A5088832268- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Neonatal Respiratory Health Research
- Blood Coagulation and Thrombosis Mechanisms
- Airway Management and Intubation Techniques
- Venous Thromboembolism Diagnosis and Management
- Antiplatelet Therapy and Cardiovascular Diseases
- Simulation-Based Education in Healthcare
- Vascular Procedures and Complications
- Speech and Audio Processing
- Heart Failure Treatment and Management
- Electrospun Nanofibers in Biomedical Applications
- Congenital Diaphragmatic Hernia Studies
- Platelet Disorders and Treatments
- Medical Imaging and Pathology Studies
- Heparin-Induced Thrombocytopenia and Thrombosis
- Peripheral Artery Disease Management
- Prostate Cancer Treatment and Research
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Blood transfusion and management
- Central Venous Catheters and Hemodialysis
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Transplantation: Methods and Outcomes
- Lipoproteins and Cardiovascular Health
The University of Texas Health Science Center at San Antonio
2016-2025
The University of Texas Health Science Center at Houston
2014-2025
United States Army Institute of Surgical Research
2016-2025
Cone Health
2024
University of Michigan
2023
Michigan United
2023
Massachusetts General Hospital
2020
Harvard University
2020
University Health System
2020
Assured Information Security (United States)
2019
Tracheal intubation-associated events (TIAEs) are common (20%) and life threatening (4%) in pediatric intensive care units. Physician trainees required to learn tracheal intubation during unit rotations. The authors hypothesized that "just-in-time" simulation-based refresher training would improve resident participation, success, decrease TIAEs.For 14 months, one of two on-call residents, nurses, respiratory therapists received 20-min multidisciplinary 10-min skill at the beginning their...
Pediatric consensus-driven cardiopulmonary resuscitation guidelines target chest compression (CC) depths of one third to half anterior-posterior (AP) depth. Estimates for this as assessed by computed tomography (CT) measurements internal and external AP dimensions could direct future pediatric guidelines.A total 280 consecutive CT scans in permuted blocks 20 each 14 age divisions between 0 8 years were reconstructed analyzed. External measured at midsternum, residual depth was calculated...
Tracheal intubation in the pediatric intensive care unit is often performed emergency situations with high risks. Simulation has been recognized as an effective methodology to train both technical and teamwork skills. Our objectives were develop a feasible tool evaluate team performance during tracheal apply clinical setting determine whether multidisciplinary teams higher number of simulation-trained providers exhibit more proficient performance.Prospective, observational pilot study.Single...
BACKGROUND Up to 40% of combat casualties with a truncal injury die massive hemorrhage before reaching surgeon. This can be prevented damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing components in 1:1:1:1 ratio platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement hemostatic function rotational thromboelastometry (ROTEM) may allow optimization the type and quantity products transfused....
A state-of-the-art centrifugal pump combined with hollow-fiber oxygenator for extracorporeal membrane oxygenation has potential advantages such as smaller priming volumes and decreased to cause tubing rupture compared the traditional roller head/silicone systems. Adoption of these systems been slow in neonates a result past evidence severe hemolysis that may lead renal failure increased mortality. Extracorporeal have also linked platelet dysfunction, contributing factor toward intracranial...
Extracorporeal membrane oxygenation (ECMO) has frequent and sometimes lethal thrombotic complications. The role that activated platelets, leukocytes, small (0.3-micron to 1-micron) extracellular vesicles (EVs) play in ECMO thrombosis is not well understood.To test the effect of blood flow rate on generation EVs a simulated neonatal circuit using heparinized human whole blood.Simulated roller pump circuits circulated at low, nominal, high rates (0.3, 0.5, 0.7 L/min) for 6 h. Coagulopathy was...
Over 10% of children develop thrombosis after cardiac surgery for congenital heart disease. Children with a single ventricle physiology have the highest risk associated increased length postoperative stay, neurologic complications, and mortality. To decrease these research is needed to understand mechanisms that promote cardiopulmonary bypass (CPB) surgery-induced thrombin generation clot formation. The objective this pilot observational study was measure prothrombotic microvesicles (MVs) in...
