Critical Care Commons^™

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Socioeconomic, Behavioral, And Health Profiles Of Women With Eclampsia: Findings From The 2020–2022 National Pregnancy Risk Assessment Monitoring System Data, Jessi Bates, Gurgen Grigoryants, Hongyun Fu

Cardiovascular Research Symposium

Background: Eclampsia is a severe obstetric complication with significant maternal health implications, disproportionately affects women with certain sociodemographic and health risk factors. This study investigates the characteristics and outcomes of women who experienced eclampsia using data from the national Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods: This analysis included a sample of 729 women with eclampsia from the 2020–2022 PRAMS (N = 238,575). Descriptive statistics, chi-square tests, and multivariate logistic regression were conducted to examine patterns and factors associated with preterm-birth, low birth weight (LBW), and cesarean delivery.

Results: Over half of the women were aged ≥35 years (50.6%), unmarried …

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Substance Use And Outcomes Of Left-Sided Valve Replacement In Patients With Infective Endocarditis, Katie J Hogan, Christopher B Sylvester, Travis J Miles, Matthew Wall, Todd K Rosengart, Marc R Moon, Joseph S Coselli, Subhasis Chatterjee, Ravi K Ghanta

Faculty, Staff and Students Publications

BACKGROUND: Rising rates of substance use (SU) have resulted in an increasing need for left-sided valve surgery for SU-associated infective endocarditis (SU-IE). We compared outcomes, readmissions, and costs between IE patients with and without SU-IE in a national cohort.

METHODS: Using the Nationwide Readmissions Database (2016-2018), we identified 10,098 patients with infective endocarditis (IE) who underwent isolated aortic or mitral valve replacement. Outcomes within the same calendar year as the index operation were compared between patients with and without SU-IE. Multivariable logistic regressions were used to identify factors associated with in-hospital mortality and 30-day and 90-day readmissions. Kaplan-Meier analysis and …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Adaptation And Validation Of The Moroccan Dialect Version Of The Nomophobia Questionnaire (Nmp-Q): Among University Students, Hicham Khabbache, Driss Ait Ali, Abdelhalim Cherqui, Abdelaziz Allioui, Zakaria Abidli, Joumana Elturk, Murat Yildirim, Nicola Luigi Bragazzi, Gabriella Nucera, Lukasz Szarpak, Amelia Rizzo, Francesco Chirico

Faculty, Staff and Students Publications

The fear of being without a mobile phone, known as nomophobia, is a new psychological issue that has arisen with the widespread use of information and communication technologies. To understand this phenomenon, more research is needed. The present study aimed to assess the factor structure of the Moroccan dialect version of the Nomophobia Questionnaire (NMP-Q) among a sample of Moroccan university students. The study included 400 students selected by convenience sampling from two universities (Fez and Rabat). First, an Exploratory Factor Analysis (EFA) was conducted using the principal component method with Varimax rotation. Then, a Confirmatory Factor Analysis (CFA), and …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Summary Of: Feasibility Of Continuous Home Monitoring Of Particulate Matter And Lung Function In Patients With Chronic Obstructive Lung Disease Who Are Exposed To Wood Smoke, S Wayne, K Cowan, L.M. Paulin, J Emery, D.A. Kaminsky

Northern New England Clinical & Translational Research

Particulate matter (PM) contains microscopic solids or liquids that are so small they can be inhaled and cause serious health problems. Examples include smoke, dust, soot, and fumes.

There is increasing evidence that small particles have harmful effects on people’s breathing. Wood stoves are a source of indoor PM.

Surgery Of The Colon; The Impact Of Colostomy And Postoperative Complications On Patients' Quality Of Life, Vlad Denis Constantin, Adrian Silaghi, Dragos Epistatu, Daniela Gabriela Bălan, Florin Silviu Groseanu, Denisa Mihaela Nedelcu, Ioana Paunica

Journal of Mind and Medical Sciences

Introduction. This study aims to evaluate the impact of stoma formation on the quality of life of patients undergoing colonic surgery, considering both emergency and elective procedures. Several factors (demographic data, Charlson comorbidity score, type of surgical intervention, duration of hospitalization, postoperative outcomes and complications, etc.) were analyzed to understand their influence on patients' well-being. Materials and Methods. A retrospective analysis was performed on patients who underwent colorectal surgery that required stoma formation. A total of 270 patients were included in the study, with 69.25% undergoing emergency surgery and 30.74% undergoing elective procedures. Results. The Charlson comorbidity score was significantly …

