2016
Perceptions 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 notesOutcomesEndobronchial Ultrasound-Guided Cautery-Assisted Transbronchial Forceps Biopsies: Safety and Sensitivity Relative to Transbronchial Needle Aspiration
Bramley K, Pisani MA, Murphy TE, Araujo KL, Homer RJ, Puchalski JT. Endobronchial Ultrasound-Guided Cautery-Assisted Transbronchial Forceps Biopsies: Safety and Sensitivity Relative to Transbronchial Needle Aspiration. The Annals Of Thoracic Surgery 2016, 101: 1870-1876. PMID: 26912301, PMCID: PMC4861078, DOI: 10.1016/j.athoracsur.2015.11.051.Peer-Reviewed Original ResearchConceptsTransbronchial needle aspirationTransbronchial forceps biopsyForceps biopsyClinical trialsEndobronchial ultrasoundNeedle aspirationConvex probe EBUSSignificant adverse eventsDiagnosis of sarcoidosisExcellent diagnostic yieldSelect clinical scenariosSequential useTBNA samplesSecondary outcomesUnselected patientsAdverse eventsLymph nodesThoracic lymphadenopathyEBUS guidanceGranulomatous inflammationCore biopsyGranulomatous diseaseAdequate specimensNeedle biopsyDiagnostic yieldComparison of Transbronchial and Cryobiopsies in Evaluation of Diffuse Parenchymal Lung Disease
Ramaswamy A, Homer R, Killam J, Pisani MA, Murphy TE, Araujo K, Puchalski J. Comparison of Transbronchial and Cryobiopsies in Evaluation of Diffuse Parenchymal Lung Disease. Journal Of Bronchology & Interventional Pulmonology 2016, 23: 14-21. PMID: 26705007, PMCID: PMC4864578, DOI: 10.1097/lbr.0000000000000246.Peer-Reviewed Original ResearchMeSH KeywordsBiopsyBronchoscopyFemaleHumansLungLung Diseases, InterstitialMaleMiddle AgedRetrospective StudiesConceptsDiffuse parenchymal lung diseaseTransbronchial lung cryobiopsyTransbronchial lung biopsyParenchymal lung diseaseLung diseaseFlexible bronchoscopyDiagnostic yieldTertiary care academic centerVideo-assisted thoracoscopic surgeryInterstitial lung diseaseHigh diagnostic yieldTBLB specimensLung biopsyLung cryobiopsyMassive hemoptysisPrior malignancyThoracoscopic surgeryClinicopathologic featuresHypersensitivity pneumonitisModerate sedationRetrospective studyTherapeutic optionsMean ageFinal diagnosisPostprocedural outcomes
2015
Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans
Attia EF, McGinnis KA, Feemster LC, Akgün KM, Butt AA, Graber CJ, Fine MJ, Goetz MB, Rodriguez-Barradas MC, Pisani MA, Tindle HA, Brown ST, Hoo G, Rimland D, Gibert CL, Huang L, Freiberg MS, Hough CL, Crothers K. Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2015, 70: 280-288. PMID: 26181820, PMCID: PMC4607625, DOI: 10.1097/qai.0000000000000751.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseCommunity-acquired pneumoniaPneumocystis jirovecii pneumoniaIndependent risk factorIncidence rate ratiosPulmonary infectionRisk factorsAssociation of COPDBurden of COPDVeterans Aging Cohort Study Virtual CohortRisk of CAPMultivariable Poisson regression modelsBaseline comorbid conditionsDifferent pulmonary infectionsInfections Requiring HospitalizationCD4 cell countHIV viral loadChronic lung diseaseObstructive pulmonary diseaseMultivariable Poisson regressionUnadjusted incidence rateNinth Revision codesPoisson regression modelsJirovecii pneumoniaPulmonary tuberculosisThe 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 diseasesComparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Barakat LA, Juthani-Mehta M, Allore H, Trentalange M, Tate J, Rimland D, Pisani M, Akgün KM, Goetz MB, Butt AA, Rodriguez-Barradas M, Duggal M, Crothers K, Justice AC, Quagliarello VJ. Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia. HIV Medicine 2015, 16: 421-430. PMID: 25959543, PMCID: PMC5015437, DOI: 10.1111/hiv.12244.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaVeterans Aging Cohort StudyVACS IndexCAP outcomesAntiretroviral therapyOlder adultsHigher VACS indexDays of dischargeAging Cohort StudyUninfected participantsCohort studyMean LOSHIV infectionLonger LOSClinical outcomesUnadjusted analysesUninfected groupMultivariable modelEligibility criteriaHIVMale veteransMortality rateART useMortalityOutcomesAssociation of Cumulative Dose of Haloperidol With Next-Day Delirium in Older Medical ICU Patients*
