Critical Care Commons^™

Nurses’ Knowledge Regarding Ventilator-Associated Pneumonia Prevention Bundle In Adult Cardiac Care Units, Marwa Abdo

Nursing

Ventilator-associated pneumonia (VAP) is among the most common ICU infections for ventilated patients, associated with increased mortality (20-50%), morbidity, and health care costs. Nurses' knowledge of VAP prevention bundles is vital to reducing its incidence in critical care areas. Aim: To assess Nurses’ knowledge regarding the ventilator-associated pneumonia prevention bundle in Adult Cardiac Care Units. Study design: A cross-sectional study design was used. Setting: This study was conducted in both the adult cardiac intensive care unit and the cardiac care unit at Aswan Heart Centre–Magdy Yacoub Foundation, Egypt. Subject: A convenience sample of 67 nurses was selected. Data collection tool: …

Trends And Demographic Disparities In Septicemia-Associated Cardiac Arrest Mortality In The United States, 1999–2023, Muhammad Owais, Maham Mehfooz, Hamza Nazir, Preeti Advani, Roha Riaz, Khanij Arya, Javeria Nawaz, Syed Hadi Raza Rizvi, Murtaza Aslam, Usman Nazeer, Jairo Melo, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Improving Sepsis Order Set Utilization Through Targeted Resident Education: A Lean Six Sigma Green Belt Quality Improvement Project, Sarah Sheikh, Puneeth Shridhar, Bushra Bangash, Valerie Chukelu, Tonya Meirhofer, Arunima Jose, Zainab Shakir, Shane Jenks, Augusto Sepulveda, Trung Nguyen, Rajeev Raghavan

Gulf Coast Division GME Research Day 2026

No abstract provided.

Refractory Status Epilepticus After Hair Transplant: A Case Of Lidocaine Toxicity In A Post-Craniotomy Patient, Sarai Arbus, Cheyenne Lockwood, Max Wei, Andrew Labelle

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Comparative Assessment Of Arterial Line And Pulse Contour Derived Hemodynamics Monitoring In A Post-Cardiac Surgery Icu Patient: Pilot Observation, Chiraag Ashokkumar, Justin Gisel

South Atlantic Division GME Research Days 2026

No abstract provided.

Trimethoprim–Sulfamethoxazole–Induced Thrombotic Thrombocytopenic Purpura, Renee Morecroft, Jyoti Moorjani, Mohamed Hussam Hallak, Tathana Rivera Hernandez, Isabella Estrada, Hammad Awad, Payam Nabizadeh-Eraghi

South Atlantic Division GME Research Days 2026

No abstract provided.

Colonic Perforation In A Patient On Glp-1 Agonist Therapy: A Case Report, Mohammed Irfan Khan, Shuchita Jhaveri, Azad Patel, Bilal Ashraf, Ahmed Ouni, John Paek, Sivatej Sarva

Gulf Coast Division GME Research Day 2026

No abstract provided.

Pulmonary Tumor Thrombotic Microangiopathy Presenting As Rapidly Progressive Pulmonary Hypertension: A Case Report, Ali Basaran, Jacob Slowinski, Tesnim Hamdan, Kumaraswamy Nutalapati, Jason Stanberry, Ahmed Tarbay, Dunn Ryan

West Florida Division GME Research Day 2026

No abstract provided.

Necrotizing Pneumonia And Alveolar-Pleural Fistula After Foreign Body Aspiration, Vineet Madishetty, Adam Hurwitz, Ritvik Peesapati, Jessica Neugebauer, James Flanagan

West Florida Division GME Research Day 2026

No abstract provided.

Clostridium Tertium Peritonitis Complicated By Bacteremia Case Report, Ryan Fernandez Q, Ebiuwa Osula, Arbab Kasi, Fernando Lugo-Hernandez, Joshua Gruber

West Florida Division GME Research Day 2026

No abstract provided.

Primary Lung Adenocarcinoma Mimicking Miliary Tuberculosis Pattern: A Rare Presentation, Reza Alavi, Casper Chen, Idelisse Suarez Maldonado, William Arvan, Mukesh Patel, Elie Feghali

West Florida Division GME Research Day 2026

No abstract provided.

