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  1. Article: From Diagnosis to Treatment: Navigating the Clinical Challenges of Dialyzer-Associated Thrombocytopenia.

    Jose, Ann / Varughese, Tony / De, Shreemayee / Alam, Bisma / Sheth, Vishad

    Cureus

    2023  Volume 15, Issue 5, Page(s) e38891

    Abstract: Thrombocytopenia is a common lab finding. The two fundamental groups are lack of production versus overconsumption of platelets. When common causes of thrombocytopenia have been ruled out and less common causes, such as thrombotic microangiopathic ... ...

    Abstract Thrombocytopenia is a common lab finding. The two fundamental groups are lack of production versus overconsumption of platelets. When common causes of thrombocytopenia have been ruled out and less common causes, such as thrombotic microangiopathic conditions, have been considered, it is important to keep in mind that patients undergoing dialysis may develop thrombocytopenia from the dialyzer itself. This case is of a 51-year-old male who presented originally with celiac artery dissection and acute kidney injury requiring emergent dialysis. He ultimately developed thrombocytopenia during his hospitalization. It was initially presumed to be from thrombocytopenic purpura without improvement after plasmapheresis. No clear etiology was identified until it was suspected that the dialyzer was the source of thrombocytopenia. After changing the dialyzer type, the patient's thrombocytopenia resolved. Dialyzer-associated thrombocytopenia is a rare but reversible complication of hemodialysis. It is important to keep this differential in mind for patients undergoing hemodialysis.
    Language English
    Publishing date 2023-05-11
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.38891
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  2. Article ; Online: Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City.

    Sheth, Vishad / Chishti, Imran / Rothman, Adam / Redlener, Michael / Liang, John / Pan, Di / Mathew, Joseph

    Resuscitation

    2020  Volume 155, Page(s) 3–5

    MeSH term(s) Adult ; Age Factors ; Aged ; COVID-19 ; Cause of Death ; Cohort Studies ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Critical Illness/mortality ; Critical Illness/therapy ; Female ; Heart Arrest/etiology ; Heart Arrest/mortality ; Heart Arrest/therapy ; Hospital Mortality/trends ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Male ; Middle Aged ; New York City ; Outcome Assessment, Health Care ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Retrospective Studies ; Severe Acute Respiratory Syndrome/complications ; Severe Acute Respiratory Syndrome/therapy ; Sex Factors
    Keywords covid19
    Language English
    Publishing date 2020-07-21
    Publishing country Ireland
    Document type Letter
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2020.07.011
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  3. Article: Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City

    Sheth, Vishad / Chishti, Imran / Rothman, Adam / Redlener, Michael / Liang, John / Pan, Di / Mathew, Joseph

    Resuscitation

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #665483
    Database COVID19

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  4. Article ; Online: Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City

    Sheth, Vishad / Chishti, Imran / Rothman, Adam / Redlener, Michael / Liang, John / Pan, Di / Mathew, Joseph

    Resuscitation

    2020  Volume 155, Page(s) 3–5

    Keywords Emergency ; Emergency Medicine ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2020.07.011
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  5. Article ; Online: In hospital cardiac arrest in Intensive Care Unit versus non Intensive Care Unit patients with COVID 19. A systematic review and meta analysis

    Mavrovounis, Georgios / Mermiri, Maria / Chalkias, Athanasios / Sheth, Vishad / Tsolaki, Vasiliki / Gourgoulianis, Konstantinos / Pantazopoulos, Ioannis

    medRxiv

    Abstract: Aim: To estimate the incidence of in hospital cardiac arrest (IHCA) and return of spontaneous circulation (ROSC) in COVID 19 patients, as well as to compare the incidence and outcomes of IHCA in Intensive Care Unit (ICU) versus non ICU patients with ... ...

