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682 results on '"Sessler, A."'

3. Incidence and Risk Factors of Chronic Postoperative Pain in Same-day Surgery: A Prospective Cohort Study.

Author

Boko, Melodie Fanay, Khanna, Ashish K., D'Aragon, Frederick, Spence, Jessica, Conen, David, Patel, Ameen, Ayad, Sabry, Wijeysundera, Duminda N., Choinière, Manon, Sessler, Daniel I., Carrier, Francois Martin, Harlock, John, Koopman, Josèph S. H. A., Durand, Madeleine, Bhojani, Naeem, Turan, Alparslan, Pagé, Gabrielle, Devereaux, P. J., Duceppe, Emmanuelle, and Daila Carling, Roberta

Published
2024
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4. The Gathering Storm: The 2023 Rovenstine Lecture.

Author

Sessler, Daniel I.

Abstract

Anesthesiologists are currently in demand and highly compensated. What appears to be a great success from our perspective is considered problematic from every other healthcare perspective. Consequently, there are powerful healthcare forces seeking to improve anesthesia access and reduce service cost. They will try to impose solutions that may radically change operative anesthesia. The Rovenstine lecture, delivered on World Anesthesia Day 2023, identified substantial challenges our specialty faces and discusses solutions that might be forced on us. It also presented opportunities in perioperative care. Anesthesiologists are currently in demand and highly compensated, which is considered problematic from every other healthcare perspective. Consequently, powerful healthcare forces seek to impose solutions that may radically change operative anesthesia. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Risk Factors for Hospital Readmission Following Noncardiac Surgery: International Cohort Study.

Author

McGillion, Michael H., Borges, Flavia K., Conen, David, Sessler, Daniel I., Coleman, Brenda L., Marcucci, Maura, Ouellette, Carley, Bird, Marissa, Whitmore, Carly, Henry, Shaunattonie, Ofori, Sandra, Pettit, Shirley M., Bedini, Deborah M., Gauthier, Leslie P., Lounsbury, Jennifer, Carter, Nancy M., Tandon, Vikas, Patel, Ameen, Cafaro, Teresa, and Simunovic, Marko R.

Published
2024
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12. One-year Outcomes after Discharge from Noncardiac Surgery and Association between Predischarge Complications and Death after Discharge: Analysis of the VISION Prospective Cohort Study.

Author

Roshanov, Pavel S., Chan, Matthew T. V., Borges, Flavia K., Conen, David, Wang, C. Y., Xavier, Denis, Berwanger, Otavio, Marcucci, Maura, Sessler, Daniel I., Szczeklik, Wojciech, Spence, Jessica, Alonso-Coello, Pablo, Fernández, Carmen, Pearse, Rupert M., Malaga, German, Garg, Amit X., Srinathan, Sadeesh K., Jacka, Michael J., Tandon, Vikas, and McGillion, Michael

Published
2024
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15. Design of Clinical Trials Evaluating Sedation in Critically Ill Adults Undergoing Mechanical Ventilation

Author

Pamela Flood, Ingrid Egerod, Timothy D. Girard, Ramona O. Hopkins, Michele C. Balas, Yahya Shehabi, Denham S. Ward, Dale M. Needham, Pratik P. Pandharipande, Lena S Sun, John W. Devlin, Doug Elliott, Douglas B. Coursin, Leanne M. Aitken, Claudia Spies, Steven L. Shafer, Gilles L. Fraser, Mervyn Maze, David L. Brown, Richard D. Urman, David Gozal, Anthony Absalom, Richard R. Riker, Daniel I. Sessler, Robert H. Dworkin, Franklin Dexter, Avery Tung, John P. Kress, Lisa Burry, Elizabeth Colantuoni, Talmage D. Egan, and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)

Subjects
Consensus, Time Factors, INTENSIVE-CARE-UNIT, Standardization, Delphi Technique, Sedation, medicine.medical_treatment, MEDLINE, Delphi method, Clinical Investigations, Critical Care and Intensive Care Medicine, VALIDATION, 03 medical and health sciences, 0302 clinical medicine, Intensive care, SCORE, PATIENT-CENTERED OUTCOMES, Medicine, Humans, Hypnotics and Sedatives, research methodology, SCALE, intensive care, Mechanical ventilation, outcome assessments, business.industry, PAIN, 030208 emergency & critical care medicine, clinical trial, Congresses as Topic, medicine.disease, ASSESSMENT TOOLS, Respiration, Artificial, Clinical trial, 030228 respiratory system, sedation, District of Columbia, ICU, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Delirium, Medical emergency, medicine.symptom, business, DELIRIUM
Abstract

