A5069308227- Sepsis Diagnosis and Treatment
- Hemodynamic Monitoring and Therapy
- Machine Learning in Healthcare
- Respiratory Support and Mechanisms
- Non-Invasive Vital Sign Monitoring
- Cardiac Arrest and Resuscitation
- COVID-19 diagnosis using AI
- Heart Rate Variability and Autonomic Control
- Renal function and acid-base balance
- Intensive Care Unit Cognitive Disorders
- Climate Change and Health Impacts
- Cardiac, Anesthesia and Surgical Outcomes
- Explainable Artificial Intelligence (XAI)
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Thermal Regulation in Medicine
- Clinical Reasoning and Diagnostic Skills
- Traumatic Brain Injury and Neurovascular Disturbances
- Healthcare Technology and Patient Monitoring
- Artificial Intelligence in Healthcare and Education
- Metabolomics and Mass Spectrometry Studies
- Emergency and Acute Care Studies
- Disaster Response and Management
- Nosocomial Infections in ICU
- Heme Oxygenase-1 and Carbon Monoxide
- Neonatal and fetal brain pathology
Emory University
2016-2025
Grady Memorial Hospital
2016-2025
Community Care
2022-2024
Cooper University Hospital
2023
IPS Research (United States)
2023
Philips (United States)
2023
University of California, Irvine
2023
NXP (Netherlands)
2023
Philips (Netherlands)
2023
University of Pennsylvania
2023
Objectives: Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival septic However, no clinically validated system exists for real-time prediction sepsis onset. We aimed to develop validate an Artificial Intelligence Expert algorithm early sepsis. Design: Observational cohort study. Setting: Academic medical center from January 2013 December 2015. Patients: Over 31,000 admissions ICUs at...
BackgroundFluid and vasopressor management in septic shock remains controversial. In this randomized controlled trial, we evaluated the efficacy of dynamic measures (stroke volume change during passive leg raise) to guide resuscitation improve patient outcome.Research QuestionWill that is guided by assessments fluid responsiveness patients with outcomes?Study Design MethodsWe conducted a prospective, multicenter, clinical trial at 13 hospitals United States Kingdom. Patients presented EDs...
<h3>Importance</h3> Discrepancies in oxygen saturation measured by pulse oximetry (Spo<sub>2</sub>), when compared with arterial (Sao<sub>2</sub>) blood gas (ABG), may differentially affect patients according to race and ethnicity. However, the association of these disparities health outcomes is unknown. <h3>Objective</h3> To examine racial ethnic discrepancies between Sao<sub>2</sub>and Spo<sub>2</sub>measures their associations clinical outcomes. <h3>Design, Setting, Participants</h3> This...
Progression from nonsevere sepsis—i.e., sepsis without organ failure or shock—to severe shock among emergency department (ED) patients has been associated with significant mortality. Early recognition in the ED of those who progress to during their hospital course may improve patient outcomes. We sought identify clinical, demographic, and laboratory parameters that predict progression sepsis, septic shock, death within 96 h triage initial presentation sepsis. This is a retrospective cohort...
We present an interpretable machine learning algorithm called ‘eARDS’ for predicting ARDS in ICU population comprising COVID-19 patients, up to 12-hours before satisfying the Berlin clinical criteria. The analysis was conducted on data collected from Intensive care units (ICU) at Emory Healthcare, Atlanta, GA and University of Tennessee Health Science Center, Memphis, TN Cerner ® Facts Deidentified Database, a multi-site EMR database. participants consisted adults over 18 years age. Clinical...
Peripherally inserted central catheters are often positioned blindly in the circulation, and this may result high malposition rates, especially critically ill patients. Recently, a new technology has been introduced (Sherlock 3CG Tip Positioning System) that uses an electro-magnetic system to guide positioning superior vena cava, then intra-cavity ECG at cavo-atrial junction. In observational study, we investigated how Sherlock System would affect peripherally catheter defined using...
