2016
Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors
Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors. American Journal Of Respiratory And Critical Care Medicine 2016, 194: 299-307. PMID: 26840348, PMCID: PMC4970594, DOI: 10.1164/rccm.201506-1256oc.Peer-Reviewed Original ResearchConceptsHigher body mass indexOlder ICU survivorsIntensive care unitBody mass indexFunctional recoveryICU survivorsICU admissionMass indexOlder Intensive Care Unit SurvivorsIntensive care unit survivorsOlder adultsPoor functional recoveryCritical illnessIndependent predictorsCare unitMultivariable analysisFunctional outcomePremorbid functionPotential predictorsVision impairmentAdmissionSurvivorsAnalytic sampleFunctional activityMonthsPerceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers
Kamdar BB, Knauert MP, Jones SF, Parsons EC, Parthasarathy S, Pisani MA. Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers. Annals Of The American Thoracic Society 2016, 13: 1370-7. PMID: 27104770, PMCID: PMC5021080, DOI: 10.1513/annalsats.201601-087oc.Peer-Reviewed Original ResearchConceptsPoor sleepICU outcomesProviders' perceptionsIntensive care unit outcomesAvailable evidence-based guidelinesDevelopment of deliriumIntensive care unitEvidence-based guidelinesCritical care providersBetter sleep qualityMinority of providersICU surveyICU patientsIll patientsCare unitMechanical ventilationICU providersPatient outcomesRecent guidelinesPhysical therapyMost cliniciansPromotion protocolSleep qualityCare providersICUComparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales
Knauert M, Jeon S, Murphy TE, Yaggi HK, Pisani MA, Redeker NS. Comparing average levels and peak occurrence of overnight sound in the medical intensive care unit on A-weighted and C-weighted decibel scales. Journal Of Critical Care 2016, 36: 1-7. PMID: 27546739, PMCID: PMC5097003, DOI: 10.1016/j.jcrc.2016.06.005.Peer-Reviewed Original ResearchConceptsIntensive care unitMedical intensive care unitCare unitWorld Health Organization recommendationsProspective observational studyICU patient roomsIllness severityPatient factorsMechanical ventilationObservational studyPeak occurrenceICU environmentSignificant discordanceCircadian disruptionPatient roomsDecibel scaleSound levelsEquivalent sound levelPeak measuresDeliriumLevelsMeaningful factorsSleepLow-frequency soundAverage levelContinuation Rate of Atypical Antipsychotics After Discharge When Initiated in the Intensive Care Unit
Farrokh S, Castle AC, Heavner M, Pisani MA. Continuation Rate of Atypical Antipsychotics After Discharge When Initiated in the Intensive Care Unit. Journal Of Pharmacy Practice 2016, 30: 342-346. PMID: 27129913, DOI: 10.1177/0897190016645026.Peer-Reviewed Original ResearchConceptsIntensive care unitAtypical antipsychoticsHospital dischargeCare unitSafety outcomesLarge tertiary academic medical centerTertiary academic medical centerFinal study populationAcademic medical centerICU stayLack of evidenceCritical illnessMedical chartsQTc prolongationExtended therapyContinuation ratesInappropriate continuationMedical CenterStudy populationAntipsychoticsExclusion criteriaPhysician documentationPatientsProgress notesOutcomesUse of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients
Han L, Pisani MA, Araujo KL, Allore HG. Use of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients. International Journal Of Statistics In Medical Research 2016, 5: 8-16. PMID: 27123153, PMCID: PMC4844076, DOI: 10.6000/1929-6029.2016.05.01.2.Peer-Reviewed Original ResearchDelirium severity scoresIntensive care unitSeverity scoreOld intensive care patientsIntensive care patientsOlder medical patientsDose of haloperidolStable patient characteristicsICU stayBaseline characteristicsAcute outcomesPatient characteristicsCare patientsCare unitMeasures of exposureMedical patientsAntipsychotic medicationFull cohortPatientsStable baselineAnalytic sampleTreatment effectsHaloperidolCohortScoresOutcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit
