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Article ; Online: A protocol for central venous access in patients with coronavirus disease 2019.

Jasinski, Patrick T / Tzavellas, Georgios / Rubano, Jerry A / Rutigliano, Daniel N / Skripochnik, Edvard / Tassiopoulos, Apostolos K

Journal of vascular surgery

2020 Volume 72, Issue 4, Page(s) 1507–1509

MeSH term(s)	Betacoronavirus/pathogenicity ; COVID-19 ; Catheterization, Central Venous ; Catheterization, Peripheral ; Clinical Protocols ; Coronavirus Infections/diagnosis ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Decision Support Techniques ; Host-Pathogen Interactions ; Humans ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-02
Publishing country	United States
Document type	Letter
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2020.06.052
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Zs.A 1933: Show issues

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Article ; Online: Adipose tissue on CT scans in critical care and trauma are associated with acute kidney injury*.

Rubano, Jerry A / Shapiro, Marc J

Critical care medicine

2014 Volume 42, Issue 7, Page(s) 1728–1729

MeSH term(s)	Abdominal Fat/diagnostic imaging ; Acute Kidney Injury/epidemiology ; Critical Illness ; Female ; Humans ; Male ; Obesity/epidemiology ; Radiography ; Wounds and Injuries/epidemiology
Language	English
Publishing date	2014-07
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000000379
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Zs.A 1261: Show issues

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Article ; Online: Low-molecular-weight heparin compared with unfractionated heparin in critically ill COVID-19 patients.

Volteas, Panagiotis / Drakos, Panagiotis / Alkadaa, Leor N / Cleri, Nathaniel A / Asencio, Anthony A / Oganov, Anthony / Giannopoulos, Stefanos / Saadon, Jordan R / Mikell, Charles B / Rubano, Jerry A / Labropoulos, Nicos / Tassiopoulos, Apostolos K / Mofakham, Sima / Bannazadeh, Mohsen

Journal of vascular surgery. Venous and lymphatic disorders

2022 Volume 10, Issue 5, Page(s) 1128–1136

Abstract: Background: Thrombosis in COVID-19 worsens mortality. In our study, we sought to investigate how the dose and type of anticoagulation (AC) can influence patient outcomes.: Methods: This is a single-center retrospective analysis of critically ill ... ...

Abstract	Background: Thrombosis in COVID-19 worsens mortality. In our study, we sought to investigate how the dose and type of anticoagulation (AC) can influence patient outcomes. Methods: This is a single-center retrospective analysis of critically ill intubated patients with COVID-19, comparing low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) at therapeutic and prophylactic doses. Of 218 patients, 135 received LMWH (70 prophylactic, 65 therapeutic) and 83 UFH (11 prophylactic, 72 therapeutic). The primary outcome was mortality. Secondary outcomes were thromboembolic complications confirmed on imaging and major bleeding complications. Cox proportional-hazards regression models were used to determine whether the type and dose of AC were independent predictors of survival. We performed Kaplan-Meier survival analysis to compare the cumulative survivals. Results: Overall, therapeutic AC, with either LMWH (65% vs 79%, P = .09) or UFH (32% vs 46%, P = .73), conveyed no survival benefit over prophylactic AC. UFH was associated with a higher mortality rate than LMWH (66% vs 28%, P = .001), which was also evident in the multivariable analysis (LMWH vs UFH mortality, hazard ratio: 0.47, P = .001) and in the Kaplan-Meier survival analysis. Thrombotic and bleeding complications did not depend on the AC type (prophylactic LMWH vs UFH: thrombosis P = .49, bleeding P = .075; therapeutic LMWH vs UFH: thrombosis P = .5, bleeding P = .17). When comparing prophylactic with therapeutic AC, the rate of both thrombotic and bleeding complications was higher with the use of LMWH compared with UFH. In addition, transfusion requirements were significantly higher with both therapeutic LMWH and UFH. Conclusions: Among intubated critically ill COVID-19 intensive care unit patients, therapeutic AC, with either LMWH or UFH, conveyed no survival benefit over prophylactic AC. AC with LMWH was associated with higher cumulative survival compared with AC with UFH.
MeSH term(s)	Anticoagulants/adverse effects ; COVID-19/complications ; Critical Illness ; Heparin/adverse effects ; Heparin, Low-Molecular-Weight/adverse effects ; Humans ; Retrospective Studies ; Thrombosis/diagnostic imaging ; Thrombosis/etiology ; Thrombosis/prevention & control
Chemical Substances	Anticoagulants ; Heparin, Low-Molecular-Weight ; Heparin (9005-49-6)
Language	English
Publishing date	2022-06-15
Publishing country	United States
Document type	Journal Article
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2022.04.019
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Article: A protocol for central venous access in patients with coronavirus disease 2019

