A5072229293- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Mechanical Circulatory Support Devices
- Heart Rate Variability and Autonomic Control
- Trauma and Emergency Care Studies
- Non-Invasive Vital Sign Monitoring
- Burn Injury Management and Outcomes
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Sepsis Diagnosis and Treatment
- Mesenchymal stem cell research
- Hemodynamic Monitoring and Therapy
- Disaster Response and Management
- Traumatic Brain Injury and Neurovascular Disturbances
- ECG Monitoring and Analysis
- Neonatal Respiratory Health Research
- Trauma Management and Diagnosis
- Optical Coherence Tomography Applications
- Thermal Regulation in Medicine
- Injury Epidemiology and Prevention
- Hemoglobin structure and function
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Optical Imaging and Spectroscopy Techniques
- Wound Healing and Treatments
- Cardiac Structural Anomalies and Repair
- Hemostasis and retained surgical items
The Geneva Foundation
2015-2024
Imation (United States)
2021-2024
United States Army Institute of Surgical Research
2014-2023
University of the Incarnate Word
2017-2023
Uniformed Services University of the Health Sciences
2014-2023
Brooke Army Medical Center
2008-2021
University of South Florida
2019-2021
United States Army
2008-2019
Eisenhower Medical Center
2019
United States Department of the Army
2006-2019
Mechanical ventilation is injurious to the lung. Use of lung-protective strategies may complicate patient management, motivating a search for better lung-replacement approaches. We investigated ability novel extracorporeal venovenous CO2 removal device reduce minute while maintaining normocarbia.Prospective animal study.Government laboratory intensive care unit.Seven sedated swine.Tracheostomy, volume-controlled mechanical ventilation, and 72 hrs round-the-clock unit care. A 15-F dual-lumen...
Acute respiratory distress syndrome (ARDS) prevalence and related outcomes in burned military casualties from Iraq Afghanistan have not been described previously. The objective of this article was to report ARDS its associated in-hospital mortality burn patients.Demographic physiologic data were collected retrospectively on mechanically ventilated admitted our intensive care unit January 2003 December 2011. Patients with identified accordance the new Berlin definition ARDS. Subjects...
Traditional vital signs often fail to identify critically injured patients soon enough permit timely intervention. To improve our ability forecast the need for prehospital lifesaving interventions (LSIs), we applied heart-rate complexity (HRC) analysis electrocardiogram (ECG) of en route trauma centers.Analysis ECG and clinical data from 374 by helicopter three urban Level I centers was conducted. Waveforms 182 were excluded (because ectopy, noise, or inadequate length). Of remaining 192...
Venovenous extracorporeal gas exchange is increasingly used in awake, spontaneously breathing patients as a bridge to lung transplantation. Limited data are available on similar use of with acute respiratory distress syndrome. The aim this study was investigate the sheep healthy lungs and syndrome describe interactions between native (healthy diseased) artificial (extracorporeal exchange) setting.Laboratory investigation.Animal ICU governmental laboratory.Eleven exchange.Sheep were studied...
Recent global events such as COVID-19 pandemic amid rising rates of chronic lung diseases highlight the need for safer, simpler, and more available treatments respiratory failure, with increasing interest in extracorporeal membrane oxygenation (ECMO). A key factor limiting use this technology is complexity blood circuit, resulting clotting bleeding necessitating treatment specialized care centers. Microfluidic oxygenators represent a promising potential solution, but have not reached scale...
Optimizing resuscitation to reduce inflammation and organ dysfunction following human trauma-associated hemorrhagic shock is a major clinical hurdle. This limited by the short duration of pre-clinical studies sparsity early data in setting.
Skin color changes and mottling are frequently described signs of hemorrhagic shock (HEM). Based on this, we developed a noninvasive, noncontact hyperspectral imaging system (HSI), which quantifies depicts the surface tissue saturation oxygen (SHSIO2) for each pixel in region interest (ROI). Our purpose was to assess HSI porcine HEM model. We hypothesized that would cause decreases SHSIO2 skin.The HyperMed employs spectral separator vary wavelength light admitted digital camera. During image...
