1
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Castater CA, Meyer C, Phillips S, Fabien J, Hill R, Hazen B, Nguyen J, Dougherty S, Fiza B, Subramanian R. Complete Heart Block After Low Dose Octreotide Infusion for Esophageal Variceal Bleeding. Am Surg 2023; 89:3867-3869. [PMID: 37144873 DOI: 10.1177/00031348231173937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Cirrhosis and chronic liver disease cause a myriad of systemic health problems mostly caused by the presence of portal hypertension. Esophageal varices are one result of portal hypertension. They can rupture and bleed, which can be catastrophic in already coagulopathic liver failure patients. We present a patient who presented with decompensated liver failure for transplant. He developed a severe and refractory gastrointestinal bleed and was put on an octreotide infusion to increase splanchnic flow and decrease portal pressures. He subsequently developed complete heart block. Understanding the mechanisms of octreotide is imperative due to its frequent use in medically complex patients.
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Affiliation(s)
| | | | | | - Jamesa Fabien
- Ross University School of Medicine, Atlanta, GA, USA
| | - Raven Hill
- Morehouse School of Medicine, Atlanta, GA, USA
| | | | | | | | - Babar Fiza
- Surgery, Emory University, Atlanta, GA, USA
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2
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Augustin KJ, Creel‐Bulos CM, Budhrani GF, Miller CF, Fiza B. Extracorporeal membrane oxygenation as acute rescue therapy for negative pressure pulmonary edema in the post anesthesia care unit: A case report. Clin Case Rep 2023; 11:e7606. [PMID: 37397579 PMCID: PMC10314190 DOI: 10.1002/ccr3.7606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/25/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023] Open
Abstract
Negative pressure pulmonary edema (NPPE) may result in respiratory failure refractory to conventional management strategies. Venovenous extracorporeal membrane oxygenation (VV ECMO) can serve as a rescue therapy in cases of severe respiratory failure. Rapid initiation of VV ECMO can decrease morbidity and mortality while facilitating early liberation from mechanical ventilation and promoting early rehabilitation. We describe the successful utilization of VV ECMO as rescue therapy for severe NPPE-induced hypoxic respiratory failure and peri-arrest state in the postanesthesia care unit (PACU) in a patient with postextubation airway obstruction after undergoing patellar tendon repair.
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Affiliation(s)
- Katrina J. Augustin
- Department of Anesthesiology, Division of Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Christina M. Creel‐Bulos
- Department of Anesthesiology, Division of Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
- Department of Emergency MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Gaurav F. Budhrani
- Department of Anesthesiology, Division of Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
| | - Casey F. Miller
- Department of Surgery, Division of Cardiothoracic SurgeryEmory UniversityAtlantaGeorgiaUSA
| | - Babar Fiza
- Department of Anesthesiology, Division of Critical Care MedicineEmory UniversityAtlantaGeorgiaUSA
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3
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O'Brien CG, Ashland M, Chang DD, Morin DP, Kapil S, Barnett CF, Khanijo S, Stavi D, Goffi A, Fiza B, Patterson A, Carrier FM, Daubert T, Castellucci C, Thompson S, Bughrara N, Zekhtser M, Courchesne K, Mayette M, Parikh R, Mohabir P. MYOCARDIAL INJURY IS NOT ASSOCIATED WITH MORTALITY IN SEVERE COVID-19. J Am Coll Cardiol 2023. [PMCID: PMC9982920 DOI: 10.1016/s0735-1097(23)01085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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4
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Devangam S, Sigakis M, Palmer LJ, Goeddel L, Fiza B. Point-of-Care Ultrasound: A Moving Picture Is Worth a Thousand Tests. Anesthesiol Clin 2023; 41:231-248. [PMID: 36872001 DOI: 10.1016/j.anclin.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The effective utilization of point-of-care ultrasound may decrease the utilization of conventional diagnostic modalities. This review describes the various pathologies that can be effectively and rapidly identified with point-of-care cardiac, lung, abdominal, vascular airway, and ocular ultrasonography.
