{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:14:33Z","timestamp":1790331273350,"version":"4.1.0"},"reference-count":34,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[1994,7,1]],"date-time":"1994-07-01T00:00:00Z","timestamp":773020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Chest"],"published-print":{"date-parts":[[1994,7]]},"DOI":"10.1378\/chest.106.1.221","type":"journal-article","created":{"date-parts":[[2007,11,7]],"date-time":"2007-11-07T18:28:23Z","timestamp":1194460103000},"page":"221-235","source":"Crossref","is-referenced-by-count":270,"title":["Causes of Fever and Pulmonary Densities in Patients with Clinical Manifestations of Ventilator-Associated Pneumonia"],"prefix":"10.1016","volume":"106","author":[{"given":"G. Umberto","family":"Meduri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory L.","family":"Mauldin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Wunderink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Kenneth V.","family":"Leeper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol B.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Tolley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Mayhall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1378\/chest.106.1.221_bib1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1378\/chest.103.2.547","article-title":"Evaluation of patients suspected of having nosocomial pneumonia: are invasive procedures necessary for accurate decision making?","volume":"103","author":"Fagon","year":"1993","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib2","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/S0891-5520(20)30524-9","article-title":"Diagnosis of pneumonia of ventilator-associated pneumonia","volume":"7","author":"Meduri","year":"1993","journal-title":"Infect Dis Clin North Am"},{"key":"10.1378\/chest.106.1.221_bib3","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1378\/chest.80.3.254","article-title":"Diagnosis of nosocomial bacterial pneumonia in acute, diffuse lung injury","volume":"80","author":"Andrews","year":"1981","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib4","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1164\/ajrccm\/139.4.877","article-title":"Nosocomial pneumonia in patients receiving continuous mechanical ventilation: prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques","volume":"139","author":"Fagon","year":"1989","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib5","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1378\/chest.101.2.500","article-title":"Management of bacterial pneumonia in ventilated patients: protected bronchoalveolar lavage as a diagnostic tool","volume":"101","author":"Meduri","year":"1992","journal-title":"Chest Chesthest"},{"key":"10.1378\/chest.106.1.221_bib6","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1378\/chest.101.2.458","article-title":"Radiologic diagnosis of autopsy-proven ventilator-associated pneumonia","volume":"101","author":"Wunderink","year":"1992","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/0003-4819-99-3-293","article-title":"Multiple organ system failure and infection in adult respiratory distress syndrome","volume":"99","author":"Bell","year":"1983","journal-title":"Ann Intern Med Meded"},{"key":"10.1378\/chest.106.1.221_bib8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00003246-199102000-00010","article-title":"Reliability of the bronchoscopic protected catheter brush in the diagnosis of pneumonia in mechanically ventilated patients","volume":"19","author":"De Castro","year":"1991","journal-title":"Crit Care Med"},{"key":"10.1378\/chest.106.1.221_bib9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1148\/radiology.188.2.8327701","article-title":"Pneumonia and ARDS in the ventilated patient: diagnostic accuracy of the chest radiograph","volume":"188","author":"Winer-Muram","year":"1993","journal-title":"Radiology"},{"key":"10.1378\/chest.106.1.221_bib10","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1164\/ajrccm\/142.3.523","article-title":"Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients","volume":"142","author":"Torres","year":"1990","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib11","first-page":"12","article-title":"Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome","volume":"134","author":"Seidenfeld","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib12","first-page":"472","article-title":"Adult respiratory distress syndrome: prognosis after onset","volume":"132","author":"Fowler","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib13","first-page":"145S","article-title":"Sources of fever in the ventilated patient: diagnostic value of gallium-67 citrate scan [Abstract]","volume":"100","author":"Belenchia","year":"1991","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib14","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1164\/ajrccm\/143.4_Pt_1.855","article-title":"Protected bronchoalveolar lavage: a new bronchoscopic technique to retrieve uncontaminated distal airway secretions","volume":"143","author":"Meduri","year":"1991","journal-title":"Am Rev Respir Dis Disis"},{"key":"10.1378\/chest.106.1.221_bib15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1378\/chest.100.1.179","article-title":"The role of bronchoalveolar lavage in diagnosing nonopportunistic bacterial pneumonia","volume":"100","author":"Meduri","year":"1991","journal-title":"Chest Chesthest"},{"key":"10.1378\/chest.106.1.221_bib16","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1378\/chest.105.5.1516","article-title":"Corticosteroid rescue treatment of progressive fibroproliferation in late ARDS: patterns of response and predictors of