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Regionalization of Critical Care in the United States: Current State and Proposed Framework From the Academic Leaders in Critical Care Medicine Task Force of the Society of Critical Care Medicine.

Sharon Leung, Stephen M Pastores, John M Oropello, Craig M Lilly, Samuel M Galvagno, Neeraj Badjatia, Judith Jacobi, Daniel L Herr, Jason David Oliveira, ,

<h4>Objectives</h4>The Society of Critical Care Medicine convened its Academic Leaders in Critical Care Medicine taskforce on February 22, 2016, during the 45th Critical Care Congress to develop a series of consensus papers with toolkits for advancing critical care organizations in North America. The goal of this article is to propose ... Read more >>

Crit Care Med (Critical care medicine)
[2022, 50(1):37-49]

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Evidence of SARS-CoV-2-Specific T-Cell-Mediated Myocarditis in a MIS-A Case.

Kevin M Vannella, Cihan Oguz, Sydney R Stein, Stefania Pittaluga, Esra Dikoglu, Arjun Kanwal, Sabrina C Ramelli, Thomas Briese, Ling Su, Xiaolin Wu, Marcos J Ramos-Benitez, Luis J Perez-Valencia, Ashley Babyak, Nu Ri Cha, Joon-Yong Chung, Kris Ylaya, Ronson J Madathil, Kapil K Saharia, Thomas M Scalea, Quincy K Tran, Daniel L Herr, David E Kleiner, Stephen M Hewitt, Luigi D Notarangelo, Alison Grazioli, Daniel S Chertow,

A 26-year-old otherwise healthy man died of fulminant myocarditis. Nasopharyngeal specimens collected premortem tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Histopathological evaluation of the heart showed myocardial necrosis surrounded by cytotoxic T-cells and tissue-repair macrophages. Myocardial T-cell receptor (TCR) sequencing revealed hyper-dominant clones with highly similar sequences ... Read more >>

Front Immunol (Frontiers in immunology)
[2021, 12:779026]

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Ultrasound-assisted catheter directed thrombolysis for pulmonary embolus during extracorporeal membrane oxygenation.

Douglas Tran, Nicole Hays, Aakash Shah, Chetan Pasrija, Rafael S Cires-Drouet, Shahab A Toursavadkohi, Michael A Mazzeffi, Daniel L Herr, Ronson J Madathil, James S Gammie, Bartley P Griffith, Kristopher B Deatrick, David J Kaczorowski,

<h4>Background</h4>Acute pulmonary embolism (PE) is the third most common cause of cardiovascular death. For patients who are hemodynamically unstable, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support has been shown to provide hemodynamic stability, and allow time for definitive treatment and recovery. Ultrasound-assisted catheter directed thrombolysis (USAT) has the potential to be ... Read more >>

J Card Surg (Journal of cardiac surgery)
[2021, 36(8):2685-2691]

Cited: 1 time

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Neurologic Outcomes After Extracorporeal Cardiopulmonary Resuscitation: Recent Experience at a Single High-Volume Center.

Jamie E Podell, Eric M Krause, Raymond Rector, Mubariz Hassan, Ashwin Reddi, Matthew N Jaffa, Nicholas A Morris, Daniel L Herr, Gunjan Y Parikh,

Extracorporeal cardiopulmonary resuscitation (ECPR)-veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory cardiac arrest-has grown rapidly, but its widespread adoption has been limited by frequent neurologic complications. With individual centers developing best practices, utilization may be increasing with an uncertain effect on outcomes. This study describes the recent ECPR experience at the ... Read more >>

ASAIO J (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2021, :]

Cited: 1 time

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Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019.

Jonathan H Chow, Ashish K Khanna, Shravan Kethireddy, David Yamane, Andrea Levine, Amanda M Jackson, Michael T McCurdy, Ali Tabatabai, Gagan Kumar, Paul Park, Ivy Benjenk, Jay Menaker, Nayab Ahmed, Evan Glidewell, Elizabeth Presutto, Shannon Cain, Naeha Haridasa, Wesley Field, Jacob G Fowler, Duy Trinh, Kathleen N Johnson, Aman Kaur, Amanda Lee, Kyle Sebastian, Allison Ulrich, Salvador Peña, Ross Carpenter, Shruti Sudhakar, Pushpinder Uppal, Benjamin T Fedeles, Aaron Sachs, Layth Dahbour, William Teeter, Kenichi Tanaka, Samuel M Galvagno, Daniel L Herr, Thomas M Scalea, Michael A Mazzeffi,

<h4>Background</h4>Coronavirus disease-2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk in critically ill patients. To our knowledge, no studies have evaluated whether aspirin use is associated with reduced risk of mechanical ventilation, intensive care unit (ICU) admission, and in-hospital mortality.<h4>Methods</h4>A retrospective, observational cohort study of adult patients admitted with ... Read more >>

Anesth Analg (Anesthesia and analgesia)
[2021, 132(4):930-941]

Cited: 104 times

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SARS-CoV-2 infection of the oral cavity and saliva.