A Greasy Imposter: A Case Of Profound Hypertriglyceridemia Mimicking Diabetic Ketoacidosis And Severe Hyponatremia, Shania Chishti, Elaheh Boroujeni, Mohammad Hussan Shafiq, Jonathan Xian

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Double-Edged Sword: Accelerated Metastasis After Video-Assisted Thoracoscopic Surgery In Advanced Lung Adenocarcinoma, Grace Anne Martin, Kanwar Bir Dhaliwal, Mala Goyal

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

When A Rare Neuromuscular Disorder Meets Covid-19: A Challenging Case Of Myotonic Dystrophy In The Intensive Care Unit, Pradeep Rajbhandari, Lawrence San Jose, Michael Waxman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Fluid Resuscitation Choice And Its Effect On Plasma Chloride And Acute Kidney Injury In Severe Acute Pancreatitis: A Randomized Study Of Normal Saline Vs. Balanced Crystalloids (Physiomax), Mandip Singh Bhatia, Ritu Attri, Ashok Kumar Pannu, Atul Saroch, Saurabh C Sharda, Neeraj Singla, Sakshi Mehta

Journal of Community Hospital Internal Medicine Perspectives

Background: Acute pancreatitis (AP) is a potentially fatal gastrointestinal condition, often associated with organ failure and acute kidney injury (AKI). Early fluid resuscitation with Normal saline (NS) may lead to hyperchloremia and AKI, which prompted interest in using balanced crystalloids. However, the optimal choice of crystalloid fluid remains uncertain. This study aimed to compare the effects of NS versus Physiomax on plasma chloride levels and AKI incidence during early resuscitation in patients with predicted severe AP (pSAP).

Methods: A single-center, prospective, randomized study was conducted between November 2022 and December 2023 at PGIMER, Chandigarh, India. 112 patients with pSAP were …

Nondominant Right Coronary Artery Occlusion Leading To An Anterior St-Segment Elevation Myocardial Infarction, Taha Ahmed, Taylor Wood, Austin Harris, Rajan Desai, Garima Handa, Naoki Misumida, Amartya Kundu

HCA Healthcare Journal of Medicine

Background

A nondominant right coronary artery supplies a small portion of the myocardium. Albeit rare, an acute occlusion of a nondominant right coronary artery is believed to be inconsequential with minimal clinical relevance.

Case Presentation

We present a case of a middle-aged man who presented with chest pain and an electrocardiogram demonstrating anterior ST-segment elevation. An emergent coronary angiogram revealed acute thrombotic occlusion of the proximal nondominant right coronary artery with no significant obstructive atherosclerotic disease in the dominant left coronary circulation. Balloon angioplasty of the occluded vessel followed by implantation of a drug-eluting stent resulted in the resolution of …

Recurrent, Acute Limb Ischemia Secondary To Arterial Thrombosis: A Devastating Complication In The Setting Of Severe Covid-19 Infection, Shaikh Afaq, Kyle S. Strouse, Sini Saju, Olugbenga Oyesanmi, Mohamad Eid, Salman Muddassir

HCA Healthcare Journal of Medicine

Background

COVID-19 infection, particularly with the Delta variant, has been associated with a heightened risk of thromboembolic events due to a profound hypercoagulable state. While venous thrombosis is more commonly reported, arterial thrombosis—including acute limb ischemia—has emerged as a serious complication with significant morbidity and mortality.

Case Presentation

We report the case of a 53-year-old man with severe COVID-19 pneumonia who developed recurrent acute limb ischemia secondary to an aortic mural thrombus. Despite therapeutic anticoagulation and multiple surgical interventions—including thrombectomy, angioplasty, and stenting—the patient experienced repeated episodes of arterial thrombosis. His clinical course was further complicated by pneumothorax and hemothorax, …

Impact Of A Sepsis Quality Improvement Initiative On Clinical And Operational Outcomes, Christopher B. Thomas, Benjamin Wyler, Claude M. D’Antonio, Mark Laperouse, Shannon Alwood, Kristen Richard, Alyse Grantham, Roya Sheybani, Matt G. Sorrells, Wei Jien Tan, James W. Teague, Hollis O’Neal, Tonya Jagneaux

School of Medicine Faculty Publications

Background/Objectives: Sepsis is a costly and life-threatening condition caused by a dysregulated host response to infection. Lack of a reliable, timely diagnostic for sepsis leads to under- and overdiagnosis, suboptimal outcomes, and strained hospital resources. Our Lady of the Lake Regional Medical Center (OLOLRMC) implemented a sepsis learning health program to evaluate and improve outcomes through standardized ED workflows and the incorporation of a novel sepsis diagnostic test. Methods: We report the results of the first year of experience following the implementation of the learning health initiative and sepsis testing. Data from the Epic EHR were analyzed across two groups: …

When The Right Ventricle Fails After Left Ventricular Assist Device Implantation: Prediction Tools, Recognition Strategies, And Support Options, Juan Jose Rodriguez Arias, James Schurr, Phyllis Billia, Joyce W. Wald

Journal of Shock and Hemodynamics

The incidence of right heart failure (RHF) during durable left ventricular assist device (LVAD) surgery ranges from 9% to 42%, depending on the definition. RHF can be divided into three peri-implantation categories: early acute, early, and late. Despite many available risk models, predicting RHF before durable LVAD implantation has been difficult. Preemptive right-sided temporary mechanical circulatory support can improve outcomes; however, if intraoperative RHF is not suspected, early recognition and appropriate intervention after surgery are important.

