Therapeutics Commons^™

Ultrasound-Triggered Release Of Vancomycin From A Novel Spinal Device: Antibiotic Release And Efficacy In Vivo, Lauren J. Delaney, Priscilla Machado, Ji-Bin Liu, Rachel Evans, Asia Winslow, Neil Zhao, Christopher K. Kepler, Rajkishen Narayanan, Teeto Ezeonu, Viren Soni, Gagan Kaushal, Rachel Hilliard, Thomas P. Schaer, Noreen J. Hickok, Flemming Forsberg

Department of Orthopaedic Surgery Faculty Papers

Post-surgical spinal infection occurs in up to 20 % of patients, despite aggressive peri-operative antibiotic treatments. To improve prophylaxis, we have designed and evaluated an ultrasound-activated prophylactic antibiotic release system to combat post-surgical bacterial survival. Polylactic acid (PLA) clips (1 cm³) were 3D-printed with an interior reservoir (0.8 cm³) for carrying drug payload, specifically vancomycin (VAN). Under IACUC approval, clips were surgically implanted into the spines of sheep (n = 9) and swine (n = 2) by removing the spinous process at several levels of the lumbar spine. In the sheep, clips were insonated and the …

Incidence And Predictors Of Woven Endobridge (Web) Shape Modification Following Treatment Of Intracranial Aneurysms In A Large Multicenter Study, Nimer Adeeb, Hamza Adel Salim, Basel Musmar, Assala Aslan, Christian Swaid, Miguel Cuellar, Mahmoud Dibas, Nicole Cancelliere, Jose Danilo Bengzon Diestro, Oktay Algin, Sherief Ghozy, Sovann Lay, Adrien Guenego, Leonardo Renieri, Joseph Carnevale, Guillaume Saliou, Panagiotis Mastorakos, Kareem El Naamani, Eimad Shotar, Markus Möhlenbruch, Michael Kral, Charlotte Chung, Mohamed Salem, Ivan Lylyk, Paul Foreman, Hamza Shaikh, Vedran Župančić, Muhammad U Hafeez, Joshua Catapano, Muhammad Waqas, Muhammet Arslan, Onur Ergun, James Rabinov, Yifan Ren, Clemens Schirmer, Mariangela Piano, Anna Kühn, Caterina Michelozzi, Robert Starke, Ameer Hassan, Mark Ogilvie, Anh Nguyen, Jesse Jones, Waleed Brinjikji, Marie Nawka, Marios Psychogios, Christian Ulfert, Bryan Pukenas, Jan-Karl Burkhardt, Thien Huynh, Juan Carlos Martinez-Gutierrez, Muhammed Amir Essibayi, Sunil Sheth, Diana Slawski, Rabih Tawk, Benjamin Pulli, Boris Lubicz, Pietro Panni, Ajit Puri, Guglielmo Pero, Eytan Raz, Christoph Griessenauer, Hamed Asadi, Adnan Siddiqui, Elad Levy, Neil Haranhalli, David Altschul, Andrew Ducruet, Felipe Albuquerque, Robert Regenhardt, Christopher Stapleton, Peter Kan, Vladimir Kalousek, Pedro Lylyk, Srikanth Boddu, Jared Knopman, Stavropoula Tjoumakaris, Pascal Jabbour, Frédéric Clarençon, Nicola Limbucci, Vivek Yedavalli, Max Wintermark, Vitor Mendes Pereira, Aman Patel, Hugo Cuellar-Saenz, Adam Dmytriw

Department of Neurosurgery Faculty Papers

The Woven EndoBridge (WEB) device is FDA-approved for the treatment of bifurcation aneurysms. Despite its wide popularity, it has been under scrutiny for its association with potential aneurysm recanalization and retreatment due to device shape modification. This study aims to analyze the shape modification rate of WEB devices and identify factors associated with this phenomenon, as well as its correlation with aneurysm retreatment. We conducted a retrospective review of the WorldWide WEB Consortium database, including adult patients treated for intracranial aneurysms with the WEB device. We assessed aneurysm occlusion using the WEB Occlusion Scale and defined WEB shape modification as …

Time To Initiation Of Antiresorptive Agents In Multiple Myeloma To Reduce Skeletal Related Events, Amman Bhasin, Adam Binder, Leland Damron, Amry Majeed, Adam Barsouk, Kelly Hughes, Thomas Jefferson University, Abdullateef O. Abdulkareem, Tingting Zhan, Divya Polu, Sai Gundepalli, Srinivas Devarakonda

