Critical Care Commons^™

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.

Platypnea-Orthodeoxia Syndrome In A Case Of Septal Occlusion Device Migration, Bike Ozkan, Richard Shalmiyev, Adam Devine, Michael Pelekhach, Siddarth Kathuria, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction

Platypnea-orthodeoxia syndrome (POS) is defined by dyspnea and hypoxemia in the upright position, which improves upon recumbency. While often linked with hepatopulmonary syndrome, intracardiac etiologies, particularly a patent foramen ovale (PFO), may also be responsible. PFOs are typically managed with device closure, and while rare, device migration can occur unbeknownst to the patient with resultant critical sequelae.

Methods

Here, we present the case of an 89-year-old female with a medical history of hypertension, diabetes, and coronary artery disease status post PCI, who arrived with severe dyspnea and was subsequently intubated for profound hypoxia. A chest CT angiogram ruled out …

Oil And Air Don’T Mix: Vitamin E Acetate In Evali, Angelo Lopez-Lacayo, Jordan Taylor-Bentley, Josef Masseli, Michelle Silva, Christy Diaz, Daniel Zapata

East Florida Division GME Research Day 2025

Introduction: Electronic cigarette or vaping-associated lung injury (EVALI) is an acute or subacute condition characterized by acute respiratory symptoms and bilateral pulmonary infiltrates seen in patients who are exposed to electronic cigarettes or vapes. The condition has been strongly linked to inhalation of aerosolized vitamin E acetate, particularly in THC-containing e-cigarette products. Despite regulation of vitamin E acetate in the production of electronic vapes, it continues to be a byproduct of EVALI due to counterfeit electronic vapes. Clinically, patients with EVALI present in various ways but are not limited to fever, shortness of breath, cough, chills, body aches, pleuritic chest …

Seizure Action Plan, Ian Holt, Sy Jama

East Florida Division GME Research Day 2025

No abstract provided.

A Case Of Recurrent Pleural Effusion Secondary To Thoracic Endometriosis Syndrome After Discontinuation Of Oral Contraceptives, Kevin Gopala-Rao, Luis Santiesteban, Carmen Tormo Carrillo, Christian Almanzar Zorilla, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: Thoracic endometriosis syndrome (TES) is a rare condition in which functional endometrial tissue spreads to the thoracic cavity. Manifestations of TES include catamenial hemoptysis, pneumothorax, and pleural effusions along with symptoms of dyspnea, cough, and pleuritic chest pain.1 Approximately 6 to 10% of women of reproductive-age women develop TES with concurrent pelvic endometriosis in 80% of patients.2 Treatment of TES includes medical management with progesterone-based oral contraceptive pills (OCPs) and surgical management involving cardiothoracic surgery. We present a case of recurrent pleural effusions in a patient who was non-compliant with medical management of TES. Methods: Data was collected during …

Cardiac Tamponade By Perforated Ventricle Post Tavr - A Rare But Life Threatening Case, Arjun Kamath, Jorge Garza, Ethan Goldberg, Deekshita Valiveti, Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2025

No abstract provided.

Severe Right Ventricular Dilation Due To Selenium Deficiency In A Post Gastric Bypass Patient - A Rare But Life Threatening Complication, Arjun Kamath, Jorge Garza, Ethan Goldberg, A Syed, Deekshita Valiveti, Abhay Vakil, Zuhair Ali, A Ashgar, Luay Alalawi, Heriberto Cantu, Thomas Alexander

Gulf Coast Division GME Research Day 2025

No abstract provided.

Fatal Overlapping Cns Infections: Radiologic Correlates Of Ventriculitis, Encephalitis, And Meningitis​, Jesse F. Simon, Sara Darwish, Stephanie Nagy, Richard Shalmiyev, David Kosoy, Bryan Rubio, Gustavo Pantol, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: This case study explores an uncommon triad of encephalitis, ventriculitis, and meningitis complicated by ischemic strokes and seizures in a COVID-19-positive patient. Prior studies suggest that bacterial meningitis and encephalitis can lead to cerebral infarctions due to inflammation and vascular injury.1,2,5 Ventriculitis, in particular, is rarely observed and typically is seen as a severe complication of meningitis, and can be managed with neurosurgical interventions such as CSF shunt placement, ventricular drains, or other intracranial devices.3,4 The simultaneous presentation of all three conditions in a single patient is rare and poses significant challenges from a diagnostic and management standpoint.

