2024
Use 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
Treatments 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 ResearchConceptsFluid 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
COVID-19 mortality risk for older men and women
Yanez ND, Weiss NS, Romand JA, Treggiari MM. COVID-19 mortality risk for older men and women. BMC Public Health 2020, 20: 1742. PMID: 33213391, PMCID: PMC7675386, DOI: 10.1186/s12889-020-09826-8.Peer-Reviewed Original ResearchConceptsIncident rate ratiosCOVID-19 mortalityCOVID-19 mortality ratesMortality rateCOVID-19 deathsCOVID-19COVID-19 mortality riskPoisson mixed effects regression modelsHigh COVID-19 mortality ratesAge-specific ratesMixed effects regression modelsCOVID-19 casesAge 54Mortality riskHigh riskOlder menConsecutive weeksAge 65Age groupsSix-week periodYoung individualsRate ratioDeathEffects regression modelsWomenAgreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults.
Tiwary N, Treggiari MM, Yanez ND, Kirsch JR, Tekkali P, Taylor CC, Schenning KJ. Agreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults. Anesthesia & Analgesia 2020, 132: 1112-1119. PMID: 33002933, DOI: 10.1213/ane.0000000000005197.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnesthesia Recovery PeriodAnesthesia, GeneralCognitionCognitive DysfunctionElective Surgical ProceduresEmergence DeliriumFemaleHumansMaleMental Status and Dementia TestsPredictive Value of TestsPreoperative CareReproducibility of ResultsRisk AssessmentRisk FactorsTreatment OutcomeConceptsPostanesthesia care unitMini-Cog scorePACU deliriumDay of surgeryTimes higher oddsNormal cognitive functionCohort studyCognitive impairmentMini-CogPostoperative deliriumCognitive functionPreoperative clinicHigher oddsPatients meeting eligibility criteriaPostanesthesia Care Unit DeliriumShort Confusion Assessment MethodConfusion Assessment MethodOlder surgical patientsProspective cohort studyAnesthesiologists physical statusMultivariable logistic regressionMeeting eligibility criteriaSubjective memory impairmentOdds ratio analysisOlder patientsImplementation 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 reductionRandomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery
Togioka BM, Yanez D, Aziz MF, Higgins JR, Tekkali P, Treggiari MM. Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery. British Journal Of Anaesthesia 2020, 124: 553-561. PMID: 32139135, DOI: 10.1016/j.bja.2020.01.016.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCholinesterase InhibitorsDelayed Emergence from AnesthesiaDouble-Blind MethodFemaleHumansIntraoperative PeriodLung DiseasesMaleNeostigmineNeuromuscular BlockadeNeuromuscular JunctionNeuromuscular Nondepolarizing AgentsPatient ReadmissionPostoperative ComplicationsRocuroniumSugammadexConceptsPostoperative pulmonary complicationsResidual neuromuscular blockPulmonary complicationsDay hospital readmissionNeuromuscular blockPrimary endpointHospital readmissionDay hospital readmission rateOlder adultsHospital readmission ratesPhase 1 recoveryRocuronium reversalNeostigmine groupSecondary endpointsSugammadex groupReadmission ratesResidual paralysisSurgical closureSugammadexComplicationsNeostigmineLarger studySurgeryIncidenceEndpoint
2019
Oropharyngeal Oxygen Concentration Is Dependent on the Oxygen Mask System and Sampling Location.
Yanez ND, Fu AY, Treggiari MM, Kirsch JR. Oropharyngeal Oxygen Concentration Is Dependent on the Oxygen Mask System and Sampling Location. Respiratory Care 2019, 65: 29-35. PMID: 31506337, DOI: 10.4187/respcare.07027.Peer-Reviewed Original ResearchElectromagnetic Interference with Protocolized Electrosurgery Dispersive Electrode Positioning in Patients with Implantable Cardioverter Defibrillators.
Schulman PM, Treggiari MM, Yanez ND, Henrikson CA, Jessel PM, Dewland TA, Merkel MJ, Sera V, Harukuni I, Anderson RB, Kahl E, Bingham A, Alkayed N, Stecker EC. Electromagnetic Interference with Protocolized Electrosurgery Dispersive Electrode Positioning in Patients with Implantable Cardioverter Defibrillators. Anesthesiology 2019, 130: 530-540. PMID: 30601218, DOI: 10.1097/aln.0000000000002571.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillatorCardiac surgeryNoncardiac surgeryCardioverter defibrillatorAntitachycardia therapyMonopolar electrosurgeryElectrode positioningInappropriate antitachycardia therapyProspective cohort studyHeart Rhythm SocietyExpert clinical opinionAcademic medical centerPaucity of dataCohort studyCurrent management recommendationsProtocolized ApproachMedical CenterClinical opinionSurgeryPatientsUmbilicusTherapyDefibrillatorDispersive electrodeAmerican Society
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
2016
Comparison of enteral ethanol and benzodiazepines for alcohol withdrawal in neurocritical care patients
Gipson G, Tran K, Hoang C, Treggiari M. Comparison of enteral ethanol and benzodiazepines for alcohol withdrawal in neurocritical care patients. Journal Of Clinical Neuroscience 2016, 31: 88-91. PMID: 27262870, DOI: 10.1016/j.jocn.2016.02.028.Peer-Reviewed Original ResearchConceptsEnteral ethanolCIWA scoreAlcohol withdrawalEthanol groupIntensive care unit lengthClinical Institute Withdrawal AssessmentAlcohol withdrawal managementRetrospective chart reviewNeurocritical care patientsGlasgow Coma ScaleLength of stayUse of benzodiazepinesLevel of comaAlcohol scale scoresPrimary endpointSecondary endpointsChart reviewClinical characteristicsFirst medicationCare patientsComa ScaleOral intakeEthanol withdrawalWithdrawal AssessmentNeurocritical carePre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival.
