Peter D. Sottile
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View article: Empirical phenotyping of joint patient-care data supports hypothesis-driven investigation of mechanical ventilation consequences
Empirical phenotyping of joint patient-care data supports hypothesis-driven investigation of mechanical ventilation consequences Open
View article: Developing A Data Pipeline to Quantify Ventilator Waveforms
Developing A Data Pipeline to Quantify Ventilator Waveforms Open
A bstract O bjective To automatically collect ventilator waveforms and integrate them with curated electronic health record data from thousands of patients to provide the data necessary to analyze the complex interactions between lung inju…
View article: Investigating the consequences of mechanical ventilation in clinical intensive care settings through an evolutionary game-theoretic framework
Investigating the consequences of mechanical ventilation in clinical intensive care settings through an evolutionary game-theoretic framework Open
Identifying the effects of mechanical ventilation strategies and protocols in critical care requires analyzing data from heterogeneous patient-ventilator systems within the context of the clinical decision-making environment. This research…
View article: Computer model-based injury prediction and evaluation of lung function in mice with acute and ventilator-induced lung injuries
Computer model-based injury prediction and evaluation of lung function in mice with acute and ventilator-induced lung injuries Open
Computer model-based analysis of lung function in healthy and lung-injured mice showed that model compliance factor (C F ) characteristics were sensitive measures of acute lung injury and ventilator-induced lung injury (VILI) severity. The…
View article: Dynamic driving pressure predicts ventilator-induced lung injury in mice with and without endotoxin-induced acute lung injury
Dynamic driving pressure predicts ventilator-induced lung injury in mice with and without endotoxin-induced acute lung injury Open
Elastic net regression analysis of ventilation waveforms recorded during mechanical ventilation of initially healthy and lung-injured mice shows that low driving pressure is a computational biomarker associated with better ventilator-induc…
View article: Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials
Association Between Neuromuscular Blocking Agents and Outcomes of Emergency Tracheal Intubation: A Secondary Analysis of Randomized Trials Open
Among critically ill adults undergoing tracheal intubation, the incidences of successful intubation on the first attempt and severe complications were not significantly different between patients who received succinylcholine and patients w…
View article: Noninvasive Ventilation for Preoxygenation during Emergency Intubation
Noninvasive Ventilation for Preoxygenation during Emergency Intubation Open
Among critically ill adults undergoing tracheal intubation, preoxygenation with noninvasive ventilation resulted in a lower incidence of hypoxemia during intubation than preoxygenation with an oxygen mask. (Funded by the U.S. Department of…
View article: Flow-Limited and Reverse-Triggered Ventilator Dyssynchrony Are Associated With Increased Tidal and Dynamic Transpulmonary Pressure*
Flow-Limited and Reverse-Triggered Ventilator Dyssynchrony Are Associated With Increased Tidal and Dynamic Transpulmonary Pressure* Open
OBJECTIVES: Ventilator dyssynchrony may be associated with increased delivered tidal volumes (V t s) and dynamic transpulmonary pressure (ΔP L,dyn ), surrogate markers of lung stress and strain, despite low V t ventilation. However, it is …
View article: Empirical phenotyping in coupled patient+care systems: Generating low-dimensional categories for hypothesis-driven investigation of mechanically-ventilated patients
Empirical phenotyping in coupled patient+care systems: Generating low-dimensional categories for hypothesis-driven investigation of mechanically-ventilated patients Open
Background Analyzing patient data under current mechanical ventilation (MV) management processes is essential to develop hypotheses about improvements and to understand MV consequences over time. How-ever, progress is complicated by the co…
View article: The Development, Optimization, and Validation of Four Different Machine Learning Algorithms to Identify Ventilator Dyssynchrony
The Development, Optimization, and Validation of Four Different Machine Learning Algorithms to Identify Ventilator Dyssynchrony Open
Objective Invasive mechanical ventilation can worsen lung injury. Ventilator dyssynchrony (VD) may propagate ventilator-induced lung injury (VILI) and is challenging to detect and systematically monitor because each patient takes approxima…
View article: Protocol and Statistical Analysis Plan for the Pragmatic Trial Examining Oxygenation Prior to Intubation of Preoxygenation With Noninvasive Ventilation vs Oxygen Mask in Critically Ill Adults
Protocol and Statistical Analysis Plan for the Pragmatic Trial Examining Oxygenation Prior to Intubation of Preoxygenation With Noninvasive Ventilation vs Oxygen Mask in Critically Ill Adults Open
View article: Differential effects of two-hit models of acute and ventilator-induced lung injury on lung structure, function, and inflammation
Differential effects of two-hit models of acute and ventilator-induced lung injury on lung structure, function, and inflammation Open
Acute respiratory distress syndrome (ARDS) and acute lung injury have a diverse spectrum of causative factors including sepsis, aspiration of gastric contents, and near drowning. Clinical management of severe lung injury typically includes…
View article: Quantifiable identification of flow-limited ventilator dyssynchrony with the deformed lung ventilator model
Quantifiable identification of flow-limited ventilator dyssynchrony with the deformed lung ventilator model Open
Objective Ventilator dyssynchrony (VD) is potentially harmful to patients with or at risk for acute respiratory distress syndrome (ARDS). In addition to injury solely caused by the ventilator, ventilator-induced lung injury may be instigat…
View article: Protocol and statistical analysis plan for the PREOXI trial of preoxygenation with noninvasive ventilation vs oxygen mask
