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Author Theodore J Iwashyna

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Transitions of Care After Critical Illness-Challenges to Recovery and Adaptive Problem Solving.

Kimberley J Haines, Elizabeth Hibbert, Nina Leggett, Leanne M Boehm, Tarli Hall, Rita N Bakhru, Anthony J Bastin, Brad W Butcher, Tammy L Eaton, Wendy Harris, Aluko A Hope, James Jackson, Annie Johnson, Janet A Kloos, Karen A Korzick, Pamela Mactavish, Joel Meyer, Ashley Montgomery-Yates, Tara Quasim, Andrew Slack, Dorothy Wade, Mary Still, Giora Netzer, Ramona O Hopkins, Theodore J Iwashyna, Mark E Mikkelsen, Joanne McPeake, Carla M Sevin, ,

<h4>Objectives</h4>Investigate the challenges experienced by survivors of critical illness and their caregivers across the transitions of care from intensive care to community, and the potential problem-solving strategies used to navigate these challenges.<h4>Design</h4>Qualitative design-data generation via interviews and data analysis via the framework analysis method.<h4>Setting</h4>Patients and caregivers from three continents, identified ... Read more >>

Crit Care Med (Critical care medicine)
[2021, 49(11):1923-1931]

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Extracorporeal membrane oxygenation for COVID-19: evolving outcomes from the international Extracorporeal Life Support Organization Registry.

Ryan P Barbaro, Graeme MacLaren, Philip S Boonstra, Alain Combes, Cara Agerstrand, Gail Annich, Rodrigo Diaz, Eddy Fan, Katarzyna Hryniewicz, Roberto Lorusso, Matthew L Paden, Christine M Stead, Justyna Swol, Theodore J Iwashyna, Arthur S Slutsky, Daniel Brodie, ,

<h4>Background</h4>Over the course of the COVID-19 pandemic, the care of patients with COVID-19 has changed and the use of extracorporeal membrane oxygenation (ECMO) has increased. We aimed to examine patient selection, treatments, outcomes, and ECMO centre characteristics over the course of the pandemic to date.<h4>Methods</h4>We retrospectively analysed the Extracorporeal Life ... Read more >>

Lancet (Lancet (London, England))
[2021, 398(10307):1230-1238]

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Hospital-specific Template Matching for Benchmarking Performance in a Diverse Multihospital System.

Brenda M Vincent, Daniel Molling, Gabriel J Escobar, Timothy P Hofer, Theodore J Iwashyna, Vincent X Liu, Amy K Rosen, Andrew M Ryan, Sarah Seelye, Wyndy L Wiitala, Hallie C Prescott,

<h4>Background</h4>Hospital-specific template matching is a newer method of hospital performance measurement that may be fairer than regression-based benchmarking. However, it has been tested in only limited research settings.<h4>Objective</h4>The objective of this study was to test the feasibility of hospital-specific template matching assessments in the Veterans Affairs (VA) health care system ... Read more >>

Med Care (Medical care)
[2021, :]

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Racial Bias in Pulse Oximetry Measurement Among Patients About to Undergo ECMO in 2019-2020, A Retrospective Cohort Study.

Valeria S M Valbuena, Ryan P Barbaro, Dru Claar, Thomas S Valley, Robert P Dickson, Steven E Gay, Michael W Sjoding, Theodore J Iwashyna,

<h4>Background</h4>Pulse oximeters may be less accurate in non-White patients.<h4>Research question</h4>Do pulse oximeter less effectively detect arterial hypoxemia in Black, Hispanic, and/or Asian patients than in White patients in respiratory failure about to initiate Extracorporeal Membrane Oxygenation (ECMO)?<h4>Study design and methods</h4>Extracorporeal Life Support Organization (ELSO) Registry of adult patients with respiratory ... Read more >>

Chest (Chest)
[2021, :]

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Temporal Trends and Hospital Variation in Time-to-Antibiotics Among Veterans Hospitalized With Sepsis.

