Scholars@Duke
Miriam Treggiari

Miriam Treggiari

Paul G. Barash Distinguished Professor of Anesthesiology
Anesthesiology, Critical Care Medicine
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Selected Publications

Early Beta-Blocker Utilization in Critically Ill Patients With Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article J Intensive Care Med · September 2024 BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice a ... Full text Link to item Cite

The role of Advance Directives and Living Wills in Anesthesia Practice.

Journal Article Anesthesiol Clin · September 2024 Preoperative review of existing advance directives and a discussion of patient goals should be routinely done to address any potential limitations on resuscitative therapies during perioperative care. Both surgeons and anesthesiologists should be collabora ... Full text Link to item Cite

Management of Muscle Relaxation With Rocuronium and Reversal With Neostigmine or Sugammadex Guided by Quantitative Neuromuscular Monitoring.

Journal Article Anesth Analg · September 1, 2024 BACKGROUND: The optimal pharmacological reversal strategy for neuromuscular blockade remains undefined even in the setting of strong recommendations for quantitative neuromuscular monitoring by several national and international anesthesiology societies. W ... Full text Link to item Cite

Opioid Dose Variation in Cardiac Surgery: A Multicenter Study of Practice.

Journal Article Anesth Analg · August 21, 2024 BACKGROUND: Although high-opioid anesthesia was long the standard for cardiac surgery, some anesthesiologists now favor multimodal analgesia and low-opioid anesthetic techniques. The typical cardiac surgery opioid dose is unclear, and the degree to which p ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article Anesth Analg · August 1, 2024 BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate ... Full text Link to item Cite

Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate - Severe traumatic brain injury: A TRACK-TBI study.

Journal Article J Clin Neurosci · August 2024 BACKGROUND: Traumatic brain injury (TBI) triggers autonomic dysfunction and inflammatory response that can result in secondary brain injuries. Dexmedetomidine is an alpha-2 agonist that may modulate autonomic function and inflammation and has been increasi ... Full text Link to item Cite

Use of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study.

Journal Article Crit Care Explor · July 1, 2024 OBJECTIVES: To describe the utilization of early ketamine use among patients mechanically ventilated for COVID-19, and examine associations with in-hospital mortality and other clinical outcomes. DESIGN: Retrospective cohort study. SETTING: Six hundred ten ... Full text Link to item Cite

Contemporary management of aneurysmal subarachnoid haemorrhage. An update for the intensivist.

Journal Article Intensive Care Med · May 2024 Aneurysmal subarachnoid haemorrhage (aSAH) is a rare yet profoundly debilitating condition associated with high global case fatality and morbidity rates. The key determinants of functional outcome include early brain injury, rebleeding of the ruptured aneu ... Full text Link to item Cite

Design and implementation of community consultation for research conducted under exception from informed consent regulations for the PreVent and the PreVent 2 trials: Changes over time and during the COVID-19 pandemic.

Journal Article Clin Trials · April 27, 2024 INTRODUCTION: Emergency clinical research has played an important role in improving outcomes for acutely ill patients. This is due in part to regulatory measures that allow Exception From Informed Consent (EFIC) trials. The Food and Drug Administration (FD ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical and Functional Outcomes Following Moderate-Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · April 1, 2024 OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ... Full text Link to item Cite

Soft phenotyping for sepsis via EHR time-aware soft clustering.

Journal Article J Biomed Inform · April 2024 OBJECTIVE: Sepsis is one of the most serious hospital conditions associated with high mortality. Sepsis is the result of a dysregulated immune response to infection that can lead to multiple organ dysfunction and death. Due to the wide variability in the c ... Full text Link to item Cite

Comments on: Reducing the Risks of Nuclear War—The Role of Health Professionals

Journal Article Anaesthesia Critical Care and Pain Medicine · February 1, 2024 Full text Cite

Intracarotid Infusion of Redox-Active Manganese Porphyrin, MnTnBuOE-2-PyP5+, following Reperfusion Improves Long-Term, 28-Day Post-Stroke Outcomes in Rats.

Journal Article Antioxidants (Basel) · October 13, 2023 Endovascular mechanical thrombectomy, combined with a tissue plasminogen activator (t-PA), is efficacious as a standard care for qualifying ischemic stroke patients. However, > 50% of thrombectomy patients still have poor outcomes. Manganese porphyrins, co ... Full text Link to item Cite

Cervical sympathectomy to treat cerebral vasospasm: a scoping review.

Journal Article Reg Anesth Pain Med · October 2023 BACKGROUND/IMPORTANCE: Delayed cerebral ischemia (DCI) is the second-leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (aSAH), and is associated with cerebral arterial vasospasm (CAV). Current treatments for CAV are ... Full text Open Access Link to item Cite

Perioperative Complications in Patients with Systemic Sclerosis: A Comparative Cohort Analysis.

Journal Article Med Res Arch · October 2023 BACKGROUND: Systemic sclerosis (SSc) is a rare autoimmune disorder with pathological manifestations affecting multiple organ systems. Few studies have examined perioperative outcomes in patients with this disorder. The primary aim of this retrospective sin ... Full text Open Access Link to item Cite

Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States.

Journal Article Crit Care Med · September 1, 2023 OBJECTIVES: To describe frequency of positive blood cultures, patterns of pathogens' characteristics and their resistance profile in patients with blood cultures drawn due to a presumed diagnosis of community-onset sepsis, and to examine the association be ... Full text Link to item Cite

Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Explor · September 2023 OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ... Full text Open Access Link to item Cite

Hemodynamic Management in the Prevention and Treatment of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage.

Journal Article Neurocrit Care · August 2023 One of the most serious complications after subarachnoid hemorrhage (SAH) is delayed cerebral ischemia, the cause of which is multifactorial. Delayed cerebral ischemia considerably worsens neurological outcome and increases the risk of death. The targets o ... Full text Link to item Cite

Early Beta-Blocker Utilization in Critically Ill Patients With Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article J Intensive Care Med · September 2024 BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice a ... Full text Link to item Cite

The role of Advance Directives and Living Wills in Anesthesia Practice.

Journal Article Anesthesiol Clin · September 2024 Preoperative review of existing advance directives and a discussion of patient goals should be routinely done to address any potential limitations on resuscitative therapies during perioperative care. Both surgeons and anesthesiologists should be collabora ... Full text Link to item Cite

Management of Muscle Relaxation With Rocuronium and Reversal With Neostigmine or Sugammadex Guided by Quantitative Neuromuscular Monitoring.

Journal Article Anesth Analg · September 1, 2024 BACKGROUND: The optimal pharmacological reversal strategy for neuromuscular blockade remains undefined even in the setting of strong recommendations for quantitative neuromuscular monitoring by several national and international anesthesiology societies. W ... Full text Link to item Cite

Opioid Dose Variation in Cardiac Surgery: A Multicenter Study of Practice.

Journal Article Anesth Analg · August 21, 2024 BACKGROUND: Although high-opioid anesthesia was long the standard for cardiac surgery, some anesthesiologists now favor multimodal analgesia and low-opioid anesthetic techniques. The typical cardiac surgery opioid dose is unclear, and the degree to which p ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article Anesth Analg · August 1, 2024 BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate ... Full text Link to item Cite

Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate - Severe traumatic brain injury: A TRACK-TBI study.

Journal Article J Clin Neurosci · August 2024 BACKGROUND: Traumatic brain injury (TBI) triggers autonomic dysfunction and inflammatory response that can result in secondary brain injuries. Dexmedetomidine is an alpha-2 agonist that may modulate autonomic function and inflammation and has been increasi ... Full text Link to item Cite

Use of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study.

