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Evaluation Of Preoperative Anemia And Transfusion Requirements In Adult Liver Transplant Recipients, Parissa M.N. Moghimi, Erika A. Aldag, Rachel Pedersen, Ajay Sahajpal, Jacob N. Clendenon, Vikraman Gunabushanam, Mehraboon S. Irani, David J. Kramer 2016 Department of Pharmacy, Aurora Health Care

Evaluation Of Preoperative Anemia And Transfusion Requirements In Adult Liver Transplant Recipients, Parissa M.N. Moghimi, Erika A. Aldag, Rachel Pedersen, Ajay Sahajpal, Jacob N. Clendenon, Vikraman Gunabushanam, Mehraboon S. Irani, David J. Kramer

Journal of Patient-Centered Research and Reviews

Background: Liver transplantation is often associated with massive blood loss due to surgical complexity and the hemostatic abnormalities of end-stage liver disease. Blood transfusions have been associated with increased risk of infection, multiorgan dysfunction, graft loss and mortality.

Purpose: To determine for liver transplantation whether correlation exists between preoperative anemia and transfusion requirements, length of stay or incidence of postoperative infection.

Methods: A retrospective review of liver transplantations from Jan. 1, 2012, to June 30, 2015, was conducted. Packed red blood cell (PRBC), fresh frozen plasma (FFP), platelet and cryoprecipitate units were collected preoperatively, intraoperatively and within the first 48 ...


Effect Of Code Status Handout On Resident Physician Comfort During The Admission Process, Krystina Pischke, Jessica Schmid, Jessica J.F. Kram, Dennis J. Baumgardner 2016 Aurora Health Care

Effect Of Code Status Handout On Resident Physician Comfort During The Admission Process, Krystina Pischke, Jessica Schmid, Jessica J.F. Kram, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Discussing code status can be a difficult part of the admission process, especially for residents. There have been various research studies looking at interventions to improve end-of-life discussions. However, these studies have focused on well-acquainted physicians and patients. With increasing use of hospitalists for inpatient care, there is increased need for improving code status discussions at admission.

Purpose: To determine if an easy-to-use handout would improve resident comfort with the code status discussion.

Methods: Following a literature search on how to discuss advance directives and end-of-life care, a code status handout was developed. The handout, written at fifth-grade reading ...


Emergency Medical Communications For Public Safety Communicators, Natalie (Tally) Wade, Alice Macpherson 2016 Kwantlen Polytechnic University

Emergency Medical Communications For Public Safety Communicators, Natalie (Tally) Wade, Alice Macpherson

All Faculty Scholarship

Emergency Medical Communications for Public Safety Communicators introduces the protocols and techniques for incident processing and dispatching in emergency medical situations. The section on emergency medical call assessment and radio dispatching can be used to create lab simulations in a team environment in training, and to simulate emergency medical telephone instruction. Medical terminology, physiology and other terms are explained in the context of emergency medical communication. Interagency coordination and mass casualty incidents are explained with examples given. This Canadian textbook is part of the Public Safety Communications program at Kwantlen Polytechnic University.


Urinary Tissue Inhibitor Of Metalloproteinase-2 And Insulin-Like Growth Factor-Binding Protein 7 For Risk Stratification Of Acute Kidney Injury In Patients With Sepsis., Patrick M Honore, H Bryant Nguyen, Michelle Gong, Lakhmir S. Chawla, Sean M Bagshaw, Antonio Artigas, Jing Shi, Olivier Joannes-Boyau, Jean-Louis Vincent, John A Kellum 2016 George Washington University

Urinary Tissue Inhibitor Of Metalloproteinase-2 And Insulin-Like Growth Factor-Binding Protein 7 For Risk Stratification Of Acute Kidney Injury In Patients With Sepsis., Patrick M Honore, H Bryant Nguyen, Michelle Gong, Lakhmir S. Chawla, Sean M Bagshaw, Antonio Artigas, Jing Shi, Olivier Joannes-Boyau, Jean-Louis Vincent, John A Kellum

Anesthesiology and Critical Care Medicine Faculty Publications

Objectives:

To examine the performance of the urinary biomarker panel tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 in patients with sepsis at ICU admission. To investigate the effect of nonrenal organ dysfunction on tissue inhibitor of metalloproteinase-2 and insulin-like growth factor-binding protein 7 in this population.

Method:

In this ancillary analysis, we included patients with sepsis who were enrolled in either of two trials including 39 ICUs across Europe and North America. The primary endpoint was moderate-severe acute kidney injury (equivalent to Kidney Disease Improving Global Outcome stage 2–3) within 12 hours of enrollment. We assessed ...


Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos 2016 University of Massachusetts Medical School

Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos

GSBS Dissertations and Theses

Background: Traumatic injury remains a major cause of mortality in the US. Older Americans experience lower rates of injury and higher rates of death at lower injury severity than their younger counterparts. The objectives of this study were to explore pre-injury factors and injury patterns that are associated with post-discharge mortality among injured elderly surviving index hospitalization.

Methods: We queried a 5% random sample of Medicare beneficiaries (n=2,002,420) for any hospitalization with a primary ICD-9 diagnosis code for injury. Patients admitted without urgent/emergent admission were excluded, as well as patients presenting from inpatient hospitalization or rehabilitation ...


Common Chronic Conditions Do Not Affect Performance Of Cell Cycle Arrest Biomarkers For Risk Stratification Of Acute Kidney Injury, Michael Heung, Luis Ortega, Lakhmir S. Chawla, Richard G. Wunderink, Wesley H. Self, Jay Koyner, Jing Shi, John A. Kellum 2016 George Washington University

Common Chronic Conditions Do Not Affect Performance Of Cell Cycle Arrest Biomarkers For Risk Stratification Of Acute Kidney Injury, Michael Heung, Luis Ortega, Lakhmir S. Chawla, Richard G. Wunderink, Wesley H. Self, Jay Koyner, Jing Shi, John A. Kellum

Anesthesiology and Critical Care Medicine Faculty Publications

Background Identification of acute kidney injury (AKI) can be challenging in patients with underlying chronic disease, and biomarkers often perform poorly in this population. In this study we examined the performance characteristics of the novel biomarker panel of urinary tissue inhibitor of metalloproteinases-2 (TIMP2) and insulin-like growth factor-binding protein 7 ([IGFBP7]) in patients with a variety of comorbid conditions.

Methods We analyzed data from two multicenter studies of critically ill patients in which [TIMP2]•[IGFBP7] was validated for prediction of Kidney Disease: Improving Global Outcomes (KDIGO) Stage 2 or 3 AKI within 12 h. We constructed receiver operating characteristic (ROC ...


Clinical Adjudication In Acute Kidney Injury Studies: Findings From The Pivotal Timp-2*Igfbp7 Biomarker Study, Kathleen D. Liu, Anitha Vijayan, Mitchell H. Rosner, Jing Shi, Lakhmir S. Chawla, John A. Kellum 2016 George Washington University

Clinical Adjudication In Acute Kidney Injury Studies: Findings From The Pivotal Timp-2*Igfbp7 Biomarker Study, Kathleen D. Liu, Anitha Vijayan, Mitchell H. Rosner, Jing Shi, Lakhmir S. Chawla, John A. Kellum

Anesthesiology and Critical Care Medicine Faculty Publications

Background The NEPROCHECK test (Astute Medical, San Diego, CA, USA) combines urinary tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) to identify patients at high risk for acute kidney injury (AKI). In a US Food and Drug Administration registration trial (NCT01573962), AKI was determined by a three-member clinical adjudication committee. The objectives were to examine agreement among adjudicators as well as between adjudicators and consensus criteria for AKI and to determine the relationship of biomarker concentrations and adjudicator agreement.

Methods Subjects were classified as AKI 3/3, 2/3, 1/3 or 0/3 according ...


Acute Appendicitis: Transcript Profiling Of Blood Identifies Promising Biomarkers And Potential Underlying Processes, Lakhmir S. Chawla, Ian Toma, Danielle L. Davison, Khashayar Vaziri, Juliet Lee, Raymond Lucas, Michael G. Seneff, Aobhinn Nyhan, Timothy A. McCaffrey 2016 George Washington University

Acute Appendicitis: Transcript Profiling Of Blood Identifies Promising Biomarkers And Potential Underlying Processes, Lakhmir S. Chawla, Ian Toma, Danielle L. Davison, Khashayar Vaziri, Juliet Lee, Raymond Lucas, Michael G. Seneff, Aobhinn Nyhan, Timothy A. Mccaffrey

Anesthesiology and Critical Care Medicine Faculty Publications

Background

The diagnosis of acute appendicitis can be surprisingly difficult without computed tomography, which carries significant radiation exposure. Circulating blood cells may carry informative changes in their RNA expression profile that would signal internal infection or inflammation of the appendix.