Ni Huang, Paola Pérez, Takafumi Kato, Yu Mikami, Kenichi Okuda, Rodney C Gilmore, Cecilia Domínguez Conde, Billel Gasmi, Sydney Stein, Margaret Beach, Eileen Pelayo, Jose O Maldonado, Bernard A Lafont, Shyh-Ing Jang, Nadia Nasir, Ricardo J Padilla, Valerie A Murrah, Robert Maile, William Lovell, Shannon M Wallet, Natalie M Bowman, Suzanne L Meinig, Matthew C Wolfgang, Saibyasachi N Choudhury, Mark Novotny, Brian D Aevermann, Richard H Scheuermann, Gabrielle Cannon, Carlton W Anderson, Rhianna E Lee, Julie T Marchesan, Mandy Bush, Marcelo Freire, Adam J Kimple, Daniel L Herr, Joseph Rabin, Alison Grazioli, Sanchita Das, Benjamin N French, Thomas Pranzatelli, John A Chiorini, David E Kleiner, Stefania Pittaluga, Stephen M Hewitt, Peter D Burbelo, Daniel Chertow, , , Karen Frank, Janice Lee, Richard C Boucher, Sarah A Teichmann, Blake M Warner, Kevin M Byrd,

Despite signs of infection-including taste loss, dry mouth and mucosal lesions such as ulcerations, enanthema and macules-the involvement of the oral cavity in coronavirus disease 2019 (COVID-19) is poorly understood. To address this, we generated and analyzed two single-cell RNA sequencing datasets of the human minor salivary glands and gingiva ... Read more >>

Nat Med (Nature medicine)
[2021, 27(5):892-903]

Cited: 66 times

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Mortality Risk Assessment in COVID-19 Venovenous Extracorporeal Membrane Oxygenation.

Ali Tabatabai, Mira H Ghneim, David J Kaczorowski, Aakash Shah, Sagar Dave, Daniel J Haase, Roumen Vesselinov, Kristopher B Deatrick, Joseph Rabin, Ronald P Rabinowitz, Samuel Galvagno, James V O'Connor, Jay Menaker, Daniel L Herr, James S Gammie, Thomas M Scalea, Ronson J Madathil,

<h4>Background</h4>A life-threatening complication of coronavirus disease 2019 (COVID-19) is acute respiratory distress syndrome (ARDS) refractory to conventional management. Venovenous (VV) extracorporeal membrane oxygenation (ECMO) (VV-ECMO) is used to support patients with ARDS in whom conventional management fails. Scoring systems to predict mortality in VV-ECMO remain unvalidated in COVID-19 ARDS. This ... Read more >>

Ann Thorac Surg (The Annals of thoracic surgery)
[2021, 112(6):1983-1989]

Cited: 1 time

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Breathing Life Back Into the Kidney-Continuous Renal Replacement Therapy and Veno-Venous Extracorporeal Membrane Oxygenation.

Kristopher B Deatrick, Michael A Mazzeffi, Samuel M Galvagno, Kimberly Boswell, David J Kaczoroswki, Ronald P Rabinowitz, Ronson J Madathil, Christopher R Cornachione, Daniel L Herr, Thomas M Scalea, Jay Menaker,

The purpose of this study was to evaluate the incidence of continuous renal replacement therapy (CRRT) in patients supported with veno-venous extracorporeal membrane oxygenation (VV ECMO). Secondary outcomes included mortality and the need for hemodialysis on hospital discharge. We performed a retrospective cohort study of all patients admitted to a ... Read more >>

ASAIO J (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2021, 67(2):208-212]

Cited: 4 times

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Brain Histopathology of Adult Decedents After Extracorporeal Membrane Oxygenation.