Pisani MA, Araujo KL, Murphy TE. Association of Cumulative Dose of Haloperidol With Next-Day Delirium in Older Medical ICU Patients*. Critical Care Medicine 2015, 43: 996-1002. PMID: 25746748, PMCID: PMC4400211, DOI: 10.1097/ccm.0000000000000863.Peer-Reviewed Original ResearchConceptsMedical ICU patientsNext-day deliriumTime-dependent confoundingICU patientsCumulative doseMedical ICUNonintubated patientsOdds ratioConfusion Assessment MethodTreatment of deliriumDose of haloperidolAge 60 yearsEfficacy of haloperidolRoute of administrationAcademic medical centerImportant clinical covariatesICU stayIntubated patientsClinical covariatesObservational studyHigher oddsMedical CenterDeliriumPatientsHaloperidolMortality among patients with pleural effusion undergoing thoracentesis
DeBiasi EM, Pisani MA, Murphy TE, Araujo K, Kookoolis A, Argento AC, Puchalski J. Mortality among patients with pleural effusion undergoing thoracentesis. European Respiratory Journal 2015, 46: 495-502. PMID: 25837039, PMCID: PMC4857137, DOI: 10.1183/09031936.00217114.Peer-Reviewed Original ResearchConceptsCongestive heart failurePleural effusionRenal failureHeart failureBenign etiologyMalignant effusionsHigh mortalityBilateral pleural effusionLong-term mortalityMortality of patientsProspective cohort studyMalignant pleural effusionBaseline characteristicsChart reviewCohort studyNonmalignant effusionsPoor prognosisHigh riskPatientsEffusionStandardised criteriaThoracentesisMortalityEtiologyFailureSleep 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 cohortFeasibility 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 stagesAdvanced Diagnostic Bronchoscopy Using Conscious Sedation and the Laryngeal Nerve Block: Tolerability, Thoroughness, and Diagnostic Yield
Goyal G, Pisani MA, Murphy TE, Araujo KL, Puchalski JT. Advanced Diagnostic Bronchoscopy Using Conscious Sedation and the Laryngeal Nerve Block: Tolerability, Thoroughness, and Diagnostic Yield. Lung 2014, 192: 905-913. PMID: 24972639, PMCID: PMC5417331, DOI: 10.1007/s00408-014-9607-4.Peer-Reviewed Original ResearchConceptsEndobronchial ultrasound-guided transbronchial needle aspirationConscious sedationDiagnostic bronchoscopic proceduresDiagnostic yieldPatient tolerabilityBronchoscopic proceduresUltrasound-guided transbronchial needle aspirationOccurrence of complicationsDosage of medicationAmount of medicationTransbronchial needle aspirationElectromagnetic navigational bronchoscopyAdvanced diagnostic bronchoscopySedation reversalSecondary outcomesPrimary outcomeNerve blockTransbronchial biopsyGeneral anesthesiaParenchymal abnormalitiesConventional bronchoscopyDiagnostic bronchoscopyResultsA totalAdditional biopsiesNeedle aspirationThe 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 illnessMKK3 regulates mitochondrial biogenesis and mitophagy in sepsis-induced lung injury