Jasinski, Patrick T / Tzavellas, Georgios / Rubano, Jerry A / Rutigliano, Daniel N / Skripochnik, Edvard / Tassiopoulos, Apostolos K

J Vasc Surg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #741391
Database	COVID19

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Article ; Online: A reference guide to rapidly implementing an institutional dashboard for resource allocation and oversight during COVID-19 pandemic surge.

Jawa, Randeep S / Tharakan, Mathew A / Tsai, Chaowei / Garcia, Victor L / Vosswinkel, James A / Rutigliano, Daniel N / Rubano, Jerry A

JAMIA open

2020 Volume 3, Issue 4, Page(s) 518–522

Abstract: Objectives: We develop a dashboard that leverages electronic health record (EHR) data to monitor intensive care unit patient status and ventilator utilization in the setting of the COVID-19 pandemic.: Materials and methods: Data visualization ... ...

Abstract	Objectives: We develop a dashboard that leverages electronic health record (EHR) data to monitor intensive care unit patient status and ventilator utilization in the setting of the COVID-19 pandemic. Materials and methods: Data visualization software is used to display information from critical care data mart that extracts information from the EHR. A multidisciplinary collaborative led the development. Results: The dashboard displays institution-level ventilator utilization details, as well as patient-level details such as ventilator settings, organ-system specific parameters, laboratory values, and infusions. Discussion: Components of the dashboard were selected to facilitate the determination of resources and simultaneous assessment of multiple patients. Abnormal values are color coded. An overall illness assessment score is tracked daily to capture illness severity over time. Conclusion: This reference guide shares the architecture and sample reusable code to implement a robust, flexible, and scalable dashboard for monitoring ventilator utilization and illness severity in intensive care unit ventilated patients.
Language	English
Publishing date	2020-12-05
Publishing country	United States
Document type	Journal Article
ISSN	2574-2531
ISSN (online)	2574-2531
DOI	10.1093/jamiaopen/ooaa054
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Article ; Online: Antithrombotic Agent Use in Elderly Patients Sustaining Low-Level Falls.

Meade, Michael J / Tumati, Abhinay / Chantachote, Chanak / Huang, Emily C / Rutigliano, Daniel N / Rubano, Jerry A / Vosswinkel, James A / Jawa, Randeep S

The Journal of surgical research

2020 Volume 258, Page(s) 216–223

Abstract: Background: Elderly patients who are injured from a low-level fall comprise an increasing percentage of trauma admissions. We sought to evaluate the prevalence of antithrombotic (anticoagulant or antiplatelet) agent use, injury patterns, and outcomes in ...

Abstract	Background: Elderly patients who are injured from a low-level fall comprise an increasing percentage of trauma admissions. We sought to evaluate the prevalence of antithrombotic (anticoagulant or antiplatelet) agent use, injury patterns, and outcomes in this population, focusing on intracranial hemorrhage (ICH). Methods: We retrospectively reviewed the trauma registry at an American College of Surgeons-verified Level I trauma center for all patients aged 65 y or older admitted between 2007 and 2016 following a low-level fall. Medical records of patients on antithrombotic agents were examined in detail. Patients were divided into four groups based on the presence/absence of ICH and presence/absence of preadmission antithrombotic medication use. Results: There were 4074 elderly patients admitted after a low-level fall, of which 1153 (28.3%) had a traumatic ICH, and 1238 (30.4%) were on antithrombotic agents. Notably, 35.9% of patients on antithrombotics had an ICH, as compared to 25.0% of 2836 patients not on antithrombotics other than aspirin (P < 0.001). The overall distribution of antithrombotic agent use differed significantly between the ICH and non-ICH groups; the ICH group had more coumadin usage. The mortality rate was significantly different across groups, with the group having ICH and a history of antithrombotics having the highest mortality at 14.2% (P < 0.001). Excluding the 27.8% of patients who were transferred into our hospital demonstrated that significantly more admissions on antithrombotics had ICH (22.4%) versus ICH admissions not on antithrombotics (14.7%, P < 0.001). The mortality rate was significantly different across groups, with the group having ICH and a history of antithrombotics having the highest mortality at 12.0% (P < 0.001). On multivariable analysis, anticoagulants, antiplatelets, and aspirin were all significantly associated with ICH; but only anticoagulants were significantly associated with mortality. Conclusions: Antithrombotic agent use was common in admitted elderly patients sustaining a low-level fall and is associated with an elevated rate of ICH. Anticoagulants were also associated with increased mortality.
MeSH term(s)	Accidental Falls ; Aged ; Aged, 80 and over ; Female ; Fibrinolytic Agents/adverse effects ; Humans ; Intracranial Hemorrhage, Traumatic/chemically induced ; Male ; Retrospective Studies
Chemical Substances	Fibrinolytic Agents
Language	English
Publishing date	2020-10-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2020.08.047
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Zs.A 178: Show issues