Kimmel Cancer Center Faculty Papers

Purpose: Current treatment guidelines strongly support the use of antiresorptive therapy in patients with newly diagnosed multiple myeloma (NDMM) with the goal of preventing skeletal related events (SRE). Despite these concrete, data-driven recommendations, the impact of delays in antiresorptive initiation in NDMM patients is understudied. Through a multicenter retrospective study, we examined the impact of delays in antiresorptive initiation on the rates of SREs. We furthered our exploration of this topic in a separate retrospective analysis with a focus on reasons for delays in antiresorptive therapy initiation. Methods: Electronic health records from two large academic institutions were used to identify …

Multi-Societal Expert Consensus Statement On The Safe Administration Of Ultrasound Contrast Agents, Jordan B. Strom, Andrew Appis, Richard G. Barr, Maria Cristina Chammas, Dirk-André Clevert, Kassa Darge, Linda Feinstein, Steven B. Feinstein, J. Brian Fowlkes, Beverly Gorman, Pintong Huang, Yuko Kono, Juan Lopez-Mattei, Andrej Lyshchik, Michael L. Main, Wilson Matthias, Christina Merrill, Sharon L. Mulvagh, Petros Nihoyannopoulos, Joan Olson, Fabio Piscaglia, Thomas Porter, Arnaldo Rabischoffsky, Roxy Senior, Jessica L Stout, Maria Stanczak, Stephanie R. Wilson

Department of Radiology Faculty Papers

Contrast enhanced ultrasound (CEUS) offers a safe, reliable imaging option to establish a clinical diagnosis across a variety of multidisciplinary settings. This Expert Consensus Statement serves to outline expert opinion on what constitutes appropriate supervision and the essential components of safe CEUS practice. The purpose of this document is to empower institutions to allow sonographers, along with other trained medical professionals, to administer UCAs at the point of care, consistent with the updated scope of practice documentation and within the broad parameters of an individual's training and licensure, while subject to appropriate supervision and meeting or exceeding minimum safety standards. …

Long-Acting Injectables: A Strategy To Mitigate Nonadherence In Bipolar Disorder, Justin Faden, Elina Maymind

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Effects Of Hvla On Shoulder Mobilization And Baseball Pitch Velocity With Dari Motion Capture, Drew T. Mortensen, James Barber, Jordyn Huecker, Garret Phillips, Jayne Stuter, Braden Ashcraft, Isabella Termini, Victoria Oyeniyi, Christina Small, Kyle Bills

Annual Research Symposium

No abstract provided.

Applications Of Machine Learning-Driven Molecular Models For Advancing Ophthalmic Precision Medicine, Rahul Kumar, Joshua Ong, Ethan Waisberg, Ryung Lee, Tuan Nguyen, Phani Paladugu, Maria C. Rivolta, Chirag Gowda, John V. Janin, Jeremy Saintyl, Dylan Amiri, Ansh Gosain, Ram Jagadeesan

SKMC Student Presentations and Publications

Ophthalmic diseases such as glaucoma, age-related macular degeneration (ARMD), and optic neuritis involve complex molecular and cellular disruptions that challenge current diagnostic and therapeutic approaches. Advanced artificial intelligence (AI) and machine learning (ML) models offer a novel lens to analyze these diseases by integrating diverse datasets, identifying patterns, and enabling precision medicine strategies. Over the past decade, applications of AI in ophthalmology have expanded from imaging-based diagnostics to molecular-level modeling, bridging critical gaps in understanding disease mechanisms. This paper systematically reviews the application of AI-driven methods, including reinforcement learning (RL), graph neural networks (GNNs), Bayesian inference, and generative adversarial networks …

The Road Ahead: Emerging Therapies For Primary Iga Nephropathy, Edward J. Filippone, Rakesh Gulati, John Farber

