Critical Care Commons^™

The Prevalence Of Abdominal Compartment Syndrome In The State Of Florida, Jason M. Clark, Laura Mena-Albors, Huazhi Liu, Darwin Ang

HCA Healthcare Journal of Medicine

Introduction

Abdominal compartment syndrome (ACS) is associated with significant mortality. Multiple studies have evaluated the prevalence of ACS at individual institutions and/or for short durations. No study has looked at the change of prevalence over an extended time or included nonresearch institutions. This study aims to evaluate the trend in the prevalence of ACS over time within the state of Florida.

Methods

This is a population-based retrospective study using deidentified data from the Florida’s Agency of Healthcare Database between 2006 and 2021. A total of 16 217 617 patients were evaluated within the intensive care unit (ICU), with 4002 developing …

Regulation Of Myogenesis By Mechanomir-200c/Foxo3 Axis, Junaith S Mohamed, Aladin M Boriek

Faculty, Staff and Students Publications

Cyclic mechanical stretch has been shown to inhibit myoblast differentiation while promoting proliferation. However, the underlying molecular mechanisms are not well understood. Here, we report that mechanical stretch inhibits the differentiation of mouse primary myoblasts by promoting the cell cycle program and by inhibiting the expression of the myogenic regulator MyoD. Stretch alters the miRNA expression profile as evidenced by miRNA microarray analysis. We identified miR-200c as one of the highly downregulated mechanosensitive miRNAs (mechanomiRs) whose expression level was increased during differentiation. This suggests that mechanomiRs-200c is a myogenic miRNA. Overexpression of mechanomiR-200c revoked the effect of stretch on myoblast …

Modifying Electronic Medical Record Workflows To Improve Protein Provision To Enterally Fed Icu Patients, Catherine Karlak

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Issue 13: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 13

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics: Original Study Summaries from early 2025 with clinical implications:

pGGNs thresholds, Phosphodiesterase-5 Inhibitors with COPD, TTIP ventilation, TAPSE/sPAP Ratio, Propofol, Triglycerides, & Pancreatitis, PEERLESS trial, Metagenomic NGS for SCAP, Termination of Resuscitation (TOR) Guidelines, Intermittent Fasting …

Best Practices For A Competency-Based Curriculum In Critical Care Ultrasonography For Fellows, Paru Patrawalla, Frances West, Navitha Ramesh, Paul Mayo, Amik Sodhi

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

New guidelines from the Accreditation Council on Graduate Medical Education for critical care ultrasound (CCUS) training went into effect on July 1, 2024, for critical care medicine and combined pulmonary and critical care medicine fellows. Fellowship programs will need to ensure that their fellows demonstrate competence in skills that are essential to CCUS, which currently encompasses applications in basic cardiac, lung/pleural, abdominal, and vascular ultrasonography (US). This may be a challenge for fellowship programs that have nascent CCUS curricula and limited faculty expertise. In this Perspective, we share expert and evidence-based recommendations on how to implement a competency-based curriculum in …

Protein Biomarkers Of Interstitial Lung Abnormalities In Relatives Of Patients With Pulmonary Fibrosis, Jonathan A Rose, Mark P Steele, Esteban J Kosak Lopez, Gisli Thor Axelsson, Andrea G Galecio Chao, Alan Waich, Katie Regan, Swati Gulati, Anthony H Maeda, Sharmin Sultana, Claire Cutting, Ann-Marcia C Tukpah, Andrew J Synn, Mary B Rice, Hilary J Goldberg, Joyce S Lee, David A Lynch, Rachel K Putman, Hiroto Hatabu, Benjamin A Raby, David A Schwartz, Ivan O Rosas, Gary M Hunninghake

Faculty, Staff and Students Publications

Rationale: First-degree relatives of patients with pulmonary fibrosis (referred to here as relatives) are at high risk for interstitial lung abnormalities (ILA), highlighting the need for biomarkers for risk prediction. We aimed to identify blood proteins associated with and predictive of ILA among relatives of patients with pulmonary fibrosis.