Rowe T, Araujo KL, Van Ness PH, Pisani MA, Juthani-Mehta M. Outcomes of Older Adults With Sepsis at Admission to an Intensive Care Unit. Open Forum Infectious Diseases 2016, 3: ofw010. PMID: 26925430, PMCID: PMC4766385, DOI: 10.1093/ofid/ofw010.Peer-Reviewed Original ResearchAssociation of sepsisICU admissionOlder adultsBaseline characteristicsSystemic inflammatory response syndrome criteriaIntensive care unit admissionCox proportional hazards modelImpact of sepsisCare unit admissionProspective cohort studyDiagnosis of sepsisDefinition of sepsisIntensive care unitMain outcome measuresProportional hazards modelUnit admissionSyndrome criteriaCohort studyCare unitOutcome measuresSepsisHazards modelAdmissionMortalityEarly use
2015
Awake or Sedated: Trends in the Evaluation and Management of Agitation in the Intensive Care Unit
DeBiasi EM, Akgün KM, Pisani M. Awake or Sedated: Trends in the Evaluation and Management of Agitation in the Intensive Care Unit. Seminars In Respiratory And Critical Care Medicine 2015, 36: 899-913. PMID: 26595050, DOI: 10.1055/s-0035-1564875.BooksConceptsICU patientsSedation practicesIll intensive care unit (ICU) patientsIntensive care unit patientsSedation assessment scaleMechanical ventilation durationCare unit patientsManagement of agitationMost ICU patientsIntensive care unitImproved clinical outcomesMultidisciplinary treatment modelLife-saving interventionsHospital lengthMinimal sedationSedative medicationsUnit patientsCare unitClinical outcomesMechanical ventilationVentilation durationPatient distressFunctional impairmentPractice guidelinesPatient discomfortThe Impact of Race on Intensity of Care Provided to Older Adults in the Medical Intensive Care Unit
Chima-Melton C, Murphy TE, Araujo KL, Pisani MA. The Impact of Race on Intensity of Care Provided to Older Adults in the Medical Intensive Care Unit. Journal Of Racial And Ethnic Health Disparities 2015, 3: 365-372. PMID: 27271078, PMCID: PMC4902115, DOI: 10.1007/s40615-015-0162-3.Peer-Reviewed Original ResearchConceptsMedical intensive care unitIntensive care unitIntensity of careTISS-28 scoresCare unitMICU interventionWhite patientsTherapeutic Intervention Scoring System-28Older adultsImpact of raceNew-onset dialysisRenal replacement therapyNon-white patientsPulmonary artery catheterizationBackgroundAfrican-AmericansICU mortalityAggressive carePrimary outcomeArtery catheterizationMechanical ventilationProspective studyReplacement therapyMore dementiaPatient preferencesChronic diseasesSedation in Critically Ill Patients
Oldham M, Pisani MA. Sedation in Critically Ill Patients. Critical Care Clinics 2015, 31: 563-587. PMID: 26118921, DOI: 10.1016/j.ccc.2015.03.010.Peer-Reviewed Original ResearchSleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit
Knauert MP, Haspel JA, Pisani MA. Sleep Loss and Circadian Rhythm Disruption in the Intensive Care Unit. Clinics In Chest Medicine 2015, 36: 419-429. PMID: 26304279, DOI: 10.1016/j.ccm.2015.05.008.BooksConceptsCritical illnessSleep disruptionAppropriate administrative supportIntensive care unit environmentIntensive care unitCircadian rhythm disruptionDelirium reductionIll patientsCare unitPharmacologic interventionsSleep disturbancesRhythm disruptionCare deliveryMultidisciplinary strategyUnit environmentSleep lossIllnessDisruptionPatientsEffective strategySleepEnvironmental factorsFunctional Trajectories Among Older Persons Before and After Critical Illness
Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Functional Trajectories Among Older Persons Before and After Critical Illness. JAMA Internal Medicine 2015, 175: 523-529. PMID: 25665067, PMCID: PMC4467795, DOI: 10.1001/jamainternmed.2014.7889.Peer-Reviewed Original ResearchConceptsIntensive care unitLong-term mortalityCritical illnessICU admissionModerate disabilityOlder personsMinimal disabilitySevere disabilityFunctional trajectoriesFunctional declineEarly deathProspective cohort studyDay of admissionPersons 70 yearsGoals of careRisk of deathShort-term mortalityGreater New HavenSignificant functional declineICU lengthCohort studyHospital dischargePremorbid disabilityCare unitMechanical ventilationSleep in the Intensive Care Unit
Pisani MA, Friese RS, Gehlbach BK, Schwab RJ, Weinhouse GL, Jones SF. Sleep in the Intensive Care Unit. American Journal Of Respiratory And Critical Care Medicine 2015, 191: 731-738. PMID: 25594808, PMCID: PMC5447310, DOI: 10.1164/rccm.201411-2099ci.Peer-Reviewed Original ResearchConceptsCritical illnessIntensive care unit patientsConcise clinical reviewCare unit patientsIntensive care unitPatient care activitiesCircadian rhythm abnormalitiesCircadian rhythmImportant physiologic processesLack of sleepUnit patientsICU patientsPatients' sleepCare unitClinical reviewAdverse outcomesSleep disturbancesRhythm abnormalitiesRole sleepCare activitiesIllnessClinical researchSleepPatientsPhysiologic processesHealth care worker attitudes and identified barriers to patient sleep in the medical intensive care unit
Hopper K, Fried TR, Pisani MA. Health care worker attitudes and identified barriers to patient sleep in the medical intensive care unit. Heart & Lung 2015, 44: 95-99. PMID: 25686516, PMCID: PMC5632814, DOI: 10.1016/j.hrtlng.2015.01.011.Peer-Reviewed Original ResearchConceptsHealth care workers' attitudesCare workers' attitudesPatients' sleepMedical intensive care unitIntensive care unit patientsCare unit patientsIntensive care unitSystem-based barriersSignificance of sleepICU careUnit patientsCare unitSleep promotionICU policyMultiple environmental barriersSleep disruptionQualitative studyICUSleepNight shiftsLack of consensusWorkers' attitudesAttitudinal barriersAdditional targetsEnvironmental barriers
2014
Feasibility study of unattended polysomnography in medical intensive care unit patients
Knauert MP, Yaggi HK, Redeker NS, Murphy TE, Araujo KL, Pisani MA. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart & Lung 2014, 43: 445-452. PMID: 25023504, PMCID: PMC4150840, DOI: 10.1016/j.hrtlng.2014.06.049.Peer-Reviewed Original ResearchConceptsMedical intensive care unitPortable polysomnographySleep efficiencyMedical intensive care unit patientsIntensive care unit patientsSleep deprivationOvernight sleep durationCare unit patientsObservational pilot studyIntensive care unitIndicators of feasibilityUnattended polysomnographyUnit patientsIll patientsPatients' sleepCare unitArousal indexPSG studiesSleep durationPatientsInterpretable qualityPilot studyGold standardSleepSleep stagesThe prevalence of undiagnosed diabetes mellitus and the association of baseline glycemic control on mortality in the intensive care unit: A prospective observational study
Hoang QN, Pisani MA, Inzucchi S, Hu B, Honiden S. The prevalence of undiagnosed diabetes mellitus and the association of baseline glycemic control on mortality in the intensive care unit: A prospective observational study. Journal Of Critical Care 2014, 29: 1052-1056. PMID: 25092614, DOI: 10.1016/j.jcrc.2014.06.007.Peer-Reviewed Original ResearchConceptsBaseline glycemic controlStress hyperglycemiaGlycemic controlUndiagnosed diabetesChronic Health Evaluation II scoreMedical intensive care unit patientsIntensive care unit patientsHemoglobin A1c levelsHistory of diabetesObservational cohort studyProspective observational studyUndiagnosed diabetes mellitusCare unit patientsIntensive care unitLower baseline HbA1cMultivariable logistic regressionSignificant differencesAcute PhysiologyHospital mortalityNondiabetic patientsBaseline HbA1cII scoreMICU patientsCohort studyCritical illness
2013
