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Supplemental material, sj-docx-1-jic-10.1177_08850666231174870 for Trajectory of PaO2/FiO2 Ratio in Shock After Angiotensin II by Patrick M. Wieruszewski, PharmD, Patrick J. Coleman, MD, MPH, Maj, MC, Andrea R. Levine, MD, Danielle Davison, MD, Nathan J. Smischney, MD, MSc, Shravan Kethireddy, MD, Yanglin Guo, MD, Jason Hecht, PharmD, Michael A. Mazzeffi, MD, and Jonathan H. Chow, MD in Journal of Intensive Care Medicine

Supplemental material, sj-docx-1-jic-10.1177_08850666231174870 for Trajectory of PaO2/FiO2 Ratio in Shock After Angiotensin II by Patrick M. Wieruszewski, PharmD, Patrick J. Coleman, MD, MPH, Maj, MC, Andrea R. Levine, MD, Danielle Davison, MD, Nathan J. Smischney, MD, MSc, Shravan Kethireddy, MD, Yanglin Guo, MD, Jason Hecht, PharmD, Michael A. Mazzeffi, MD, and Jonathan H. Chow, MD in Journal of Intensive Care Medicine

Supplemental material, sj-docx-1-jic-10.1177_08850666221142265 for Thromboelastography Parameters do not Discriminate for Thrombotic Events in Hospitalized Patients With COVID-19 by Susan Kartiko, Naoru Koizumi, David Yamane, Babak Sarani, Abu B. Siddique and Andrea R. Levine, Amanda M. Jackson, Patrick M. Wieruszewski, Nathan J. Smischney, Ashish K. Khanna, Jonathan H. Chow, in Journal of Intensive Care Medicine

Supplemental material, sj-docx-2-jicm-10.1177_08850666221085256 for Hypotension Prediction Score for Endotracheal Intubation in Critically Ill Patients: A Post Hoc Analysis of the HEMAIR Study* by Nathan J. Smischney, Salim R. Surani, Ashley Montgomery, Pablo Moreno Franco, Cynthia Callahan, Gozde Demiralp, Rudy Tedja, Sarah Lee, Santhi I. Kumar and Ashish K. Khanna in Journal of Intensive Care Medicine

Supplemental material, sj-docx-1-jicm-10.1177_08850666221085256 for Hypotension Prediction Score for Endotracheal Intubation in Critically Ill Patients: A Post Hoc Analysis of the HEMAIR Study* by Nathan J. Smischney, Salim R. Surani, Ashley Montgomery, Pablo Moreno Franco, Cynthia Callahan, Gozde Demiralp, Rudy Tedja, Sarah Lee, Santhi I. Kumar and Ashish K. Khanna in Journal of Intensive Care Medicine

Supplememt_material for Risk Factors for and Outcomes Associated With Peri-Intubation Hypoxemia: A Multicenter Prospective Cohort Study by Nathan J. Smischney, Ashish K. Khanna, Ernesto Brauer, Lee E. Morrow, Uchenna R. Ofoma, David A. Kaufman, Ayan Sen, Chakradhar Venkata, Peter Morris, Vikas Bansal and On behalf of SCCM Discovery (Critical Care Research Network of Critical Care Medicine) HEMAIR Investigators in Journal of Intensive Care Medicine

Additional file 1. Figure S1. Initial attrition diagram leading into cohort selection for current study. Method S1. Brief description of the machine learning approach to identify patients discharged to the ICU for patients with an undocumented post-surgery care location. Table S1. Comorbidities and additional cohort patient characteristics. Table S2. International Classification of Diseases (ICD) codes. Table S3. List of antihypertensive drug classes. Table S4. Multivariate model results. Table S5. P-values of hazard ratios for primary and secondary outcomes. Table S6. E-values to assess the magnitude of an unobserved or unaccounted confounding effect for postoperative hypotension in intensive care unit setting. Table S7. Hazard/Incidence rate ratios and p-values for length-of-stay and use of intensive care unit-specific endpoints for intensive care unit patients with postoperative hypotension (exploratory outcomes).