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Affiliation(s)
- Suhas Devangam
- Department of Anesthesiology, Division of Critical Care, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5048, USA
| | - Matthew Sigakis
- Department of Anesthesiology, Division of Critical Care, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5048, USA
| | - Louisa J Palmer
- Department of Anesthesiology, Division of Critical Care, Brigham and Women's Hospital, 75 Francis Street, Boston MA 02115, USA
| | - Lee Goeddel
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Bloomberg 6320, 1800 Orleans Street, Baltimore, MD, USA 21287
| | - Babar Fiza
- Department of Anesthesiology, Division of Critical Care Medicine, Emory School of Medicine, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA.
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5
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Castater C, Gliga LA, Meyer C, Hazen B, Greene W, Fiza B. Successful Non-Operative Management of Extensive Pneumatosis Cystoides Intestinalis Due to Graft Versus Host Disease. Am Surg 2022; 88:1000-1002. [DOI: 10.1177/00031348211060454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Graft versus host disease is a serious complication of allogenic stem cell transplants and can manifest with gastrointestinal complications including pneumatosis cystoides intestinali (PCI). A 43-year-old male with a history of acute myeloid leukemia presented to the hospital with abdominal pain and sepsis. The patient was intubated and admitted to the ICU. His CT scan demonstrated extensive colonic pneumatosis. He was high risk for laparotomy so was treated non-operatively. He improved and his abdominal exam remained benign. With aggressive resuscitation, close monitoring, and antibiotics, the patient was able to avoid major abdominal surgery. pneumatosis cystoides intestinali is a concerning finding that often leads to surgical interventions. Concurrent sepsis, gut ischemia, and frank perforation often lead to surgical intervention. In patients with high surgical risk and lack of critical bowel findings, non-operative management can be successful.
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Affiliation(s)
- Christine Castater
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - Louise A. Gliga
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - Courtney Meyer
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - Ben Hazen
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - Wendy Greene
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - Babar Fiza
- Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA
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6
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Ferrero NA, Ward CT, Groff RF, Prabhakar A, Fiza B. A rare case of neurological dysfunction due to severe hyponatremia after carotid artery endarterectomy: A review of the clinical approach to hyponatremia. Clin Case Rep 2021; 9:e05171. [PMID: 34917379 PMCID: PMC8643490 DOI: 10.1002/ccr3.5171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 10/12/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Development of severe hyponatremia after carotid endarterectomy procedure is rare. Several pathophysiological mechanisms related to the carotid endarterectomy procedure may infer an increased risk of developing this complication in specific populations.
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Affiliation(s)
- Natalie A. Ferrero
- Department of Anesthesiology and the Emory Critical Care CenterEmory School of MedicineAtlantaGAUSA
| | - Ceressa T. Ward
- Department of PharmacyEmory University Hospital MidtownAtlantaGAUSA
| | - Robert F. Groff
- Department of Anesthesiology and the Emory Critical Care CenterEmory School of MedicineAtlantaGAUSA
| | - Amit Prabhakar
- Department of Anesthesiology and the Emory Critical Care CenterEmory School of MedicineAtlantaGAUSA
| | - Babar Fiza
- Department of Anesthesiology and the Emory Critical Care CenterEmory School of MedicineAtlantaGAUSA
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7
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Ward CT, Boorman DW, Afshar A, Prabhakar A, Fiza B, Pyronneau LR, Kimathi A, Paul C, Moser B, Moll V. A Screening Tool to Detect Chronic Critically Ill Cardiac Surgery Patients at Risk for Low Levels of Testosterone and Somatomedin C: A Prospective Observational Pilot Study. Cureus 2021; 13:e15298. [PMID: 34221757 PMCID: PMC8237911 DOI: 10.7759/cureus.15298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/05/2022] Open
Abstract
