8 results on '"Michael J. Erdman"'
Search Results
2. Factors associated with bleeding after ultrasound-assisted catheter-directed thrombolysis for the treatment of pulmonary embolism
- Author
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Elizabeth A, Shald, Kelsey, Ohman, Denise, Kelley, Kirsten, Busey, Michael J, Erdman, Carmen, Smotherman, and Jason A, Ferreira
- Subjects
Hematology ,General Medicine - Abstract
Ultrasound-assisted catheter directed thrombolysis (US-CDT) is frequently used for the treatment of pulmonary embolism. Due to the variety of thrombolytic and anticoagulant dosing utilized in practice, patients with pulmonary embolism who undergo US-CDT may be at an increased risk of bleeding. The primary objective of this study was to determine factors associated with major bleeding occurring with US-CDT. Secondary outcomes included in-hospital mortality and ventilator-free days. This multicentre retrospective cohort study evaluated inpatients diagnosed with pulmonary embolism and treated with US-CDT and systemic anticoagulation. A total of 173 patients were included. Most patients receiving US-CDT had a submassive pulmonary embolism with a median Pulmonary Embolism Severity Index (PESI) score of 85. Major bleeding events occurred in 37 of the 173 patients (21%). In-hospital mortality occurred in four (11%) of the patients who experienced major bleeding and three (2%) patients who did not experience major bleeding (P = 0.04). Factors associated with a higher risk of major bleeding included female sex and anticoagulation strategy. The odds of major bleeding were 3.3 times higher for women than for men (odds ratio = 3.32, 95% confidence interval 1.29-8.54). In addition, for each second increase in goal aPTT the odds of major bleeding increased by 5% (odds ratio = 1.05, 95% confidence interval 1.02-1.09). In patients with pulmonary embolism treated with US-CDT, major bleeding may be underestimated. In this analysis, major bleeding was associated with female sex and higher goal aPTT levels. In addition, bleeding with US-CDT was associated with a higher risk of in-hospital mortality.
- Published
- 2022
3. Factor Xa Inhibitor-Related Intracranial Hemorrhage
- Author
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Nicholas G. Panos, Aaron M. Cook, Sayona John, G. Morgan Jones, Hallie Kelly, Richard K. Choi, Nirali Kalaria, Jamie M. Rosini, Mathew Jones, Mohammed Rehman, Philip M. Ross, Benjamin Motley, Samantha Delibert, Benjamin P. George, Charles M Andrews, Ron R Neyens, Ryan Martin, Kendra J. Schomer, Michael J. Armahizer, Mehrnaz Pajoumand, Casey C. May, Keaton S. Smetana, Tamara Strohm, Christian Hamm, Laurel Jakubowski, Shaun P. Keegan, Vasisht Srinivasan, Christopher J. Burdick, Omar J. Martinez, Farhad Bahrassa, Scott T. May, K. Ashley Sowers, Eugene I. Lin, Deidre J. Rohaley, Jason Mackey, Lori L. Wetmore, Christine Frick, Meena Thatikunta, Lindsay Urben, Abdalla A. Ammar, Kent A. Owusu, Keith Nguyen, Michael J. Erdman, Brian W. Gilbert, Joshua M. DeMott, Gary D. Peksa, Philip E. Tobias, Ivan Da Silva, Leana N. Mahmoud, Bethany Sheahan, Aimee Gowler Gennaro, Michael A. Pizzi, Gretchen M. Brophy, Dennis J. Rivet, Micheal Strein, Kristine Arandela, Van Hellerslia, and Meghan M. Caylor
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Subarachnoid hemorrhage ,medicine.drug_mechanism_of_action ,Pyridones ,medicine.drug_class ,Factor Xa Inhibitor ,030204 cardiovascular system & hematology ,Hemostatics ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Rivaroxaban ,Risk Factors ,law ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Hospital Mortality ,Aged ,Retrospective Studies ,Hemostasis ,business.industry ,Anticoagulant ,Length of Stay ,Middle Aged ,Subarachnoid Hemorrhage ,medicine.disease ,Intensive care unit ,Blood Coagulation Factors ,United States ,Hematoma, Subdural ,Treatment Outcome ,Cohort ,Pyrazoles ,Female ,Apixaban ,Intracranial Thrombosis ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Factor Xa Inhibitors ,medicine.drug ,Cohort study - Abstract
