Chest
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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. ⋯ iCPET revealed significant heterogeneity in post-PE dyspnea. Three phenotypes are 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.
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Review
Point-of-care lung ultrasound in emergency medicine: A scoping review with an interactive database.
This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives. ⋯ Observational diagnostic studies have been produced in abundance, leaving a paucity of research exploring clinical utility. Notably, research exploring whether LUS causes changes to clinical decisions is imperative prior to any further research being made into patient benefits.
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Observational Study
Veno-venous Extracorporeal Membrane Oxygenation (VV ECMO) Candidacy Decision-Making: Lessons and Hypotheses from a Single Center Observational Analysis.
Use of venovenous extracorporeal membrane oxygenation (ECMO) is increasing, but candidacy selection processes are variable and subject to bias. ⋯ ECMO candidacy decisions are inconsistent. We identified four patterns of inconsistency in our center and propose a three-domain model for understanding and categorizing contraindications, yielding five lessons that may improve candidacy decision processes until further research can guide practice more definitively.