Publications by authors named "Dalton Whitman"
Background: Critical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitoring and management) of adults during and after ECMO support.
Methods: These guidelines are based on clinical practice consensus recommendations and scientific statements.
Article Synopsis
- The study analyzes sex differences in ICU outcomes for severe COVID-19 patients, focusing on mortality rates between males and females.
- It includes data from 10,259 patients admitted to ICUs worldwide between January 2020 and June 2022, revealing that males had a higher hazard of death (HR=1.14) despite adjustment for complications.
- Additionally, males exhibited more severe health issues, requiring greater interventions and showing higher risks for cardiac arrest and pulmonary embolism compared to females.
Article Synopsis
- - The text discusses the lack of strong clinical evidence in the critical care of ECMO patients with acute brain injury (ABI) and presents guidelines for their neurological care.
- - Guidelines were developed using input from an international panel of 30 ECMO experts through a structured voting process, focusing on five key clinical areas.
- - The consensus emphasizes the importance of early detection and intervention for ABI in ECMO patients to improve health outcomes and outlines multiple recommendations to guide clinical practice and highlight research needs.
Article Synopsis
- A study was conducted to compare stroke incidences and mortality rates in critically ill COVID-19 patients from low-and middle-income countries (LMICs) and high-income countries (HICs).
- The results showed that stroke incidence was significantly higher in LMICs (35.7 per 1000 admitted-days) compared to HICs (17.6 per 1000 admitted-days), with patients from LMICs also facing higher mortality rates (43.6% vs. 29.2%).
- The findings highlight the need for better stroke diagnosis and healthcare resource allocation in LMICs, as both higher income status and the presence of stroke are associated with increased risk of death
Article Synopsis
- ECMO is utilized as a critical therapy for COVID-19 patients suffering from severe ARDS, but bleeding and thrombotic complications are significant issues during treatment.
- Data from a global study involving over 1,200 severe COVID-19 patients on ECMO indicates that 38% experienced coagulation issues, with 54% facing hemorrhagic complications and higher mortality rates among those with bleeding.
- The study suggests that while coagulation disorders are common and serious in these patients, the associated mortality risk may be lower than earlier reports from single-nation studies.
Sparse data exist on sex-related differences in extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest (rCA). We explored the role of sex on the utilization and outcomes of ECPR for rCA by retrospective analysis of the Extracorporeal Life Support Organization (ELSO) International Registry. The primary outcome was in-hospital mortality.
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- The study examines the connection between initial neurological symptoms of COVID-19 and long-term neurological issues (PANSC) in hospitalized adults across 407 international sites from January 2020 to April 2022.
- It analyzes the prevalence and risk factors for PANSC, with a focus on how male and female patients experience symptom resolution over time.
- Results show that fatigue and muscle/joint pain were the most common symptoms post-hospitalization, with a higher prevalence in females compared to males, and highlights differences in ICU admission rates and mechanical ventilation usage between the sexes.
Objectives: To determine the prevalence and outcomes associated with hemorrhage, disseminated intravascular coagulopathy, and thrombosis (HECTOR) complications in ICU patients with COVID-19.
Design: Prospective, observational study.
Setting: Two hundred twenty-nine ICUs across 32 countries.
Article Synopsis
- Acute brain injury (ABI) is a common complication following extracorporeal cardiopulmonary resuscitation (ECPR), prompting researchers to examine the effects of arterial oxygen (PaO) and carbon dioxide (PaCO) levels on ABI incidence.
- A study of over 3,100 adult ECPR patients revealed that 16% experienced ABI, with moderate to severe hyperoxia increasing the risk of ABI and associated complications like ischemic stroke and intracranial hemorrhage.
- The findings suggest that early severe hyperoxia during ECMO is linked to a higher risk of ABI and mortality, indicating the need for cautious management of oxygen delivery in ECPR patients to minimize reperfusion injury.
Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances.
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- Veno-arterial extracorporeal membrane oxygenation (ECMO) is a vital short-term treatment for children with severe heart and lung issues, especially after heart surgery, to help with blood circulation and oxygenation.
- Two types of cannulation methods are used: central for recent surgeries and peripheral for patients who haven't had surgery, supporting various cardiac conditions.
- There are still many unanswered questions about the best practices for selecting patients for ECMO, managing their treatment, and understanding the outcomes, prompting further investigation into these areas within the pediatric population.
Recent advances in both ionization methods and mass spectrometers have resulted in powerful new techniques for the study of drug metabolism and disposition. The interest in high-performance liquid chromatography/mass spectrometry (HPLC/MS) is the result of the lack of a sensitive universal detector for HPLC. Although it is not the ideal detector, HPLC/MS has become a reliable technique for xenobiotic analysis.
View Article and Find Full Text PDFCrystals of 4-oxalocrotonate tautomerase have been obtained by the vapor-diffusion method using polyethylene glycol as precipitant. The crystals belong to the orthorhombic space group P2(1)2(1)2(1), with unit cell parameters a = 118.1, b = 95.
View Article and Find Full Text PDFInositol 1,4,5-trisphosphate (IP3) is produced in cells as a breakdown product of the diphosphorylated form of phosphatidylinositol, phosphatidylinositol 4,5-bisphosphate. Stimulated breakdown of phosphoinositides has been correlated with a wide variety of hormonal stimuli which mobilize intracellular calcium, and IP3 has recently been found to cause calcium release from intracellular stores, thus implicating it as a second messenger in hormonal stimulation. In this paper we have examined the effect of IP3 on protein phosphorylation, and have found that IP3 stimulates phosphorylation of a 62-kDa protein in cell lysates made from cultured monkey fibroblasts and from bovine brain.
View Article and Find Full Text PDFDNA derived from the methanogenic archaebacterium Methanococcus voltae was digested with PstI restriction endonuclease and cloned into the PstI site of pBR322. The recombinant plasmids generated were used to transform a multiply auxotrophic strain of Escherichia coli with selection for tetracycline resistance. Plasmids complementing the argG(pAW1) or hisA(pAW2) mutations were isolated and characterized.
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