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  1. Article: Successful use of an automated proning system to achieve prone positioning in a patient with severe ARDS requiring veno-venous ECMO.

    Lehr, Andrew L / Smith, Deane E / Toy, Bridget / Goldenberg, Ronald / Brosnahan, Shari B

    Respiratory medicine case reports

    2020  Volume 31, Page(s) 101315

    Abstract: A morbidly obese middle aged woman in her 40's presented to another hospital with methicillin resistant staphylococcus aureus pneumonia and subsequently developed severe acute respiratory distress syndrome. Her oxygenation demonstrated no improvement ... ...

    Abstract A morbidly obese middle aged woman in her 40's presented to another hospital with methicillin resistant staphylococcus aureus pneumonia and subsequently developed severe acute respiratory distress syndrome. Her oxygenation demonstrated no improvement with low tidal volume ventilation, paralysis, or prostagladin therapy. She was unable to be manually proned secondary to her habitus. She was subsequently transferred to our facility, where she was initiated on VV-ECMO. Maximal flow through the ECMO circuit was inadequate for oxygenation given significant systemic shunt through her native lungs. In order to optimize lung protective ventilation and treat ARDS, we used an automated kinetic system (Rotoprone Therapy System) to prone the patient. To our knowledge, this is the first description in the literature of using an automated proning system with an ECMO circuit in place. This report describes the technique we used to safely perform axial rotations for two days with fewer providers required than manual proning.
    Language English
    Publishing date 2020-12-04
    Publishing country England
    Document type Case Reports
    ZDB-ID 2666110-X
    ISSN 2213-0071
    ISSN 2213-0071
    DOI 10.1016/j.rmcr.2020.101315
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The ABCDs of Lifestyle Counseling.

    Lehr, Andrew L / Driver, Steven L / Stone, Neil J

    JAMA cardiology

    2016  Volume 1, Issue 5, Page(s) 505–506

    MeSH term(s) Cardiovascular Diseases/prevention & control ; Counseling ; Humans ; Life Style
    Language English
    Publishing date 2016-07-18
    Publishing country United States
    Document type Journal Article
    ISSN 2380-6591
    ISSN (online) 2380-6591
    DOI 10.1001/jamacardio.2016.1419
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis.

    Fleitas Sosa, Derlis / Lehr, Andrew L / Zhao, Huaqing / Roth, Stephanie / Lakhther, Vlad / Bashir, Riyaz / Cohen, Gary / Panaro, Joseph / Maldonado, Thomas S / Horowitz, James / Amoroso, Nancy E / Criner, Gerard J / Brosnahan, Shari B / Rali, Parth

    European respiratory review : an official journal of the European Respiratory Society

    2022  Volume 31, Issue 165

    Abstract: Background: The impact of pulmonary embolism response teams (PERTs) on treatment choice and outcomes of patients with acute pulmonary embolism (PE) is still uncertain.: Objective: To determine the effect of PERTs in the management and outcomes of ... ...

    Abstract Background: The impact of pulmonary embolism response teams (PERTs) on treatment choice and outcomes of patients with acute pulmonary embolism (PE) is still uncertain.
    Objective: To determine the effect of PERTs in the management and outcomes of patients with PE.
    Methods: PubMed, Embase, Web of Science, CINAHL, WorldWideScience and MedRxiv were searched for original articles reporting PERT patient outcomes from 2009. Data were analysed using a random effects model.
    Results: 16 studies comprising 3827 PERT patients and 3967 controls met inclusion criteria. The PERT group had more patients with intermediate and high-risk PE (66.2%) compared to the control group (48.5%). Meta-analysis demonstrated an increased risk of catheter-directed interventions, systemic thrombolysis and surgical embolectomy (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.74-2.53; p<0.01), similar bleeding complications (OR 1.10, 95% CI 0.88-1.37) and decreased utilisation of inferior vena cava (IVC) filters (OR 0.71, 95% CI 0.58-0.88; p<0.01) in the PERT group. Furthermore, there was a nonsignificant trend towards decreased mortality (OR 0.87, 95% CI 0.71-1.07; p=0.19) with PERTs.
    Conclusions: The PERT group showed an increased use of advanced therapies and a decreased utilisation of IVC filters. This was not associated with increased bleeding. Despite comprising more severe PE patients, there was a trend towards lower mortality in the PERT group.
    MeSH term(s) Acute Disease ; Embolectomy/adverse effects ; Hemorrhage ; Humans ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/therapy ; Vena Cava Filters
    Language English
    Publishing date 2022-07-12
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 1077620-5
    ISSN 1600-0617 ; 0905-9180
    ISSN (online) 1600-0617
    ISSN 0905-9180
    DOI 10.1183/16000617.0023-2022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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