2024
Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate – Severe traumatic brain injury: A TRACK-TBI study
Wongsripuemtet P, Ohnuma T, Temkin N, Barber J, Komisarow J, Manley G, Hatfield J, Treggiari M, Colton K, Sasannejad C, Chaikittisilpa N, Ivins-O’Keefe K, Grandhi R, Laskowitz D, Mathew J, Hernandez A, James M, Raghunathan K, Miller J, Vavilala M, Krishnamoorthy V, investigators T. Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate – Severe traumatic brain injury: A TRACK-TBI study. Journal Of Clinical Neuroscience 2024, 126: 338-347. PMID: 39029302, DOI: 10.1016/j.jocn.2024.07.003.Peer-Reviewed Original ResearchConceptsC-reactive proteinNeuron-specific enolaseGlial fibrillary acidic proteinBiomarker levelsUbiquitin C-terminal hydrolase-L1Traumatic brain injuryDexmedetomidine exposureInjury biomarkersSevere traumatic brain injuryTRACK-TBIS100 calcium-binding protein BInflammatory biomarkers C-reactive proteinCalcium-binding protein BHs-CRP levelsLevel 1 trauma centerRetrospective cohort studyCritically ill TBI patientsAlpha-2 agonistsBrain injuryBrain injury biomarkersBiomarkers C-reactive proteinModulate autonomic functionGlasgow Coma Scale score 3No significant associationSecondary brain injuryUse of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study
Royce-Nagel G, Jarzebowski M, Wongsripuemtet P, Krishnamoorthy V, Fuller M, Ohnuma T, Treggiari M, Yaport M, Cobert J, Garrigan E, Bartz R, Raghunathan K. Use of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study. Critical Care Explorations 2024, 6: e1105. PMID: 38904975, PMCID: PMC11196078, DOI: 10.1097/cce.0000000000001105.Peer-Reviewed Original ResearchConceptsRenal replacement therapyLength of stayHospital length of stayHigher hospital mortalityKetamine infusionTotal hospital costsHospital mortalityVasopressor daysKetamine useVentilator daysSample of U.S. hospitalsRenal replacement therapy useAssociated with higher hospital mortalityDays of mechanical ventilationAssociated with in-hospital mortalityHospital costsManagement of critically ill patientsExtracorporeal membrane oxygenationPropensity score matching analysisRetrospective cohort studyPremier Healthcare DatabaseDays of hospitalizationDays of intubationMechanically ventilated patientsCritically ill patients
2021
Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample
Bardia A, Treggiari MM, Michel G, Dai F, Tickoo M, Wai M, Schuster K, Mathis M, Shah N, Kheterpal S, Schonberger RB. Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample. JAMA Network Open 2021, 4: e2137296. PMID: 34905007, PMCID: PMC8672234, DOI: 10.1001/jamanetworkopen.2021.37296.Peer-Reviewed Original ResearchConceptsSurgical site infectionAntibiotic prophylaxis guidelinesWeight-adjusted dosingInfectious Diseases SocietyAntibiotic choiceProphylaxis guidelinesCohort studyDiseases SocietyOverall adherenceFuture quality improvement effortsStudy periodAntibiotic administration guidelinesPrimary end pointTiming of administrationGynecological surgical proceduresQuality improvement effortsIntraoperative antibioticsOverall nonadherenceNoncardiac surgeryAdult patientsEmergency surgeryFirst doseGuideline adherenceSurgical encountersAmerica guidelinesTreatments Associated with Lower Mortality among Critically Ill COVID-19 Patients: A Retrospective Cohort Study
Zhao X, Gao C, Dai F, Treggiari MM, Deshpande R, Meng L. Treatments Associated with Lower Mortality among Critically Ill COVID-19 Patients: A Retrospective Cohort Study. Anesthesiology 2021, 135: 1076-1090. PMID: 34597362, DOI: 10.1097/aln.0000000000003999.Peer-Reviewed Original ResearchConceptsIll COVID-19 patientsCOVID-19 patientsPropensity score-matched analysisRetrospective cohort studyLower mortalityHospital mortalityCohort studyMultivariable analysisYale New Haven Health SystemIntensive care unit admissionOrgan support treatmentUse of apixabanCare unit admissionSevere COVID-19Intensive care unitCOVID-19 mortalityLower COVID-19 mortalityApixaban treatmentUnit admissionAspirin treatmentCare unitTreatment AssociatedCandidate treatmentSupport treatmentPatientsEarly but not late convalescent plasma is associated with better survival in moderate-to-severe COVID-19
