A5085840627- Intensive Care Unit Cognitive Disorders
- Respiratory Support and Mechanisms
- Family and Patient Care in Intensive Care Units
- Emergency and Acute Care Studies
- Sepsis Diagnosis and Treatment
- Biomedical Text Mining and Ontologies
- Electronic Health Records Systems
- Cardiac Arrest and Resuscitation
- COVID-19 Clinical Research Studies
- Venous Thromboembolism Diagnosis and Management
- COVID-19 diagnosis using AI
- Topic Modeling
- SARS-CoV-2 and COVID-19 Research
- Renal function and acid-base balance
- SARS-CoV-2 detection and testing
- Pneumonia and Respiratory Infections
- Ultrasound in Clinical Applications
- Healthcare Decision-Making and Restraints
- Nosocomial Infections in ICU
- EEG and Brain-Computer Interfaces
- Chronic Disease Management Strategies
- Healthcare Technology and Patient Monitoring
- Semantic Web and Ontologies
- Cardiovascular Syncope and Autonomic Disorders
- Long-Term Effects of COVID-19
Intermountain Medical Center
2019-2024
American Society of Echocardiography
2024
Intermountain Healthcare
2019-2024
Cotton (United States)
2020
University of Utah
2013-2015
Century (United States)
2013
Ritonavir-boosted Nirmatrelvir (NMV-r), a protease inhibitor with
Abstract Background In patients with acute respiratory distress syndrome (ARDS), low tidal volume ventilation has been associated reduced mortality. Driving pressure (tidal normalized to system compliance) may be an even stronger predictor of ARDS survival than volume. We sought study whether these associations hold true in failure without ARDS. Methods This is a retrospectively cohort analysis mechanically ventilated adult admitted ICUs from 12 hospitals over 2 years. used natural language...
Background SARS-CoV-2 reinfection and reactivation has mostly been described in case reports. We therefore investigated the epidemiology of recurrent COVID-19 SARS-CoV-2. Methods Among patients testing positive for between March 11 July 31, 2020 within an integrated healthcare system, we identified with a reverse transcription polymerase chain reaction (RT-PCR) assay ≥60 days after initial test. To assign overall likelihood recurrence, combined quantitative data from RT-PCR cycle...
Rationale: Care of emergency department (ED) patients with pneumonia can be challenging. Clinical decision support may decrease unnecessary variation and improve care. Objectives: To report patient outcomes processes care after deployment electronic clinical (ePNa): a comprehensive, open loop, real-time embedded within the health record. Methods: We conducted pragmatic, stepped-wedge, cluster-controlled trial at 2-month intervals in 16 community hospitals. ePNa extracts historical data to...
Abstract Background Lung-protective ventilation (LPV) improves outcomes for patients with acute respiratory distress syndrome (ARDS) through the administration of low tidal volumes (≤ 6.5 ml/kg predicted body weight [PBW]) co-titration positive end-expiratory pressure and fraction inspired oxygen. Many ARDS, however, are not managed LPV. The purpose this study was to understand implementation barriers facilitators use LPV a computerized clinical decision support (CDS) tool in intensive care...
Rationale: Routine spontaneous awakening and breathing trial coordination (SAT/SBT) improves outcomes for mechanically ventilated patients, but adherence varies. Understanding barriers to facilitators of consistent daily use SAT/SBT (implementation determinants) can guide the development implementation strategies increase these evidence-based interventions. Objectives: We conducted an explanatory, sequential mixed-methods study measure variation in routine identify determinants that might...
Abstract Objective Multiple professional societies recommend pre‐test probability (PTP) assessment prior to imaging in the evaluation of patients with suspected pulmonary embolism (PE), however, PTP testing remains uncommon, occurring frequently and rates confirmed PE remaining low. The goal this study was assess impact a clinical decision support tool embedded into electronic health record improve diagnostic yield computerized tomography angiography (CTPA) emergency department (ED). Methods...
Sepsis survivors face increased risk for cardiovascular complications; however, the contribution of intrasepsis events to profiles is unclear.Kaiser Permanente Northern California (KPNC) and Intermountain Healthcare (IH) integrated healthcare delivery systems.Sepsis (2011-2017 [KPNC] 2018-2020 [IH]) greater than or equal 40 years old without prior disease.Data across KPNC IH were harmonized grouped into presepsis (demographics, atherosclerotic disease scores, comorbidities) factors (e.g.,...
Lung-protective ventilation (LPV) improves outcomes for patients with acute respiratory distress syndrome (ARDS), but adherence remains inadequate.
We implemented a computerized protocol for low tidal volume ventilation (LTVV) to improve management and outcomes of mechanically ventilated patients with, without, the acute respiratory distress syndrome (ARDS).Pragmatic, nonrandomized stepped wedge type II hybrid implementation/effectiveness trial.Twelve hospitals in an integrated healthcare system over 2-year period.Patients greater than or equal 18 years old who had initiation mechanical emergency department ICU. excluded died...
Syncope occurs in 1 4 people during their lifetime and accounts for 1% to 1.5% of emergency department (ED) visits. Most causes syncope are benign, but may be caused by life-threatening conditions including pulmonary embolism (PE) up 2% cases. A recent publication reported the prevalence PE patients with over 17%.
Summary Background: Following liver transplantation, patients require lifelong immunosuppressive care and monitoring. Computerized clinical decision support (CDS) has been shown to improve post-transplant processes outcomes. The readiness of transplant information systems implement computerized CDS is unknown. Objectives: a) Describe the current system functionality manual automated for laboratory monitoring care, b) describe use guidelines that may be used produce computable logic alerts...
The utility of the Risk Assessment Profile (RAP) score in predicting VTE was assessed, and risk factors identified to guide a duplex ultrasound (DUS) protocol injured patients. Secondary analysis prospective data on trauma inpatients (March 2017-September 2019), with admission RAP ≥5. Inhospital patients compared those without. Regression analyses DVT, PE proximal ROC evaluating RAP's predictability were performed. 1989 analyzed. 163(8.2%), DVT 159(8.0%), 10(0.5%) Strongest predictors...
Intensive care unit (ICU) patients on mechanical ventilation often require sedation and analgesia to improve comfort decrease pain. Prolonged analgesia, however, may increase time ventilation, risk for ventilator associated pneumonia, delirium. Coordinated interruptions in [spontaneous awakening trials (SATs)] spontaneous breathing (SBTs) ventilator-free days mortality. Coordination of SATs SBTs is difficult with substantial implementation barriers due difficult-to-execute sequencing between...
Epidemiologists create and publish criteria for laboratory tests that must be reported to public health agencies. The sets of LOINC <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">®</sup> codes are critical electronic reporting but vary by source, difficult curate, may missing desired or include undesired tests. Using Chlamydia as an example, we developed ontology classifies the terminology used describe coded For each test, created a new term...
Receipt of fluid and vasopressors, common treatments in septic shock, may affect cardiac function.
Sepsis care delivery-including the initiation of prompt, appropriate antimicrobials-remains suboptimal.
OBJECTIVES: To determine if the implementation of automated clinical decision support (CDS) with embedded minor severe community-acquired pneumonia (sCAP) criteria was associated improved ICU utilization among emergency department (ED) patients who did not require vasopressors or positive pressure ventilation at admission. DESIGN: Planned secondary analysis a stepped-wedge, cluster-controlled CDS trial. SETTING: Sixteen hospitals in six geographic clusters from Intermountain Health; large,...