Division of Nephrology Faculty Papers

Primary IgA nephropathy (IgAN) is the most common form of primary glomerulopathy. A slowly progressive disease presenting in the young to middle-aged, most patients with reduced eGFR or proteinuria will progress to end-stage kidney disease (ESKD) in their lifetimes. The pathogenesis involves increased production of galactose-deficient IgA1 (Gd-IgA1) that forms immune complexes that deposit in the glomerulus, eliciting mesangial cell proliferation, inflammation, and complement activation. The backbone of therapy is supportive, including lifestyle modifications, strict blood pressure control, and renin-angiotensin system inhibition targeting proteinuria < 300 mg/day. Sodium-glucose transporter 2 inhibitors are indicated for persisting proteinuria or declining eGFR. Sparsentan is indicated for persisting proteinuria. Immunosuppression should be considered for all patients at risk for progression (persisting proteinuria and/or declining eGFR). To reduce Gd-IgA1 production, targeted-release budesonide is approved. Agents targeting B cell survival factors APRIL or BAFF/APRIL have significantly reduced Gd-IgA1 production and proteinuria in phase 2 trials but await phase 3 data for approval. To reduce inflammation, high-dose steroids are ineffective and toxic in Caucasian patients, although lower-dose regimens may be effective in Chinese patients. Complement inhibition is being actively studied. The factor B inhibitor iptacopan has conditional approval. The terminal pathway inhibitors cemdisiran and ravulizumab show promise in phase 2 studies. Our current approach for those requiring immunosuppression involves combining the reduction of Gd-IgA1 (nefecon) with suppressing the effects of inflammation (iptacopan). The optimal duration of such therapy is uncertain. Clearly, there is more to be learned with many trials underway.

Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis In The Management Of Intermediate-Risk Pulmonary Embolism: Primary Results Of The Peerless Randomized Controlled Trial, Wissam Jaber, Carin Gonsalves, Stefan Stortecky, Samuel Horr, Orestis Pappas, Ripal Gandhi, Keith Pereira, Jay Giri, Sameer Khandhar, Khawaja Afzal Ammar, David Lasorda, Brian Stegman, Lucas Busch, David Dexter, Ezana Azene, Nikhil Daga, Fakhir Elmasri, Chandra Kunavarapu, Mark Rea, Joseph Rossi, Joseph Campbell, Jonathan Lindquist, Adam Raskin, Jason Smith, Thomas Tamlyn, Gabriel Hernandez, Parth Rali, Torrey Schmidt, Jeffrey Bruckel, Juan Camacho, Jun Li, Samy Selim, Catalin Toma, Sukhdeep Singh Basra, Brian Bergmark, Bhavraj Khalsa, David Zlotnick, Jordan Castle, David O'Connor, C. Michael Gibson

Department of Radiology Faculty Papers

BACKGROUND: There are a lack of randomized controlled trial data comparing outcomes of different catheter-based interventions for intermediate-risk pulmonary embolism.

METHODS: PEERLESS is a prospective, multicenter, randomized controlled trial that enrolled 550 patients with intermediate-risk pulmonary embolism with right ventricular dilatation and additional clinical risk factors randomized 1:1 to treatment with large-bore mechanical thrombectomy (LBMT) or catheter-directed thrombolysis (CDT). The primary end point was a hierarchal win ratio composite of the following (assessed at the sooner of hospital discharge or 7 days after the procedure): (1) all-cause mortality, (2) intracranial hemorrhage, (3) major bleeding, (4) clinical deterioration and/or escalation to …

Validation Of A Novel Landmark-Guided Intra-Articular Postero-Medial Surgeon-Administered Injection Technique, Nicolas Piuzzi, Andrew Spitzer, Jason Mussell, Ignacio Pasqualini, Stan Dysart, Jeffrey Gonzales, Michael Mont, Jess H. Lonner, Md, William Mihalko

Rothman Institute Papers

BACKGROUND: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB).

METHODS: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dye. An orthopedic surgeon performed a medial parapatellar arthrotomy and introduced an 18-gauge needle 1-2 cm proximal to the palpated adductor tubercle angled posteromedially. Needle position and dye spread were fluoroscopically documented.

RESULTS: This technique consistently reached the infrapatellar branch of the saphenous nerve, nerve to the vastus medialis muscle, and posterior capsule, with minimal proximal dye spread.

CONCLUSIONS: This …

Five-Year Outcomes Of Lenadogene Nolparvovec Gene Therapy In Leber Hereditary Optic Neuropathy, Patrick Yu-Wai-Man, Nancy Newman, Valérie Biousse, Valerio Carelli, Mark Moster, Catherine Vignal-Clermont, Thomas Klopstock, Alfredo Sadun, Robert C Sergott, Rabih Hage, Simona Degli Esposti, Chiara La Morgia, Claudia Priglinger, Rustum Karanja, Magali Taiel, José-Alain Sahel

Department of Neurology Faculty Papers

IMPORTANCE: Limited studies have assessed the long-term benefit/risk of gene therapy for Leber hereditary optic neuropathy (LHON).

OBJECTIVE: To determine the safety and efficacy of lenadogene nolparvovec in patients with LHON due to the MT-ND4 gene variant for up to 5 years after administration.

