2024
Arterial hyperoxia and mortality in the cardiac intensive care unit
Jentzer J, van Diepen S, Alviar C, Miller P, Metkus T, Geller B, Kashani K. Arterial hyperoxia and mortality in the cardiac intensive care unit. Current Problems In Cardiology 2024, 49: 102738. PMID: 39025170, DOI: 10.1016/j.cpcardiol.2024.102738.Peer-Reviewed Original ResearchCardiac intensive care unitIn-hospital mortalityIntensive care unitEvaluate predictors of in-hospital mortalityArterial hyperoxiaPaO2 >Mayo Clinic CICU patientsAssociated with increased in-hospital mortalityCare unitPredictors of in-hospital mortalityAssociated with higher in-hospital mortalityAssociated with adverse outcomesTime of CICU admissionAdmission PaO2Higher in-hospital mortalityCritically ill populationArterial partial pressure of oxygenPositive-pressure ventilationJ-shaped associationExposure to hyperoxiaCICU patientsArterial partial pressureCICU admissionEvaluate predictorsMedian PaO2Exposure to hyperoxemia and mortality in cardiac intensive care unit patients
Alviar C, Jentzer J, Van Diepen S, Metkus T, Miller P, Kashani K. Exposure to hyperoxemia and mortality in cardiac intensive care unit patients. European Heart Journal Acute Cardiovascular Care 2024, 13: zuae036.138. DOI: 10.1093/ehjacc/zuae036.138.Peer-Reviewed Original ResearchIn-hospital mortalityCardiac intensive care unitCardiac intensive care unit admissionJ-shaped associationJ-shaped relationshipCritical care settingCardiac intensive care unit patientsCare settingsAssociated with increased in-hospital mortalityCare conditionsInpatient deathCharlson Comorbidity IndexMayo Clinic CICU patientsIntensive care unit patientsAssociated with adverse outcomesAdmission diagnosisLogistic regressionCICU patientsExposure to hyperoxemiaHigher mortalityPrimary outcomeIntensive care unitIll cardiac patientsGeneral critical care settingCardiac patientsEarly Serial Assessment of Aggregate Vasoactive Support and Mortality in Cardiogenic Shock: Insights From the Critical Care Cardiology Trials Network Registry
Patel S, Berg D, Bohula E, Baird-Zars V, Barsness G, Chaudhry S, Chonde M, Cooper H, Ginder C, Jentzer J, Kontos M, Miller P, Newby L, O’Brien C, Park J, Pierce M, Pisani B, Potter B, Shah K, Teuteberg J, Katz J, van Diepen S, Morrow D. Early Serial Assessment of Aggregate Vasoactive Support and Mortality in Cardiogenic Shock: Insights From the Critical Care Cardiology Trials Network Registry. Circulation Heart Failure 2024, 17: e011736. PMID: 38587438, DOI: 10.1161/circheartfailure.124.011736.Peer-Reviewed Original ResearchVasoactive-inotropic scoreCardiac intensive care unitVasoactive supportCardiogenic shockGradient of riskMechanical circulatory supportPatients admitted with CSCardiac intensive care unit admissionClinical decision-makingCritical Care Cardiology Trials NetworkIntensive care unitSCAI stagesNetwork registryCare unitTrials NetworkSOFA scoreMulticenter registryPrognostic associationMortalitySerial assessmentCirculatory supportSupportEarly changesScoresPatients
2023
Research Priorities in Critical Care Cardiology JACC Expert Panel
Miller P, Huber K, Bohula E, Krychtiuk K, Pöss J, Roswell R, Tavazzi G, Solomon M, Kristensen S, Morrow D, Care A. Research Priorities in Critical Care Cardiology JACC Expert Panel. Journal Of The American College Of Cardiology 2023, 82: 2329-2337. PMID: 38057075, PMCID: PMC10752230, DOI: 10.1016/j.jacc.2023.09.828.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitCritical care cardiologyHigh-quality evidencePatient populationIntensive care unitCritical care researchCare unitIll patientsSociety guidelinesClinical trialsPractice patternsCare researchExpert panelDiagnosisResearch prioritiesComorbiditiesPatientsPopulationLimited guidanceCliniciansCardiologyTrialsCarePrognostic significance of haemodynamic parameters in patients with cardiogenic shock