Methods

Genome-wide expression profiling was applied to whole blood RNA of acute appendicitis patients versus patients with other abdominal disorders, in order to identify biomarkers of appendicitis. From a large cohort of emergency patients, a discovery set of patients with surgically confirmed appendicitis, or abdominal pain from other causes, was identified. RNA from whole blood was profiled by microarrays, and ...


Intra-Abdominal Hypertension And Abdominal Compartment Syndrome, Patrick B. Murphy 2016 The University of Western Ontario

Intra-Abdominal Hypertension And Abdominal Compartment Syndrome, Patrick B. Murphy

Electronic Thesis and Dissertation Repository

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized in critically ill patients; no non operative treatments exist, and mortality remains high.

The purpose of this thesis was to prospectively characterize the incidence of IAH in a mixed medical-surgical intensive care unit, and to test the potential therapeutic benefit of carbon monoxide (CO) and hydrogen sulphide (H2S) using an animal model of ACS. IAH was diagnosed in 30% of patients on admission; further 15% developed IAH during ICU stay. Incidence of ACS was 3%, with obesity, sepsis, mechanical ventilation and 24-hour fluid balance as independent predictors, also predicting ...


Reducing Phlebotomy-­Induced Blood Loss In The Picu: A Quality Improvement Study, Amanda Johnson, Ariel Hoch, Scot T. Bateman, Stacey L. Valentine 2016 University of Massachusetts Medical School

Reducing Phlebotomy-­Induced Blood Loss In The Picu: A Quality Improvement Study, Amanda Johnson, Ariel Hoch, Scot T. Bateman, Stacey L. Valentine

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Phlebotomy­induced blood loss contributes to development of anemia in critically ill children. Major factors contributing to this include blood overdraw from indwelling catheters and utilization of larger volume containers. We targeted these causes of excessive blood draws to decrease volumes of both the discarded blood and sample sent to the laboratory for standard tests. Methods: Pre and post quality improvement study in a 10­bed pediatric intensive care unit 2014­2015. All patients admitted to PICU during each 2­month study period were eligible for enrollment. Pre-intervention, nurses used standard pediatric tubes (3­3.5mL). A wash­out ...


Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews 2016 Dominican University of California

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Master's Theses and Capstone Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall ...


An Evaluation Of Patient Surveys To Determine Possible Causes Of Hospital Readmissions, Monica Weinberg MS, Matthew McCambridge MD 2016 USF MCOM - LVHN Campus

An Evaluation Of Patient Surveys To Determine Possible Causes Of Hospital Readmissions, Monica Weinberg Ms, Matthew Mccambridge Md

USF-LVHN SELECT

No abstract provided.


Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John 2016 University of Central Florida

Intensive Care In Oncology: Admission And Outcomes In Adult Patients With Cancer, Surya John

Honors in the Major Theses

Background: Historically, patients with cancer have been perceived as poor candidates for ICU admission. General ICU admission criteria lists cancer patients as low priority in ICU admission depriving them of the care they rightfully deserve. The purpose of this literary synthesis was to examine ICU admission criteria, risk factors, and outcomes of ICU admission in relation to hematological and solid tumor cancers and discuss ways that practitioners and nurses can educate patients with cancer and their families on appropriateness of ICU care.

Methods: A total of 768 articles were found in a literature search including all literature from 2005 to ...


National Institutes Of Health Stroke Scale (Nihss) And Tissue Plasminogen (Tpa) Education For All Critical Care Nurses, Cheriese Rawlins 2015 Baptist Hospital of Miami

National Institutes Of Health Stroke Scale (Nihss) And Tissue Plasminogen (Tpa) Education For All Critical Care Nurses, Cheriese Rawlins

All Publications

No abstract provided.


Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions, Ahmad Nusair,, Balwinder Singh,, Shifang Ding,, Ognjen Gajic,, Guangxi Li, 2015 Marshall University School of Medicine

Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions, Ahmad Nusair,, Balwinder Singh,, Shifang Ding,, Ognjen Gajic,, Guangxi Li,

Ahmad R. Nusair

Objective There is no widely accepted standard definition for Ventilator Associated Pneumonia (VAP). The reliability of the current definitions in use remains controversial. Our objective was to assess the reliability of six commonly used VAP definitions: The Loose, The Rigorous, The Modified Clinical Pulmonary Infection Score (CPIS), The Canadian Critical Care Trials Group (CCCTG), The International Sepsis Forum Consensus (ISFC) and The Center for Disease Control and Prevention (CDC). Design We examined the electronic health records of all the consecutively admitted adult patients at our institution who received invasive mechanical ventilation (IMV) for ≥ 48 hours, from January 2006 through December ...


Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions#11;, Ahmad Nusair, Balwinder Singh, Ognjen Gajic, Guangxi Li 2015 Marshall University Joan C. Edwards school of Medicine

Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions#11;, Ahmad Nusair, Balwinder Singh, Ognjen Gajic, Guangxi Li

Ahmad R. Nusair

There is no widely accepted standard definition for Ventilator Associated Pneumonia (VAP). The reliability of the current definitions in use remains controversial. Our objective was to assess the reliability of six commonly used VAP definitions: The Loose, The Rigorous, The Modified Clinical Pulmonary Infection Score (CPIS), The Canadian Critical Care Trials Group (CCCTG), The International Sepsis Forum Consensus (ISFC) and The Center for Disease Control and Prevention (CDC).


Alkali Therapy In Lactic Acidosis, Zeid Khitan,, Deepak Malhotra,, Dominic Raj,, Antonios Tzamaloukas,, Joseph Shapiro, 2015 Marshall University Joan C. Edwards School of Medicine

Alkali Therapy In Lactic Acidosis, Zeid Khitan,, Deepak Malhotra,, Dominic Raj,, Antonios Tzamaloukas,, Joseph Shapiro,

Zeid J. Khitan

This report attempts to frame the debate about clinical administration of sodium bicarbonate in the setting of lactic acidosis in terms of simple questions. Specifically, we address why we develop lactic acidosis in some circumstances, how acute lactic acidosis impairs cardiovascular function and why sodium bicarbonate may have deleterious effects which limit its utility. We also attempt to explore treatment alternatives to sodium bicarbonate.


Alkali Therapy In Lactic Acidosis, Zeid Khitan,, Deepak Malhotra,, Dominic Raj,, Antonios Tzamaloukas,, Joseph Shapiro, 2015 Marshall University Joan C. Edwards School of Medicine

Alkali Therapy In Lactic Acidosis, Zeid Khitan,, Deepak Malhotra,, Dominic Raj,, Antonios Tzamaloukas,, Joseph Shapiro,

Joseph I Shapiro MD

This report attempts to frame the debate about clinical administration of sodium bicarbonate in the setting of lactic acidosis in terms of simple questions. Specifically, we address why we develop lactic acidosis in some circumstances, how acute lactic acidosis impairs cardiovascular function and why sodium bicarbonate may have deleterious effects which limit its utility. We also attempt to explore treatment alternatives to sodium bicarbonate.


Alkali Therapy In Lactic Acidosis, Zeid J. Khitan, MD, Deepak Malhotra, MD, Dominic S. Raj, MD, Antonios H. Tzamaloukas, MD, Joseph I. Shapiro, MD 2015 Marshall University Joan C. Edwards School of Medicine

Alkali Therapy In Lactic Acidosis, Zeid J. Khitan, Md, Deepak Malhotra, Md, Dominic S. Raj, Md, Antonios H. Tzamaloukas, Md, Joseph I. Shapiro, Md

Marshall Journal of Medicine

This report attempts to frame the debate about clinical administration of sodium bicarbonate in the setting of lactic acidosis in terms of simple questions. Specifically, we address why we develop lactic acidosis in some circumstances, how acute lactic acidosis impairs cardiovascular function and why sodium bicarbonate may have deleterious effects which limit its utility. We also attempt to explore treatment alternatives to sodium bicarbonate.


Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions, Ahmad Nusair, MD, Balwinder Singh, MD, MS., Shifang Ding, MD, PhD., Ognjen Gajic, MD, Guangxi Li, MD 2015 Marshall University School of Medicine

Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions, Ahmad Nusair, Md, Balwinder Singh, Md, Ms., Shifang Ding, Md, Phd., Ognjen Gajic, Md, Guangxi Li, Md

Marshall Journal of Medicine

Objective

There is no widely accepted standard definition for Ventilator Associated Pneumonia (VAP). The reliability of the current definitions in use remains controversial. Our objective was to assess the reliability of six commonly used VAP definitions: The Loose, The Rigorous, The Modified Clinical Pulmonary Infection Score (CPIS), The Canadian Critical Care Trials Group (CCCTG), The International Sepsis Forum Consensus (ISFC) and The Center for Disease Control and Prevention (CDC).

Design

We examined the electronic health records of all the consecutively admitted adult patients at our institution who received invasive mechanical ventilation (IMV) for ≥ 48 hours, from January 2006 through December ...


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