DESIGN, SETTING, AND PARTICIPANTS: The RESCUE and REVERSE Long-Term Follow-up Study (RESTORE), conducted from 2018 to 2022, is the 5-year follow-up study of the 2 phase 3 clinical studies RESCUE (Efficacy Study of Lenadogene Nolparvovec for the Treatment of Vision Loss Up to 6 Months From Onset in LHON Due to the MT-ND4 Mutation) and REVERSE …

Patient-Reported Outcomes: Comparing Functional Avoidance And Standard Thoracic Radiation Therapy In Lung Cancer, Spencer Poiset, Joseph Lombardo, Edward Castillo, Richard Castillo, Bernard Jones, Moyed Miften, Brian Kavanagh, Adam Dicker, Cullen Boyle, Nicole Simone, Benjamin Movsas, Inga Grills, Chad Rusthoven, Yevgeniy Vinogradskiy, Lydia Wilson

Department of Radiation Oncology Faculty Papers

PURPOSE: Novel methods generate functional images using image processing techniques combined with four-dimensional computed tomography (4DCT) data (4DCT-ventilation). 4DCT-ventilation was implemented in a phase II, multicenter functional avoidance clinical trial. The work compares functional avoidance patient-reported outcomes (PROs) against historical standards.

METHODS: Patients with locally advanced lung cancer undergoing curative-intent chemoradiation were accrued. 4DCT-ventilation imaging was generated and functional avoidance treatment plans created reduced dose to functional lung. PRO instruments included Functional Assessment of Cancer Therapy Lung questionnaire and accompanying subscales (including the Trial Outcome Index [TOI]), EuroQol-5 Dimension (EQ-5D), and EQ-Visual Analog Scale (EQ-VAS). The average change from baseline …

Accelerated Symptom Improvement In Parkinson’S Disease Via Remote Internet-Based Optimization Of Deep Brain Stimulation Therapy: A Randomized Controlled Multicenter Trial, Alireza Gharabaghi, Sergiu Groppa, Marta Navas-Garcia, Alfons Schnitzler, Laura Muñoz-Delgado, Vicky L. Marshall, Jessica Karl, Lin Zhang, Ramiro Alvarez, Mary S. Feldman, Michael J. Soileau, Lan Luo, S. Elizabeth Zauber, Benjamin L. Walter, Chengyuan Wu, Hong Lei, Damian M. Herz, Ming-Hua Chung, Yagna Pathak, Bram Blomme, Binith Cheeran, Corneliu Luca, Daniel Weiss

Department of Neurosurgery Faculty Papers

BACKGROUND: Deep brain stimulation (DBS) has emerged as an important therapeutic intervention for neurological and neuropsychiatric disorders. After initial programming, clinicians are tasked with fine-tuning DBS parameters through repeated in-person clinic visits. We aimed to evaluate whether DBS patients achieve clinical benefit more rapidly by incorporating remote internet-based adjustment (RIBA) of stimulation parameters into the continuum of care.

METHODS: We conducted a randomized controlled multicenter study (ClinicalTrails.gov NCT05269862) involving patients scheduled for de novo implantation with a DBS System to treat Parkinson's Disease. Eligibility criteria included the ability to incorporate RIBA as part of routine follow-up care. Ninety-six patients were …

A Guide To Diagnosis And Management Of Hypertrichosis, Rahib K. Islam, Victoria T. Tong, Shari R. Lipner

School of Medicine Faculty Publications

Hypertrichosis is a phenotype characterized by excessive hair growth in areas not typically prone to dense hair coverage. It may be congenital or acquired, and has significant clinical and psychosocial implications, often leading to psychological distress and social stigmatization. Diagnostic approaches emphasize the importance of thorough clinical evaluation and differentiation from hirsutism. Treatment options include topical and systemic treatments, as well as mechanical methods and laser therapies. Special considerations are given to pediatric patients regarding the psychosocial aspects of the phenotype. This review aims to provide physicians and researchers with a thorough understanding of hypertrichosis to facilitate better diagnosis, treatment, …

A Longer Duration Of Intravenous Antibiotic Treatment For Patients With Early Periprosthetic Joint Infections Is Not Associated With A Lower Failure Rate, Janneke Meijer, Alex Soriano, Wierd Zijlstra, Bas Ten Have, Saad Tarabichi, Paul Jutte, Javad Parvizi, Marjan Wouthuyzen-Bakker

Rothman Institute Papers

BACKGROUND: In recent years, many studies have demonstrated the efficacy of an early switch to oral antibiotics after surgical treatment in orthopedic-related infections. However, large analyses on periprosthetic joint infections (PJIs) are lacking.

