Iatrogenic delirium and coma: a "near miss".

Abstract:

:A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likelihood of improvement existed, prompting clinical consideration of withdrawal of care. The correct diagnosis of iatrogenic drug-induced coma alternating with drug-induced delirium only became apparent after the IV administration of repeated doses of a benzodiazepine antagonist. The patient and husband (co-authors) provide insights often unheard within care circles.

journal_name

Chest

journal_title

Chest

authors

Dunn WF,Adams SC,Adams RW

doi

10.1378/chest.08-0471

subject

Has Abstract

pub_date

2008-05-01 00:00:00

pages

1217-20

issue

5

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)51757-1

journal_volume

133

pub_type

杂志文章

相关文献

CHEST文献大全
  • Acute Effects of Nasal CPAP in Patients With Hypertrophic Cardiomyopathy.

    abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is a common genetic disease that may cause left ventricular outflow tract (LVOT) obstruction, heart failure, and sudden death. Recent studies have shown a high prevalence of OSA among patients with HCM. Because the hemodynamics in patients with LVOT obstruction are unstable ...

    journal_title:Chest

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.chest.2016.05.004

    authors: Nerbass FB,Salemi VMC,Pedrosa RP,Portilho NP,Ferreira-Filho JCA,Moriya HT,Antunes MO,Arteaga-Fernández E,Drager LF,Lorenzi-Filho G

    更新日期:2016-11-01 00:00:00

  • A 78-Year-Old Man With Repeated Dyspnea and Neutrophilia in Peripheral Blood and BAL.

    abstract:CASE PRESENTATION:A 78-year-old man with asthma and COPD presented with shortness of breath, cough, and severe malaise for 4 days. Upon arrival, the patient was conscious and body temperature was 37.5°C. Arterial oxygen saturation (Spo2) was 80% on room air. Laboratory data demonstrated a WBC count of 17,400/μL (89.5% ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2019.07.034

    authors: Nakamatsu E,Morita T,Morishima A,Tagawa H,Furukawa M,Matsushita M,Yamane H

    更新日期:2020-01-01 00:00:00

  • Congenital unilateral absence of the left pulmonary artery. Echocardiography in reverse.

    abstract::This study demonstrates that when the heart is markedly displaced posteriorly to the left, or perhaps to the right, the posterior approach may make echocardiographic evaluation possible. Thus, in a patient with congenital unilateral absence of the left pulmonary artery, with marked displacement of the heart posteriorl...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.77.1.106

    authors: Borgeson E,Vogel JH

    更新日期:1980-01-01 00:00:00

  • Increased serum calcitonin levels in bronchogenic cancer.

    abstract::A study of 26 men with bronchogenic cancer demonstrated high serum calcitonin levels in 62 percent (16). Levels were particularly high in patients with small-cell cancer and adenocarcinoma. Two varieties of hypercalcitonemia have been encountered: (1) ectopic hypercalcitonemia, in which the hormone is secreted by the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.69.4.495

    authors: Silva OL,Becker KL,Primack A,Doppman JL,Snider RH

    更新日期:1976-04-01 00:00:00

  • Reversal of the central hypotensive effect of clonidine by intracisternal curare-like agents.

    abstract::Administration of tubocurarine, pancuronium, gallamine, or decamethonium into the cisterna magna of chloralosed dogs induced a rise in blood pressure. Clonidine (3 micrograms/kg) administered into the cisterna magna after tubocurarine, pancuronium, or gallamine significantly increased blood pressure; no significant ch...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.2_supplement.349

    authors: Tsoucaris-Kupfer D,Schmitt H

    更新日期:1983-02-01 00:00:00

  • Cost-effective preoperative evaluation and testing.

    abstract::Cost-effective preoperative evaluation can be approached from a variety of methods, educational strategies, and use of data to modify clinical practice. This article focuses on the proposed organizational and clinical changes in the process of preoperative evaluations, the cost-effective outcomes, and the relative mer...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.115.suppl_2.96s

    authors: Fischer SP

    更新日期:1999-05-01 00:00:00

  • Calcified plaque in the superior portion of the major fissure. An unusual manifestation of asbestos exposure.

