Abstract：
:The last 5 years have brought dramatic changes to the care of patients with severe sepsis. While early diagnosis remains a challenge and, regrettably, a rapid, sensitive, and specific diagnostic test is still lacking, the methods to identify those critically ill patients who are likely to die have become clearer. The presence of multiple organ failure, vasopressor-dependent shock, and high values in formalized scoring methods such as the APACHE (acute physiology and chronic health evaluation) and sequential organ failure assessment systems all have some utility for outcome prediction for groups of patients. Refinements in long-used supportive practices such as lower tidal volume ventilation and enhanced glucose control have improved outcomes. A growing appreciation of the importance of timely provision of antimicrobial therapy, circulatory resuscitation, and activated protein C administration have also improved survival. Optimal treatment candidates for, and the timing and dose of some treatments (eg, corticosteroids) remain controversial and are undergoing additional study. Perhaps the most important change in the care of patients with severe sepsis is awareness that the syndrome is more common, lethal, and expensive, than previously appreciated, and as such it warrants an organized approach to care provided by experts. Although there is still much to learn, numerous studies now indicate that improvements in outcomes are possible when treatment protocols that incorporate all known beneficial therapies are applied in a timely fashion.
journal_name
Chestjournal_title
Chestauthors
Wheeler APdoi
10.1378/chest.06-2535subject
Has Abstractpub_date
2007-12-01 00:00:00pages
1967-76issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(15)52474-4journal_volume
132pub_type
杂志文章,评审相关文献
CHEST文献大全abstract：:To assess the value of bronchoalveolar lavage (BAL) for diagnosis, understanding, and treatment of amiodarone-associated pneumonitis, we examined the results of BAL total and differential cell counts and phenotyping of lymphocytes in 22 patients with this lung disorder and in 33 normal subjects. Overall, the total cel...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.99.5.1177
更新日期：1991-05-01 00:00:00
abstract：OBJECTIVES:To describe the anatomy and neurophysiology of the cough reflex. METHODS:A review of the literature was carried out using PubMed and the ISI Web of Knowledge from 1951 to 2004. Most of the referenced studies were carried out in animals CONCLUSIONS:Studies carried out in animals provide suggestive but incon...
journal_title：Chest
pub_type： 杂志文章,评审
doi：10.1378/chest.129.1_suppl.33S
更新日期：2006-01-01 00:00:00
abstract：:The Resource-Based Relative Value Scale (RBRVS) is fundamentally undermined by the following foundational errors: (1) The full range of office-based evaluation and management (E/M) activities are not captured by the Current Procedural Terminology (CPT) code choices, (2) it places relatively high values on procedural s...
journal_title：Chest
pub_type： 杂志文章,评审
doi：10.1378/chest.13-0381
更新日期：2013-09-01 00:00:00
abstract：:Results of preoperative pulmonary function tests were evaluated in 106 patients who had major thoracic or upper abdominal cardiovascular surgery. These results were related to the occurrence of postoperative complications by comparison of pulmonary function data in patients with an ICU stay of less than 5 days versus ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.76.2.130
更新日期：1979-08-01 00:00:00
abstract：:We have assessed right and left ventricular function by multigated radionuclide ventriculography in 12 consecutive patients with acquired immunodeficiency syndrome (AIDS) grouped according to the CDC classification system for HIV infection. Results were correlated with clinical, electrocardiographic and echocardiograp...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.93.3.592
更新日期：1988-03-01 00:00:00
abstract：OBJECTIVE:To investigate the associations of maternal and grandmaternal smoking before, during, and after pregnancy with childhood asthma. DESIGN, SETTING, AND PARTICIPANTS:We conducted a case-control study nested within the Children's Health Study in southern California. The case patients consisted of 338 children wi...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.127.4.1232
更新日期：2005-04-01 00:00:00