To evaluate the effectiveness of an admixture of ketamine and propofol on peri-induction hemodynamics during airway manipulation, we searched electronic databases of randomized controlled trials from January 1, 2000, to October 17, 2018. Trial screening, selection, and data extraction were done independently by two reviewers with outcomes pooled across included trials using the random-effects model. We included 10 randomized trials (722 patients, mean age of 53.99 years, 39.96% female). American Society of Anesthesiologists physical status was reported in 9 trials with classes I and II representing the majority. Ketamine/propofol admixture was associated with a nonsignificant increase in heart rate (weighted mean difference, 3.36 beats per minute (95% CI, −0.88, 7.60), I2 = 88.6%), a statistically significant increase in systolic blood pressure (weighted mean difference, 9.67 mmHg (95% CI, 1.48, 17.86), I2 = 87.2%), a nonsignificant increase in diastolic blood pressure (weighted mean difference, 2.18 mmHg (95% CI, −2.82, 7.19), I2 = 73.1%), and a nonsignificant increase in mean arterial pressure (weighted mean difference, 3.28 mmHg (95% CI, −0.94, 7.49), I2 = 69.9%) compared to other agents. The risk of bias was high and the certainty of evidence was low. In conclusion, among patients undergoing airway manipulation and needing sedation, the use of a ketamine/propofol admixture may be associated with better hemodynamics compared to nonketamine/propofol sedation. This trial is registered with CRD42019125725.

Supplemental Material, Appendix_1_HEMAIR_Survey for Survey on the Current State of Endotracheal Intubation Among the Critically Ill by Mohamed O. Seisa, Venkatesh Gondhi, Onur Demirci, Daniel A. Diedrich, Rahul Kashyap, and Nathan J. Smischney in Journal of Intensive Care Medicine

Background: Emergent use research—research involving human subjects that have a life-threatening medical condition and who are unlikely to provide informed consent—in critical illness is fraught with challenges related to obtaining informed consent. Per federal regulations, to meet criteria to conduct such trials, the investigators have to seek community consultations. Effective ways of obtaining this consultation remains ill-defined. Objective: We sought to describe methods, interpretations, and our experiences of conducting community consultation in a planned emergent use randomized controlled trial. Methods: As part of a planned emergent use clinical trial in our study, community consultation consisted of four focus groups sessions with members from the community in which the clinical trial was conducted. Three focus group sessions were conducted with members who had an affiliation to Mayo Clinic, and the other focus group session was conducted with non-Mayo affiliation members. The feedback from the focus group sessions led to the creation of the public notification plan. The public was notified of the trial through community meetings as well as social media. Results: As compared to community meetings, focus group sessions resulted in greater attendance with more interactive discussions. Moreover, focus group sessions resulted in greater in-depth conversations leading to institutional acceptance of the clinical trial under study. Conclusions: Exception from informed consent can be acceptable to the community. Focus groups provided better participation and valuable interactive insight as compared to community meetings in our study. This could serve as a valuable guide for investigators pursuing exception from informed consent in their research studies. [JMIR Res Protoc 2018;7(5):e10062]

Endotracheal intubation is frequently performed in the intensive care unit (ICU). It can be life-saving for many patients who present with acute respiratory distress. However, it is equally associated with complications that may lead to unwanted effects in this patient population. According to the literature, the rate of complications associated with endotracheal intubation is much higher in an environment such as the ICU as compared to other, more controlled environments (i.e., operating room). Thus, the conduct of performing such a procedure needs to be accomplished with the utmost care. To facilitate establishment of the breathing tube, sedation is routinely administered. Given the tenuous hemodynamic status of the critically ill, etomidate was frequently chosen to blunt further decreases in blood pressure and/or heart rate. Recently however, reports have demonstrated a possible association with the use of etomidate for endotracheal intubation and mortality in the critically ill. In addition, this association seems to be predominantly in patients diagnosed with sepsis. As a result, some have advocated against the use of this medication in septic patients. Due to the negative associations identified with etomidate and mortality, several investigators have evaluated potential alternatives to this solution (e.g., ketamine and ketamine-propofol admixture). These studies have shown promise. However, despite the evidence against using etomidate for endotracheal intubation, other studies have demonstrated no such association. This leaves the critical care clinician with uncertainty regarding the best sedative to administer in this patient population. The following editorial discusses current evidence regarding etomidate use for endotracheal intubation and mortality. In particular, we highlight a recent article with the largest population to date that found no association between etomidate and mortality in the critically ill and illustrate important findings that the reader should be aware of regarding this article.