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  1. Article: Urea(lly) Got Me: An Uncommon Etiology of Peripartum Liver Failure.

    Spiller, Robert E / Colombo, Christopher J / Lindholm, Phillip C / Kwon, James

    ACG case reports journal

    2022  Volume 9, Issue 5, Page(s) e00780

    Abstract: A 23-year-old woman presented 4 days postpartum for agitation and confusion, with initial evaluation consistent with acute fatty liver of pregnancy (AFLP). Later in her course, an amino acid panel was highly suggestive of citrullinemia type 1. She was ... ...

    Abstract A 23-year-old woman presented 4 days postpartum for agitation and confusion, with initial evaluation consistent with acute fatty liver of pregnancy (AFLP). Later in her course, an amino acid panel was highly suggestive of citrullinemia type 1. She was started on arginine supplementation and glycerol phenylbutyrate and evaluated for a liver transplant. After starting the medication and diet modification, her liver failure resolved, and she was safely discharged. Urea cycle disorders may mimic AFLP with liver enzyme elevation, delirium, and hyperammonemia, but unlike AFLP, patients with urea cycle disorders will typically not recover without dietary modifications and/or medication.
    Language English
    Publishing date 2022-05-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2814825-3
    ISSN 2326-3253
    ISSN 2326-3253
    DOI 10.14309/crj.0000000000000780
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Family-Centered Care in the ICU: Strength in Numbers.

    Mount, Cristin A / Colombo, Christopher J

    Critical care medicine

    2019  Volume 47, Issue 12, Page(s) 1800–1801

    MeSH term(s) Intensive Care Units ; Patient-Centered Care ; Professional-Family Relations
    Language English
    Publishing date 2019-11-18
    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.0000000000004051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  3. Article ; Online: Reflections in the Lens: Video-Assisted Debriefing Augments Simulation-Based Medical Education.

    Britton, Garrett W / Switzer, Michael S / Colombo, Christopher J

    Critical care medicine

    2020  Volume 48, Issue 9, Page(s) 1387–1388

    MeSH term(s) Clinical Competence ; Critical Illness ; Education, Medical ; Humans ; Prospective Studies
    Language English
    Publishing date 2020-08-21
    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.0000000000004479
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  4. Article: Patient Self-Performed Point-of-Care Ultrasound: Using Communication Technologies to Empower Patient Self-Care.

    Kirkpatrick, Andrew W / McKee, Jessica L / Couperus, Kyle / Colombo, Christopher J

    Diagnostics (Basel, Switzerland)

    2022  Volume 12, Issue 11

    Abstract: Point-of-Care ultrasound (POCUS) is an invaluable tool permitting the understanding of critical physiologic and anatomic details wherever and whenever a patient has a medical need. Thus the application of POCUS has dramatically expanded beyond hospitals ... ...

    Abstract Point-of-Care ultrasound (POCUS) is an invaluable tool permitting the understanding of critical physiologic and anatomic details wherever and whenever a patient has a medical need. Thus the application of POCUS has dramatically expanded beyond hospitals to become a portable user-friendly technology in a variety of prehospital settings. Traditional thinking holds that a trained user is required to obtain images, greatly handicapping the scale of potential improvements in individual health assessments. However, as the interpretation of ultrasound images can be accomplished remotely by experts, the paradigm wherein experts guide novices to obtain meaningful images that facilitate remote care is being embraced worldwide. The ultimate extension of this concept is for experts to guide patients to image themselves, enabling secondary disease prevention, home-focused care, and self-empowerment of the individual to manage their own health. This paradigm of remotely telementored self-performed ultrasound (RTMSPUS) was first described for supporting health care on the International Space Station. The TeleMentored Ultrasound Supported Medical Interventions (TMUSMI) Research Group has been investigating the utility of this paradigm for terrestrial use. The technique has particular attractiveness in enabling surveillance of lung health during pandemic scenarios. However, the paradigm has tremendous potential to empower and support nearly any medical question poised in a conscious individual with internet connectivity able to follow the directions of a remote expert. Further studies and development are recommended in all areas of acute and chronic health care.
    Language English
    Publishing date 2022-11-21
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics12112884
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  5. Article ; Online: Performance comparison of peripheral arterial tonometry-based testing and polysomnography to diagnose obstructive sleep apnea in military personnel.

