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32 results on '"Wolff, Armand"'

2. Variation in Fluid and Vasopressor Use in Shock With and Without Physiologic Assessment: A Multicenter Observational Study.

Author

Chen, Jen-Ting, Roberts, Russel, Fazzari, Melissa J, Kashani, Kianoush, Qadir, Nida, Cairns, Charles B, Mathews, Kusum, Park, Pauline, Khan, Akram, Gilmore, James F, Brown, Anne Rain T, Tsuei, Betty, Handzel, Michele, Lee Chang, Alfredo, Duggal, Abhijit, Lanspa, Michael, Herbert, James Taylor, Martinez, Anthony, Tonna, Joseph, Ammar, Mahmoud A, Hammond, Drayton, Nazer, Lama H, Heavner, Mojdeh, Pender, Erin, Chambers, Lauren, Kenes, Michael T, Kaufman, David, Downey, April, Brown, Brent, Chaykosky, Darlene, Wolff, Armand, Smith, Michael, Nault, Katie, Sevransky, Jonathan, and Gong, Michelle N

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Clinical Research, Hematology, Good Health and Well Being, APACHE, Adult, Aged, Aged, 80 and over, Blood Pressure, Central Venous Pressure, Dose-Response Relationship, Drug, Female, Fluid Therapy, Hospital Mortality, Humans, Intensive Care Units, Male, Middle Aged, Organ Dysfunction Scores, Prospective Studies, Shock, Vasoconstrictor Agents, fluid, hemodynamic monitor, mortality, resuscitation, shock, vasopressor, VOLUME-CHASERS Study Group and Society of Critical Care Medicine Discovery Network, Clinical Sciences, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences
Abstract

ObjectivesTo characterize the association between the use of physiologic assessment (central venous pressure, pulmonary artery occlusion pressure, stroke volume variation, pulse pressure variation, passive leg raise test, and critical care ultrasound) with fluid and vasopressor administration 24 hours after shock onset and with in-hospital mortality.DesignMulticenter prospective cohort study between September 2017 and February 2018.SettingsThirty-four hospitals in the United States and Jordan.PatientsConsecutive adult patients requiring admission to the ICU with systolic blood pressure less than or equal to 90 mm Hg, mean arterial blood pressure less than or equal to 65 mm Hg, or need for vasopressor.InterventionsNone.Measurement and main resultsOf 1,639 patients enrolled, 39% had physiologic assessments. Use of physiologic assessment was not associated with cumulative fluid administered within 24 hours of shock onset, after accounting for baseline characteristics, etiology and location of shock, ICU types, Acute Physiology and Chronic Health Evaluation III, and hospital (beta coefficient, 0.04; 95% CI, -0.07 to 0.15). In multivariate analysis, the use of physiologic assessment was associated with a higher likelihood of vasopressor use (adjusted odds ratio, 1.98; 95% CI, 1.45-2.71) and higher 24-hour cumulative vasopressor dosing as norepinephrine equivalent (beta coefficient, 0.37; 95% CI, 0.19-0.55). The use of vasopressor was associated with increased odds of in-hospital mortality (adjusted odds ratio, 1.88; 95% CI, 1.27-2.78). In-hospital mortality was not associated with the use of physiologic assessment (adjusted odds ratio, 0.86; 95% CI, 0.63-1.18).ConclusionsThe use of physiologic assessment in the 24 hours after shock onset is associated with increased use of vasopressor but not with fluid administration.

Published
2020

5. Evaluation of Vasopressor Exposure and Mortality in Patients With Septic Shock*

Author

Roberts, Russel J., Miano, Todd A., Hammond, Drayton A., Patel, Gourang P., Chen, Jen-Ting, Phillips, Kristy M., Lopez, Natasha, Kashani, Kianoush, Qadir, Nida, Cairns, Charles B., Mathews, Kusum, Park, Pauline, Khan, Akram, Gilmore, James F., Brown, Anne Rain Tanner, Tsuei, Betty, Handzel, Michele, Chang, Alfredo Lee, Duggal, Abhijit, Lanspa, Michael, Herbert, James Taylor, Martinez, Anthony, Tonna, Joseph, Ammar, Mahmoud A., Nazer, Lama H., Heavner, Mojdeh, Pender, Erin, Chambers, Lauren, Kenes, Michael T., Kaufman, David, Downey, April, Brown, Brent, Chaykosky, Darlene, Wolff, Armand, Smith, Michael, Nault, Katie, Gong, Michelle N., Sevransky, Jonathan E., and Lat, Ishaq

Published
2020
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16. Positive Pressure for Obesity Hypoventilation Syndrome

Author

Chanda, Arijit, Kwon, Jeff S., Wolff, Armand John, and Manthous, Constantine A.

Subjects
Article Subject
Abstract

Obesity is increasing world-wide; obesity hypoventilation syndrome (OHS), formerly Pickwickian syndrome, has increased in parallel. Despite its prevalence, OHS has not been studied well, but there is abundant evidence that it is tightly linked with sleep-disordered breathing, most commonly obstructive sleep apnea. This article reviews the pathophysiology of OHS as well as the literature regarding the benefits of treating this disorder with positive airway pressure. We also emphasize that while positive pressure treatments may temporize cardiopulmonary disease progression, simultaneous pursuit of weight reduction is central to long-term management of this condition.

Published
2012
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20. Cardiac injury in patients with COPD presenting with dyspnea: a pilot study

Author

Odigie-Okon,Esosa, Jordan,Bryan, Dijeh,Sylvester, Wolff,Armand, Dadu,Razvan, Lall,Priyanka, Zarich,Stuart, Amoateng-Adjepong,Yaw, Manthous,C A, Odigie-Okon,Esosa, Jordan,Bryan, Dijeh,Sylvester, Wolff,Armand, Dadu,Razvan, Lall,Priyanka, Zarich,Stuart, Amoateng-Adjepong,Yaw, and Manthous,C A

Abstract

Esosa Odigie-Okon, Bryan Jordan, Sylvester Dijeh, Armand Wolff, Razvan Dadu, Priyanka Lall, Stuart Zarich, Yaw Amoateng-Adjepong, Constantine A ManthousBridgeport Hospital and Yale University School of Medicine, Bridgeport, CT, USAPurpose: The aim of this pilot study was to test the hypothesis that myocardial ischemia complicates the management of some patients with chest-pain-free chronic obstructive pulmonary disease (COPD) exacerbations.Methods: In this prospective, observational, cohort study, patients admitted to a 350-bed community teaching hospital, with dyspnea and a primary diagnosis of COPD exacerbation, were followed for enzymatic and electrocardiographic evidence of myocardial ischemia for the first 24 hours of hospital admission.Results: A total of 114 patients were studied. Overall, four patients had definite myocardial infarctions, one had definite myocardial ischemia and 14 had possible myocardial ischemia. In multiple logistic regression models, age, number of coronary risk factors, and amount of administered albuterol were not associated with myocardial injury.Conclusion: While unrecognized myocardial injury is relatively rare in patients with an exacerbation of COPD, it occurs frequently enough to warrant some caution since beta-agonists are the mainstays of therapy.Keywords: COPD, myocardial ischemia, acute coronary syndrome, troponin

Published
2010

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