Chest
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Heterotopic ossification (HO), deposition of para-articular ectopic bone, is associated with musculoskeletal trauma and certain congenital and metabolic disorders. Additionally, HO may follow paralysis from diverse traumatic and nontraumatic neurologic insults. We describe three cases of HO associated with catastrophic nontraumatic respiratory illness requiring prolonged chemical paralysis and cardiorespiratory support.
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Do-not-resuscitate (DNR) orders have been espoused for the enhancement of patient autonomy, avoidance of futile medical intervention, and cost containment. Outcomes of cardiopulmonary resuscitation (CPR) in the intensive care setting have been dismal, with few patients surviving to discharge. This study compares patients who died in medical and surgical ICUs in a DNR status with those who died after attempted CPR. ⋯ Among patients dying in the medical and surgical ICUs in the authors' institution, only age and level of consciousness discriminated patients who died in a DNR status from those who died after attempted CPR.