Journal Article Crit Care Explor · July 1, 2024 OBJECTIVES: To describe the utilization of early ketamine use among patients mechanically ventilated for COVID-19, and examine associations with in-hospital mortality and other clinical outcomes. DESIGN: Retrospective cohort study. SETTING: Six hundred ten ... Full text Link to item Cite

Contemporary management of aneurysmal subarachnoid haemorrhage. An update for the intensivist.

Journal Article Intensive Care Med · May 2024 Aneurysmal subarachnoid haemorrhage (aSAH) is a rare yet profoundly debilitating condition associated with high global case fatality and morbidity rates. The key determinants of functional outcome include early brain injury, rebleeding of the ruptured aneu ... Full text Link to item Cite

Design and implementation of community consultation for research conducted under exception from informed consent regulations for the PreVent and the PreVent 2 trials: Changes over time and during the COVID-19 pandemic.

Journal Article Clin Trials · April 27, 2024 INTRODUCTION: Emergency clinical research has played an important role in improving outcomes for acutely ill patients. This is due in part to regulatory measures that allow Exception From Informed Consent (EFIC) trials. The Food and Drug Administration (FD ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical and Functional Outcomes Following Moderate-Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · April 1, 2024 OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ... Full text Link to item Cite

Soft phenotyping for sepsis via EHR time-aware soft clustering.

Journal Article J Biomed Inform · April 2024 OBJECTIVE: Sepsis is one of the most serious hospital conditions associated with high mortality. Sepsis is the result of a dysregulated immune response to infection that can lead to multiple organ dysfunction and death. Due to the wide variability in the c ... Full text Link to item Cite

Comments on: Reducing the Risks of Nuclear War—The Role of Health Professionals

Journal Article Anaesthesia Critical Care and Pain Medicine · February 1, 2024 Full text Cite

Intracarotid Infusion of Redox-Active Manganese Porphyrin, MnTnBuOE-2-PyP5+, following Reperfusion Improves Long-Term, 28-Day Post-Stroke Outcomes in Rats.

Journal Article Antioxidants (Basel) · October 13, 2023 Endovascular mechanical thrombectomy, combined with a tissue plasminogen activator (t-PA), is efficacious as a standard care for qualifying ischemic stroke patients. However, > 50% of thrombectomy patients still have poor outcomes. Manganese porphyrins, co ... Full text Link to item Cite

Cervical sympathectomy to treat cerebral vasospasm: a scoping review.

Journal Article Reg Anesth Pain Med · October 2023 BACKGROUND/IMPORTANCE: Delayed cerebral ischemia (DCI) is the second-leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (aSAH), and is associated with cerebral arterial vasospasm (CAV). Current treatments for CAV are ... Full text Open Access Link to item Cite

Perioperative Complications in Patients with Systemic Sclerosis: A Comparative Cohort Analysis.

Journal Article Med Res Arch · October 2023 BACKGROUND: Systemic sclerosis (SSc) is a rare autoimmune disorder with pathological manifestations affecting multiple organ systems. Few studies have examined perioperative outcomes in patients with this disorder. The primary aim of this retrospective sin ... Full text Open Access Link to item Cite

Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States.

Journal Article Crit Care Med · September 1, 2023 OBJECTIVES: To describe frequency of positive blood cultures, patterns of pathogens' characteristics and their resistance profile in patients with blood cultures drawn due to a presumed diagnosis of community-onset sepsis, and to examine the association be ... Full text Link to item Cite

Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Explor · September 2023 OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ... Full text Open Access Link to item Cite

Hemodynamic Management in the Prevention and Treatment of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage.

Journal Article Neurocrit Care · August 2023 One of the most serious complications after subarachnoid hemorrhage (SAH) is delayed cerebral ischemia, the cause of which is multifactorial. Delayed cerebral ischemia considerably worsens neurological outcome and increases the risk of death. The targets o ... Full text Link to item Cite

Guidelines for the Neurocritical Care Management of Aneurysmal Subarachnoid Hemorrhage.

Journal Article Neurocrit Care · August 2023 BACKGROUND: The neurointensive care management of patients with aneurysmal subarachnoid hemorrhage (aSAH) is one of the most critical components contributing to short-term and long-term patient outcomes. Previous recommendations for the medical management ... Full text Link to item Cite

Economic Evaluation of Anesthesiology-Led Cardiac Implantable Electronic Device Service.

Journal Article Healthcare (Basel) · June 27, 2023 BACKGROUND: Implementation of an anesthesiology-led cardiac implantable electronic device (CIED) service can be viewed to have economic and efficiency challenges. This study evaluates the cost savings of an anesthesiology-led CIED service. METHODS: A total ... Full text Link to item Cite

Comparison of electronic versus phone-based administration of the Quality of Recovery-40 survey after ambulatory surgery.

Journal Article J Clin Anesth · June 2023 STUDY OBJECTIVE: Studies that track patient-centered outcomes are better suited to evaluate the relative benefits and harms of an intervention in ambulatory surgery as severe morbidity and mortality have become increasingly rare. This pilot study aimed to ... Full text Link to item Cite

Pro-Con Debate: Interdisciplinary Perspectives on Industry-Sponsored Research.

Journal Article J Arthroplasty · June 2023 PRO: Nearly all new devices and drugs come from industry that provides two-thirds of the funding for medical research, and a much higher fraction of clinical research. Realistically, without corporate-funded studies, perioperative research would stagnate w ... Full text Link to item Cite

Evaluation of a Protocol for the Management of Maintenance and Reversal of Rocuronium Block Using Neostigmine or Sugammadex.

Journal Article Anesth Analg · June 1, 2023 BACKGROUND: Postoperative residual neuromuscular blockade (PRNB) is defined as an adductor pollicis train-of-four ratio (TOFR) <0.9. It is a common postoperative complication when nondepolarizing muscle relaxants are either not reversed or reversed with ne ... Full text Link to item Cite

Pro-Con Debate: Interdisciplinary Perspectives on Industry-Sponsored Research.

Journal Article Anesth Analg · June 1, 2023 Pro: Nearly all new devices and drugs come from industry that provides two-thirds of the funding for medical research, and a much higher fraction of clinical research. Realistically, without corporate-funded studies, perioperative research would stagnate w ... Full text Link to item Cite

Utilization and Outcomes of Extracorporeal Membrane Oxygenation Following Traumatic Brain Injury in the United States.

Journal Article J Intensive Care Med · May 2023 Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ... Full text Link to item Cite

Association of Appropriate Empirical Antimicrobial Therapy With In-Hospital Mortality in Patients With Bloodstream Infections in the US.

Journal Article JAMA Netw Open · January 3, 2023 IMPORTANCE: Bloodstream infections (BSIs) are a major public health problem associated with high morbidity. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy. OBJECTIVE: To estimate the ass ... Full text Link to item Cite

Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery

Journal Article Annals of Internal Medicine · January 1, 2023 Background: The REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) trial found similar ambulation and survival at 60 days with spinal versus general anesthesia for hip fracture surgery. Trial outcomes evaluating pain, ... Full text Cite

Association of Blood Culture-positive Pathogens With Outcomes in Community Onset Sepsis in the Intensive Care Unit

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · 2023 Cite

Efficacy and Safety of Sugammadex to Shorten Time-to-Extubation Following Cardiac Surgery: A Single-Center Randomized Placebo-Controlled Trial

Journal Article Critical Care Explorations · December 22, 2022 OBJECTIVES: Residual neuromuscular blockade (NMB) is an important and modifiable factor associated with prolonged mechanical ventilation after cardiac surgery. Studies evaluating the use of sugammadex for residual NMB reversal in the post-cardiac surgery I ... Full text Cite

Pharmacokinetics and Tolerability of Intraperitoneal Chloroprocaine After Fetal Extraction in Women Undergoing Cesarean Delivery.