Supplemental Digital Content is available in the text., OBJECTIVES: Clinical trials evaluating the safety and effectiveness of sedative medication use in critically ill adults undergoing mechanical ventilation differ considerably in their methodological approach. This heterogeneity impedes the ability to compare results across studies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research Recommendations convened a meeting of multidisciplinary experts to develop recommendations for key methodologic elements of sedation trials in the ICU to help guide academic and industry clinical investigators. DESIGN: A 2-day in-person meeting was held in Washington, DC, on March 28–29, 2019, followed by a three-round, online modified Delphi consensus process. PARTICIPANTS: Thirty-six participants from academia, industry, and the Food and Drug Administration with expertise in relevant content areas, including two former ICU patients attended the in-person meeting, and the majority completed an online follow-up survey and participated in the modified Delphi process. MEASUREMENTS AND MAIN RESULTS: The final recommendations were iteratively refined based on the survey results, participants’ reactions to those results, summaries written by panel moderators, and a review of the meeting transcripts made from audio recordings. Fifteen recommendations were developed for study design and conduct, subject enrollment, outcomes, and measurement instruments. Consensus recommendations included obtaining input from ICU survivors and/or their families, ensuring adequate training for personnel using validated instruments for assessments of sedation, pain, and delirium in the ICU environment, and the need for methodological standardization. CONCLUSIONS: These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who require mechanical ventilation. These recommendations should be viewed as a starting point to improve clinical trials and help reduce methodological heterogeneity in future clinical trials.

Published
2021
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20. Association of Preoperative Growth Differentiation Factor-15 Concentrations and Postoperative Cardiovascular Events after Major Noncardiac Surgery.

Author

Duceppe, Emmanuelle, Borges, Flavia K., Conen, David, Tiboni, Maria, Chan, Matthew T. V., Patel, Ameen, Sessler, Daniel I., Kavsak, Peter A., Ofori, Sandra, Srinathan, Sadeesh, Pearse, Rupert, Jaffe, Allan S., Heels-Ansdell, Diane, Garg, Amit X., Pettit, Shirley, Sapsford, Robert, and Devereaux, P. J.

Published
2023
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24. Ultrasound-guided Percutaneous Cryoneurolysis to Treat Chronic Postamputation Phantom Limb Pain: A Multicenter Randomized Controlled Trial.

Author

Ilfeld, Brian M., Smith, Cameron R., Turan, Alparslan, Mariano, Edward R., Miller, Matthew E., Fisher, Rick L., Trescot, Andrea M., Cohen, Steven P., Eisenach, James C., Sessler, Daniel I., Prologo, J. David, Mascha, Edward J., Liu, Liu, Gabriel, Rodney A., Hayek, Salim M., Wadhwa, Anupama N., Beck, Gerald J., Abdullah, Baharin, Esa, Wael Ali Sakr, and Altinpulluk, Ece Yamak

Published
2023
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27. Intraoperative Inspiratory Oxygen Fraction and Myocardial Injury After Noncardiac Surgery: Results From an International Observational Study in Relation to Recent Controlled Trials.

Author

Pedersen, Sofie S., Holse, Cecilie, Mathar, Clara E., Chan, Matthew T. V., Sessler, Daniel I., Liu, Yingzhi, Zhang, Lin, Kurz, Andrea, Jacka, Mike, Torborg, Alexandra, Biyase, Thuli, Montes, Felix R., Wang, Chew Yin, Pettit, Shirley, Devereaux, P. J., and Meyhoff, Christian S.

Published
2022
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28. Tidal Volume and Positive End-expiratory Pressure and Postoperative Hypoxemia during General Anesthesia: A Single-center Multiple Crossover Factorial Cluster Trial.

Author

Turan, Alparslan, Esa, Wael Ali Sakr, Rivas, Eva, Wang, Jiayi, Bakal, Omer, Stamper, Samantha, Farag, Ehab, Maheswari, Kamal, Mao, Guangmei, Ruetzler, Kurt, Sessler, Daniel I., Sakr Esa, Wael Ali, Wang, Dr., Maheshwari, Kamal, Gama de Abreu, Marcelo, Markwei, Metabel, Helfand, Robert, Kuhel, Allen, Cohen, Barak, and Mounir Soliman, Loran

Published
2022
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30. Global Health and Nursing Advocacy.