abstract：:Seventy-two consecutive adult asthmatic patients seen in the Pulmonary Clinic at Rhode Island Hospital were tested for atopy by prick test with 14 standard aeroallergens and by in vitro total and specific IgE determinations (FAST). A total of 58.3 percent of patients were found to be atopic by these tests. There was a...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.96.6.1336
更新日期：1989-12-01 00:00:00
abstract：:Urticaria with systemic effects occurred in a patient being treated with propranolol and was reproducible upon rechallenge with the drug; Successful beta-adrenergic blocking therapy was achieved using a new agent, tolamolol, with no evidence of any adverse effects. ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.67.4.496
更新日期：1975-04-01 00:00:00
abstract：:Pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is associated with a poor prognosis. Reduction of pulmonary artery pressure in COPD by prolonged oxygen treatment has been shown to be associated with increased survival. In an attempt to find a suitable pharmacologic method of reducing pulmonary a...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.103.5.1354
更新日期：1993-05-01 00:00:00
abstract：STUDY OBJECTIVE:To evaluate the antituberculous treatment responsiveness of endobronchial tuberculosis in the different stages of evolution. DESIGN:A prospective study before and after trial with 9 months of antituberculosis chemotherapy without steroid. PATIENTS AND INTERVENTION:One hundred thirty-six endobronchial ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.103.3.673
更新日期：1993-03-01 00:00:00
abstract：BACKGROUND:Matrix metalloproteinase (MMP)-7 was reported to be a key molecule in the pathogenesis of idiopathic pulmonary fibrosis (IPF) based on the result of microarray analysis and knockout mice. However, the role of MMP-7 has not been determined in other types of idiopathic interstitial pneumonia (IIP). The aim of ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.07-2116
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:To develop an evidence-based approach to follow-up of patients after curative intent therapy for lung cancer. METHODS:Guidelines on lung cancer diagnosis and management published between 2002 and December 2005 were identified by a systematic review of the literature, and supplemental material appropriate to...
journal_title：Chest
pub_type： 杂志文章,实务指引
doi：10.1378/chest.07-1390
更新日期：2007-09-01 00:00:00
abstract：:Twenty-one patients with malignant pleural effusion (MPE) were prospectively entered into a nonrandomized, single-armed study to evaluate the efficacy and safety of recombinant interferon (IFN) alpha-2b (INTRON A; Schering-Plough; Kenilworth, NJ) as an intrapleural palliative agent. From March 1989 through February 19...
journal_title：Chest
pub_type： 临床试验,杂志文章
doi：10.1378/chest.111.6.1597
更新日期：1997-06-01 00:00:00
abstract：:Myiasis refers to a parasitic infestation of vertebrate mammals by dipterous larvae (maggots) of higher flies. Infections in humans typically occur in tropical and subtropical regions, regions with limited medical access, and areas with poor hygiene and living conditions. Infestations in humans have been described in ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1016/j.chest.2015.12.022
更新日期：2016-06-01 00:00:00
abstract：:A 35-year-old male homosexual, a former intravenous drug abuser, was found to be human immunodeficiency virus (HIV) positive in 1984. He developed AIDS in 1987 and began treatment with zidovudine in 1989. One year later he developed left apical pleural blebs, a pneumothorax and an exudative pleural effusion. A maligna...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.103.4.1268
更新日期：1993-04-01 00:00:00
abstract：:The spectrum of pathogens and the microbiologic investigations used to obtain a diagnosis in 178 patients with severe pneumonia (88 percent requiring intermittent positive-pressure ventilation) are reviewed. Ninety-five patients had primary pneumonia, 31 had nosocomial pneumonia, 24 were immunocompromised patients, an...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.101.1.199
更新日期：1992-01-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate the accuracy and practicality of the Apnea Risk Evaluation System (ARES; Advanced Brain Monitoring; Carlsbad, CA), a limited-channel system for diagnosing sleep apnea/hypopnea in the home. DESIGN:Prospective randomized study with blinded analysis. SETTINGS:Two independent, community-based...
