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  1. Article: Enhancing the awakening to family engagement bundle with music therapy.

    Modrykamien, Ariel M

    World journal of critical care medicine

    2023  Volume 12, Issue 2, Page(s) 41–52

    Abstract: Survivors of prolonged intensive care unit (ICU) admissions may present undesirable long-term outcomes. In particular, physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation ... ...

    Abstract Survivors of prolonged intensive care unit (ICU) admissions may present undesirable long-term outcomes. In particular, physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation and sedation. One of the strategies to prevent the aforementioned outcomes involves the implementation of a bundle composed by: (1) Spontaneous awakening trial; (2) Spontaneous breathing trial; (3) Choosing proper sedation strategies; (4) Delirium detection and management; (5) Early ICU mobility; and (6) Family engagement (ABCDEF bundle). The components of this bundle contribute in shortening length of stay on mechanical ventilation and reducing incidence of delirium. Since the first description of the ABCDEF bundle, other relevant therapeutic factors have been proposed, such as introducing music therapy. This mini-review describes the current evidence supporting the use of the ABCDEF bundle, as well as current knowledge on the implementation of music therapy.
    Language English
    Publishing date 2023-03-09
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2220-3141
    ISSN 2220-3141
    DOI 10.5492/wjccm.v12.i2.41
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The ICU medical director leadership during Covid-19 pandemic.

    Modrykamien, Ariel M

    American journal of disaster medicine

    2020  Volume 15, Issue 2, Page(s) 141–142

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Humans ; Intensive Care Units/organization & administration ; Leadership ; Pandemics/prevention & control ; Physician Executives ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-08-03
    Publishing country United States
    Document type Journal Article
    ISSN 1932-149X
    ISSN 1932-149X
    DOI 10.5055/ajdm.2020.0346
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Strategies for communicating with conscious mechanically ventilated critically ill patients.

    Modrykamien, Ariel M

    Proceedings (Baylor University. Medical Center)

    2019  Volume 32, Issue 4, Page(s) 534–537

    Abstract: Critically ill patients admitted to the intensive care unit (ICU) frequently require ventilatory support. To provide this life-saving therapy, oral intubation or tracheostomy placements are needed. Consequently, verbal ability to communicate is lost. ... ...

    Abstract Critically ill patients admitted to the intensive care unit (ICU) frequently require ventilatory support. To provide this life-saving therapy, oral intubation or tracheostomy placements are needed. Consequently, verbal ability to communicate is lost. Furthermore, depending on the severity of the clinical condition and other comorbidities, patients commonly develop ICU-acquired weakness, which may preclude gestural communication and motor abilities. Under this circumstance, the patient's inability to interact with health care providers and/or family members results in psychological alterations, as well as isolation and reduction of self-esteem. A variety of tools have been developed to improve patient-clinician communication. This article reviews patient complications due to lack of communication, available tools to enhance interactions, and current published evidence to support communication tools.
    Language English
    Publishing date 2019-07-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2019.1635413
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sepsis mortality and ICU length of stay after the implementation of an intensive care team in the emergency department.

    Tuttle, Erin / Wang, Xuan / Modrykamien, Ariel

    Internal and emergency medicine

    2023  Volume 18, Issue 6, Page(s) 1789–1796

    Abstract: Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis ... ...