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Article ; Online: Acute Gastrointestinal Injury and Feeding Intolerance as Prognostic Factors in Critically Ill COVID-19 Patients.

Drakos, Panagiotis / Volteas, Panagiotis / Cleri, Nathaniel A / Alkadaa, Leor N / Asencio, Anthony A / Oganov, Anthony / Pryor, Aurora / Talamini, Mark / Rubano, Jerry / Bannazadeh, Mohsen / Mikell, Charles B / Spaniolas, Konstantinos / Mofakham, Sima

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2021 Volume 26, Issue 1, Page(s) 181–190

Abstract: Background: Although acute gastrointestinal injury (AGI) and feeding intolerance (FI) are known independent determinants of worse outcomes and high mortality in intensive care unit (ICU) patients, the incidence of AGI and FI in critically ill COVID-19 ... ...

Abstract	Background: Although acute gastrointestinal injury (AGI) and feeding intolerance (FI) are known independent determinants of worse outcomes and high mortality in intensive care unit (ICU) patients, the incidence of AGI and FI in critically ill COVID-19 patients and their prognostic importance have not been thoroughly studied. Methods: We reviewed 218 intubated patients at Stony Brook University Hospital and stratified them into three groups based on AGI severity, according to data collected in the first 10 days of ICU course. We used chi-square test to compare categorical variables such as age and sex and two-sample t-test or Mann-Whitney U-tests for continuous variables, including important laboratory values. Cox proportional hazards regression models were utilized to determine whether AGI score was an independent predictor of survival, and multivariable analysis was performed to compare risk factors that were deemed significant in the univariable analysis. We performed Kaplan-Meier survival analysis based on the AGI score and the presence of FI. Results: The overall incidence of AGI was 95% (45% AGI I/II, 50% AGI III/IV), and FI incidence was 63%. Patients with AGI III/IV were more likely to have prolonged mechanical ventilation (22 days vs 16 days, P-value <0.002) and higher mortality rate (58% vs 28%, P-value <0.001) compared to patients with AGI 0/I/II. This was confirmed with multivariable analysis which showed that AGI score III/IV was an independent predictor of higher mortality (AGI III/IV vs AGI 0/I/II hazard ratio (HR), 2.68; 95% confidence interval (CI), 1.69-4.25; P-value <0.0001). Kaplan-Meier survival analysis showed that both AGI III/IV and FI (P-value <0.001) were associated with worse outcomes. Patients with AGI III/IV had higher daily and mean D-dimer and CRP levels compared to AGI 0/I/II (P-value <0.0001). Conclusions: The prevalence of AGI and FI among critically ill COVID-19 patients was high. AGI grades III/IV were associated with higher risk for prolonged mechanical ventilation and mortality compared to AGI 0/I/II, while it also correlated with higher D-dimer and C-reactive protein (CRP) levels. FI was independently associated with higher mortality. The development of high-grade AGI and FI during the first days of ICU stay can serve as prognostic tools to predict outcomes in critically ill COVID-19 patients.
MeSH term(s)	COVID-19 ; Critical Illness ; Gastrointestinal Diseases ; Humans ; Infant, Newborn ; Intensive Care Units ; Prognosis ; SARS-CoV-2
Language	English
Publishing date	2021-04-27
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-021-05015-z
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Zs.A 5207: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Complete small bowel obstruction resulting from a mushroom bezoar.