Berg D, Kaur G, Bohula E, Baird-Zars V, Alviar C, Barnett C, Barsness G, Burke J, Chaudhry S, Chonde M, Cooper H, Daniels L, Dodson M, Gerber D, Ghafghazi S, Gidwani U, Goldfarb M, Guo J, Hillerson D, Kenigsberg B, Kochar A, Kontos M, Kwon Y, Lopes M, Loriaux D, Miller P, O’Brien C, Papolos A, Patel S, Pisani B, Potter B, Prasad R, Roswell R, Shah K, Sinha S, Smith T, Solomon M, Teuteberg J, Thompson A, Zakaria S, Katz J, van Diepen S, Morrow D. Prognostic significance of haemodynamic parameters in patients with cardiogenic shock. European Heart Journal Acute Cardiovascular Care 2023, 12: 651-660. PMID: 37640029, PMCID: PMC10599641, DOI: 10.1093/ehjacc/zuad095.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitInvasive haemodynamic assessmentRight atrial pressureCardiogenic shockHaemodynamic parametersHaemodynamic assessmentCICU admissionSerum lactateCritical Care Cardiology Trials NetworkLower pulmonary artery pulsatility indexPulmonary capillary wedge pressure ratioLow systemic vascular resistancePulmonary artery pulsatility indexLower systolic blood pressureTemporary mechanical circulatory supportMedian cardiac indexTIMI Study GroupVasoactive-inotropic scoreArtery pulsatility indexEnd-organ dysfunctionRight ventricular dysfunctionSystemic vascular resistancePulmonary artery catheterSystolic blood pressureManagement of patientsPulmonary Artery Catheter Use and Mortality in the Cardiac Intensive Care Unit
Kadosh B, Berg D, Bohula E, Park J, Baird-Zars V, Alviar C, Alzate J, Barnett C, Barsness G, Burke J, Chaudhry S, Daniels L, DeFilippis A, Delicce A, Fordyce C, Ghafghazi S, Gidwani U, Goldfarb M, Katz J, Keeley E, Kenigsberg B, Kontos M, Lawler P, Leibner E, Menon V, Metkus T, Miller P, O'Brien C, Papolos A, Prasad R, Shah K, Sinha S, Snell R, So D, Solomon M, Ternus B, Teuteberg J, Toole J, van Diepen S, Morrow D, Roswell R. Pulmonary Artery Catheter Use and Mortality in the Cardiac Intensive Care Unit. JACC Heart Failure 2023, 11: 903-914. PMID: 37318422, PMCID: PMC10527413, DOI: 10.1016/j.jchf.2023.04.007.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitPulmonary artery catheterUse of PACHospital mortalityCare unitPAC useCardiac patientsCritical Care Cardiology Trials NetworkPulmonary artery catheter usePatient-level factorsIll cardiac patientsIntensive care unitMechanical circulatory supportCardiac critical careAppropriate useCardiogenic etiologyAdmission diagnosisShock patientsCatheter useArtery catheterCICU admissionHeart failureRandomized trialsCirculatory supportCritical careLiberation From Mechanical Ventilation in the Cardiac Intensive Care Unit
Shahu A, Banna S, Applefeld W, Rampersad P, Alviar C, Ali T, Luk A, Fajardo E, van Diepen S, Miller P. Liberation From Mechanical Ventilation in the Cardiac Intensive Care Unit. JACC Advances 2023, 2: 100173. PMID: 38939038, PMCID: PMC11198553, DOI: 10.1016/j.jacadv.2022.100173.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsContemporary cardiac intensive care unitsInvasive mechanical ventilationCardiac intensive care unitIntensive care unitCare unitMechanical ventilationPost-extubation careSpontaneous breathing trialCareful clinical assessmentPositive pressure ventilationExtubation failureRespiratory decompensationSedation managementBreathing trialRespiratory failurePressure ventilationVentilator weaningExtubation readinessCardiovascular patientsClinical assessmentCardiopulmonary interactionsHigh riskPatientsVentilationSignificant increase
2022
Characteristics, therapies, and outcomes of In-Hospital vs Out-of-Hospital cardiac arrest in patients presenting to cardiac intensive care units: From the critical care Cardiology trials network (CCCTN)
Carnicelli A, Keane R, Brown K, Loriaux D, Kendsersky P, Alviar C, Arps K, Berg D, Bohula E, Burke J, Dixson J, Gerber D, Goldfarb M, Granger C, Guo J, Harrison R, Kontos M, Lawler P, Miller P, Nativi-Nicolau J, Newby L, Racharla L, Roswell R, Shah K, Sinha S, Solomon M, Teuteberg J, Wong G, van Diepen S, Katz J, Morrow D. Characteristics, therapies, and outcomes of In-Hospital vs Out-of-Hospital cardiac arrest in patients presenting to cardiac intensive care units: From the critical care Cardiology trials network (CCCTN). Resuscitation 2022, 183: 109664. PMID: 36521683, PMCID: PMC9899313, DOI: 10.1016/j.resuscitation.2022.12.002.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitCritical Care Cardiology Trials NetworkOutcome of admissionIntensive care unitCardiac arrestCare unitContemporary cardiac intensive care unitsTertiary cardiac intensive care unitsTrials NetworkLower lactateLower crude mortalityRenal replacement therapyMechanical circulatory supportHospital cardiac arrestHospital mortalityIHCA patientsInvasive hemodynamicsCICU admissionIn-HospitalCoronary diseaseCrude mortalityHeart failureOHCA patientsAtrial fibrillationCirculatory supportPatients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry
Fagundes A, Berg DD, Park JG, Baird-Zars VM, Newby LK, Barsness GW, Miller PE, van Diepen S, Katz JN, Phreaner N, Roswell RO, Menon V, Daniels LB, Morrow DA, Bohula EA, Investigators F. Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry. Circulation Cardiovascular Quality And Outcomes 2022, 15: e008652. PMID: 35862019, DOI: 10.1161/circoutcomes.121.008652.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitAcute coronary syndromeContemporary cardiac intensive care unitsIntensive care unitCICU admissionAdmission indicationsCICU mortalityCoronary syndromeCare unitPrimary diagnosisIntensive care unit therapyEpidemiology of patientsNon-ACS diagnosisLow-risk patientsTime of admissionCICU lengthAcute severityVasoactive therapyPatient characteristicsRespiratory insufficiencyRisk patientsCommon indicationRoutine admissionACS admissionsProspective studyStaffing models in the cardiac intensive care unit
Quien M, Thomas A, Ludmir J, Miller PE. Staffing models in the cardiac intensive care unit. Current Opinion In Critical Care 2022, 28: 453-459. PMID: 35757936, DOI: 10.1097/mcc.0000000000000958.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsCardiac intensive care unitIntensive care unitCare unitContemporary cardiac intensive care unitsModern cardiac intensive care unitMechanical circulatory supportSick patient populationFuture multicenter studiesStaffing modelsPreponderance of dataShock teamRespiratory failureIll patientsCirculatory supportMulticenter studyCardiac arrestPatient populationCardiac intensivistsIll populationMortalityRecent evidenceIntensivistsPatientsRecent dataPopulation
2021
The association between cardiac intensive care unit mechanical ventilation volumes and in-hospital mortality
Nandiwada S, Islam S, Jentzer JC, Miller PE, Fordyce CB, Lawler P, Alviar CL, Sun LY, Dover DC, Lopes RD, Kaul P, van Diepen S. The association between cardiac intensive care unit mechanical ventilation volumes and in-hospital mortality. European Heart Journal Acute Cardiovascular Care 2021, 10: 797-805. PMID: 34318875, PMCID: PMC9067446, DOI: 10.1093/ehjacc/zuab055.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitMechanical ventilationHospital mortalityRespiratory failureCICU LOSNon-invasive mechanical ventilationNational population-based dataInvasive mechanical ventilationVolume-mortality relationshipProlonged mechanical ventilationProportion of patientsHigh-volume hospitalsPercutaneous coronary interventionLow-volume centersHigh-volume centersIntensive care unitPopulation-based dataOutcomes of interestCICU lengthCICU admissionCoronary interventionSurgical ICUCare unitVolume centersLower incidenceHigher CICU mechanical ventilation volumes are associated with lower in-hospital mortality
Nandiwada S, Islam S, Jentzer J, Miller P, Fordyce C, Lawler P, Alviar C, Sun L, Dover D, Kaul P, Van Diepen S. Higher CICU mechanical ventilation volumes are associated with lower in-hospital mortality. European Heart Journal Acute Cardiovascular Care 2021, 10: zuab020.161. DOI: 10.1093/ehjacc/zuab020.161.Peer-Reviewed Original ResearchCardiac intensive care unitCICU LOSIn-hospital mortalityAssociated with lower in-hospital mortalityProlonged MVLower in-hospital mortalityProportion of patientsMechanical ventilationRespiratory failureVolume centersCardiac intensive care unit lengthCardiac intensive care unit admissionIncidence of respiratory failureNon-invasive mechanical ventilationAssociated with reduced mortalityInvasive mechanical ventilationLow-volume centersIntensive care unitHigh-volume hospitalsCardiac intensive care unit populationPopulation-based dataSurgical ICUOdds ratioAcademic centersCare unitTransition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes
Miller PE, Chouairi F, Thomas A, Kunitomo Y, Aslam F, Canavan ME, Murphy C, Daggula K, Metkus T, Vallabhajosyula S, Carnicelli A, Katz JN, Desai NR, Ahmad T, Velazquez EJ, Brennan J. Transition From an Open to Closed Staffing Model in the Cardiac Intensive Care Unit Improves Clinical Outcomes. Journal Of The American Heart Association 2021, 10: e018182. PMID: 33412899, PMCID: PMC7955420, DOI: 10.1161/jaha.120.018182.Peer-Reviewed Original ResearchConceptsCardiac intensive care unitIntensive care unitHospital mortalityCare unitCICU mortalityClinical outcomesModern cardiac intensive care unitSurgical intensive care unitTotal hospital chargesSeverity of illnessMultivariable logistic regressionCICU lengthMultivariable adjustmentRespiratory insufficiencyPrimary outcomeUnique admissionsHospital chargesCardiac arrestSubgroup analysisImproved outcomesMortalityLogistic regressionAdmissionClosed unitStaffing models