Briggs N, Gormally MV, Li F, Browning SL, Treggiari MM, Morrison A, Laurent-Rolle M, Deng Y, Hendrickson JE, Tormey CA, Desruisseaux MS. Early but not late convalescent plasma is associated with better survival in moderate-to-severe COVID-19. PLOS ONE 2021, 16: e0254453. PMID: 34320004, PMCID: PMC8318280, DOI: 10.1371/journal.pone.0254453.Peer-Reviewed Original ResearchConceptsCOVID-19 convalescent plasmaSevere COVID-19Convalescent plasmaPlasma recipientsHospital mortalityUnexposed cohortCCP administrationSevere COVID-19 infectionPropensity score-matched analysisCOVID-19Limited therapeutic optionsCOVID-19 infectionCoronavirus disease 2019CCP recipientsHospital stayPrimary endpointSecondary endpointsHospital daysHospital dischargeEarly administrationComplete followMechanical ventilationTherapeutic optionsClinical differencesSevere diseaseAssisted Fluid Management Software Guidance for Intraoperative Fluid Administration
Maheshwari K, Malhotra G, Bao X, Lahsaei P, Hand WR, Fleming NW, Ramsingh D, Treggiari MM, Sessler DI, Miller TE. Assisted Fluid Management Software Guidance for Intraoperative Fluid Administration. Anesthesiology 2021, 135: 273-283. PMID: 33901281, DOI: 10.1097/aln.0000000000003790.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesFemaleFluid TherapyHumansIntraoperative CareMaleMiddle AgedTherapy, Computer-AssistedConceptsFluid administrationFluid bolusStroke volumeNoncardiac surgeryHigh-risk noncardiac surgeryGoal-directed managementInadequate fluid administrationIntraoperative fluid administrationArterial catheter insertionIntravenous fluid administrationIntraoperative fluid managementCatheter insertionCohort evaluationMechanical ventilationFluid responsivenessFluid managementSD increaseFluid strategySurgeryBolusCliniciansAdministrationSV increaseExploratory basisMulticenter
2020
Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia
Martini RP, Yanez ND, Treggiari MM, Tekkali P, Soelberg C, Aziz MF. Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia. BMC Anesthesiology 2020, 20: 211. PMID: 32838740, PMCID: PMC7446207, DOI: 10.1186/s12871-020-01117-4.Peer-Reviewed Original ResearchConceptsPostoperative pneumoniaSubgroup of patientsBaseline cohortSurgical patientsIntervention cohortEndotracheal intubationOdds ratioNational Surgical Quality Improvement ProjectSurgical Quality Improvement ProjectUnselected surgical populationUnadjusted odds ratioHigh-risk populationPatient-level dataRisk of ventilatorQuality improvement projectInterrupted time series designElectronic health recordsHospital mortalityVAP bundleSurgical populationPatient characteristicsPneumonia riskHistoric cohortHospital admissionFurther risk reduction
2018
Cohort Study of Albumin versus Lactated Ringer's for Postoperative Cardiac Surgery Fluid Resuscitation in the Intensive Care Unit
Fink RJ, Young A, Yanez ND, Hom M, Mai J, Treggiari M, Merkel M. Cohort Study of Albumin versus Lactated Ringer's for Postoperative Cardiac Surgery Fluid Resuscitation in the Intensive Care Unit. Pharmacotherapy The Journal Of Human Pharmacology And Drug Therapy 2018, 38: 1241-1249. PMID: 30403299, DOI: 10.1002/phar.2195.Peer-Reviewed Original ResearchConceptsIntensive care unitPostcardiac surgery patientsCardiovascular intensive care unitFluid resuscitation strategySurgery patientsCare unitCohort studySecondary outcomesAlbumin useResuscitation strategiesPost interventionAfter cohort studyPost-intervention periodPost-intervention time periodsNet cost savingsIntervention time periodFluid resuscitationClinical parametersAlbumin reductionEvidence-based practiceAdmission ordersIntervention periodLactated Ringer'sPatientsEducational interventionRight Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery
Yockelson SR, Heitner SB, Click S, Geleto G, Treggiari MM, Hutchens MP. Right Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery. Journal Of Cardiothoracic And Vascular Anesthesia 2018, 33: 725-731. PMID: 30316640, PMCID: PMC6379134, DOI: 10.1053/j.jvca.2018.09.012.Peer-Reviewed Original ResearchConceptsAcute kidney injuryRV systolic pressureSpeckle tracking echocardiographyCardiac surgeryAKI groupTransthoracic echocardiogramKidney injurySystolic pressureMyocardial performanceElevated RV systolic pressureRight ventricular myocardial performanceCardiovascular intensive care unitRetrospective observational cohort studyRV myocardial performancePreoperative serum creatinineCardiac surgery patientsCentral venous pressureObservational cohort studyVentricular systolic performanceSerum creatinine valuesVentricular myocardial performanceBody mass indexIntensive care unitIntravascular volume statusSpeckle-tracking analysisManagement of rocuronium neuromuscular block using a protocol for qualitative monitoring and reversal with neostigmine
Thilen SR, Ng IC, Cain KC, Treggiari MM, Bhananker SM. Management of rocuronium neuromuscular block using a protocol for qualitative monitoring and reversal with neostigmine. British Journal Of Anaesthesia 2018, 121: 367-377. PMID: 30032875, DOI: 10.1016/j.bja.2018.03.029.Peer-Reviewed Original ResearchConceptsPostoperative residual neuromuscular blockResidual neuromuscular blockNeuromuscular blockTracheal extubationNeostigmine reversalRocuronium neuromuscular blockIdeal body weightConfidence intervalsNeostigmine administrationRocuronium administrationSecondary endpointsAppropriate dosingAbdominal surgeryFemale sexDose reductionExtubationBody weightControl groupPatientsIncidenceSurgical requirementsSignificant differencesNeostigmineAdministrationSubjective monitoring
2017
Process Improvement Initiative for the Perioperative Management of Patients With a Cardiovascular Implantable Electronic Device
Ellis MKM, Treggiari MM, Robertson JM, Rozner MA, Graven PF, Aziz MF, Merkel MJ, Kahl EA, Cohen NA, Stecker EC, Schulman PM. Process Improvement Initiative for the Perioperative Management of Patients With a Cardiovascular Implantable Electronic Device. Anesthesia & Analgesia 2017, 125: 58-65. PMID: 28319519, DOI: 10.1213/ane.0000000000001953.Peer-Reviewed Original ResearchMeSH KeywordsAcademic Medical CentersAgedAged, 80 and overCardiac Surgical ProceduresCardiovascular SystemCohort StudiesDefibrillators, ImplantableFemaleHealth Care CostsHumansMaleMiddle AgedOperating RoomsOutcome and Process Assessment, Health CarePacemaker, ArtificialPatient SafetyPerioperative CarePerioperative PeriodRisk AssessmentTime FactorsConceptsCardiovascular implantable electronic devicesSafe perioperative carePreintervention periodPostintervention periodImplantable electronic devicesPerioperative carePerioperative surgical home modelPrimary end pointCohort of patientsSame eligibility criteriaLarge academic medical centerPatient Safety DatabaseImprovement initiativesAcademic medical centerAdequate patient safetyNew care modelsImproved operating room efficiencyBaseline characteristicsAdverse eventsPerioperative managementPotential confoundersConcurrent cohortDay surgerySurgical proceduresCare model
2015
Comparison of train-of-four count by anesthesia providers versus TOF-Watch® SX: a prospective cohort study
Bhananker SM, Treggiari MM, Sellers BA, Cain KC, Ramaiah R, Thilen SR. Comparison of train-of-four count by anesthesia providers versus TOF-Watch® SX: a prospective cohort study. Journal Canadien D'anesthésie 2015, 62: 1089-1096. PMID: 26224034, DOI: 10.1007/s12630-015-0433-9.Peer-Reviewed Original ResearchConceptsTOF-Watch SXTOF countNeuromuscular blockadeReversal agentsAnesthesia providersCohort studyTOF-WatchMethodsThis prospective observational cohort studyAnesthesiologists physical status IIIProspective observational cohort studyDose of rocuroniumObservational cohort studyProspective cohort studyComparison of TrainPremature administrationInadequate dosingElective surgeryBlockadeDoseAmerican SocietyPatientsCountSubjective assessmentProvidersLower counts
