A5075198300- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Intensive Care Unit Cognitive Disorders
- Traumatic Brain Injury and Neurovascular Disturbances
- Nitric Oxide and Endothelin Effects
- Neuroscience of respiration and sleep
- Hemoglobin structure and function
- Anesthesia and Sedative Agents
- Intracranial Aneurysms: Treatment and Complications
- Sepsis Diagnosis and Treatment
- Thermal Regulation in Medicine
- Airway Management and Intubation Techniques
- Family and Patient Care in Intensive Care Units
- Cerebrospinal fluid and hydrocephalus
- Cardiac, Anesthesia and Surgical Outcomes
- Renal function and acid-base balance
- Hemodynamic Monitoring and Therapy
- Nosocomial Infections in ICU
- Spinal Fractures and Fixation Techniques
- Mechanical Circulatory Support Devices
- Anesthesia and Neurotoxicity Research
- Pulmonary Hypertension Research and Treatments
- Healthcare Decision-Making and Restraints
- Spine and Intervertebral Disc Pathology
- Heart Rate Variability and Autonomic Control
Swedish Medical Center
2023-2024
Swedish Medical Center
2015-2023
Pain and Rehabilitation Medicine
2015
University of Washington
2005-2014
Harborview Medical Center
2002-2013
Geneva College
2013
Seattle University
1998-2012
Washington University in St. Louis
2012
California University of Pennsylvania
2012
American Association of Neuropathologists
2005
Hospital cooling improves outcome after cardiac arrest, but prehospital immediately return of spontaneous circulation may result in better outcomes.To determine whether outcomes resuscitation from arrest patients with ventricular fibrillation (VF) and without VF.A randomized clinical trial that assigned adults to standard care or cooling, accomplished by infusing up 2 L 4°C normal saline as soon possible following circulation. Adults King County, Washington, resuscitated paramedics were...
Although delayed hospital cooling has been demonstrated to improve outcome after cardiac arrest, in-field started immediately the return of spontaneous circulation may be more beneficial. The aims present pilot study were assess feasibility, safety, and effectiveness cooling.We determined effect on esophageal temperature, before arrival, infusing up 2 L 4 degrees C normal saline as soon possible resuscitation from out-of-hospital arrest. A total 125 such patients randomized receive standard...
: To investigate if light sedation favorably affects subsequent patient mental health compared with deep sedation. Symptoms of posttraumatic stress disorder are common in patients after they have undergone prolonged mechanical ventilation and associated depth.: Randomized, open-label, controlled trial.: Single tertiary care center.: Adult requiring ventilation.: Patients were randomized to receive either (patient awake cooperative) or asleep, awakening upon physical stimulation).:...
Recent clinical studies have demonstrated that mild hypothermia (32 degrees C to 34 C) induced by surface cooling improves neurological outcome after resuscitation from out-of-hospital cardiac arrest. Results animal models suggest the effectiveness of could be improved if initiated as soon possible return spontaneous circulation. Infusion cold, intravenous fluid has been proposed a safe, effective, and inexpensive technique induce arrest.In 17 hospitalized survivors arrest, we determined...
Pulmonary complications account for significant morbidity and mortality following aneurysmal subarachnoid hemorrhage; however, the effect of acute lung injury is largely unknown. The goal this study was to determine incidence in a large cohort patients with hemorrhage as well risk factors its on length stay. Ventilator management analyzed proportion who received low-tidal volume ventilation strategy.Retrospective study.University-affiliated county hospital Seattle, WA.Six-hundred twenty...
Intensive insulin therapy (IIT) with tight glycemic control may reduce mortality and morbidity in critically ill patients has been widely adopted practice throughout the world. However, there is only one randomized controlled trial showing unequivocal benefit to this approach that study population was dominated by post-cardiac surgery patients. We aimed determine association between IIT a mixed of patients.We conducted cohort comparing three consecutive time periods before after protocol...
Rationale: Introduction of sedation protocols has been associated with improved patient outcomes. It is not known if an update to existing high-quality protocol, featuring increased assessment and reduced benzodiazepine exposure, process outcome quality metrics.Methods: This was observational before (n = 703) after 780) cohort study mechanically ventilated patients in a 24-bed trauma-surgical intensive care unit (ICU) from 2009 2011. The three main protocol updates were: (1) requirement...
The authors sought to describe changes in clinical management associated with brain tissue oxygen (PbO(2)) monitoring and how these affected outcomes resource utilization.The cohort study comprised 629 patients admitted a Level I trauma center diagnosis of severe traumatic injury over period 3 years. Hospital mortality rate, neurological outcome, utilization 123 who underwent both PbO(2) intracranial pressure (ICP) were compared the same measures 506 ICP only. main hospital functional...
Objective: To evaluate whether implementation of a therapeutic hypothermia protocol on arrival in community hospital improved survival and neurologic outcomes patients initially found to have ventricular fibrillation, pulseless electrical activity, or asystole, then successfully resuscitated from out-of-hospital cardiac arrest. Design: A retrospective study who presented after compared with those before the was implemented. Setting: Harborview Medical Center, Seattle, WA. Patients: total 491...
Timing and preparation for tracheal extubation are as critical the initial intubation. There limited data on specific strategies a planned extubation. The extent to which difficult airway at reintubation contributes patient morbidity is unknown. aim of present study was describe occurrence complications failed associated risk factors, estimate mortality with attempts.Cohort 2,007 critically ill adult patients admitted ICU an ETT. Patients were classified in 2 groups, based requirement...
<h3>BACKGROUND:</h3> Assessment of a patient9s readiness for removal the endotracheal tube in ICU is based on respiratory, airway, and neurological measures. However, nearly 20% patients require reintubation. We created prediction model need reintubation, which incorporates variables importantly contributing to extubation failure. <h3>METHODS:</h3> This was cohort study 2,007 endotracheally intubated subjects who required admission at tertiary care center. Data collection included...
Red blood cells (RBCs) are known to augment hypoxic pulmonary vasoconstriction (HPV ). To determine whether this phenomenon is hematocrit (Hct) dependent and related alterations of either nitric oxide (NO) or adenosine metabolism, we studied mechanically ventilated, pump-perfused lungs from euthanized New Zealand White rabbits. Lungs were perfused in situ a recirculating manner at constant flow; perfusates consisted Krebs–Henseleit buffer plus washed RBCs Hct 10% 30%. HPV was quantitated as...
Background Randomized trials of prehospital cooling after cardiac arrest have shown that neither nor targeted temperature management differentially affected short‐term survival or neurological function. In this follow‐up study, we assess the association hypothermia with function at least 3 months and 1 year arrest. Methods Results There were 508 individuals who discharged alive from hospitals in King County, Washington; 373 (73%) interviewed by telephone 123±43 days initial event. Overall,...
In critically ill patients, induction with etomidate is hypothesized to be associated an increased risk of mortality. Previous randomized studies suggest a modest trend toward death among recipients; however, this relationship has not been measured great statistical precision. We aimed test whether hospital mortality and other clinical outcomes in patients.We conducted retrospective cohort study from January 1, 2001, December 31, 2005, 824 subjects requiring mechanical ventilation, who...