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22 results on '"Phreaner, Nicholas"'

1. Validation of Patient-Reported Outcomes in Patients With Nonmetastatic Breast Cancer Receiving Comprehensive Nodal Irradiation in the RadComp Trial

Author

Godette, Karen D., Patel, Sagar, Langen, Katja M., Zielan, Ryan R., DeBlois, David, Pang, Dalong, Rudra, Sonali, Benhabib, Sidi, Chawla, Ashish, Chen, Kuanling, Dadkhah, Hossein, Majithia, Lonika, Rao, Avani D., Stephenson, Lisa, Wang, Peng, Croog, Victoria J., Li, Heng, Smith, Karen, Stinson, Susan, Walker, Amanda J., Devisetty, Kiran, Hyde, Christian, Depauw, Nicholas, Godishala, Anuradha, Ho, Alice, Paganetti, Harald, Soto, Daniel, Suero-Abreu, Giselle, Taghian, Alphonse G., Corbin, Kimberly S., Halyard, Michele Y., Jackson, Amanda, Liang, Xiaoying, Manke, Heather, McGee, Lisa A., Pafundi, Deanna H., Remmes, Nicholas B., Shumway, Dean A., Yan, Elizabeth S., Bakhoum, Samuel F., Barron, David A., Bernstein, Michael, Cuaron, John J., Dover, Laura, Gelblum, Daphna Y., Gilbo, Philip, Gewanter, Richard M., Guttman, David M., Hong, Linda, Khan, Atif, LaPlant, Quincey, Mann, Justin, McCormick, Beryl, Mueller, Boris A., Mychalczak, Borys, Parikh, Dhwani, Powell, Simon N., Romesser, Paul B., Roth O'Brien, Diana, Schupak, Karen D., Shepherd, Annemarie F., Xu, Amy, Yu, Anthony, Zinovoy, Melissa, Bennouna, Jaafar, Fagundes, Marcio, Panoff, Joseph, Amelia Rodrigues, Maria, Yu, Jen, Lee, Choonsik, Chen, Chin-Cheng, Choi, J. Isabelle, Lin, Haibo, Akthar, Adil S., Akhter, Nausheen, Mihalcik, Stephen A., Pankuch, Mark, Parhar, Preeti K., Stutz, Michael D., Thukral, Arpi D., Mah, Dennis, Tsai, Henry K., Paulus, Rebecca, Haffty, Bruce G., Goyal, Sharad, Yue, Ning J., Sturgeon, Jared D., Wilkinson, J. Ben, Boggs, D. Hunter, Cardan, Rex A., Dalton, Allison, McDonald, Andrew, Prior, Fred, Mayadev, Jyoti S., Moiseenko, Vitali, Narezkina, Anya, Phreaner, Nicholas, Rash, Dominique, Seibert, Tyler, Yashar, Catheryn, Daugherty, Emily C., Mascia, Anthony, Medek, Sara A., Meier, Teresa, Bradley, Julie A., Lockney, Natalie, Mailhot, Raymond B., Mendenhall, Nancy, Rutenberg, Michael, Harris, Eleanor E., Lyons, Janice, Hong, Jack J., Kunaprayoon, Dan K., McAvoy, Sarah A., Manu Mysore, Nowak Choi, Kamila A., Patel, Akshar N., Vyfhuis, Melissa A.L., Wilson, Joelle, Algan, Ozer, Chen, Yong, Henson, Christina E., Dvorak, Tomas, Willoughby, Twyla, Zeidan, Omar, Berman, Abigail T., Chen, Et-tsu, Dong, Lei, Driscoll, Amanda, Feigenberg, Steven J., Feriozzi, Ashley, Hencek, Carolyn, Kolker, James D., Konski, Andre A., Ky, Bonnie, Lin, Lilie L., Novick, Kristina L., Reza, Nosheen, Siegal, Ann Marie, Tabakha, Sara, Taunk, Neil K., Wilcox, Nicholas, Zou, Wei, Bhooshan, Neha, Croley, Richard, Weksberg, David C., Ahmad, Neelour, Hoffman, Karen E., Joyner, Melissa M., Mitchell, Melissa P., Poenisch, Falk, Smith, Benjamin D., Strom, Eric A., Vallabhaneni, Srilakshmi, Cheng, Richard, Kang, Kylie H., Kim, H. Katherine, Kim, Janice N., Wang, Waylene A., Wong, Tony, Bosch, Walter, Mitchell, Joshua, Straube, William, Zoberi, Imran, Balanescu, Dinu, Chen, Peter Y., Dilworth, Joshua T., Ding, Xuanfeng, Donisan, Teodora, Hamstra, Daniel A., Daniella Dang, Phuong, Katz, Stanford, Wang, Chiachien J., Terry Wu, Hahn, Elizabeth A., Pugh, Stephanie L., Lu, Hien L., Vela, Alyssa M., Gillespie, Erin F., Nichols, Elizabeth M., Wright, Jean L., MacDonald, Shannon M., Cahlon, Oren, Baas, Carole, Braunstein, Lior Z., Fang, L. Christine, Freedman, Gary M., Jimenez, Rachel B., Kesslering, Christy M., Mishra, Mark V., Mutter, Robert W., Ohri, Nisha, Rosen, Lane R., Urbanic, James J., Jagsi, Reshma, Mitchell, Sandra A., Bekelman, Justin E., and Cella, David

