Critical Care Commons^™

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.

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 …

Prepared To Protect: Improving Cardiac Emergency Response Through Education And Action Planning In Youth Club Sports, Melissa Garcia

Nursing | Senior Theses

Sudden cardiac arrest (SCA) is the leading cause of death in youth sports, illuminating the essential demand for adequate emergency response, including cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) usage, and comprehensive emergency action plans (EAPs). Research shows that despite the importance of prompt intervention, the majority of youth club sports programs outside of the school setting lack the training and resources needed to respond effectively to SCA incidents. This study will evaluate the effectiveness of an educational seminar that includes CPR/AED training and EAP simulation exercises in improving participants’ knowledge, skills, and confidence in managing cardiac emergencies. A quasi-experimental …

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 …

Editing Approaches To Treat Alpha-1 Antitrypsin Deficiency, Derek M. Erion, Leah Y. Liu, Christopher R. Brown, Stephen I. Rennard, Humam Farah

Journal Articles: Pulmonary & Critical Care Med

TOPIC IMPORTANCE: Alpha-1 antitrypsin (AAT) deficiency is a genetic disorder most commonly due to a single G to A point mutation (E342K), leading to debilitating lung and/or liver disorders and is associated with increased mortality. The E342K point mutation causes a conformational change of the AAT protein resulting in its retention in liver hepatocytes. This reduces AAT secretion into the serum resulting in higher protease activities due to the lack of inhibition from AAT, causing damage to healthy lung tissue. The current standard of care for lung manifestations involves weekly IV augmentation therapy and is considered suboptimal for these patients. …

Comparing Human Milk-Derived Vs Bovine-Derived Fortifiers In Formula-Fed Preterm Infants On The Incidence Of Necrotizing Enterocolitis, Maya C. Kern

Nursing | Student Research Posters

Necrotizing enterocolitis (NEC) is one of the leading causes of death in infants < 32 weeks gestation and/or < 1500g. Human breast milk lowers NEC rates through immunologic, microbial, and gut-protective mechanisms. When maternal or donor milk is unavailable, infants require formula with fortification but the safest type of fortifiers remains unclear. Bovine-derived fortifiers may increase gut inflammation; human milk-derived fortifiers may offer more protection. Limited research exists comparing these fortifiers when infants are exclusively formula fed. Determining if human milk-derived fortifiers still reduce NEC risk could influence NICU feeding guidelines and improve outcomes.

Leveraging Clinical Standards To Improve The Translational Relevance Of Therapies For Experimental Spinal Cord Injury, Aaron L. Silverstein

Theses and Dissertations--Neuroscience

Efforts to improve treatment of spinal cord injury (SCI) often use animals to develop effective therapeutics, intending to improve the survival and the quality of life of persons with SCI. Over half of all SCIs in the United States occur at the cervical level and often cause locomotor deficits and life-threatening breathing dysfunction. Thus, my dissertation is focused on this important patient population.

After beginning with a description of translational research and surveying SCI from a clinical standpoint, I turned to describe experimental models of cervical SCI and more detailed neuroimmunological findings relevant to my work. Then, I conducted a …

A New Risk Assessment Scale For Pressure Injuries In The Icu: The M.D.R. Scale, Ann Murdock, Andrea Daily, Deb Reilly, Shih-Ting Chiu

Articles, Abstracts, and Reports

No abstract provided.

Improving Timely Palliative Care Consultation In The Micu: A Nurse-Driven Quality Improvement Initiative, Sandy Louise Gray

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Improving Timely Palliative Care Consultation in the MICU: A Nurse-Driven Quality Improvement Initiative

Sandy L Gray

Background: Early palliative care in intensive care units improves outcomes and reduces costs, yet referrals are often delayed. At J.W. Ruby Memorial Hospital’s medical intensive care unit (MICU), baseline median time to consultation was 112 hours (mean=246), exceeding recommended benchmarks and highlighting the need for a standardized process.

Purpose: This quality improvement project evaluated a nurse-driven screening tool to improve timeliness and consistency of palliative care consultations in the MICU.

Intervention: The tool was embedded in the electronic health record (EHR) …

A Nurse-Driven Protocol To Increase Music Therapy Referrals To Manage Patient Pain And Anxiety In The Medicine Intensive Care Unit, Ashley Fox

DNP Projects

Background: Critically ill patients often suffer from pain and anxiety. Music therapy is a safe and effective treatment option. However, most nurses never receive education or training on it, resulting in a lack of awareness of its value and its actual usage in care.

Purpose: The purpose of this project was to increase the number of music therapy referrals to manage pain and anxiety in eligible medicine intensive care unit (MICU) patients via a music therapy protocol that increased nurses’ knowledge, attitudes, and skills related to the use of music as an alternative treatment option for pain and anxiety in …

Does Mean Arterial Pressure Augmentation Improve Neurological Recovery Of Blunt Spinal Cord Injuries: An East Multicenter Trial., Aimee Lariccia, Stephanie Doris, Bhairav Shah, Tanisha Kashikar, Erik Teicher, Lindsey Perea, Jennifer Huber, Malia Eischen, H Akin Erol, Michael Steven Farrell, Lauren Colom, Stephanie Scott, Brian Daley, James Bardes, Gregory Schaefer, Melissa Moncrief, William Devoe, Ryan Peter Dumas, Caitlin Anne Fitzgerald, William Brigode, John D Berne, Dalier R Mederos, Scott Armen, Melissa Linskey Dougherty, Asanthi Ratnasekera, Emily Alberto, Alison Smith, Bradley M Dennis, Stephen Gadomski, Jeffry Nahmias, Claudia Alvarez, Salina Wydo, Jennifer Schweinsburg, Carlos H Palacio, M Chance Spalding, Joshua Hill

Trauma and Acute Care Articles

BACKGROUND: Treatment of blunt traumatic spinal cord injuries (SCIs) often includes maintaining elevated mean arterial blood pressures (MAP) to enhance perfusion to the spinal cord. Optimal hyperperfusion protocols and treatment algorithms have yet to be delineated due to a paucity of large volume prospective studies. This study aims to identify predictors of neurological improvement in American Spinal Injury Association (ASIA) impairment score following blunt SCI.

STUDY DESIGN: Prospective (January 10, 2021 to June 1, 2023) multicenter study included blunt SCI patients age >18 with complete neurological examination documented on hospital arrival. Patients were divided into two groups: neurological improvement and …

Is Fixation Of A Single End Of Flail Segment Rib Fractures Enough?, Anthony Perugini, James Iandoli, Nicholas Pelz, Daniel Degenova, Anthony Melaragno, Mallory Faherty, Benjamin C Taylor

OhioHealth Research Institute Articles

BACKGROUND: Segmental rib fractures in blunt thoracic trauma present with increased morbidity and mortality with an association of increased pulmonary insult and concomitant injuries. There is a paucity within the literature regarding the necessity of fixation of one or both segments of rib fractures in a flail chest. This study aimed to analyze surgical rib fixation and assess outcomes for non-fixed fractured rib ends in segmental rib fractures.

METHODS: This is a retrospective review of 125 patients who underwent open reduction internal fixation of flail segmental rib fractures at our urban Level 1 trauma center. Initial plain films and CT …