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Your search keyword '"Cowan, Scott W"' showing total 256 results
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256 results on '"Cowan, Scott W"'

1. Implementation of an opioid reduction toolkit in pancreatectomy patients significantly increases patient awareness of safe practice and decreases amount prescribed and consumed

Author

Lamm, Ryan, Cannaday, Shawnna, Ponzini, Francesca, Moskal, David, Lundgren, Megan, Williamson, John E., Wummer, Brandon, Huang, Rachel, Sun, George, Song, Steven G., Im, Brian, Kowal, Luke L., Wu, Inga, Bowne, Wilbur B., Nevler, Avinoam, Cowan, Scott W., Yeo, Theresa, Yeo, Charles J., and Lavu, Harish

Published
2023
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17. Joseph Pancoast, MD (1805-1882)

Author

Savitch, Samantha L., primary, Tholey, Renee M., additional, Cowan, Scott W., additional, Yeo, Charles J., additional, and Evans, Nathaniel R., additional

Published
2020
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21. The Pathway to Low Outlier Status in Venous Thromboembolism Events: An Analysis of Pancreatic Surgery in the National Surgical Quality Improvement Program

Author

Savitch, Samantha L., primary, Bauer, Tyler M., additional, Alvarez, Nkosi H., additional, Johnson, Adam P., additional, Yeo, Theresa P., additional, Lavu, Harish, additional, Yeo, Charles J., additional, Winter, Jordan M., additional, Merli, Geno J., additional, and Cowan, Scott W., additional

Published
2020
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24. Extracorporeal life support and cardiopulmonary bypass for central airway surgery: A systematic review.

Author

O'Malley, Thomas J., Yost, Colin C., Prochno, Kyle W., Saxena, Abhiraj, Grenda, Tyler R., Evans, Nathaniel R., Cowan, Scott W., Morris, Rohinton J., Massey, Howard Todd, and Tchantchaleishvili, Vakhtang

Subjects
EXTRACORPOREAL membrane oxygenation, CARDIOPULMONARY bypass, AIRWAY (Anatomy), ARTIFICIAL blood circulation, HOSPITAL mortality
Abstract

Background: Major airway surgery can pose a complex problem to perioperative central airway management. Adjuncts to advanced ventilation strategies have included cardiopulmonary bypass, veno‐arterial, or veno‐venous extracorporeal life support. We performed a systematic review to assess the existing evidence utilizing these strategies. Methods: An electronic search was conducted to identify studies written in English reporting the use of extracorporeal life support (ECLS) during central airway surgery. Thirty‐six articles consisting of 78 patients were selected and patient‐level data were analyzed. Results: Median patient age was 47 [IQR: 34‐53] and 59.0% (46/78) were male. Indications for surgery included central airway or mediastinal cancer in 57.7% (45/78), lesion or injury in 15.4% (12/78), and stenosis in 12.8% (10/78). Support was initiated pre‐operatively in 9.9% (7/71) and at the time of induction in 55.3% (42/76). It was most commonly used at the time of tracheal resection/repair [93.2% (68/73)], intubation of the tracheal stump [94.4% (68/72)], and re‐anastomosis [94.2% (65/69)]; 13.7% (10/73) patients were supported post‐operatively. The most commonly performed surgery was tracheal repair or resection in 70.3% (52/74). Median hospital stay was 12 [8, 25] days and in‐hospital mortality was 7.9% (6/76). There was no significant difference in survival between the three groups (p =.54). Conclusions: Extracorporeal membrane oxygenation offers versatility in timing, surgical approach, and ECLS runtime that makes it a viable addition to the surgical armamentarium for treating complex central airway pathologies. [ABSTRACT FROM AUTHOR]

Published
2022
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39. Adherence to Inpatient Venous Thromboembolism Prophylaxis: A Single Institution's Concurrent Review.

Author

Bauer, Tyler M., Johnson, Adam P., Dukleska, Katerina, Beck, Johanna, Dworkin, Myles S., Patel, Kamini, Cowan, Scott W., and Merli, Geno J.

Abstract

Hospital-acquired venous thromboembolism (VTE) affects morbidity and mortality and increases health care costs. Poor adherence to recommended prophylaxis may be a potential cause of ongoing events. This study aims to identify institutional adherence rates and barriers to optimal VTE prophylaxis. The authors performed patient and nurse interviews and a concurrent review of clinical documentation, utilizing a cloud-based, HIPAA-compliant tool, on a convenience sample of hospitalized patients. Adherence and agreement between different assessment modalities were calculated. Seventy-six patients consented for participation. Nurse documented adherence was 66% (29/44), 44% (27/61), and 89% (50/56) for mechanical, ambulatory, and chemoprophylactic prophylaxis, respectively. Patient report and nurse documentation showed moderate agreement for mechanical and no agreement for ambulatory adherence (κ = 0.51 and 0.07, respectively). Concurrent review using a cloud-based tool can provide robust, timely, and relevant information on adherence to recommended VTE prophylaxis. Iterative concurrent reviews can guide efforts to improve adherence and reduce rates of hospital-acquired VTE. [ABSTRACT FROM AUTHOR]

Published
2019
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43. Management considerations of massive hemoptysis while on extracorporeal membrane oxygenation.

Author

Pitcher, Harrsion T., Harrison, Meredith A., Shaw, Colette, Cowan, Scott W., Hirose, Hitoshi, Cavarocchi, Nicholas C., Pitcher, Harrsion T., Harrison, Meredith A., Shaw, Colette, Cowan, Scott W., Hirose, Hitoshi, and Cavarocchi, Nicholas C.

Abstract

BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a life-saving procedure in patients with both respiratory and cardiac failure. Bleeding complications are common since patients must be maintained on anticoagulation. Massive hemoptysis is a rare complication of ECMO; however, it may result in death if not managed thoughtfully and expeditiously. METHODS: A retrospective chart review was performed of consecutive ECMO patients from 7/2010-8/2014 to identify episodes of massive hemoptysis. The management of and the outcomes in these patients were studied. Massive hemoptysis was defined as an inability to control bleeding (>300 mL/day) from the endotracheal tube with conventional maneuvers, such as bronchoscopy with cold saline lavage, diluted epinephrine lavage and selective lung isolation. All of these episodes necessitated disconnecting the ventilator tubing and clamping the endotracheal tube, causing full airway tamponade. RESULTS: During the period of review, we identified 118 patients on ECMO and 3 (2.5%) patients had the complication of massive hemoptysis. One case was directly related to pulmonary catheter migration and the other two were spontaneous bleeding events that were propagated by antiplatelet agents. All three patients underwent bronchial artery embolization in the interventional radiology suite. Anticoagulation was held during the period of massive hemoptysis without any embolic complications. There was no recurrent bleed after appropriate intervention. All three patients were successfully separated from ECMO. CONCLUSIONS: Bleeding complications remain a major issue in patients on ECMO. Disconnection of the ventilator and clamping the endotracheal tube with full respiratory and cardiac support by V-A ECMO is safe. Early involvement of interventional radiology to embolize any potential sources of the bleed can prevent re-hemoptysis and enable continued cardiac and respiratory recovery.

Published
2016

46. Updated NSQIP Frailty Index

Author

Johnson, Adam P., primary, Koller, Sarah, additional, Busch, Emily A., additional, Philp, Matthew M., additional, Ross, Howard M., additional, Cowan, Scott W., additional, and Pitt, Henry A., additional

Published
2016
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