Max T Wayne, Sarah Seelye, Daniel Molling, Xiao Qing Wang, John P Donnelly, Cainnear K Hogan, Makoto M Jones, Theodore J Iwashyna, Vincent X Liu, Hallie C Prescott,

<h4>Importance</h4>It is unclear whether antimicrobial timing for sepsis has changed outside of performance incentive initiatives.<h4>Objective</h4>To examine temporal trends and variation in time-to-antibiotics for sepsis in the US Department of Veterans Affairs (VA) health care system.<h4>Design, setting, and participants</h4>This observational cohort study included 130 VA hospitals from 2013 to 2018. Participants ... Read more >>

JAMA Netw Open (JAMA network open)
[2021, 4(9):e2123950]

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Continuing Cardiopulmonary Symptoms, Disability, and Financial Toxicity 1 Month After Hospitalization for Third-Wave COVID-19: Early Results From a US Nationwide Cohort.

Theodore J Iwashyna, Lee A Kamphuis, Stephanie J Gundel, Aluko A Hope, Sarah Jolley, Andrew J Admon, Ellen Caldwell, Max L Monahan, Katherine Hauschildt, B Taylor Thompson, Catherine L Hough, ,

<h4>Background</h4>Patients discharged after COVID-19 report ongoing needs.<h4>Objectives</h4>To measure incident symptoms after COVID-19 hospitalization.<h4>Design, setting, and participants</h4>Preplanned early look at 1-month follow-up surveys from patients hospitalized August 2020 to January 2021 in NHLBI PETAL Network's Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. English- or Spanish-speaking hospitalized adults without substantial ... Read more >>

J Hosp Med (Journal of hospital medicine)
[2021, :]

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The impact of distance on post-ICU disability.

Jack D'Arcy, Kimberley Haines, Eldho Paul, Zakary Doherty, Andrew Goodwin, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J Gabbe, Alisa M Higgins, Theodore J Iwashyna, Lynne J Murray, Paul S Myles, Jennie Ponsford, David Pilcher, Andrew A Udy, Craig Walker, Meredith Young, D J Jamie Cooper, Carol L Hodgson, ,

<h4>Background</h4>Nonurban residential living is associated with adverse outcomes for a number of chronic health conditions. However, it is unclear what effect it has amongst survivors of critical illness.<h4>Objectives</h4>The purpose of this study is to determine whether patients living greater than 50 km from the treating intensive care unit (ICU) have ... Read more >>

Aust Crit Care (Australian critical care : official journal of the Confederation of Australian Critical Care Nurses)
[2021, :]

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Multimorbidity and Its Relationship With Long-Term Outcomes After Critical Care Discharge: A Prospective Cohort Study.

Joanne McPeake, Tara Quasim, Philip Henderson, Alastair H Leyland, Nazir I Lone, Matthew Walters, Theodore J Iwashyna, Martin Shaw,

<h4>Background</h4>Survivors of critical illness have poor long-term outcomes with subsequent increases in health care utilization. Less is known about the interplay between multimorbidity and long-term outcomes.<h4>Research question</h4>How do baseline patient demographics impact mortality and health care utilization in the year after discharge from critical care?<h4>Study design and methods</h4>Using data from ... Read more >>

Chest (Chest)
[2021, :]

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Long term outcomes following critical care hospital admission: A prospective cohort study of UK biobank participants✰,★.

Joanne McPeake, Theodore J Iwashyna, Philip Henderson, Alastair H Leyland, Daniel Mackay, Tara Quasim, Matthew Walters, Michael Harhay, Martin Shaw,

<h4>Background</h4>: This study aimed to understand the impact of a critical care admission on long-term outcomes, compared to other hospitalised patients without a critical care encounter. A secondary aim was to examine the interrelationship between emotional, physical, and social problems during recovery.<h4>Methods</h4>: We utilised data from the UK Biobank, an ... Read more >>

Lancet Reg Health Eur (The Lancet regional health. Europe)
[2021, 6:100121]

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Post-intensive care syndrome following cardiothoracic critical care: Feasibility of a complex intervention.