The inherent flexibility of machine learning-based clinical predictive models to learn from episodes patient care at a new institution (site-specific training) comes the cost performance degradation when applied external cohorts. To exploit full potential cross-institutional big data, learning systems must gain ability transfer their knowledge across institutional boundaries and without forgetting previously learned patterns. In this work, we developed privacy-preserving algorithm named...
Abstract Objective To develop an electronic medical record (EMR) data processing tool that confers clinical context to machine learning (ML) algorithms for error handling, bias mitigation, and interpretability. Materials Methods We present Trust-MAPS, algorithm translates domain knowledge into high-dimensional, mixed-integer programming models capture physiological biological constraints on measurements. EMR are projected onto this constrained space, effectively bringing outliers fall within...
OBJECTIVES: To train a model to predict vasopressor use in ICU patients with sepsis and optimize external performance across hospital systems using domain adaptation, transfer learning approach. DESIGN: Observational cohort study. SETTING: Two academic medical centers from January 2014 June 2017. PATIENTS: Data were analyzed 14,512 (9,423 at the development site 5,089 validation site) who admitted an met Center for Medicare Medicaid Services definition of severe either before or during stay....
Body temperature trajectories of infected patients are associated with specific immune profiles and survival. We determined the association between distinct manifestations coronavirus disease 2019.Retrospective observational study.Four hospitals within an academic healthcare system from March 2020 to February 2021.All adult hospitalized 2019.Using a validated group-based trajectory model, we classified into four previously defined subphenotypes using oral measurements first 72 hours...
OBJECTIVES: Significant practice variation exists in the amount of resuscitative IV fluid given to patients with sepsis. Current research suggests equipoise between a tightly restrictive or more liberal strategy but data is lacking on wider range resuscitation practices. We sought examine relationship wide practices and sepsis mortality then identify primary driver this variation. DESIGN: Retrospective analysis Premier Healthcare Database. SETTING: Six hundred twelve U.S. hospitals....
Importance Intravenous fluids are an essential part of treatment in sepsis, but there remains clinical equipoise on which type crystalloid to use sepsis. A previously reported sepsis subphenotype (ie, group D) has demonstrated a substantial mortality benefit from balanced crystalloids compared with normal saline. Objective To test the hypothesis that targeting patients D through electronic health record (EHR) alert will reduce 30-day inpatient mortality. Design, Setting, and Participants The...
Aims Currently, there is no effective resuscitative adjunct to fluid and blood products limit tissue injury for traumatic hemorrhagic shock. The objective of this study was investigate the role inhaled carbon monoxide (CO) inflammation injury, specifically mitochondrial damage, in experimental models hemorrhage resuscitation. Results Inhaled CO (250 ppm 30 minutes) protected against mortality severe murine shock resuscitation (HS/R) (20% vs. 80%; P<0.01). Additionally, limited development as...
IMPORTANCE: Progressive hypoxemia is the predominant mode of deterioration in COVID-19. Among measures, ratio Pa o 2 to F io (P/F ratio) has optimal construct validity but poor availability because it requires arterial blood sampling. Pulse oximetry reports oxygenation continuously (ratio Sp [S/F ratio]), affected by skin color and occult can occur Black patients. Oxygen dissociation curves allow noninvasive estimation P/F ratios (ePFRs) remain unproven. OBJECTIVES: Measure overt using ePFR....
To identify circumstances in which repeated measures of organ failure would improve mortality prediction ICU patients.Retrospective cohort study, with external validation a deidentified database.Eleven ICUs three university hospitals within an academic healthcare system 2014.Adults (18 yr old or older) who satisfied the following criteria: 1) two four systemic inflammatory response syndrome criteria plus ordered blood culture, all 24 hours hospital admission; and 2) admission for at least 2...
Abstract Introduction Tissue reperfusion following hemorrhagic shock may paradoxically cause tissue injury and organ dysfunction by mitochondrial free radical expression. Both nitrite carbon monoxide (CO) protect from this limiting radial production. We explored the effects of very small doses inhaled CO on in a porcine model shock. Methods Twenty pigs (mean wt. 30.6 kg, range 27.2 to 36.4 kg) had microdialysis catheters inserted muscle, peritoneum, liver measure lactate, pyruvate, glucose,...