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T1 Age 2 13 53 year old T2 Sex 14 20 female T3 History 21 61 without significant past medical history T4 Disease_disorder 85 94 pneumonia E1 Disease_disorder:T4 T5 Detailed_description 79 84 viral T6 Severity 72 78 severe R1 MODIFY Arg1:T5 Arg2:E1 R2 MODIFY Arg1:T6 Arg2:E1 T7 Diagnostic_procedure 141 159 respiratory status E2 Diagnostic_procedure:T7 T8 Lab_value 120 133 deterioration T9 Detailed_description 108 119 progressive T10 Detailed_description 101 106 rapid R3 MODIFY Arg1:T9 Arg2:T8 R4 MODIFY Arg1:T10 Arg2:T8 R5 MODIFY Arg1:T8 Arg2:E2 T11 Disease_disorder 175 179 ARDS E3 Disease_disorder:T11 #1 AnnotatorNotes E3 Acute respiratory distress syndrome T12 Therapeutic_procedure 184 217 mechanical ventilatory management E4 Therapeutic_procedure:T12 T13 Detailed_description 224 237 ARDS protocol R6 MODIFY Arg1:T13 Arg2:E4 T14 Diagnostic_procedure 271 282 oxygenation E5 Diagnostic_procedure:T14 T15 Lab_value 243 270 unable to maintain adequate R7 MODIFY Arg1:T15 Arg2:E5 T16 Therapeutic_procedure 308 312 ECMO E6 Therapeutic_procedure:T16 #2 AnnotatorNotes E6 Extracorporeal membrane oxygenation T17 Detailed_description 305 307 VV #3 AnnotatorNotes T17 veno-venous R8 MODIFY Arg1:T17 Arg2:E6 T18 Diagnostic_procedure 326 358 Transesophageal echocardiography E7 Diagnostic_procedure:T18 T19 Diagnostic_procedure 360 363 TEE E8 Diagnostic_procedure:T19 R9 IDENTICAL Arg1:E8 Arg2:E7 T20 Detailed_description 297 304 bedside R10 MODIFY Arg1:T20 Arg2:E6 T21 Therapeutic_procedure 399 427 positioning of the guidewire E9 Therapeutic_procedure:T21 T22 Therapeutic_procedure 432 439 cannula E10 Therapeutic_procedure:T22 T23 Coreference 523 544 guide wire was placed E11 Coreference:T23 R11 IDENTICAL Arg1:E11 Arg2:E9 T24 Biological_structure 476 503 right internal jugular vein R12 MODIFY Arg1:T24 Arg2:E11 T25 Detailed_description 451 470 Seldinger technique R13 MODIFY Arg1:T25 Arg2:E11 T26 Coreference 582 585 IVC E12 Coreference:T26 R14 IDENTICAL Arg1:E12 Arg2:T24 T27 Coreference 546 572 Placement of the guidewire E13 Coreference:T27 R15 IDENTICAL Arg1:E13 Arg2:E11 T28 Detailed_description 619 645 migration of the guidewire R16 MODIFY Arg1:T28 Arg2:E13 T29 Biological_structure 655 670 right ventricle R17 MODIFY Arg1:T29 Arg2:T28 T30 Medication 818 825 heparin E14 Medication:T30 T31 Dosage 792 802 5000 units T32 Administration 806 817 intravenous R18 MODIFY Arg1:T32 Arg2:E14 R19 MODIFY Arg1:T31 Arg2:E14 T33 Therapeutic_procedure 887 894 dilated E15 Therapeutic_procedure:T33 #4 AnnotatorNotes E15 an intentional dilation, rather than a problematic one T34 Biological_structure 841 870 right internal jugular venous R20 MODIFY Arg1:T34 Arg2:E15 T35 Detailed_description 778 783 bolus R21 MODIFY Arg1:T35 Arg2:E14 T36 Disease_disorder 1159 1179 pericardial effusion E16 Disease_disorder:T36 T37 