Protocol and statistical analysis plan for the PREOXI trial of preoxygenation with noninvasive ventilation vs oxygen mask Open
Background Hypoxemia is a common and life-threatening complication during emergency tracheal intubation of critically ill adults. The administration of supplemental oxygen prior to the procedure (“preoxygenation”) decreases the risk of hyp…
View article: Association between Substance Misuse and Outcomes in Critically III Patients with Pneumonia
Association between Substance Misuse and Outcomes in Critically III Patients with Pneumonia Open
Rationale: In patients with pneumonia requiring intensive care unit (ICU) admission, alcohol misuse is associated with increased mortality, but the relationship between other commonly misused substances and mortality is unknown. …
View article: Table of Contents
Table of Contents Open
View article: Hypothesis-driven modeling of the human lung–ventilator system: A characterization tool for Acute Respiratory Distress Syndrome research
Hypothesis-driven modeling of the human lung–ventilator system: A characterization tool for Acute Respiratory Distress Syndrome research Open
View article: Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure
Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure Open
View article: Prone Positioning for Nonintubated Patients With COVID-19—Potential Dangers of Extrapolation and Intermediate Outcome Variables
Prone Positioning for Nonintubated Patients With COVID-19—Potential Dangers of Extrapolation and Intermediate Outcome Variables Open
Edward Tang Qian, MD; Cheryl L. Gatto, PhD; Olga Amusina, DNP; Mary Lynn Dear, PhD; William Hiser, BA; Reagan Buie, MHA; Sunil Kripalani, MD; Frank E. Harrell Jr, PhD; Robert E. Freundlich, MD, MS, MSCI; Yue Gao, MS; Wu Gong, MD, MS; Cassa…
View article: A Damaged-Informed Lung Ventilator Model for Ventilator Waveforms
A Damaged-Informed Lung Ventilator Model for Ventilator Waveforms Open
Motivated by a desire to understand pulmonary physiology, scientists have developed physiological lung models of varying complexity. However, pathophysiology and interactions between human lungs and ventilators, e.g., ventilator-induced lu…
View article: Significant Variability in Surrogate Informed Consent Rates in ARDS and Prevention and Early Treatment of Acute Lung Injury Network Multicenter Trials
Significant Variability in Surrogate Informed Consent Rates in ARDS and Prevention and Early Treatment of Acute Lung Injury Network Multicenter Trials Open
View article: Real-time electronic health record mortality prediction during the COVID-19 pandemic: a prospective cohort study
Real-time electronic health record mortality prediction during the COVID-19 pandemic: a prospective cohort study Open
Objective To rapidly develop, validate, and implement a novel real-time mortality score for the COVID-19 pandemic that improves upon sequential organ failure assessment (SOFA) for decision support for a Crisis Standards of Care team. Mater…
View article: Real-Time Electronic Health Record Mortality Prediction During the COVID-19 Pandemic: A Prospective Cohort Study
Real-Time Electronic Health Record Mortality Prediction During the COVID-19 Pandemic: A Prospective Cohort Study Open
Background The SARS-CoV-2 virus has infected millions of people, overwhelming critical care resources in some regions. Many plans for rationing critical care resources during crises are based on the Sequential Organ Failure Assessment (SOF…
View article: Myorelaxants in ARDS patients
Myorelaxants in ARDS patients Open
View article: A damaged-informed lung model for ventilator waveforms
A damaged-informed lung model for ventilator waveforms Open
The acute respiratory distress syndrome (ARDS) is characterized by the acute development of diffuse alveolar damage (DAD) resulting in increased vascular permeability and decreased alveolar gas exchange. Mechanical ventilation is a potenti…
View article: Clinical informatics accelerates health system adaptation to the COVID-19 pandemic: examples from Colorado
Clinical informatics accelerates health system adaptation to the COVID-19 pandemic: examples from Colorado Open
Objective Large health systems responding to the coronavirus disease 2019 (COVID-19) pandemic face a broad range of challenges; we describe 14 examples of innovative and effective informatics interventions. Materials and Methods A team of …
View article: Ethical Triage Demands a Better Triage Survivability Score
Ethical Triage Demands a Better Triage Survivability Score Open
There is perhaps no clinical situation where this truism of ethics should be more important than when making potentially life-ending triage decisions. Any ethical triage system must, at minimum, sa...
View article: Patterns of utilization and effects of hospital-specific factors on physical, occupational, and speech therapy for critically ill patients with acute respiratory failure in the USA: results of a 5-year sample
Patterns of utilization and effects of hospital-specific factors on physical, occupational, and speech therapy for critically ill patients with acute respiratory failure in the USA: results of a 5-year sample Open
Physical, occupational, and speech therapy are not routinely delivered to critically ill patients, particularly while on mechanical ventilation in the USA. The utilization of these therapies varies according to insurance coverage, geograph…
View article: Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with moderate-to-severe acute respiratory distress syndrome
Neuromuscular blockade is associated with the attenuation of biomarkers of epithelial and endothelial injury in patients with moderate-to-severe acute respiratory distress syndrome Open
View article: The Association Between Ventilator Dyssynchrony, Delivered Tidal Volume, and Sedation Using a Novel Automated Ventilator Dyssynchrony Detection Algorithm*
The Association Between Ventilator Dyssynchrony, Delivered Tidal Volume, and Sedation Using a Novel Automated Ventilator Dyssynchrony Detection Algorithm* Open
Objective: Ventilator dyssynchrony is potentially harmful to patients with or at risk for the acute respiratory distress syndrome. Automated detection of ventilator dyssynchrony from ventilator waveforms has been difficult. It is unclear i…