    Abstract Aim: To estimate the incidence of in hospital cardiac arrest (IHCA) and return of spontaneous circulation (ROSC) in COVID 19 patients, as well as to compare the incidence and outcomes of IHCA in Intensive Care Unit (ICU) versus non ICU patients with COVID 19. Methods: We systematically reviewed the PubMed, Scopus and clinicaltrials.gov databases to identify relevant studies. Results: Eleven studies were included in our study. The pooled prevalence/incidence, pooled odds ratios (OR) and 95% Confidence Intervals (95% CI) were calculated, as appropriate. The quality of the included studies was assessed using appropriate tools. The pooled incidence of IHCA in COVID 19 patients was 7% [95% CI: 4, 11%; P < 0.0001] and 44% [95% CI: 30, 58%; P < 0.0001] achieved ROSC. Of those that survived, 58% [95% CI: 42, 74%; P < 0.0001] had a good neurological outcome (Cerebral Performance Category 1 or 2) and the mortality at the last follow up was 59% [95% CI: 37, 81%; P < 0.0001]. A statistically significant higher percentage of ROSC [OR (95% CI): 5.088 (2.852, 9.079); P < 0.0001] was found among ICU patients versus those in the general wards. Conclusion: The incidence of IHCA amongst hospitalized COVID 19 patients is 7%, with 44% of them achieving ROSC. Patients in the ICU were more likely to achieve ROSC than those in the general wards, however the mortality did not differ.
    Keywords covid19
    Language English
    Publishing date 2021-05-14
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.05.08.21256885
    Database COVID19

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  6. Article ; Online: PNEUMOMEDIASTINUM AS A COMPLICATION OF COVID-19

    Miyakawa, Lina / Rothman, Adam / Sheth, Vishad / Patrawalla, Paru / Steiger, David / Li, Nan / Zatakia, Jigna / Mathew, Joseph / Lee, Young Im

    Chest

    MAY NOT NEED INTERVENTION

    2020  Volume 158, Issue 4, Page(s) A2455–A2456

    Keywords Critical Care and Intensive Care Medicine ; Pulmonary and Respiratory Medicine ; Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2020.09.036
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  7. Article ; Online: A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients With Coronavirus Disease 2019.

    Lim, Zheng Jie / Ponnapa Reddy, Mallikarjuna / Curtis, J Randall / Afroz, Afsana / Billah, Baki / Sheth, Vishad / Hayek, Salim S / Leaf, David E / Miles, Jeremy A / Shah, Priyank / Yuriditsky, Eugene / Jones, Daryl / Shekar, Kiran / Subramaniam, Ashwin

    Critical care medicine

    2021  Volume 49, Issue 6, Page(s) 901–911

    Abstract: Objectives: To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, ...

    Abstract Objectives: To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest. Finally, we evaluated outcomes stratified by age.
    Data sources: A systematic review of PubMed, EMBASE, and preprint websites was conducted between January 1, 2020, and December 10, 2020. Prospective Register of Systematic Reviews identification: CRD42020203369.
    Study selection: Studies reporting on consecutive in-hospital cardiac arrest with a resuscitation attempt among patients with coronavirus disease 2019.
    Data extraction: Two authors independently performed study selection and data extraction. Study quality was assessed with the Newcastle-Ottawa Scale. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines. Discrepancies were resolved by consensus or through an independent third reviewer.
    Data synthesis: Eight studies reporting on 847 in-hospital cardiac arrest were included. In-hospital cardiac arrest incidence varied between 1.5% and 5.8% among hospitalized patients and 8.0-11.4% among patients in ICU. In-hospital cardiac arrest occurred more commonly in older male patients. Most initial rhythms were nonshockable (83.9%, [asystole = 36.4% and pulseless electrical activity = 47.6%]). Return of spontaneous circulation occurred in 33.3%, with a 91.7% in-hospital mortality. In-hospital cardiac arrest events in ICU had higher incidence of return of spontaneous circulation (36.6% vs 18.7%; p < 0.001) and relatively lower mortality (88.7% vs 98.1%; p < 0.001) compared with in-hospital cardiac arrest in non-ICU locations. Patients greater than or equal to 60 years old had significantly higher in-hospital mortality than those less than 60 years (93.1% vs 87.9%; p = 0.019).
    Conclusions: Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU locations and seems comparable with prepandemic survival for nonshockable rhythms. Although the data provide guidance surrounding prognosis after in-hospital cardiac arrest, it should be interpreted cautiously given the paucity of information surrounding treatment limitations and resource constraints during the pandemic. Further research is into actual causative mechanisms is needed.
    MeSH term(s) COVID-19/mortality ; COVID-19/therapy ; Cause of Death ; Heart Arrest/mortality ; Heart Arrest/therapy ; Hospital Mortality ; Humans ; Incidence ; Treatment Outcome
    Language English
    Publishing date 2021-04-01
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004950
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    Zs.A 1261: Show issues Location:
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  8. Article: Pneumomediastinum as a Complication of Covid-19: May Not Need Intervention

