2020
Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency.
Tolchin B, Latham SR, Bruce L, Ferrante LE, Kraschel K, Jubanyik K, Hull SC, Herbst JL, Kapo J, Moritz ED, Hughes J, Siegel MD, Mercurio MR. Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency. The Journal Of Clinical Ethics 2020, 31: 303-317. PMID: 32991327, DOI: 10.1086/jce2020314303.Peer-Reviewed Original ResearchConceptsPublic health emergencyTriage protocolScarce medical resourcesYale New Haven Health SystemMedical resourcesEthical challengesHealth emergencyCOVID-19 pandemicAllocating Scarce Medical ResourcesFuture wavesMajor ethical challengesChronic comorbiditiesPregnant patientsSimilar public health emergenciesHealthcare workersTriage assessmentClinical judgmentCoronavirus diseaseHealth systemSocioeconomic disparitiesRole of ageCOVID-19Less needPublic discussionSecondary goal
2019
Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours?
Leder SB, Warner HL, Suiter DM, Young NO, Bhattacharya B, Siner JM, Davis KA, Maerz LL, Rosenbaum SH, Marshall PS, Pisani MA, Siegel MD, Brennan JJ, Schuster KM. Evaluation of Swallow Function Post-Extubation: Is It Necessary to Wait 24 Hours? Annals Of Otology Rhinology & Laryngology 2019, 128: 619-624. PMID: 30841709, DOI: 10.1177/0003489419836115.Peer-Reviewed Original ResearchConceptsIntensive care unitSwallow evaluationDifferent intensive care unitsRe-intubation rateYale Swallow ProtocolMajority of patientsPost-extubation dysphagiaIntubation durationNosocomial pneumoniaPost extubationLonger hospitalizationCare unitProspective InvestigationSwallow ProtocolSwallowingHoursDysphagiaHospitalizationIntubationPneumoniaPatientsIncidenceEvaluation
2015
Use of the Blom Tracheotomy Tube with Suction Inner Cannula to Decontaminate Microorganisms from the Subglottic Space. A Proof of Concept
Rabach L, Siegel MD, Puchalski JT, Towle D, Follert M, Johnson KM, Rademaker AW, Leder SB. Use of the Blom Tracheotomy Tube with Suction Inner Cannula to Decontaminate Microorganisms from the Subglottic Space. A Proof of Concept. Annals Of The American Thoracic Society 2015, 12: 859-863. PMID: 25849332, DOI: 10.1513/annalsats.201501-010bc.Peer-Reviewed Original ResearchConceptsMechanical ventilationTracheotomy tubeSubglottic spaceInner cannulaNormal floraPulmonary complicationsSignificant reductionOngoing mechanical ventilationEndotracheal tube intubationSingle-center studyTube intubationIll patientsEndotracheal tubeICU adultsSputum samplesTracheotomyMicrobiologic analysisCannulaVentilationComplicationsWeeksPathogensDurationSupraTracheostomyAn Official American Thoracic Society Policy Statement: Managing Conscientious Objections in Intensive Care Medicine
Lewis-Newby M, Wicclair M, Pope T, Rushton C, Curlin F, Diekema D, Durrer D, Ehlenbach W, Gibson-Scipio W, Glavan B, Langer L, Manthous C, Rose C, Scardella A, Shanawani H, Siegel MD, Halpern SD, Truog RD, White DB. An Official American Thoracic Society Policy Statement: Managing Conscientious Objections in Intensive Care Medicine. American Journal Of Respiratory And Critical Care Medicine 2015, 191: 219-227. PMID: 25590155, DOI: 10.1164/rccm.201410-1916st.Peer-Reviewed Original ResearchMeSH KeywordsAccess to InformationAdolescentAdultAgedAttitude of Health PersonnelBioethical IssuesChildConscienceDisclosureFemaleGuidelines as TopicHealth Services AccessibilityHumansInfantIntensive Care UnitsMaleMiddle AgedOrganizational PolicyPatient RightsPregnancyProfessional AutonomySocieties, MedicalUnited StatesWorkforceConceptsCritical care settingCare settingsConscientious objectionMedical servicesAmerican Thoracic Society StatementIntensive care unit cliniciansMoral integrityTimely accessIntensive care medicineHospital administratorsMultidisciplinary expert committeeAvailable medical servicesPolicy statementsSociety statementCare medicineAdult medicineClinician judgmentPatient accessPatient advocacyCliniciansPatientsDiverse working groupExcessive hardshipsInstitutional mechanismsMoral dialogue
2012
Pathogenetic and predictive value of biomarkers in patients with ALI and lower severity of illness: results from two clinical trials
Agrawal A, Zhuo H, Brady S, Levitt J, Steingrub J, Siegel MD, Soto G, Peterson MW, Chesnutt MS, Matthay MA, Liu KD. Pathogenetic and predictive value of biomarkers in patients with ALI and lower severity of illness: results from two clinical trials. American Journal Of Physiology - Lung Cellular And Molecular Physiology 2012, 303: l634-l639. PMID: 22865551, PMCID: PMC3469636, DOI: 10.1152/ajplung.00195.2012.Peer-Reviewed Original ResearchMeSH KeywordsAcute Lung InjuryAdultAgedAPACHEBiomarkersBronchoalveolar Lavage FluidCohort StudiesFemaleHumansInterleukin-6Interleukin-8MaleMiddle AgedPlasminogen Activator Inhibitor 1PneumoniaPredictive Value of TestsProtein CPulmonary EdemaRespiratory Distress SyndromeRespiratory InsufficiencyRisk FactorsSeverity of Illness IndexThrombomodulinConceptsAcute lung injuryVentilator-free daysPlasma plasminogen activator inhibitor-1IL-6Oxygenation indexClinical trialsPredictive valueClinical outcomesIL-8Treatment of ALIHigher APACHE II scoreHigher plasma IL-6Severe acute lung injuryRelevant outcomesBronchoalveolar lavage (BAL) biomarkersAPACHE II scorePlasma IL-6Cohort of patientsMarker of severitySimilar baseline characteristicsPoor clinical outcomePlasminogen activator inhibitor-1Future clinical trialsAssociation of plasmaActivator inhibitor-1Using standardized family members to teach end-of-life skills to critical care trainees*
