What Are the Real Issues in Providing Extracorporeal Membrane Oxygenation (ECMO) Support: A Survey.

Introduction: By using a novel survey our study aimed to assess the challenges ECMO and Critical Care (CC) teams face when initiating and managing patient's ECMO support.

Methods: A qualitative survey-based observational study was performed of members of 2 Critical Care Medicine organizations involved in decision-making around the practice of Extracorporeal Membrane Oxygenation (ECMO). The range of exploratory questions covered ethical principles of informed consent, autonomy and goals of care discussions, beneficence, non-maleficence (offering life-sustaining treatments in end-of-life care), and justice (insurance-related limitations of treatment).

Intraoperative pump thrombosis (PT) in HeartMate (HM) III.

Pump thrombosis (PT) is a rare and infrequent complication of HeartMate III left ventricular assist device (LVAD). While there are reports of PT in the postoperative period, to our knowledge, there have been no prior reports on PT in the intraoperative period. Here we present a case of a 24-year-old female who required HeartMate III LVAD implantation for progressive heart failure and the intraoperative period was complicated with PT.

A 12-hospital prospective evaluation of a clinical decision support prognostic algorithm based on logistic regression as a form of machine learning to facilitate decision making for patients with suspected COVID-19.

Objective: To prospectively evaluate a logistic regression-based machine learning (ML) prognostic algorithm implemented in real-time as a clinical decision support (CDS) system for symptomatic persons under investigation (PUI) for Coronavirus disease 2019 (COVID-19) in the emergency department (ED).

Methods: We developed in a 12-hospital system a model using training and validation followed by a real-time assessment. The LASSO guided feature selection included demographics, comorbidities, home medications, vital signs.

Responding to COVID-19 Through Interhospital Resource Coordination: A Mixed-Methods Evaluation.

Objectives: The COVID-19 pandemic stressed hospital operations, requiring rapid innovations to address rise in demand and specialized COVID-19 services while maintaining access to hospital-based care and facilitating expertise. We aimed to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital.

Methods: We included patients who tested positive for SARS-CoV-2 by polymerase chain reaction admitted to a 12-hospital network including a dedicated COVID-19 hospital.

Implementation and 1-year follow-up of the cardiovascular ICU standardised handover.

Background: Miscommunication during clinical handover can lead to partial information transfer and healthcare provider dissatisfaction. We hypothesised that a quality improvement project to standardise the cardiovascular intensive care unit (CVICU) handover could improve healthcare provider satisfaction and reduce information omission.

Methods: After institutional review board approval, the operating room (OR) to CVICU handover was audited prior, post and 1 year after standardisation implementation.

A fast, resource efficient, and reliable rule-based system for COVID-19 symptom identification.

Objective: With COVID-19, there was a need for a rapidly scalable annotation system that facilitated real-time integration with clinical decision support systems (CDS). Current annotation systems suffer from a high-resource utilization and poor scalability limiting real-world integration with CDS. A potential solution to mitigate these issues is to use the rule-based gazetteer developed at our institution.

Former substance abusing women, interpersonal relationships and social cognition: Social comparison & sober housemate harmony predict women's abstinence-specific efficacy.

The Relational Theory of Addiction hypothesizes that women's substance abuse SUD development and (SA) recovery experiences differ from men's because of women's tendency to form nested self-concepts and increased relative desire for close interpersonal connections. We suggest that these two differences may have a dynamic and complex influence on recovery success, particularly for women living in group sober homes. This project uses Relational and Social Cognitive Theories as theoretical springboards to investigate the link between and on women's individual perceptions of .

Characterizing COVID-19 clinical phenotypes and associated comorbidities and complication profiles.

Purpose: Heterogeneity has been observed in outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19). Identification of clinical phenotypes may facilitate tailored therapy and improve outcomes. The purpose of this study is to identify specific clinical phenotypes across COVID-19 patients and compare admission characteristics and outcomes.

Characterizing COVID-19 Clinical Phenotypes and Associated Comorbidities and Complication Profiles.

Background: There is limited understanding of heterogeneity in outcomes across hospitalized patients with coronavirus disease 2019 (COVID-19). Identification of distinct clinical phenotypes may facilitate tailored therapy and improve outcomes.

Objective: Identify specific clinical phenotypes across COVID-19 patients and compare admission characteristics and outcomes.

Improvement in serum lipids and liver morphology after supplementation of the diet with fish oil is more evident under regular feeding conditions than under high-fat or mixed diets in rats.

Background: Dietary n polyunsaturated fatty acids (PUFAs) have a role in preventing cardiovascular and hepatic diseases. However, their effects might differ significantly depending on individual dietary patterns. The aim of the present study was to evaluate the effects of dietary supplementation with ω-3 fatty acids (FA), administered in different schedules, on hepatic and aortic histological structure, lipid profile, and body weight (BW) in male Wistar rats under standard (SD), high-fat diet (HFD) and mixed feeding conditions.

The association between ASA status and other risk stratification models on postoperative intensive care unit outcomes.

Background: There is limited medical literature investigating the association between perioperative risk stratification methods and surgical intensive care unit (SICU) outcomes. Our hypothesis contends that routine assessments such as higher ASA physical status classification, surgical risk as defined by American College of Cardiology/American Heart Association guidelines, and simplified Revised Cardiac Index (SRCI) can reliably be associated with SICU outcomes.

Methods: We performed a chart review of all patients 18 years or older admitted to the SICU between October 1, 2010, and March 1, 2011.

Changes in vasopressin use and outcomes in surgical intensive care unit patients with septic shock.

Introduction: This study compares recent vasopressin use and outcomes to our early practice when vasopressin was introduced for septic shock.

Methods: Charts of Surgical Intensive Care Unit (SICU) patients receiving vasopressin for septic shock in 2005-2006 (05-06 cohort,) were retrospectively reviewed. Demographics, APACHE II, hemodynamic variables, and vasoactive drug data were compared to a similar 1999-2000 cohort (99-00 cohort).

Inadequate antibiotic therapy in solid organ transplant recipients is associated with a higher mortality rate.

Background: Inadequate antibiotic therapy and failure to administer antibiotics in a timely fashion have been associated with substantial mortality rates in patients in the intensive care unit (ICU). We analyzed the infection pattern in solid organ transplant recipients as well as the impact of antibiotic resistance and inadequate antibiotic treatment on mortality rates and morbidity outcomes.

Methods: Charts of adult solid organ transplant recipients in 2006 from a single institution were reviewed.

Conventional treatment or epidural blood patch for the treatment of different etiologies of post dural puncture headache.

Post dural puncture headache (PDPH) represents a complication of anesthesia (with an increased incidence in obstetric patients) or as the consequence of a diagnostic lumbar puncture. The aim of the present study was to evaluate the efficacy of the epidural blood-patch (EBP) versus the conventional medical treatment of post-anesthetic headaches also including the PDPH following a diagnostic puncture, a category of patients rarely referred to the anesthesia consultation in our hospital because it was believed that they might have equal benefit from conventional measures due to the smaller size of needles used. We studied in a prospective, randomized, double-blinded manner 32 obstetric and non-obstetric patients with PDPH having the onset of the symptoms 24 hours before the inclusion in the study.