2014
Variation in Tracheal Reintubations Among Patients Undergoing Cardiac Surgery Across Washington State Hospitals
Khandelwal N, Dale CR, Benkeser DC, Joffe AM, Yanez ND, Treggiari MM. Variation in Tracheal Reintubations Among Patients Undergoing Cardiac Surgery Across Washington State Hospitals. Journal Of Cardiothoracic And Vascular Anesthesia 2014, 29: 551-559. PMID: 25802193, PMCID: PMC4427545, DOI: 10.1053/j.jvca.2014.11.009.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAirway ExtubationAirway ManagementCardiac Surgical ProceduresCohort StudiesCoronary Artery BypassCritical CareDatabases, FactualFemaleHealth SurveysHumansIntubation, IntratrachealMaleMiddle AgedRetrospective StudiesRisk FactorsSocioeconomic FactorsTreatment FailureTreatment OutcomeWashingtonConceptsIntensive care unitCardiac surgeryWashington State hospitalsNonfederal hospitalsState HospitalAcute care daysGreater hospital volumeOdds of reintubationCoronary artery bypassRetrospective cohort studyPatient-level characteristicsMultivariate logistic regressionSignificant heterogeneityValvular surgeryArtery bypassCohort studyHospital factorsHospital volumePatient characteristicsTracheal reintubationCare unitProcedure characteristicsHospital characteristicsCare daysReintubationAssessment of Circulating Blood Volume with Fluid Administration Targeting Euvolemia or Hypervolemia
Joffe AM, Khandelwal N, Hallman MR, Treggiari MM. Assessment of Circulating Blood Volume with Fluid Administration Targeting Euvolemia or Hypervolemia. Neurocritical Care 2014, 22: 82-88. PMID: 25142828, DOI: 10.1007/s12028-014-9993-8.Peer-Reviewed Original ResearchConceptsSubgroup of patientsBlood volumeHV groupDay 5Fluid administrationFluid balanceDelayed ischemic neurologic deficitsCrystalloid fluid administrationIschemic neurologic deficitCumulative fluid balanceML/Higher fluid balanceT-testStudent's t-testProphylactic hypervolemiaICU admissionICU stayResultsTwenty patientsNeurologic deficitsCerebral vasospasmClinical trialsHypervolemiaNormovolemiaBVA-100Concurrent groupImproved Analgesia, Sedation, and Delirium Protocol Associated with Decreased Duration of Delirium and Mechanical Ventilation
Dale CR, Kannas DA, Fan VS, Daniel SL, Deem S, Yanez ND, Hough CL, Dellit TH, Treggiari MM. Improved Analgesia, Sedation, and Delirium Protocol Associated with Decreased Duration of Delirium and Mechanical Ventilation. Annals Of The American Thoracic Society 2014, 11: 367-374. PMID: 24597599, PMCID: PMC4028734, DOI: 10.1513/annalsats.201306-210oc.Peer-Reviewed Original ResearchConceptsCAM-ICU assessmentsIntensive care unitMechanical ventilationMedian durationICU stayBenzodiazepine doseSedation protocolPatient assessmentBaseline cohortTrauma-surgical intensive care unitConfusion Assessment Method-ICURichmond Agitation-Sedation Scale scorePrespecified secondary endpointSedation Scale scoreDays of deliriumImproved patient outcomesMultivariable linear regressionBenzodiazepine dosingBenzodiazepine exposureDelirium protocolHospital mortalityPneumonia ratesProtocol cohortRASS assessmentsImproved analgesia
2013
Predictors of Reintubation in Critically Ill Patients
Miu T, Joffe AM, Yanez ND, Khandelwal N, Dagal AH, Deem S, Treggiari MM. Predictors of Reintubation in Critically Ill Patients. Respiratory Care 2013, 59: 178-185. PMID: 23882103, DOI: 10.4187/respcare.02527.Peer-Reviewed Original ResearchConceptsAcute Physiology Score IIDiastolic blood pressureExtubation failureScore IIBlood pressureMinute ventilationAdmission Simplified Acute Physiology Score IISimplified Acute Physiology Score IIRapid shallow breathing indexMultivariable logistic regression analysisPredictors of reintubationTertiary care centerShallow breathing indexAdditional independent predictorsBivariate logistic regression modelLogistic regression analysisLogistic regression modelsICU extubationExtubation successICU admissionBaseline characteristicsCohort studyIll patientsIndependent predictorsBreathing indexPatterns of Preoperative Consultation and Surgical Specialty in an Integrated Healthcare System