Journal Article Anesth Analg · October 1, 2022 BACKGROUND: Intraperitoneal chloroprocaine has been used during cesarean delivery to supplement suboptimal neuraxial anesthesia for decades. The short in vitro half-life of chloroprocaine (11-21 seconds) has been cited to support the safety of this approac ... Full text Link to item Cite

A Double-Blind, Randomized, Placebo-Controlled Trial of Soluble Epoxide Hydrolase Inhibition in Patients with Aneurysmal Subarachnoid Hemorrhage.

Journal Article Neurocrit Care · June 2022 BACKGROUND: Epoxyeicosatrienoates (EETs) are endogenous regulators of neuroinflammation and cerebral blood flow. Their metabolism to dihydroxyeicosatrienoates (DHETs) is catalyzed by soluble epoxide hydrolase (sEH). After subarachnoid hemorrhage (SAH), EET ... Full text Link to item Cite

Combined Use of ECMO, Prone Positioning, and APRV in the Management of Severe COVID-19 Patients.

Journal Article Clin Med Insights Circ Respir Pulm Med · 2022 BACKGROUND: Severe COVID-19-associated Acute Respiratory Distress Syndrome (ARDS) may warrant extracorporeal membrane oxygenation (ECMO). We evaluated the safety and physiologic changes in oxygenation and hemodynamic profile during ECMO, prone positioning, ... Full text Link to item Cite

Basics of Perioperative Fluid Requirements in Neurosurgical Patients

Chapter · January 1, 2022 Patients scheduled for elective neurosurgical procedures present unique considerations regarding perioperative intravenous fluid management in the context of multiple distinctive factors encountered in this patient population. Commonly used indicators for ... Full text Cite

Treatments Associated with Lower Mortality among Critically Ill COVID-19 Patients: A Retrospective Cohort Study.

Journal Article Anesthesiology · December 1, 2021 BACKGROUND: Mortality in critically ill COVID-19 patients remains high. Although randomized controlled trials must continue to definitively evaluate treatments, further hypothesis-generating efforts to identify candidate treatments are required. This study ... Full text Link to item Cite

Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample.

Journal Article JAMA Netw Open · December 1, 2021 IMPORTANCE: Despite widespread adherence to Surgical Care Improvement Project antibiotic measures, prevention of surgical site infections (SSIs) remains a clinical challenge. Several components of perioperative antibiotic prophylaxis guidelines are incompl ... Full text Link to item Cite

Longitudinal Course of Traumatic Brain Injury Biomarkers for the Prediction of Clinical Outcomes: A Review.

Journal Article J Neurotrauma · September 15, 2021 Protein biomarkers are often measured at hospital presentation to diagnose traumatic brain injury (TBI) and predict patient outcomes. However, a biomarker measurement at this single time point is no more accurate at predicting patient outcomes than less in ... Full text Link to item Cite

The Role of Anesthesiologists in Perioperative Limitation of Potentially Life-Sustaining Medical Treatments: A Narrative Review and Perspective.

Journal Article Anesth Analg · September 1, 2021 No patient arrives at the hospital to undergo general anesthesia for its own sake. Anesthesiology is a symbiont specialty, with the primary mission of preventing physical and psychological pain, easing anxiety, and shepherding physiologic homeostasis so th ... Full text Link to item Cite

Assisted Fluid Management Software Guidance for Intraoperative Fluid Administration.

Journal Article Anesthesiology · August 1, 2021 BACKGROUND: Excessive or inadequate fluid administration causes complications, but despite this, fluid administration during noncardiac surgery is highly variable. Goal-directed management helps optimize the amount and timing of fluid administration; howev ... Full text Open Access Link to item Cite

Factor VIII inhibitor bypass activity (FEIBA) for the reduction of transfusion in cardiac surgery: a randomized, double-blind, placebo-controlled, pilot trial.

Journal Article Pilot Feasibility Stud · July 2, 2021 BACKGROUND: Uncontrolled bleeding after cardiac surgery can be life-threatening. Factor eight inhibitor bypassing activity (FEIBA) is a prothrombin complex concentrate empirically used as rescue therapy for correction of refractory bleeding diathesis post- ... Full text Link to item Cite

Agreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults.

Journal Article Anesth Analg · April 1, 2021 BACKGROUND: Cognitive impairment is common in older surgical patients and is associated with postoperative delirium. However, cognitive function is inconsistently assessed preoperatively, leading to missed opportunities to recognize vulnerable patients. We ... Full text Link to item Cite

Anesthesia for Acute Spinal Cord Injury.

Journal Article Anesthesiol Clin · March 2021 The spinal cord extends from the base of the skull to the first lumbar vertebrae from which it continues as cauda equina. Injuries to the spinal cord can lead to significant short- and long-term morbidities. Depending on the level of injury, morbidities ma ... Full text Link to item Cite

Basics of Neuromonitoring and Anesthetic Considerations.

Journal Article Anesthesiol Clin · March 2021 It is important anesthesiologists understand the pharmacologic interactions of anesthetics and monitoring of evoked potentials or electroencephalography. Intravenous and inhaled anesthetics have varying degrees of influence on different monitoring modaliti ... Full text Link to item Cite

Early but not late convalescent plasma is associated with better survival in moderate-to-severe COVID-19.

Journal Article PLoS One · 2021 BACKGROUND: Limited therapeutic options exist for coronavirus disease 2019 (COVID-19). COVID-19 convalescent plasma (CCP) is a potential therapeutic, but there is limited data for patients with moderate-to-severe disease. RESEARCH QUESTION: What are outcom ... Full text Link to item Cite

COVID-19 mortality risk for older men and women.

Journal Article BMC Public Health · November 19, 2020 BACKGROUND: Case-fatality from COVID-19 has been reported to be relatively high in patients age 65 years or older. We sought to determine the age-specific rates of COVID-19 mortality at the population level. METHODS: We obtained information regarding the t ... Full text Open Access Link to item Cite

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

Journal Article Br J Surg · October 2020 BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A glob ... Full text Link to item Cite

Implementation of the TaperGuardâ„¢ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia.

Journal Article BMC Anesthesiol · August 24, 2020 BACKGROUND: Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuardâ„¢ ETT has a tapered, polyvinylchloride cuff designed to reduce ... Full text Open Access Link to item Cite

Randomized Pilot Trial of Acute Normovolemic Hemodilution in Pediatric Cardiac Surgery Patients.

Journal Article World J Pediatr Congenit Heart Surg · July 2020 BACKGROUND: Due to the substantial improvement in survival among pediatric patients undergoing congenital heart surgery, reducing early and long-term morbidity is becoming the major focus of care. Blood transfusion is associated with worse postoperative ou ... Full text Link to item Cite

Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery.

Journal Article Br J Anaesth · May 2020 BACKGROUND: Residual neuromuscular block has been associated with postoperative pulmonary complications. We hypothesised that sugammadex reduces postoperative pulmonary complications in patients aged ≥70 yr having surgery ≥3 h, compared with neostigmine. M ... Full text Link to item Cite

Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1.

Journal Article Neurocrit Care · February 2020 INTRODUCTION: Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists a ... Full text Link to item Cite

Global Survey of Outcomes of Neurocritical Care Patients: Analysis of the PRINCE Study Part 2.