Philip Henderson, Tara Quasim, Annette Asher, Lucy Campbell, Malcolm Daniel, Lisa Davey, Helen Devine, Martyn Gall, Pamela Mactavish, Karen Mcgroarty, Fiona Nolan, Colin Purdie, Isma Quasim, John Sharp, Martin Shaw, Theodore J Iwashyna, Joanne McPeake,

<h4>Objectives</h4>To describe the long-term outcomes of cardiac intensive care unit patients and their primary caregivers, and to explore the feasibility of implementing a complex intervention, designed to support problems associated with post-intensive care syndrome and post-intensive care syndrome-family, in the year following discharge from the cardiac intensive care unit.<h4>Design</h4>A complex ... Read more >>

J Rehabil Med (Journal of rehabilitation medicine)
[2021, 53(6):jrm00206]

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Scarce Resource Allocation in a Pandemic: A Protocol to Promote Equity, Timeliness, and Transparency.

Julia F Lynch, Isabel M Perera, Theodore J Iwashyna,

Shortages of equipment, medication, and staff under coronavirus disease 2019 may force hospitals to make wrenching decisions. Although bioethical guidance is available, published procedures for decision-making processes to resolve the time-sensitive conflicts are rare. Failure to establish decision-making procedures before scarcities arise exposes clinicians to moral distress and potential legal ... Read more >>

Crit Care Explor (Critical care explorations)
[2021, 3(6):e0466]

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Short-term health-related quality of life, physical function and psychological consequences of severe COVID-19.

Luca Carenzo, Alessandro Protti, Francesca Dalla Corte, Romina Aceto, Giacomo Iapichino, Angelo Milani, Alessandro Santini, Chiara Chiurazzi, Michele Ferrari, Enrico Heffler, Claudio Angelini, Alessio Aghemo, Michele Ciccarelli, Arturo Chiti, Theodore J Iwashyna, Margaret S Herridge, Maurizio Cecconi, ,

<h4>Background</h4>Survivors of severe COVID-19 are at risk of impaired health-related quality of life (HRQoL) and persistent physical and psychological disability after ICU and hospital discharge. The subsequent social burden is a major concern. We aimed to assess the short-term HRQoL, physical function and prevalence of post-traumatic stress symptoms of invasively ... Read more >>

Ann Intensive Care (Annals of intensive care)
[2021, 11(1):91]

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Exploring the process of information sharing in an adult intensive care unit: an ethnographic study.

Emily M Boltey, Nathan Wright, Elizabeth A Mosley, Matthew R White, Theodore J Iwashyna, Milisa Manojlovich, Deena Kelly Costa,

Information sharing, a component of patient and family engagement (PFE), is an important process that may contribute to intensive care unit (ICU) quality of care. Yet, virtually no studies explore how the process of information sharing unfolds in the ICU from the interprofessional team and family member perspectives. To better ... Read more >>

J Interprof Care (Journal of interprofessional care)
[2021, :1-8]

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Optimizing Critical Illness Recovery: Perspectives and Solutions From the Caregivers of ICU Survivors.

Carla M Sevin, Leanne M Boehm, Elizabeth Hibbert, Anthony J Bastin, James C Jackson, Joel Meyer, Tara Quasim, Rita N Bakhru, Ashley Montgomery-Yates, Andrew Slack, Mary Still, Giora Netzer, Mark E Mikkelsen, Theodore J Iwashyna, Kimberley J Haines, Joanne McPeake,

<h4>Objectives</h4>To understand the unmet needs of caregivers of ICU survivors, how they accessed support post ICU, and the key components of beneficial ICU recovery support systems as identified from a caregiver perspective.<h4>Design</h4>International, qualitative study.<h4>Subjects</h4>We conducted 20 semistructured interviews with a diverse group of caregivers in the United States, the United ... Read more >>

Crit Care Explor (Critical care explorations)
[2021, 3(5):e0420]

Cited: 1 time

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Deep learning to detect acute respiratory distress syndrome on chest radiographs: a retrospective study with external validation.

