A5082228894- Anesthesia and Sedative Agents
- Sepsis Diagnosis and Treatment
- Antibiotics Pharmacokinetics and Efficacy
- Mechanical Circulatory Support Devices
- COVID-19 and healthcare impacts
- Hemodynamic Monitoring and Therapy
- Pharmacological Effects and Toxicity Studies
- Intensive Care Unit Cognitive Disorders
- Venous Thromboembolism Diagnosis and Management
- COVID-19 Clinical Research Studies
- Long-Term Effects of COVID-19
- Acute Kidney Injury Research
- Thermal Regulation in Medicine
- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Heparin-Induced Thrombocytopenia and Thrombosis
- Blood Pressure and Hypertension Studies
- Process Optimization and Integration
- Sodium Intake and Health
- Central Venous Catheters and Hemodialysis
- Pain Management and Opioid Use
- Cardiovascular Issues in Pregnancy
- Case Reports on Hematomas
- Inhalation and Respiratory Drug Delivery
- Bone and Joint Diseases
Massachusetts General Hospital
2014-2025
Regional Medical Center
2017
Objectives: The objectives of this study were to: 1) determine the association between vasopressor dosing intensity during first 6 hours and 24 after onset septic shock 30-day in-hospital mortality; 2) whether effect varies by fluid resuscitation volume; 3) titration pattern. Design: Multicenter prospective cohort September 2017 February 2018. Vasopressor was defined as total dose infused across all vasopressors in norepinephrine equivalents. Setting: Thirty-three hospital sites United...
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...
<b><i>Background:</i></b> Continuous renal replacement therapy (CRRT) is commonly employed in the intensive care unit (ICU), though there are no guidelines around transition between CRRT and intermittent hemodialysis (iHD). Accelerated venovenous hemofiltration (AVVH) a modality utilizing higher rates (4–5 L/h) with shorter session durations (8–10 h) to “accelerate” clearance volume removal that normally spread out over 24-h period CRRT. We examined AVVH as iHD, aim...
Current fluconazole dosing strategies can be described using either standardized doses (800 or 400 mg) as weight-based recommendations (12 mg/kg loading dose followed by 6 maintenance dose). The ideal method of is still unclear for certain patient populations, such those receiving renal replacement therapy the morbidly obese. We describe a 48-year-old man with body mass index 84 kg/m(2) who was continuous venovenous hemofiltration (CVVH) and treated determined lean weight, infused at rate...
Patients receiving extracorporeal membrane oxygenation (ECMO) are at risk of circuit thrombosis due to constant contact between blood and the components. Unfractionated heparin has traditionally been used in this setting as a systemic form anticoagulation prevent circuit. However, if patient develops heparin-induced thrombocytopenia (HIT), an alternative anticoagulant would be required while is maintained on ECMO. Unfortunately, pharmacokinetic changes induced by ECMO critical illness may...
Abstract Background and Objectives Valproate has wide pharmacokinetic variability a narrow therapeutic index. Its protein binding is unpredictable, particularly among critically ill patients who may experience unexpectedly elevated free concentrations. We sought to identify the clinical consequences determinants of occult valproate toxicity in adults. Methods conducted multicenter retrospective cohort study adult admitted an intensive care unit (ICU) were receiving had concurrent total...
Objective: Although heparin is the current standard anticoagulant during venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO), factors including heparin-induced thrombocytopenia, resistance drug shortages necessitate alternative anticoagulants such as direct thrombin inhibitors. The aim was to characterize dosing, safety, efficacy of bivalirudin ECMO support. Methods: This retrospective single-center study included 24 adults on support who received ≥6 hours...
Background Persistent vasopressor requirements are a common reason for delayed liberation from the intensive care unit (ICU) and adjunct oral agents sometimes used to hasten time discontinuation. We sought describe use of droxidopa weaning in critically ill patients with prolonged hypotension. Materials Methods This retrospective, single-arm, observational study included adult admitted an ICU at two academic centers between 06/2016–07/2023 who received weaning. Patients prior admission or...
Introduction: Droxidopa is a norepinephrine prodrug approved for neurogenic orthostatic hypotension and used off-label persistent in patients who cannot wean off vasopressors. Package labeling states the capsules should be swallowed whole which limits use when gastric tube (GT) required administration. Despite lack of data, GT administration occurs clinical practice. We report safety effectiveness droxidopa administered via hypotension. Methods: Adult admitted to intensive care units (ICU)...
Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Copyright © 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Copyright © 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Institutional policies restricting pregnant providers from caring for patients receiving inhaled epoprostenol exist across the nation based on little to no data substantiate this practice. Over last 2 decades, use of pulmonary vasodilators has expanded in with cardiac and respiratory disease providing more evidence safety these medications obstetrical patients. We propose a thoughtful consideration review literature remove restriction reduce need reveal early pregnancy status employers,...
Abstract Introduction Vancomycin pharmacokinetics are affected by renal replacement therapy and physiologic changes in critically ill patients. Literature regarding vancomycin removal during accelerated venovenous hemofiltration (AVVH), a form of prolonged intermittent therapy, is limited. Objective To describe the AVVH. Methods Eighteen adults receiving AVVH were included. serum concentrations obtained within 4 h before 2–6 after session. Patients' plotted against time, individual...
Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Lin, Hsin1; Boidin, Clement2; Evans, Danielle3; Lopez, Natasha4; Healy, Daniel5; Serpico, Elena4; Goutelle, Sylvain6; Roberts, Jason7 Author Information