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 providersICU
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 discomfortSedation 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.BooksMeSH KeywordsCircadian RhythmCritical IllnessDeliriumHumansIntensive Care UnitsSleepSleep DeprivationConceptsCritical 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 processes
2014
Functional status after critical illness: agreement between patient and proxy assessments
Ahasic AM, Van Ness PH, Murphy TE, Araujo KL, Pisani MA. Functional status after critical illness: agreement between patient and proxy assessments. Age And Ageing 2014, 44: 506-510. PMID: 25324334, PMCID: PMC4411220, DOI: 10.1093/ageing/afu163.Peer-Reviewed Original ResearchConceptsMonths post-ICU dischargePost-ICU dischargeFunctional statusCritical illnessInter-observer agreementICU admissionOlder patientsExact testIntensive care unit admissionProxy assessmentsPremorbid functional statusCare unit admissionBaseline functional statusCurrent functional statusMcNemar's exact testUnit admissionICU dischargeMedical ICUNeuropsychological morbidityInstrumental ADLCognitive dysfunctionDaily livingPatientsCognitive impairmentParent cohortThe 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
2012
Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes
Pisani MA, Ferrante L. Among patients admitted to ICU, delirium is most common in those with neurological diagnoses, and is associated with adverse health outcomes. Evidence-Based Nursing 2012, 16: 81. PMID: 23171569, DOI: 10.1136/eb-2012-101054.Commentaries, Editorials and LettersICU delirium
Jones SF, Pisani MA. ICU delirium. Current Opinion In Critical Care 2012, 18: 146-151. PMID: 22322260, DOI: 10.1097/mcc.0b013e32835132b9.Peer-Reviewed Original ResearchConceptsICU deliriumRisk factorsLong-term neurocognitive impairmentDelirium-related outcomesPreferred pharmacologic treatmentSignificant adverse outcomesUse of sedativesUse of protocolsPharmacologic treatmentAtypical antipsychoticsVentilator managementAdverse outcomesUnderdiagnosed problemDeliriumNeurocognitive impairmentSusceptible individualsAvailable evidenceRecent evidenceOutcomesLong-term impactTreatmentLimited studiesRobust evidenceNegative outcomesManagement
2011
Critical Illness in HIV-Infected Patients in the Era of Combination Antiretroviral Therapy
Akgün KM, Huang L, Morris A, Justice AC, Pisani M, Crothers K. Critical Illness in HIV-Infected Patients in the Era of Combination Antiretroviral Therapy. Annals Of The American Thoracic Society 2011, 8: 301-307. PMID: 21653532, PMCID: PMC3132789, DOI: 10.1513/pats.201009-060wr.Peer-Reviewed Original ResearchConceptsCombination antiretroviral therapyAntiretroviral therapyICU admissionCritical illnessAdministration of ARTImpact of ARTProportion of deathsHIV eraOpportunistic infectionsHIVAIDS epidemicMore recent studiesIllnessPatientsAdmissionTherapyRecent studiesICUEtiologyInfectionMortalityIncidenceDiseaseAdministrationThe 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 syndromeDisability in activities of daily living, depression, and quality of life among older medical ICU survivors: a prospective cohort study
Vest MT, Murphy TE, Araujo K, Pisani MA. Disability in activities of daily living, depression, and quality of life among older medical ICU survivors: a prospective cohort study. Health And Quality Of Life Outcomes 2011, 9: 9. PMID: 21294911, PMCID: PMC3041645, DOI: 10.1186/1477-7525-9-9.Peer-Reviewed Original ResearchConceptsPost-ICU dischargeQuality of lifeYear post-ICU dischargeOlder ICU survivorsICU survivorsPhysical scoresICU dischargeADL disabilityMental scoresSF-12Daily livingMonths post-ICU admissionMonths post-ICU dischargeMean MCS scoreMedical ICU survivorsPost-ICU admissionSF12 physical scoreProspective cohort studyMean PCS scoreTreatment of depressionCross-sectional associationsMean physical scoreSF-12 dataImpaired ADLICU admission
2008
Analytic Reviews: Considerations in Caring for the Critically Ill Older Patient
Pisani MA. Analytic Reviews: Considerations in Caring for the Critically Ill Older Patient. Journal Of Intensive Care Medicine 2008, 24: 83-95. PMID: 19114416, DOI: 10.1177/0885066608329942.Peer-Reviewed Original ResearchConceptsOlder patientsPhysiologic changesOlder intensive care unit patientsIntensive care unit admissionIntensive care unit patientsIll Older PatientsImportant physiologic changesOlder ICU patientsCare unit admissionCare unit patientsDevelopment of sepsisSeverity of illnessUnit admissionCritical illnessUnit patientsICU patientsPoor outcomeAdverse outcomesRisk factorsCritical careOutcome studiesChronologic agePatientsAge 65Sepsis
2003
Cognitive impairment in the intensive care unit
Pisani MA, McNicoll L, Inouye SK. Cognitive impairment in the intensive care unit. Clinics In Chest Medicine 2003, 24: 727-737. PMID: 14710700, DOI: 10.1016/s0272-5231(03)00092-3.Peer-Reviewed Original ResearchMeSH KeywordsCognition DisordersCritical IllnessDeliriumDementiaHumansIntensive Care UnitsRisk FactorsConceptsPre-existing cognitive impairmentCognitive impairmentICU stayICU settingRisk factorsPost-ICU stayRate of deliriumDevelopment of deliriumIntensive care unitPsychoactive medication usePersistence of deliriumDelirium preventionDelirium ratesMedical ICUOlder patientsFrequent complicationMedication useCare unitHigh prevalenceDeliriumICUOlder personsStayImpairmentPatients