Phipps AI, Bhatti P, Neuhouser ML, Chen C, Crane TE, Kroenke CH, Ochs-Balcom H, Rissling M, Snively BM, Stefanick ML, Treggiari MM, Watson NF. Pre-diagnostic Sleep Duration and Sleep Quality in Relation to Subsequent Cancer Survival. Journal Of Clinical Sleep Medicine 2016, 12: 495-503. PMID: 26612513, PMCID: PMC4795275, DOI: 10.5664/jcsm.5674.Peer-Reviewed Original ResearchConceptsWomen's Health InitiativeShort sleep durationSleep characteristicsHazard ratioCancer survivalCancer sitesSleep durationHealth initiativesPrimary invasive cancerCancer-specific survivalConfidence intervalsPoor sleep qualityFrequent snoringStudy armsCox regressionCancer outcomesInvasive cancerCommon cancerWHI participantsPhysical activitySleep qualityElevated riskCancer typesCancerMarital statusCharacteristics of Sepsis-Induced Cardiac Dysfunction using Speckle-Tracking Echocardiography: A Feasibility Study
Zaky A, Gill EA, Lin CP, Paul CP, Bendjelid K, Treggiari MM. Characteristics of Sepsis-Induced Cardiac Dysfunction using Speckle-Tracking Echocardiography: A Feasibility Study. Anaesthesia And Intensive Care 2016, 44: 65-76. PMID: 26673591, PMCID: PMC5050013, DOI: 10.1177/0310057x1604400111.Peer-Reviewed Original ResearchConceptsLeft ventricular longitudinal strainGlobal left ventricular longitudinal strainEjection fractionSepsis outcomeSepsis-Induced Cardiac DysfunctionLeft ventricular ejection fractionTwo-dimensional speckle trackingBasal anterior segmentLow ejection fractionPrimary study endpointTertiary care centerObservational feasibility studyVentricular ejection fractionDiagnosis of sepsisVentricular longitudinal strainSpeckle-tracking echocardiographyRisk of mortalitySpeckle tracking echocardiographyEnd-diastolic volumeMitral annular displacementLeft ventricular segmentsHospital mortalityHospital lengthHospital staySevere sepsisRandomized Pilot Trial of Two Modified Endotracheal Tubes To Prevent Ventilator-associated Pneumonia
Deem S, Yanez D, Sissons-Ross L, Broeckel JA, Daniel S, Treggiari M. Randomized Pilot Trial of Two Modified Endotracheal Tubes To Prevent Ventilator-associated Pneumonia. Annals Of The American Thoracic Society 2016, 13: 72-80. PMID: 26523433, PMCID: PMC4722846, DOI: 10.1513/annalsats.201506-346oc.Peer-Reviewed Original ResearchConceptsEndotracheal tubeTracheal colonizationChest radiograph criteriaOccurrence of VAPPrevention of VAPCoprimary end pointsSerious adverse eventsInstitutional review board approvalEmergency endotracheal intubationStandard endotracheal tubeMajority of intubationsReview board approvalModified Endotracheal TubeSafety concernsAdverse eventsVAP preventionEndotracheal intubationSubglottic secretionsEmergency intubationClinical trialsClinical signsNosocomial infectionsPilot trialStudy groupHospital setting
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 countsRandomized Pilot Trial of Intensive Management of Blood Pressure or Volume Expansion in Subarachnoid Hemorrhage (IMPROVES)
Togashi K, Joffe AM, Sekhar L, Kim L, Lam A, Yanez D, Broeckel-Elrod JA, Moore A, Deem S, Khandelwal N, Souter MJ, Treggiari MM. Randomized Pilot Trial of Intensive Management of Blood Pressure or Volume Expansion in Subarachnoid Hemorrhage (IMPROVES). Neurosurgery 2015, 76: 125-135. PMID: 25549192, DOI: 10.1227/neu.0000000000000592.Peer-Reviewed Original ResearchConceptsRankin Scale scoreCerebral ischemiaSubarachnoid hemorrhageCBP groupBlood pressureLarge trialsPilot trialScale scoreOptimal blood pressure managementSystolic blood pressure differenceModified Rankin Scale scoreBlood pressure manipulationIntravenous fluid intakeWorse neurobehavioral outcomesBlood pressure managementBlood pressure differenceDelayed Cerebral IschemiaRandomized pilot trialPulmonary complicationsAdverse eventsDischarge dispositionHemodynamic managementStudy endpointPatient populationProtocol adherence