A5033813700- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Airway Management and Intubation Techniques
- Cardiac, Anesthesia and Surgical Outcomes
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Hemodynamic Monitoring and Therapy
- Tracheal and airway disorders
- Sepsis Diagnosis and Treatment
- Burn Injury Management and Outcomes
- Long-Term Effects of COVID-19
- Ultrasound in Clinical Applications
- Mechanical Circulatory Support Devices
- Nosocomial Infections in ICU
- COVID-19 Clinical Research Studies
- Thermal Regulation in Medicine
- Anesthesia and Neurotoxicity Research
- Anesthesia and Pain Management
- Trauma Management and Diagnosis
- Family and Patient Care in Intensive Care Units
- Emergency and Acute Care Studies
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Electroconvulsive Therapy Studies
- Simulation-Based Education in Healthcare
- Acute Kidney Injury Research
Massachusetts General Hospital
2016-2025
Harvard University
2016-2025
Boston University
2012-2024
Harvard University Press
2011-2023
Pain and Rehabilitation Medicine
2011-2023
Shriners Hospitals for Children - Erie
2019-2023
Shriners Hospitals for Children - Boston
2014-2022
National Heart Lung and Blood Institute
2020
Mercy General Hospital
2020
National Institutes of Health
2020
Multiple studies have used administrative datasets to examine the epidemiology of sepsis in general, but entity postoperative has been studied less intensively. Therefore, we undertook an analysis using Nationwide Inpatient Sample, largest in-patient dataset available United States.Elective admissions patients aged 18 yr or older with a length stay more than 3 days for any 1 20 most common elective operative procedures were extracted from years 1997-2006. Postoperative was defined...
Opioids administered to treat postsurgical pain are a major contributor the opioid crisis, leading chronic use in considerable proportion of patients. Initiatives promoting opioid-free or opioid-sparing modalities perioperative management have led reduced administration operating room, but this reduction could unforeseen detrimental effects terms postoperative outcomes, as relationship between intraoperative usage and later requirements is not well understood.To characterize association...
Objective To evaluate whether the level of mobilization achieved and barriers for progressing to next differ between nurses physical therapists. Design Prospective, observational study. Setting Twenty‐bed surgical intensive care unit (SICU) Massachusetts General Hospital. Participants Sixty‐three critically ill patients. Methods Physical therapists performed 179 therapies with 63 Outcome Measurement Mobilization was defined as process enhancing mobility in SICU, including bed mobility, edge...
Emergent intubation is associated with a high complication rate. These intubations are often performed by resident physicians in teaching hospitals. The authors evaluated whether supervision an anesthesia-trained intensivist decreases complications of emergent intubations.The prospective cohort study Academic Tertiary Care Hospital. They enrolled 322 consecutive patients who required between November 1, 2006, and April 15, 2008. Emergency anesthesia residents during their surgical intensive...
Procedural sedation is frequently performed in spontaneously breathing patients, but hypnotics and opioids decrease respiratory drive place the upper airway at risk for collapse.In a randomized, controlled, cross-over, pharmaco-physiologic study 12 rats, we conducted acute experiments to compare genioglossus electromyogram activity equianesthetic concentrations of ketamine, noncompetitive N-methyl-D-aspartate receptor antagonist that combines potent analgesic with hypnotic action effects,...
To the Editor Management of patient sedation and analgesia to alleviate anxiety pain facilitate mechanical ventilation is one key roles every intensivist. During coronavirus disease 2019 (COVID-19) pandemic, unprecedented numbers patients require in intensive care units (ICUs) other hospital locations due their ventilator dependence. However, pharmacologic mechanically ventilated with COVID-19 has thus far received very little attention critical literature, minimal mention Society Critical...
Objectives: 1) To characterize vitamin D status at initiation of critical care in surgical ICU patients and 2) to determine whether this is associated with the risk prolonged hospital length stay, 90-day readmission, mortality. Design: Prospective cohort study. Setting: A teaching Boston, MA. Patients: Hundred patients. Interventions: None. Measurements Main Results: Mean (± SD) serum total 25-hydroxyvitamin 1,25-dihydroxyvitamin levels were 17 ± 8 ng/mL 32 19 pg/mL, respectively. calculated...
Emergent intubation is associated with a high rate of complications. Neuromuscular blocking agents are routinely used in the operating room and emergency department to facilitate intubation. However, use neuromuscular during emergent airway management outside controversial. We hypothesized that decreased prevalence hypoxemia reduced procedure-related complications.Five hundred sixty-six patients undergoing intubations two tertiary care centers, Massachusetts General Hospital, Boston, MA,...
Controversies and practice variations exist related to the pharmacologic nonpharmacologic management of airway during rapid sequence intubation (RSI).To develop evidence-based recommendations on topics RSI.A guideline panel 20 Society Critical Care Medicine members with experience RSI emergency met virtually at least monthly from panel's inception in 2018 through 2020 face-to-face Congress. The included pharmacists, physicians, a nurse practitioner, respiratory therapist medicine, critical...
The effects of high-dose inhaled nitric oxide on hypoxemia in coronavirus disease (COVID-19) acute respiratory failure are unknown.
Objectives: To test if the surgical intensive care unit optimal mobility score predicts mortality and hospital length of stay. Design: Prospective single-center cohort study. Setting: Surgical Massachusetts General Hospital. Patients: One hundred thirteen consecutive patients admitted to unit. Investigations: We tested hypotheses that independent comorbidity index, Acute Physiology Chronic Health Evaluation II, creatinine, hypotension, hypernatremia, acidosis, hypoxia, hypercarbia mortality,...
FORMATION of noncardiogenic pulmonary edema has been observed after a variety inciting events, including upper airway obstruction (negative pressure [NPPE]),1acute lung injury,2anaphylaxis,3fluid maldistribution,4and severe central nervous system trauma (neurogenic edema).5Both the diagnosis and an understanding its underlying pathophysiology have important implications for treatment. Patients with postoperative who require mechanical ventilation should be ventilated low-tidal...
Vitamin D is a promising, though under-explored, potential modifiable risk factor for acute respiratory infections (ARIs). We sought to investigate the association of vitamin status with ARI in large, nationally-representative sample non-institutionalized individuals from United States. analyzed 14,108 over 16 years age National Health and Nutrition Survey (NHANES) 2001-2006 this cross-sectional study. used locally weighted scatterplot smoothing (LOWESS) depict relationship between...
Postoperative hospital-acquired infections (HAIs) may result from disruption of natural barrier sites. Recent studies have linked vitamin D status and site integrity.To investigate the association between preoperative risk for HAIs.A retrospective analysis was performed using propensity score methods to construct a matched-pairs cohort reduce baseline differences patients with 25-hydroxyvitamin (25[OH]D) levels less than 30 ng/mL vs or greater. Multivariable logistic regression then examine...
ObjectiveTo investigate the association between serum 25-hydroxyvitamin D [25(OH)D] level and history of community-acquired pneumonia (CAP). Patients MethodsWe identified 16,975 individuals (≥17 years) from third National Health Nutrition Examination Survey (NHANES III) with documented 25(OH)D levels. To CAP in these participants, we developed a multivariable logistic regression model, adjusting for demographic factors (age, sex, race, poverty-to-income ratio, geographic location), clinical...