Published
2024
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2. De Novo vs Acute-on-Chronic Presentations of Heart Failure-Related Cardiogenic Shock: Insights from the Critical Care Cardiology Trials Network Registry

Author

Bhatt, Ankeet S., Berg, David D., Bohula, Erin A., Alviar, Carlos L., Baird-Zars, Vivian M., Barnett, Christopher F., Burke, James A., Carnicelli, Anthony P., Chaudhry, Sunit-Preet, Daniels, Lori B., Fang, James C., Fordyce, Christopher B., Gerber, Daniel A., Guo, Jianping, Jentzer, Jacob C., Katz, Jason N., Keller, Norma, Kontos, Michael C., Lawler, Patrick R., Menon, Venu, Metkus, Thomas S., Nativi-Nicolau, Jose, Phreaner, Nicholas, Roswell, Robert O., Sinha, Shashank S., Jeffrey Snell, R., Solomon, Michael A., Van Diepen, Sean, and Morrow, David A.

Published
2021
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3. Sex Differences in Characteristics, Resource Utilization, and Outcomes of Cardiogenic Shock: Data From the Critical Care Cardiology Trials Network (CCCTN) Registry.

Author

Daniels, Lori B., Phreaner, Nicholas, Berg, David D., Bohula, Erin A., Chaudhry, Sunit-Preet, Fordyce, Christopher B., Goldfarb, Michael J., Katz, Jason N., Kenigsberg, Benjamin B., Lawler, Patrick R., Correa, Miguel A. Martillo, Papolos, Alexander I., Roswell, Robert O., Sinha, Shashank S., van Diepen, Sean, Jeong-Gun Park, and Morrow, David A.

Abstract

BACKGROUND: Sex disparities exist in the management and outcomes of various cardiovascular diseases. However, little is known about sex differences in cardiogenic shock (CS). We sought to assess sex-related differences in the characteristics, resource utilization, and outcomes of patients with CS. METHODS: The Critical Care Cardiology Trials Network is a multicenter registry of advanced cardiac intensive care units (CICUs) in North America. Between 2018 and 2022, each center (N=35) contributed annual 2-month snapshots of consecutive CICU admissions. Patients with CS were stratified as either CS after acute myocardial infarction or heart failure-related CS (HF-CS). Multivariable logistic regression was used for analyses. RESULTS: Of the 22 869 admissions in the overall population, 4505 (20%) had CS. Among 3923 patients with CS due to ventricular failure (32% female), 1235 (31%) had CS after acute myocardial infarction and 2688 (69%) had HF-CS. Median sequential organ failure assessment scores did not differ by sex. Women with HF-CS had shorter CICU lengths of stay (4.5 versus 5.4 days; P<0.0001) and shorter overall lengths of hospital stay (10.9 versus 12.8 days; P<0.0001) than men. Women with HF-CS were less likely to receive pulmonary artery catheters (50% versus 55%; P<0.01) and mechanical circulatory support (26% versus 34%; P<0.0001) compared with men. Women with HF-CS had higher in-hospital mortality than men, even after adjusting for age, illness severity, and comorbidities (34% versus 23%; odds ratio, 1.76 [95% CI, 1.42-2.17]). In contrast, there were no significant sex differences in utilization of advanced CICU monitoring and interventions, or mortality, among patients with CS after acute myocardial infarction. CONCLUSIONS: Women with HF-CS had lower use of pulmonary artery catheters and mechanical circulatory support, shorter CICU lengths of stay, and higher in-hospital mortality than men, even after accounting for age, illness severity, and comorbidities. These data highlight the need to identify underlying reasons driving the differences in treatment decisions, so outcomes gaps in HF-CS can be understood and eliminated. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry

Author

Berg, David D., Barnett, Christopher F., Kenigsberg, Benjamin B., Papolos, Alexander, Alviar, Carlos L., Baird-Zars, Vivian M., Barsness, Gregory W., Bohula, Erin A., Brennan, Joseph, Burke, James A., Carnicelli, Anthony P., Chaudhry, Sunit-Preet, Cremer, Paul C., Daniels, Lori B., DeFilippis, Andrew P., Gerber, Daniel A., Granger, Christopher B., Hollenberg, Steven, Horowitz, James M., Gladden, James D., Katz, Jason N., Keeley, Ellen C., Keller, Norma, Kontos, Michael C., Lawler, Patrick R., Menon, Venu, Metkus, Thomas S., Miller, P. Elliott, Nativi-Nicolau, Jose, Newby, L. Kristin, Park, Jeong-Gun, Phreaner, Nicholas, Roswell, Robert O., Schulman, Steven P., Sinha, Shashank S., Snell, R. Jeffrey, Solomon, Michael A., Teuteberg, Jeffrey J., Tymchak, Wayne, van Diepen, Sean, and Morrow, David A.

Published
2019
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8. Epidemiology of Shock in Contemporary Cardiac Intensive Care Units: Data From the Critical Care Cardiology Trials Network Registry

Author

Berg, David D., Bohula, Erin A., van Diepen, Sean, Katz, Jason N., Alviar, Carlos L., Baird-Zars, Vivian M., Barnett, Christopher F., Barsness, Gregory W., Burke, James A., Cremer, Paul C., Cruz, Jennifer, Daniels, Lori B., DeFilippis, Andrew P., Haleem, Affan, Hollenberg, Steven M., Horowitz, James M., Keller, Norma, Kontos, Michael C., Lawler, Patrick R., Menon, Venu, Metkus, Thomas S., Ng, Jason, Orgel, Ryan, Overgaard, Christopher B., Park, Jeong-Gun, Phreaner, Nicholas, Roswell, Robert O., Schulman, Steven P., Jeffrey Snell, R., Solomon, Michael A., Ternus, Bradley, Tymchak, Wayne, Vikram, Fnu, and Morrow, David A.

Published
2019
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10. Epidemiology of Acute Heart Failure in Critically Ill Patients With COVID-19: An Analysis From the Critical Care Cardiology Trials Network

Author

Berg, David D., Alviar, Carlos L, Bhatt, Ankeet S., Baird-Zars, Vivian M., Barnett, Christopher F., Daniels, Lori B., Defilippis, Andrew P., Fagundes, Antonio, JR, Katrapati, Praneeth, Kenigsberg, Benjamin B., Guo, Jianping, Keller, Norma, Lopes, Mathew S., Mody, Anika, Papolos, Alexander I, Phreaner, Nicholas, Sedighi, Romteen, Sinha, Shashank S., Toomu, Sandeep, Varshney, Anubodh S., Morrow, David A., and Bohula, Erin A.

Published
2022
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14. The Range of Cardiogenic Shock Survival by Clinical Stage: Data From the Critical Care Cardiology Trials Network Registry

Author

Lawler, Patrick R., primary, Berg, David D., additional, Park, Jeong-Gun, additional, Katz, Jason N., additional, Baird-Zars, Vivian M., additional, Barsness, Gregory W., additional, Bohula, Erin A., additional, Carnicelli, Anthony P., additional, Chaudhry, Sunit-Preet, additional, Jentzer, Jacob C., additional, Menon, Venu, additional, Metkus, Thomas, additional, Nativi-Nicolau, Jose, additional, Phreaner, Nicholas, additional, Sinha, Shashank S., additional, Teuteberg, Jeffrey J., additional, van Diepen, Sean, additional, and Morrow, David A., additional

Published
2021
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16. Incidence, underlying conditions, and outcomes of patients receiving acute renal replacement therapies in tertiary cardiac intensive care units: An analysis from the Critical Care Cardiology Trials Network Registry