MATERIAL AND METHODS: We conducted a retrospective observational multicenter study in patients diagnosed with an early post-operative PJI, defined as one occurringdebridement, antibiotics, and implant retention (DAIR). Patients from Europe and the USA were included. We took advantage of the fact that an early oral antibiotic switch is routine practice in Europe as opposed to a long duration of intravenous (IV) antibiotic treatment in the USA. Failure …

Improving Antibiotic Decision Making Amongst Medical Residents, Andrew Baird, Mina Guirguis, Brian Steiner, Daniel Khashchuk

South Atlantic Division GME Research Day 2025

No abstract provided.

Reproductive Autonomy In Immunological Intervention: Ethical Boundaries In Maternal-Fetal Immune Therapy, Marium Z. Rizvi

Journal of Health Ethics

Recent advances in immunology have broken barriers in reproductive medicine through immune-modulating therapies that support fertility and pregnancy. Treatments such as intravenous immunoglobulin (IVIG) and intralipid infusions are increasingly offered to patients with Recurrent Implantation Failure (RIF) or Recurrent Pregnancy Loss (RPL), conditions that result in miscarriages and failed IVF treatments (Pillarysetti et al., 2023). Maternal-fetal immunology reveals a delicate interplay between immune tolerance and defense: the maternal system must accept a genetically foreign fetus while preserving immunological protection. Disruptions in this balance are implicated in implantation disorders and pregnancy failure. As a result, immune-based therapies have emerged as promising …

Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr

North Texas Research Forum 2025

Background Patients with massive/sub-massive pulmonary embolism (PE) and right ventricular strain have a significant risk of hemodynamic collapse. VA ECMO support provides an excellent salvage option for patients with acute/unstable pulmonary embolism with obstructive cardiogenic shock undergoing mechanical thrombectomy. Using VA-ECMO for a “protective PE” procedure allows control of hemodynamics and enables interventionalists to perform the thrombectomy in a more controlled environment. Here, we present our experience. Methods A retrospective data analysis on consecutive VA ECMO patients with cardiogenic shock secondary to pulmonary embolism was abstracted from August 2022 to June 2024. Results Patient characteristics and outcomes are described in …

Interprofessional Neonatal Resuscitation Simulations: An In-Situ Assessment Of Pediatric Readiness At A Multi-Site Academic Center, Jessyca C. Gibson, Petru C. Nemes

South Atlantic Division GME Research Day 2025

No abstract provided.

Exosomes And Encapsulated Exomirs In Breast Cancer: Theragnostic Applications And Clinical Implications, Muhammad Imran Sajid, Shafia Bukhari, Hamid Ilyas, Rubina Malik, Minahil Fatima, Rakesh Kumar Tiwari, Surya M. Nauli, Khawaja Husnain Haider

Pharmacy Faculty Books and Book Chapters

Exosomes, released by cells, are small vesicles that have emerged as critical theranostic tools in breast cancer due to their unique ability to transport diverse biomolecules such as proteins, lipids, and RNAs, including microRNAs (ExomiRs). These vesicles are critical in modulating the tumor microenvironment, driving processes like cancer proliferation, invasion, metastasis, and drug resistance. Exosomal microRNAs such as ExomiR-21, ExomiR-1246, and ExomiR-155, with their profound influence on the gene expressions in the recipient cells, are the unsung heroes in tumor progression and immune modulation. This chapter delves into exosome's dual diagnostic and therapeutic potential in breast cancer. It highlights their …

Beyond Appearances: A Case Report Of Mistaken Identity In Dialysis Access, Ephrem D. Demie, Shahin Owji, Mohammad Shafiq, Srikanth Raayasa

Gulf Coast Division GME Research Day 2025

No abstract provided.

Beta-Lactam Allergy De-Labeling Quality Improvement, Eric Riha, Alexandria Kim, David Kim, Brandon Robinson, Kevin Garnepudi

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Case Of Severe Synodic Stenosis In A Patient With Granalomatosis With Polyangitis Requiring Tracheostomy, Yousuf Sherwani, Mohan Sengodan

North Texas Research Forum 2025

Granulomatosis with polyangiitis (GPA) is characterized by vasculitis of small and medium sized blood vessels and granulomatous lesions of the upper respiratory tract. A rare condition associated with GPA, subglottic stenosis, presents in about 20% of cases on inpatient GPA. Symptoms such as stridor, hoarseness, dyspnea and dysphagia are hall marks of subglottic stenosis. Here we present the case of a male patient with life threatening subglottic stenosis that required tracheostomy.

