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3. A Randomized Clinical Trial of Antimicrobial Duration for Cystic Fibrosis Pulmonary Exacerbation Treatment

Author

Goss, Christopher H., primary, Heltshe, Sonya L., additional, West, Natalie E., additional, Skalland, Michelle, additional, Sanders, Don B., additional, Jain, Raksha, additional, Barto, Tara L., additional, Fogarty, Barbra, additional, Marshall, Bruce C., additional, VanDevanter, Donald R., additional, Flume, Patrick A., additional, Omlor, Gregory, additional, Bourne, Brenda, additional, Roberts, Dion, additional, Roberts, Vicki, additional, Nasr, Samya, additional, Kruse, Dawn, additional, Linnemann, Rachel, additional, Hailemichael, Tsion, additional, Forseen, Caralee, additional, Stapp, Heidi, additional, West, Natalie, additional, Patel, S., additional, Claudio, A., additional, Lysinger, Jerimiah, additional, Harmala, Amy, additional, Solomon, George, additional, Kersh, Latona, additional, Miller, Karen, additional, Durham, Dixie, additional, Uluer, Ahmet, additional, Fowler, Robert, additional, Frederick, Carla, additional, Caci, Nadine, additional, Teneback, Charlotte, additional, Sweet, Julie, additional, Parkins, Michael, additional, Smith, Clare, additional, Goralski, Jennifer, additional, Haywood, Kelsey, additional, Flume, Patrick, additional, Brailsford, Caroline, additional, Albon, Dana, additional, Aderholt, Christie, additional, McBennett, Kimberly, additional, Schaefer, Cindy, additional, Patel, Alpa, additional, Hunt, April, additional, Schumacher, Lauren, additional, Polenakovik, Hari, additional, Clark, Linda, additional, Nick, Jerry, additional, Poch, Katie, additional, Kissner, Dana, additional, Cahill, James, additional, Lascano, Jorge, additional, Silverman, Erin, additional, McArdle, John, additional, Champagne, Alison, additional, Vender, Robert, additional, Allwein, Lisa, additional, Cohen, Lance, additional, Barton, Norma (Jean), additional, Barto, Tara, additional, Patel, Ami, additional, Brown, Cynthia, additional, Vorhees, Nia, additional, Crosser, Michael, additional, Scott, Lawrence, additional, Ashare, Alix, additional, Rodgers, Barbara, additional, Zanni, Robert, additional, Koval, Lisa, additional, Braun, Andrew, additional, Stevens, Sophia Chiron, additional, Ortiz, Maria Tupayachi, additional, Graham, Patricia, additional, Biller, Julie, additional, Hubertz, Erin, additional, Moffett, Kathryn, additional, Clark, Tammy, additional, Griffith, Rebecca, additional, Martinez, Nancy, additional, Hussain, Sabiha, additional, Chen, Fei, additional, Egan, Marie, additional, Guzman, Catalina, additional, Wang, Janice, additional, Espinal, Aileen, additional, Walker, Patricia, additional, Kukral, Anne, additional, DiMango, Emily, additional, Francis, Sarah Fracasso, additional, Milla, Carlos, additional, Dunn, Colleen, additional, Chittivelu, Subramanyam, additional, Scott, Ashley, additional, Dorgan, Daniel, additional, Ng, Sharon, additional, Pilewski, Joseph, additional, Lanzo, Rose, additional, Chaudary, Nauman, additional, Hayden, Ryan, additional, Scofield, Steven, additional, Johnson, Barb, additional, Morrissey, Brian, additional, Robinson, Brandt, additional, Conrad, Douglas, additional, Mielke, Jenna, additional, Aitken, Moira, additional, Sanlors, Chami, additional, Nayak, Ravi, additional, Branch, Freda, additional, Rosenbluth, Daniel, additional, Siegel, Molly, additional, Ghimire, Anil, additional, Forell, Mary, additional, Daines, Cori, additional, Varela, Monica, additional, Couch, Leslie, additional, Hibbard, Rebekah, additional, Dozor, Allen, additional, Ramirez, Armando, additional, Ortega, Victor, additional, Kennedy, Kathryn, additional, Fish, David, additional, and Longtine, Karen, additional

Published
2021
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5. Venoarterial Extracorporeal Membrane Oxygenation in Massive Pulmonary Embolism-Related Cardiac Arrest: A Systematic Review*

Author

Scott, John Harwood, primary, Gordon, Matthew, additional, Vender, Robert, additional, Pettigrew, Samantha, additional, Desai, Parag, additional, Marchetti, Nathaniel, additional, Mamary, Albert James, additional, Panaro, Joseph, additional, Cohen, Gary, additional, Bashir, Riyaz, additional, Lakhter, Vladimir, additional, Roth, Stephanie, additional, Zhao, Huaqing, additional, Toyoda, Yoshiya, additional, Criner, Gerard, additional, Moores, Lisa, additional, and Rali, Parth, additional

Published
2021
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10. Chronic pulmonary hypertension: cell biology to pathophysiology

Author

Vender, Robert L.

Subjects
Pulmonary hypertension -- Physiological aspects, Health, Physiological aspects
Abstract

(Chest 1994; 106:236-43) AHPR = acute hypoxic pressor response; cGMP = guanosine cyclic monophosphate; NO = nitric oxide; PAP = pulmonary arterial pressure; PVR = pulmonary vascular resistance; PVSMC = [...]