Mannam P, Shinn AS, Srivastava A, Neamu RF, Walker WE, Bohanon M, Merkel J, Kang MJ, Dela Cruz CS, Ahasic AM, Pisani MA, Trentalange M, West AP, Shadel GS, Elias JA, Lee PJ. MKK3 regulates mitochondrial biogenesis and mitophagy in sepsis-induced lung injury. American Journal Of Physiology - Lung Cellular And Molecular Physiology 2014, 306: l604-l619. PMID: 24487387, PMCID: PMC3962628, DOI: 10.1152/ajplung.00272.2013.Peer-Reviewed Original ResearchConceptsSepsis-induced lung injuryPeripheral blood mononuclear cellsPrimary mouse lung endothelial cellsLethality of sepsisLevels of lungSystemic inflammatory responsePathogenesis of sepsisBlood mononuclear cellsCurrent medical careEffective therapeutic strategyRelevant animal modelsMitochondrial functionLung endothelial cellsNew diagnostic markersMitochondrial biogenesisAction of SIRT1Mouse lung endothelial cellsLung injurySeptic patientsNonseptic controlsMononuclear cellsSpecific therapyInflammatory responseSepsisTherapeutic strategies
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 deprivationFentanylThe Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk
Puchalski JT, Argento AC, Murphy TE, Araujo KL, Pisani MA. The Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk. Annals Of The American Thoracic Society 2013, 10: 336-341. PMID: 23952852, PMCID: PMC3960907, DOI: 10.1513/annalsats.201210-088oc.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsBlood Coagulation DisordersClopidogrelCohort StudiesDrainageFemaleHepatic InsufficiencyHumansInternational Normalized RatioMaleMiddle AgedPlatelet Aggregation InhibitorsPleural EffusionPostoperative HemorrhageProspective StudiesRenal Insufficiency, ChronicRisk FactorsThrombocytopeniaTiclopidineWarfarinConceptsBleeding riskHematocrit levelsProspective observational cohort studySafety of thoracentesisWithholding of medicationsObservational cohort studyPotential bleeding riskElevated INRCohort studyRenal diseaseCommon etiologyPleural effusionRisk factorsObservational studyPatientsThoracentesisMedicationsHemothoraxTransfusionSignificant differencesRiskDiseasePhysiological factorsPhysiological parametersSafetyMedical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*
Akgün KM, Tate JP, Pisani M, Fried T, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Medical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*. Critical Care Medicine 2013, 41: 1458-1467. PMID: 23507717, PMCID: PMC4283206, DOI: 10.1097/ccm.0b013e31827caa46.Peer-Reviewed Original ResearchConceptsMedical ICU admissionVeterans Aging Cohort Study (VACS) IndexICU admissionAntiretroviral therapyRespiratory diagnosesMechanical ventilationVeterans Aging Cohort Study Index scoresUndetectable HIV-1 RNALogistic regressionStudy indicesVeterans Affairs Medical CenterCombination antiretroviral eraCritical care requirementsICU admission diagnosisMedical ICU careCombination antiretroviral therapyInfection/sepsisHIV-1 RNAHuman immunodeficiency virusMultivariable logistic regressionRoutine clinical biomarkersHigh mortality rateRevenue center codesAdmission diagnosisICU mortalityRisk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans
Akgün KM, Gordon K, Pisani M, Fried T, McGinnis KA, Tate JP, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Risk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2013, 62: 52-59. PMID: 23111572, PMCID: PMC4182723, DOI: 10.1097/qai.0b013e318278f3fa.Peer-Reviewed Original ResearchConceptsVACS Index scoreMedical intensive care unit admissionIntensive care unit admissionVeterans Aging Cohort StudyCare unit admissionMICU admissionIndex scoreRisk factorsHazardous alcohol useVACS IndexUnit admissionCurrent smokingChronic obstructive pulmonary diseaseAlcohol useNon-AIDS diseasesVA administrative databasesMultivariable Cox regressionSurvival of HIVObstructive pulmonary diseaseAging Cohort StudyElectronic medical recordsAntiretroviral therapyCause mortalityPrior AIDSPrior cancer