A5040757935- Intensive Care Unit Cognitive Disorders
- Nosocomial Infections in ICU
- Pharmaceutical Practices and Patient Outcomes
- Anesthesia and Sedative Agents
- Sepsis Diagnosis and Treatment
- Clinical Nutrition and Gastroenterology
- Respiratory Support and Mechanisms
- Electrolyte and hormonal disorders
- Cholinesterase and Neurodegenerative Diseases
- Venous Thromboembolism Diagnosis and Management
- Cardiac, Anesthesia and Surgical Outcomes
- Patient Safety and Medication Errors
- Antibiotic Use and Resistance
- Atrial Fibrillation Management and Outcomes
- Cardiac Arrest and Resuscitation
- Healthcare Decision-Making and Restraints
- Anesthesia and Neurotoxicity Research
- Pharmaceutical studies and practices
- Family and Patient Care in Intensive Care Units
- Alcoholism and Thiamine Deficiency
- Poisoning and overdose treatments
- Hemodynamic Monitoring and Therapy
- Liver Disease and Transplantation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Antifungal resistance and susceptibility
University of Colorado System
2012-2025
University of Colorado Anschutz Medical Campus
2016-2025
University of Colorado Denver
2012-2025
University of Montana
2012-2024
American College of Clinical Pharmacy
2020-2023
University of North Carolina at Pembroke
2020-2023
University of Colorado Hospital
2002-2023
Iowa City Public Library
2022-2023
Indianapolis Zoo
2020
The Medical Center of Aurora
2018-2019
<h3>Importance</h3> Histamine-2 receptor antagonists (H<sub>2</sub>RAs) and proton pump inhibitors (PPIs) are commonly used to prevent gastrointestinal tract (GI) hemorrhage in critically ill patients. The stronger acid suppression of PPIs may reduce the rate bleeding but enhance infectious complications, specifically pneumonia and<i>Clostridium difficile</i>infection (CDI). <h3>Objective</h3> To evaluate occurrence risk factors for GI hemorrhage, pneumonia, CDI <h3>Design, Setting,...
Nosocomial infections caused by Pseudomonas aeruginosa in critically ill patients are often difficult to treat due resistance multiple antimicrobials. The purpose of this study was evaluate antimicrobial among P. isolates from intensive care unit the United States 1993 2002 using Intensive Care Unit Surveillance Study database. Over 10-year period, susceptibility 13,999 nonduplicate analyzed. From 2002, nationwide increases were greatest for ciprofloxacin, imipenem, tobramycin, and...
To determine whether the absence or presence of clinical pharmacists in intensive care units (ICUs) results differences mortality rates, length ICU stay, and charges for Medicare patients with nosocomial-acquired infections, community-acquired sepsis.The type level pharmacy services provided to ICUs were obtained from a 2004 national survey. Clinical defined as having at least partial pharmacist full-time equivalent specifically devoted purpose direct involvement patient care. Infections...
Extracorporeal treatments (ECTRs), such as hemodialysis and hemoperfusion, are used in poisoning despite a lack of controlled human trials demonstrating efficacy. To provide uniform recommendations, the EXTRIP group was formed an international collaboration among recognized experts from nephrology, clinical toxicology, critical care, or pharmacology supported by over 30 professional societies. For every poison, benefit ECTR is weighed against associated complications, alternative therapies,...
Objectives: To provide a multiorganizational statement to update recommendations for critical care pharmacy practice and make future practice. A position paper outlining pharmacist activities was last published in 2000. Since that time, significant changes healthcare have occurred. Design: The Society of Critical Care Medicine, American College Clinical Pharmacy Practice Research Network, the Health-Systems Pharmacists convened joint task force 15 pharmacists representing broad cross-section...
RATIONALE: Critically ill adults can develop stress-related mucosal damage from gastrointestinal hypoperfusion and reperfusion injury, predisposing them to clinically important upper bleeding (UGIB). OBJECTIVES: The objective of this guideline was evidence-based recommendations for the prevention UGIB in ICU. DESIGN: A multiprofessional panel 18 international experts dietetics, critical care medicine, nursing, pharmacy, two methodologists developed alignment with Grading Recommendations,...
