A5077421035- Burn Injury Management and Outcomes
- Wound Healing and Treatments
- Poisoning and overdose treatments
- Antibiotics Pharmacokinetics and Efficacy
- Disaster Response and Management
- Trauma and Emergency Care Studies
- Cardiac Arrest and Resuscitation
- Antifungal resistance and susceptibility
- Antibiotic Resistance in Bacteria
- Injury Epidemiology and Prevention
- Drug-Induced Hepatotoxicity and Protection
- Human-Animal Interaction Studies
- Clinical Nutrition and Gastroenterology
- Pediatric Pain Management Techniques
- Pressure Ulcer Prevention and Management
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Sedative Agents
- Reconstructive Surgery and Microvascular Techniques
- Pneumonia and Respiratory Infections
- Planarian Biology and Electrostimulation
- Sepsis Diagnosis and Treatment
- Nosocomial Infections in ICU
- Antibiotic Use and Resistance
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Essential Oils and Antimicrobial Activity
United States Army Institute of Surgical Research
2017-2025
Uniformed Services University of the Health Sciences
2019-2023
Brooke Army Medical Center
2017-2020
Joint Base San Antonio
2019-2020
Urology San Antonio
2019
University of Maryland Medical Center
2017
University of Maryland, Baltimore
2017
Ketamine may be used to manage pain and agitation that is refractory what are usually considered traditional agents such as fentanyl, propofol, benzodiazepines, dexmedetomidine; however, literature describing the use of ketamine continuous infusions for this purpose in critically ill trauma patients limited.The primary objective study was determine impact initiation a infusion on sedative analgesic patients. Secondary objectives were identify patient population which initiated, assess...
Maintaining body temperature is a unique challenge with burn care. We sought to describe core goals in the operating room (OR) and methods used achieve maintain these goals, along current of warming intensive care unit (ICU), perception effect increased ambient on work performance, concerns contamination sterile fields due temperature. A 24 question survey was disseminated centers United States Canada. The questions included demographics, target temperatures, methods, beliefs temperature's...
Invasive fungal wound infection (FWI) after burn injury, while uncommon, is associated with significant morbidity and mortality. There are numerous risk factors for FWI, including large size incomplete excision of wounds. FWI can be challenging to diagnose. Close attention changes in the physical examination and, particular, appearance wounds leads team suspicious FWI. Once suspected, histopathological evaluation an incisional biopsy provides definitive diagnosis, tissue culture enables...
Background: Infection is common after burn injury and accounts for the most frequent complications of injury. This review describes effects on pharmacokinetics, focusing impact these changes antimicrobial therapy. Methods: The published literature pharmacokinetics pharmacodynamics in antibiotic use was reviewed. Results: Physiologic metabolic can alter pharmacokinetic parameters, leading to larger volumes distribution, faster hepatic metabolism, increased renal clearance. Changes may lead...
Severe burn injury involves widespread skin and tissue damage leading to systemic inflammation, hypermetabolism multi-organ failure. The hypermetabolic phase of has been associated with increased antibiotic clearance; however, critical illness in the absence may also induce similar physiologic changes. Continuous renal replacement therapy (CRRT) is often implemented critically ill patients affect clearance. Although pharmacokinetics (PK) meropenem described both non-burn populations, direct...
Critical illness caused by burn and sepsis is associated with pathophysiologic changes that may result in the alteration of pharmacokinetics (PK) antibiotics. However, it unclear if one mechanism critical alters PK more significantly than another. We developed a population model for piperacillin tazobactam (pip-tazo) using data from 19 critically ill patients (14 non-burn trauma 5 burn) treated Military Health System. A two-compartment best described pip-tazo data. There were no significant...
Abstract Patients who suffer hand burns are at a high contracture risk, partly due to numerous cutaneous functional units, or risk areas, located within the hand. undergo split-thickness skin grafting often immobilized postoperatively for graft protection. Recent practice our burn center includes an early range of motion (EROM) following limit unnecessary immobilization. The purpose this study was determine whether EROM is safe perform after and if there any clinical benefit. This...
Abstract Introduction Hydroxocobalamin is administered to patients after injures sustained during structure fires or in enclosed spaces. It unknown how the administration of hydroxocobalamin affects patient outcomes, however, there have been reports increased risk acute kidney injury (AKI). The purpose this study was determine population which and assess outcomes who receive medication ICU setting. Methods This a retrospective chart review that included all admitted burn between July 2016...
Critical Care Medicine: January 2020 - Volume 48 Issue 1 p 141 doi: 10.1097/01.ccm.0000619624.70007.14
1US Army Institute of Surgical Research, Fort Sam Houston, TX, 2N/A, Jbsa Ft 3Brooke Medical Center, JBSA TX
Abstract Introduction Patients who suffer hand burns are at a high risk for developing contractures, partly due to the presence of numerous cutaneous functional units, or contracture areas, located within hand. undergo split-thickness skin grafting (STSG) often immobilized post-operatively graft protection. Restricting mobility following STSG is thought protect against subdermal edema and shear forces, despite limited evidence. Early range motion (EROM) has been described previously. Recent...