Systemic inflammation & #delirium in #ICU ?
🔍1000 critically ill pts
🧪higher inflammation markers/lower endogenous anticoagulant activity consistently associated w delirium/coma day following marker measurement + delirium/coma-free days over next week
🔓 rdcu.be/dFtSD

'Tackling Brain and Muscle Dysfunction in Acute Respiratory Distress Syndrome Survivors: NIH NHLBI Workshop Report'

Online early ATS Blue Journal

Report led by J. Palakshappa (@WakePCCM), Terri Hough Timothy Girard

atsjournals.org/doi/abs/10.116…

Jack Iwashyna🫁 Stephanie Parks Taylor

Excited to see this in the Blue journal! Thanks to NIH NHLBI , co-lead Timothy Girard , leadwriter Jess Palakshappa, and all who contributed, including editors ATS Blue Journal who made it better. Lots of work still to be done! pubmed.ncbi.nlm.nih.gov/38477657/

Patients undergoing pressure support compared with T-piece SBTs were more likely to be extubated successfully and more likely to pass an SBT (excluding results of an outlier trial) without increased risk of reintubation.
ja.ma/3URAHDj

'What Is the Point of Bayesian Analysis?'

With Ewan Goligher

atsjournals.org/doi/full/10.11…

That’s my boy! Go Night Train Ultimate!!

Congrats to Anne E Palermo and Keith McNaughton for all their hard work in the build up to this trial, thanks to the American DoD for providing funding and thanks to Angus McLachlan Leo Heunks Timothy Girard for scientific advice

Death-truncated non-mortality outcomes challenge trials in many fields, esp critical care.

While I still don't find any approach conceptually ideal, here is a new-ish idea from us: conditional survivor average causal effects.

projecteuclid.org/journals/annal…

Fan Li Tony Guangyu TONG

Incredible time at the 2024 PACCSM Research Retreat, surrounded by so many brilliant researchers🤩 Shared my work, gained invaluable insights from our guest, Dr. Loretta Que, and crowned a bowling champion! 🫁 #ThisIsPACCSM

In this secondary analysis of MIND USA including 566 patients with delirium neither haloperidol nor ziprasidone significantly increased QTc intervals compared with placebo in patients with QTc<550. No study drug–related fatal cardiac arrhythmias occurred. jamanetwork.com/journals/jaman…

Future work should now examine heterogeneity of treatment effect and biomarkers in these subtypes to identify therapeutic targets for #delirium .

Big thanks to our team, especially Timothy Girard, Christopher Seymour, WesElyMD, and Pratik Pandharipande for mentorship throughout this project! 3/3

Our findings are important because:
▪️ There is no evidence-based treatment for delirium
▪️ Treatments should be precise
▪️ Existing subtypes often co-occur or rely on clinician observation
▪️ Data-driven methods have the potential to identify treatment-responsive subtypes 3/

We identified four data-derived #delirium #subtypes , and these subtypes had different clinical profiles and outcomes. The subtypes were also distinct from prior attempts at splitting delirium, including psychomotor symptom and risk factor-based approaches. #icu #heterogeneity 2/

Happy to share two new papers available today! The first in eBioMedicine – The Lancet Discovery Science describes our derivation of #delirium #subtypes during #criticalillness using #latentclassanalysis . 1/

sciencedirect.com/science/articl…

Always a pleasure to present with this all-star implementation science crew! Thanks Mihaela Stefan (NIH NHLBI), Timothy Girard, Andrew Knighton, Colin Grissom, and selfie king Raj Srivastava at #DIScience23
Pediatric Research in Inpatient Settings Network

Can bearly contain our excitement for #Big12MBB

CHEST Margaret Pisani Now Timothy Girard talking about #delirium in the ICU.
Delirium in the ICU has multiple consequences:
✅ more days on the ventilator
✅ long term cognitive impairment in ICU survivors
✅ increased ICU mortality
CHEST #CHEST2023

CHEST Margaret Pisani Timothy Girard The #ABCDEF ICU bundle is part of the assessment and treatment of #delirium
➡️ benzos are associated w/ increased delirium in a dose-dependent fashion
➡️ haldol has been shown to be similar to placebo in several trials
➡️ anti-psychotics may work for SOME pts #CHEST2023

CHEST Margaret Pisani Timothy Girard #delirium is a disorder of consciousness and cognition. Clinicians under-recognize delirium in the ICU when they use only clinical signs and symptoms and don’t use validated tools #CHEST2023 CHEST

In great company with Timothy Girard and Anders Perner we discuss #AIDICU and #MINDUSA and the current evidence we have for the effects of haloperidol in ICU patients with delirium. Go read👇