A5056882428- Respiratory Support and Mechanisms
- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Sedative Agents
- Neuroscience of respiration and sleep
- Intensive Care Unit Cognitive Disorders
- Anesthesia and Pain Management
- Hemodynamic Monitoring and Therapy
- Obstructive Sleep Apnea Research
- Healthcare Technology and Patient Monitoring
- Airway Management and Intubation Techniques
- Healthcare Operations and Scheduling Optimization
- Non-Invasive Vital Sign Monitoring
- Surgical Simulation and Training
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Emergency and Acute Care Studies
- Cardiac Arrest and Resuscitation
- Nausea and vomiting management
- Opioid Use Disorder Treatment
- Epilepsy research and treatment
- Family and Patient Care in Intensive Care Units
- Phonocardiography and Auscultation Techniques
- Palliative Care and End-of-Life Issues
- Hospital Admissions and Outcomes
- Cardiovascular Syncope and Autonomic Disorders
- Tracheal and airway disorders
Roper St. Francis Healthcare
2016-2021
Lakeridge Health
2021
Trident Systems (United States)
2021
Jikei University School of Medicine
2020
Medtronic (United Kingdom)
2018
Leiden University Medical Center
2018
Inserm
2018
Université Libre de Bruxelles
2018
Indianapolis Zoo
2017
College of Charleston
1999-2017
BACKGROUND: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who likely to experience opioid-induced respiratory depression on the general care floor and may benefit from improved monitoring early intervention. The trial objective was derive validate risk prediction tool for receiving opioids, as detected by continuous pulse oximetry capnography monitoring. METHODS: PRediction of Opioid-induced Depression In monitored capnoGraphY...
In Brief BACKGROUND: The most serious complication of patient-controlled analgesia (PCA) is respiratory depression (RD). incidence RD in the literature derived from intermittent sampling pulse oximetry (Spo2) and rate defined as a deviation below an arbitrary threshold. METHODS: We monitored postsurgical patients hospital ward receiving morphine or meperidine PCA with continuous capnography. Nurses responding to audible monitor bedside alarms documented status interventions. RESULTS: A total...
In this prospective study, we evaluated the etiology of operating room (OR) delays in an academic institution, examined impact multidisciplinary strategies to improve OR efficiency, and established timing benchmarks for use future efficiency studies.OR times delay etiologies were collected 94 cases during initial phase study. Timing data analyzed, 2 wk awareness education was conducted nursing, surgical, anesthesia staff. After period, from 1787 cases, monthly reports listing individual case...
Abstract Objectives/Hypothesis: To determine the reliability and validity of drug‐induced sleep endoscopy (DISE) for patients undergoing surgery sleep‐disordered breathing (SDB). Study Design: Non‐randomized, prospective clinical trial. Methods: Patients with were evaluated multi‐level upper airway by awake to identify levels degree collapse. The a rating index was assessed comparing scores three blinded investigators. comparison from endoscopy; correlation between Apnea‐Hypopnea Index;...
Background While opioid use confers a known risk for respiratory depression, the incremental of in-hospital cardiopulmonary arrest, or resuscitation (CPRA) has not been studied. Our aim was to investigate prevalence, outcomes, and profile CPRA patients receiving opioids medications with central nervous system sedating side effects (sedatives). Methods A retrospective analysis adult inpatient discharges from 2008–2012 reported in Premier Database. Patients were grouped into four mutually...
BACKGROUND: Obstructive sleep apnea (OSA) patients are at increased risk for pulmonary and cardiovascular complications; perioperative mortality is unclear. This report analyzes cases submitted to the OSA Death Near Miss Registry, focusing on factors associated with poor outcomes after an OSA-related event. We hypothesized that more severe would be severity, less intense monitoring, higher cumulative opioid doses. METHODS: Inclusion criteria were age ≥18 years, diagnosed or suspected, event...
Continuous electronic monitoring of patient respiratory status frequently includes PetCO2 (end tidal CO2), RR (respiration rate), SpO2 (arterial oxygen saturation), and PR (pulse rate). Interpreting integrating these vital signs as numbers or waveforms is routinely done by anesthesiologists intensivists but challenging for clinicians in low acuity areas such medical wards, where continuous becoming more common place. We describe a heuristic algorithm that simplifies the interpretation four...
Opioid induced respiratory depression is a known cause of preventable death in hospitals. Medications with sedative properties additionally potentiate opioid-induced and effects, thereby elevating the risk for adverse events. The goal this study was to determine what specific factors increase in-hospital cardiopulmonary arrest (CPRA) medical surgical patients on opioid therapy.
BACKGROUND: The frequency and temporal distribution of postoperative respiratory depression (RD) events are not completely understood. This study determined the RD episodes in postsurgical patients continuously monitored by bedside capnography pulse oximetry. METHODS: was a post hoc subset enrolled PRediction Opioid-induced Depression In capnoGraphY (PRODIGY) trial from 2 sites United States. These had undergone continuous monitoring on general care wards. data were adjudicated for potential...
Importance Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by team remains elusive. Objective We evaluated impact of remote video auditing real-time provider feedback on compliance sign-in, time-out sign-out case turnover times. Design, setting Prospective, cluster randomised study in a 23-operating room (OR) suite. Participants Surgeons, anaesthesia providers, nurses support staff....
A new proportional-integral-derivative (PID) controller for the automated closed-loop delivery of atracurium was tested in 32 patients. Groups 8 patients received halothane, enflurane, isoflurane, or N2O/morphine anesthesia. After induction anesthesia with sodium thiopental 3-5 mg.kg-1, a bolus 0.2 mg.kg-1 delivered by controller; this followed an infusion calculated to maintain electromyogram (EMG) at setpoint 90% neuromuscular blockade. The average overshoot 10.1% and mean steady-state...
Purpose: "Code Blue" is a standard term used to alertt hospital staff that patient requires resuscitation. This study determined rates of survival from Code Blue events and the role opioids other factors on survival. Methods: Data derived medical records Pharmacy databases were analyzed for affecting Results: During 2006, code only discharge 25.9% 26.4%, respectively, involving cardiopulmonary resuscitation (CPR; N = 216). Survival not ultimately requiring CPR (N 77) higher, with 32.5%...
Despite the high incidence of respiratory depression on general care floor and evidence that continuous monitoring improves patient outcomes, cost–benefit pulse oximetry capnography patients remains unknown. This study modeled cost length stay savings, investment break-even point, likelihood savings for at risk depression. A decision tree model was created to compare intermittent versus monitoring. The utilized costs outcomes from PRediction Opioid-induced Depression In monitored by...
This study aimed to determine the potential cost-savings for implementing continuous vital sign monitoring in a hospital's medical-surgical units.A analysis was designed calculate an average-sized U.S. community hospital (153 total beds) over 1-year time horizon. Analysis parameters were extracted from national databases and previous studies that compared outcomes patients receiving (SpO2, HR, RR) or standard of care (intermittent measurements) units based on targeted literature review....
BACKGROUND: Sleep disorders affect up to 25% of the general population and are associated with increased risk adverse perioperative events. The key sleep medicine topics that most important for practice anesthesiology have not been well-defined. objective this study was determine high-priority should be included in education anesthesia residents based on insight experts fields medicine. METHODS: We conducted a prospective cross-sectional survey Delphi technique establish consensus...