Objective The neuroendocrine response to critical illness is dichotomous as it is adaptive during the acute phase then transitions to maladaptive as critical illness becomes prolonged in 25-30% of patients. Presently, monitoring all critically ill patients for endocrinopathies is not the standard of care. However, given the negative impact on patient prognosis, a need to identify those at risk for endocrinopathies, may exist. Thus, a screening tool to identify endocrinopathies along the somatotroph and gonadal axes in a cardiothoracic surgery population was developed. Methods A prospective observational pilot study was conducted in two cardiothoracic surgery intensive care units (ICU) within a multi-site healthcare system. Total testosterone and somatomedin C levels were obtained from 20 adult patients who remained in the ICU for greater than seven days after cardiothoracic surgery and were tolerating nutrition, had a risk of malnutrition and a mobility score of moderate to dependent assistance. Results Twenty patients were included for descriptive analysis (seven females). Thirteen patients tested low for total testosterone, with males more likely to have a testosterone-related endocrinopathy as compared to females (100% vs. 0 to 43%, p = 0.0072). A higher proportion of low somatomedin C levels was found in females than males (57% vs. 31%); however, the difference was not statistically significant (p = 0.251). Conclusions The screening tool used in this pilot study accurately predicted low total testosterone in all men and reasonably predicted low somatomedin C in a majority of women. However, the ability of the tool to predict low total testosterone in women and low somatomedin C in men is less certain. A gender-specific screening tool might be necessary to predict hormonal deficiencies.
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Affiliation(s)
- Ceressa T Ward
- Anesthesiology, Emory University School of Medicine, Atlanta, USA
| | - David W Boorman
- Anesthesiology, Emory University School of Medicine, Atlanta, USA
| | - Ava Afshar
- Pharmacy, Emory University Hospital Midtown, Atlanta, USA
| | - Amit Prabhakar
- Anesthesiology, Emory University School of Medicine, Atlanta, USA
| | - Babar Fiza
- Anesthesiology, Emory University School of Medicine, Atlanta, USA
| | | | - Amber Kimathi
- Food and Nutrition, Emory University Hospital Midtown, Atlanta, USA
| | - Carmen Paul
- Rehab Therapy, Emory University Hospital Midtown, Atlanta, USA
| | - Berthold Moser
- Anesthesiology and Critical Care, See-Spital Horgen, Horgen, CHE
| | - Vanessa Moll
- Anesthesiology, Emory University School of Medicine, Atlanta, USA
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8
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Connor-Schuler R, Wong AI, Shah A, Fiza B, Lyle M, Ramonell R, Hockstein M, Chang G, Markham D, Searles C, McDaniel M, Baer J, Powell C, Daniels L. Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019. Crit Care Explor 2020; 2:e0288. [PMID: 33294847 PMCID: PMC7717747 DOI: 10.1097/cce.0000000000000288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Coronavirus disease 2019 is associated with high mortality rates and multiple organ damage. There is increasing evidence that these patients are at risk for various cardiovascular insults; however, there are currently no guidelines for the diagnosis and management of such cardiovascular complications in patients with coronavirus disease 2019. We share data and recommendations from a multidisciplinary team to highlight our institution's clinical experiences and guidelines for managing cardiovascular complications of coronavirus disease 2019. DESIGN SETTING AND PATIENTS This was a retrospective cohort study of patients admitted to one of six ICUs dedicated to the care of patients with coronavirus disease 2019 located in three hospitals within one academic medical center in Atlanta, Georgia. MEASUREMENTS/INTERVENTIONS Chart review was conducted for sociodemographic, laboratory, and clinical data. Rates of specific cardiovascular complications were assessed, and data were analyzed using a chi-square or Wilcoxon rank-sum test for categorical and continuous variables. Additionally, certain cases are presented to demonstrate the sub committee's recommendations. MAIN RESULTS Two-hundred eighty-eight patients were admitted to the ICU with coronavirus disease 2019. Of these, 86 died (29.9%), 242 (84.03%) had troponin elevation, 70 (24.31%) had dysrhythmias, four (1.39%) had ST-elevation myocardial infarction, eight (2.78%) developed cor pulmonale, and 190 (65.97%) with shock. There was increased mortality risk in patients with greater degrees of troponin elevation (p < 0.001) and with the development of arrhythmias (p < 0.001), cor pulmonale (p < 0.001), and shock (p < 0.001). CONCLUSIONS While there are guidelines for the diagnosis and management of pulmonary complications of coronavirus disease 2019, there needs to be more information regarding the management of cardiovascular complications as well. These recommendations garnered from the coronavirus disease 2019 cardiology subcommittee from our institution will add to the existing knowledge of these potential cardiovascular insults as well as highlight suggestions for the diagnosis and management of the range of cardiovascular complications of coronavirus disease 2019. Additionally, with the spread of coronavirus disease 2019, our case-based recommendations provide a bedside resource for providers newly caring for patients with coronavirus disease 2019.