Case …

The Role Of Bandemia In Clinical Outcomes Of Critically Ill Septic Patients., Yerandi Gil, Grettel Gonzalez Garcia, Ambar Sekulis, Rafael Miret, Siddarth Kathuria, Mauricio Danckers, Daniel Heller

East Florida Division GME Research Day 2025

Rationale: Bandemia, defined as the presence of immature neutrophils in circulation, is commonly used as an early marker of systemic inflammation and infection. 1 However, its prognostic significance in sepsis, severe sepsis, and septic shock remains uncertain. 1-2 This study aimed to determine whether bandemia is associated with adverse clinical outcomes and increased intensive care unit (ICU) resource utilization among critically ill septic patients admitted from the emergency department (ED).

Methods: A retrospective analysis was conducted using de-identified data from the HCA Healthcare database. Adult patients (aged 18–90 years) admitted to the ICU at HCA Florida Aventura Hospital from the …

Hemophagocytic Lymphohistiocytosis In A Critically Ill Patient: A Case Report Of A Potentially Fatal Entity, Ali Khreisat, Inna Mikaella Sta Maria, Giovi Grasso-Knight, Meghan Mansour

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is a non-neoplastic proliferation and macrophage activation that induces cytokine-mediated bone marrow suppression and features of intense phagocytosis in the bone marrow and liver, leading to multi-organ dysfunction and ultimate failure. The diagnosis of HLH in an intensive care setting is challenging, and it is associated with high morbidity and mortality. HLH-94 is the standard protocol for treatment, consisting of dexamethasone and chemotherapy like etoposide.

Case Presentation

We present the case of a 73-year-old woman who had a prolonged hospitalization for vomiting, diarrhea, and dehydration. Her conditions were complicated by acute refractory pancytopenia on the 12th …

Inpatient Falls: Epidemiology, Risk Assessment, And Prevention Measures. A Narrative Review, Taylor Locklear, Jeannie Kontos, Callaham A. Brock, Alexander B. Holland, Rachel Hemsath, Anna Deal, Shannon Leonard, Carsten Steinmetz, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Patient falls are a common inpatient dilemma and comprise the largest category of preventable adverse events in hospitalized patients. These events place a clinical burden on the patient, such as increased morbidity and reduced quality of life, in addition to an economic burden on the hospital system. Fall prevention strategies have the opportunity to decrease inpatient health care costs and length of stay. Several risk factors have been identified that contribute to inpatient falls and several strategies have been identified to minimize this risk. These risk factors are typically characterized as intrinsic and extrinsic factors. Intrinsic factors include characteristics such …

A Clinical Review On Spinal Epidural Abscess: Epidemiology, Pathophysiology, Diagnosis, And Management For Emergency Medicine And Hospitalist Physicians, Madeline A. Guy, Jeffrey S. Guy

HCA Healthcare Journal of Medicine

Spinal epidural abscess (SEA), a critical surgical emergency, demands prompt recognition and intervention to prevent severe complications and fatalities. The incidence of SEA is notably increasing, particularly among individuals with diabetes, intravenous drug use, or a history of invasive spinal procedures. Although SEA can manifest through various clinical symptoms, the presence of its classic triad—back pain, fever, and neurological deficits—is noteworthy despite its occurrence in only 10% to 13% of cases. Identifying this triad is vital due to its high specificity for SEA, which is essential to guiding swift diagnostic and therapeutic actions in a condition where early intervention is …

Eye Care For Corneal Transplant Donors In The Icu: What We Didn’T See Coming, Ashton Lackey, Joey Royea, Alexandra Hartman, Aaron Worthley, Abbi Mason, Bryan Howington, Bharat Meenavalli, George Helmrich, Stephen M. Meyer

South Atlantic Division GME Research Day 2024

No abstract provided.

Recurrent Pleural Effusion, An Extraarticular Manifestation Of Seronegative Rheumatoid Arthritis, Ronald Spinelle, Jeffin Cherian, Luke Rogers, Domenick Sorresso

West Florida Division GME Research Day 2024

No abstract provided.

A Nicu Quality Initiative To Decrease Unsatisfactory Newborn Screen Samples, Karina Patel, Emily Ward, Eric Shaw, Palmer Johnston

South Atlantic Division GME Research Day 2024

No abstract provided.

Prophylactic Antibiotics For Aspiration: Does It Prevent Pneumonia?, Akash Patel, James Dunne, Himani Patel

South Atlantic Division GME Research Day 2024

No abstract provided.

Acute Mesenteric Ischemia Secondary To Lupus Vasculitis, Karen Valdez-Cuen, Ammar Mahmood, Mohammad Ridha, Fahad Omar

Central & West Texas GME Research Day 2024

No abstract provided.