Chronic Adolescent Stress Alters Gr-Fkbp5 Interactions In The Hippocampus Of Adult Female Rats, Sydney Rowson, Mandakh Bekhbat, Sean Kelly, Molly M Hyer, Samya Dyer, David Weinshenker, Gretchen Neigh

Faculty, Staff and Student Publications

Chronic stress exposure during development can have lasting behavioral consequences that differ in males and females. More specifically, increased depressive behaviors in females, but not males, are observed in both humans and rodent models of chronic stress. Despite these known stress-induced outcomes, the molecular consequences of chronic adolescent stress in the adult brain are less clear. The stress hormone corticosterone activates the glucocorticoid receptor, and activity of the receptor is regulated through interactions with co-chaperones-such as the immunophilin FK506 binding proteins 5 (FKBP5). Previously, it has been reported that the adult stress response is modified by a history of chronic …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Stroke Survivors’ Telemedicine Experiences During The Covid-19 Pandemic: A Phenomenological Investigation, Barbara Kimmel, Annette Walder, Anette Ovalle, Chethan P Venkatasubba Rao, Sean I Savitz, Mark Goldberg, Steven Warach, Salvador Cruz-Flores, Daiwai M Olson, Jane A Anderson

Faculty, Staff and Student Publications

PURPOSE: This study aimed to describe stroke survivors' experiences receiving telemedicine visits at the Lone Star Stroke Consortium during the COVID-19 pandemic.

MATERIALS AND METHODS: A qualitative descriptive phenomenological design was applied to gather patients' telemedicine experiences through in-depth interviews, using a study guide. Audio-recorded interviews were conducted via ZOOM and transcribed verbatim. Two independent reviewers used the Giorgi descriptive method to analyze the data and search for the essence of stroke survivors' follow-up telemedicine experiences during the COVID-19 pandemic.

RESULTS: Fifteen underserved patients were recruited: mean age, 51.8 (15.7), and 9 (60%) females. Three themes emerged: (1) vivid memory …

Plasma Metabolomics And Quantitative Interstitial Abnormalities In Ever-Smokers, Bina Choi, Raúl San José Estépar, Suneeta Godbole, Jeffrey L Curtis, Jennifer M Wang, Rubén San José Estépar, Ivan O Rosas, Jared R Mayers, Brian D Hobbs, Craig P Hersh, Samuel Y Ash, Meilan K Han, Russell P Bowler, Kathleen A Stringer, George R Washko, Wassim W Labaki

Faculty, Staff and Students Publications

BACKGROUND: Quantitative interstitial abnormalities (QIA) are an automated computed tomography (CT) finding of early parenchymal lung disease, associated with worse lung function, reduced exercise capacity, increased respiratory symptoms, and death. The metabolomic perturbations associated with QIA are not well known. We sought to identify plasma metabolites associated with QIA in smokers. We also sought to identify shared and differentiating metabolomics features between QIA and emphysema, another smoking-related advanced radiographic abnormality.

METHODS: In 928 former and current smokers in the Genetic Epidemiology of COPD cohort, we measured QIA and emphysema using an automated local density histogram method and generated metabolite profiles …

Sustaining Care Team Engagement Using A Hierarchy Of Needs Framework, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Natalia Johnson, Rebecca A. Brookes

Operations Transformation

Cardiology Intensive Care & Cardiovascular Interventional (CICU & R9 West) teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of physical and mental health wellbeing, as well as care team engagement in order to continue to provide outstanding care to patients. CICU/R9 West Leadership looked for ways to improve team engagement and ensure that care team members’ needs are met and sustained.

Cocaine Use Disorder Effects On Blood Oxytocin Levels And Oxtr Dna Methylation, Manassés Soares Souza, Breno Sanvicente-Vieira, Aline Zaparte, Talita Baptista, Maria Aparecida Nagai, Flávia Rotea Mangone, Ana Carolina Pavanelli, Thiago Wendt Viola, Rodrigo Grassi-Oliveira

School of Medicine Faculty Publications

Substance use disorders have been associated with alterations in the oxytocinergic system, but few studies have investigated both the peptide and epigenetic mechanisms potentially implicated in the regulation of oxytocin receptor. In this study, we compared plasma oxytocin and blood DNA methylation in the OXTR gene between people with and without cocaine use disorder (CUD). We measured the oxytocin levels of 51 people with CUD during acute abstinence and of 30 healthy controls using an enzyme immunoassay. The levels of DNA methylation in four CpG sites at exon III of the OXTR gene were evaluated in a subsample using pyrosequencing. …

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

Readmissions After Surgical Aortic Valve Replacement: Influence Of Prosthesis Type, Christopher B Sylvester, Christopher T Ryan, William C Frankel, Rodrigo Zea-Vera, Qianzi Zhang, Matthew J Wall, Marc R Moon, Joseph S Coselli, Todd K Rosengart, Subhasis Chatterjee, Ravi K Ghanta

Faculty, Staff and Students Publications

INTRODUCTION: Prosthesis choice during aortic valve replacement (AVR) weighs lifelong anticoagulation with mechanical valves (M-AVR) against structural valve degeneration in bioprosthetic valves (B-AVR).