Author

Shimek, Aric, Branden, Pennie Sessler, Clary-Muronda, Valerie, Hawkins, Janice, and Mousa, Dania Itani

Subjects
*SOCIAL participation, *PATIENT advocacy, *WORLD health, *LEADERS, *NURSING practice, *NURSES, *HEALTH promotion
Abstract

Editor's note: The Sigma Theta Tau International Honor Society of Nursing is a global organization focused on leadership and scholarship, with more than 135,000 members from more than 100 countries. This second article in a series highlights the work of Sigma's representatives at the United Nations and their perspectives on advocating for global health and nursing leadership. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Prediction of opioid-induced respiratory depression on inpatient wards using continuous capnography and oximetry

Author

Sabry Ayad, Susan J. Dempsey, Hiroshi Morimatsu, Alberto A. Uribe, Maria Wittmann, Carlos Tornero, Luca Brazzi, Morgan Le Guen, Carla R. Jungquist, Robert C. McIntyre, Vanessa Moll, Lian Kah Ti, Sergio D. Bergese, Wolfgang Buhre, Ashish Khanna, Richard D. Urman, Paola Di Stefano, Toby N. Weingarten, Frank J. Overdyk, Albert Dahan, Roop Kaw, Daniel I. Sessler, Leif Saager, Dennis Auckley, Frank Schramm, Shoichi Uezono, Roy Soto, Simon C. Lee, MUMC+: Centrum voor Acute en Kritieke Zorg (3), Anesthesiologie, MUMC+: MA Anesthesiologie (9), RS: MHeNs - R3 - Neuroscience, University of Zurich, and Khanna, Ashish K

Subjects
medicine.medical_specialty, Respiratory rate, 10216 Institute of Anesthesiology, MODELS, Vital signs, 610 Medicine & health, PATIENT, VALIDATION, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Interquartile range, POSTOPERATIVE HYPOXEMIA, medicine, Original Clinical Research Report, Prospective cohort study, Depression (differential diagnoses), INDEX, RISK, Capnography, PAIN MANAGEMENT, OUTCOMES, medicine.diagnostic_test, Featured Articles, business.industry, Apnea, 3. Good health, Anesthesiology and Pain Medicine, Predictive value of tests, SAFETY, Emergency medicine, 2703 Anesthesiology and Pain Medicine, medicine.symptom, ADVERSE EVENTS, business, 030217 neurology & neurosurgery
Abstract

BACKGROUND: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who are likely to experience opioid-induced respiratory depression events on the general care floor and may benefit from improved monitoring and early intervention. The trial objective was to derive and validate a risk prediction tool for respiratory depression in patients receiving opioids, as detected by continuous pulse oximetry and capnography monitoring. METHODS: PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) was a prospective, observational trial of blinded continuous capnography and oximetry conducted at 16 sites in the United States, Europe, and Asia. Vital signs were intermittently monitored per standard of care. A total of 1335 patients receiving parenteral opioids and continuously monitored on the general care floor were included in the analysis. A respiratory depression episode was defined as respiratory rate = 60 mm Hg for >= 3 minutes; apnea episode lasting >30 seconds; or any respiratory opioid-related adverse event. A risk prediction tool was derived using a multivariable logistic regression model of 46 a priori defined risk factors with stepwise selection and was internally validated by bootstrapping. RESULTS: One or more respiratory depression episodes were detected in 614 (46%) of 1335 general care floor patients (43% male; mean age, 58 +/- 14 years) continuously monitored for a median of 24 hours (interquartile range [IQR], 17-26). A multivariable respiratory depression prediction model with area under the curve of 0.740 was developed using 5 independent variables: age >= 60 (in decades), sex, opioid naivety, sleep disorders, and chronic heart failure. The PRODIGY risk prediction tool showed significant separation between patients with and without respiratory depression (P< .001) and an odds ratio of 6.07 (95% confidence interval [CI], 4.44-8.30;P< .001) between the high- and low-risk groups. Compared to patients without respiratory depression episodes, mean hospital length of stay was 3 days longer in patients with >= 1 respiratory depression episode (10.5 +/- 10.8 vs 7.7 +/- 7.8 days;P< .0001) identified using continuous oximetry and capnography monitoring. CONCLUSIONS: A PRODIGY risk prediction model, derived from continuous oximetry and capnography, accurately predicts respiratory depression episodes in patients receiving opioids on the general care floor. Implementation of the PRODIGY score to determine the need for continuous monitoring may be a first step to reduce the incidence and consequences of respiratory compromise in patients receiving opioids on the general care floor.

