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639 results on '"Tung, Avery"'

1. Tracheal intubation in critically ill adults with a physiologically difficult airway. An international Delphi study

Author

Karamchandani, Kunal, Nasa, Prashant, Jarzebowski, Mary, Brewster, David J., De Jong, Audrey, Bauer, Philippe R., Berkow, Lauren, Brown, III, Calvin A., Cabrini, Luca, Casey, Jonathan, Cook, Tim, Divatia, Jigeeshu Vasishtha, Duggan, Laura V., Ellard, Louise, Ergan, Begum, Jonsson Fagerlund, Malin, Gatward, Jonathan, Greif, Robert, Higgs, Andy, Jaber, Samir, Janz, David, Joffe, Aaron M., Jung, Boris, Kovacs, George, Kwizera, Arthur, Laffey, John G., Lascarrou, Jean-Baptiste, Law, J. Adam, Marshall, Stuart, McGrath, Brendan A., Mosier, Jarrod M., Perin, Daniel, Roca, Oriol, Rollé, Amélie, Russotto, Vincenzo, Sakles, John C., Shrestha, Gentle S., Smischney, Nathan J., Sorbello, Massimiliano, Tung, Avery, Jabaley, Craig S., and Myatra, Sheila Nainan

Published
2024
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6. Design of Clinical Trials Evaluating Sedation in Critically Ill Adults Undergoing Mechanical Ventilation: Recommendations From Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) Recommendation III

Author

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

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Clinical Trials and Supportive Activities, Clinical Research, Patient Safety, Generic health relevance, Quality Education, Congresses as Topic, Consensus, Delphi Technique, District of Columbia, Humans, Hypnotics and Sedatives, Respiration, Artificial, Time Factors, clinical trial, intensive care, outcome assessments, research methodology, sedation, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences
Abstract

ObjectivesClinical 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.DesignA 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.ParticipantsThirty-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 resultsThe 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.ConclusionsThese 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

35. Variability in expiratory flow requirements among oscillatory positive expiratory pressure

Author

Morgan Sherwin E., Mosakowski Steven, Giles Brenda L., Naureckas Edward, and Tung Avery

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Introduction Oscillatory positive expiratory pressure (OPEP) devices facilitate secretion clearance by generating positive end expiratory pressure. However, different device designs may produce different levels of expiratory pressure with the same expiratory flow rate. We bench tested four devices to determine the relationship between expiratory flow and expiratory pressure in each. Methods A bench model was created to test the gas flow rates required by different OPEP devices to generate target expiratory pressure. Four different devices were tested: Acapella^®^ (DH Green, Smiths Medical), AerobiKa^®^ (Monaghan Medical Corporation), VibraPEP^®^ (Curaplex), and vPEP™ (D R Burton Healthcare). Each OPEP device was tested to determine the expiratory flow needed to generate expiratory pressure thresholds considered appropriate for OPEP therapy. Results The expiratory flow required to generate the same expiratory pressure thresholds varied considerably among devices. Valved OPEP devices such as the VibraPEP required less flow than mechanical devices such as the vPEP, Aerobika, and Acapella. Discussion In this bench test of OPEP devices, we found considerable variability in expiratory flow requirements needed to generate an expiratory pressure of \>10 cm H~2~O. Our finding suggests that smaller patients or those with limited expiratory airflow due to diseases such as COPD, obesity, chronic congestive heart failure, and restrictive lung disease may have better results when matched to OPEP devices requiring less expiratory airflow.

Published
2020
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