Background: Since the approval of the oral factor Xa inhibitors, there have been concerns regarding the ability to neutralize their anticoagulant effects after intracranial hemorrhage (ICH). Multiple guidelines suggest using prothrombin complex concentrates (PCCs) in these patients on the basis of research that includes a limited number of patients with ICH. Given this, we aimed to evaluate the safety and efficacy of PCCs for factor Xa inhibitor–related ICH in a large, multicenter cohort of patients. Methods: This was a multicenter, retrospective, observational cohort study of patients with apixaban- or rivaroxaban-related ICH who received PCCs between January 1, 2015, and March 1, 2019. The study had 2 primary analysis groups: safety and hemostatic efficacy. The safety analysis evaluated all patients meeting inclusion criteria for the occurrence of a thrombotic event, which were censored at hospital discharge or 30 days after PCC administration. Patients with intracerebral, subarachnoid, or subdural hemorrhages who had at least 1 follow-up image within 24 hours of PCC administration were assessed for hemostatic efficacy. The primary efficacy outcome was the percentage of patients with excellent or good hemostasis on the basis of the modified Sarode criteria. Secondary outcomes included an evaluation of in-hospital mortality, length of stay, infusion-related reactions, and thrombotic event occurrence during multiple predefined periods. Results: A total of 663 patients were included and assessed for safety outcomes. Of these, 433 patients met criteria for hemostatic efficacy evaluation. We observed excellent or good hemostasis in 354 patients (81.8% [95% CI, 77.9–85.2]). Twenty-five (3.8%) patients had a total of 26 thrombotic events, of which 22 occurred in the first 14 days after PCC administration. One patient had documentation of an infusion-related reaction. For the full cohort of patients, in-hospital mortality was 19.0%, and the median intensive care unit and hospital lengths of stay were 2.0 and 6.0 days, respectively. Conclusions: Administration of PCCs after apixaban- and rivaroxaban-related ICH provided a high rate of excellent or good hemostasis (81.8%) coupled with a 3.8% thrombosis rate. Randomized, controlled trials evaluating the clinical efficacy of PCCs in patients with factor Xa inhibitor–related ICH are needed.
- Published
- 2020
4. Effect of desmopressin acetate on acute spontaneous intracranial hemorrhage in patients on antiplatelet therapy
- Author
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Jessica McManus, Jason Ferreira, G. Morgan Jones, Keaton S. Smetana, Melanie Smith Condeni, Karen Berger, Corey Witenko, Carmen Smotherman, Shiva Gautam, Michael A. Pizzi, and Michael J. Erdman
- Subjects
Cohort Studies ,Hematoma ,Neurology ,Humans ,Deamino Arginine Vasopressin ,Neurology (clinical) ,Intracranial Hemorrhages ,Platelet Aggregation Inhibitors ,Retrospective Studies - Abstract
To evaluate the impact of desmopressin acetate (DDAVP) on poor outcomes, hematoma expansion, and adverse events in patients diagnosed with a non-traumatic, antiplatelet-associated intracranial hemorrhage (ICH).This was a multicenter, retrospective, propensity-matched cohort study comparing DDAVP to control in patients diagnosed with a non-traumatic ICH previously on antiplatelet therapy. Notable exclusion criteria included admission to trauma service, subarachnoid hemorrhages, confounding coagulopathic factors, and hematoma evacuation. Poor outcome, defined as discharge to hospice or in-patient mortality, was the primary outcome. Secondary outcomes included intracranial hematoma expansion and occurrence of adverse events, which included hyponatremia and thromboembolic events.A total of 49 patients receiving DDAVP were compared to 107 controls in the unmatched cohort. Thirty-seven patients treated with DDAVP and 55 controls were included in the propensity-matched analysis, which was adjusted for age, ethnicity, history of diabetes, receipt of platelet transfusion, and thromboembolism prophylaxis. Poor outcome (16.2% DDAVP vs 29% control, p = 0.13), rates of hematoma expansion (11.8% DDAVP vs 11.1% control, p = 0.99), and adverse events (21.6% DDAVP vs 20% control, p = 0.99) were statistically similar between the matched groups.DDAVP administration in patients with spontaneous antiplatelet-associated ICH was not associated with a reduction in poor outcomes, hematoma expansion, or an increase in adverse events. Use of DDAVP in this patient population appears to be safe. Larger prospective studies are warranted to evaluate DDAVP utility in this patient population.