Published
2020

35. Prediction of Opioid-Induced Respiratory Depression on Inpatient Wards Using Continuous Capnography and Oximetry: An International Prospective, Observational Trial

Author

Khanna, Ashish K, Bergese, Sergio D, Jungquist, Carla R, Morimatsu, Hiroshi, Uezono, Shoichi, Lee, Simon, Ti, Lian Kah, Urman, Richard D, McIntyre, Robert, Tornero, Carlos, Dahan, Albert, Saager, Leif, Weingarten, Toby N, Wittmann, Maria, Auckley, Dennis, Brazzi, Luca, Le Guen, Morgan, Soto, Roy, Schramm, Frank, Ayad, Sabry, Kaw, Roop, Di Stefano, Paola, Sessler, Daniel I, Uribe, Alberto, Moll, Vanessa, Dempsey, Susan J, Buhre, Wolfgang, Overdyk, Frank J, Khanna, Ashish K, Bergese, Sergio D, Jungquist, Carla R, Morimatsu, Hiroshi, Uezono, Shoichi, Lee, Simon, Ti, Lian Kah, Urman, Richard D, McIntyre, Robert, Tornero, Carlos, Dahan, Albert, Saager, Leif, Weingarten, Toby N, Wittmann, Maria, Auckley, Dennis, Brazzi, Luca, Le Guen, Morgan, Soto, Roy, Schramm, Frank, Ayad, Sabry, Kaw, Roop, Di Stefano, Paola, Sessler, Daniel I, Uribe, Alberto, Moll, Vanessa, Dempsey, Susan J, Buhre, Wolfgang, and Overdyk, Frank J

Abstract

Background: Opioid-related adverse events are a serious problem in hospitalized patients. Little is known about patients who are likely to experience opioid-induced respiratory depression events on the general care floor and may benefit from improved monitoring and early intervention. The trial objective was to derive and validate a risk prediction tool for respiratory depression in patients receiving opioids, as detected by continuous pulse oximetry and capnography monitoring. Methods: PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) was a prospective, observational trial of blinded continuous capnography and oximetry conducted at 16 sites in the United States, Europe, and Asia. Vital signs were intermittently monitored per standard of care. A total of 1335 patients receiving parenteral opioids and continuously monitored on the general care floor were included in the analysis. A respiratory depression episode was defined as respiratory rate ≤5 breaths/min (bpm), oxygen saturation ≤85%, or end-tidal carbon dioxide ≤15 or ≥60 mm Hg for ≥3 minutes; apnea episode lasting >30 seconds; or any respiratory opioid-related adverse event. A risk prediction tool was derived using a multivariable logistic regression model of 46 a priori defined risk factors with stepwise selection and was internally validated by bootstrapping. Results: One or more respiratory depression episodes were detected in 614 (46%) of 1335 general care floor patients (43% male; mean age, 58 ± 14 years) continuously monitored for a median of 24 hours (interquartile range [IQR], 17-26). A multivariable respiratory depression prediction model with area under the curve of 0.740 was developed using 5 independent variables: age ≥60 (in decades), sex, opioid naivety, sleep disorders, and chronic heart failure. The PRODIGY risk prediction tool showed significant separation between patients with and without respiratory depression (P < .001) and an odds ratio of 6.

Published
2020

36. Association between In-hospital Mortality and Low Cardiac Output Syndrome with Morning versus Afternoon Cardiac Surgery.

Author

Hijazi, Ryan M., Sessler, Daniell., Liang, Chen, Rodriguez- Patarroyo, Fabio A ., Soltesz, Edward G., Duncan, Andra E., and Sessler, Daniel I

Subjects
*CARDIAC surgery, *RESEARCH, *TIME, *RETROSPECTIVE studies, *MEDICAL cooperation, *EVALUATION research, *HOSPITAL mortality, *COMPARATIVE studies, *CARDIAC output, *HEART diseases, *LONGITUDINAL method, HEART disease epidemiology
Abstract

Background: Recent work suggests that having aortic valve surgery in the morning increases risk for cardiac-related complications. This study therefore explored whether mortality and cardiac complications, specifically low cardiac output syndrome, differ for morning and afternoon cardiac surgeries.Methods: The study included adults who had aortic and/or mitral valve repair/replacement and/or coronary artery bypass grafting from 2011 to 2018. The components of the in-hospital composite outcome were in-hospital mortality and low cardiac output syndrome, defined by requirement for at least two inotropic agents at 24 to 48 h postoperatively or need for mechanical circulatory support. Patients who had aortic cross-clamping between 8 and 11 am (morning surgery) versus between 2 and 5 pm (afternoon surgery) were compared on the incidence of the composite outcome.Results: Among 9,734 qualifying operations, 0.4% (29 of 6,859) died after morning, and 0.7% (20 of 2,875) died after afternoon surgery. The composite of in-hospital mortality and low cardiac output syndrome occurred in 2.8% (195 of 6,859) of morning patients and 3.4% (97 of 2,875) of afternoon patients: morning versus afternoon confounder-adjusted odds ratio, 0.96 (95% CI, 0.75 to 1.24; P = 0.770). There was no evidence of interaction between morning versus afternoon and surgery type (P = 0.965), and operation time was statistically nonsignificant for surgery subgroups.Conclusions: Patients having aortic valve surgery, mitral valve surgery, and/or coronary artery bypass grafting with aortic cross-clamping in the morning and afternoon did not have significantly different outcomes. No evidence was found to suggest that morning or afternoon surgical timing alters postoperative risk.Editor’s Perspective: [ABSTRACT FROM AUTHOR]

