1
|
G J, Narayanan S, Kumar S, Banjade M, Bairwa M. Spontaneous Pneumothorax, Pneumomediastinum, and Pneumopericardium in an HIV Patient With Tuberculosis: A Rare Trio. Cureus 2024; 16:e58440. [PMID: 38765397 PMCID: PMC11099490 DOI: 10.7759/cureus.58440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
A trio of spontaneous pneumomediastinum, pneumopericardium, and pneumothorax is a highly unusual presentation. The majority of reported cases are due to trauma, while the remaining cases are iatrogenic. Among infections, this trio has so far been reported in COVID-19 pneumonia and pneumocystis pneumonia in HIV-positive patients. There are case reports on pneumothorax and pneumomediastinum in tuberculosis, but the trio is not reported. Here, we present a case of a recently diagnosed HIV-positive patient with complaints of cough and shortness of breath whose initial workup was negative for Mycobacterium. The patient was, however, started on antitubercular drugs based on clinical radiological evidence. He developed spontaneous pneumothorax, pneumomediastinum, and pneumopericardium, and repeat bronchoalveolar lavage (BAL) came positive for Mycobacterium. The patient, however, could not be revived and succumbed to obstructive and septic shock.
Collapse
Affiliation(s)
- Jithesh G
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Swetha Narayanan
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Sahil Kumar
- Hospital Medicine and Critical Care, Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Madhav Banjade
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Mukesh Bairwa
- Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| |
Collapse
|
2
|
Li JC, Nie G, Dai HF. A Case of Spontaneous Mediastinal and Subcutaneous Emphysema in a Patient with HIV-Infected Pneumonia. Curr HIV Res 2022; 20:479-484. [PMID: 36043739 DOI: 10.2174/1570162x20666220829143802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acquired immunodeficiency syndrome is a chronic infectious disease with high mortality and is caused by the Human Immunodeficiency Virus (HIV). Pneumonia caused by HIV is common, but it rarely causes spontaneous mediastinal and subcutaneous emphysema. CASE PRESENTATION A 21-year-old man with severe pneumonia was hospitalized owing to dyspnea that had been persisting for 1 day; blood test results confirmed HIV infection. Initial chest Computed Tomography (CT) did not reveal mediastinal or subcutaneous emphysema. However, after 21 days of treatment, the patient experienced discomfort in the neck region and experienced the feeling of snowflakes on applying pressure. Chest CT showed mediastinal and subcutaneous emphysema, located in the bilateral cervical roots, anterior upper chest wall, left axillary chest wall, mediastinum, and other parts. Metagenomic Next Generation Sequencing (mNGS) of the sputum and blood samples suggested multiple pathogenic infections. Antiinfection treatment was initiated, and changes in the patient's condition were monitored. The patient's subcutaneous emphysema improved during the follow-up. CONCLUSION In HIV-infected patients with sudden mediastinal and subcutaneous emphysema, mNGS can be used to determine the etiological agent during symptomatic treatment. Targeted antipathogen therapy is helpful in improving the condition of patients with subcutaneous emphysema.
Collapse
Affiliation(s)
- Jun-Chen Li
- Department of Internal Medicine, University-Town Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Gang Nie
- Department of Internal Medicine, University-Town Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Hai-Feng Dai
- Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| |
Collapse
|
3
|
Polyantsev AA, Panin SI, Polyantsev AA, Kotrunov VV. [Pneumomediastinum in patients with a novel coronavirus infection (COVID-19)]. Khirurgiia (Mosk) 2021:20-24. [PMID: 33977694 DOI: 10.17116/hirurgia202105120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the optimal management of pneumomediastinum in patients with a novel coronavirus infection (COVID-19). MATERIAL AND METHODS There were 14 patients with pneumomediastinum and COVID-19 infection without mechanical ventilation. We discussed the world data on pneumomediastinum in patients with coronavirus infection. RESULTS Before the COVID-19 pandemic, the annual number of own observations of spontaneous pneumomediastinum did not exceed 1-2 patients. The mechanism of pneumomediastinum is explained by the Macklin effect. COVID-19 pandemic in the Russian Federation was followed by increase of the number of patients with pneumomediastinum up to 2.4% of the total number of patients in the thoracic department. In this sample, pneumomediastinum occurred at all variants of the course of coronavirus infection. The timing of pneumomediastinum ranged from 2 to 18 (median 14) days after clinical manifestation of COVID-19. In 2 out of 14 cases, pneumomediastinum was the main symptom of coronavirus infection at admission. One patient had a combination of pneumomediastinum and pneumothorax. In 6 cases, pneumomediastinum was stable and regressed under conservative therapy. Eight patients underwent Razumovsky suprajugular mediastinotomy. There were no postoperative deaths. Recurrent pneumomediastinum was noted in one patient. CONCLUSION The causes of pneumomediastinum in some patients with coronavirus infection, peculiarities of diagnosis and treatment and clarification of indications for invasive interventions require further study.