METHODS: The Nationwide Readmissions Database was queried to identify patients who underwent isolated surgical AVR between January 1, 2016 and December 31, 2018, stratifying by prothesis type. Propensity score matching was used to compare risk-adjusted outcomes. Readmission at 1 y was estimated with Kaplan-Meier (KM) analysis.

RESULTS: Patients (n = 109,744) who underwent AVR (90,574 B-AVR and 19,170 M-AVR) were included. B-AVR patients were older (median 68 versus 57 y; P < 0.001) and had more comorbidities (mean Elixhauser score: 11.8 versus 10.7; P < 0.001) compared to M-AVR patients. After matching (n = 36,951), there was no difference in age (58 versus 57 y; P = 0.6) and Elixhauser score (11.0 versus 10.8; P = 0.3). B-AVR patients had similar in-hospital mortality (2.3% versus 2.3%; P = 0.9) and cost (mean: $50,958 versus $51,200; P = 0.4) compared with M-AVR patients. However, B-AVR patients had shorter length of stay (8.3 versus 8.7 d; P < 0.001) and fewer readmissions at 30 d (10.3% versus 12.6%; P < 0.001) and 90 d (14.8% versus 17.8%; P < 0.001), and 1 y (P < 0.001, KM analysis). Patients undergoing B-AVR were less likely to be readmitted for bleeding or coagulopathy (5.7% versus 9.9%; P < 0.001) and effusions (9.1% versus 11.9%; P < 0.001).

CONCLUSIONS: B-AVR patients had similar early …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Rowan-Virtua Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Barriers To Care In Juvenile Localized And Systemic Scleroderma: An Exploratory Survey Study Of Caregivers’ Perspectives, Leigh A Stubbs, Andrew M Ferry, Danielle Guffey, Christina Loccke, Erin Moriarty Wade, Pamela Pour, Kaveh Ardalan, Peter Chira, Ingrid M Ganske, Daniel Glaser, Gloria Higgins, Nadia Luca, Katharine F Moore, Vidya Sivaraman, Katie Stewart, Natalia Vasquez-Canizares, Raegan D Hunt, Renata S Maricevich, Kathryn S Torok, Suzanne C Li, Childhood Arthritis, Rheumatology Research Alliance (Carra) Scleroderma Workgroup

Faculty, Staff and Students Publications

BACKGROUND: Juvenile localized scleroderma (LS) and systemic sclerosis (SSc) are rare pediatric conditions often associated with severe morbidities. Delays in diagnosis are common, increasing the risk for permanent damage and worse outcomes. This study explored caregiver perspectives on barriers they encountered while navigating diagnosis and care for their child's scleroderma.

METHODS: In this cross-sectional study, caregivers of juvenile LS or SSc patients were recruited from a virtual family scleroderma educational conference and a juvenile scleroderma online interest group. The survey queried respondents about their child's condition and factors affecting diagnosis and treatment.

RESULTS: The response rate was 61% (73/120), with …

Benzodiazepine-Minimizing Protocol For Alcohol Withdrawal: A Comparative Analysis, Jennifer Gaston, Hsin-Fang Li, Emily J Cox, Caitlin Klamper, John F Wurzel

View All Graduate Medical Education Content

No abstract provided.

Efficacy Of A Relaxation Scenario In Virtual Reality For The Comorbid Symptoms Of Anxiety And Asthenia In A General Hospital Setting: A Pilot Comparative Randomized Open-Label Study, Taisiya А Lepilkina, Allan G Beniashvili, Roman A Cheremin, Natalya G Malyukova, Margarita A Morozova, Mikhail A Bogdanov, Denis S Burminsky, Sergei S Potanin, Svetlana V Rodkina, George E Rupchev, Margarita N Eip

Faculty, Staff and Student Publications

BACKGROUND: Patients in general hospitals often display concomitant signs of mental maladjustment: low mood, anxiety, apathy, asthenia, all of which can have a negative impact on the course of the underlying disease and the recovery process. One of the non-pharmacological approaches that has gained wider acceptance in medical practice in recent years is the use of procedures based on virtual reality.

AIM: Assess the efficacy of the new domestic, virtual reality application Flow as relates to symptoms of anxiety and asthenia in patients undergoing inpatient treatment.

