Citations 32
854: VIRTUAL IS REALITY: IMPACT AND LOGISTICS OF TRANSITIONING POST-ICU CLINIC FROM IN-PERSON TO VIRTUAL
Johnson, Annie, Piche, Shannon L., Schmitt, Emily, Oeckler, Richard A. , Lehman, Lindsey, Lechner, Hannah, Burke, Sarah
Critical Care Medicine | December 16, 2021 | Volume: 50 | Issue: 1 | Pages: 422-422
Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients
Johnstone, Jennie , Meade, Maureen O. , Lauzier, François, Duan, Erick , Dionne, Joanna C. , Heels‐Ansdell, Diane , Thabane, Lehana , Lamarche, Daphnée , Zytaruk, Nicole , Mehta, Sangeeta , Dodek, Peter , McIntyre, Lauralyn , Karachi, Tim , Henderson, William R. , Wood, Gordon , Ovakim, Daniel , Herridge, Margaret S. , Granton, John , Wilcox, M. Elizabeth , Goffi, Alberto , Niven, Daniel J. , Lamontagne, François , D’Aragon, Frédérick , St.-Arnaud, Charles, Ball, Ian, Nagpal, Dave , Girard, Martin , Aslanian, Pierre, Charbonney, Emmanuel , Sligl, Wendy , Adhikari, Neill K. 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JAMA | September 21, 2021 | Volume: 326 | Issue: 11 | Pages: 1024
Etomidate Infusion for Ectopic Cushing Syndrome
Subat, Yosuf W., Oeckler, Richard A. , Nguyen, Kianna M.
TP140. TP140 THORACIC ONCOLOGY: SMALL CELL LUNG CANCER | May 4, 2021 | Volume: No volume available | Issue: No issue available | Pages: A4875-A4875
Awareness of the Post-Intensive Care Syndrome in the Primary Care Setting: A Cross-Sectional Study at a Large Academic Medical Center
Sanborn, D., Falde, Samuel , Colbenson, Gretchen A. , Johnson, Keely, Oeckler, Richard A. , Johnson, K., Moraes, Alice Gallo de , Johnson, A.
TP19. TP019 QUALITY, PROCESS, AND OUTCOMES IN ACUTE AND CRITICAL CARE | May 4, 2021 | Volume: No volume available | Issue: No issue available | Pages: A1695-A1695
The Impact of a Standardized Refractory Hypoxemia Protocol on Outcome of Subjects Receiving Venovenous Extracorporeal Membrane Oxygenation
Zhou, Yongfang , Holets, Steven R, Meyer, Todd J., Latuche, Laureano J Rangel, Oeckler, Richard A. , Bohman, J. Kyle , Rangel Latuche, Laureano J, Bohman, John K , Li, Man
Respiratory Care | March 2, 2021 | Volume: 66 | Issue: 5 | Pages: 837-844
BACKGROUND: Current mechanical ventilation practice and the use of treatment adjuncts in patients requiring extracorporeal membrane oxygenation (ECMO) for refractory hypoxemia (RH) vary widely and their impact on outcomes remains unclear. In 2015, we implemented a standardized approach to protocolized ventilator settings and guide the escalation of adjunct therapies in patients with RH. This study aimed to investigate ICU mortality, its associated risk factors, and mechanical ventilation practice before and after the implementation of a standardized RH guideline in patients requiring venovenous ECMO (VV-ECMO). METHODS: This was a single-center, retrospective cohort study of patients undergoing VV-ECMO due to RH respiratory failure between January 2008 and March 2015 (before RH protocol implementation) and between April 2015 and October 2019 (after RH protocol implementation). RESULTS: A total of 103 subjects receiving VV-ECMO for RH were analyzed. After implementation of the RH protocol, more subjects received prone positioning (6.7% vs 23.3%, P = .02), and fewer received high-frequency oscillatory ventilation than before launching the RH protocol (0% vs 13.3%, P = .01). Plateau pressure was also lower before initiation of ECMO ( P = .04) and at day 1 during ECMO ( P = .045). Driving pressure was consistently lower at days 1, 2, and 3 after ECMO initiation: median 13.0 (interquartile range [IQR] 10.6–18.0) vs 16.0 (IQR 14.0–20.0) cm H 2 O at day 1 ( P = .003); 13.0 (IQR 11.0–15.9) vs 15.5 (IQR 12.0–20.0) cm H 2 O at day 2 ( P = .03); and 12.0 (IQR 10.0–14.5) vs 15.0 (IQR 12.0–19.0) cm H 2 O at day 3 ( P = .005). CONCLUSIONS: The implementation of a standardized RH guideline improved compliance with a lung-protective ventilation strategy and utilization of the prone position and was associated with lower driving pressure during the first 3 days after ECMO initiation in subjects with refractory hypoxemia.