journal_title：Chest
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1378/chest.128.4.2166
更新日期：2005-10-01 00:00:00
abstract：STUDY OBJECTIVES:Recent studies combining medical and surgical patients have suggested that mortality is higher for mechanically ventilated women than for men. This study was designed to determine whether there are gender-based differences in outcomes in mechanically ventilated medical ICU (MICU) patients. DESIGN AND ...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.116.3.732
更新日期：1999-09-01 00:00:00
abstract：:Cocaine use is associated with adverse events in nearly every organ system. Cardiovascular complications include hemorrhagic and ischemic stroke, aortic dissection, cardiomyopathy, accelerated coronary artery disease, myocardial infarction, and sudden cardiac death. Syncope may be the presenting symptom in these condi...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.117.1.275
更新日期：2000-01-01 00:00:00
abstract：STUDY OBJECTIVES:To evaluate cardiac autonomic modulation in patients with COPD during peak exercise. METHODS:Fifty-three patients with COPD (mean FEV(1), 35% predicted [SD, 11% predicted]; mean PaO(2), 68 mm Hg [SD, 11 mm Hg]; mean PaCO(2), 40 mm Hg [SD, 7 mm Hg]; mean age, 61 years [SD, 10 years]; 26 women and 27 me...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.124.3.863
更新日期：2003-09-01 00:00:00
abstract：:A patient had accelerated attacks of chest pain associated with transient ST elevation or depression in the anterior leads. Coronary angiogram revealed severe multi-vessel disease. Anginal attacks with conspicuous ST depression were induced repeatedly by both oral and sublingual administration of nifedipine. Among var...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.81.5.646
更新日期：1982-05-01 00:00:00
abstract：STUDY OBJECTIVE:To determine the role of craniofacial risk factors in increasing apneic activity between nonobese and obese habitual snorers. DESIGN:Cross-sectional. SETTING:Care-seeking volunteers identified through advertisements, and referral-based volunteers from two sleep centers serving the greater Cleveland ar...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.111.1.154
更新日期：1997-01-01 00:00:00
abstract：:Strapping of the chest causes decreased lung volumes and increased elastic recoil pressure. Such strapping was used in conjunction with single-breath nitrogen washout to study the effects of changes in these factors on the dynamics of the small airways. Studies consisted of simultaneous measurements of the quasistatic...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.76.1.83
更新日期：1979-07-01 00:00:00
abstract：:Bilateral tuberculous pneumonia with the syndrome of inappropriate secretion of antidiuretic hormone was the cause of the adult respiratory distress syndrome in an elderly patient. Early recognition and prompt therapy enabled the patient to make a complete recovery without the necessity for mechanical ventilation. Wit...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.72.5.678
更新日期：1977-11-01 00:00:00
abstract：STUDY OBJECTIVES:To clarify the significance of a functional lung pattern characterized by a decreased vital capacity (VC) and an increased residual volume (RV), but with a normal FEV1/VC ratio. SETTING:A university teaching hospital. SUBJECTS:Patients with bronchial asthma, pulmonary emphysema, and small airways dis...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.116.1.231
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:The presence and progression of interstitial lung abnormalities (ILAs) is known to be associated with a decline of lung function and increased risk of mortality. RESEARCH QUESTION:We aimed to elucidate the clinical course according to ILAs in patients with COPD. STUDY DESIGN AND METHODS:A retrospective stu...
journal_title：Chest
pub_type： 杂志文章
doi：10.1016/j.chest.2020.08.017
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Strong evidence exists for clinically relevant night-to-night variability of respiratory events in patients with suspected OSA. RESEARCH QUESTION:How many sleep study nights are required to diagnose OSA accurately? STUDY DESIGN AND METHODS:Patients with suspected OSA underwent up to 14 nights of pulse oxim...
journal_title：Chest
pub_type： 杂志文章
doi：10.1016/j.chest.2020.09.098
更新日期：2020-09-25 00:00:00
abstract：:We studied retrospectively 69 cases of chagasic megaesophagus (group 1) and 207 cases of chronic chagasic myocardiopathy (CCM) without megaesophagus (group 2) by autopsy in the Pathology Department of the Federal University of Bahia, Brazil, from 1953 to 1975. It was shown that pulmonary tuberculosis was significantly...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.83.1.87
更新日期：1983-01-01 00:00:00
abstract：OBJECTIVE:To assess the effect of baseline variables, including treatment, on outcome in patients with nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). DESIGN:Retrospective analysis of data from two prospective, randomized, double-blind studies. SETTING:Multinational study with 134 site...
journal_title：Chest
pub_type： 杂志文章
doi：
更新日期：2003-11-01 00:00:00
abstract：:We report an individual with limb-girdle muscular dystrophy who has devised a way to assist her respiration by using her hands braced against the tray of her wheelchair. Utilizing this method, she was able to increase her tidal volume (VT) and lower her respiratory rate compared to unassisted spontaneous breathing, th...
journal_title：Chest
pub_type： 杂志文章
doi：10.1378/chest.123.3.949
更新日期：2003-03-01 00:00:00
