A5063719833- Respiratory Support and Mechanisms
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- Cardiac Arrest and Resuscitation
- Intensive Care Unit Cognitive Disorders
- Chronic Obstructive Pulmonary Disease (COPD) Research
- SARS-CoV-2 and COVID-19 Research
- COVID-19 and healthcare impacts
- Sepsis Diagnosis and Treatment
- COVID-19 epidemiological studies
- Neonatal Respiratory Health Research
- COVID-19 and Mental Health
- Vaccine Coverage and Hesitancy
- Mechanical Circulatory Support Devices
- Cellular Mechanics and Interactions
- Hemodynamic Monitoring and Therapy
- Thermal Regulation in Medicine
- vaccines and immunoinformatics approaches
- Phagocytosis and Immune Regulation
- Delphi Technique in Research
- Family and Patient Care in Intensive Care Units
- 3D Printing in Biomedical Research
- Cancer Cells and Metastasis
- Immune cells in cancer
- Cardiovascular and exercise physiology
Massachusetts General Hospital
2014-2025
Harvard University
2008-2024
Pulmonary and Critical Care Associates
2020-2022
University of Cyprus
2020
Brigham and Women's Hospital
2020
University of Missouri
2006
To the Editor:Five to twenty percent of hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted ICU, mortality reported between 26% and 61.5% (1-3).Nearly all ICU present failure, up 88% managed invasive mechanical ventilation (1-3).Descriptions pathophysiological characteristics disease (COVID-19) failure limited.Reports preserved system mechanics despite hypoxemia in early small series have led some investigators hypothesize that a...
Macrophages serve to maintain organ homeostasis in response challenges from injury, inflammation, malignancy, particulate exposure, or infection. Until now, receptor ligation has been understood as being the central mechanism that regulates macrophage function. Using macrophages of different origins and species, we report elasticity is a major determinant innate Macrophage modulated not only by classical biologic activators such LPS IFN-γ, but an equal extent substrate rigidity stretch....
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Significance A distinctive feature of COVID-19 is its extreme heterogeneity—illness ranges from minimally symptomatic to life threatening. Heterogeneity results a poorly understood combination patient factors, viral dynamics, antiviral and immune modulating therapies, dynamics the innate adaptive responses. In order better understand clinical heterogeneity optimal treatment, we developed comprehensive mathematical model incorporating elements responses, renin−angiotensin system (which virus...
SARS-CoV-2 vaccines are effective at limiting disease severity, but effectiveness is lower among patients with cancer or immunosuppression. Effectiveness wanes time and varies by vaccine type. Moreover, previously prescribed were based on the ancestral spike-protein that emerging variants may evade. Here, we describe a mechanistic mathematical model for vaccination-induced immunity. We validate it available clinical data use to simulate of against viral antigenicity, increased virulence,...
Rationale: Obesity is characterized by elevated pleural pressure (Ppl) and worsening atelectasis during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS).Objectives: To determine the effects of a lung recruitment maneuver (LRM) presence Ppl on hemodynamics, left right ventricular pressure, pulmonary vascular resistance. We hypothesized that protects cardiovascular system against high airway prevents overdistension.Methods: First, an interventional crossover...
Dyspnea and exercise intolerance are commonly reported post-acute sequelae of SARS-CoV-2 infection (PASC), but routine diagnostic testing is often normal. Cardiopulmonary (CPET) offers comprehensive assessment dyspnea to characterize pulmonary PASC.We performed a retrospective cohort study CPET on patients reporting and/or following confirmed Covid-19 between August 1, 2020 March 2021, compared them age- sex-matched with unexplained referred for at the same center in pre-Covid-19...
Acute respiratory distress syndrome (ARDS) secondary to coronavirus disease-2019 (COVID-19) is characterized by substantial heterogeneity in clinical, biochemical, and physiological characteristics. However, the pathophysiology of severe COVID-19 infection poorly understood. Previous studies established clinical biological phenotypes among classical ARDS cohorts, with important therapeutic implications. The phenotypic profile associated remains unknown.We used latent class modeling via a...
Rationale: The leading cause of death in coronavirus disease 2019 (COVID-19) is severe pneumonia, with many patients developing acute respiratory distress syndrome (ARDS) and diffuse alveolar damage (DAD). Whether DAD fatal COVID-19 distinct from other causes remains unknown. Objective: To compare lung parenchymal vascular alterations between pneumonia DAD-causing etiologies using a multidimensional approach. Methods: This autopsy cohort consisted consecutive (n = 20) failure histologic 21;...
Cells comprising a tissue migrate as part of collective. In order to coordinate collective multi- cellular migration, each constituent cell integrates local information including chemical signals and mechanical stresses. The boundary between its immediate neighbors comprises cell-cell junctions cryptic lamellipodia, but the state stress exerted at that has not been accessible experimentally. As such it is clear how processes could be coordinated over length scales spanning large...
In this work, we describe a benchtop model that recreates the motion and function of diaphragm using combination advanced robotic organic tissue. First, build high-fidelity anthropomorphic thermoplastic elastomeric material based on clinical imaging data. We then attach pneumatic artificial muscles to diaphragm, pre-programmed move in clinically relevant manner when pressurized. By inserting as divider between two chambers model—one representing thorax other abdomen—and subsequently...
Objective Recent cohort studies have identified obesity as a risk factor for poor outcomes in coronavirus disease 2019 (COVID-19). To further explore the relationship between and critical illness COVID-19, association of BMI with baseline demographic intensive care unit (ICU) parameters, laboratory values, critically ill patient was examined. Methods In this retrospective study, first 277 consecutive patients admitted to Massachusetts General Hospital ICUs laboratory-confirmed COVID-19 were...
Coronavirus disease 2019 (COVID-19) appears to be associated with increased arterial and venous thromboembolic disease. These presumed abnormalities in hemostasis have been filter clotting during continuous renal replacement therapy (CRRT). We aimed characterize the burden of CRRT COVID-19 infection describe a anticoagulation protocol that used anti-factor Xa levels for systemic heparin dosing. Multi-center study consecutive patients receiving CRRT. Primary outcome was loss. Sixty-five were...
Prone positioning improves clinical outcomes in moderate-to-severe acute respiratory distress syndrome and has been widely adopted for the treatment of patients with due to coronavirus disease 2019. Little is known about effects prone among less severe syndrome, obesity, or those treated pulmonary vasodilators.We characterize change oxygenation, system compliance, dead-space-to-tidal-volume ratio response 2019 a range severities. A subset analysis inhaled nitric oxide subsequent explored...
Importance The use of race-based coefficients in pulmonary function testing has led to the recent development race-neutral Global Lung Function Initiative (GLI) reference equation (hereafter GLI Global). performance comparison race-adjusted 2012) not been well characterized. Objective To compare implications 2012 vs equations for lung trajectory. Design, Setting, and Participants This cohort study at Massachusetts General Hospital analyzed data patients aged 18 95 years who completed...
Critical illness, such as severe COVID-19, is heterogenous in presentation and treatment response. However, it remains possible that clinical course may be influenced by dynamic and/or random events similar patients subject to injuries yet follow different trajectories. We deployed a mechanistic mathematical model of COVID-19 determine the range courses after SARS-CoV-2 infection, which from specific changes viral properties, immune modality external factors initial load. find efficacy...