2020
Prevalence of Noncardiac Multimorbidity in Patients Admitted to Two Cardiac Intensive Care Units and Their Association with Mortality
Miller PE, Thomas A, Breen TJ, Chouairi F, Kunitomo Y, Aslam F, Damluji AA, Anavekar NS, Murphy JG, van Diepen S, Barsness GW, Brennan J, Jentzer J. Prevalence of Noncardiac Multimorbidity in Patients Admitted to Two Cardiac Intensive Care Units and Their Association with Mortality. The American Journal Of Medicine 2020, 134: 653-661.e5. PMID: 33129785, PMCID: PMC8079541, DOI: 10.1016/j.amjmed.2020.09.035.Peer-Reviewed Original ResearchConceptsCritical care therapiesNoncardiac comorbiditiesCICU populationCare therapyLong-term adverse clinical outcomesCardiac intensive care unitIntensive care unit practiceBetter care pathwaysIncreased hospital mortalityNoncardiac organ failureUnique patient admissionsAdverse clinical outcomesIntensive care unitMultivariable logistic regressionLength of stayAcute cardiac illnessCICU patientsHospital mortalityNoncardiac indicationsICU admissionMultivariable adjustmentOrgan failureCare unitClinical outcomesCardiac illness
2019
Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry
Berg DD, Barnett CF, Kenigsberg BB, Papolos A, Alviar CL, Baird-Zars VM, Barsness GW, Bohula EA, Brennan J, Burke JA, Carnicelli AP, Chaudhry SP, Cremer PC, Daniels LB, DeFilippis AP, Gerber DA, Granger CB, Hollenberg S, Horowitz JM, Gladden JD, Katz JN, Keeley EC, Keller N, Kontos MC, Lawler PR, Menon V, Metkus TS, Miller PE, Nativi-Nicolau J, Newby LK, Park JG, Phreaner N, Roswell RO, Schulman SP, Sinha SS, Snell RJ, Solomon MA, Teuteberg JJ, Tymchak W, van Diepen S, Morrow DA. Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry. Circulation Heart Failure 2019, 12: e006635. PMID: 31707801, PMCID: PMC7008928, DOI: 10.1161/circheartfailure.119.006635.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiologistsCoronary Care UnitsExtracorporeal Membrane OxygenationFemaleHealthcare DisparitiesHeart-Assist DevicesHemodynamicsHumansIntra-Aortic Balloon PumpingMaleMiddle AgedNorth AmericaPatient AdmissionPractice Patterns, Physicians'Recovery of FunctionRisk FactorsSeverity of Illness IndexShock, CardiogenicTime FactorsTreatment OutcomeConceptsIntraaortic balloon pumpTemporary MCSCardiogenic shockIllness severityBalloon pumpPractice patternsAcute myocardial infarction-related cardiogenic shockCritical Care Cardiology Trials Network RegistryLower Sequential Organ Failure Assessment scoresSequential Organ Failure Assessment scoreTemporary mechanical circulatory support devicesVeno-arterial extracorporeal membrane oxygenationIntraaortic balloon pump useOrgan Failure Assessment scoreTemporary mechanical circulatory supportCardiac intensive care unitInfarction-related cardiogenic shockMechanical circulatory support devicesOverall practice patternsTemporary MCS devicesExtracorporeal membrane oxygenationSevere metabolic derangementHospital-level variationIntensive care unitMechanical circulatory support
2018
Positive Pressure Ventilation in the Cardiac Intensive Care Unit
Alviar CL, Miller PE, McAreavey D, Katz JN, Lee B, Moriyama B, Soble J, van Diepen S, Solomon MA, Morrow DA, Group A. Positive Pressure Ventilation in the Cardiac Intensive Care Unit. Journal Of The American College Of Cardiology 2018, 72: 1532-1553. PMID: 30236315, PMCID: PMC11032173, DOI: 10.1016/j.jacc.2018.06.074.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsContemporary cardiac intensive care unitsPositive pressure ventilationInvasive positive pressure ventilationCardiac intensive care unitIntensive care unitCare unitPressure ventilationNoninvasive positive pressure ventilationMechanical positive pressure ventilationCardiogenic pulmonary edemaProportion of patientsManagement of patientsRisk of complicationsMechanical circulatory supportComplex patient populationRight ventricular physiologyCICU mortalityCardiogenic shockRespiratory failurePulmonary edemaCirculatory supportCardiac arrestPatient populationVentricular physiologyMedical complexity