Imad R Khan, Yang Gu, Benjamin P George, Laura Malone, Kyle S Conway, Fabienne Francois, Jack Donlon, Nadim Quazi, Ashwin Reddi, Cheng-Ying Ho, Daniel L Herr, Mahlon D Johnson, Gunjan Y Parikh,

<h4>Objective</h4>To test the hypothesis that brain injury is more common and varied in patients receiving extracorporeal membrane oxygenation (ECMO) than radiographically observed, we described neuropathology findings of ECMO decedents and associated clinical factors from 3 institutions.<h4>Methods</h4>We conducted a retrospective multicenter observational study of brain autopsies from adult ECMO recipients. Pathology ... Read more >>

Neurology (Neurology)
[2021, 96(9):e1278-e1289]

Cited: 1 time

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Intoxication and overdose should not preclude veno-venous extracorporeal membrane oxygenation.

Jason S Radowsky, Michael M Mazzeffi, K Barry Deatrick, Samuel M Galvagno, Brandon M Parker, Ali Tabatabai, Ronson J Madathil, David J Kaczorowski, Ronald P Rabinowitz, Daniel L Herr, Thomas Scalea, Jay Menaker,

<h4>Introduction</h4>Acute intoxication (AI) related morbidity and mortality are increasing in the United States. For patients with severe respiratory failure in the setting of an acute ingestion, veno-venous extracorporeal membrane oxygenation (VV ECMO) can provide salvage therapy. The purpose of this study was to evaluate outcomes in patients with overdose-related need ... Read more >>

Perfusion (Perfusion)
[2021, 36(8):839-844]

Cited: 1 time

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Outcomes of Venovenous Extracorporeal Membrane Oxygenation When Stratified by Age: How Old Is Too Old?

Kristopher B Deatrick, Michael A Mazzeffi, Samuel M Galvagno, Ronald B Tesoriero, David J Kaczoroswki, Daniel L Herr, Katelyn Dolly, Ronald P Rabinowitz, Thomas M Scalea, Jay Menaker,

The purpose of this study was to evaluate survival to hospital discharge for patients on venovenous extracorporeal membrane oxygenation (VV ECMO) when stratified by age. We performed a retrospective study at single, academic, tertiary care center intensive care unit for VV ECMO. All patients, older than 17 years of age, ... Read more >>

ASAIO J (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2020, 66(8):946-951]

Cited: 4 times

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Extracorporeal Membrane Oxygenation for COVID-19.

Zachary Sanford, Ronson J Madathil, Kristopher B Deatrick, Ali Tabatabai, Jay Menaker, Samuel M Galvagno, Michael A Mazzeffi, Joseph Rabin, Mehrdad Ghoreishi, Raymond Rector, Daniel L Herr, David J Kaczorowski,

Innovations (Phila) (Innovations (Philadelphia, Pa.))
[2020, 15(4):306-313]

Cited: 0 times

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Methylprednisolone may be associated with improved lung compliance in acute respiratory distress syndrome patients on veno-venous extracorporeal membrane oxygenation.

Ali Tabatabai, Jay Menaker, Edward Stene, Joseph A Kufera, Ronald P Rabinowitz, Zachary Kon, Daniel L Herr, Thomas M Scalea,

<h4>Introduction</h4>Methylprednisolone has been used for acute respiratory distress syndrome with variable results. Veno-venous extracorporeal membrane oxygenation use in acute respiratory distress syndrome has increased. Occasionally, both are used. We hypothesized that methylprednisolone could improve lung compliance and ease weaning from extracorporeal membrane oxygenation in acute respiratory distress syndrome patients.<h4>Methods</h4>We retrospectively ... Read more >>

Perfusion (Perfusion)
[2020, 35(6):515-520]

Cited: 1 time

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Clinical utility of venoarterial-extracorporeal membrane oxygenation (VA-ECMO) in patients with drug-induced cardiogenic shock: a retrospective study of the Extracorporeal Life Support Organizations' ECMO case registry.

Lindsay Weiner, Michael A Mazzeffi, Elizabeth Q Hines, David Gordon, Daniel L Herr, Hong K Kim,

<b>Background:</b> Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is increasingly utilized to treat severe or refractory drug-induced cardiovascular shock. There is limited evidence regarding VA-ECMO's clinical utility in poisoning. Therefore, we investigated the clinical benefit of VA-ECMO use in drug-induced cardiovascular shock using the Extracorporeal Life Support Organization (ELSO)'s ECMO case registry.<b>Methods:</b> The ... Read more >>

Clin Toxicol (Phila) (Clinical toxicology (Philadelphia, Pa.))
[2020, 58(7):705-710]

Cited: 5 times

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High-efficiency, high-flux in-line hemofiltration using a high blood flow extracorporeal circuit.