Detailed_description 1141 1158 rapidly enlarging R22 MODIFY Arg1:T37 Arg2:E16 T38 Sign_symptom 1078 1105 premature ventricular beats E17 Sign_symptom:T38 T39 Detailed_description 1069 1077 Multiple R23 MODIFY Arg1:T39 Arg2:E17 T40 Lab_value 1032 1067 lost visualization of the guidewire T41 Coreference 1019 1026 cannula E18 Coreference:T41 T42 Diagnostic_procedure 1028 1031 TEE E19 Diagnostic_procedure:T42 R24 MODIFY Arg1:T40 Arg2:E19 #5 AnnotatorNotes T40 a qualitative concept as it's more of a result than a property of how TEE was done T43 Detailed_description 1002 1018 23 French Avalon R25 MODIFY Arg1:T43 Arg2:E18 T44 Therapeutic_procedure 948 964 dilator exchange E20 Therapeutic_procedure:T44 R26 SUB_PROCEDURE Arg1:E20 Arg2:E15 R27 IDENTICAL Arg1:E18 Arg2:E10 T45 Therapeutic_procedure 1260 1282 surgical decompression E21 Therapeutic_procedure:T45 T46 Biological_structure 1290 1307 pericardial space R28 MODIFY Arg1:T46 Arg2:E21 T47 Disease_disorder 1360 1377 cardiac tamponade E22 Disease_disorder:T47 T48 Diagnostic_procedure 1334 1348 blood pressure E23 Diagnostic_procedure:T48 T49 Lab_value 1329 1333 lost R29 MODIFY Arg1:T49 Arg2:E23 T50 Detailed_description 1354 1359 acute R30 MODIFY Arg1:T50 Arg2:E22 T51 Coreference 1390 1397 cannula E24 Coreference:T51 R31 IDENTICAL Arg1:E24 Arg2:E18 T52 Detailed_description 1414 1448 clamped at the end but not removed R32 MODIFY Arg1:T52 Arg2:E24 T53 Therapeutic_procedure 1472 1490 pericardial window E25 Therapeutic_procedure:T53 T54 Biological_structure 1461 1471 subxiphoid R33 MODIFY Arg1:T54 Arg2:E25 T55 Diagnostic_procedure 1563 1577 blood pressure E26 Diagnostic_procedure:T55 T56 Lab_value 1548 1559 restoration R34 MODIFY Arg1:T56 Arg2:E26 T57 Sign_symptom 1519 1527 drainage E27 Sign_symptom:T57 T58 Biological_structure 1531 1543 venous blood R35 MODIFY Arg1:T58 Arg2:E27 T59 Therapeutic_procedure 1579 1590 Transfusion E28 Therapeutic_procedure:T59 T60 Clinical_event 1636 1647 transported E29 Clinical_event:T60 T61 Nonbiological_location 1655 1669 operating room R36 MODIFY Arg1:T61 Arg2:E29 T62 Diagnostic_procedure 1674 1694 surgical exploration E30 Diagnostic_procedure:T62 T63 Detailed_description 1383 1389 Avalon R37 MODIFY Arg1:T63 Arg2:E24 T64 Detailed_description 1700 1706 Avalon T65 Coreference 1707 1714 cannula E31 Coreference:T65 R38 IDENTICAL Arg1:E31 Arg2:E24 R39 MODIFY Arg1:T64 Arg2:E31 T66 Disease_disorder 1733 1743 perforated E32 Disease_disorder:T66 T67 Biological_structure 1748 1775 apex of the right ventricle R40 MODIFY Arg1:T67 Arg2:E32 T68 Coreference 1781 1787 injury E33 Coreference:T68 R41 IDENTICAL Arg1:E33 Arg2:E32 T69 Therapeutic_procedure 1792 1800 repaired E34 Therapeutic_procedure:T69 T70 Coreference 1826 1833 cannula E35 Coreference:T70 R42 IDENTICAL Arg1:E35 Arg2:E31 T71 Detailed_description 1819 1825 Avalon R43 MODIFY Arg1:T71 Arg2:E35 T72 