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29 results on '"Shmookler, Aaron"'

5. Essential laboratory tests for medical education

Author

Deyrup, Andrea, Knollmann-Ritschel, Barbara, D'Ambrosio, Danielle, Muir, Jeannie, Scordino, Teresa, Kraswoski, Matthew, Cao, Liyun, Shah, Kinjal, Zepf, Jennifer, Grindstaff, Samuel, Inman, Ashley, Moser, Karen, Olson, Kristin, Parker, Lynette, Shmookler, Aaron, Ou, Joyce, Putnam, Angelica, Watts, Luisa, Betts, Elham Vali, Lovitch, Scott, Stashek, Kristen, Flanagan, Melina, Singh, Nirupama, Suarez, Eric, Dudrey, Ellen, Furlong, Mary, Margeta, Marta, Wilberger, Adam, Chan, Joanna, Lin, Amy, and Deyrup, Andrea T.

Published
2022
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15. The Use of Whole Blood in Rural Trauma Leads to Decreased Resource Utilization

Author

Niemann, Britney R., Grabo, Daniel J., Mullens, Cody, Shmookler, Aaron D., Lopez, Santiago, Lander, Owen M., Griffin, Peter L., and Bardes, James M.

Abstract

Background Nearly 40% of trauma deaths result from uncontrolled hemorrhage. Most of these deaths occur within 24 hours, highlighting the importance of early resuscitation. Balanced component resuscitation has been shown to improve outcomes in hemorrhagic shock. However, hemostatic properties may then be decreased, leading to inadequate coagulopathy treatment or higher transfusion requirements. Data comparing the efficacy of component vs. whole blood (WB) resuscitation in early trauma is poor, particularly in the rural population. This study investigates WB use and resource utilization at a rural Level 1 trauma center.Methods A prospective cohort study with historical controls (HC) was performed using patients over age 17 presenting as the highest priority trauma. Two units of WB were available to patients with signs of hemorrhagic shock, with subsequent transfusions via massive transfusion protocol or thromboelastography guidance. Component utilization, time to hemorrhage control, complications, and transfer times were examined.Results Forty patients received WB vs. 153 HC. WB patients had lower complication rates (35% vs. 55.6%; P= .02), and a significant reduction in pRBC utilization in the emergency department (0 vs. 2; P< .0001) and throughout admission (2.0 vs. 4.0; P= .0003). All patients had prolonged transport times given the rural setting (1.42 hours HC vs. 2.03 hours WB; P= .002).Discussion Unlike most urban WB studies, this study occurred in a rural area with extended transportation times, when WB is inaccessible for patients. Despite this delay, WB patients demonstrated lower component utilization and complication rates. Further research is needed to characterize the impact of early WB access.

Published
2023
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17. Serial Convalescent Plasma Infusions for the Initial COVID-19 Infections in the Appalachian Region of West Virginia

Author

Peppers, Brian P., primary, Shmookler, Aaron, additional, Stanley, Johnathan, additional, Giblin Sutton, Lisa, additional, Perrotta, Peter L., additional, Kieffer, Theodore, additional, Skoner, David, additional, Mahady, Stacey, additional, Lewandrowski, Callum, additional, Damron, Heath, additional, Horspool, Alexander, additional, Sakhuja, Ankit, additional, McCarthy, Paul, additional, and Hostoffer, Robert W., additional

Published
2022
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18. List of contributors