    Abstract Emergency department patient boarding is associated with hospital mortality and increased hospital length of stay. The objective of the present study is to describe the impact of deploying an Intensive Care team in the ED and its association with sepsis mortality and ICU length of stay. Patients admitted to ICU through the ED with an ICD-10 CM diagnosis of sepsis were included. Preintervention and postintervention phases included 4 and 15 months, respectively. Sepsis time zero, SEP-1 compliance, and lag time from time zero to antibiotic administration were compared. Outcomes of interest were mortality and ICU LOS. 1021 septic patients were included. Sixty-six percent fulfilled compliance with 3 h SEP-1 bundle. Lag time from time zero to antibiotic administration was 75 min. Multivariate analysis showed no association between ICU team in the ED and hospital mortality (Log OR 0.94, CI 0.67-1.34; p = 0.73). The ICU team in the ED was associated with prolonged ICU LOS (Log OR 1.21, CI 1.13-1.30; p < 0.01). Septic shock and ED boarding time were associated with prolonged ICU LOS. Compliance with SEP-1 bundle was associated with its reduction. Implementation of an ICU team in the ED for the treatment of septic patients during high volume hospitalizations is not associated with a reduction of mortality or ICU LOS.
    MeSH term(s) Humans ; Length of Stay ; Intensive Care Units ; Sepsis/therapy ; Critical Care ; Hospital Mortality ; Emergency Service, Hospital ; Anti-Bacterial Agents ; Retrospective Studies
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2023-04-19
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-023-03265-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Implementation of a medical intensive care team in the emergency department of a tertiary medical center in the USA.

    Tuttle, Erin / Wang, Xuan / Modrykamien, Ariel

    Hospital practice (1995)

    2022  Volume 50, Issue 5, Page(s) 387–392

    Abstract: Objective: Critically ill patients boarding in the ED have higher mortality rates. Several strategies have been implemented to deliver care to boarding patients. Our institution opted for a strategy consisting on deploying an Intensive Care team in the ... ...

    Abstract Objective: Critically ill patients boarding in the ED have higher mortality rates. Several strategies have been implemented to deliver care to boarding patients. Our institution opted for a strategy consisting on deploying an Intensive Care team in the ED. This article reports outcomes before-and-after implementation of that team.
    Methods: On November 2020, a Medical Intensive Care Team was deployed in the ED. The team performed consultations for ICU patients boarding in the ED. A retrospective analysis of critically ill patients arriving to the ED before-and-after team implementation was performed. Outcome data were reviewed. Direct hospitalization costs per patient, and direct costs per department were assessed. Wilcoxon rank sum and Chisq-test were utilized to compare differences pre- and post-implementation. Multivariate analyses to model outcomes toward pre- and post-implementation and other variables were performed.
    Results: 1,828 and 3,272 patients were included in the pre- and post-intervention groups. ICU LOS (days) pre- and post-intervention were 3 (1,6) and 3 (1,6), respectively (p = 0.41). ICU readmission rates were 6.7% pre-intervention and 7.4% post-intervention (p = 0.37). Total direct costs were US$ 19,928 (11,006, 37,815) and US$ 15,795 (9016, 28,993), respectively (p < 0.01). Multivariate analysis showed no association between team deployment and ICU LOS or readmission. However, there was association between its implementation and hospitalization cost reduction per patient of US$ 7,171.
    Conclusion: The implementation of a Medical Intensive Care team in the ED is not associated with a reduction of ICU LOS or ICU readmission. Nevertheless, its implementation is associated with a reduction of hospitalization costs.
    MeSH term(s) Humans ; Critical Illness/therapy ; Length of Stay ; Intensive Care Units ; Retrospective Studies ; Emergency Service, Hospital ; Critical Care
    Language English
    Publishing date 2022-09-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2570453-9
    ISSN 2377-1003 ; 2154-8331 ; 8750-2836
    ISSN (online) 2377-1003
    ISSN 2154-8331 ; 8750-2836
    DOI 10.1080/21548331.2022.2126255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Critically ill patients boarding in the emergency department and the association with intensive care unit length of stay and hospital mortality during the COVID-19 pandemic.

    Tuttle, Erin / Wisecup, Ciara / Lemieux, Eric / Wang, Xuan / Modrykamien, Ariel

    Proceedings (Baylor University. Medical Center)

    2022  Volume 35, Issue 2, Page(s) 145–148

    Abstract: Boarding of critically ill patients in the emergency department (ED) has been associated with mortality and intensive care unit (ICU) length of stay (LOS). This study evaluated whether boarding time in the ED was associated with those outcomes. A ... ...

