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  1. Article ; Online: Mounting Clarity on Enteral Feeding in Critically Ill Patients.

    Morrissette, Katelin M / Stapleton, Renee D

    American journal of respiratory and critical care medicine

    2020  Volume 201, Issue 7, Page(s) 758–760

    MeSH term(s) Critical Illness ; Enteral Nutrition ; Humans ; Intensive Care Units
    Language English
    Publishing date 2020-02-03
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202001-0126ED
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Classification of clinically relevant intravascular volume status using point of care ultrasound and machine learning.

    Wshah, Safwan / Xu, Beilei / Steinharter, John / Reilly, Clifford / Morrissette, Katelin

    Journal of medical imaging (Bellingham, Wash.)

    2022  Volume 9, Issue 5, Page(s) 54502

    Abstract: Purpose: This is a foundational study in which multiorgan system point of care ultrasound (POCUS) and machine learning (ML) are used to mimic physician management decisions regarding the functional intravascular volume status (IVS) and need for diuretic ...

    Abstract Purpose: This is a foundational study in which multiorgan system point of care ultrasound (POCUS) and machine learning (ML) are used to mimic physician management decisions regarding the functional intravascular volume status (IVS) and need for diuretic therapy. We present this as an impactful use case of an application of ML in aided decision making for clinical practice. IVS represents complex physiologic interactions of the cardiac, renal, pulmonary, and other organ systems. In particular, we focus on vascular congestion and overload as an evolving concept in POCUS diagnosis and clinical relevance. It is critical for physicians to be able to evaluate IVS without disrupting workflow or exposing patients to unnecessary testing, radiation, or cost. This work utilized a small retrospective dataset as a feasibility test for ML binary classification of diuretic administration validated with clinical decision data. Future work will be directed toward artificial intelligence (AI) delivery at the bedside and assessment of the impact on patient-centered outcomes and physician workflow improvement.
    Approach: We retrospectively reviewed and processed 1039 POCUS video clips, including cardiac, thoracic, and inferior vena cava (IVC) views. Multiorgan POCUS clips were correlated with clinical data extracted from the electronic health record and deidentified for algorithm training and validation. We implemented a two-stream three-dimensional (3D) deep learning approach that fuses heart and IVC data to perform binary classification of the need for diuretic use.
    Results: Our proposed approach achieves high classification accuracy (84%) for the determination of diuretic use with 0.84 area under the receiver operating characteristic curve.
    Conclusions: Our two-stream 3D deep neural network is able to classify POCUS video clips that match physicians' classification for or against diuretic use with high accuracy. This serves as a foundational step in the progress toward AI-aided diagnosis and AI implementation in the field of IVS evaluation by POCUS.
    Language English
    Publishing date 2022-09-30
    Publishing country United States
    Document type Journal Article
    ISSN 2329-4302
    ISSN 2329-4302
    DOI 10.1117/1.JMI.9.5.054502
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Should reperfusion be revisited?

    Morrissette, Katelin M / Paradis, Norman A

    The American journal of emergency medicine

    2016  Volume 34, Issue 6, Page(s) 1086–1087

    MeSH term(s) Animals ; Calcineurin Inhibitors/therapeutic use ; Cyclosporine/therapeutic use ; Humans ; Hypothermia, Induced ; Reperfusion Injury/etiology ; Reperfusion Injury/prevention & control
    Chemical Substances Calcineurin Inhibitors ; Cyclosporine (83HN0GTJ6D)
    Language English
    Publishing date 2016-06
    Publishing country United States
    Document type Editorial
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2016.02.070
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Hemophagocytic Lymphohistiocytosis in the Emergency Department: Recognizing and Evaluating a Hidden Threat.

    Morrissette, Katelin / Bridwell, Rachel / Lentz, Skyler / Brem, Elizabeth / Gutierrez, Karla Olmedo / Singh, Manpreet / Koyfman, Alex / Long, Brit

    The Journal of emergency medicine

    2021  Volume 60, Issue 6, Page(s) 743–751

    Abstract: Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hematologic disorder resulting from an ineffective and pathologic activation of the immune response system that may mimic common emergency department presentations, including ... ...

