A5028620802- Trauma and Emergency Care Studies
- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Respiratory Support and Mechanisms
- Trauma Management and Diagnosis
- Hernia repair and management
- Cardiac Structural Anomalies and Repair
- Disaster Response and Management
- Appendicitis Diagnosis and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Intestinal and Peritoneal Adhesions
- Congenital Diaphragmatic Hernia Studies
- Bariatric Surgery and Outcomes
- Nosocomial Infections in ICU
- Tracheal and airway disorders
- Clinical Nutrition and Gastroenterology
- Emergency and Acute Care Studies
- Atrial Fibrillation Management and Outcomes
- Inflammatory mediators and NSAID effects
- Diet and metabolism studies
- COVID-19 Clinical Research Studies
- Acute Kidney Injury Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Healthcare Decision-Making and Restraints
Oncology Hematology Care
2025
Brooke Army Medical Center
2015-2024
University of Cincinnati
2023-2024
University of Cincinnati Medical Center
2023-2024
Joint Base San Antonio
2020-2024
University of Maryland, Baltimore
2023
University of Maryland Medical Center
2023
Anne Arundel Medical Center
2023
Memorial Hospital
2023
Uniformed Services University of the Health Sciences
2022
There is a dearth of clinical data regarding the effect nonsteroidal anti-inflammatory drugs (NSAIDs) on long-bone fracture (LBF) healing in acute trauma setting. The orthopedic community believes that use NSAIDs postoperative period will result poor and increased infectious complications. We hypothesized that, first, NSAID would not increase nonunion/malunion infection rates after LBF. Second, we tobacco cause higher these complications.A retrospective study all patients with femur, tibia,...
Existing trials studying the use of Gastrografin for management adhesive small bowel obstruction (SBO) are limited by methodological flaws and sample sizes. We compared institutional protocols with without (GG), hypothesizing that a SBO protocol utilizing GG is associated lesser rates exploration, shorter length stay, fewer complications.A multi-institutional, prospective, observational study was performed on patients appropriate SBO. Exclusion criteria were internal/external hernia, signs...
Bariatric surgery induces significant weight loss, increases insulin sensitivity, and reduces mortality, but the underlying mechanisms are not clear. It was hypothesized that Roux-en-Y gastric bypass (RYGB) improves metabolic profile along with loss. The objective of this pilot study to evaluate changes in serum metabolites fatty acids (FA) at 2 weeks 6 months after RYGB.Serum samples were collected pre-surgery, post-surgery from 20 patients undergoing RYGB surgery. Serum non-esterified free...
BACKGROUND Rational development of technology for rapid control noncompressible torso hemorrhage (NCTH) requires detailed understanding what is bleeding. Our objectives were to describe the anatomic location truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS This a retrospective study adult trauma admitted four urban Level I centers Houston San Antonio metropolitan areas 2008 2012. Inclusion criteria include...
Right heart failure (RHF) is a common, yet difficult to manage, complication of severe acute respiratory distress syndrome requiring extracorporeal membrane oxygenation (ECMO) that associated with increased mortality. Reports the use percutaneous mechanical circulatory support devices for concurrent right and are limited. This series describes cannulation pulmonary artery conversion from veno-venous veno-pulmonary return ECMO in 21 patients who developed secondary RHF. All cannulated between...
<b><i>Background:</i></b> Extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are modalities used in critically ill patients suffering organ failure metabolic derangements. Although the effects of CRRT have been extensively studied, impact simultaneous ECMO is less well described. The purpose this study to evaluate incidence on outcomes receiving ECMO. <b><i>Methods:</i></b> A single center, retrospective...
Military experience has shown low-titer O whole blood (LTOWB) to be safe and beneficial in the resuscitation of hemorrhaging trauma patients. However, few civilian centers use LTOWB for resuscitation. We evaluated early safety a program at level 1 center.We retrospectively reviewed our registry from January 2018 June 2020 patients admitted shock (defined as ≥1 following: heart rate, >120 beats per minute; systolic pressure, <90 mm Hg; or index, >0.9) who received products within 24 hours....
With a relative shortage of type AB plasma, many centers have converted to A plasma for resuscitation patients whose blood is unknown. The goal this study determine outcomes trauma who received incompatible transfusions as part massive transfusion protocol (MTP). METHODS As an Eastern Association the Surgery Trauma multi-institutional trial, registry and bank data were collected from eight (age, ≥ 15 years) receiving emergency release MTPs January 2012 August 2016. Incompatible was defined...