A Rare Case Of Esophageal Perforation: Esophageal Perforation Following Cervical Spine Hardware Removal, Amira Al-Nabolsi, Jessica Kopchia, Cameron Hubbard, Hussein Hamade, Mouhamed Shatila

Conference Presentation Abstracts

An esophageal perforation is an uncommonly encountered life-threatening emergency that can lead to leakage of gastric contents into surrounding esophageal tissue. It is most commonly due to iatrogenic injury, typically involving endoscopy, intubation, or esophageal surgery. We describe an unusual case of esophageal perforation secondary to the removal of infected cervical spine hardware. A 73-year-old male with cervical spine central stenosis with history of an anterior cervical spinal fusion of C5-C7 over 40 years ago presented to the emergency department at the request of his pulmonologist. A CT scan of the neck was obtained in the outpatient setting, as the …

Development Of Parapneumonic Effusion In A Patient Using Kratom, Emma Glover, Morgan Kiryakoza, Nader Mina

Conference Presentation Abstracts

Introduction: “Kratom” refers to both Mitragyna speciosa, a tree native to Southeast Asia, and to its products, derived from the tree’s leaves, which are marked as an herbal supplement. Kratom is an herbal supplement with both opioid and stimulant-like effects. While there are no approved uses for kratom by the U.S. Food and Drug Administration, it is frequently used by individuals to manage withdrawal symptoms and cravings (especially related to opioid use), pain, fatigue, and mental health disorders. Furthermore, because kratom is unregulated, it can contain contaminants, including heavy metals and harmful bacteria. This case details the development of parapneumonic …

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Evaluation Of Hyponatremia Management Pathway, Mahmoud Ammar Pharmd, Jonathan M. Siner, Mary Judson, Christopher Winterbottom

Abstracts

Society of Critical Care Medicine's (SCCM) 2025 Critical Care Congress:

Evaluation of Hyponatremia Management Pathway Implementation in a Large Academic Health System

Submission Number: 1894079

Patients with severe hyponatremia managed using the Care Signature pathway were more likely to receive hypertonic saline and had lower mortality rates compared to those not managed with the pathway. These results suggest that the pathway can improve clinical outcomes and reduce resource use. Further studies are needed to evaluate its impact on other patients’ outcomes and long-term effectiveness.

P.C.U. (Please Cut Unnecessary Use): Making Room For Better Care And Costs, Taylor Croteau, Emmanuella Gomez Martinez, Jafaar Abou-Ghaida, Nelson Reyes Perez, Katya Grovac, Shamol Williams, Olga Karasik

North Florida Division GME Research Day 2025

No abstract provided.

Acute Respiratory Compromise Secondary To Superior Vena Cava Syndrome In A Sickle Cell Patient. Vaso-Occlusion Triggered By Steroids?, Ashley Diaz, Priya Mohan, Abhishek Sharma, David Zarabanda, Raiko Diaz

East Florida Division GME Research Day 2025

No abstract provided.

Post-Operative Afib After Cabg: A Retrospective Analysis, Leonardo A. Almaguer Gongora, Myrna E. Reinhardt, Manuel Jimenez, Luis E. Remedios Carbonell, Daniel Padron, Priya Mohan, Juliette Camejo, Bernardo Reyes

East Florida Division GME Research Day 2025

No abstract provided.

Not So Sle-Ghtly Bloody, A Nguyen, Napat Rangsipat, Shai Ring, Suhas Tatapudi, Cassie Robertson, Achi Chary, Damon Cao

Gulf Coast Division GME Research Day 2025

No abstract provided.

Bleeding Lungs: A Case Of Hydralazine Induced Systemic Lupus Erythematosus With Diffuse Alveolar Hemorrhage, Damara Miller, Munanchu Poudel, Neil Maithel, Deekshita Valiveti, Arjun Kamath, Rahul Dadhwal, Ali Mohammed, Rene Franco Jr., Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2025

No abstract provided.

Impact Of Fluid Balance On Clinical Outcomes In Icu Patients W. Pulmonary Arterial Hypertension, Geran Maule, John Rickards, Abdallah Rayyan, Moh'd Alamin Daise, Kobina Essilfie-Quaye, Peters Okonoboh

North Florida Division GME Research Day 2025

No abstract provided.