- Published
- 2021
5. The authors reply
- Author
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G. Morgan Jones, Michael J. Erdman, and Heidi M. Riha
- Subjects
Saline Solution, Hypertonic ,Water-Electrolyte Imbalance ,Humans ,Pilot Projects ,Acid-Base Imbalance ,Critical Care and Intensive Care Medicine ,Cerebral Hemorrhage - Published
- 2018
6. Major publications in the critical care pharmacotherapy literature: January-December 2013
- Author
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Megan A, Rech, Sarah A, Day, Jenna M, Kast, Elisabeth E, Donahey, Mehrnaz, Pajoumand, Shawn J, Kram, Michael J, Erdman, Gregory J, Peitz, John M, Allen, Allison, Palmer, Bridgette, Kram, Serena A, Harris, Charles J, Turck, and Amanda, Zomp
- Subjects
Pharmacology ,medicine.medical_specialty ,business.industry ,Health Policy ,Pharmacy ,Guideline ,medicine.disease ,Intensive care unit ,law.invention ,Pharmacotherapy ,law ,Critical care nursing ,medicine ,Pharmacy practice ,Myocardial infarction ,business ,Intensive care medicine ,Stroke - Abstract
Purpose Ten recently published articles with important implications for critical care pharmacotherapy are summarized. Summary The Critical Care Pharmacotherapy Literature Update (CCPLU) group is a national assembly of experienced intensive care unit (ICU) pharmacists across the United States. Group members monitor 25 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on (1) applicability to critical care practice, (2) relevance to pharmacy practitioners, and (3) quality of evidence or research methodology. Hundreds of relevant articles were evaluated by the group during the period January–December 2013, of which 98 were summarized and disseminated nationally to CCPLU group members. Among those 98 publications, 10 deemed to be of particularly high utility to critical care practitioners were included in this review. The 10 articles address topics such as rapid lowering of blood pressure in patients with intracranial hemorrhage, adjunctive therapy to prevent renal injury due to acute heart failure, triple-drug therapy to improve neurologic outcomes after cardiac arrest, and continuous versus intermittent infusion of β-lactam antibiotics in severe sepsis. Conclusion There were many important additions to the critical care pharmacotherapy literature in 2013, including an updated guideline on the management of myocardial infarction and reports on advances in research focused on improving outcomes in patients with stroke or cardiac arrest and preventing the spread of drug-resistant pathogens in the ICU.
- Published
- 2015
7. Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients.
- Author
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Jones GM, Bode L, Riha H, and Erdman MJ
- Subjects
- Academic Medical Centers, Aged, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Retrospective Studies, Water-Electrolyte Balance, Brain Injuries therapy, Cerebrovascular Disorders therapy, Critical Care methods, Saline Solution, Hypertonic administration & dosage, Saline Solution, Hypertonic adverse effects, Vascular Access Devices
- Abstract
Background: Numerous drug information resources recommend that continuous intravenous 3% sodium chloride solution be administered via a central catheter., Objectives: To evaluate the incidence of infusion-related reactions and electrolyte abnormalities in neurocritical care patients treated with continuous intravenous infusion of 3% sodium chloride solution via a peripheral catheter., Methods: Data on patients treated with continuous intravenous infusion of 3% sodium chloride solution at 2 academic medical centers were evaluated retrospectively to determine the administration site. Electronic notes on catheter status were reviewed to determine the occurrence of infusion-related reactions. Prespecified thresholds were used to assess electrolyte abnormalities., Results: Of 213 patients who had peripheral continuous intravenous infusions of 3% sodium chloride solution, 15 (7%) had infusion-related reactions. Administration was changed to a central catheter in 56 patients (26.3%), but only 5 changes were due to an infusion-related reaction. Most (157 patients, 73.7%) received their entire treatment peripherally, for a median duration of 44 hours, 3 minutes. The most common electrolyte abnormalities were hyperchloremia in 49.3% and hypokalemia in 46.9% of patients., Conclusion: Current recommendations that a central catheter is required for continuous intravenous infusion of 3% sodium chloride solution should be reevaluated. Only a few patients who had peripheral infusions had infusion-related reactions. Electrolyte abnormalities occurred frequently with peripheral infusion, but the clinical importance of the abnormalities remains unclear., (©2016 American Association of Critical-Care Nurses.)
- Published
- 2016
- Full Text
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8. Major publications in the critical care pharmacotherapy literature: January-December 2013.
- Author
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Rech MA, Day SA, Kast JM, Donahey EE, Pajoumand M, Kram SJ, Erdman MJ, Peitz GJ, Allen JM, Palmer A, Kram B, Harris SA, and Turck CJ
- Abstract
Purpose: Ten recently published articles with important implications for critical care pharmacotherapy are summarized., Summary: The Critical Care Pharmacotherapy Literature Update (CCPLU) group is a national assembly of experienced intensive care unit (ICU) pharmacists across the United States. Group members monitor 25 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on (1) applicability to critical care practice, (2) relevance to pharmacy practitioners, and (3) quality of evidence or research methodology. Hundreds of relevant articles were evaluated by the group during the period January-December 2013, of which 98 were summarized and disseminated nationally to CCPLU group members. Among those 98 publications, 10 deemed to be of particularly high utility to critical care practitioners were included in this review. The 10 articles address topics such as rapid lowering of blood pressure in patients with intracranial hemorrhage, adjunctive therapy to prevent renal injury due to acute heart failure, triple-drug therapy to improve neurologic outcomes after cardiac arrest, and continuous versus intermittent infusion of β-lactam antibiotics in severe sepsis., Conclusion: There were many important additions to the critical care pharmacotherapy literature in 2013, including an updated guideline on the management of myocardial infarction and reports on advances in research focused on improving outcomes in patients with stroke or cardiac arrest and preventing the spread of drug-resistant pathogens in the ICU., (Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
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