Rubano, Jerry A / Quarrier, Scott / Demuro, Jonas P

The American surgeon

2013 Volume 79, Issue 3, Page(s) E102–3

MeSH term(s)	Agaricales ; Aged ; Bezoars/complications ; Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Jejunal Diseases/diagnostic imaging ; Jejunal Diseases/etiology ; Male ; Tomography, X-Ray Computed
Language	English
Publishing date	2013-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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Article: D-Dimer-Driven Anticoagulation Reduces Mortality in Intubated COVID-19 Patients: A Cohort Study With a Propensity-Matched Analysis.

Tassiopoulos, Apostolos K / Mofakham, Sima / Rubano, Jerry A / Labropoulos, Nicos / Bannazadeh, Mohsen / Drakos, Panagiotis / Volteas, Panagiotis / Cleri, Nathaniel A / Alkadaa, Leor N / Asencio, Anthony A / Oganov, Anthony / Hou, Wei / Rutigliano, Daniel N / Singer, Adam J / Vosswinkel, James / Talamini, Mark / Mikell, Charles B / Kaushansky, Kenneth

Frontiers in medicine

2021 Volume 8, Page(s) 631335

Abstract: Objective: ...

Abstract	Objective:
Language	English
Publishing date	2021-02-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2775999-4
ISSN	2296-858X
ISSN	2296-858X
DOI	10.3389/fmed.2021.631335
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Article ; Online: An Evolving Clinical Need: Discordant Oxygenation Measurements of Intubated COVID-19 Patients.

Rubano, Jerry A / Maloney, Lauren M / Simon, Jessica / Rutigliano, Daniel N / Botwinick, Isadora / Jawa, Randeep S / Shapiro, Marc J / Vosswinkel, James A / Talamini, Mark / Kaushansky, Kenneth

Annals of biomedical engineering

2021 Volume 49, Issue 3, Page(s) 959–963

Abstract: Since the first appearance of the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) earlier this year, clinicians and researchers alike have been faced with dynamic, daily challenges of recognizing, understanding, and treating the coronavirus ...

Abstract	Since the first appearance of the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) earlier this year, clinicians and researchers alike have been faced with dynamic, daily challenges of recognizing, understanding, and treating the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2. Those who are moderately to severely ill with COVID-19 are likely to develop acute hypoxemic respiratory failure and require administration of supplemental oxygen. Assessing the need to initiate or titrate oxygen therapy is largely dependent on evaluating the patient's existing blood oxygenation status, either by direct arterial blood sampling or by transcutaneous arterial oxygen saturation monitoring, also referred to as pulse oximetry. While the sampling of arterial blood for measurement of dissolved gases provides a direct measurement, it is technically challenging to obtain, is painful to the patient, and can be time and resource intensive. Pulse oximetry allows for non-invasive, real-time, continuous monitoring of the percent of hemoglobin molecules that are saturated with oxygen, and usually closely predicts the arterial oxygen content. As such, it was particularly concerning when patients with severe COVID-19 requiring endotracheal intubation and mechanical ventilation within one of our intensive care units were observed to have significant discordance between their predicted arterial oxygen content via pulse oximetry and their actual measured oxygen content. We offer these preliminary observations along with our speculative causes as a timely, urgent clinical need. In the setting of a COVID-19 intensive care unit, entering a patient room to obtain a fresh arterial blood gas sample not only takes exponentially longer to do given the time required for donning and doffing of personal protective equipment (PPE), it involves the consumption of already sparce PPE, and it increases the risk of viral exposure to the nurse, physician, or respiratory therapist entering the room to obtain the sample. As such, technology similar to pulse oximetry which can be applied to a patients finger, and then continuously monitored from outside the room is essential in preventing a particularly dangerous situation of unrealized hypoxia in this critically-ill patient population. Additionally, it would appear that conventional two-wavelength pulse oximetry may not accurately predict the arterial oxygen content of blood in these patients. This discordance of oxygenation measurements poses a critical concern in the evaluation and management of the acute hypoxemic respiratory failure seen in patients with COVID-19.
MeSH term(s)	Blood Gas Analysis/methods ; COVID-19/blood ; COVID-19/therapy ; Humans ; Intubation, Intratracheal ; Oximetry ; Oxygen/blood ; Respiration, Artificial
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2021-01-19
Publishing country	United States
Document type	Editorial
ZDB-ID	185984-5
ISSN	1573-9686 ; 0191-5649 ; 0090-6964
ISSN (online)	1573-9686
ISSN	0191-5649 ; 0090-6964
DOI	10.1007/s10439-020-02722-7
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