Alison Grazioli, Sanjeev R Shah, Joseph Rabin, Rashmikant Shah, Ronson J Madathil, Joshua D King, Laura DiChiacchio, Raymond P Rector, Kristopher B Deatrick, Zhongjun J Wu, Daniel L Herr,

The ability of current renal replacement therapy modalities to achieve rapid solute removal is limited by membrane surface area and blood flow rate. Extracorporeal membrane oxygenation offers high blood flow and hemodynamic support that may be harnessed to overcome limitations in traditional renal replacement therapy. Using an extracorporeal membrane oxygenation ... Read more >>

Perfusion (Perfusion)
[2020, 35(4):351-355]

Cited: 1 time

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Pilot study evaluating a non-titrating, weight-based anticoagulation scheme for patients on veno-venous extracorporeal membrane oxygenation.

Kristopher B Deatrick, Samuel M Galvagno, Michael A Mazzeffi, David J Kaczoroswki, Daniel L Herr, Raymond Rector, Eric Hochberg, Ronald P Rabinowitz, Thomas M Scalea, Jay Menaker,

<h4>Objective</h4>There is no universally accepted algorithm for anticoagulation in patients on veno-venous extracorporeal membrane oxygenation. The purpose of this pilot study was to compare a non-titrating weight-based heparin infusion to that of a standard titration algorithm.<h4>Methods</h4>We performed a prospective randomized non-blinded study of patients: Arm 1-standard practice of titrating heparin ... Read more >>

Perfusion (Perfusion)
[2020, 35(1):13-18]

Cited: 3 times

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Are Current Protein Recommendations for the Critically Ill Adequate for Patients on VV ECMO: Experience From a High-Volume Center.

Stacy L Pelekhaty, Samuel M Galvagno, James H Lantry, Katelyn N Dolly, Daniel L Herr, Zachary N Kon, Kristopher B Deatrick, Christopher R Cornachione, Thomas M Scalea, Jay Menaker,

<h4>Background</h4>The nutrition needs of patients requiring extracorporeal membrane oxygenation (ECMO) have not been established in the literature. The purpose of this study is to investigate if current protein recommendations are adequate to achieve nitrogen equilibrium in patients on venovenous ECMO (VV ECMO).<h4>Methods</h4>Patients aged ≥18 years on VV ECMO admitted November ... Read more >>

JPEN J Parenter Enteral Nutr (JPEN. Journal of parenteral and enteral nutrition)
[2020, 44(2):220-226]

Cited: 0 times

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Workforce, Workload, and Burnout Among Intensivists and Advanced Practice Providers: A Narrative Review.

Stephen M Pastores, Vladimir Kvetan, Craig M Coopersmith, J Christopher Farmer, Curtis Sessler, John W Christman, Rhonda D'Agostino, Jose Diaz-Gomez, Sara R Gregg, Roozehra A Khan, April N Kapu, Henry Masur, Gargi Mehta, Jason Moore, John M Oropello, Kristen Price, ,

OBJECTIVES:To assess-by literature review and expert consensus-workforce, workload, and burnout considerations among intensivists and advanced practice providers. DESIGN:Data were synthesized from monthly expert consensus and literature review. SETTING:Workforce and Workload section workgroup of the Academic Leaders in Critical Care Medicine Task Force. MEASUREMENTS AND MAIN RESULTS:Multidisciplinary care teams led by ... Read more >>

Crit Care Med (Critical care medicine)
[2019, 47(4):550-557]

Cited: 18 times

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Veno-Venous Extracorporeal Membrane Oxygenation for Respiratory Failure: How Long Is Too Long?

Jay Menaker, Ronald P Rabinowitz, Ali Tabatabai, Ronald B Tesoriero, Katelyn Dolly, Christopher Cornachione, Edward Stene, Jessica Buchner, Joseph Kufera, Zachary N Kon, Kristopher B Deatrick, Daniel L Herr, James V O'Connor, Thomas M Scalea,

The use of veno-venous extracorporeal membrane oxygenation (VV ECMO) in adults with respiratory failure has steadily increased during the past decade. Recent literature has demonstrated variable outcomes with the use of extended ECMO. The purpose of this study is to evaluate survival to hospital discharge in patients with extended ECMO ... Read more >>

ASAIO J (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2019, 65(2):192-196]

Cited: 4 times

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Ambulation With Femoral Arterial Cannulation Can Be Safely Performed on Venoarterial Extracorporeal Membrane Oxygenation.