Author

van Diepen, Sean, primary, Tymchak, Wayne, additional, Bohula, Erin A., additional, Park, Jeong-Gun, additional, Daniels, Lori B., additional, Phreaner, Nicholas, additional, Barnett, Christopher F., additional, Kenigsberg, Benjamin B, additional, DeFilippis, Andrew, additional, Singam, Narayana Sarma, additional, Barsness, Gregory W., additional, Jentzer, Jacob C., additional, Ternus, Bradley, additional, Morrow, David A., additional, and Katz, Jason N., additional

Published
2020
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18. Demographics, Care Patterns, and Outcomes of Patients Admitted to Cardiac Intensive Care Units: The Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness

Author

Bohula, Erin A., Katz, Jason N., van Diepen, Sean, Alviar, Carlos L., Baird-Zars, Vivian M., Park, Jeong-Gun, Barnett, Christopher F., Bhattal, Gurjaspreet, Barsness, Gregory W., Burke, James A., Cremer, Paul C., Cruz, Jennifer, Daniels, Lori B., DeFilippis, Andrew, Granger, Christopher B., Hollenberg, Steven, Horowitz, James M, Keller, Norma, Kontos, Michael C., Lawler, Patrick R., Menon, Venu, Metkus, Thomas S., Ng, Jason, Orgel, Ryan, Overgaard, Christopher B., Phreaner, Nicholas, Roswell, Robert O., Schulman, Steven P., Snell, R. Jeffrey, Solomon, Michael A., Ternus, Bradley, Tymchak, Wayne, Vikram, Fnu, and Morrow, David A.

Abstract

IMPORTANCE: Single-center and claims-based studies have described substantial changes in the landscape of care in the cardiac intensive care unit (CICU). Professional societies have recommended research to guide evidence-based CICU redesigns. OBJECTIVE: To characterize patients admitted to contemporary, advanced CICUs. DESIGN, SETTING, AND PARTICIPANTS: This study established the Critical Care Cardiology Trials Network (CCCTN), an investigator-initiated multicenter network of 16 advanced, tertiary CICUs in the United States and Canada. For 2 months in each CICU, data for consecutive admissions were submitted to the central data coordinating center (TIMI Study Group). The data were collected and analyzed between September 2017 and 2018. MAIN OUTCOMES AND MEASURES: Demographics, diagnoses, management, and outcomes. RESULTS: Of 3049 participants, 1132 (37.1%) were women, 797 (31.4%) were individuals of color, and the median age was 65 years (25th and 75th percentiles, 55-75 years). Between September 2017 and September 2018, 3310 admissions were included, among which 2557 (77.3%) were for primary cardiac problems, 337 (10.2%) for postprocedural care, 253 (7.7%) for mixed general and cardiac problems, and 163 (4.9%) for overflow from general medical ICUs. When restricted to the initial 2 months of medical CICU admissions for each site, the primary analysis population included 3049 admissions with a high burden of noncardiovascular comorbidities. The top 2 CICU admission diagnoses were acute coronary syndrome (969 [31.8%]) and heart failure (567 [18.6%]); however, the proportion of acute coronary syndrome was highly variable across centers (15%-57%). The primary indications for CICU care included respiratory insufficiency (814 [26.7%]), shock (643 [21.1%]), unstable arrhythmia (521 [17.1%]), and cardiac arrest (265 [8.7%]). Advanced CICU therapies or monitoring were required for 1776 patients (58.2%), including intravenous vasoactive medications (1105 [36.2%]), invasive hemodynamic monitoring (938 [30.8%]), and mechanical ventilation (652 [21.4%]). The overall CICU mortality rate was 8.3% (95% CI, 7.3%-9.3%). The CICU indications that were associated with the highest mortality rates were cardiac arrest (101 [38.1%]), cardiogenic shock (140 [30.6%]), and the need for renal replacement therapy (51 [34.5%]). Notably, patients admitted solely for postprocedural observation or frequent monitoring had a mortality rate of 0.2% to 0.4%. CONCLUSIONS AND RELEVANCE: In a contemporary network of tertiary care CICUs, respiratory failure and shock predominated indications for admission and carried a poor prognosis. While patterns of practice varied considerably between centers, a substantial, low-risk population was identified. Multicenter collaborative networks, such as the CCCTN, could be used to help redesign cardiac critical care and to test new therapeutic strategies.

Published
2019
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21. Patients With Acute Coronary Syndromes Admitted to Contemporary Cardiac Intensive Care Units: Insights From the CCCTN Registry.