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Affiliation(s)
- Randi Connor-Schuler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - A Ian Wong
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Anand Shah
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Babar Fiza
- Emory Critical Care Center, Atlanta, GA
- Division of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - Melissa Lyle
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Richard Ramonell
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Maxwell Hockstein
- Division of Critical Care Medicine, Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
| | - George Chang
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - David Markham
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Charles Searles
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Michael McDaniel
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Jefferson Baer
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Cindy Powell
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center, Atlanta, GA
| | - Lisa Daniels
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA
- Emory Critical Care Center, Atlanta, GA
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9
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Moll V, Fiza B, Ward C, Lee S, Prabhakar A. Severe Hypoxia and Compartment Syndrome in a Patient With Sickle Cell Trait After Redo Aortic Valve Replacement: A Case Report and Review of the Literature. J Cardiothorac Vasc Anesth 2020; 34:175-178. [DOI: 10.1053/j.jvca.2019.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 01/26/2023]
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10
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Prabhakar A, Ward CT, Watson M, Sanford J, Fiza B, Moll V, Kaye RJ, Morgan Hall O, Cornett EM, Urman RD, Kaye AD. Liposomal bupivacaine and novel local anesthetic formulations. Best Pract Res Clin Anaesthesiol 2019; 33:425-432. [DOI: 10.1016/j.bpa.2019.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
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11
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Ward CT, Fiza B, Prabhakar A, Budhrani G, Moll V. A Case of Multifactorial Diabetic Ketoacidosis Acquired in the Intensive Care Unit: A Case Report. Cureus 2019; 11:e5128. [PMID: 31523559 PMCID: PMC6741380 DOI: 10.7759/cureus.5128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Diabetic ketoacidosis (DKA) is a potentially fatal endocrine emergency resulting from uncontrolled diabetes mellitus (DM). The development of DKA has been linked to a number of precipitating factors such as infectious process, ischemia, medications, and other medical-surgical illnesses. These factors have been found to aggravate or unmask pre-existing glucose dysregulation secondary to absolute or relative insulin deficiency and increased levels of counter-regulatory hormones. We describe the case of a 61-year-old male with a history of insulin dependent DM who develops DKA postoperatively after a three-vessel coronary artery bypass surgery and mitral valve repair while in the intensive care unit (ICU). The patient’s postoperative course was complicated by presumed pneumonia and hyperactive delirium. On postoperative day (POD) five, the patient’s insulin infusion was held due to non-symptomatic hypoglycemia. Eleven hours later, the insulin infusion was resumed to treat DKA after laboratory findings revealed hyperglycemia, an elevated β-hydroxybutyrate, and anion gap metabolic acidosis. Multiple contributing factors for the development of DKA are suspected and discussed. It is paramount that clinicians are knowledgeable of the multiple factors that can contribute to the development of DKA in the ICU.