Methods: Relatives enrolled in two independent cohorts had protein levels measured using an aptamer-based proteomic platform. ILA were assessed with computed tomography scans as per Fleischner Society recommendations. Protein associations with ILA were assessed using regression. Significant proteins were used with clinical variables to detect ILA.

Results: Of 237 relatives from …

Targeting S1pr2 In Sepsis, One Fragmented Mitochondrion At A Time, Chao He, Jennifer L Larson-Casey

Faculty, Staff and Students Publications

No abstract provided.

Airway Immune Signatures In Severe And Fatal Infection With Covid-19, Naresh Doni Jayavelu, Jing Jing Qi, Slim Fourati, Farrah Kheradmand, Charles R Langelier, Lauren I R Ehrlich, Joann Diray-Arce, Annmarie Hoch, Monica Kraft, Patrice M Becker, Matthew C Altman, Ruth R Montgomery

Faculty, Staff and Students Publications

No abstract provided.

Secreted Phosphoprotein 1 In Lung Diseases, Hongli Liu, Cristian Coarfa, Arzoo N Charania, Jennifer L Larson-Casey, Ivan O Rosas, Chao He

Faculty, Staff and Students Publications

Secreted phosphoprotein 1 (SPP1), also known as osteopontin (OPN) or early T lymphocyte activation protein 1 (ETA-1), is a multifunctional protein involved in numerous biological processes, including immune modulation, stress response, and tissue remodeling. The role of SPP1 in interstitial lung diseases (ILDs) has become an area of increasing interest, given its elevated expression in various ILDs such as idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD (CTD-ILD), and pneumoconiosis, especially with recent data derived from single-cell RNA sequencing. In addition to ILDs, SPP1 has been implicated in infectious granulomatous lung diseases, lung and pleural malignancies, airway diseases, and COVID-19. …

Midline Catheters And Vtes: Should We Be Using Them In Trauma Patients?, Roslyn M. Alexander Do, Alison A. Smith Md, Phd, Patrick Greiffenstein Md, Lillian Bellfi Pharm D

Quality Improvement & Patient Safety Forum

No abstract provided.

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: …

The Perk/Atf4 Pathway Is Required For Metabolic Reprogramming And Progressive Lung Fibrosis, Jyotsana Pandey, Jennifer L Larson-Casey, Mallikarjun H Patil, Chao He, Nisarat Pinthong, A Brent Carter

Faculty, Staff and Students Publications

Asbestosis is a prototypical type of fibrosis that is progressive and does not resolve. ER stress is increased in multiple cell types that contribute to fibrosis; however, the mechanism(s) by which ER stress in lung macrophages contributes to fibrosis is poorly understood. Here, we show that ER stress resulted in protein kinase RNA-like ER kinase (PERK; Eif2ak3) activation in humans with asbestosis. Similar results were seen in asbestos-injured mice. Mice harboring a conditional deletion of Eif2ak3 were protected from fibrosis. Lung macrophages from asbestosis individuals had evidence of metabolic reprogramming to fatty acid oxidation (FAO). Eif2ak3fl/fl mice had increased oxygen …

Exploring Anticoagulation Trends As Early Infection Markers In Pediatric Ecmo And Crrt Patients, Samantha Davidson, Jay Rilinger, Jenna Miller, Caroline Holton, Joshua Herigon, Brian Lee

Research Days

This retrospective cohort study at a tertiary pediatric hospital included ICU patients who developed infections after 72 hours on extracorporeal support from 2017-2023. We assessed whether the number of anticoagulation dose changes are linked to acquired infections.

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.