    Abstract Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hematologic disorder resulting from an ineffective and pathologic activation of the immune response system that may mimic common emergency department presentations, including sepsis, acute liver failure, disseminated intravascular coagulation, and flu-like illnesses such as coronavirus disease 2019 (COVID-19).
    Objective: This narrative review provides a summary of the disease and recommendations for the recognition and diagnostic evaluation of HLH with a focus on the emergency clinician.
    Discussion: Though the condition is rare, mortality rates are high, ranging from 20% to 80% and increasing with delays in treatment. Importantly, HLH has been recognized as a severe variation of the cytokine storm associated with COVID-19. Common features include a history of infection or malignancy, fever, splenomegaly or hepatomegaly, hyperferritinemia, cytopenias, coagulopathies, abnormal liver enzymes, and hypertriglyceridemia. Using specific features of the history, physical examination, laboratory studies, and tools such as the HScore, HLH-2004/2009, and hyperferritinemia thresholds, the emergency clinician can risk-stratify patients and admit for definitive testing. Once diagnosed, disease specific treatment can be initiated.
    Conclusion: This review describes the relevant pathophysiology, common presentation findings, and a framework for risk stratification in the emergency department.
    MeSH term(s) COVID-19 ; Emergency Service, Hospital ; Humans ; Lymphohistiocytosis, Hemophagocytic/diagnosis ; Splenomegaly/etiology
    Language English
    Publishing date 2021-03-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2021.02.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: What is the Role of Sugammadex in the Emergency Department?

    Lentz, Skyler / Morrissette, Katelin M / Porter, Blake A / DeWitt, Kyle M / Koyfman, Alex / Long, Brit

    The Journal of emergency medicine

    2020  Volume 60, Issue 1, Page(s) 44–53

    Abstract: Background: Sugammadex is a medication newly available to many emergency physicians. It effectively, and within minutes, reverses neuromuscular blockade in patients who have received rocuronium or vecuronium. The role of sugammadex for the reversal of ... ...

    Abstract Background: Sugammadex is a medication newly available to many emergency physicians. It effectively, and within minutes, reverses neuromuscular blockade in patients who have received rocuronium or vecuronium. The role of sugammadex for the reversal of neuromuscular blockade after rapid sequence intubation in the emergency department (ED) is evolving, and limited emergency medicine-specific literature exists.
    Objective: This narrative review evaluates the role of sugammadex for the reversal of neuromuscular blockade in the ED.
    Discussion: The basic pharmacology, duration of action, adverse effects, and important medication and disease interactions specific to sugammadex are well described. Case reports suggest sugammadex can reverse neuromuscular blockade to facilitate an urgent, neurologic examination by an emergency physician or consultant. Multiple case reports of failure to improve airway patency with the use of sugammadex, even when neuromuscular blockade is completely reversed, and concern for added difficulty of definitive airway management in a patient with spontaneous movement suggest that sugammadex should largely be omitted from failed or difficult airway management strategies. Instead, it is important to focus on the ability to oxygenate and ventilate, including progression to surgical airway or jet ventilation if needed.
    Conclusion: Sugammadex is an effective, rapid reversal agent for rocuronium and has the potential use to facilitate an urgent neurologic examination shortly after administration of rocuronium. Its routine inclusion in a failed or difficult emergency airway is not supported by available literature.
    MeSH term(s) Androstanols/pharmacology ; Androstanols/therapeutic use ; Emergency Service, Hospital ; Humans ; Neuromuscular Blockade ; Neuromuscular Nondepolarizing Agents/pharmacology ; Neuromuscular Nondepolarizing Agents/therapeutic use ; Sugammadex/pharmacology ; Sugammadex/therapeutic use ; gamma-Cyclodextrins/pharmacology ; gamma-Cyclodextrins/therapeutic use
    Chemical Substances Androstanols ; Neuromuscular Nondepolarizing Agents ; gamma-Cyclodextrins ; Sugammadex (361LPM2T56)
    Language English
    Publishing date 2020-09-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2020.08.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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