Differences In Clinical Interventions And Outcomes In Septic Patients With Heart Failure A Prospective Single Center Experience From The Sepsisquad Investigators, Jose Rodriguez Castro, Manjot Malhi, Rafael Miret, Kristen Santana, Anna Feliszek, Kevin Gopala Rao, Lyanne Rolon, Garrett Wagner, Siddarth Kathuria, Raiko Diaz, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2024

No abstract provided.

An Interesting Case Of Hypothyroidism In The Critical Care Setting, Lance Mwangi, Ladi Larry

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Lazarus Syndrome After Aortic Aneurysm Repair, Kevyn Niu, Jamie Lee Aldakkour, Charles Huyghues-Despointes, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Lazarus syndrome is defined as the spontaneous return of circulation after cessation of cardiopulmonary resuscitation (CPR). Though there have been multiple cases of Lazarus syndrome documented in the literature, it is a significantly underreported phenomenon with less than 100 cases reported in the literature since the first case in 1982.

Case Presentation

After elective aortic aneurysm repair, an 88-year-old with a do-not-resuscitate directive had cardiac arrest, briefly showing post-mortem respiration and pulse. Despite resuscitation efforts including pharmacological intervention and CPR, he passed away within an hour. This case highlights complexities in end-of-life care and warrants exploration of post-mortem physiological …

Death Due To Drug Reaction With Eosinophilia And Systemic Symptoms (Dress) Syndrome: A Case Report, Samantha P. Sternad, Jane Pangburn, Chad Johnston, David Rowe

HCA Healthcare Journal of Medicine

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening, multi-organ adverse drug reaction with an incidence of 1 in 1000 to 1 in 10 000 highrisk drug exposures.

Case Presentation

An elderly female presented to the hospital with progressive weakness and a diffuse erythematous macular rash covering most of her body that started 3 days prior. Over the next 3 days, the patient quickly deteriorated, developing disorientation with acute onset left-sided weakness, leukocytosis, thrombocytopenia, eosinophilia, liver and kidney failure, and hypoxia. Clinical and histological changes supported the diagnosis of DRESS syndrome caused by intravenous (IV) ampicillin …

Complications Of Cardiopulmonary Bypass From An Anesthesia Perspective: A Clinical Review, Alex Roberts, Elizabeth C. Duncan, Paul Hargrave, David Redding Kingery, Josh Barnes, Derek L. Horstemeyer, Russell F. Stahl

HCA Healthcare Journal of Medicine

Cardiopulmonary bypass (CPB) is frequently used for open heart surgery and other procedures that utilize temporary substitution or support of heart and lung function. While it is widely accepted as the predominant method to carry out these procedures, it is not without possible complications. CPB can be seen as the ultimate “team sport” as it includes and is dependent on contributions from multiple professionals including anesthesiologists, cardiothoracic surgeons, and perfusion technicians. In this clinical review paper, we examine possible complications of CPB, primarily from the perspective of the anesthesiologist, and how to troubleshoot them if they arise, which often requires …

Lungs Of A Chronic Smoker: The Case Of Heroin Induced Emphysema In A 35-Year-Old Male, Neil Gerts, George Ishak, Ian Joel, Jasprit Takher

Far West Division GME Research Day 2023

No abstract provided.

Atraumatic Splenic Rupture: An Unaccustomed Complication Of H. Parainfluenzae Endocarditis, Daniel P. High, Jose M. Acosta-Rullan, Danay Herrera, Mauricio Danckers

East Florida Division GME Research Day 2023

No abstract available.

Where’S Adam? Successful Treatment Of Covid-19 Vaccine-Related Refractory Thrombotic Thrombocytopenic Purpura, Christopher Fontela, Alfredo Toll, Jose Fernandez, Gabriel Barciela-Perez, Jorge Diaz, Greisy Curbelo-Sesin, Ilde Manuel Lee, Jose Gascon

East Florida Division GME Research Day 2023

A 54-year-old man with a medical history notable for hypertension and type 2 diabetes mellitus presented with altered mental status. Initial assessment revealed altered consciousness, aphasia, and diffuse generalized petechiae. Having recently migrated from Colombia, he had received four doses of the Pfizer COVID-19 vaccine, with the last dose administered one month prior to presentation. Laboratory results indicated severe thrombocytopenia (platelet count: 3), microangiopathic hemolytic anemia, acute myocardial, liver, and kidney injury, prompting a presumptive diagnosis of thrombotic thrombocytopenic purpura (TTP). Confirmation was achieved through an ADAMTS13 level of less than 2 percent. Despite initiating high-dose solumedrol and emergent plasmapheresis, …