Standardizing Icu-To-Ward Transitions: Implementing Icu-Pause In The Process Of Medical Intensive Care Unit Downgrade, Edwin Perez, Md, Benjamin Tasevac, Md, Timothy J. Kuchera, Md, Erika J. Yoo, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• The ICU-to-ward transition is a high-risk process in which unstandardized communication can increase the risk for adverse events.
• Variability exists in documentation content, quality, and even authorship.
• Aims:
  • Institute the standardized ICU-PAUSE framework for ICU downgrades
  • Reassign documentation responsibility to the sending rather than receiving team
  • Evaluate the impact of these interventions on provider satisfaction & understanding of patient care

Ecmo Without Compressions Versus Ecpr For Lcos Following Cardiac Surgery, Amjad Halloum, Apurva Panchal, Sarah Tabbutt, Martina Steurer, Mousumi Banerjee, John Charpie, Javi Lasa, Amy Mccammond, Katie Moynihan, Nancy Ghanayem, Tia Raymond

Research Days

A retrospective study looking into ECMO vs eCPR outcomes in the CICU. By refining the approach to postoperative ECMO initiation, this study aims to contribute valuable insights that could improve survival and reduce complications in pediatric cardiac surgery patients.

Respiratory Failure In Pediatric Hematology And Oncology Patients On Extracorporeal Membrane Oxygenation: A Comparative Analysis, Michelle Brown Do, Jenna Miller, Asdis Finnsdottir Wagner, Erin Hall, Maya Dewan Md, Christopher Dandoy Md, Kalee Grassia Md, Bin Zhang Phd

Research Days

This project was a retrospective comparative analysis between two tertiary care pediatric institutions. The primary objective entailed examining survival outcomes in the oncologic and hematopoetic stem cell transplant patient populations with respiratory failure in the presence and absence of ECMO support.

Evaluation Of An External Urinary Device Protocol And Practices In Hospitalized Female Patients: A Quality Improvement Project At A Rural Midwestern Hospital, Melissa Leibnitz, Ashley Causa, Susana Lopez

Doctor of Nursing Practice Projects: College of Nursing

Aims and Objectives- 1: Describe and measure current implementation and management practices of the PureWick™. 2: Describe and measure current outcomes in the use of the PureWick™ device including mobility scores, skin breakdown, Braden scores, moisture-associated dermatitis, CAUTIs, PAUTIs, hospital LOS, HAIs and HPIs. 3: Measure the survey results from staff regarding the current PureWick™ practices. 4: Propose recommendations for an improved EB protocol for the PureWick^TM.

Background: Currently, the PureWick^TM device has been utilized by facilities as an alternative to indwelling urinary catheters in an effort to reduce the incidence of CAUTI. Since the introduction …

Let-7 Restrains An Epigenetic Circuit In At2 Cells To Prevent Fibrogenic Intermediates In Pulmonary Fibrosis, Matthew J Seasock, Md Shafiquzzaman, Maria E Ruiz-Echartea, Rupa S Kanchi, Brandon T Tran, Lukas M Simon, Matthew D Meyer, Phillip A Erice, Shivani L Lotlikar, Stephanie C Wenlock, Scott A Ochsner, Anton Enright, Alex F Carisey, Freddy Romero, Ivan O Rosas, Katherine Y King, Neil J Mckenna, Cristian Coarfa, Antony Rodriguez

Faculty, Staff and Students Publications

MicroRNA-mediated post-transcriptional regulation of lung alveolar type 2 (AT2) and AT1 cell differentiation remains understudied. Here, we demonstrate that the let-7 miRNA family plays a homeostatic role in AT2 quiescence by preventing the uncontrolled accumulation of AT2 transitional cells and promoting AT1 differentiation. Using mouse and organoid models, we show that genetic ablation of let-7a1/let-7f1/let-7d cluster (let-7afd) in AT2 cells prevents AT1 differentiation and leads to KRT8 transitional cell accumulation in progressive pulmonary fibrosis. Integration of AGO2-eCLIP with RNA-sequencing identified direct let-7 targets within an oncogene feed-forward regulatory network, including BACH1/EZH2/MYC, which drives an aberrant fibrotic cascade. Additional CUT&RUN-sequencing analyses …

Communication Matters! Exploring Experiences Of Non-English Language Preferred Families In The Neonatal And Pediatric Intensive Care Units, Sana Haq, Erin Cohen, Susan Schmidt, Rochanak Moassabeb, Folasade Kehinde

St. Chris Research Day

No abstract provided.

