Chest
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Single lung transplantation (SLT) has been shown to be associated with worse long-term outcomes than bilateral lung transplantation (BLT), but often is performed in older adults at risk of not tolerating BLT. ⋯ Our findings show that in older adults, SLT is associated with less morbidity and comparable early survival relative to BLT, but lower 5-year survival. This suggests that SLT is reasonable to perform in older adults at high risk of not tolerating BLT.
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Post-pulmonary embolism (PE) dyspnea is common. Existing noninvasive studies have demonstrated that post-PE dyspnea is associated with elevations in right ventricular (RV) afterload, dead space ventilation, and deconditioning. We aimed to use invasive cardiopulmonary exercise testing (iCPET) parameters in patients with post-PE dyspnea to identify unique physiologic phenotypes. ⋯ In this study, iCPET revealed significant heterogeneity in post-PE dyspnea. Three phenotypes were characterized by differences in RV afterload: ventilatory efficiency, respiratory mechanics, and peripheral oxygen use.
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The diagnostic performance of the available risk assessment models for VTE in patients who are critically ill receiving pharmacologic thromboprophylaxis is unclear. ⋯ gov. ISRCTN44653506; International Standard Randomised Controlled Trial No.: ISRCTN44653506, URL: https://www.isrctn.com.
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Randomized Controlled Trial Multicenter Study
Distribution of Acute and Chronic Kidney Disease across Clinical Phenotypes for Sepsis.
Sepsis is the most common cause of acute kidney injury (AKI) in critically ill patients. Four phenotypes (α, β, γ, δ) for sepsis, which have different outcomes and responses to treatment, were described using routine clinical data in the electronic health record. ⋯ The rates of AKI and AKD differed across clinical sepsis phenotypes and are more common among patients with phenotypes β and δ. Phenotype β showed a higher level of underlying CKD that predisposed patients to new AKI. The α and γ phenotypes showed lower frequencies of AKI and less progression to AKD.