Author

Fagundes Jr, Antonio, Berg, David D., Park, Jeong-Gun, Baird-Zars, Vivian M., Newby, L. Kristin, Barsness, Gregory W., Miller, P. Elliott, van Diepen, Sean, Katz, Jason N., Phreaner, Nicholas, Roswell, Robert O., Menon, Venu, Daniels, Lori B., Morrow, David A., Bohula, Erin A., Fagundes, Antonio Jr, and CCCTN Investigators

Subjects
TREATMENT of acute coronary syndrome, INTENSIVE care units, ACUTE coronary syndrome, RETROSPECTIVE studies, ACQUISITION of data, CORONARY care units, HOSPITAL mortality, PSYCHOLOGICAL tests, PATIENT-family relations, LONGITUDINAL method
Abstract

Background: With the improvement in outcomes for acute coronary syndrome (ACS), the practice of routine admission to cardiac intensive care units (CICUs) is evolving. We aimed to describe the epidemiology of patients with ACS admitted to contemporary CICUs.Methods: Using the CCCTN (Critical Care Cardiology Trials Network) Registry for consecutive medical CICU admissions across 26 advanced CICUs in North America between 2017 and 2020, we identified patients with a primary diagnosis of ACS at CICU admission and compared patient characteristics, resource utilization, and outcomes to patients admitted with a non-ACS diagnosis and across sub-populations of patients with ACS, including by indication for CICU admission.Results: Of 10 118 CICU admissions, 29.4% (n=2978) were for a primary diagnosis of ACS, with significant interhospital variability (range, 13.4%-56.6%). Compared with patients admitted with a diagnosis other than ACS, patients with ACS had fewer comorbidities, lower acute severity of illness with less utilization of advanced CICU therapies (41.3% versus 66.1%, P<0.0001), and lower CICU mortality (5.4% versus 9.9%, P<0.0001). Monitoring alone, without another CICU indication at the time of admission, was the most frequent admission indication in patients with ACS (53.8%); less common indications in patients with ACS included respiratory insufficiency, shock, or the need for vasoactive therapy. Of patients with ACS admitted for monitoring alone, 94.8% did not subsequently require advanced intensive care unit therapies and had a low CICU length of stay (1.5 days [0.9-2.4] versus 2.6 [1.4-5.1], P<0.0001) and CICU mortality (0.6% versus 11.0%, P<0.0001), compared with patients with ACS with an admission indication beyond monitoring.Conclusions: In a registry of tertiary care CICUs, ACS represent ≈1/3 of all admissions with significant variability across hospitals. More than half of the ACS admissions to the CICU were for routine monitoring alone, with a low rate of complications and mortality. This observation highlights an opportunity for prospective studies to refine triage strategies for lower risk patients with ACS. [ABSTRACT FROM AUTHOR]

Published
2022
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22. A case report of cardiogenic shock from takotsubo cardiomyopathy with left ventricular outflow tract obstruction: fundamental lessons in cardiac pathophysiology.

Author

Bui QM, Ang L, and Phreaner N

Abstract

Background: A subset of patients with takotsubo cardiomyopathy will develop significant dynamic left ventricular outflow tract (LVOT) obstruction leading to cardiogenic shock. However, traditional therapies for cardiogenic shock that focus on increased inotropy and afterload reduction can be detrimental in this situation., Case Summary: We describe a 71-year-old woman who presented to the emergency department with typical, substernal chest pain found to be hypotensive with ST-elevations in the lateral leads. Coronary angiography showed no significant coronary artery disease, but a left ventriculogram demonstrated takotsubo cardiomyopathy. Right heart catheterization revealed cardiogenic shock and elevated filling pressures. Haemodynamics and symptoms worsened with the initiation of dopamine and placement of intra-aortic balloon pump but improved with the initiation of phenylephrine. Follow-up echocardiogram demonstrated dynamic LVOT obstruction with concomitant severe mitral regurgitation (MR). The patient recovered in the intensive care unit for 5 days after successful weaning of phenylephrine and initiation of low-dose beta-blocker. Repeat echocardiogram 3 weeks later showed complete resolution of apical akinesis, LVOT obstruction, and MR., Discussion: Elucidating whether dynamic LVOT obstruction is contributing to cardiogenic shock physiology is paramount since the management radically differs depending on the presence or absence of obstruction. Corrective therapy focuses on reducing the LVOT gradient and includes fluid administration to improve preload, beta-blocker therapy to increase diastolic filling time, and vasopressors to raise afterload., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2021
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