Collapse
Affiliation(s)
- A A Polyantsev
- Volgograd State Medical University, Volgograd, Russia.,Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - S I Panin
- Volgograd State Medical University, Volgograd, Russia.,Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - A A Polyantsev
- Volgograd State Medical University, Volgograd, Russia.,Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| | - V V Kotrunov
- Volgograd State Medical University, Volgograd, Russia.,Volgograd Regional Clinical Hospital No. 1, Volgograd, Russia
| |
Collapse
|
4
|
Cancelliere A, Procopio G, Mazzitelli M, Lio E, Petullà M, Serapide F, Pelle MC, Davoli C, Trecarichi EM, Torti C. A case report of pneumomediastinum in a COVID-19 patient treated with high-flow nasal cannula and review of the literature: Is this a "spontaneous" complication? Clin Case Rep 2021; 9:e04007. [PMID: 34084480 PMCID: PMC8142302 DOI: 10.1002/ccr3.4007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/21/2021] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
Oxygen support with high-flow nasal cannula (HFNC) is gentler than mechanical ventilation and may provide significant benefits, but more studies are needed to investigate the efficacy and safety of different respiratory supports in patients with COVID-19 pneumonia.
Collapse
Affiliation(s)
- Anna Cancelliere
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Giada Procopio
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Maria Mazzitelli
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Elena Lio
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Maria Petullà
- Radiology UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Francesca Serapide
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Maria Chiara Pelle
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Chiara Davoli
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Enrico Maria Trecarichi
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | - Carlo Torti
- Infectious and Tropical Disease UnitDepartment of Medical and Surgical Sciences“Magna Graecia” University of CatanzaroCatanzaroItaly
| | | |
Collapse
|
5
|
Xie D, Xu W, You J, Yuan X, Li M, Bi X, Zhang K, Li H, Xian Y. Clinical descriptive analysis of severe Pneumocystis jirovecii pneumonia in renal transplantation recipients. Bioengineered 2021; 12:1264-1272. [PMID: 33896387 PMCID: PMC8806328 DOI: 10.1080/21655979.2021.1911203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pneumocystis jirovecii (P. jirovecii) pneumonia (PJP) is an opportunistic fungal infection after renal transplantation, which is always severe, difficult to diagnose, combined with multiple complications and have poor prognosis. We retrospectively analyzed clinical data, including risk factors, diagnosis, treatment and complications of seven clinical cases suffered with severe PJP after renal transplantation in our department in 2019. All the seven recipients were routinely prescribed with PJP prophylaxis after renal transplantation, and six of them suffered acute graft rejection before the infection. P. jirovecii sequence was identified in blood or broncho-alveolar lavage fluid (BALF) by the metagenomic next-generation sequencing (mNGS) in all patients. All the patients were improved with the therapy trimethoprim-sulfamethoxazole (TMP-SMX) combined with caspofungin for the PJP treatment, but suffered with complications including renal insufficiency, leukopenia, thrombocytopenia, gastrointestinal bleeding, mediastinalemphysema, pulmonary hemorrhage, and hemophagocytic syndrome and other severe infections. Taken together, mNGS is a powerful tool that could be used to diagnose PJP in renal transplantation recipients. And PJP prophylaxis should be prescribed during and after treatment for acute rejection. TMP-SMX is the first-line and effective drug for PJP treatment, but the complications are always life-threatening and lead to poor prognosis. We should pay attention to these life-threatening complications.
