A5011892177- Fungal Infections and Studies
- Antifungal resistance and susceptibility
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Respiratory Support and Mechanisms
- Actinomycetales infections and treatment
- Airway Management and Intubation Techniques
- Pancreatic and Hepatic Oncology Research
- COVID-19 Clinical Research Studies
- Cardiac Structural Anomalies and Repair
- SARS-CoV-2 and COVID-19 Research
- Nail Diseases and Treatments
- Intensive Care Unit Cognitive Disorders
- Hemodynamic Monitoring and Therapy
- Tracheal and airway disorders
- Disaster Response and Management
- Phytoplasmas and Hemiptera pathogens
- Ultrasound in Clinical Applications
- Respiratory viral infections research
- Infectious Diseases and Mycology
- Pleural and Pulmonary Diseases
- Sepsis Diagnosis and Treatment
- Foreign Body Medical Cases
- Abdominal Trauma and Injuries
- Minimally Invasive Surgical Techniques
University of Arizona
2016-2025
Methodist Richardson Medical Center
2024
Banner - University Medical Center Tucson
2014-2023
Arizona Science Center
2011
Southern Arizona VA Health Care System
2007-2008
Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal life support that augments oxygenation, ventilation and/or cardiac output via cannulae connected to circuit pumps blood through an oxygenator and back into the patient. ECMO has been used for decades cardiopulmonary disease refractory conventional therapy. While not robust, there are promising data use in acute hypoxemic respiratory failure, arrest, cardiogenic shock potential indications continue increase. This review...
We ventilated separately the right and left lungs of seven dogs having thoracotomies catheters in both lower lobe veins. Two hours after atrial injection oleic acid, shunt (Qs/QT) each increased from 0.10 to 0.47. Ten minutes positive end-expiratory pressure (PEEP) was 3 13 cmH2O one lung, mean lobar Qs/QT decreased 0.06 with no change its fraction pulmonary blood flow measured by microsphere techniques. At same time other 0.48. end expiration hilum then clamped, excised quickly frozen over...
Rationale: The use of neuromuscular blocking agents (NMBAs) has been shown to be valuable in improving successful tracheal intubation the operating room and emergency department. However, data on NMBA critically ill intensive care unit (ICU) patients are lacking. Furthermore, there no with video laryngoscopy.Objectives: To evaluate effect first-attempt success (FAS) ICU.Methods: Single-center observational study 709 consecutive intubated medical ICU a university center from January 1, 2012...
Rationale: Urgent tracheal intubation is performed frequently in intensive care units and incurs higher risk than when under more controlled circumstances. Video laryngoscopy may improve the chances of successful on first attempt; however, existing comparative data outcomes are limited.Objectives: To compare first-attempt success complication rates during using video compared with traditional direct a tertiary academic medical unit.Methods: We prospectively collected analyzed from continuous...
Airway management in the intensive care unit (ICU) is challenging, as many patients have limited physiologic reserve and are at risk for clinical deterioration if airway not quickly secured. In academic medical centers, ICU intubations often performed by trainees, making education paramount pulmonary critical trainees.To improve our we developed a comprehensive training program including an 11-month simulation-based curriculum. The curriculum emphasizes recognition of preparation potentially...
Rationale: Video laryngoscopy has overcome the need to align anatomic axes obtain a view of glottic opening place tracheal tube. However, despite this advantage, large number attempts are unsuccessful. There no existing data on characteristics in critically ill patients associated with failed first attempt at when using video laryngoscopy.Objectives: To identify first-attempt failure intubation intensive care unit (ICU).Methods: This is an observational study 906 consecutive intubated ICU...
ABSTRACT Coccidioidomycosis is a common cause of community-acquired pneumonia in areas the southwestern United States which disease endemic. Clinical presentations range from self-limited to severe disseminated disease. Therefore, early and accurate diagnosis essential ensure appropriate treatment monitoring. Currently available diagnostic tests have variable accuracy, particularly certain patient populations, new may offer improved accuracy for coccidioidomycosis. Serum samples 103 cases...
Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management critical in patients while on extracorporeal membrane oxygenation (ECMO) prevent thromboembolism and for the optimal functioning of circuit. We identified five with respiratory failure at our hospital managed ECMO last 2 years that were treated HIT. A brief clinical course their are discussed. also briefly review literature best evidence such patients.
Coccidioidomycosis is a common cause of community-acquired pneumonia in endemic areas the southwestern United States. Clinical presentations range from self-limited disease to severe, disseminated disease. As such, early and accurate diagnosis essential ensure appropriate treatment monitoring. Currently available diagnostic testing has variable accuracy, particularly certain patient populations, new tests may offer improved accuracy for coccidioidomycosis. Serum samples patients with...
Fungal antigen testing in immunosuppressed patients has emerged as a powerful diagnostic tool. Some assays are relatively nonspecific, and misinterpretation can have severe clinical consequences. Additionally, when new become commercially available it is important to evaluate the potential for cross reactivity. We recently observed several with positive (1→3)-β-D-glucan (BG) who were eventually diagnosed coccidioidomycosis endemic area of Tucson, Arizona. Although BG assay known detect...
Thrombosis within the membrane oxygenator (MO) during extracorporeal oxygenation (ECMO) can lead to sudden dysfunction with deleterious effects patient. The purpose of this study was identify predictors circuit exchange ECMO. This is a single-center, retrospective all patients who received ECMO at our institution from January 2010 December 2015. Changes in potential markers were compared on Day 3 vs. 0 before MO exchange. Of 150 ECMO, there 58 exchanges 35 patients. Mean duration 21.1...
Abstract Background How cigarette smoke (CS) and chronic obstructive pulmonary disease (COPD) affect severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection severity is controversial. We investigated the effects of COPD CS on expression SARS-CoV-2 entry receptor ACE2 in vivo patients controls CS-exposed mice, human bronchial epithelial cells vitro. Methods quantified: (1) protein levels by immunostaining ELISA, both and/or TMPRSS2 mRNA RT-qPCR two independent cohorts; (2) ELISA...
Revised and greatly expanded treatment guidelines for coccidioidomycosis were published last year by the Infectious Diseases Society of America. We have selected 4 questions that commonly arise in management patients suspected this disease which there remain divided opinions.
Cardiogenic shock and cardiac arrest are life-threatening emergencies that result in high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via peripheral cannulation is an option for patients who do not respond to conventional therapies. Left ventricular (LV) distention a major limitation with VA-ECMO thought contribute poor recovery the inability wean off VA-ECMO. We report on novel technique combines off-pump insertion of trans-apical LV venting cannula right...