    abstract::Parietal pleural plaque is a well-recognized sign of exposure to asbestos. Visceral pleural involvement is an uncommon manifestation, and calcified visceral pleural plaques are rare. Those reported have been in the minor fissure and inferior major fissure. We describe a unique calcified plaque in the superior major fi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.96.6.1436

    authors: Rupp SB,Jolles H

    更新日期:1989-12-01 00:00:00

  • Survival characteristics after neodymium: YAG laser photoresection in advanced stage lung cancer.

    abstract::In order to assess the long-term clinical benefits of palliative Nd:YAG laser photoresection, we studied 69 patients with obstructing exophytic tracheobronchial lesions treated with this modality between Oct 25, 1984 and May 8, 1989. In 55 patients, there was greater than 75 percent restoration of the luminal caliber ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.3.581

    authors: Ross DJ,Mohsenifar Z,Koerner SK

    更新日期:1990-09-01 00:00:00

  • African-American race and antibodies to topoisomerase I are associated with increased severity of scleroderma lung disease.

    abstract:STUDY OBJECTIVES:To determine whether African-American race is independently associated with lung disease in scleroderma. DESIGN:Retrospective review. SETTING:University medical center in Baltimore. PATIENTS:One hundred one patients with diffuse cutaneous scleroderma with available serum samples. MEASUREMENTS:Patie...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.114.3.801

    authors: Greidinger EL,Flaherty KT,White B,Rosen A,Wigley FM,Wise RA

    更新日期:1998-09-01 00:00:00

  • Use of balloon-expandable metallic stents in the management of bronchial stenosis and bronchomalacia after lung transplantation.

    abstract:STUDY OBJECTIVES:Bronchial stenosis (BS) and bronchomalacia (BM) are often associated with lung allograft rejection or infection in lung transplant (LT) recipients. We reviewed our experience using balloon-expandable metallic (Palmaz) stents in the management of BS and BM in LT. DESIGN:Retrospective review of cases. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.114.5.1330

    authors: Susanto I,Peters JI,Levine SM,Sako EY,Anzueto A,Bryan CL

    更新日期:1998-11-01 00:00:00

  • Efficacy and Safety of Pulmonary Arterial Hypertension-specific Therapy in Pulmonary Arterial Hypertension: A Meta-analysis of Randomized Controlled Trials.

    abstract:BACKGROUND:Previous meta-analyses of pulmonary arterial hypertension (PAH)-specific therapy for PAH pooled PAH-specific combination therapy and monotherapy. This flaw may threaten the authenticity of their findings. METHODS:PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials that ev...

    journal_title:Chest

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.chest.2016.03.031

    authors: Liu HL,Chen XY,Li JR,Su SW,Ding T,Shi CX,Jiang YF,Zhu ZN

    更新日期:2016-08-01 00:00:00

  • O2 uptake kinetics in response to exercise. A measure of tissue anaerobiosis in heart failure.

    abstract::Oxygen uptake (VO2) reflects the rate of aerobic regeneration of high-energy phosphate compounds (primarily adenosine triphosphate [ATP]). Since lactate increase is thought to result from an inadequate rate of aerobic ATP regeneration, it might be expected that lactate increase would be associated with a delayed attai...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.3.735

    authors: Zhang YY,Wasserman K,Sietsema KE,Ben-Dov I,Barstow TJ,Mizumoto G,Sullivan CS

    更新日期:1993-03-01 00:00:00

  • Differential response in the male and female tracheal epithelium following exposure to tobacco smoke.

    abstract::Histochemical quantification of goblet cells and measurements of the epithelial thickness were made in the trachea of male and female rats exposed to fresh whole tobacco smoke for 30 consecutive days. Exposure to tobacco smoke resulted in an increase in the total goblet cell count in both sexes, with the female rats d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.73.4.515

    authors: Hayashi M,Sornberger GC,Huber GL

    更新日期:1978-04-01 00:00:00

  • A 69-Year-Old Man With Chronic Cough and Recurrent Pneumonia.

    abstract:CASE PRESENTATION:A 69-year-old man consulted for a 3-day history of fever, wet cough, and yellow-green phlegm. He denied having any dyspnea, chest pain, hemoptysis, swallowing disorders, choke, chills, asthenia, anorexia, or weight loss. He reported a continuous dry cough and three episodes of pneumonia in the past 4 ...

    journal_title:Chest

    pub_type:

    doi:10.1016/j.chest.2020.07.033

    authors: Hoan L,Hang LM,Thanh Hong DT,Nhu Quynh NT,Linh LT,Cuong NN,Minh TN,Luan DT,Thang ND,Delphine N