Patient-Ventilator Asynchrony in Critically-Ill Adult Patients Undergoing Invasive Mechanical Ventilation: Incidence, Risk Factors and Outcomes
Zhou, Yongfang , Holets, Steven R, Li, Man , Puentes, G.A. Cortes, Meyer, Todd J., Hanson, Andrew C. , Schulte, Phillip J. , Oeckler, Richard A.
No container title available | December 17, 2020 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Background: Patient-ventilator asynchrony (PVA) is commonly encountered during mechanical ventilation of critically ill patients. Estimates of PVA incidence vary widely. Type, risk factors, and consequences of PVA remain unclear. We aimed to measure the incidence and identify types of PVA, characterize risk factors for development, and explore the relationship between PVA and outcome among critically ill, mechanically ventilated adult patients admitted to medical, surgical, and medical-surgical intensive care units in a large academic institution staffed with varying provider training background.Methods: A single center, retrospective cohort study of all adult critically ill patients undergoing invasive mechanical ventilation for ≥12 hours.Results: A total of 676 patients who underwent 696 episodes of mechanical ventilation were included. Overall PVA occurred in 170 (24%) episodes. Double triggering 92(13%) was most common, followed by flow starvation 73(10%). A history of smoking, and pneumonia, sepsis, or ARDS were risk factors for overall PVA and double triggering (all P<0.05). Compared with volume targeted ventilation, pressure targeted ventilation decreased the occurrence of events (all P<0.01). During volume controlled synchronized intermittent mandatory ventilation and pressure targeted ventilation, ventilator settings were associated with the incidence of overall PVA. The number of overall PVA, as well as double triggering and flow starvation specifically, were associated with worse outcomes and fewer hospital-free days (all P<0.01).Conclusion: Double triggering and flow starvation are the most common PVA among critically ill, mechanically ventilated patients. Overall incidence as well as double triggering and flow starvation PVA specifically, portend worse outcome.
Dynamic Airway Driving Pressure and Mechanical Power Across the Lung and Respiratory System in Acute Respiratory Distress Syndrome (ARDS)
Falde, S., Holets, Steven R, Oeckler, Richard A. , Puentes, G.A. Cortes, Marini, John J.
B67. UNDERSTANDING LUNG INJURY: FROM GENE TO DYSFUNCTION | July 7, 2020 | Volume: No volume available | Issue: No issue available | Pages: A4100-A4100
A Closer Look at Mechanical Power: Secondary Analysis of the Individual Variables Contributing to the Risk for Ventilator-Induced Lung Injury (VILI)
Norton, Michelle, Oeckler, Richard A. , Puentes, G.A. Cortes, Norton, M.
B46. CRITICAL CARE: ALL THINGS ARDS | July 7, 2020 | Volume: No volume available | Issue: No issue available | Pages: A3525-A3525
Bedside Visualization of Heart-Lung Interactions by Speckle Tracking Echocardiography: A Tale of Two Hearts
Long, C., Moraes, Adriano, Lin, Guan‐Ling , Oeckler, Richard A. , Wiley, Brandon M.
B25. MECHANICAL VENTILATION AND ARDS: CLINICAL AND PHYSIOLOGICAL STUDIES | July 7, 2020 | Volume: No volume available | Issue: No issue available | Pages: A2886-A2886
Patient-Ventilator Asynchrony in Critically-Ill Adult Patients Undergoing Invasive Mechanical Ventilation: Incidence, Risk Factors and Outcomes
Zhou, Yongfang , Puentes, G.A. Cortes, Holets, Steven R, Li, Minling, Meyer, Thomas Joseph , Oeckler, Richard A. , Meyer, T.J.
B25. MECHANICAL VENTILATION AND ARDS: CLINICAL AND PHYSIOLOGICAL STUDIES | July 7, 2020 | Volume: No volume available | Issue: No issue available | Pages: A2872-A2872