METHODS: The study was open-label and had a comparison group; the patients were assigned …

Acoustic Voice And Speech Biomarkers Of Treatment Status During Hospitalization For Acute Decompensated Heart Failure, Olivia M Murton, G William Dec, Robert E Hillman, Maulik D Majmudar, Johannes Steiner, John V Guttag, Daryush D Mehta

Faculty, Staff and Student Publications

This study investigates acoustic voice and speech features as biomarkers for acute decompensated heart failure (ADHF), a serious escalation of heart failure symptoms including breathlessness and fatigue. ADHF-related systemic fluid accumulation in the lungs and laryngeal tissues is hypothesized to affect phonation and respiration for speech. A set of daily spoken recordings from 52 patients undergoing inpatient ADHF treatment was analyzed to identify voice and speech biomarkers for ADHF and to examine the trajectory of biomarkers during treatment. Results indicated that speakers produce more stable phonation, a more creaky voice, faster speech rates, and longer phrases after ADHF treatment compared …

Sex And Race Disparities In Mortality And Years Of Potential Life Lost Among People With Hiv: A 21-Year Observational Cohort Study, Rachael A Pellegrino, Peter F Rebeiro, Megan Turner, Amber Davidson, Noelle Best, Chandler Shaffernocker, Asghar Kheshti, Sean Kelly, Stephen Raffanti, Timothy R Sterling, Jessica L Castilho

Faculty, Staff and Student Publications

BACKGROUND: Since the availability of antiretroviral therapy, mortality rates among people with HIV (PWH) have decreased; however, this does not quantify premature deaths among PWH, and disparities persist.

METHODS: We examined all-cause and premature mortality among PWH receiving care at the Vanderbilt Comprehensive Care Clinic from January 1998 to December 2018. Mortality rates were compared by demographic and clinical factors, and adjusted incidence rate ratios (aIRRs) were calculated using multivariable Poisson regression. For individuals who died, age-adjusted years of potential life lost (aYPLL) per total person-years living with HIV were calculated from US sex-specific life tables, and sex and race …

Financial Toxicity In Cancer Patients And Subsequent Risk Of Repeat Acute Care Utilization, Julia J Shi, J Alberto Maldonado, Chi-Fang Wu, Susan K Peterson, Ying-Shiuan Chen, Kevin Diao, Robert J Volk, Sharon H Giordano, Ya-Chen T Shih, Kelsey Kaiser, Grace L Smith

Faculty, Staff and Student Publications

BACKGROUND: Acute care (AC) visits by cancer patients are costly sources of healthcare resources and can exert a financial burden of oncology care both for individuals with cancer and healthcare systems. We sought to identify whether cancer patients who reported more severe initial financial toxicity (FT) burdens shouldered excess risks for acute care utilization.

METHODS: In 225 adult patients who participated in the Economic Strain and Resilience in Cancer (ENRICh) survey study of individuals receiving ambulatory cancer care between March and September 2019, we measured the baseline FT (a multidimensional score of 0-10 indicating the least to most severe global, …

Fear Of Covid-19, Anxiety, Depression And Suicide Among Elderly Patients With Chronic Physical Or Mental Diseases, Vasiliki Holeva, Vasiliki Aliki Nikopoulou, Eleni Parlapani, Konstantinos Karkaletsis, Styliani Kokkoni, Dimitrios Nouvakis, Patroklos Theocharis, Ioannis Diakogiannis

Journal of Mind and Medical Sciences

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9. According to the results, older chronic disease patients showed higher …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Are Thyrotropin-Releasing Hormone (Trh) And Analog Taltirelin Viable Reversal Agents Of Opioid-Induced Respiratory Depression?, Marieke Hyke Algera, Joseph F Cotten, Monique Van Velzen, Marieke Niesters, Martijn Boon, Daniel S Shoham, Kaye E Dandrea, Rutger Van Der Schrier, Albert Dahan

Faculty, Staff and Student Publications

Opioid-induced respiratory depression (OIRD) is a potentially life-threatening complication of opioid consumption. Apart from naloxone, an opioid antagonist that has various disadvantages, a possible reversal strategy is treatment of OIRD with the hypothalamic hormone and neuromodulator thyrotropin-releasing hormone (TRH). In this review, we performed a search in electronic databases and retrieved 52 papers on the effect of TRH and TRH-analogs on respiration and their efficacy in the reversal of OIRD in awake and anesthetized mammals, including humans. Animal studies show that TRH and its analog taltirelin stimulate breathing via an effect at the preBötzinger complex, an important respiratory rhythm generator …