Akgün KM, Siegel MD. Using standardized family members to teach end-of-life skills to critical care trainees*. Critical Care Medicine 2012, 40: 1978-1980. PMID: 22610211, DOI: 10.1097/ccm.0b013e3182536cd1.Peer-Reviewed Original ResearchAdapting To the New Consensus Guidelines for Managing Hyperglycemia During Critical Illness: the Updated Yale Insulin Infusion Protocol
Shetty S, Inzucchi SE, Goldberg PA, Cooper D, Siegel MD, Honiden S. Adapting To the New Consensus Guidelines for Managing Hyperglycemia During Critical Illness: the Updated Yale Insulin Infusion Protocol. Endocrine Practice 2012, 18: 363-370. PMID: 22138078, DOI: 10.4158/ep11260.or.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlood GlucoseCohort StudiesConnecticutCritical CareDiabetes MellitusDrug MonitoringFemaleHealth Plan ImplementationHumansHyperglycemiaHypoglycemiaHypoglycemic AgentsInfusions, IntravenousInsulin, Regular, HumanMaleMiddle AgedPractice Guidelines as TopicProspective StudiesTime FactorsConceptsYale Insulin Infusion ProtocolInsulin infusion protocolBlood glucose concentrationIntensive care unitBlood glucose valuesInsulin infusionInfusion protocolChronic Health Evaluation II scoreGlucose valuesMedical intensive care unitGlucose concentrationAdmission Acute PhysiologyUse of vasopressorsBlood glucose targetsContinuous venovenous hemodialysisIntravenous dextrose infusionBlood glucose controlBaseline blood glucose concentrationRecent national guidelinesNew consensus guidelinesInsulin infusion rateAcute PhysiologyIntravenous dextroseII scoreMedian durationWithin the black box
Siegel MD, Perez MT. Within the black box. Critical Care Medicine 2012, 40: 1339-1340. PMID: 22425829, DOI: 10.1097/ccm.0b013e3182451b76.Peer-Reviewed Original ResearchStranger in a strange land
Akgün KM, Siegel MD. Stranger in a strange land. Critical Care Medicine 2012, 40: 312-313. PMID: 22179354, DOI: 10.1097/ccm.0b013e3182326694.Peer-Reviewed Original Research
2011
Safe initiation of oral diets in hospitalized patients based on passing a 3-ounce (90 cc) water swallow challenge protocol
Leder SB, Suiter DM, Warner HL, Acton LM, Siegel MD. Safe initiation of oral diets in hospitalized patients based on passing a 3-ounce (90 cc) water swallow challenge protocol. QJM 2011, 105: 257-263. PMID: 22006561, DOI: 10.1093/qjmed/hcr193.Peer-Reviewed Original ResearchConceptsSpecific diet recommendationsOral dietChallenge protocolDiet recommendationsOvert signsThin liquidsProspective single groupOptimum patient careDysphagia testingAspiration eventsHospitalized patientsSafe initiationCase seriesOral alimentationAcute careTertiary careTeaching hospitalInclusion criteriaMedian volumeIntake informationCare providersPatientsPatient careShort-term successCareThe Management of the Critically Ill Obstetric Patient
Honiden S, Abdel-Razeq SS, Siegel MD. The Management of the Critically Ill Obstetric Patient. Journal Of Intensive Care Medicine 2011, 28: 93-106. PMID: 21841145, DOI: 10.1177/0885066611411408.Peer-Reviewed Original ResearchConceptsObstetric patientsCritically Ill Obstetric PatientIntensive care unit admissionIll obstetric patientsCare unit admissionCritical care physiciansMortality prediction toolProvision of careAcid-base statusUnit admissionHypertensive disordersICU mortalityMaternal outcomesRespiratory failureCesarean deliveryCommon indicationCare physiciansPostpartum hemorrhageCardiac arrestPhysiologic changesTreatment choicePatientsSpecial populationsRadiographic testsExposure limits
2010
The Perception Gap Race, Religion, and Prognosis in the ICU
Siegel MD, Prigerson HG. The Perception Gap Race, Religion, and Prognosis in the ICU. CHEST Journal 2010, 138: 8-9. PMID: 20605808, DOI: 10.1378/chest.10-0454.Peer-Reviewed Original Research
2009
ELEVATED SERUM ANGIOPOIETIN 2 LEVELS ARE ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS
Siner JM, Bhandari V, Engle KM, Elias JA, Siegel MD. ELEVATED SERUM ANGIOPOIETIN 2 LEVELS ARE ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS. Shock 2009, 31: 348-353. PMID: 18791490, DOI: 10.1097/shk.0b013e318188bd06.Peer-Reviewed Original ResearchConceptsAng-2 levelsIntensive care unitAng-2Tertiary care medical intensive care unitProspective observational cohort studySerum Ang-2 levelsSerum angiopoietin-2 levelsMedical intensive care unitSerum Ang-2Observational cohort studyAngiopoietin-2 levelsIL-6 levelsHospital mortalityHuman sepsisICU admissionSevere sepsisCohort studyEndothelial dysfunctionHospital dischargeICU patientsIllness scoresSeptic shockCare unitIL-6Increased Mortality