    更新日期:2020-12-01 00:00:00

  • Pulmonary Langerhans cell histiocytosis-associated pulmonary hypertension: clinical characteristics and impact of pulmonary arterial hypertension therapies.

    abstract:BACKGROUND:Precapillary pulmonary hypertension (PH) is a complication of pulmonary Langerhans cell histiocytosis (PLCH) associated with increased mortality. However, outcomes and efficacy of pulmonary arterial hypertension (PAH) therapies in patients with PH complicating PLCH(PLCH-PH) remain unknown. METHODS:Consecuti...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.11-2490

    authors: Le Pavec J,Lorillon G,Jaïs X,Tcherakian C,Feuillet S,Dorfmüller P,Simonneau G,Humbert M,Tazi A

    更新日期:2012-11-01 00:00:00

  • Pulmonary edema associated with hyperbaric oxygen therapy.

    abstract::We report three cases of pulmonary edema associated with hyperbaric oxygen therapy, including one fatality. All three patients had cardiac disease and reduced left ventricular (LV) ejection fractions (EFs). Two patients had diabetes, and one patient had severe aortic stenosis. Hyperbaric oxygen therapy may contribute ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.4.1407

    authors: Weaver LK,Churchill S

    更新日期:2001-10-01 00:00:00

  • OSA Syndrome and Posttraumatic Stress Disorder: Clinical Outcomes and Impact of Positive Airway Pressure Therapy.

    abstract:BACKGROUND:We sought to determine the impact of OSA syndrome (OSAS) on symptoms and quality of life (QoL) among patients with posttraumatic stress disorder (PTSD). In addition, we assessed adherence and response to positive airway pressure (PAP) therapy in this population. METHODS:This was a case-controlled observatio...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.15-0693

    authors: Lettieri CJ,Williams SG,Collen JF

    更新日期:2016-02-01 00:00:00

  • Increased CSF opioid activity in sleep apnea syndrome. Regression after successful treatment.

    abstract::The etiology of the SAS is unknown. To test whether endogenous opioids could be pathologically active in SAS, markers of opioid systems were measured in the CSF of 15 patients with SAS and in control subjects. Measured by receptor assay, the concentration of so-called fraction 1 opioid was higher in patients with SAS ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.96.2.250

    authors: Gislason T,Almqvist M,Boman G,Lindholm CE,Terenius L

    更新日期:1989-08-01 00:00:00

  • Implications of lower- and upper-limb training procedures in patients with chronic airway obstruction.

    abstract::In assessing the effectiveness of lower-limb and upper-limb nonspecific physical training, we have considered 3 objectives in this study: (1) determination of clinical and functional actual state in patients with chronic airway obstruction (CAO), before and after training; (2) determination of the tests, level of work...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.101.5_supplement.279s

    authors: Gimenez M,Predine E,Marchand M,Servera E,Ponz JL,Polu JM

    更新日期:1992-05-01 00:00:00

  • Prediction of successful ventilator weaning using airway occlusion pressure and hypercapnic challenge.

    abstract::We studied eleven patients during 14 attempts at weaning from mechanical ventilation to determine whether central ventilatory drive, measured as airway occlusion pressure 0.1 s after onset of inspiration (P 0.1), during spontaneous breathing before and during a brief hypercapnic challenge, could accurately predict the...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.91.4.496

    authors: Montgomery AB,Holle RH,Neagley SR,Pierson DJ,Schoene RB

    更新日期:1987-04-01 00:00:00

  • Expression of CXC chemokine receptors 1 and 2 in human bronchial epithelial cells.

    abstract:INTRODUCTION:CXC chemokine receptor 1 (CXCR1) and CXC chemokine receptor 2 (CXCR2) have been shown to play an important role in transepithelial migration of neutrophil granulocytes during inflammation in various tissues. This study investigated the regulation of gene expression and surface expression of CXCR1 and CXCR2...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.128.5.3724

    authors: Farkas L,Hahn MC,Schmoczer M,Jentsch N,Krätzel K,Pfeifer M,Schulz C

    更新日期:2005-11-01 00:00:00

  • Extracorporeal circulation as an alternative to open-chest cardiac compression for cardiac resuscitation.