Journal Article Neurocrit Care · February 2020 BACKGROUND: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and i ... Full text Link to item Cite

Randomized controlled trial of acupuncture to prevent emergence delirium in children undergoing myringotomy tube placement.

Journal Article Minerva Anestesiol · February 2020 BACKGROUND: Myringotomy tube placement is a pediatric procedure frequently performed under inhalational anesthesia without intravenous line placement. Emergence delirium is common following sevoflurane anesthesia, and can lead to patient harm and escalatio ... Full text Link to item Cite

Oropharyngeal Oxygen Concentration Is Dependent on the Oxygen Mask System and Sampling Location.

Journal Article Respir Care · January 2020 BACKGROUND: Numerous oxygen delivery systems are used to treat hypoxemia. It is unknown if FIO2 at the lips predicts oropharyngeal FIO2 for various oxygen mask systems. We tested whether FIO2 measurements differed between the lips and oropharynx, and wheth ... Full text Link to item Cite

Education Program Regarding Labor Epidurals Increases Utilization by Hispanic Medicaid Beneficiaries: A Randomized Controlled Trial.

Journal Article Anesthesiology · October 2019 BACKGROUND: Hispanic women choose epidural labor analgesia less commonly than non-Hispanic women. This may represent a healthcare disparity related to a language barrier and inadequate opportunities for labor analgesia education. It was hypothesized that a ... Full text Link to item Cite

Inhaled Iloprost Versus Epoprostenol in Heart Transplant Recipients.

Journal Article Respir Care · July 2019 BACKGROUND: Acute right ventricular dysfunction is a challenging problem in the immediate postoperative period following orthotopic heart transplantation. There are no prior reports of the use of inhaled iloprost in the setting of acute right ventricular d ... Full text Link to item Cite

Electromagnetic Interference with Protocolized Electrosurgery Dispersive Electrode Positioning in Patients with Implantable Cardioverter Defibrillators.

Journal Article Anesthesiology · April 2019 WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Electromagnetic interference from monopolar electrosurgery may disrupt implantable cardioverter defibrillators.Current management recommendations by the American Society of Anesthesiologists and Heart Rhythm Society a ... Full text Link to item Cite

Right Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · March 2019 OBJECTIVE: An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performan ... Full text Link to item Cite

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research.

Journal Article Br J Surg · January 2019 BACKGROUND: The Clavien-Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the C ... Full text Link to item Cite

Cohort Study of Albumin versus Lactated Ringer's for Postoperative Cardiac Surgery Fluid Resuscitation in the Intensive Care Unit.

Journal Article Pharmacotherapy · December 2018 PURPOSE: A new postcardiac surgery fluid resuscitation strategy was implemented in our cardiovascular intensive care unit (CVICU) to implement evidence-based practice. We transitioned from a primarily albumin fluid-based strategy to a lactated Ringer's flu ... Full text Link to item Cite

Management of rocuronium neuromuscular block using a protocol for qualitative monitoring and reversal with neostigmine.

Journal Article Br J Anaesth · August 2018 BACKGROUND: Neuromuscular block using subjective monitoring and neostigmine reversal is commonly associated with postoperative residual neuromuscular block. We tested whether a protocol for the management of neuromuscular block that specified appropriate d ... Full text Link to item Cite

The use of acute normovolemic hemodilution in paediatric cardiac surgery.

Journal Article Acta Anaesthesiol Scand · July 2018 BACKGROUND: Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood-loss surgeries. We determined the association between ANH and the intraoperative use ... Full text Link to item Cite

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis.

Journal Article Br J Anaesth · January 2018 BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. METHODS: Prospective analysis of data from the International Surgical Out ... Full text Link to item Cite

In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study.

Journal Article Eur J Surg Oncol · December 2017 AIMS: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level. ... Full text Link to item Cite

Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery.

Journal Article Br J Anaesth · August 1, 2017 BACKGROUND: The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple hea ... Full text Link to item Cite

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries.

Journal Article Intensive Care Med · July 2017 PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperati ... Full text Link to item Cite

Process Improvement Initiative for the Perioperative Management of Patients With a Cardiovascular Implantable Electronic Device.

Journal Article Anesth Analg · July 2017 BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, ... Full text Link to item Cite

An initiative to optimize waste streams in the operating room: RECycling in the operating room (RECOR) project

Journal Article AANA Journal · April 1, 2017 The goal of this project was to optimally sort waste material in the operating room (OR) environment and divert waste such that streams of low-cost disposal, including recyclable material, could be maximized. Using the Lean Six Sigma method, we followed 5 ... Cite

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

Journal Article Br J Anaesth · October 31, 2016 BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day ... Full text Open Access Link to item Cite

Comparison of enteral ethanol and benzodiazepines for alcohol withdrawal in neurocritical care patients.

Journal Article J Clin Neurosci · September 2016 We designed a study to evaluate the use of benzodiazepines and ethanol in patients being assessed for alcohol withdrawal and compare outcomes between the two agents. This is a retrospective chart review of patients admitted to neurocritical care or neurosu ... Full text Link to item Cite

Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival.

Journal Article J Clin Sleep Med · April 15, 2016 STUDY OBJECTIVES: Poor sleep quality and short sleep duration have been associated with elevated risk for several cancer types; however, the relationship between sleep and cancer outcomes has not been well characterized. We assessed the association between ... Full text Link to item Cite

Preoperative Consultations.

Journal Article Anesthesiol Clin · March 2016 Preoperative consultation is an important intervention that likely has most benefits for intermediate-risk to high-risk patients undergoing major surgery. Consultation rates are likely increasing and there is significant practice variation in the use of co ... Full text Link to item Cite

Characteristics of sepsis-induced cardiac dysfunction using speckle-tracking echocardiography: a feasibility study.

Journal Article Anaesth Intensive Care · January 2016 Septic cardiomyopathy is commonly encountered in patients with severe sepsis and septic shock. This study explores whether novel global and segmental echocardiographic markers of myocardial deformation, using two-dimensional speckle tracking, are associate ... Full text Link to item Cite

Randomized Pilot Trial of Two Modified Endotracheal Tubes To Prevent Ventilator-associated Pneumonia.

Journal Article Ann Am Thorac Soc · January 2016 RATIONALE: Ventilator-associated pneumonia (VAP) is a prevalent and costly nosocomial infection related to instrumentation of the airway with an endotracheal tube (ETT), enabling microaspiration of contaminated secretions. Modification of the ETT design to ... Full text Link to item Cite

Comparison of train-of-four count by anesthesia providers versus TOF-Watch® SX: a prospective cohort study.

Journal Article Can J Anaesth · October 2015 PURPOSE: Qualitative monitoring of neuromuscular blockade using the train-of-four (TOF) count is widely used to determine the timing and dose of reversal agents for neuromuscular blockade. We compared TOF count measured manually by anesthesia providers wit ... Full text Link to item Cite

Dexmedetomidine Does Not Affect Evoked Potentials During Spine Surgery.

Journal Article Anesth Analg · August 2015 BACKGROUND: The effect of dexmedetomidine on evoked potentials (EPs) has not been elucidated. We aimed to investigate the effect of dexmedetomidine on somatosensory, motor, and visual EPs. METHODS: After IRB approval, 40 adult patients scheduled for electi ... Full text Link to item Cite

Randomized pilot trial of intensive management of blood pressure or volume expansion in subarachnoid hemorrhage (IMPROVES).

Journal Article Neurosurgery · February 2015 BACKGROUND: Volume expansion and hypertension are widely used for the hemodynamic management of patients with subarachnoid hemorrhage. OBJECTIVE: To investigate the feasibility, adherence, and retention in a trial of volume expansion and blood pressure man ... Full text Link to item Cite

Assessment of circulating blood volume with fluid administration targeting euvolemia or hypervolemia.