Michael W Sjoding, Daniel Taylor, Jonathan Motyka, Elizabeth Lee, Ivan Co, Dru Claar, Jakob I McSparron, Sardar Ansari, Meeta Prasad Kerlin, John P Reilly, Michael G S Shashaty, Brian J Anderson, Tiffanie K Jones, Harrison M Drebin, Caroline A G Ittner, Nuala J Meyer, Theodore J Iwashyna, Kevin R Ward, Christopher E Gillies,

<h4>Background</h4>Acute respiratory distress syndrome (ARDS) is a common, but under-recognised, critical illness syndrome associated with high mortality. An important factor in its under-recognition is the variability in chest radiograph interpretation for ARDS. We sought to train a deep convolutional neural network (CNN) to detect ARDS findings on chest radiographs.<h4>Methods</h4>CNNs were ... Read more >>

Lancet Digit Health (The Lancet. Digital health)
[2021, 3(6):e340-e348]

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Patients' Adaptations After Acute Respiratory Distress Syndrome: A Qualitative Study.

Katrina E Hauschildt, Claire Seigworth, Lee A Kamphuis, Catherine L Hough, Marc Moss, Joanne M McPeake, Molly Harrod, Theodore J Iwashyna,

<h4>Background</h4>Many patients confront physical, cognitive, and emotional problems after acute respiratory distress syndrome (ARDS). No proven therapies for these problems exist, and many patients manage new disability and recovery with little formal support. Eliciting patients' adaptations to these problems after hospitalization may identify opportunities to improve recovery.<h4>Objectives</h4>To explore how patients ... Read more >>

Am J Crit Care (American journal of critical care : an official publication, American Association of Critical-Care Nurses)
[2021, 30(3):221-229]

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Association of Tracheostomy with Changes in Sedation during COVID-19: A Quality Improvement Evaluation at the University of Michigan.

Leigh M Cagino, Jacquelyn B Kercheval, Michael T Kenes, Jakob I McSparron, Ross Blank, Steven B Chinn, Dru D Claar, Theodore J Iwashyna, Jose De Cardenas,

Ann Am Thorac Soc (Annals of the American Thoracic Society)
[2021, 18(5):907-909]

Cited: 2 times

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Visitor Guidelines in US Children's Hospitals During COVID-19.

Ashlee J Vance, Joanne Duy, Naomi Laventhal, Theodore J Iwashyna, Deena K Costa,

<h4>Objectives</h4>To examine visitor guidelines among children's hospitals in the United States in response to the coronavirus 2019 (COVID-19) pandemic.<h4>Methods</h4>A retrospective assessment of visitor guidelines in 239 children's hospitals in the United States.<h4>Results</h4>In this study, we present an analysis of 239 children's hospital visitor guidelines posted to hospitals' Web sites during ... Read more >>

Hosp Pediatr (Hospital pediatrics)
[2021, 11(6):e83-e89]

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Effect of Early High-Dose Vitamin D3 Repletion on Cognitive Outcomes in Critically Ill Adults.

Jin H Han, Adit A Ginde, Samuel M Brown, Adrienne Baughman, Erin M Collar, E Wesley Ely, Michelle N Gong, Aluko A Hope, Peter C Hou, Catherine L Hough, Theodore J Iwashyna, James C Jackson, Akram Khan, Onur M Orun, Mayur B Patel, Rameela Raman, Todd W Rice, Nancy Ringwood, Matthew W Semler, Nathan I Shapiro, Daniel S Talmor, Wesley H Self, ,

<h4>Background</h4>Long-term cognitive impairment frequently occurs after critical illness; no treatments are known to improve long-term cognition.<h4>Research question</h4>Does a single high-dose (540,000 International Units) enteral treatment of vitamin D3 given shortly after hospital admission in critically ill patients who are vitamin D deficient improve long-term global cognition or executive function?<h4>Study design ... Read more >>

Chest (Chest)
[2021, 160(3):909-918]

Cited: 1 time

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Recall of clinical trial participation and attrition rates in survivors of acute respiratory distress syndrome.

