2024
Guidelines for Neuroprognostication in Critically Ill Adults with Moderate–Severe Traumatic Brain Injury
Muehlschlegel S, Rajajee V, Wartenberg K, Alexander S, Busl K, Creutzfeldt C, Fontaine G, Hocker S, Hwang D, Kim K, Madzar D, Mahanes D, Mainali S, Meixensberger J, Sakowitz O, Varelas P, Weimar C, Westermaier T. Guidelines for Neuroprognostication in Critically Ill Adults with Moderate–Severe Traumatic Brain Injury. Neurocritical Care 2024, 40: 448-476. PMID: 38366277, PMCID: PMC10959796, DOI: 10.1007/s12028-023-01902-2.Peer-Reviewed Original ResearchTraumatic brain injuryBrain injuryFunctional outcomesSurrogate decision-makersSurrogates of patientsSystematic narrative reviewIMPACT lab modelQuality of evidenceClinical variablesDesirability of outcomesClinically relevant predictorsCritically ill adultsRecommendations AssessmentComfort measuresIn-hospital mortalityConclusionsThese guidelinesMsTBIEligibility criteriaPoor outcomeIll adultsPatient triagePractice recommendationsIndividual predictorsInternational Mission for PrognosisNarrative review
2022
Pilot Randomized Clinical Trial of a Goals-of-Care Decision Aid for Surrogates of Patients With Severe Acute Brain Injury
Muehlschlegel S, Goostrey K, Flahive J, Zhang Q, Pach JJ, Hwang DY. Pilot Randomized Clinical Trial of a Goals-of-Care Decision Aid for Surrogates of Patients With Severe Acute Brain Injury. Neurology 2022, 99: e1446-e1455. PMID: 35853748, PMCID: PMC9576301, DOI: 10.1212/wnl.0000000000200937.Peer-Reviewed Original ResearchConceptsCode status changeTraumatic brain injuryBrain injuryIschemic strokeCare decisionsIntracerebral hemorrhageDA groupAcute brain injury patientsSevere acute brain injuryNeurologic intensive care unitCare decision aidSurrogates of patientsAcute brain injuryAcute ischemic strokeClass IV evidenceLong-term prognosisIntensive care unitBrain injury patientsClinician-family communicationAdditional psychosocial supportPatient-centered careLife-sustaining treatmentPsychological outcomesDecision-making interventionClassification of evidenceCoping Strategies and Psychosocial Resource Needs Reported by Families of Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (RP423)
Kubota R, Meurer K, Baskaran N, Zhang Q, Bannon S, Fishbein N, Lichstein K, Reichman M, Popok P, Lester E, Motta M, Muehlschlegel S, Reznik M, Jaffa M, Creutzfeldt C, Fehnel C, Freeman W, Williamson C, Vranceanu A, Hwang D. Coping Strategies and Psychosocial Resource Needs Reported by Families of Patients Recovering from Coma in Neurointensive Care Units: Preliminary Findings from a Multicenter Qualitative Study (RP423). Journal Of Pain And Symptom Management 2022, 63: 1095-1096. DOI: 10.1016/j.jpainsymman.2022.04.064.Peer-Reviewed Original ResearchCommon coping strategiesCoping strategiesSevere acute brain injuryPsychosocial resourcesSABI patientsFamily caregiversPsychosocial supportAcute brain injuryNeurointensive care unitFamily support interventionBrain injuryPositive emotionsCare unitPsychological distressYears of collegeSocial supportPersonal social networksGlasgow Coma Scale scorePrimary caregiversTeam membersPrior experienceEffective interventionsInterview transcriptsFamilies of patientsMulticenter qualitative studyTop Ten Tips Palliative Care Clinicians Should Know About Disorders of Consciousness: A Focus on Traumatic and Anoxic Brain Injury