Published
1994

15. Characteristics of Resting Metabolic Rate in Critically Ill, Mechanically Ventilated Adults With Cystic Fibrosis.

Author

Frankenfield, David C., Ashcraft, Christine M., Drasher, Tammy L., Reid, Elizabeth K., and Vender, Robert L.

Subjects
CYSTIC fibrosis treatment, ARTIFICIAL respiration, BASAL metabolism, BODY weight, CALORIMETRY, CARBON dioxide, CATASTROPHIC illness, CRITICAL care medicine, LEANNESS, BODY mass index, OXYGEN consumption, CASE-control method
Abstract

Background: Critically ill patients with cystic fibrosis may be especially sensitive to the negative consequences of overfeeding and underfeeding, yet there is almost no information available about the energy needs of these patients. The purpose of this study was to characterize the metabolic rate of critically ill adult patients with cystic fibrosis requiring mechanical ventilation.Methods: This was an observational study in which the resting metabolic rate, oxygen consumption, and carbon dioxide production of adult patients with cystic fibrosis requiring critical care, sedation, and mechanical ventilation were measured with indirect calorimetry. This group was compared with a cohort of adult critical care patients without cystic fibrosis.Results: Twelve patients with cystic fibrosis were identified and measured. These were compared with a control group of 25 critically ill patients. Both groups were underweight (body mass index, 17.4 ± 4.0 kg/m2 in cystic fibrosis and 18.4 ± 2.3 kg/m2 in control). Adjusting for differences in age, sex, height, and weight, there was no difference in resting metabolic rate between the cystic fibrosis and control groups (1702 ± 193 vs 1642 ± 194 kcal/d, P = .388). Measured resting metabolic rate matched predicted values 58% of the time in cystic fibrosis and 60% of the time in control.Conclusions: The resting metabolic rate of sedated adult patients with cystic fibrosis being assisted with mechanical ventilation is not different from that of adult critical care patients without cystic fibrosis. In both these underweight groups, accurate prediction of resting metabolic rate is difficult to obtain. [ABSTRACT FROM AUTHOR]

Published
2017
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26. Cystic Fibrosis Pulmonary Guidelines: Airway Clearance Therapies.

Author

Flume, Patrick A., Robinson, Karen A., Brian P. O'Sullivan, Finder, Jonathan D., Vender, Robert L., Willey-Courand, Donna-Beth, White, Terry B., and Marshall, Bruce C.

Subjects
CYSTIC fibrosis treatment, AIRWAY (Anatomy), LUNG diseases, LUNG infections, RESPIRATORY therapy, AEROBIC exercises, EXERCISE therapy
Abstract

Cystic fibrosis (CF) is a genetic disease characterized by dehydration of airway surface liquid and impaired mucociliary clearance. As a result, there is difficulty clearing pathogens from the lung, and patients experience chronic pulmonary infections and inflammation. Clearance of airway secretions has been a primary therapy for those with CF, and a variety of airway clearance therapies (ACTs) have been developed. Because ACTs are intrusive and require considerable time and effort, it is important that appropriate techniques are recommended on the basis of available evidence of efficacy and safety. Therefore, the Cystic Fibrosis Foundation established a committee to examine the clinical evidence for each therapy and provide guidance for their use. A systematic review was commissioned, which identified 7 unique reviews and 13 additional controlled trials that addressed one or more of the comparisons of interest and were deemed eligible for inclusion. Recommendations for use of the ACTs were made, balancing the quality of evidence and the potential harms and benefits. The committee determined that, although there is a paucity of controlled trials that assess the long-term effects of ACTs, the evidence quality overall for their use in CF is fair and the benefit is moderate. The committee recommends airway clearance be performed on a regular basis in all patients. There are no ACTs demonstrated to be superior to others, so the prescription of ACTs should be individualized. Aerobic exercise is recommended as an adjunctive therapy for airway clearance and for its additional benefits to overall health. [ABSTRACT FROM AUTHOR]

Published
2009

28. Severe hypercapnia in critically ill adult cystic fibrosis patients.

Author

Sheikh HS, Tiangco ND, Harrell C, and Vender RL

Abstract

Background: Cystic fibrosis (CF) is a monogenetic autosomal recessive multi-organ disease affecting approximately 50,000 patients worldwide. Overall median survival is continually increasing but pulmonary disease remains the most common cause of death. Guidelines have been published in relation to the outpatient maintenance of lung health for CF patients and treatment of acute lung exacerbations but little information exists about the management of the critically ill CF patient. Invasive mechanical ventilation in CF patients with acute respiratory failure is associated with poor outcome and high mortality., Methods: Retrospective analysis of adult patients with CF who required endotracheal intubation and invasive mechanical ventilation in the Medical Intensive Care Unit (MICU)., Results: Between the years 2003 - 2009, 14 adult patients with CF required endotracheal intubation and invasive mechanical ventilation in the Medical Intensive Care Unit (MICU) of the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA. Eleven patients died in the MICU because of progressive respiratory failure and inability to liberate from mechanical ventilation. Seven individuals consistently manifested arterial partial pressures of carbon dioxide (PaCO(2)) greater than 20.00 kPa despite high levels of conventional modes of mechanical ventilation., Conclusion: Intubated CF patients with respiratory failure have a high mortality rate. Based on our experience, multiple factors contribute to severe hypercapnia and the effectiveness of conventional modes of mechanical ventilation in many of these patients is limited., Keywords: Cystic fibrosis; Mechanical ventilation; Critical care; Hypercapnia; Respiratory failure.

Published
2011
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