outcome","volume":"105","author":"Meduri","year":"1994","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib17","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1164\/ajrccm\/138.1.110","article-title":"Detection of nosocomial lung infection in ventilated patients: use of a protected specimen brush and quantitative culture techniques in 147 patients","volume":"138","author":"Fagon","year":"1988","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib18","first-page":"497","article-title":"The epidemiology of nosocomial pneumonia in medical intensive care unit (MICU) patients: a prospective study based on protected bronchoscopic sampling [Abstract]","volume":"21","author":"George","year":"1992","journal-title":"Infect Control Hosp Epidemiol"},{"key":"10.1378\/chest.106.1.221_bib19","doi-asserted-by":"crossref","first-page":"540","DOI":"10.7326\/0003-4819-116-7-540","article-title":"Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position","volume":"116","author":"Torres","year":"1992","journal-title":"Ann Intern Med"},{"key":"10.1378\/chest.106.1.221_bib20","first-page":"157","article-title":"Nosocomial pneumonia in the 1990's: update of epidemiology and risk factors","volume":"5","author":"Craven","year":"1990","journal-title":"Sem Respir Infect Infectnfect"},{"key":"10.1378\/chest.106.1.221_bib21","doi-asserted-by":"crossref","first-page":"701","DOI":"10.7326\/0003-4819-77-5-701","article-title":"Nosocomial respiratory infections with Gram-negative bacilli","volume":"77","author":"Johanson","year":"1972","journal-title":"Ann Intern Med"},{"key":"10.1378\/chest.106.1.221_bib22","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1378\/chest.102.5_Supplement_1.557S","article-title":"The standardization of bronchoscopic techniques for ventilator-associated pneumonia","volume":"102","author":"Meduri","year":"1992","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib23","article-title":"Roentgentologic signs in the diagnosis of chest disease","year":"1988","journal-title":"In: Fraser RG, Par\u00e9 JAP, Fraser RS, Genereux GP, eds. Diagnosis of Diseases of the Chest. Philadelphia: WB Saunders"},{"key":"10.1378\/chest.106.1.221_bib24","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1378\/chest.91.2.233","article-title":"Use of the protected specimen brush in patients with endotracheal or tracheostomy tubes","volume":"91","author":"Baughman","year":"1987","journal-title":"Chest Chesthest"},{"key":"10.1378\/chest.106.1.221_bib25","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1164\/ajrccm\/138.1.117","article-title":"Diagnostic value of telescoping plugged catheters in mechanically ventilated patients with bacterial pneumonia using the Metras catheter","volume":"138","author":"Torres","year":"1988","journal-title":"Am Rev Respir Dis Disis"},{"key":"10.1378\/chest.106.1.221_bib26","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1001\/archsurg.1973.01350150026007","article-title":"Misdiagnosis of pneumonia in patients needing mechanical respiration","volume":"106","author":"Bryant","year":"1973","journal-title":"Arch Surg"},{"key":"10.1378\/chest.106.1.221_bib27","first-page":"4S","article-title":"Diagnosis of pneumonia in critically ill patients [Abstract]","volume":"94","author":"Joshi","year":"1988","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib28","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1001\/archsurg.1985.01390290012002","article-title":"Idiopathic pulmonary fibrosis in adult respiratory distress syndrome","volume":"120","author":"Ashbaugh","year":"1985","journal-title":"Arch Surg"},{"key":"10.1378\/chest.106.1.221_bib29","first-page":"12","article-title":"Incidence, site, and outcome of infections in patients with the adult respiratory distress syndrome","volume":"134","author":"Seidenfeld","year":"1986","journal-title":"Am Rev Respir Dis"},{"key":"10.1378\/chest.106.1.221_bib30","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/00003246-199002000-00009","article-title":"Use of bronchoalveolar lavage to diagnose bacterial pneumonia in mechanically ventilated patients","volume":"18","author":"Guerra","year":"1990","journal-title":"Crit Care Med Meded"},{"key":"10.1378\/chest.106.1.221_bib31","first-page":"865","article-title":"Sepsis complicating the acute respiratory distress syndrome","volume":"135","author":"Ashbaugh","year":"1972","journal-title":"Surgery"},{"key":"10.1378\/chest.106.1.221_bib32","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1378\/chest.100.4.943","article-title":"Fibroproliferative phase of ARDS clinical findings and effects of corticosteroids","volume":"100","author":"Meduri","year":"1991","journal-title":"Chest"},{"key":"10.1378\/chest.106.1.221_bib33","first-page":"69","article-title":"Interpretation of diagnostic data","author":"Sackett","year":"1991","journal-title":"Sackett DL, et al, ed. Clinical epidemiology: a basic science for clinical medicine. 2nd ed. Boston: Little Brown & Co"},{"key":"10.1378\/chest.106.1.221_bib34","first-page":"120","article-title":"The application of decision analysis to critical care medicine","volume":"9","author":"Chalfin","year":"1992","journal-title":"Intensive Care World"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S001236921638984X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S001236921638984X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T01:55:28Z","timestamp":1630029328000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S001236921638984X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,7]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1994,7]]}},"alternative-id":["S001236921638984X"],"URL":"https:\/\/doi.org\/10.1378\/chest.106.1.221","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[1994,7]]}}}