    abstract::Open-chest direct cardiac compression represents a more potent but highly invasive option for cardiac resuscitation when conventional techniques of closed-chest cardiac resuscitation fail after prolonged cardiac arrest. We postulated that venoarterial extracorporeal circulation might be a more effective intervention w...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.6.1846

    authors: Gazmuri RJ,Weil MH,Terwilliger K,Shah DM,Duggal C,Tang W

    更新日期:1992-12-01 00:00:00

  • Abdominal placement of tube thoracostomy due to lack of recognition of paralysis of hemidiaphragm.

    abstract::Tube thoracostomy is an invasive procedure that carries a risk of complications. We report a patient with liver cirrhosis, ascites and large left-sided pleural effusion, in whom a trocar type chest tube was inserted at the seventh left intercostal space in the midaxillary line. Chest roentgenogram revealed that the dr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.1.292

    authors: Foresti V,Villa A,Casati O,Parisio E,De Filippi G

    更新日期:1992-07-01 00:00:00

  • A 62-Year-Old Woman With Diffuse Myalgias, Fatigue, and Shortness of Breath.

    abstract:CASE PRESENTATION:A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the abla...

    journal_title:Chest

    pub_type:

    doi:10.1016/j.chest.2019.09.041

    authors: Park BD,Lyn-Kew K,Granchelli A,Mehta A

    更新日期:2020-03-01 00:00:00

  • Treatment of warfarin-associated coagulopathy: a physician survey.

    abstract:STUDY OBJECTIVES:(1) To determine physician preferences in the management of warfarin-induced excessive anticoagulation (AC); and (2) to assess compliance with the American College of Chest Physicians (ACCP) guidelines for the reversal of excessive AC. DESIGN:Cross-sectional physician survey. PARTICIPANTS:Members of ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.6.1972

    authors: Wilson SE,Douketis JD,Crowther MA

    更新日期:2001-12-01 00:00:00

  • Bilateral diaphragm paralysis treated with cuirass ventilation.

    abstract::The therapeutic effects of cuirass ventilation were studied in two patients with bilateral diaphragm paralysis. Negative inspiratory and positive expiratory pressure applied to the cuirass shell was transmitted to the abdominal and thoracic cavities. Diaphragm excursion was enhanced. Nocturnal cuirass ventilation appe...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.92.4.683

    authors: Driver AG,Blackburn BB,Marcuard SP,Austin EH Jr

    更新日期:1987-10-01 00:00:00

  • Reducing COPD Readmissions: Strategies for the Pulmonologist to Improve Outcomes.

    abstract::Hospitalizations for patients with acute exacerbations of COPD are associated with several adverse patient outcomes as well as with significant health-care costs. Despite many interventions targeted at reducing readmissions following an initial hospitalization, there are few strategies that have been consistently asso...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1016/j.chest.2019.06.005

    authors: Freedman N

    更新日期:2019-10-01 00:00:00

  • Magnetic resonance imaging evaluation of pulmonary vascular malformations.

    abstract:OBJECTIVE:The purpose of our study was to establish magnetic resonance imaging (MRI) criteria for the diagnosis of pulmonary vascular malformations (PVMs). MATERIALS AND METHODS:Since 1987, 11 patients have been referred for chest MRI at our institution because of findings suggestive of a PVM. They were evaluated with...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.106.5.1333

    authors: Silverman JM,Julien PJ,Herfkens RJ,Pelc NJ

    更新日期:1994-11-01 00:00:00

  • A Man in His 20s With Cough, Unilateral Pleural Effusion, and Nodular Pleural Thickening.

    abstract:CASE PRESENTATION:A man in his 20s presented to the ED after several months of progressive dyspnea, dry cough, and night sweats. He had no chest pain, fevers, weight loss, or sick contacts. He was previously healthy and took no medications. Social history was notable for 5 pack-years of tobacco use. The patient was sex...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2019.05.040

    authors: Sonnick MA,Weisman S,Borczuk AC,Turetz ML

    更新日期:2019-12-01 00:00:00

  • OSA and pulmonary hypertension: time for a new look.

    abstract::OSA is a common yet underdiagnosed disorder encountered in everyday practice. The disease is a unique physiologic stressor that contributes to the development or progression of many other disorders, particularly cardiovascular conditions. The pulmonary circulation is specifically affected by the intermittent hypoxic a...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.14-0614

    authors: Ismail K,Roberts K,Manning P,Manley C,Hill NS

    更新日期:2015-03-01 00:00:00