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Affiliation(s)
- Ceressa T Ward
- Miscellaneous, Emory University Hospital Midtown, Atlanta, USA
| | - Babar Fiza
- Anesthesiology, Emory School of Medicine, Atlanta, USA
| | | | | | - Vanessa Moll
- Anesthesiology, Emory School of Medicine, Atlanta, USA
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12
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Novitch M, Prabhakar A, Siddaiah H, Sudbury AJ, Kaye RJ, Wilson KE, Haroldson A, Fiza B, Armstead-Williams CM, Cornett EM, Urman RD, Kaye AD. Point of care ultrasound for the clinical anesthesiologist. Best Pract Res Clin Anaesthesiol 2019; 33:433-446. [PMID: 31791562 DOI: 10.1016/j.bpa.2019.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023]
Abstract
Diagnostic ultrasonography was first utilized in the 1940s. The past 70+ years have seen an explosion in both ultrasound technology and availability of ultrasound technology to more and more clinicians. As ultrasound technology and availability have grown, the utility of ultrasound technology in the clinical setting as only been limited by clinicians' imagination. Due to its lack of radiation, non-invasive nature, and gentle learning curve, medical ultrasonography is now a tremendously useful Point of Care technology in the clinical arena. What follows is a discussion of Point of Care Ultrasound (PoCUS) and how it can be incorporated in the daily practice of any regional anesthesiology. While most regional anesthesiologists usually focus on the interventional aspects of ultrasonography (i.e. nerve blocks), our discussion will center on the diagnostic value of ultrasonography-especially concerning assessment of cardiac physiology and pathophysiology, gastric anatomy, airway anatomy, and intracranial pathophysiology. After reading and reviewing this chapter, the learner will have the knowledge to start training themselves in a variety of PoCUS exams that will allow rapid diagnosis of normal and abnormal patient conditions. Once an accurate diagnosis is established, the anesthesiologist and his/her team can then confidently optimize an anesthetic pain, prevent harm, and/or treat a patient condition. In this day and age, the ability to rapidly establish an accurate diagnosis cannot be overstated-especially in a critical situation. It is the authors' sincerest hope that the following discussion will help regional anesthesiologist to become even better and well-rounded clinical leaders.
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Affiliation(s)
- Matthew Novitch
- Department of Anesthesiology, University of Washington, 520 Terry Ave, Seattle, WA 98104, USA.
| | - Amit Prabhakar
- Department of Anesthesiology, Emory University School of Medicine, 550 Peachtree St NE, Atlanta, GA 30308, USA.
| | - Harish Siddaiah
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Anna J Sudbury
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Wauwatosa, WI 53226, USA.
| | - Rachel J Kaye
- Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Kyle E Wilson
- M3, LSUHSC New Orleans School of Medicine, 1901 Period St., New Orleans, LA 70112, USA.
| | - Alexander Haroldson
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Wauwatosa, WI 53226, USA.
| | - Babar Fiza
- Department of Anesthesiology, Division of Critical Care, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA.
| | - C M Armstead-Williams
- Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA 70112, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA.
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
| | - Alan D Kaye
- Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA 70112, USA.
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Fiza B, Tang M, Maile M. Management of cardiopulmonary assist devices in critically ill patients using point-of-care transthoracic echocardiography: a case series. Crit Ultrasound J 2017; 9:24. [PMID: 29159487 PMCID: PMC5696269 DOI: 10.1186/s13089-017-0080-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/11/2017] [Indexed: 11/10/2022] Open
Abstract
Point-of-care transthoracic echocardiography is increasingly being utilized by the intensive care physicians in the management of hemodynamically unstable patients. However, its use in the management of critically ill patients requiring cardiopulmonary mechanical device support remains to be well described. In this case series, we present two case reports where point-of-care echocardiography was successfully used by the intensive care team in diagnosing and managing problems related to cardiopulmonary assist device malposition.