Journal Article Neurocrit Care · February 2015 BACKGROUND: The occurrence of hypovolemia in the setting of cerebral vasospasm reportedly increases the risk for delayed ischemic neurologic deficits. Few studies have objectively assessed blood volume (BV) in response to fluid administration targeting nor ... Full text Link to item Cite

Variation in tracheal reintubations among patients undergoing cardiac surgery across Washington state hospitals.

Journal Article J Cardiothorac Vasc Anesth · 2015 OBJECTIVES: The objectives of this study were to examine the variation in reintubations across Washington state hospitals that perform cardiac surgery, and explore hospital and patient characteristics associated with variation in reintubation. DESIGN: Retr ... Full text Link to item Cite

Patient-level interventions to prevent the acquisition of resistant gram-negative bacteria in critically ill patients: a systematic review.

Journal Article Anaesth Intensive Care · January 2015 The rising incidence of multidrug-resistant Gram-negative bacterial (MDR-GNB) infections acquired in intensive care units has prompted a variety of patient-level infection control efforts. However, it is not known whether these measures are effective in re ... Full text Link to item Cite

Validity of exchangeable solute balance as a measure of blood volume in neurologically injured adults.

Journal Article Neurocrit Care · August 2014 BACKGROUND: Daily weight (DW) and examination of fluid balances (FB) are commonly used in assessments of extracellular fluid (ECF) and circulating blood volume (BV). We hypothesized that a calculated total body exchangeable solute, the main determinant of ... Full text Link to item Cite

Long-term survival in patients with severe acute respiratory distress syndrome and rescue therapies for refractory hypoxemia*.

Journal Article Crit Care Med · July 2014 OBJECTIVES: To describe long-term survival in patients with severe acute respiratory distress syndrome and assess differences in patient characteristics and outcomes among those who receive rescue therapies (prone position ventilation, inhaled nitric oxide ... Full text Link to item Cite

In vitro evaluation of diffusion of lidocaine and alkalinized lidocaine through the polyurethane membrane of the endotracheal tube.

Journal Article Ann Fr Anesth Reanim · April 2014 OBJECTIVES: Endotracheal tube (ETT) and its inflated cuff are likely to induce specific reactivity at the emergence time. In ICU, the tolerance of the ETT cuff could be a part of patient agitation and increased of sedation. MATERIALS AND METHODS: Using spe ... Full text Link to item Cite

Improved analgesia, sedation, and delirium protocol associated with decreased duration of delirium and mechanical ventilation.

Journal Article Ann Am Thorac Soc · March 2014 RATIONALE: Introduction of sedation protocols has been associated with improved patient outcomes. It is not known if an update to an existing high-quality sedation protocol, featuring increased patient assessment and reduced benzodiazepine exposure, is ass ... Full text Link to item Cite

Preoperative consultations for medicare patients undergoing cataract surgery.

Journal Article JAMA Intern Med · March 2014 IMPORTANCE: Low-risk elective surgical procedures are common, but there are no clear guidelines for when preoperative consultations are required. Such consultations may therefore represent a substantial discretionary service. OBJECTIVE: To assess temporal ... Full text Link to item Cite

Predictors of reintubation in critically ill patients.

Journal Article Respir Care · February 2014 BACKGROUND: Assessment of a patient's readiness for removal of the endotracheal tube in the ICU is based on respiratory, airway, and neurological measures. However, nearly 20% of patients require reintubation. We created a prediction model for the need for ... Full text Link to item Cite

Characterization of cardiac dysfunction in sepsis: an ongoing challenge.

Journal Article Shock · January 2014 Sepsis-induced cardiomyopathy (SIC), which is a common morbid condition, occurs in patients with severe sepsis and septic shock. The clinical characterization of SIC has been largely concept-driven. Heart function has traditionally been evaluated according ... Full text Link to item Cite

A greater analgesia, sedation, delirium order set quality score is associated with a decreased duration of mechanical ventilation in cardiovascular surgery patients.

Journal Article Crit Care Med · November 2013 OBJECTIVE: Protocols and order sets for the delivery of analgesia, sedation, and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniform in hospitals across geographic areas. The extent t ... Full text Link to item Cite

Standard care versus protocol based therapy for new onset Pseudomonas aeruginosa in cystic fibrosis.

Journal Article Pediatr Pulmonol · October 2013 RATIONALE: The Early Pseudomonal Infection Control (EPIC) randomized trial rigorously evaluated the efficacy of different antibiotic regimens for eradication of newly identified Pseudomonas (Pa) in children with cystic fibrosis (CF). Protocol based therapy ... Full text Link to item Cite

In reply.

Journal Article Anesthesiology · June 2013 Full text Link to item Cite

Patterns of preoperative consultation and surgical specialty in an integrated healthcare system.

Journal Article Anesthesiology · May 2013 BACKGROUND: Many patients scheduled for elective surgery are referred for a preoperative medical consultation. Only limited data are available on factors associated with preoperative consultations. The authors hypothesized that surgical specialty contribut ... Full text Link to item Cite

Etomidate, adrenal function, and mortality in critically ill patients.

Journal Article Respir Care · April 2013 BACKGROUND: In critically ill patients, induction with etomidate is hypothesized to be associated with an increased risk of mortality. Previous randomized studies suggest a modest trend toward an increased risk of death among etomidate recipients; however, ... Full text Link to item Cite

Critical care medicine

Chapter · March 1, 2013 Cite

Pseudomonas aeruginosa serology and risk for re-isolation in the EPIC trial.

Journal Article J Cyst Fibros · March 2013 BACKGROUND: The prognostic value of Pseudomonas aeruginosa serology for antibiotic therapy in cystic fibrosis patients is not well understood. METHODS: Using five antigens from two ELISAs, we assessed whether positive serology in CF patients participating ... Full text Link to item Cite

Targeting brain tissue oxygenation in traumatic brain injury.

Conference Respir Care · January 2013 The management of patients with traumatic brain injury has evolved in the last several years, due to the introduction of new, invasive monitoring devices. The ability to monitor parameters other than measurements related to pressures has generated substant ... Full text Link to item Cite

Intraoperative neuromuscular monitoring site and residual paralysis.

Journal Article Anesthesiology · November 2012 BACKGROUND: Residual paralysis is common after general anesthesia involving administration of neuromuscular blocking drugs (NMBDs). Management of NMBDs and reversal is frequently guided by train-of-four (TOF) monitoring. We hypothesized that monitoring of ... Full text Link to item Cite

Mortality and long-term functional outcome associated with intracranial pressure after traumatic brain injury.

Journal Article Intensive Care Med · November 2012 PURPOSE: Elevated intracranial pressure (ICP) has been associated with increased mortality in patients with severe traumatic brain injury (TBI). We have examined whether raised ICP is independently associated with mortality, functional status and neuropsyc ... Full text Link to item Cite

The association between fluid balance and outcomes after subarachnoid hemorrhage.

Journal Article Neurocrit Care · October 2012 BACKGROUND: We sought to determine the association between early fluid balance and neurological/vital outcome of patients with subarachnoid hemorrhage. METHODS: Hospital admission, imaging, ICU and outcome data were retrospectively collected from the medic ... Full text Link to item Cite

Prehospital amiodarone may increase the incidence of acute respiratory distress syndrome among patients at risk.