Background: To improve our ability to identify physiologic deterioration caused by critical injury, we applied nonlinear analysis the R-to-R interval (RRI) of electrocardiogram prehospital trauma patients. Methods: Ectopy-free, 800-beat sections from 31 patients were identified. Twenty survived (S) and 11 died (NonS) after hospital admission. Demographic data, heart rate, blood pressure, field Glasgow Coma Scale (GCS) score, survival times recorded. RRI complexity was assessed via...
Objective: To improve our ability to identify physiologic deterioration caused by critical illness, we applied nonlinear and frequency-domain analytical methods R-to-R interval (RRI) systolic arterial pressure (SAP) time series during hemorrhagic shock. Design: Prospective, randomized, controlled trial. Setting: Animal laboratory of a government research institute. Subjects: Twenty swine (weight 36.4 ± 0.11 kg). Interventions: Fixed-volume hemorrhage followed resuscitation; off-line analysis...
Host inflammatory response to any form of tissue injury, including burn, trauma, or shock, has been well documented. After significant burns, cytokines can increase substantially within the first 24 h after injury and may contribute subsequent organ failure. Hemoadsorption by cytokine-adsorbing columns attenuate this maladaptive response, thereby improving outcomes. The aim study was investigate feasibility, technical safety, efficacy cytokine myoglobin removal early use a absorbing column...
BACKGROUND Prone positioning (PP) improves oxygenation and may provide a benefit in patients with acute respiratory distress syndrome (ARDS). This approach adds significant challenges to intensive care by limiting access the endotracheal or tracheostomy tube vascular access. PP also significantly complicates burn making skin protection wound more difficult. We hypothesize that can be performed safely ARDS. METHODS was implemented unit for 18 severe refractory The characteristics of these...
Background . One of the most plentiful sources for MSCs is bone marrow; however, it unknown whether MSC yield differs among different marrow sites. In this study, we quantified cellular and evaluated resident population from five sites in porcine model. addition, assessed feasibility a commercially available platelet concentrator (Magellan® MAR01™ Arteriocyte Medical Systems, Hopkinton, MA) as bedside stem cell concentration device. Methods Analyses aspirate (BMA) concentrated (cBMA)...
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...
Several preclinical and clinical reports have demonstrated that levels of circulating high mobility group box 1 protein (HMGB1) are increased early after trauma associated with systemic inflammation outcomes. However, the mechanisms interaction between HMGB1 inflammatory mediators lead to development remote organ damage remain obscure. were analyzed in plasma from 54 combat casualties, collected on admission a military hospital Iraq, at 8 24 h admission. In total, 45 (83%) these patients had...
Objective: The role of airway pressure release ventilation in the management early smoke inhalation injury has not been studied. We compared effects and conventional mechanical on oxygenation a porcine model acute respiratory distress syndrome induced by wood inhalation. Design: Prospective animal study. Setting: Government laboratory intensive care unit. Patients: Thirty-three Yorkshire pigs. Interventions: Smoke injury. Measurements Main Results: Anesthetized female pigs (n = 33) inhaled...
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) is less invasive than emergency department thoracotomy for treatment massive hemorrhage. We evaluated effects REBOA on carotid blood flow (Qcarotid) in a porcine model hypothesized that restores Qcarotid faster reinfusion blood. METHODS Spontaneously breathing sedated Sinclair pigs underwent exponential hemorrhage 65% total volume 1 hour. They were randomized into three groups. Positive control (PC, n = 7) immediate...
In critically ill intubated patients, assessment of adequacy ventilation relies on measuring partial pressure arterial carbon dioxide (PaCO2), which requires invasive blood gas analysis. Alternative noninvasive technologies include transcutaneous CO2 (tPCO2) and end-tidal (EtCO2) monitoring. We evaluated accuracy tPCO2 EtCO2 monitoring in a porcine model acute lung injury (ALI) due to smoke inhalation burns. Eight anesthetized Yorkshire pigs underwent mechanical ventilation, wood-bark...
To evaluate the association between acute respiratory distress syndrome and kidney injury with respect to their contributions mortality in critically ill patients.Retrospective analysis of consecutive adult burn patients requiring mechanical ventilation.A 16-bed ICU at tertiary military teaching hospital.Adult more than 18 years old ventilation during initial admission our from January 1, 2003, December 31, 2011.None.A total 830 were included, whom 48.2% had (n = 400). These a 73% increased...