Erin F Carlton, Erin Ice, Ryan P Barbaro, Lee Kampuis, Marc Moss, Derek C Angus, Valerie M Banner-Goodspeed, Adit A Ginde, Michelle N Gong, Colin K Grissom, Peter C Hou, David T Huang, Catherine Terri Lee Hough, Daniel S Talmor, B Taylor Thompson, Donald M Yealy, Mick P Couper, Theodore J Iwashyna, ,

<h4>Purpose</h4>To measure the rate of recall of study participation and study attrition in survivors of acute respiratory distress syndrome(ARDS).<h4>Materials/methods</h4>In this ancillary study of the Re-evaluation of Systemic Early neuromuscular blockade(ROSE) trial, we measured the rate of study participation recall 3 months following discharge and subsequent study attrition at 6 months. ... Read more >>

J Crit Care (Journal of critical care)
[2021, 64:160-164]

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More on Racial Bias in Pulse Oximetry Measurement. Reply.

Michael Sjoding, Theodore J Iwashyna, Thomas S Valley,

N Engl J Med (The New England journal of medicine)
[2021, 384(13):1278]

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Benefits of Peer Support for Intensive Care Unit Survivors: Sharing Experiences, Care Debriefing, and Altruism.

Joanne McPeake, Theodore J Iwashyna, Leanne M Boehm, Elizabeth Hibbert, Rita N Bakhru, Anthony J Bastin, Brad W Butcher, Tammy L Eaton, Wendy Harris, Aluko A Hope, James Jackson, Annie Johnson, Janet A Kloos, Karen A Korzick, Joel Meyer, Ashley Montgomery-Yates, Mark E Mikkelsen, Andrew Slack, Dorothy Wade, Mary Still, Giora Netzer, Ramona O Hopkins, Tara Quasim, Carla M Sevin, Kimberley J Haines,

<h4>Background</h4>After critical illness, patients are often left with impairments in physical, social, emotional, and cognitive functioning. Peer support interventions have been implemented internationally to ameliorate these issues.<h4>Objective</h4>To explore what patients believed to be the key mechanisms of effectiveness of peer support programs implemented during critical care recovery.<h4>Methods</h4>In a secondary analysis ... Read more >>

Am J Crit Care (American journal of critical care : an official publication, American Association of Critical-Care Nurses)
[2021, 30(2):145-149]

Cited: 2 times

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Establishing a Peer Support Program for Survivors of COVID-19: A Report From the Critical and Acute Illness Recovery Organization.

Aluko A Hope, Andrea Annie Johnson, Joanne McPeake, Hali Felt, Carla M Sevin, Mark E Mikkelsen, Theodore J Iwashyna, Caroline Lassen-Greene, Kimberley J Haines, Sachin Agarwal, Rita N Bakhru, Leanne M Boehm, Brad W Butcher, Kelly Drumright, Tammy L Eaton, Elizabeth Hibbert, Karen Sara Hoehn, David Hornstein, Heather Imperato-Shedden, James C Jackson, Janet A Kloos, Anna Lewis, Joel Meyer, Ashley Montgomery-Yates, Veronica Rojas, Christa Schorr, Dorothy Wade, Cydni Williams,

Am J Crit Care (American journal of critical care : an official publication, American Association of Critical-Care Nurses)
[2021, :e1-e5]

Cited: 0 times

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Readmission and Death After Initial Hospital Discharge Among Patients With COVID-19 in a Large Multihospital System.

John P Donnelly, Xiao Qing Wang, Theodore J Iwashyna, Hallie C Prescott,

JAMA (JAMA)
[2021, 325(3):304-306]

Cited: 27 times

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Association of Severe Trauma With Work and Earnings in a National Cohort in Canada.

Barbara Haas, Sung-Hee Jeon, Michelle Rotermann, Michael Stepner, Randy Fransoo, Claudia Sanmartin, Hannah Wunsch, Damon C Scales, Theodore J Iwashyna, Allan Garland,

<h4>Importance</h4>Traumatic injury disproportionately affects adults of working age. The ability to work and earn income is a key patient-centered outcome. The association of severe injury with work and earnings appears to be unknown.<h4>Objective</h4>To evaluate the association of severe traumatic injury with subsequent employment and earnings in long-term survivors.<h4>Design, setting, and ... Read more >>

JAMA Surg (JAMA surgery)
[2021, 156(1):51-59]

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