Collapse
Affiliation(s)
- Dan Xie
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wen Xu
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jingya You
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaofeng Yuan
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Mingliang Li
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaogang Bi
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Kouxing Zhang
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Heng Li
- Department of Kidney Transplantation, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying Xian
- Department of General Intensive Care Unit, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| |
Collapse
|
6
|
Kong N, Gao C, Xu MS, Xie YL, Zhou CY. Spontaneous pneumomediastinum in an elderly COVID-19 patient: A case report. World J Clin Cases 2020; 8:3573-3577. [PMID: 32913866 PMCID: PMC7457117 DOI: 10.12998/wjcc.v8.i16.3573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/16/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Spontaneous pneumomediastinum (SPM) is more common in young adults, usually caused by external factors like trauma. It causes symptoms such as chest pain or dyspnea, but it is rare to see elderly patients who develop SPM. Here we report the case of an elderly patient diagnosed with coronavirus disease 2019 (COVID-19) who neither got mechanical ventilation nor had chest trauma but were found to develop SPM for unknown reason. CASE SUMMARY A 62-year-old man complained of a 14-d history of fever accompanied by dry cough, shortness of breath, wheezing, myalgia, nausea, and vomiting. Real-time fluorescence polymerase chain reaction confirmed the diagnosis of COVID-19. The patient was treated with supplementary oxygen by nasal cannula and gamma globulin. Other symptomatic treatments included antibacterial and antiviral treatments. On day 4 of hospitalization, he reported sudden onset of dyspnea. On day 6, he was somnolent. On day 12, the patient reported worsening right-sided chest pain which eventually progressed to bilateral chest pain. He was diagnosed with SPM, with no clear trigger found. Conservative treatment was administrated. During follow-up, the pneumomediastinum had resolved and the patient recovered without other complications. CONCLUSION We presume that aging lung changes and bronchopulmonary infection play an important part in the onset of SPM in COVID-19, but severe acute respiratory syndrome may represent a separate pathophysiologic mechanism for pneumomediastinum. Although the incidence of SPM in elderly patients is low, clinicians should be alert to the possibility of SPM in those infected with severe acute respiratory syndrome coronavirus 2 for life-threatening complications such as cardiorespiratory arrest may occur.
Collapse
Affiliation(s)
- Ning Kong
- Department of Radiology, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
| | - Mao-Sheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
| | - Yuan-Liang Xie
- Department of Radiology, Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
| | - Chang-Yu Zhou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
| |
Collapse
|
7
|
Dunphy L, Patel N, Palmer B, McKeown E. Missed opportunity to diagnose HIV with Pneumocystis carinii pneumonia as its sequela. BMJ Case Rep 2020; 13:e235386. [PMID: 32587119 PMCID: PMC7319719 DOI: 10.1136/bcr-2020-235386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2020] [Indexed: 11/03/2022] Open
Abstract
Pneumocystis carinii pneumonia (PCP) is an opportunistic infection of the lung occurring primarily in patients with HIV infection with a CD4 cell count <200 mm3, solid organ transplant recipients and those taking immunosuppressive therapy. The 1980s heralded the HIV pandemic, turning PCP into a major medical and public health problem worldwide. Manifestations of unusual infections such as pneumocystis and Kaposi's sarcoma, were, after all, the first signs of the emerging pandemic to be recognised and may indeed, be the presenting feature of a previously undiagnosed HIV infection. With the advent of pneumocystis chemoprophylaxis and the initiation of highly active antiretroviral therapy, there has been a decreased incidence in developed countries, but it remains high in developing countries. Unfortunately, late presentation of HIV remains a problem resulting in significant morbidity and mortality. The authors report the case of a new diagnosis of HIV infection in a 45-year-old woman, presenting with a dry cough, dyspnoea, unintentional weight loss and PCP. Two weeks after commencing highly active antiretroviral therapy, she was diagnosed with immune reconstitution inflammatory syndrome. Research shows that stigma and discrimination in the healthcare setting contributes to keeping individuals from accessing HIV prevention, care and treatment services and adopting key preventive behaviours. The barriers to HIV testing and stigma eradication in primary care will be explored as well as missed opportunities to diagnosis HIV in primary care in individuals presenting with signs and symptoms of immunosuppression, in this case shingles.
