Publications by authors named "Joseph LaGrew"
A 37-year-old male smoker with asthma presented with status asthmaticus refractory to terbutaline, intravenous magnesium, continuous bronchodilators, steroids, heliox and theophylline infusion. He was intubated on hospital day 2 and cannulated for veno-venous extracorporeal membrane oxygenation (V-V ECMO) on hospital day 3 for refractory respiratory acidosis secondary to hypercapnia and hypoxemia despite maximum medical management over 4 days. He was started on inhaled isoflurane with improvement in peak airway pressures and respiratory acidosis, allowing for prompt weaning from V-V ECMO and extubation.
View Article and Find Full Text PDFBackground: The facet joints contribute to chronic cervical spine pain in an estimated 55% of chronic neck pain cases and can be treated with percutaneous radiofrequency neurotomy (PRN). Damage to surrounding structures during treatment or successful treatment of the primary pain source leading to unmasking could lead to new onset of pain, including cervicogenic headache (CGH). In this study, we aimed to define the incidence of headache in patients who have been previously treated with PRN for lower cervical facet pain.
View Article and Find Full Text PDFBackground: Transcatheter aortic valve replacement is indicated for severe symptomatic aortic stenosis in patients who have a very high or prohibitive surgical risk as assessed pre-procedurally by the Society of Thoracic Surgery Risk Score, EuroSCORE (II), frailty testing, and other predictors. When combined with another left ventricular outflow tract obstruction, careful consideration must be taken prior to proceeding with transcatheter aortic valve replacement because an additional masked left ventricular outflow tract pathology can lead to challenging hemodynamics in the peri-deployment phase, as reported in this case.
Case Presentation: A 56-year-old Caucasian man with multiple comorbidities and severe aortic stenosis underwent transcatheter aortic valve replacement under monitored anesthesia care.
Introduction: Naval Surface Forces provide care in austere environments with unique facility, personnel, and material limitations that can put the patient at risk without proper consideration of these circumstances. Tailored shipboard education currently exists but is greatly dependent on the time, preferences, expertise, and ability of a single teaching officer, allowing for significant variability in the level of training.
Materials And Methods: One hundred and twenty-two individuals were trained in 19 topics presented over 12 months through the Naval Surface Forces Pacific Command Medical Readiness Division to all surface providers on Naval Base San Diego.
Objective: This study evaluated the efficacy of IV cosyntropin as an alternative to epidural blood patch (EBP) for refractory or severe post-dural puncture headache (PDPH).
Methods: Twenty-eight patients were randomized to receive EBP or intravenous cosyntropin after diagnosis with post-dural puncture headache. Efficacy was evaluated immediately after treatment and at 1 day, 3 days, and 7 days following treatment using self-reported verbal reported scores for pain and function related to their headache on a 10-point scale using two-way repeated measures analysis of variance (ANOVA) with multiple comparisons.
Introduction: The USNS Mercy has been integral in providing humanitarian and civic assistance as part of the Department of Defense's ongoing Combatant Commander Theater Security Cooperation Plans. The purpose of this study was to critically assess patient demographics and procedures performed to provide guidance for future missions.
Methods: A retrospective review was performed on a cohort of 825 surgical patients who underwent surgery during a 4-month period during Pacific Partnership 2010.