Journal Article J Crit Care · October 2012 PURPOSE: Amiodarone has been implicated as a risk factor for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) when used in the hospital. This study aims to estimate whether prehospital amiodarone also increases the risk of ALI/ARDS. M ... Full text Link to item Cite

Occurrence and complications of tracheal reintubation in critically ill adults.

Journal Article Respir Care · October 2012 BACKGROUND: Timing and preparation for tracheal extubation are as critical as the initial intubation. There are limited data on specific strategies for a planned extubation. The extent to which the difficult airway at reintubation contributes to patient mo ... Full text Link to item Cite

Sedation practices in a cohort of critically ill patients receiving prolonged mechanical ventilation.

Journal Article Minerva Anestesiol · July 2012 BACKGROUND: The aim of this paper was to describe type and amount of sedatives, opioid analgesics and anti- psychotics administered to critically ill patients receiving prolonged mechanical ventilation and identify patient-specific factors associated with ... Link to item Cite

A national survey of airway management training in United States internal medicine-based critical care fellowship programs.

Journal Article Respir Care · July 2012 BACKGROUND: Intensivists may be primarily responsible for airway management in non-operating room locations. Little is known of airway management training provided during fellowship.Our primary aim was to describe the current state of airway education in i ... Full text Link to item Cite

Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: a cohort study.

Journal Article Crit Care · June 18, 2012 INTRODUCTION: Protocols for the delivery of analgesia, sedation and delirium care of the critically ill, mechanically ventilated patient have been shown to improve outcomes but are not uniformly used. The extent to which elements of analgesia, sedation and ... Full text Open Access Link to item Cite

The authors respond

Journal Article Respiratory Care · February 1, 2012 Cite

Initial Pseudomonas aeruginosa treatment failure is associated with exacerbations in cystic fibrosis.

Journal Article Pediatr Pulmonol · February 2012 RATIONALE: The risk of pulmonary exacerbation following Pseudomonas aeruginosa (Pa) acquisition in children with cystic fibrosis (CF) is unknown. OBJECTIVES: To determine if failure of antibiotic therapy to eradicate Pa and frequency of Pa recurrence are a ... Full text Link to item Cite

Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference.

Journal Article Neurocrit Care · September 2011 Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are car ... Full text Link to item Cite

Comparative efficacy and safety of 4 randomized regimens to treat early Pseudomonas aeruginosa infection in children with cystic fibrosis.

Journal Article Arch Pediatr Adolesc Med · September 2011 OBJECTIVE: To investigate the efficacy and safety of 4 antipseudomonal treatments in children with cystic fibrosis with recently acquired Pseudomonas aeruginosa infection. DESIGN: Randomized controlled trial. SETTING: Multicenter trial in the United States ... Full text Link to item Cite

Hemodynamic management of subarachnoid hemorrhage.

Journal Article Neurocrit Care · September 2011 Hemodynamic augmentation therapy is considered standard treatment to help prevent and treat vasospasm and delayed cerebral ischemia. Standard triple-H therapy combines volume expansion (hypervolemia), blood pressure augmentation (hypertension), and hemodil ... Full text Link to item Cite

Cardioplegia and ventricular late potentials in cardiac surgical patients.

Journal Article J Clin Monit Comput · August 2011 BACKGROUND AND OBJECTIVE: Ventricular late potentials (LP) recording with signal-averaged electrocar- diogram allow identifying patients at risk of sudden death and ventricular tachycardia. Cardiac surgery with cardiopulmonary bypass (CPB) could predispose ... Full text Link to item Cite

Open-label randomized trial of the safety and efficacy of a single dose conivaptan to raise serum sodium in patients with traumatic brain injury.

Journal Article Neurocrit Care · June 2011 BACKGROUND: Conivaptan is an arginine-vasopressin-receptor antagonist approved for the treatment of hyponatremia. We hypothesized that administration of conivaptan to normonatremic patients with traumatic brain injury (TBI) is safe and could reduce intracr ... Full text Link to item Cite

Intraoperative adherence to a low tidal volume ventilation strategy in critically ill patients with preexisting acute lung injury.

Journal Article J Crit Care · April 2011 PURPOSE: Low tidal volume (LTV) ventilation reduces mortality in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). This study investigates adherence of intraoperative LTV and whether patient outcomes were different with o ... Full text Link to item Cite

Current practices of triple-H prophylaxis and therapy in patients with subarachnoid hemorrhage.

Journal Article Neurocrit Care · February 2011 BACKGROUND: Medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) includes hypertensive, hypervolemic, and hemodilution ("triple-H") therapy. However, there is little information regarding the indications and guidance ... Full text Link to item Cite

The second-generation air-Q intubating laryngeal mask for airway maintenance during anaesthesia in adults: a report of the first 70 uses.

Journal Article Anaesth Intensive Care · January 2011 The second-generation air-Q intubating laryngeal airway is a newer commercially available supraglottic airway device. In this retrospective review, we describe our initial clinical experience of 70 insertions. The ease and number of insertion attempts, air ... Full text Link to item Cite

New endotracheal tubes designed to prevent ventilator-associated pneumonia: do they make a difference?

Journal Article Respir Care · August 2010 Ventilator-associated pneumonia (VAP) is a pervasive and expensive nosocomial infection that is largely related to instrumentation of the airway with an endotracheal tube (ETT), followed by microaspiration of contaminated secretions. VAP prevention will pr ... Link to item Cite

Response

Journal Article Journal of Neurosurgery · August 1, 2010 Full text Cite

Atrial and brain natriuretic peptide concentrations and the response to inhaled nitric oxide in patients with acute respiratory distress syndrome.

Journal Article J Crit Care · March 2010 PURPOSE: The response to inhaled nitric oxide (iNO) is inconsistent in patients with acute respiratory distress syndrome (ARDS). We sought to determine whether the response to iNO, defined as 20% Pao(2)/Fio(2) increase from baseline, depends on the level o ... Full text Link to item Cite

Response

Journal Article Journal of Neurosurgery · October 19, 2009 Full text Cite

Management guided by brain tissue oxygen monitoring and outcome following severe traumatic brain injury.

Journal Article J Neurosurg · October 2009 OBJECT: The authors sought to describe changes in clinical management associated with brain tissue oxygen (PbO(2)) monitoring and how these changes affected outcomes and resource utilization. METHODS: The cohort study comprised 629 patients admitted to a L ... Full text Link to item Cite

Prolonged propofol anesthesia is not associated with an increase in blood lactate.

Journal Article Anesth Analg · October 2009 BACKGROUND: Lactic acidosis is considered an early sign of propofol infusion syndrome. In this study, we investigated the changes in lactate and pH with propofol versus volatile anesthesia (VA) of long duration. METHODS: Demographic and intraoperative data ... Full text Link to item Cite

Randomized trial of light versus deep sedation on mental health after critical illness.

Journal Article Crit Care Med · September 2009 OBJECTIVES: : To investigate if light sedation favorably affects subsequent patient mental health compared with deep sedation. Symptoms of posttraumatic stress disorder are common in patients after they have undergone prolonged mechanical ventilation and a ... Full text Link to item Cite

Early anti-pseudomonal acquisition in young patients with cystic fibrosis: rationale and design of the EPIC clinical trial and observational study'.

Journal Article Contemp Clin Trials · May 2009 BACKGROUND: The primary cause of morbidity and mortality in patients with cystic fibrosis (CF) is progressive obstructive pulmonary disease due to chronic endobronchial infection, particularly with Pseudomonas aeruginosa (Pa). Risk factors for and clinical ... Full text Link to item Cite

Which H is the most important in triple-H therapy for cerebral vasospasm?