    O'Reilly, Brian M / Wang, Qing / Collen, Jacob / Matsangas, Panagiotis / Colombo, Christopher J / Mysliwiec, Vincent

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2022  Volume 18, Issue 6, Page(s) 1523–1530

    Abstract: Study objectives: Obstructive sleep apnea (OSA) is increasingly common among military personnel, but diagnostic capabilities are challenged by limited capability for polysomnography (PSG). We sought to evaluate the diagnostic properties of peripheral ... ...

    Abstract Study objectives: Obstructive sleep apnea (OSA) is increasingly common among military personnel, but diagnostic capabilities are challenged by limited capability for polysomnography (PSG). We sought to evaluate the diagnostic properties of peripheral arterial tonometry (PAT)-based home sleep apnea testing (HSAT) to accurately identify and classify OSA among active-duty military personnel.
    Methods: This study was a retrospective review of all patients suspected of having OSA who completed an initial PAT-based HSAT followed by confirmatory PSG within 120 days. The diagnostic properties of a PAT-based, HSAT-derived apnea-hypopnea index (AHI) vs a PSG-derived AHI were assessed.
    Results: Two hundred eight matched pairs of asynchronous studies were analyzed. The prevalence of OSA was 63.5%. PAT-based HSAT overdiagnosed 27.4% of patients with OSA and underdiagnosed 46.6% of patients with OSA. The majority (n = 116, 55.8%) of patients changed OSA severity classification (absent, mild, moderate, severe) after PSG. OSA severity classification concordance between PAT-based HSAT and PSG was observed in 53.4%, 40.5%, 28.6%, and 40.0% of patients with absent, mild, moderate, and severe OSA, respectively. Receiver operating characteristic curve analysis showed an area under the curve of 0.715 and a proposed PAT-based, HSAT-derived AHI cutoff score for OSA diagnosis of 9.0 events/h. This PAT-based, HSAT-derived AHI provided a 52% sensitivity, 83% specificity, 84% positive predictive value, and 50% negative predictive value. Bland-Altman plots showed an unacceptable degree of agreement between PAT-based, HSAT-derived AHI and AHI.
    Conclusions: There is significant discordance between PAT-based HSAT and PSG among active-duty military personnel evaluated for OSA. PAT-based HSAT may have limited utility for diagnosing OSA and grading severity in this unique patient population.
    Citation: O'Reilly BM, Wang Q, Collen J, Matsangas P, Colombo CJ, Mysliwiec V. Performance comparison of peripheral arterial tonometry-based testing and polysomnography to diagnose obstructive sleep apnea in military personnel.
    MeSH term(s) Humans ; Manometry ; Military Personnel ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive/diagnosis
    Language English
    Publishing date 2022-05-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    DOI 10.5664/jcsm.9894
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  6. Article ; Online: The Road to Unintended Consequences Is Paved With Good Intentions.

    Harris, Danny G / Colombo, Christopher J

    Critical care medicine

    2017  Volume 45, Issue 6, Page(s) 1100–1101

    MeSH term(s) Humans ; Intensive Care Units ; Intention ; Resuscitation Orders
    Language English
    Publishing date 2017-05-16
    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.0000000000002394
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  7. Article ; Online: The Trifecta of Tele-Critical Care: Intrahospital, Operational, and Mass Casualty Applications.

    Ieronimakis, Kristina M / Colombo, Christopher J / Valovich, Justin / Griffith, Mark / Davis, Konrad L / Pamplin, Jeremy C

    Military medicine

    2021  Volume 186, Issue Suppl 1, Page(s) 253–260

    Abstract: Introduction: Tele-critical care (TCC) has improved outcomes in civilian hospitals and military treatment facilities (MTFs). Tele-critical care has the potential to concurrently support MTFs and operational environments and could increase capacity and ... ...