Thilen SR, Bryson CL, Reid RJ, Wijeysundera DN, Weaver EM, Treggiari MM. Patterns of Preoperative Consultation and Surgical Specialty in an Integrated Healthcare System. Anesthesiology 2013, 118: 1028-1037. PMID: 23503373, PMCID: PMC4162741, DOI: 10.1097/aln.0b013e31828ea68a.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAgedAged, 80 and overCohort StudiesComorbidityDelivery of Health Care, IntegratedFemaleHealth Status IndicatorsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisPractice Patterns, Physicians'Preoperative PeriodPrescription DrugsReferral and ConsultationRiskSpecialties, SurgicalSurgical Procedures, OperativeYoung AdultConceptsIntegrated healthcare systemPreoperative consultationSurgical specialtiesHealthcare systemDeyo comorbidity indexPreoperative medical consultationsCardiac Risk IndexCardiac risk scoreLow-risk surgeryLow cardiac riskGroup Health CooperativeSubstantial practice variationMultivariable logistic regressionComorbidity indexMedication classesCohort studyCardiac riskElective surgeryPotential confoundersPrescription medicationsHealth CooperativeOdds ratioPractice variationGeneral internistsFamily physicians
2012
Sedation practices in a cohort of critically ill patients receiving prolonged mechanical ventilation.
Karir V, Hough CL, Daniel S, Caldwell E, Treggiari MM. Sedation practices in a cohort of critically ill patients receiving prolonged mechanical ventilation. Minerva Anestesiologica 2012, 78: 801-9. PMID: 22475804.Peer-Reviewed Original ResearchConceptsCumulative doseMorphine equivalentsIll patientsMechanical ventilationSubstance abuseDecreased opioid useLow cumulative doseRetrospective cohort studyHigh cumulative dosesMajority of patientsAmount of sedativesPatient-specific factorsUse of sedativesLess frequent useLorazepam equivalentsSedative needsAdult patientsCohort studyOpioid usePatient characteristicsOpioid analgesicsCumulative dosesEthanol abuseSedation practicesAlcohol abuseAssociation between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: a cohort study
Dale CR, Hayden SJ, Treggiari MM, Curtis JR, Seymour CW, Yanez ND, Fan VS. Association between hospital volume and network membership and an analgesia, sedation and delirium order set quality score: a cohort study. Critical Care 2012, 16: r106. PMID: 22709540, PMCID: PMC3580663, DOI: 10.1186/cc11390.Peer-Reviewed Original Research
2009
Management guided by brain tissue oxygen monitoring and outcome following severe traumatic brain injury.
Martini RP, Deem S, Yanez ND, Chesnut RM, Weiss NS, Daniel S, Souter M, Treggiari MM. Management guided by brain tissue oxygen monitoring and outcome following severe traumatic brain injury. Journal Of Neurosurgery 2009, 111: 644-9. PMID: 19392603, DOI: 10.3171/2009.2.jns08998.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrainBrain InjuriesCohort StudiesFemaleHealth ResourcesHospital CostsHospital MortalityHumansIntracranial PressureLength of StayMaleMiddle AgedMonitoring, PhysiologicOxygenPrognosisRegression AnalysisRespiration, ArtificialRetrospective StudiesTrauma Severity IndicesTreatment OutcomeConceptsBrain tissue oxygen monitoringHospital mortality rateTissue oxygen monitoringTraumatic brain injurySevere traumatic brain injuryMortality rateBrain injuryHospital lengthNeurological outcomeHospital dischargeClinical managementICP monitoringMedian hospital lengthWorse neurological outcomeHospital resource utilizationOxygen monitoringMain outcome measuresFunctional Independence ScoreIntracranial pressure monitoringSeverity of injuryBaseline characteristicsCohort studyPatient ageMore patientsOsmotic therapy