Journal Article Curr Opin Crit Care · April 2009 PURPOSE OF REVIEW: To summarize the recent literature of the hemodynamic management of subarachnoid hemorrhage and cerebral vasospasm, also designated as 'triple-H' therapy, and discuss each component of this management approach individually. RECENT FINDIN ... Full text Link to item Cite

Tezosentan normalizes hepatomesenteric perfusion in a porcine model of cardiac tamponade.

Journal Article Acta Anaesthesiol Scand · February 2009 BACKGROUND: To investigate endothelin-1 (ET-1)-dependent hepatic and mesenteric vasoconstriction, and oxygen and lactate fluxes in an acute, fixed low cardiac output (CO) state. METHODS: Sixteen anesthetized, mechanically ventilated pigs were studied. Card ... Full text Link to item Cite

Accuracy of transcranial Doppler ultrasonography and single-photon emission computed tomography in the diagnosis of angiographically demonstrated cerebral vasospasm.

Journal Article J Neurosurg · January 2009 OBJECT: The goal of this study was to assess the accuracy of the routine clinical use of transcranial Doppler (TCD) ultrasonography and SPECT in predicting angiographically demonstrated vasospasm. METHODS: Following receipt of institutional review board ap ... Full text Link to item Cite

Effects of anemia and hypotension on porcine optic nerve blood flow and oxygen delivery.

Journal Article Anesthesiology · May 2008 BACKGROUND: Perioperative ischemic optic neuropathy occurs after major surgical procedures, which are often associated with hypotension, anemia, or venous congestion. However, the effects of these conditions on optic nerve (ON) blood flow are unknown and c ... Full text Link to item Cite

The effect of an intensive care unit staffing model on tidal volume in patients with acute lung injury.

Journal Article Crit Care · 2008 INTRODUCTION: Little is known about the mechanisms through which intensivist physician staffing influences patient outcomes. We aimed to assess the effect of closed-model intensive care on evidence-based ventilatory practice in patients with acute lung inj ... Full text Link to item Cite

Intensive insulin therapy and mortality in critically ill patients.

Journal Article Crit Care · 2008 INTRODUCTION: Intensive insulin therapy (IIT) with tight glycemic control may reduce mortality and morbidity in critically ill patients and has been widely adopted in practice throughout the world. However, there is only one randomized controlled trial sho ... Full text Link to item Cite

Reply to the comments by Drs. Marik and Emery and Dr. Singer [8]

Journal Article Intensive Care Medicine · October 1, 2007 Full text Cite

Effect of intensive care unit organizational model and structure on outcomes in patients with acute lung injury.

Journal Article Am J Respir Crit Care Med · October 1, 2007 RATIONALE: Prior studies supported an association between intensive care unit (ICU) organizational model or staffing patterns and outcome in critically ill patients. OBJECTIVES: To examine the association of closed versus open models with patient mortality ... Full text Link to item Cite

Approach to eradication of initial Pseudomonas aeruginosa infection in children with cystic fibrosis.

Journal Article Pediatr Pulmonol · September 2007 The primary cause of morbidity and mortality in children with cystic fibrosis (CF) is the progression of obstructive lung disease secondary to chronic endobronchial infection, mainly caused by Pseudomonas aeruginosa (Pa). Initial Pa isolates are typically ... Full text Link to item Cite

Is it now time to promote mixed enteral and parenteral nutrition for the critically ill patient?

Journal Article Intensive Care Med · June 2007 BACKGROUND: Intensive care outcome measured by morbidity and mortality is altered in the severely malnourished ICU patient, and nutritional support of the critically ill is accepted as a standard of care. Current recommendations suggest starting enteral fe ... Full text Link to item Cite

Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review.

Journal Article Neurocrit Care · 2007 INTRODUCTION: Raised intracranial pressure (ICP) has been consistently associated with poor neurological outcome. Our purpose was to systematically review the literature to estimate the association between ICP values and patterns and short- and long-term v ... Full text Link to item Cite

Risk factors for reperfusion injury after lung transplantation.

Journal Article Intensive Care Med · April 2006 OBJECTIVE: To assess the influence of recipient's and donor's factors as well as surgical events on the occurrence of reperfusion injury after lung transplantation. DESIGN AND SETTING: Retrospective study in the surgical intensive care unit (ICU) of a univ ... Full text Link to item Cite

Cerebral autoregulation and CO2 reactivity in anterior and posterior cerebral circulation during sevoflurane anesthesia.

Journal Article Anesth Analg · February 2006 The purpose of the study was to compare cerebral autoregulation (CA) and CO2 reactivity (CO2R) between the anterior and posterior circulation under sevoflurane anesthesia. We studied 9 adult ASA physical status I patients (22-47 yr) scheduled for elective ... Full text Link to item Cite

A nationwide survey of intensive care unit discharge practices.

Journal Article Intensive Care Med · December 2005 OBJECTIVE: To describe intensive care unit (ICU) discharge practices, examine factors associated with physicians' discharge decisions, and explore ICU and hospital characteristics and clinical determinants associated with the discharge process. DESIGN: Sur ... Full text Link to item Cite

Fluid responsiveness in spontaneously breathing patients: a review of indexes used in intensive care.

Journal Article Crit Care Med · December 2005 OBJECTIVE: In spontaneously breathing patients, indexes predicting hemodynamic response to volume expansion are very much needed. The present review discusses the clinical utility and accuracy of indexes tested as bedside indicators of preload reserve and ... Full text Link to item Cite

Factors associated with failure of noninvasive positive pressure ventilation in the emergency department.

Journal Article Acad Emerg Med · December 2005 OBJECTIVES: To determine the factors associated with failure of noninvasive positive pressure ventilation (NPPV) in patients presenting with acute respiratory failure to the emergency department (ED). METHODS: The authors retrospectively analyzed patients ... Full text Link to item Cite

Transpulmonary lactate gradient after hypothermic cardiopulmonary bypass.

Journal Article Intensive Care Med · May 2004 OBJECTIVE: Several studies demonstrated that the lungs could produce lactate in patients with acute lung injury (ALI). Because after cardiopulmonary bypass (CPB) some patients develop ALI, the effect of CPB on pulmonary lactate release was investigated. DE ... Full text Link to item Cite

Occupational asbestos exposure and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract: an ecologic study.

Journal Article Ann Epidemiol · March 2004 PURPOSE: A previous case-control study observed a strong association between occupational exposure to asbestos and the incidence of non-Hodgkin lymphoma of the gastrointestinal tract (GINHL). To test this hypothesis, we sought to determine whether the geog ... Full text Link to item Cite

Randomized trial of the effect of antipyresis by metamizol, propacetamol or external cooling on metabolism, hemodynamics and inflammatory response.

Journal Article Intensive Care Med · March 2004 OBJECTIVE: We investigated the metabolic, hemodynamic, and inflammatory responses of pharmacological and physical therapies aimed at reducing body temperature in febrile critically ill patients. DESIGN AND SETTING: Open-label, randomized trial in a surgica ... Full text Link to item Cite

Outcome scales.

Journal Article J Neurosurg · February 2004 Full text Link to item Cite

Effect of acute lung injury and acute respiratory distress syndrome on outcome in critically ill trauma patients.

Journal Article Crit Care Med · February 2004 OBJECTIVE: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are known to be associated with increased mortality and costs in trauma patients. We estimated the independent impact of these conditions on mortality and cost, beyond the se ... Full text Link to item Cite

Systematic review of the prevention of delayed ischemic neurological deficits with hypertension, hypervolemia, and hemodilution therapy following subarachnoid hemorrhage.