Chetan Pasrija, Kristen M Mackowick, Maxwell Raithel, Douglas Tran, Francesca M Boulos, Kristopher B Deatrick, Michael A Mazzeffi, Raymond Rector, Si M Pham, Bartley P Griffith, Daniel L Herr, Zachary N Kon,

<h4>Background</h4>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support can be associated with significant deconditioning due to the requirement for strict bedrest as a result of femoral arterial cannulation. To address this issue, we evaluated our experience with ambulation in patients with peripheral femoral cannulation for VA-ECMO.<h4>Methods</h4>All patients that were peripherally cannulated for ... Read more >>

Ann Thorac Surg (The Annals of thoracic surgery)
[2019, 107(5):1389-1394]

Cited: 5 times

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Nitrogen Balance During Venovenous Extracorporeal Membrane Oxygenation Support: Preliminary Results of a Prospective, Observational Study.

Stacy Pelekhaty, Samuel M Galvagno, Eric Hochberg, Daniel L Herr, James H Lantry, Zachary N Kon, Kristopher B Deatrick, Jay Menaker,

<h4>Background</h4>Current literature is insufficient to support specific guidelines for estimating nutrition needs during extracorporeal membrane oxygenation (ECMO). The purpose of this single-center observational study was to investigate protein catabolism during venovenous (VV) ECMO support and assess whether current nutrition recommendations were adequate.<h4>Methods</h4>All patients admitted to the Lung Rescue Unit between ... Read more >>

JPEN J Parenter Enteral Nutr (JPEN. Journal of parenteral and enteral nutrition)
[2020, 44(3):548-553]

Cited: 1 time

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Critical Care Organizations: Building and Integrating Academic Programs.

Jason E Moore, John M Oropello, Daniel Stoltzfus, Henry Masur, Craig M Coopersmith, Joseph Nates, Christopher Doig, John Christman, R Duncan Hite, Derek C Angus, Stephen M Pastores, Vladimir Kvetan, ,

OBJECTIVE:Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. ... Read more >>

Crit Care Med (Critical care medicine)
[2018, 46(4):e334-e341]

Cited: 5 times

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Utilization of Veno-Arterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism.

Chetan Pasrija, Anthony Kronfli, Praveen George, Maxwell Raithel, Francesca Boulos, Daniel L Herr, James S Gammie, Si M Pham, Bartley P Griffith, Zachary N Kon,

<h4>Background</h4>The management of massive pulmonary embolism remains challenging, with a considerable mortality rate. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for massive pulmonary embolism has been reported, its use as salvage therapy has been associated with poor outcomes. We reviewed our experience utilizing an aggressive, protocolized approach of VA-ECMO to triage, ... Read more >>

Ann Thorac Surg (The Annals of thoracic surgery)
[2018, 105(2):498-504]

Cited: 17 times

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Incidence of Cannula-Associated Deep Vein Thrombosis After Veno-Venous Extracorporeal Membrane Oxygenation.

Jay Menaker, Ali Tabatabai, Raymond Rector, Katelyn Dolly, Joseph Kufera, Eugenia Lee, Zachary Kon, Pablo Sanchez, Si Pham, Daniel L Herr, Michael Mazzeffi, Ronald P Rabinowitz, James V O'Connor, Deborah M Stein, Thomas M Scalea,

Limited literature regarding the incidence of cannula-associated deep vein thrombosis (CaDVT) after veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty-eight patients were admitted between August 2014 and January 2016 to ... Read more >>

ASAIO J (ASAIO journal (American Society for Artificial Internal Organs : 1992))
[2017, 63(5):588-591]

Cited: 16 times

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The lung rescue unit-Does a dedicated intensive care unit for venovenous extracorporeal membrane oxygenation improve survival to discharge?

Jay Menaker, Katelyn Dolly, Raymond Rector, Joseph Kufera, Eugenia E Lee, Ali Tabatabai, Ronald P Rabinowitz, Zachary N Kon, Pablo Sanchez, Si Pham, Daniel L Herr, James V O'Connor, Deborah M Stein, Thomas M Scalea,

<h4>Background</h4>The use of venovenous extra corporeal membrane oxygenation (VV ECMO) for acute respiratory failure (ARF)/acute respiratory (ARDS) has increased since 2009. Specialized units for patients requiring VV ECMO are not standard and patients are often cohorted with other critically ill patients. The purpose of this study was to report the ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2017, 83(3):438-442]

Cited: 9 times

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