11 healthy pregnant wom...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.2.446
更新日期:1996-08-01 00:00:00
abstract::A 77-year-old man with a history of renal cell carcinoma presented with orthostatic syncope. Investigation revealed metastatic carcinoma in the left lung extending through the pulmonary veins into the left atrium obstructing the mitral orifice. On review of the literature, this case appears to be the first to describe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.2.481
更新日期:1990-08-01 00:00:00
abstract::Aortopulmonary window is a rare congenital cardiac anomaly. When it coexists with a ventricular septal defect, the accurate diagnosis of aortopulmonary window on the basis of clinical examination is difficult. We report the case of an infant who had an aortopulmonary window together with a ventricular septal defect. A...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.1.280
更新日期:1992-01-01 00:00:00
abstract::Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the a...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1016/j.chest.2019.12.002
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Cytochrome P-450 2J2 (CYP2J2) has recently been shown to be an important enzyme in the metabolism of epoxygenase-derived eicosanoids that play important functional roles in pulmonary physiology and may contribute to the pathogenesis of asthma. STUDY OBJECTIVE:The focus of our pilot study was to evaluate whe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.07-0371
更新日期:2007-07-01 00:00:00
abstract::Although the relationship between blood pressure and cardiac performance has been widely recognized, there are few published clinical observations concerning the effect of blood pressure control on cardiac function. We evaluated the effect of prazosin, an antihypertensive agent which also improves hemodynamic measurem...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.80.6.692
更新日期:1981-12-01 00:00:00
abstract::Substantial experimental evidence supports the idea that the fibroblast may play a significant role in the vascular response to injury, especially under hypoxic conditions. Fibroblasts have the ability to rapidly respond to hypoxic stress and to modulate their function to adapt rapidly to local vascular needs. Fibrobl...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.122.6_suppl.326s
更新日期:2002-12-01 00:00:00
abstract::A 60-year-old laboratory technician developed pulmonary infiltrates consistent with chemical pneumonitis following accidental exposure to a mixture of hydrogen bromide and phosphorus tribromide. A protracted clinical course ensued consistent with bronchiolitis obliterans. These problems may have been avoided if the po...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.1.208
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the relationship between respiratory symptom intensity and quality and dynamic lung hyperinflation (DH) during induced bronchoconstriction in asthma. PATIENTS AND METHODS:Subjects with asthma (n = 116) underwent baseline spirometry and lung volume measurement follow...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.130.4.1072
更新日期:2006-10-01 00:00:00
abstract:STUDY OBJECTIVE:Our group performed a randomized trial to assess whether the addition of endobronchial ultrasound (EBUS) guidance will lead to better results than standard transbronchial needle aspiration (TBNS). EBUS guidance seems to be beneficial in increasing the yield of TBNA but has not been proven to be superior...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.125.1.322
更新日期:2004-01-01 00:00:00
abstract::In a 75-year-old patient presenting with a solitary pulmonary mass, a localized form of Wegener's granulomatosis was diagnosed after lobectomy. In the absence of extrapulmonary manifestations and after a benign postoperative course, the patients was discharged without medical treatment. Three months later, diffuse alv...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.3.955
更新日期:1993-09-01 00:00:00
abstract::The risk and benefits of three treatment strategies were examined in 64 consecutive patients with acute myocardial infarction and cardiogenic shock. Thirteen patients received thrombolytic therapy (group 1), 29 patients received intra-aortic balloon pump counterpulsation support (group 2), and 22 patients were treated...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.4.997
更新日期:1994-04-01 00:00:00