    Abstract Boarding of critically ill patients in the emergency department (ED) has been associated with mortality and intensive care unit (ICU) length of stay (LOS). This study evaluated whether boarding time in the ED was associated with those outcomes. A retrospective analysis of patients admitted through the ED to the ICU was performed. Information on demographics, severity score, and diagnoses was collected. The continuous primary endpoint of ICU LOS was fitted by a log normal model on covariates, including ED LOS. A multivariate log normal model was also used to model covariates toward ICU LOS. The binary patient expiration status was modeled by univariate and multivariate logistic regressions to evaluate the association of mortality with covariates. ED LOS was not associated with ICU LOS (correlation with an estimate of -0.02 ± 0.06 [SE],
    Language English
    Publishing date 2022-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2021.2014761
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  8. Article ; Online: Inhaled epoprostenol in ARDS.

    Modrykamien, Ariel M

    Respiratory care

    2014  Volume 59, Issue 8, Page(s) 1312–1313

    MeSH term(s) Administration, Inhalation ; Antihypertensive Agents/therapeutic use ; Epoprostenol/therapeutic use ; Hospital Mortality ; Humans ; Respiratory Distress Syndrome, Adult/drug therapy ; Respiratory Distress Syndrome, Adult/mortality ; Survival Rate
    Chemical Substances Antihypertensive Agents ; Epoprostenol (DCR9Z582X0)
    Language English
    Publishing date 2014-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.03424
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: The acute respiratory distress syndrome.

    Wood, Christopher / Kataria, Vivek / Modrykamien, Ariel M

    Proceedings (Baylor University. Medical Center)

    2020  Volume 33, Issue 3, Page(s) 357–365

    Abstract: Acute respiratory distress syndrome (ARDS) is a prevalent cause of acute respiratory failure with high rates of mortality, as well as short- and long-term complications, such as physical and cognitive impairment. Therefore, early recognition of this ... ...

    Abstract Acute respiratory distress syndrome (ARDS) is a prevalent cause of acute respiratory failure with high rates of mortality, as well as short- and long-term complications, such as physical and cognitive impairment. Therefore, early recognition of this syndrome and application of well-demonstrated therapeutic interventions are essential to change the natural course of this entity and bring about positive clinical outcomes. In this article, we review updated concepts in ARDS. Specifically, we discuss the current definition of ARDS, its risk factors, and the evidence supporting ventilation management, adjunctive therapies, and interventions required in refractory hypoxemia.
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2020.1764817
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  10. Article: Factors among patients receiving prone positioning for the acute respiratory distress syndrome found useful for predicting mortality in the intensive care unit.

    Modrykamien, Ariel M / Daoud, Yahya

    Proceedings (Baylor University. Medical Center)

    2018  Volume 31, Issue 1, Page(s) 1–5

    Abstract: Optimal mechanical ventilation management in patients with the acute respiratory distress syndrome (ARDS) involves the use of low tidal volumes and limited plateau pressure. Refractory hypoxemia may not respond to this strategy, requiring other ... ...

    Abstract Optimal mechanical ventilation management in patients with the acute respiratory distress syndrome (ARDS) involves the use of low tidal volumes and limited plateau pressure. Refractory hypoxemia may not respond to this strategy, requiring other interventions. The use of prone positioning in severe ARDS resulted in improvement in 28-day survival. To determine whether mechanical ventilation strategies or other parameters affected survival in patients undergoing prone positioning, a retrospective analysis was conducted of a consecutive series of patients with severe ARDS treated with prone positioning. Demographic and clinical information involving mechanical ventilation strategies, as well as other variables associated with prone positioning, was collected. The rate of in-hospital mortality was obtained, and previously described parameters were compared between survivors and nonsurvivors. Forty-three patients with severe ARDS were treated with prone positioning, and 27 (63%) died in the intensive care unit. Only three parameters were significant predictors of survival: APACHE II score (
    Language English
    Publishing date 2018-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703932-8
    ISSN 1525-3252 ; 0899-8280
    ISSN (online) 1525-3252
    ISSN 0899-8280
    DOI 10.1080/08998280.2017.1391560
    Database MEDical Literature Analysis and Retrieval System OnLINE

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