Patterns of Opiate, Benzodiazepine, and Antipsychotic Drug Dosing in Older Patients in a Medical Intensive Care Unit
Pisani MA, Bramley K, Vest MT, Akgün KM, Araujo KL, Murphy TE. Patterns of Opiate, Benzodiazepine, and Antipsychotic Drug Dosing in Older Patients in a Medical Intensive Care Unit. American Journal Of Critical Care 2013, 22: e62-e69. PMID: 23996429, PMCID: PMC4309662, DOI: 10.4037/ajcc2013835.Peer-Reviewed Original ResearchConceptsMedical intensive care unitIntensive care unitOlder patientsCare unitNursing shiftsHigh dosesEvening shiftsNight shiftsYale-New Haven HospitalEvening nursing shiftsPatients 60 yearsRoute of administrationImportant clinical covariatesMean ageClinical covariatesPsychoactive medicationsDrug dosingRandom effects Poisson modelDose levelsPatientsHaloperidolTotal dosesLorazepamSleep deprivationFentanyl
2012
"Short-Stay" Patients In The Intensive Care Unit: Characterizing Patient Acuity, Throughput, And Critical Care Resource Utilization
Mathews K, Jenq G, Siner J, Long E, Pisani M. "Short-Stay" Patients In The Intensive Care Unit: Characterizing Patient Acuity, Throughput, And Critical Care Resource Utilization. 2012, a6731-a6731. DOI: 10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a6731.Peer-Reviewed Original Research
2011
The Changing Epidemiology of HIV-Infected Patients in the Intensive Care Unit
Akgün KM, Pisani M, Crothers K. The Changing Epidemiology of HIV-Infected Patients in the Intensive Care Unit. Journal Of Intensive Care Medicine 2011, 26: 151-164. PMID: 21436170, DOI: 10.1177/0885066610387996.Peer-Reviewed Original ResearchConceptsPneumocystis jirovecii pneumoniaImpact of HAARTICU admissionRespiratory failureIntensive care unit admissionOutcome of HIVActive antiretroviral therapyCare unit admissionLow serum albuminPoor functional statusInflammatory response syndromeIntensive care unitHAART administrationHAART initiationHospital mortalityMedication toxicityUnit admissionAntiretroviral therapyICU mortalityICU survivalComorbid diseasesHIV diagnosisJirovecii pneumoniaCommon indicationResponse syndrome
2010
Does Gender Impact Intensity of Care Provided to Older Medical Intensive Care Unit Patients?
Akgün KM, Murphy TE, Araujo KL, Van Ness PH, Pisani M. Does Gender Impact Intensity of Care Provided to Older Medical Intensive Care Unit Patients? Critical Care Research And Practice 2010, 2010: 404608. PMID: 20981259, PMCID: PMC2964007, DOI: 10.1155/2010/404608.Peer-Reviewed Original ResearchMedical intensive care unitTISS-28 scoresMICU interventionMICU patientsMICU admissionTISS-28Medical intensive care unit patientsTherapeutic Intervention Scoring System-28Intensive care unit patientsUrban university teaching hospitalAggressive critical careChronic respiratory failureCare unit patientsIntensive care unitUniversity Teaching HospitalCritical care literatureEquivalence of careLevel of careRespiratory failureProspective cohortUnit patientsPrimary outcomeCare unitTeaching hospitalCritical care
2009
Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population*
Pisani MA, Murphy TE, Araujo KL, Slattum P, Van Ness PH, Inouye SK. Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population*. Critical Care Medicine 2009, 37: 177-183. PMID: 19050611, PMCID: PMC2700732, DOI: 10.1097/ccm.0b013e318192fcf9.Peer-Reviewed Original ResearchConceptsModifiable risk factorsICU deliriumDelirium durationOpioid useRisk factorsFirst episodeMedical intensive care unit patientsIntensive care unit deliriumMedical intensive care unitIntensive care unit patientsUrban university teaching hospitalConfusion Assessment MethodProspective cohort studyCare unit patientsSeverity of illnessIntensive care unitUniversity Teaching HospitalMain outcome measuresUse of benzodiazepinesChart review methodMultivariable regression modelsImpact of benzodiazepinesCohort studyMedian durationUnit patients