Background: The purpose of this study is to evaluate erythromycin vs metoclopramide for facilitating gastric emptying and tolerance intragastric enteral nutrition (EN). Methods: Twenty critically ill patients with a residual >150 mL while receiving EN were randomized receive 4 intravenous doses 250 mg or 10 mg, each administered every 6 hours. Acetaminophen 975 was enterally at baseline after the fourth dose. peak plasma concentration (Cmax), 60 minutes (C ), time Cmax (Tmax), area under...
To assess the effects of clinical pharmacist participation in care critically ill Medicare patients with thromboembolic or infarction-related events (TIE) on and economic outcomes.In this retrospective database review (September 1, 2004-August 31, 2005), patient data were retrieved from 2004 Expanded Modified Provider Analysis Review database. Outcomes evaluated included mortality rates, length intensive unit (ICU) stay, total charges, drug laboratory rates bleeding complications. In...
To evaluate dexmedetomidine as adjunctive therapy to lorazepam for severe alcohol withdrawal.Prospective, randomized, double-blind, placebo-controlled trial.Single center; medical ICU.Twenty-four adult patients with a Clinical Institute Withdrawal Assessment score greater than or equal 15 despite 16 mg of over 4-hour period.Patients received symptom-triggered protocol and were randomized 1.2 μg/kg/hr (high dose), 0.4 (low placebo up 5 days resolution withdrawal symptoms.High-dose low-dose...
Abstract Introduction Intravenous (IV) voriconazole is not recommended in patients with creatinine clearance <50 ml/min to avoid potentially toxic accumulation of sulfobutylether-β-cyclodextrin (SBECD). The purpose this study was evaluate the pharmacokinetics SBECD, voriconazole, and N-oxide critically ill undergoing continuous renal replacement therapy (CRRT) determine if CRRT removes SBECD sufficiently allow for use IV without significant risk accumulation. Methods This prospective,...
Therapeutic drug monitoring (TDM) aims to minimize the clinical impact of posaconazole and voriconazole pharmacokinetic variability. However, its benefits on outcomes are still being defined. Additionally, TDM data limited for IV delayed-release tablet formulations among specific patient populations, including critically ill. The aim this study was determine percentage therapeutic levels across all in a real-world setting elucidate factors affecting attainment target concentrations.This...
Involvement of clinical pharmacists in the ICU attenuates costs, avoids adverse drug events, and reduces morbidity mortality. This survey assessed services activities pharmacists.A 27-question, pretested survey.1,220 U.S. institutions.Critical care pharmacists.Electronic questionnaire pharmacy across practice, education, scholarship, administration.A total 401 (response rate 35.4%) surveys representing 493 ICUs were completed. Median daily census was 12 (interquartile range, 6-20) beds with...
Objectives: To develop the first core Critical Care Data Dictionary (C2D2) with common data elements (CDEs) to characterize critical illness and injuries. Design: Group consensus process using modified Delphi approach. Setting: Electronic surveys in-person meetings. Subjects: A multidisciplinary workgroup of clinicians researchers expertise in care critically ill injured. Interventions: The was divided into domain CDE portions each composed two item generation rounds one reduction/refinement...
To compare empiric and protocol-based therapies of sedation analgesia in terms pharmacologic cost, effects on mechanical ventilation intensive care unit (ICU) stay, quality analgesia.Prospective study.A 24-bed medical-surgical-neurologic ICU.Seventy-two patients evaluated during therapy 86 therapy.Assessment data collected for 4 months before 5 after an evidence-based protocol was implemented.Protocol adherence rate 83.7%. The hourly cost (Canadian dollars) less with ($5.68 +/- 4.27 vs $7.69...
Objective: To evaluate the comparative efficacy of enteral cisapride, metoclopramide, erythromycin, and placebo for promoting gastric emptying in critically ill patients with intolerance to nutrition (EN). Design: A randomized, crossover study. Setting: Adult medical intensive care unit at a university-affiliated private hospital trauma university teaching hospital. Patients: Ten adult, ill, mechanically ventilated not tolerating fiber-containing EN product defined as single aspirated...
Background: Administration of gastric enteral nutrition (EN) in the intensive care unit (ICU) is commonly impeded by high residual volumes (GRV). This study evaluated emptying patients with limited GRV (tolerant group) vs ≥150 mL (intolerant and whether prokinetic therapy improves motility intolerant patients. Methods: To assess motility, mechanically ventilated received acetaminophen 975 mg, peak plasma concentration (Cmax), at 60 minutes (C ), time to Cmax (Tmax), area under...