A5028877408- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Intensive Care Unit Cognitive Disorders
- Sepsis Diagnosis and Treatment
- Mechanical Circulatory Support Devices
- Neonatal Respiratory Health Research
- Long-Term Effects of COVID-19
- COVID-19 Clinical Research Studies
- Cardiac Structural Anomalies and Repair
- Patient-Provider Communication in Healthcare
- COVID-19 and healthcare impacts
- Heart Failure Treatment and Management
- Emergency and Acute Care Studies
- Palliative Care and End-of-Life Issues
- Pulmonary Hypertension Research and Treatments
- Family and Patient Care in Intensive Care Units
- Lung Cancer Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Statistical Methods in Clinical Trials
- Cardiac, Anesthesia and Surgical Outcomes
- Meta-analysis and systematic reviews
- Disaster Response and Management
- SARS-CoV-2 and COVID-19 Research
- Inhalation and Respiratory Drug Delivery
- Pleural and Pulmonary Diseases
Johns Hopkins Medicine
2016-2025
Johns Hopkins University
2016-2025
Pulmonary and Critical Care Associates
2024
Johns Hopkins Hospital
2013-2024
Cardiovascular Innovation Institute
2010-2017
University of Louisville
2010-2017
University of Tennessee Health Science Center
2016
University of Louisville Hospital
2009
Mechanical ventilation can cause acute diaphragm atrophy and injury, this is associated with poor clinical outcomes. Although the importance impact of lung-protective widely appreciated well established, concept diaphragm-protective has recently emerged as a potential complementary therapeutic strategy. This Perspective, developed from discussions at meeting international experts convened by PLUG (the Pleural Pressure Working Group) European Society Intensive Care Medicine, outlines...
This document updates previously published Clinical Practice Guidelines for the management of patients with acute respiratory distress syndrome (ARDS), incorporating new evidence addressing use corticosteroids, venovenous extracorporeal membrane oxygenation, neuromuscular blocking agents, and positive end-expiratory pressure (PEEP).
Most bronchoscopic procedures are performed using moderate sedation achieved by combining a short-acting benzodiazepine with an opioid agent. Propofol (2.6-diisopropylphenol), hypnotic agent, has been increasingly used to provide deep in the endoscopy community acceptable safety profile.To compare impact of versus on adequacy and diagnostic yield endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).A retrospective review prospectively collected data was at two...
Importance Individuals who survived COVID-19 often report persistent symptoms, disabilities, and financial consequences. However, national longitudinal estimates of symptom burden remain limited. Objective To measure the incidence changes over time in disability, status after COVID-19–related hospitalization. Design, Setting, Participants A US multicenter prospective cohort study with 1-, 3-, 6-month postdischarge visits was conducted at 44 sites participating National Heart, Lung, Blood...
Importance Early observations suggested that COVID-19 pneumonia had a higher mortality rate than other causes of pneumonia. Objective To compare outcomes between mechanically ventilated patients with due to (March 2020 June 2021) and etiologies (July 2016 December 2019). Design, Setting, Participants This retrospective cohort study was conducted at the Johns Hopkins Healthcare System among adult (aged ≥18 years) who required mechanical ventilation in first 2 weeks hospitalization. Clinical,...
"The Rise of Adaptive Platform Trials in Critical Care." American Journal Respiratory and Care Medicine, 0(ja), pp.
Use of prone positioning in patients with acute respiratory distress syndrome (ARDS) from COVID-19 may be greater than treated for ARDS before the pandemic. However, magnitude this increase, sources practice variation, and extent to which use adheres guidelines is unknown.To compare practices versus pandemic.We conducted a multicenter retrospective cohort study mechanically ventilated early moderate-to-severe (2020-2021) or non-COVID-19 pneumonia (2018-2019) across 19 ICUs at five hospitals...
B-cell depletion therapy is employed in a variety of clinical contexts from auto-immune diseases to malignancy. Prior research on patients with prior treatment has suggested mortality risk hospitalized COVID-19 however previous case–control studies have differed their methods patient comparison. Patients previously treated B-cell-depletion were compared matched controls the Johns Hopkins Health System between March 1, 2020 and November 30, 2021. The primary outcome was 30-day all-cause...
Background Understanding COVID-19 epidemiology is crucial to clinical care and trial design interpretation. Objective To describe characteristics, treatment, outcomes among patients hospitalized with early in the pandemic. Methods A retrospective cohort study of consecutive adult laboratory-confirmed, symptomatic SARS-CoV-2 infection admitted 57 US hospitals from March 1 April 1, 2020. Results Of 1480 inpatients COVID-19, median (IQR) age was 62.0 (49.4-72.9) years, 649 (43.9%) were female,...
ABSTRACT Background and objective The main purpose of treatment in patients with malignant pleural effusion (MPE) is symptom palliation. Currently, undergo repeat thoracenteses prior to receiving a definitive procedure as clinicians are not aware the risk factors associated fluid recurrence. primary this study was identify recurrent symptomatic MPE. Methods Retrospective multicentre cohort who underwent first thoracentesis performed. outcome time recurrence requiring intervention evidence...
Abstract Background Higher inspiratory airway pressures are associated with worse outcomes in mechanically ventilated patients the acute respiratory distress syndrome (ARDS). This relationship, however, has not been well investigated without ARDS. We hypothesized that higher driving (ΔP) and plateau (Pplat) patient-centered ARDS as those Methods Using data collected during a prospective, observational cohort study of 6179 critically ill participants enrolled 59 ICUs across USA, we used...
<h3>BACKGROUND:</h3> Observational studies report that lower driving pressure (ie, the difference between plateau and PEEP) is associated with improved survival in patients ARDS may be a key mediator of lung-protective ventilation strategies. The primary objective this study was to characterize reductions could achieved through changes PEEP. <h3>METHODS:</h3> In prospective physiological pilot study, 10 subjects were placed on PEEP according Network Lower PEEP/F<sub>IO<sub>2</sub></sub>...
A mock circulation system has been developed to approximate key anatomic features and simulate the pressures flows of an infant. Pulsatile flow is generated by 10 cc pulsatile ventricles (Utah infant ventricular assist device). Systemic vasculature mimicked through use 3/8" ID bypass tubing with two flexible reservoirs provide compliance. Vascular resistance, including pulmonary, aortic, major branches, controlled via a series variable pinch clamps. The coronary branch dynamic resistor so...
ObjectiveTo develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require clear understanding patients' treatment goals.BackgroundA 2016 policy statement from the American Thoracic Society and College Critical Care Medicine calls on intensivists to engage shared decision-making when "making major decisions may be affected by personal values, goals, preferences."MethodsA three-round modified Delphi consensus process was conducted via panel 6...
An important, but not well characterized, population receiving intermediate care is that of medical patients admitted directly from the emergency department.To characterize and their outcomes when to an unit with clearly defined admission guidelines.Demographic data, admitting diagnoses, illness severity, comorbid conditions, lengths stay, hospital mortality were characterized for all July through December 2012.A total 317 unique (mean age, 54 [SD, 16] years). Most respiratory (26.5%) or...