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Abstract Low titer type O Rh‐D + whole blood (LTO WB) has become a first‐line resuscitation medium for hemorrhagic shock in many centers around the World. Showing early effectiveness on battlefield, LTO WB is used both pre‐hospital and in‐hospital settings traumatic non‐traumatic hemorrhage resuscitation. Starting 2018, San Antonio Whole Blood Collaborative worked to provide across Southwest Texas, initially form of remote damage control followed by trauma This program since expanded include...
BACKGROUND The American Association for the Surgery of Trauma (AAST) anatomic severity grading system adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate AAST ASBO using Eastern multi-institutional prospective observational study. METHODS Adults (age ≥ 18) with were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), laboratory tests (lactate, hemoglobin, creatinine, leukocytosis),...
OBJECTIVES: A significant proportion of patients with coronavirus disease 2019 requiring venovenous extracorporeal membrane oxygenation at our institution demonstrated heparin resistance, which in combination a shortage resulted the transition to argatroban or without aspirin as an alternative anticoagulation strategy. The optimal strategy for is unknown, and therefore, we sought evaluate efficacy safety this patient population. DESIGN: Retrospective cohort. SETTING: Single-center...
Background: Appropriate indications for resuscitative thoracotomy (RT) in an austere environment continue to evolve; the aim of this study was determine survival and analyze demographics survivors within U.S. military personnel undergoing RT. Methods: A retrospective review performed all soldiers who underwent theater during Operation Iraqi Freedom Enduring Freedom. After individualized review, patients extremis or lost pulses had their 10 minutes arrival emergency department were included....
Adenosine, lidocaine, and magnesium (ALM) is a cardioplegic agent shown to improve survival by improving cardiac function, tissue perfusion, coagulopathy in animal models of shock. We hypothesized prehospital ALM treatment hemorrhagic shock would compared current Tactical Combat Casualty Care (TCCC) resuscitation beyond the golden hour.Swine were randomized to: (1) TCCC, (2) 2 mL·kg vehicle control (VC), (3) + drip, (4) 4 5) delayed drip at 0.5 mL·kg·h, 6) mL/kg VC, 7) for 15 minutes 3...
BACKGROUND Coagulation monitoring capabilities during transport are limited. Thromboelastography (TEG) is a whole-blood clotting test measuring clot formation, stabilization, and fibrinolysis traditionally performed in laboratory. We evaluated new point-of-care TEG analyzer, 6s (Haemonetics, Braintree, MA), large animal model of combat-relevant trauma managed with extracorporeal life support ground high-altitude aeromedical evacuation. The objective was to compare used versus the predicate...
Abstract Introduction The use of extracorporeal membrane oxygenation (ECMO) for the care critically ill adult patients has increased over past decade. It been utilized in more austere locations, to include combat wounded. U.S. military established Acute Lung Rescue Team 2005 transport and unable be managed by standard medical evacuation resources. In 2012, expanded upon this capacity, establishing an ECMO program at Brooke Army Medical Center. To maintain currency, treats both civilian...
ABSTRACT Background The Critical Care Air Transport (CCAT) Advanced Course utilizes fully immersive high-fidelity simulations to assess personnel readiness for deployment. This study aims determine whether simple well-defined demographic identifiers can be used predict CCAT students’ performance at Advanced. Materials and Methods student survey data course status (pass/fail) between March 2006 April 2020 were analyzed. included Force Specialty Code (AFSC), military (active duty...
Diagnosis of lung injury requires invasive blood draws to measure oxygen tension in blood. This capability is nonexistent austere settings and during prolonged field care (PFC), that is, medical characterized by inability evacuate casualties from the point for up 72 hours. We analyzed pulse-oximeter-derived noninvasive SpO2 assessed SpO2/FiO2 ratio (SFR) as a surrogate PaO2/FiO2 (PFR), an accepted marker function. hypothesized SFR suitable PFR data set animal models combat-relevant trauma,...
Background : Enteral nutrition has been demonstrated to reduce ventilator days and the incidence of pneumonia, but safest route for providing enteral mechanically ventilated patients is unclear. Our objective was determine if there a difference between incidences microaspiration gastric secretions in fed via nasogastric tube vs postpyloric while undergoing rotational therapy acute respiratory distress syndrome (ARDS). Materials Methods Institutional review board approval obtained this...