A5040177732- Intensive Care Unit Cognitive Disorders
- Respiratory Support and Mechanisms
- Sepsis Diagnosis and Treatment
- Family and Patient Care in Intensive Care Units
- Cardiac Arrest and Resuscitation
- Anesthesia and Sedative Agents
- Healthcare Decision-Making and Restraints
- Emergency and Acute Care Studies
- Cardiac, Anesthesia and Surgical Outcomes
- Disaster Response and Management
- Anesthesia and Neurotoxicity Research
- Patient Safety and Medication Errors
- Nosocomial Infections in ICU
- Thermal Regulation in Medicine
- Traumatic Brain Injury and Neurovascular Disturbances
- Trauma and Emergency Care Studies
- Clinical Reasoning and Diagnostic Skills
- Liver Disease and Transplantation
- Machine Learning in Healthcare
- Hospital Admissions and Outcomes
- Palliative Care and End-of-Life Issues
- Healthcare Technology and Patient Monitoring
- Healthcare Policy and Management
- Liver Disease Diagnosis and Treatment
- Long-Term Effects of COVID-19
Hospital of the University of Pennsylvania
2013-2024
University of Pennsylvania
2014-2023
Pulmonary and Allergy Associates
2013-2023
National Heart Lung and Blood Institute
2023
National Institutes of Health
2023
University of Pennsylvania Health System
2019-2021
Philadelphia VA Medical Center
2017
Community Care
2017
University of Pittsburgh
2016
Penn Presbyterian Medical Center
2015
INTRODUCTION Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection (1). and septic shock are major healthcare problems, impacting millions of people around the world each year killing between one in three six those it affects (2–4). Early identification appropriate management initial hours after development sepsis improve outcomes. The recommendations this document intended provide guidance for clinician caring adult patients with or hospital...
Objective: Decades-old, common ICU practices including deep sedation, immobilization, and limited family access are being challenged. We endeavoured to evaluate the relationship between ABCDEF bundle performance patient-centered outcomes in critical care. Design: Prospective, multicenter, cohort study from a national quality improvement collaborative. Setting: 68 academic, community, federal ICUs collected data during 20-month period. Patients: 15,226 adults with at least one day....
There are conflicting data on the effects of antipsychotic medications delirium in patients intensive care unit (ICU).
In critically ill patients receiving mechanical ventilation, daily interruption of sedative infusions decreases duration ventilation and intensive care unit length stay. Whether this sedation strategy reduces the incidence complications commonly associated with critical illness is not known.Blinded, retrospective chart review.University-based hospital in Chicago, IL.One hundred twenty-eight continuous drugs a medical unit.None.We performed blinded, evaluation database from our previous trial...
The Surviving Sepsis Campaign (SSC) International Guidelines for the Management of and Septic Shock provide guidance on care hospitalized adult patients with (or at risk for) sepsis, based systematic summary assessment relevant literature. This executive reviews history, scope, methodology, major recommendations guidelines, focusing aspects that are new or different compared 2016 guidelines were published in 2017. Full description process provided complete document. HISTORY AND SCOPE OF THE...
Physical and occupational therapy are possible immediately after intubation in mechanically ventilated medical intensive care unit patients. The objective of this study was to describe a protocol daily sedative interruption early physical specify details unit-based therapy, including neurocognitive state, potential barriers, adverse events related intervention.Detailed descriptive the intervention arm trial patients receiving therapy.Two tertiary academic centers participating randomized...
Section:ChooseTop of pageAbstract <<ContentsSummary Recommendation...IntroductionMethodsResults1SummaryReferencesCITING ARTICLES
Develop and implement a machine learning algorithm to predict severe sepsis septic shock evaluate the impact on clinical practice patient outcomes.Retrospective cohort for derivation validation, pre-post evaluation.Tertiary teaching hospital system in Philadelphia, PA.All non-ICU admissions; July 2011 June 2014 (n = 162,212); validation October December 2015 10,448); silent versus alert comparison January 2016 February 2017 (silent n 22,280; 32,184).A random-forest classifier, derived...
The coronavirus disease 2019 (COVID-19) pandemic continues to surge in the United States and globally.To describe epidemiology of COVID-19-related critical illness, including trends outcomes care delivery.Single-health system, multihospital retrospective cohort study.5 hospitals within University Pennsylvania Health System.Adults with illness who were admitted an intensive unit (ICU) acute respiratory failure or shock during initial pandemic.The primary exposure for delivery trend analyses...
Increasing numbers of intensive care units (ICUs) are adopting the practice nighttime intensivist staffing despite lack experimental evidence its effectiveness.
This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between American Thoracic Society and College Chest Physicians.A multidisciplinary panel posed Population, Intervention, Comparator, Outcomes format. A comprehensive literature search evidence synthesis was performed for each question, which included appraising certainty (i.e., quality evidence) using Grading...
To assess clinician perceptions of a machine learning-based early warning system to predict severe sepsis and septic shock (Early Warning System 2.0).Prospective observational study.Tertiary teaching hospital in Philadelphia, PA.Non-ICU admissions November-December 2016.During 6-week study period conducted 5 months after Early 2.0 alert implementation, nurses providers were surveyed twice about their the alert's helpfulness impact on care, first within 6 hours alert, again 48 alert.For 362...
Early mobilization (EM) improves outcomes for mechanically ventilated patients. Variation in structure and organizational characteristics may affect implementation of EM practices.We queried intensive care unit (ICU) environment standardized ICU practices to evaluate that enable practice.We recruited 151 ICUs France, 150 Germany, the United Kingdom, 500 States by telephone. Survey domains included respondent characteristics, hospital protocols.We surveyed 1,484 leaders received a 64%...
Early mobilization improves patient outcomes. However, diffusion of this intervention into standard ICU practice is unknown. Dissemination and implementation efforts may be guided by an environmental scan to detail readiness for early mobilization, current practice, barriers mobilization.A telephone survey.U.S. ICUs.Five hundred randomly selected U.S. ICUs stratified regional hospital density size.None.We surveyed 687 a 73% response rate (500 ICUs); 99% respondents were nursing leadership....
It is unclear whether extracorporeal CO
Low tidal volume ventilation strategies for patients with respiratory failure from acute lung injury may lead to breath stacking and higher volumes than intended.To determine frequency, risk factors, of stacked breaths during low injury.Prospective cohort study mechanically ventilated (enrolled August 2006 through May 2007) treated in a medical intensive care unit at an academic tertiary hospital.Patients were using the Acute Respiratory Distress Syndrome Network protocol injury. Continuous...
To determine the prevalence of myocardial ischemia in mechanically ventilated patients with coronary risk factors and compare periods sedative interruption vs. infusion.Prospective, blinded observational study.Medical intensive care unit tertiary medical center.Intubated, established artery disease factors.Continuous three-lead Holter monitors ST-segment analysis by a cardiologist were used to detect ischemia. Ischemia was defined as elevation or depression >0.1 mV from baseline.Comparisons...