Diagnostic_procedure 1875 1878 TEE E36 Diagnostic_procedure:T72 T73 Detailed_description 1884 1914 additional direct manipulation R44 MODIFY Arg1:T73 Arg2:E36 T74 Biological_structure 1862 1865 IVC R45 MODIFY Arg1:T74 Arg2:E35 T75 Therapeutic_procedure 1919 1923 ECMO E37 Therapeutic_procedure:T75 T76 Detailed_description 1916 1918 VV R46 MODIFY Arg1:T76 Arg2:E37 T77 Diagnostic_procedure 1946 1957 oxygenation E38 Diagnostic_procedure:T77 T78 Lab_value 1958 1966 improved R47 MODIFY Arg1:T78 Arg2:E38 T79 Disease_disorder 1985 1999 coagulopathies E39 Disease_disorder:T79 T80 Therapeutic_procedure 2017 2026 left open E40 Therapeutic_procedure:T80 T81 Biological_structure 2005 2012 sternum R48 MODIFY Arg1:T81 Arg2:E40 T82 Therapeutic_procedure 2035 2041 closed E41 Therapeutic_procedure:T82 T83 Date 2059 2064 day 2 E42 Date:T83 T84 Sign_symptom 2132 2145 complications E43 Sign_symptom:T84 A1 POLARITY E43 NEG T85 Detailed_description 2121 2131 infectious T86 Biological_structure 2110 2117 cardiac R49 MODIFY Arg1:T85 Arg2:E43 R50 MODIFY Arg1:T86 Arg2:E43 T87 Diagnostic_procedure 2154 2173 pulmonary condition E44 Diagnostic_procedure:T87 T88 Lab_value 2174 2189 slowly improved R51 MODIFY Arg1:T88 Arg2:E44 T89 Therapeutic_procedure 2227 2231 ECMO E45 Therapeutic_procedure:T89 T90 Detailed_description 2224 2226 VV R52 MODIFY Arg1:T90 Arg2:E45 A2 POLARITY E45 NEG T91 Date 2249 2254 day 9 E46 Date:T91 T92 Clinical_event 2263 2273 discharged E47 Clinical_event:T92 T93 Nonbiological_location 2274 2278 home R53 MODIFY Arg1:T93 Arg2:E47 T94 Date 2296 2302 day 24 E48 Date:T94 T95 Therapeutic_procedure 2324 2335 home oxygen E49 Therapeutic_procedure:T95 A3 POLARITY E49 NEG T96 Diagnostic_procedure 2355 2373 physical functions E50 Diagnostic_procedure:T96 T97 Lab_value 2350 2354 full R54 MODIFY Arg1:T97 Arg2:E50 T98 Diagnostic_procedure 2403 2421 pulmonary function E51 Diagnostic_procedure:T98 T99 Lab_value 2396 2402 normal R55 MODIFY Arg1:T99 Arg2:E51 T100 Date 2425 2433 3 months E52 Date:T100 T101 Clinical_event 2444 2453 discharge E53 Clinical_event:T101 T102 Nonbiological_location 2463 2471 hospital R56 MODIFY Arg1:T102 Arg2:E53 * OVERLAP E1 E2 R57 BEFORE Arg1:E2 Arg2:E3 * OVERLAP E3 E4 E5 R58 BEFORE Arg1:E5 Arg2:E6 * OVERLAP E6 E7 E9 E10 E14 E15 E19 E17 E16 R59 BEFORE Arg1:E16 Arg2:E21 * OVERLAP E21 E23 E22 E24 R60 BEFORE Arg1:E24 Arg2:E25 * OVERLAP E25 E27 E26 E28 R61 BEFORE Arg1:E28 Arg2:E29 * OVERLAP E29 E30 R62 AFTER Arg1:E30 Arg2:E31 * OVERLAP E31 E32 E33 R63 BEFORE Arg1:E33 Arg2:E34 * OVERLAP E34 E35 E36 R64 BEFORE Arg1:E36 Arg2:E37 * OVERLAP E37 E38 E39 E40 R65 BEFORE Arg1:E40 Arg2:E41 * OVERLAP E41 E42 R66 BEFORE Arg1:E42 Arg2:E43 * OVERLAP E43 E44 R67 BEFORE Arg1:E44 Arg2:E45 * OVERLAP E45 E46 R68 BEFORE Arg1:E46 Arg2:E47 * OVERLAP E47 E48 E49 R69 BEFORE Arg1:E49 Arg2:E50 * OVERLAP E50 E51 E52 R70 AFTER Arg1:E52 Arg2:E53