Publications by authors named "Kelly Grogan"

Background: Atomized intranasal dexmedetomidine is an attractive option when sedation is required for pediatric patients as either premedication or the sole agent for noninvasive, nonpainful procedures. While intranasal dexmedetomidine is used frequently in this population, it is still unclear what dose and time of administration relative to the procedure will result in the optimal effect. Knowledge regarding the maximum concentration (C max ) and time to reach maximum concentration (T max ) of intranasally administered dexmedetomidine is the first step toward this.

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Congenital heart disease (CHD) is one of the most common birth anomalies, and the care of children with CHD has improved over the past 4 decades. However, children with CHD who undergo general anesthesia remain at increased risk for morbidity and mortality. The proliferation of electronic health record systems and sophisticated patient monitors affords the opportunity to capture and analyze large amounts of CHD patient data, and the application of novel, effective analytics methods to these data can enable clinicians to enhance their care of pediatric CHD patients.

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The objective of this research was to develop a method suitable for the determination of aqueous concentrations of radioactive iodine as I2, I(-), and IO3(-). As one of the primary risk-drivers and contaminants of concern at nuclear waste repositories, the accurate determination of (129)I in aqueous systems is of significant concern. The redox-active nature of iodine makes its mobility and fate in the environment difficult to predict, thus underscoring the importance of species-specific determination of iodine concentrations.

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Although the evidence strongly supports perioperative glycemic control among cardiac surgical patients, there is scant literature to describe the practical application of such a protocol in the complex ICU environment. This paper describes the use of the Lean Six Sigma methodology to implement a perioperative insulin protocol in a cardiac surgical intensive care unit (CSICU) in a large academic hospital. A preintervention chart audit revealed that fewer than 10% of patients were admitted to the CSICU with glucose <200 mg/dL, prompting the initiation of the quality improvement project.

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The objective of this research was to develop a scintillating anion exchange resin selective for monitoring (129)I at concentrations at or below ~0.4 Bq/L. One of the primary long-term risk-drivers and contaminants associated with nuclear waste sites is (129)I.

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The effect of the spatial variability of K(d) on calculations of contaminant travel time in the vadose zone was determined. Depth discrete measurements of K(d) were made for a suite of radionuclides ((109)Cd, (57)Co, (60)Co, (85)Sr, (137)Cs, and (88)Y) utilizing a sediment core from the E-Area at the Savannah River Site. The K(d)'s were ordered as (85)Sr(2+) < (137)Cs(+) < (109)Cd(2+) < (57)Co(2+) = (60)Co(2+) << (88)Y(3+) and the values generally fell below or near the lowest quartile of values reported in the literature.

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Background: Adverse cardiac events that follow cardiac surgery are an important source of perioperative morbidity and mortality for women. Troponin I provides a sensitive measure of cardiac injury, but the levels after cardiac surgery may vary between sexes. Our purpose in this study was to evaluate the prognostic value of troponin I levels for predicting cardiovascular complications in postmenopausal women undergoing cardiac surgery.

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Background: Since the Institute of Medicine's report, To Err is Human, was published, numerous interventions have been designed and implemented to correct the defects that lead to medical errors and adverse events; however, most efforts were largely reactive. Safety, communication, team performance, and efficiency are areas of care that attract a great deal of attention, especially regarding the introduction of new technologies, techniques, and procedures. We describe a multidisciplinary process that was implemented at our hospital to identify and mitigate hazards before the introduction of a new technique: high-dose-rate intraoperative radiation therapy, (HDR-IORT).

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Brain injury is a major source of patient morbidity after cardiac surgery, and is associated with prolonged hospitalization, excessive operative mortality, high hospital costs, and altered quality of life. Frequency and the clinical manifestations depend on multiple factors, including the completeness and timing of neurologic testing. Ischemic brain infarctions may or may not be associated with stroke or postoperative neurocognitive dysfunction, but the long-term implications of these lesions on neurologic function have not yet been extensively evaluated.

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