    Miyakawa, L. / Rothman, A. / Sheth, V. / Patrawalla, P. / Steiger, D. / Li, N. / Zatakia, J. / Mathew, J. / Lee, Y. I.

    Chest

    Abstract: ... relevant relationships by Vishad Sheth, source=Web Response No relevant relationships by David Steiger ...

    Abstract SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Evaluate patients with pneumomediastinum (PTM) as a complication of coronavirus 2019 (Covid-19) infection and their outcomes METHODS: Data was obtained by retrospective analysis of a database of Covid-19 patients, admitted to two New York hospitals from March 25th to April 26th, 2020 Identified 13 patients with PTM as a complication of Covid-19 RESULTS: Median age of patients was 67 years, 7 (54%) were men, and 1 patient had pre-existing emphysema Presenting symptoms included dyspnea (13/13, 100%), fever (10/13, 77%), and cough (9/13, 69%);none had chest pain Median presenting SaO2/FiO2 ratio was 359 Pneumomediastinum was diagnosed on presentation in 2 patients (15%), during hospitalization but prior to invasive mechanical ventilation in 4 patients (31%), and after invasive mechanical ventilation in 7 patients (54%) Six patients had CT scans confirming the diagnosis of PTM Twelve of the 13 patients were initiated on mechanical ventilation at median 5 5 days Four patients (31%) developed pneumothoraces and 1 patient required bilateral chest tube drainage Tension pneumothorax, tension pneumopericardium, and chest wall compartment syndrome were not observed in our cohort Pneumomediastinum self-resolved in 5 patients (38%) while on mechanical ventilation (Fig 1) Seven out of 12 intubated patients (58%) underwent prone ventilation without worsening of PTM One patient was discharged home, 10 patients expired, and 2 patients remain hospitalized CONCLUSIONS: Pneumomediastinum is a known sequelae of noncompliant lungs in severe acute respiratory distress syndrome (ARDS), typically in the setting of positive pressure delivered with invasive mechanical ventilation Our cohort had a low prevalence of predisposing risk factors such as emphysema, and a high mortality Pneumomediastinum was not strongly associated with mechanical ventilation, as nearly half (6/13) of the patients developed PTM prior to intubation CLINICAL IMPLICATIONS: In our cohort, findings of PTM may be attributed to two main etiologies converging: damage from Covid-19 and self-inflicted increases in transpulmonary pressures We postulate that impaired surfactant production from type II pneumocytes may predispose to atelectrauma leading to diffuse alveolar injury and risk of rupture, unlike in typical ARDS where barotrauma occurs in the context of poorly compliant lungs Moreover, the increased work of breathing and pronounced cough seen in Covid-19 pneumonia may lead to increased transpulmonary pressures resulting in PTM Reductions in transpulmonary pressures after intubation with initiation of sedation and neuromuscular blockade may explain the resolution of PTM in spite of invasive ventilation Given the high mortality we observed, early identification and initiation of methods to reduce transpulmonary pressures is imperative to reduce risk of further complications DISCLOSURES: No relevant relationships by Young Im Lee, source=Web Response No relevant relationships by Nan Li, source=Web Response No relevant relationships by Joseph Mathew, source=Web Response No relevant relationships by Lina Miyakawa, source=Web Response No relevant relationships by Paru Patrawalla, source=Web Response No relevant relationships by Paru Patrawalla, source=Web Response No relevant relationships by Adam Rothman, source=Web Response No relevant relationships by Vishad Sheth, source=Web Response No relevant relationships by David Steiger, source=Web Response No relevant relationships by Jigna Zatakia, source=Web Response
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #871898
    Database COVID19

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