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Affiliation(s)
- Babar Fiza
- Department of Anesthesiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5861, USA.
| | - Michael Tang
- Department of Anesthesiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5861, USA
| | - Michael Maile
- Department of Anesthesiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-5861, USA
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14
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Zhu GD, Salazar G, Zlatic SA, Fiza B, Doucette MM, Heilman CJ, Levey AI, Faundez V, L'Hernault SW. SPE-39 family proteins interact with the HOPS complex and function in lysosomal delivery. Mol Biol Cell 2009; 20:1223-40. [PMID: 19109425 PMCID: PMC2642739 DOI: 10.1091/mbc.e08-07-0728] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Revised: 12/02/2008] [Accepted: 12/05/2008] [Indexed: 01/19/2023] Open
Abstract
Yeast and animal homotypic fusion and vacuole protein sorting (HOPS) complexes contain conserved subunits, but HOPS-mediated traffic in animals might require additional proteins. Here, we demonstrate that SPE-39 homologues, which are found only in animals, are present in RAB5-, RAB7-, and RAB11-positive endosomes where they play a conserved role in lysosomal delivery and probably function via their interaction with the core HOPS complex. Although Caenorhabditis elegans spe-39 mutants were initially identified as having abnormal vesicular biogenesis during spermatogenesis, we show that these mutants also have disrupted processing of endocytosed proteins in oocytes and coelomocytes. C. elegans SPE-39 interacts in vitro with both VPS33A and VPS33B, whereas RNA interference of VPS33B causes spe-39-like spermatogenesis defects. The human SPE-39 orthologue C14orf133 also interacts with VPS33 homologues and both coimmunoprecipitates and cosediments with other HOPS subunits. SPE-39 knockdown in cultured human cells altered the morphology of syntaxin 7-, syntaxin 8-, and syntaxin 13-positive endosomes. These effects occurred concomitantly with delayed mannose 6-phosphate receptor-mediated cathepsin D delivery and degradation of internalized epidermal growth factor receptors. Our findings establish that SPE-39 proteins are a previously unrecognized regulator of lysosomal delivery and that C. elegans spermatogenesis is an experimental system useful for identifying conserved regulators of metazoan lysosomal biogenesis.
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Affiliation(s)
| | | | - Stephanie A. Zlatic
- Graduate Program in Biochemistry, Cell, and Developmental Biology
- Cell Biology, and
| | | | | | - Craig J. Heilman
- Department of Neurology
- Center for Neurodegenerative Disease, Emory University, Atlanta, GA 30322
| | - Allan I. Levey
- Department of Neurology
- Center for Neurodegenerative Disease, Emory University, Atlanta, GA 30322
| | - Victor Faundez
- Graduate Program in Biochemistry, Cell, and Developmental Biology
- Cell Biology, and
- Center for Neurodegenerative Disease, Emory University, Atlanta, GA 30322
| | - Steven W. L'Hernault
- Graduate Program in Biochemistry, Cell, and Developmental Biology
- Departments of *Biology and
- Center for Neurodegenerative Disease, Emory University, Atlanta, GA 30322
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15
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Wright N, Fiza B, Samuelson L, Walkup M, Gerber DA. Proinflammatory cytokine effects on NO and hepatic progenitor cell differentiation. FASEB J 2007. [DOI: 10.1096/fasebj.21.6.a1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Natasha Wright
- SurgeryUniversity of North Carolina at Chapel HillCB#7211, 4020 Burnett‐Womack BuildingChapel HillNC27599
| | - Babar Fiza
- SurgeryUniversity of North Carolina at Chapel HillCB#7211, 4020 Burnett‐Womack BuildingChapel HillNC27599
| | - Lisa Samuelson
- SurgeryUniversity of North Carolina at Chapel HillCB#7211, 4020 Burnett‐Womack BuildingChapel HillNC27599
| | - Maggie Walkup
- SurgeryUniversity of North Carolina at Chapel HillCB#7211, 4020 Burnett‐Womack BuildingChapel HillNC27599
| | - David A Gerber
- SurgeryUniversity of North Carolina at Chapel HillCB#7211, 4020 Burnett‐Womack BuildingChapel HillNC27599
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