Author

Allison, Kimberly H., Allyse, Megan A., B. Smolkin, Matthew, Bartel, Michael J., Beam, Elena, Beechem, Joseph M., Behdad, Amir, Bennett, Katie M., Best, D. Hunter, Betz, Bryan L., Booker, Jessica K., Bourlet, Thomas, Brown, Noah A., Cappelle, Saraswathi, Caprioli, Richard M., Castellano, Juliana, Church, Sarah E., Clarke, Eamonn, Coleman, William B., Crooks, Kristy R., D. Shmookler, Aaron, Dong, Jianli, Fernandes, Helen, Fernandez, Bridget A., Fitts, Eric, Fulmer, Makenzie L., Furtado, Larissa V., Gale, Bruce K., Gallinella, Giorgio, Gonzalo, Sylvie, Grattard, Florence, Gutierrez, Danielle B., Hamilton, Robert, Hasadsri, Linda, Hsiao, Susan J., Ismail, Nahed, Kerr, S.E., Khan, Wahab A., Lambert, Christopher, Laurentius, Lars B., Lee, Grace, Levy, Joshua, Linos, Konstantinos, Mahmood, Tawsif, Malick, M. Shaheen, Mariani, Raffaella, Marie McLaughlin, Heather, Marshall, Christian R., Memmi, Meriam, Michalak, Tomasz I., Molinski, John H., Mulrooney-Cousins, Patricia M., Murphy, Breana, Nikiforov, Yuri E., Norris, Jeremy L., Ornstein, Deborah L., Parra, Ourania, Patel, Dhruv, Patterson, Nathan Heath, Pelucchi, Sara, Perez, Jessica, Pillet, Sylvie, Piperno, Alberto, Pirmohamed, Munir, Porter, Marc D., Powell, Eleanor A., Powers-Fletcher, Margaret V., Pozzetto, Bruno, Pratt, Victoria M., Procop, Gary W., Rai, Alex J., Raimondo, Massimo, Sadimin, Evita, Sant, Himanshu, Saqi, Anjali, Sathyanarayana, Shivaprasad H., Sato, Hiromi, Scherer, Stephen W., Scott, Stuart A., Shahi, M., Shi, Chanjuan, Shiau, Carolyn J., Shinder, Brian M., Si, Yue, Singer, Eric A., Skaugen, John M., Sood, Neil, Sriharan, Aravindhan, Stephen, Samantha, Stephenson, Ryan D., Suriawinata, Arief, Szabolcs, Matthias J., Tadimety, Amogha, Thomas, Jessica S., Thompson, Cecilia M., Toledo, Diana M., Trembath, Dimitri G., Tsao, Ming-Sound, Tsongalis, Gregory J., Turner, Richard Myles, Vaickus, Louis, Vatta, Matteo, Verhoeven, Paul O., Vorstman, Jacob A.S., Wainman, Lauren M., Walker, David H., Warren, Sarah E., Weidmann, Maxwell D., Wicks, Stephen J., Yan, Shaofeng, Yen-Lieberman, Belinda, Yetmar, Zachary, Zang, Ling, and Zhang, John X.J.

Published
2024
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19. Utilization of Thromboelastogram and Inflammatory Markers in the Management of Hypercoagulable State in Patients with COVID-19 Requiring ECMO Support

Author

Smolarz, Angela, McCarthy, Paul, Shmookler, Aaron, Badhwar, Vinay, Hayanga, Awori J., and Sakhuja, Ankit

Subjects
Article Subject
Abstract

The role of extracorporeal membrane oxygenation (ECMO) in the management of critically ill patients with COVID-19 is evolving. Extracorporeal support independently confers an increased predilection for thrombosis, which can be exacerbated by COVID-19-associated coagulopathy. We present the successful management of a hypercoagulable state in two patients who required venovenous ECMO for the treatment of COVID-19. This included monitoring inflammatory markers (D-dimer and fibrinogen), performing a series of therapeutic plasma exchange procedures, and administering high-intensity anticoagulation therapy and thromboelastography- (TEG-) guided antiplatelet therapy. TPE was performed to achieve goal D-dimer less than 3000 ng/mL D-dimer units (N≤232 ng/mL D-dimer units) and goal fibrinogen less than 600 mg/dL (N=200-400 mg/dL). These therapies resulted in improved TEG parameters and normalized inflammatory markers. Patients were decannulated after 37 days and 21 days, respectively. Post-ECMO duplex ultrasound of the upper and lower extremities and cannulation sites revealed a nonsignificant deep venous thrombosis at the site of femoral cannulation in patient 2 and no deep venous thrombosis in patient 1. The results of this case report show successful management of a hypercoagulable state among COVID-19 patients requiring ECMO support by utilization of inflammatory markers and TEG.

Published
2021
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