Journal Article J Neurosurg · May 2003 OBJECT: There is uncertainty about the efficacy of hypertension, hypervolemia, and hemodilution (triple-H) therapy in reducing the occurrence of delayed ischemic neurological deficits (DINDs) and death after subarachnoid hemorrhage. The authors therefore c ... Full text Link to item Cite

Cervical sympathetic block to reverse delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage.

Journal Article Stroke · April 2003 BACKGROUND AND PURPOSE: The purpose of the present study was to evaluate the feasibility and safety of a locoregional cervical sympathetic block to improve cerebral perfusion in patients suffering from cerebral vasospasm after aneurysmal subarachnoid hemor ... Full text Link to item Cite

Propofol increased cerebral perfusion as compared with isoflurane during a cerebral angiography in a child with moyamoya disease.

Journal Article J Neurosurg Anesthesiol · January 2003 We report the case of a child with Moyamoya disease during a cerebral angiography procedure in which the effects of propofol on the cerebral perfusion were seen to be different compared with isoflurane. We suggest propofol was associated with a better pres ... Full text Link to item Cite

Effect of increasing norepinephrine dosage on regional blood flow in a porcine model of endotoxin shock.

Journal Article Crit Care Med · June 2002 OBJECTIVE: To evaluate the effect of a norepinephrine-induced differential increase in mean arterial pressure on splanchnic and renal perfusion in a porcine model of volume-resuscitated endotoxic shock. DESIGN: Prospective, controlled, acute interventional ... Full text Link to item Cite

Air cysts and bronchiectasis prevail in nondependent areas in severe acute respiratory distress syndrome: A computed tomographic study of ventilator-associated changes

Journal Article Critical Care Medicine · January 1, 2002 Objective: To investigate prevalence and spatial distribution of air cysts and bronchiectasis associated with mechanical ventilation in patients with severe acute respiratory distress syndrome. Design: Retrospective observational study. Setting: University ... Full text Cite

Postmenopausal hormone use and skeletal fracture: Does the size of the benefit decrease with increasing age?

Journal Article Obstetrics and Gynecology · January 1, 2002 Results of a recent meta-analysis of randomized trials suggest that, among postmenopausal women, the relative impact of hormone use in reducing the incidence of skeletal fracture declines with increasing age. We contend that: 1) the duration of the randomi ... Full text Cite

Stent impact on the geometry of the carotid bifurcation and the course of the internal carotid artery.

Journal Article Neuroradiology · January 2002 A measurement system is proposed to evaluate reconstructive effects of carotid stents on the geometry of the carotid bifurcation and the course of the internal carotid artery. To describe deviations of the stenotic internal carotid artery (ICA) from the ex ... Full text Link to item Cite

Endothelin-1 blockade corrects mesenteric hypoperfusion in a porcine low cardiac output model.

Journal Article Crit Care Med · August 2001 OBJECTIVE: To study the importance of endothelin-1-induced vasoconstriction in a model of acute and maintained low cardiac output, by investigating regional changes within the mesenteric and particularly the intestinal mucosal circulation. DESIGN: Prospect ... Full text Link to item Cite

In vitro evaluation of the effectiveness of distal protection in the prevention of cerebral thromboembolism during carotid stent placement.

Journal Article Acad Radiol · July 2001 RATIONALE AND OBJECTIVES: The purpose of this in vitro study was to evaluate and quantify the benefit of the balloon protection device, to identify the most effective sequence of irrigation or flushing, and to determine the most effective catheter position ... Full text Link to item Cite

Role of the distal balloon protection technique in the prevention of cerebral embolic events during carotid stent placement.

Journal Article Stroke · February 2001 BACKGROUND AND PURPOSE: We sought to quantitatively and qualitatively evaluate the release of atheromatous plaque debris induced by carotid stenting procedures. METHODS: Eight patients with severe carotid atheromatous stenoses were treated by stent implant ... Full text Link to item Cite

Current intensive care management proposals after aneurysmal subarachnoid hemorrhage

Journal Article Intensivmedizin und Notfallmedizin · February 1, 2001 Aneurysmal subarachnoid (SAH) is a serious disease associated with considerable mortality and morbidity: it accounts for 6-10% of all strokes and 22-25% of cerebrovascular deaths (46). The most common causes of death or disability include direct effect of ... Full text Cite

Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care.

Journal Article Neurosurgery · February 2001 Cerebral vasospasm remains a devastating medical complication of aneurysmal subarachnoid hemorrhage (SAH). It is associated with high morbidity and mortality rates, even after the aneurysm has been secured surgically or radiologically. A great deal of expe ... Full text Link to item Cite

Intravenous amiodarone or magnesium sulphate is not cost-beneficial prophylaxis for atrial fibrillation after coronary artery bypass surgery.

Journal Article Br J Anaesth · November 2000 Our aims were to examine whether the administration of amiodarone or magnesium sulphate after coronary artery bypass graft surgery (CABG) could reduce the occurrence of atrial fibrillation, and to identify the risk factors associated with atrial fibrillati ... Full text Link to item Cite

Hepatic haemodynamic changes following inhibition of endothelium-derived relaxing and hyperpolarising factors in anaesthetised miniature pigs.

Journal Article Schweiz Med Wochenschr · April 29, 2000 The influence of endothelium-dependent vasodilatation in regulating the hepatic circulation has been investigated by intraportal infusion of inhibitors of either endothelium-derived relaxing factor (NG-nitro-L-arginine-methyl-ester [L-NAME]) or of endothel ... Link to item Cite

Hemodynamic effects of synchronized high-frequency jet ventilation compared with low-frequency intermittent positive-pressure ventilation after myocardial revascularization.

Journal Article Anesthesiology · January 2000 BACKGROUND: The purpose of this prospective study was to examine the effect on cardiac performance of selective increases in airway pressure at specific points of the cardiac cycle using synchronized high-frequency jet ventilation (sync-HFJV) delivered con ... Full text Link to item Cite

Infection in the critically ill surgical patient

Conference Bailliere's Best Practice in Clinical Anaesthesiology · January 1, 1999 After surgery, critically ill patients in the intensive care unit (ICU) may acquire infections which differ from those acquired elsewhere with regard to the anatomical site involved and the causative micro-organisms. Specific risk factors for infection in ... Full text Cite

Analgesia for total hip replacement: Epidural analgesia versus femoral nerve blockade?

Journal Article Cahiers d'Anesthesiologie · October 1, 1998 The pain management, neuroendocrine and metabolic responses to surgery were compared in two groups of patients undergoing a total hip arthroplasty; one receiving epidural anaesthesia (EPI, n = 12) and the other a femoral nerve block (FNB1 n = 12). The gene ... Cite

The response to repeated nitric oxide inhalation is inconsistent in patients with acute respiratory distress syndrome.

Journal Article Anesthesiology · March 1998 BACKGROUND: Nitric oxide (NO) is administered frequently in patients with acute respiratory distress syndrome (ARDS) and pulmonary hypertension. The efficacy of this therapy over several days is not well known. The authors first determined the consistency ... Full text Link to item Cite

Overnight sedation with midazolam or propofol in the ICU: effects on sleep quality, anxiety and depression.

Journal Article Intensive Care Med · November 1996 OBJECTIVE: To assess and compare the impact of overnight sedation with midazolam or propofol on anxiety and depression levels, as well as sleep quality, in non-intubated patients in intensive care. DESIGN: Open, comparative prospective, randomised study. S ... Full text Link to item Cite

The role of nitric oxide in sepsis and adult respiratory distress syndrome

Journal Article Medecine et Hygiene · January 1, 1993 Cite