Published
2021
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39. Prophylactic Penehyclidine Inhalation for Prevention of Postoperative Pulmonary Complications in High-risk Patients: A Double-blind Randomized Trial.

Author

Yan, Ting M.D., Liang, Xin-Quan M.D., Wang, Guo-Jun M.D., Wang, Tong M.D., Li, Wei-Ou M.D., Liu, Yang M.D., Wu, Liang-Yu M.D., Yu, Kun-Yao M.D., Zhu, Sai-Nan M.Sc., Wang, Dong-Xin M.D., Ph.D., Sessler, Daniel I. M.D., Yan, Ting, Liang, Xin-Quan, Wang, Guo-Jun, Wang, Tong, Li, Wei-Ou, Liu, Yang, Wu, Liang-Yu, Yu, Kun-Yao, and Zhu, Sai-Nan

Published
2022
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41. In Response.

Author

Cohen, Barak, Rivas, Eva, Yang, Dongsheng, Li, Shuyi, Mascha, Edward J., and Sessler, Daniel I.

Published
2023
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42. Development and Validation of a Fall Prevention Efficiency Scale.

Author

Dykes, Patricia C., Khasnabish, Srijesa BA, Burns, Zoe, Adkison, Lesley E., Alfieri, Lois, Bogaisky, Michael, Carroll, Diane L., Carter, Eileen J., Hurley, Ann C. DNSc,, Jackson, Emily, Kurian, Susan, Lindros, Mary Ellen, Ryan, Virginia, Scanlan, Maureen -BC,, Sessler, Kelly, Shelley, Alexandra MS, FNP-BC, -BC, Spivack, Linda B., Walsh, Mary-Ann N, CPPS,, Bates, David W., and Adelman, Jason S. MS

Published
2022
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49. Effect of Intraoperative Goal-directed Balanced Crystalloid versus Colloid Administration on Major Postoperative Morbidity

Author

Kabon, Barbara, Sessler, Daniel I, Kurz, Andrea, Maheshwari, Kamal, et al, Kabon, Barbara, Sessler, Daniel I, Kurz, Andrea, Maheshwari, Kamal, and et al

Abstract

BACKGROUND: Crystalloid solutions leave the circulation quickly, whereas colloids remain for hours, thus promoting hemodynamic stability. However, colloids are expensive and promote renal toxicity in critical care patients. This study tested the hypothesis that goal-directed colloid administration during elective abdominal surgery decreases 30-day major complications more than goal-directed crystalloid administration. METHODS: In this parallel-arm double-blinded multicenter randomized trial, adults having moderate- to high-risk open and laparoscopically assisted abdominal surgery with general anesthesia were randomly assigned to Doppler-guided intraoperative volume replacement with 6% hydroxyethyl starch 130/0.4 (n = 523) or lactated Ringer's solution (n = 534). The primary outcome was a composite of serious postoperative cardiac, pulmonary, infectious, gastrointestinal, renal, and coagulation complications that were assessed with a generalized estimating equation multivariate model. The primary safety outcome was a change in serum creatinine concentration up to 6 months postoperatively, compared to baseline concentrations. RESULTS: A total of 1,057 patients were included in the analysis. Patients assigned to crystalloid received a median [quartile 1, quartile 3] amount of 3.2 l [2.3, 4.4] of crystalloid, and patients assigned to colloid received 1.0 l [0.5, 1.5] of colloid and 1.8 l [1.2, 2.4] of crystalloid. The estimated intention-to-treat common effect relative risk for the primary composite was 0.90 for colloids versus crystalloids (95% CI: 0.65 to 1.23, P = 0.51), and 18% (91 of 523) of colloid patients and 20% (103 of 534) of crystalloid patients incurred at least one component of the primary outcome composite. There was no evidence of renal toxicity at any time. CONCLUSIONS: Doppler-guided intraoperative hydroxyethyl starch administration did not significantly reduce a composite of serious complications. However, there was also no indication of renal or othe

Published
2019

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