    Abstract Introduction: Tele-critical care (TCC) has improved outcomes in civilian hospitals and military treatment facilities (MTFs). Tele-critical care has the potential to concurrently support MTFs and operational environments and could increase capacity and capability during mass casualty events. TCC services distributed across multiple hub sites may flexibly adapt to rapid changes in patient volume and complexity to fully optimize resources. Given the highly variable census in MTF intensive care units (ICU), the proposed TCC solution offers system resiliency and redundancy for garrison, operational, and mass casualty needs, while also maximizing return on investment for the Defense Health Agency.
    Materials and methods: The investigators piloted simultaneous TCC support to the MTF during three field exercises: (1) TCC concurrently monitored the ICU during a remote mass casualty exercise: the TCC physician monitored a high-risk ICU patient while the nurse monitored 24 simulated field casualties; (2) TCC concurrently monitored the garrison ICU and a remote military medical field exercise: the physician provided tele-mentoring during prolonged field care for a simulated casualty, and the nurse provided hospital ICU TCC; (3) the TCC nurse simultaneously monitored the ICU while providing reach-back support to field hospital nurses training in a simulation scenario.
    Results: TCC proved feasible during multiple exercises with concurrent tele-mentoring to different care environments including physician and nurse alternating operational and hospital support roles, and an ICU nurse managing both simultaneously. ICU staff noted enhanced quality and safety of bedside care. Field exercise participants indicated TCC expanded multipatient monitoring during mass casualties and enhanced novice caregiver procedural capability and scope of patient complexity.
    Conclusions: Tele-critical care can extend critical care services to anywhere at any time in support of garrison medicine, operational medicine, and mass casualty settings. An interoperable, flexibly staffed, and rapidly expandable TCC network must be further developed given the potential for large casualty volumes to overwhelm a single TCC provider with multiple duties. Lessons learned from development of this capability should have applicability for managing military and civilian mass casualty events.
    MeSH term(s) Critical Care ; Humans ; Intensive Care Units ; Mass Casualty Incidents ; Monitoring, Physiologic ; Telemedicine
    Language English
    Publishing date 2021-01-26
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 391061-1
    ISSN 1930-613X ; 0026-4075
    ISSN (online) 1930-613X
    ISSN 0026-4075
    DOI 10.1093/milmed/usaa298
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  8. Article ; Online: All Organ Dysfunctions Are Equal…But Some Are More Equal Than Others.

    Britton, Garrett W / Babcock, Cody / Colombo, Christopher J

    Critical care medicine

    2018  Volume 46, Issue 5, Page(s) 818–819

    MeSH term(s) Blood Coagulation Disorders ; Communicable Diseases ; Hospital Mortality ; Humans ; Multiple Organ Failure ; Sepsis
    Language English
    Publishing date 2018-04-13
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000003042
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  9. Article ; Online: Nonbeneficial care: we have got to do something?*.

    George, Amaya D / Colombo, Christopher J

    Critical care medicine

    2015  Volume 43, Issue 2, Page(s) 474–475

    MeSH term(s) Attitude of Health Personnel ; Critical Care/psychology ; Decision Making ; Female ; Humans ; Intensive Care Units ; Male ; Medical Futility/psychology
    Language English
    Publishing date 2015-02
    Publishing country United States
    Document type Comment ; Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000000759
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  10. Article ; Online: Does blast limb trauma constitute a multisystem critical illness?

    Rizzo, Julie A / Colombo, Christopher J

    Critical care medicine

    2014  Volume 42, Issue 1, Page(s) 226–227

    MeSH term(s) Animals ; Blast Injuries/complications ; Hypothermia, Induced/methods ; Leg Injuries/complications ; Lung Injury/prevention & control ; Male
    Language English
    Publishing date 2014-01
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000000008
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