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.

Gut Dysbiosis Patterns In Cvid Patients With Noninfectious Complications Observed In A Germ-Free Mouse Model Through Fecal Microbiota Transplantation, Joud Hajjar, Anita Y Voigt, Margaret E Conner, Alton G Swennes, Stephanie Fowler, Chadi Calarge, Danielle D Mendonca, Dominique Armstrong, Chen-Yen Chang, Jolan E Walter, Manish J Butte, Tor Savidge, Julia Oh, Farrah Kheradmand, Joseph F Petrosino

Faculty, Staff and Students Publications

Patients with common variable immunodeficiency (CVID) who develop noninfectious complications (NIC) have worse clinical outcomes than those with infections only (INF). While gut microbiome aberrations have been linked to NIC, reductionist animal models that accurately recapitulate CVID are lacking. Our aim in this study was to uncover potential microbiome roles in the development of NIC in CVID. We performed whole-genome shotgun sequencing on fecal samples from CVID patients with NIC, INF, and their household controls. We also performed fecal microbiota transplants from CVID patients to germ-free mice. We found potentially pathogenic microbes

Factors Associated With Emergency Difficult Tracheal Intubation And Difficult Airway Management In A Non–Operating Room Setting At A Cancer Treatment Center, Jackson Su, Neil Bailard, Jens Tan, Jeffrey Lim, Catherine Vu, Wenli Dong, Gang Zheng

Advances in Cancer Education and Quality Improvement

Difficult tracheal intubations are reported more often in the emergency non−operating room setting than in the operating setting. To identify the factors associated with emergency difficult intubation (DI) and difficult airway (DA) management in hospitalized patients with cancer, we conducted a single-center retrospective study in hospitalized patients who underwent emergency intubations in a non−operating setting from 2016 to 2019 at a cancer treatment center. Cases of DI (inability to visualize the vocal cords and/or >2 intubation attempts) and DA (DI, advanced airway device use, and/or need for a surgical airway) were included. We reviewed 763 cases; the DI and DA …

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 …

A New Approach: Evaluating The Effectiveness Of Artificial Intelligence Developments For Trauma Triage In The Emergency Department, William C. Anoka

2025 Spring Honors Capstone Projects - Archive

Triage in emergent situations occurs when patients are assigned to areas of the hospital with different levels of care according to the perceived risks determined by their signs and symptoms. The variability of current triage protocols substantially increases the proportion of lower acuity patients who die unexpectedly due to improper risk stratification. However, recent artificial intelligence (AI) developments have been applied to trauma triage situations to improve accuracy and patient outcomes. To further evaluate the effectiveness of this new tool, this study used various AI models to assess the presenting assessments of multiple situations and determine the appropriate level of …

Do Hourly Neuro Exams Lead To Sleep Deprivation And Icu Delirium: A Research Review, Toni Gafford

Covenant Nurses Week 2025

No abstract provided.

Every Patient Every Time: Hapi Bundle Implementation On Micu And Nsicu, Kelsey Sawyer, Sara Tucker, Stephan Smith

Covenant Nurses Week 2025

No abstract provided.

The Potential Of The Eat, Sleep, Console Method In The Neonatal Intensive Care Unit: An Integrative Research Review (Irr), Kelsey Seigman

Covenant Nurses Week 2025

No abstract provided.

Strategic Innovation And Management By Nursing Leaders: Enhancing Icu Staffing For The Implementation Of A Rapid Response Team, Matthew Mitchell, Kelsey Sawyer, Sara Tucker, Stephan Smith, Stephanie Pigg, Jonathan Ortegon, Mitch Young

Covenant Nurses Week 2025

No abstract provided.