Teaching Ultrasound-Guided Knee Injection & Aspiration In A Family Medicine Residency Clinic, James Wesley, Dauwd Farooqi, Christopher Bazemore

North Florida Division GME Research Day 2025

No abstract provided.

Single-Agent And Short-Course Antibiotic Result In Optimal Outcomes For The Nonoperative Management Of Perforated Peptic Ulcer, Dimitri Sagwo Tchienga, Ramon Gil, Robyn Meadows, Shaikh Hai

East Florida Division GME Research Day 2025

No abstract provided.

Heterotopic Ossification (Ho) Prophylaxis In Total Hip Arthroplasty (Tha): A Systematic Review Of Level I And Level Ii Evidence Since 2000, Troy Puga, Mckenna Box, Vincent Dieu, Charles Marchese, John T. Riehl

North Texas Research Forum 2025

Introduction: Heterotopic ossification (HO) is a somewhat common occurrence after total hip arthroplasty (THA), particularly with certain approaches. This complication can be detrimental to the success of the surgical outcome. Indomethacin and radiotherapy remain common treatment modalities; however, no true gold-standard treatment is universally agreed upon. This study aims to evaluate Level I and Level II evidence for treatment practices of HO prophylaxis since 2000. Methods: To evaluate HO prophylaxis in total hip arthroplasty, a search was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases using keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility for …

The Impact Of Early Vs. Late Intubation On Morality Among Obese Patients With Idiopathic Pulmonary Fibrosis, Peter Holleb, Enkhbileg Batbileg, Brandon Chong, Jameel Osborne

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Optimizing Fluid Resuscitation: Balancing Access Efficiency And Infusion Speed In Trauma Care, Chris Robert, Enoch Wong, David Bassa, Danielle Pigneri, Paul Granet

North Texas Research Forum 2025

Study Objective: Time is a critical resource during the initial treatment of an injured patient. Fluid resuscitation is also a critical component of trauma care. Clinicians are faced with the need to actively resuscitate an injured patient while simultaneously working to provide them operative or procedural hemorrhage control as quickly as possible. In these circumstances, physicians must balance perceived flow efficiency with time required to place certain types of access devices, though little data exists to guide this decision process. This study aims to evaluate the infusion times of different sizes of peripheral and central venous catheters to optimize fluid …

Navigating The Complexity Of Ards And Cardiogenic Shock With Veno-Arterial Ecmo: A Case Report, Sanjana Kesireddy, Mohan Sengodan

North Texas Research Forum 2025

INTRODUCTION: When deciding between VA ECMO (veno-arterial ECMO) and VV ECMO (veno-venous ECMO), the primary consideration is the underlying pathology affecting the patient’s heart and lungs. VA ECMO provides support for both the cardiovascular and respiratory systems, making it suitable for patients experiencing cardiogenic shock or combined cardiac and respiratory failure. In contrast, VV ECMO is used exclusively for respiratory failure, offering support to patients with severe lung dysfunction but intact cardiac function. CASE PRESENTATION: 41 year old male with no known past medical history presented s/p cardiac arrest secondary to aspiration pneumonia due to alcohol and opioid intoxication. Chest …

Use Of Va Ecmo In Patients With Acute Pulmonary Embolism Presenting With Obstructive Cardiogenic Shock Undergoing Mechanical Thrombectomy, Luke Taylor, Otoniel Espinoza, Omar O. Hernandez, Shannon Biggers, Shirin Miller, Srinivas Yallapragada, Amer Alaiti, Andrew Fredericks, Song Li, Claudius Mahr

North Texas Research Forum 2025

BACKGROUND: Management of VA ECMO has substantially evolved over the years. Much literature has been published regarding indications, management, and outcomes; however, limited evidence exists detailing strategies to manage, progress, and wean patients from VA ECMO. We present our experience using a VA ECMO expected progression patient management guideline. METHODS: The VA ECMO Expected Progression Patient Management Guideline, approved on June 1, 2021, consists of six goal-oriented stages with suggestive interventions for managing cardiogenic shock patients undergoing VA ECMO therapy. Patient characteristics and outcomes were collected retrospectively and compared between March 2019 to May 2021 (VA Non-Expected Progression group) and …