Over 32% of burned battlefield causalities develop trauma-induced hypoxic respiratory failure, also known as acute distress syndrome (ARDS). Recently, 9 out 10 US combat soldiers' survived life-threatening ARDS supported with extracorporeal membrane oxygenation (ECMO), a portable form cardiopulmonary bypass. Unfortunately, the size, incidence coagulation complications, and need for systematic anticoagulation traditional ECMO devices have prevented widespread use this lifesaving technology....
Current anticoagulation strategies do not eliminate thromboembolic stroke or limb loss during neonatal extracorporeal membrane oxygenation (ECMO), a form of cardiopulmonary bypass (CPB). In adults, CPB surgery generates prothrombotic platelet-derived microparticles (PMPs), submicron vesicles released from activated platelets. However, information on PMP generation in ECMO systems is lacking. The objective this study was to compare five different systems, using simulated circuit with swine...
To evaluate the safety, effectiveness, and dosing of off-label bivalirudin to argatroban lepirudin in patients with heparin-induced thrombocytopenia (HIT) using a new pharmacist driven protocol.Retrospective cohort study forty eight treated lepirudin, argatroban, or from November 2010 February 2012 for suspected HIT. Patients were excluded if therapy was being used acute coronary syndrome treatment duration less than 24 hours. The primary endpoint time therapeutic activated partial...
Purpose: The purpose of this study was to evaluate the persistence electrostatically seeded endothelial cells (ECs) lining an expanded polytetrafluorethylene (e-PTFE) graft after one week exposure in vivo circulation a canine femoral artery bypass model. This accomplished by visualizing PKH 26 (red fluorescent) label placed EC membranes prior seeding procedure. Furthermore, performed confirm that thesourceof ECs thegraft werethosefrom theinitial inoculum. Methods: evaluation consisted...
We evaluated the extent (luminal coverage) of endothelial cell (EC) lining/neointimal development and thromboresistance electrostatically EC seeded small diameter Chrono Flex-polyurethane vascular grafts. The evaluation consisted harvesting autologous, canine jugular vein ECs, seeding polyurethane grafts (4-mm I.D., length = 6 cm) with harvested implanting in a femoral artery model for four to six weeks, excising histological scanning electron microscopy evaluations. Results (mid-graft...
(1) Purpose: The purpose of this study was to evaluate the extent (luminal coverage) endothelial cell (EC) lining/neointimal development and thromboresistance electrostatically EC seeded small diameter e-PTFE vascular grafts. (2) Methods: This evaluation consisted harvesting autologous, canine jugular vein ECs, seeding grafts (4 mm GORE-TEX,® Length = 6 cm), implanting in a femoral artery model for six weeks, excising graft histological scanning electron microscopy evaluations. (3) Results:...
Five personal observations of an acute amnestic episode in younger individuals after intake clioquinol are described together with three from the medical literature. In five these cases began unusually large dose, a therapeutic one latency about 24 hours. The clinical aspect closely resembled classical transient global amnesia but lasted longer (24 hours to days) and more or less extensive retrograde persisted permanently. patient tablets Mexase concentration 12 microgram/ml plasma was found...
To develop a scoring system that can assess the multidisciplinary management of respiratory failure in pediatric ICU.In single tertiary ICU we conducted simulation-based evaluation patient care area auxiliary to ICU. The subjects were and emergency medicine residents, nurses, therapists who work A focus group with experienced providers airway safety specialists was formed. task-based instrument developed evaluate primary provider's performance through Healthcare Failure Mode Effect Analysis....
Extracorporeal life support (ECLS) is fast becoming more common place for use in adult patients failing mechanical ventilation. Management of coagulation and thrombosis has long been a major complication the ECLS therapies. Scanning electron microscopy (SEM) membrane oxygenators (MOs) after circuits can offer novel insight into any thrombotic material deposition on MO. In this pilot study, we analyzed five explanted MOs immediately sheep model different acute respiratory distress syndrome...
American College of Cardiology/American Heart Association guidelines recommend high-intensity statin therapy and consideration for nonstatin patients with peripheral vascular disease (PVD); however, utilization rates remain suboptimal. The primary objective this study was to determine whether pharmacist intervention PVD could improve the percentage discharged on a statin.