Collapse
Affiliation(s)
- Louise Dunphy
- Department of Acute Medicine, The Royal Berkshire Hospital, Reading, United Kingdom
| | - Neil Patel
- Department of Acute Medicine, The Royal Berkshire Hospital, Reading, United Kingdom
| | - Bret Palmer
- Department of Acute Medicine, The Royal Berkshire Hospital, Reading, United Kingdom
| | - Edward McKeown
- Department of Acute Medicine, The Royal Berkshire Hospital, Reading, United Kingdom
| |
Collapse
|
8
|
Bouwmeester NH, Kieft H, Shahin GM, Nierich AP. A novel approach to resolve severe mediastinal and subcutaneous emphysema occurring in Pneumocystis jirovecii pneumonia using vacuum-assisted closure therapy. SAGE Open Med Case Rep 2020; 8:2050313X20918989. [PMID: 32477555 PMCID: PMC7233891 DOI: 10.1177/2050313x20918989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 03/18/2020] [Indexed: 11/15/2022] Open
Abstract
A 50-year-old human immunodeficiency virus positive patient who was diagnosed with Pneumocystis jirovecii pneumonia developed severe subcutaneous and mediastinal emphysema, which was progressive despite low pressure mechanical ventilation. Infraclavicular skin incisions and vacuum-assisted closure therapy were used to resolve the emphysema. The subcutaneous emphysema decreased significantly, and after 1 week the vacuum-assisted closure therapy was ended successfully. This technique has previously been described in several case reports, where it is a promising treatment in severe subcutaneous emphysema, but it is not yet widely used. This case report supports the further use of vacuum-assisted closure therapy in subcutaneous emphysema. Successful treatment of severe mediastinal and subcutaneous emphysema in Pneumocystis jirovecii pneumonia can be achieved by vacuum-assisted closure therapy on infraclavicular skin incisions.
Collapse
Affiliation(s)
| | - Hans Kieft
- Department of Intensive Care, Isala, Zwolle, The Netherlands
| | - Ghada Mm Shahin
- Department of Cardiothoracic Surgery, Isala, Zwolle, The Netherlands
| | - Arno P Nierich
- Department of Cardiothoracic Anesthesiology, Isala, Zwolle, The Netherlands
| |
Collapse
|
9
|
Affiliation(s)
- Tomohiro Hosoda
- Department of Infectious Disease, Kawasaki Municipal Kawasaki Hospital, Japan
| | - Mitsuo Sakamoto
- Department of Infectious Disease, Kawasaki Municipal Kawasaki Hospital, Japan
| |
Collapse
|
10
|
Weng L, Huang X, Chen L, Feng LQ, Jiang W, Hu XY, Peng JM, Wang CY, Zhan QY, Du B. Prognostic factors for severe Pneumocystis jiroveci pneumonia of non-HIV patients in intensive care unit: a bicentric retrospective study. BMC Infect Dis 2016; 16:528. [PMID: 27686235 PMCID: PMC5041573 DOI: 10.1186/s12879-016-1855-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 09/20/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Pneumocystis jiroveci pneumonia (PJP) in non-HIV patients is still a challenge for intensivists. The aim of our study was to evaluate mortality predictors of PJP patients requiring Intensive care unit (ICU) admission. METHODS Retrospectively review medical records of patients with diagnosis of PJP admitted to four ICUs of two academic medical centers from October 2012 to October 2015. RESULTS Eighty-two patients were enrolled in the study. Overall hospital mortality was 75.6 %. Compared with survivors, the non-survivors had older age (55 ± 16 vs. 45 ± 17, p = 0.014), higher APACHE II score (20 ± 5 vs. 17 ± 5, p = 0.01), lower white blood cell count (7.68 ± 3.44 vs. 10.48 ± 4.62, p = 0.005), less fever (80.6%vs. 100 %, p = 0.033), more hypotension (58.1 % vs. 20 %, p = 0.003), more pneumomediastinum (29 % vs. 5 %, p = 0.027). Logistic regression analysis demonstrated that age [odds ratio (OR)1.051; 95 % CI 1.007-1.097; p = 0.022], white blood cell count [OR 0.802; 95 % CI 0.670-0.960; p = 0.016], and pneumomediastinum [OR 16.514; 95 % CI 1.330-205.027; p = 0.029] were independently associated with hospital mortality. CONCLUSIONS Mortality rate for non-HIV PJP patients requiring ICU admission was still high. Poor prognostic factors included age, white blood cell count and pneumomediastinum.
Collapse
Affiliation(s)
- Li Weng
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| | - Xu Huang
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Beijing, 100029 China
| | - Lie Chen
- Department of General Internal Medicine, Shijingshan hospital, Capital Medical University, 24 Shijingshan street, Shijingshan district, Beijing, 100043 China
| | - Li-Qin Feng
- Intensive Care Unit, Fifth Hospital of Shi Jia Zhuang, 42 Tanan street, Yuhua district, Shijiazhuang, 050021 China
| | - Wei Jiang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| | - Xiao-Yun Hu
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| | - Jin-Min Peng
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| | - Chun-Yao Wang
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| | - Qing-Yuan Zhan
- Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Hepingli, Beijing, 100029 China
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng district, Beijing, 100730 China
| |
Collapse
|