Steinberg A, Hudoba C, Hwang DY, Kramer NM, Mehta AK, Muehlschlegel S, Jones CA, Besbris J. Top Ten Tips Palliative Care Clinicians Should Know About Disorders of Consciousness: A Focus on Traumatic and Anoxic Brain Injury. Journal Of Palliative Medicine 2022, 25: 1571-1578. PMID: 35639356, DOI: 10.1089/jpm.2022.0202.Peer-Reviewed Original Research
2021
Low-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349)
Mazurek M, Yuen M, Cahn B, Rosen M, Gobeske K, Gilmore E, Hwang D, Kaddouh F, Kim J, Falcone G, Petersen N, Siner J, Spudich S, Sze G, Kimberly W, Sheth K. Low-Field, Portable Magnetic Resonance Imaging at the Bedside to Assess Brain Injury in Patients with Severe COVID-19 (1349). Neurology 2021, 96 DOI: 10.1212/wnl.96.15_supplement.1349.Peer-Reviewed Original ResearchPredictors of Surrogate Decision Makers Selecting Life-Sustaining Therapy for Severe Acute Brain Injury Patients: An Analysis of US Population Survey Data
Garg A, Soto AL, Knies AK, Kolenikov S, Schalk M, Hammer H, White DB, Holloway RG, Sheth KN, Fraenkel L, Hwang DY. Predictors of Surrogate Decision Makers Selecting Life-Sustaining Therapy for Severe Acute Brain Injury Patients: An Analysis of US Population Survey Data. Neurocritical Care 2021, 35: 468-479. PMID: 33619667, PMCID: PMC8380750, DOI: 10.1007/s12028-021-01200-9.Peer-Reviewed Original ResearchConceptsSevere acute brain injuryAcute brain injuryLife-sustaining treatmentSurrogate decision makersBrain injuryAcute brain injury patientsPatient's surrogate decision makersSevere disabilityPoor neurological prognosisIntensive care unitSevere brain injuryLife-Sustaining TherapyBrain injury patientsCost of careYounger age groupsCross-sectional survey studyUS population sampleBinary logistic regressionNeurological prognosisIndependent predictorsCare unitInjury patientsPoor prognosisMale genderUnivariate analysis
2020
Goals-of-care decision aid for critically ill patients with TBI: Development and feasibility testing.
Muehlschlegel S, Hwang DY, Flahive J, Quinn T, Lee C, Moskowitz J, Goostrey K, Jones K, Pach JJ, Knies AK, Shutter L, Goldberg R, Mazor KM. Goals-of-care decision aid for critically ill patients with TBI: Development and feasibility testing. Neurology 2020, 95: e179-e193. PMID: 32554766, PMCID: PMC7455326, DOI: 10.1212/wnl.0000000000009770.Peer-Reviewed Original ResearchConceptsCare decision aidSurrogates of patientsEarly feasibilityFeasibility trial protocolTraumatic brain injuryDecision aidConsecutive patientsIll patientsFeasibility trialStudy protocolTrial protocolBrain injuryInterim analysisCare communicationPatientsPaper-based decision aidExcellent usabilityComplete dataFeasibility testingHigh rateFamily membersBehavioral outcomesQualitative studyAcceptabilityIterative revisionsConcerns of surrogate decision makers for patients with acute brain injury: A US population survey.
Hwang DY, Knies AK, Mampre D, Kolenikov S, Schalk M, Hammer H, White DB, Holloway RG, Sheth KN, Fraenkel L. Concerns of surrogate decision makers for patients with acute brain injury: A US population survey. Neurology 2020, 94: e2054-e2068. PMID: 32341190, PMCID: PMC7282883, DOI: 10.1212/wnl.0000000000009406.Peer-Reviewed Original ResearchConceptsSevere acute brain injurySevere functional disabilityAcute brain injurySurrogate decision makersBrain injuryLatent class analysisPatient's wishesVegetative stateLong-term careFunctional disabilityPoor prognosisUS population surveySD groupPrognostic accuracyHypothetical patientsPatientsUS populationAdditional groupOlder adultsFuture interventionsCompletion ratesInjuryFamily consensusPopulation surveyUnique concerns