Jarrod M Mosier

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Scholarly Contributions

Chapters

• Berkow, L. C., Sakles, J. C., & Mosier, J. M. (2015). Airway management of patients with smoke inhalation. In Cases in Emergency Airway Management. Cambridge University Press. doi:10.1017/cbo9781139941471.020
• Mosier, J. M., & Keim, S. M. (2010). Complications of Cardiac Transplatation. In Rosen and Barkin's 5-Minute Emergency Medicine Consult. Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.
• Antonuccio, D., & Mosier, J. M. (2006). Smoking (Nicotine Dependence). In Practitioner's Guide to Evidence Based Psychotherapy(pp 660-667). New York, NY: Springer US.

Journals/Publications

• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2025). Circulating endothelial signatures correlate with worse outcomes in COVID-19, respiratory failure and ARDS. Critical Care, 29(Issue 1). doi:10.1186/s13054-025-05596-0
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  Background: Elevated circulating endothelial cells (CECs), released from monolayers after insult, have been implicated in worse outcomes in ARDS and COVID-19, however there is no consensus proteomic phenotype that define CECs. We queried whether a transcriptomic approach would alternatively support the presence of endothelial cells in circulation and correlate with worsening respiratory failure. Methods: To test whether elevated endothelial cell signatures (ECS) in circulation plays a role in worse respiratory outcomes, we used unsupervised bulk-transcriptome deconvolution to quantify ECS% in two cohorts. Our pilot analysis included pediatric patients requiring invasive mechanical ventilation (CAF-PINT, NCT01892969). Our validation cohort included adult hospitalized patients with COVID-19 (IMPACC, NCT04378777), testing the association of ECS% to outcomes in patients at risk of acute respiratory failure/ARDS. Primary outcome was 28-day mortality. Results: In CAF-PINT, day 0 ECS% was higher in non-survivors compared to survivors of respiratory failure (2.8%, IQR 2.4–3.4% versus 2.6%, IQR 2.2–3.0% n = 244, p < 0.05, Wilcoxon rank-sum). In IMPACC, baseline ECS% (< 72 h of hospitalization) was higher in COVID-19 non-survivors versus survivors (2.9%, IQR 2.6–3.4%, versus 2.7%, IQR 2.3–3.1%, n = 932, p < 0.001, Wilcoxon rank-sum). Each 1% increase in baseline ECS% was significantly associated with mortality (adjusted OR 1.36, CI 1.03–1.79) by multivariable logistic regression. Increased baseline ECS% was associated with worse respiratory trajectories (2.5%, IQR 2.2–2.8% for trajectory with no oxygen requirements, 2.9%, IQR 2.6–3.4% for the trajectory with fatal outcome by day 28, n = 932, p < 0.001, one-way ANOVA). Conclusion: Quantifying ECS by deconvolution supports a transcriptomics-driven approach towards the non-invasive evaluation of endothelial damage in respiratory outcomes. This is a first step towards elucidating mechanistic components linking endothelial damage to ARDS utilizing non-invasive, circulating transcriptomic data by leveraging a novel deconvolution approach.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2025). Correction: Peri-intubation complications in critically ill obese patients: a secondary analysis of the international INTUBE cohort (Critical Care, (2025), 29, 1, (192), 10.1186/s13054-025-05419-2). Critical Care, 29(Issue 1). doi:10.1186/s13054-025-05475-8
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  Following the publication of the original article [1], the author reported that due to an error the institutional author group was not indicated on the title page and therefore the institutional authors were not visible as being part of the INTUBE Study Investigators. The institutional author names given in the additional file 1 of the original article [1] have been added to the INTUBE Study Investigators institutional author group. The title page and the institutional author group has been updated in this correction article and the original article [1] has been corrected.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2025). Host-microbe multiomic profiling identifies distinct COVID-19 immune dysregulation in solid organ transplant recipients. Nature Communications, 16(1). doi:10.1038/s41467-025-55823-z
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  Coronavirus disease 2019 (COVID-19) poses significant risks for solid organ transplant recipients, who have atypical but poorly characterized immune responses to infection. We aim to understand the host immunologic and microbial features of COVID-19 in transplant recipients by leveraging a prospective multicenter cohort of 86 transplant recipients age- and sex-matched with 172 non-transplant controls. We find that transplant recipients have higher nasal SARS-CoV-2 viral abundance and impaired viral clearance, and lower anti-spike IgG levels. In addition, transplant recipients exhibit decreased plasmablasts and transitional B cells, and increased senescent T cells. Blood and nasal transcriptional profiling demonstrate unexpected upregulation of innate immune signaling pathways and increased levels of several proinflammatory serum chemokines. Severe disease in transplant recipients, however, is characterized by a less robust induction of pro-inflammatory genes and chemokines. Together, our study reveals distinct immune features and altered viral dynamics in solid organ transplant recipients.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2025). Type 2 immune responses are associated with less severe COVID-19 in a hospitalized cohort. Journal of Allergy and Clinical Immunology: Global, 4(Issue 4). doi:10.1016/j.jacig.2025.100515
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  Background: The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly after its identification in December 2019 to cause a global pandemic. The respiratory tract is the primary site of infection, and there is a large range in the severity of respiratory illnesses caused by the virus. Defining molecular and cellular factors for protection from severe disease and death has been a goal to better understand and to predict and mitigate the effects of SARS-CoV-2 and future coronaviruses. Objective: Despite well-known susceptibilities to respiratory viral infections, respiratory allergy and allergic asthma have not been identified as risk factors for severe coronavirus disease 2019 (COVID-19) in most epidemiologic studies and may be protective. We sought to investigate associations between markers of type 2 (T2) immune responses with SARS-CoV-2 clinical outcomes and virus loads in a cohort of 1164 individuals hospitalized for COVID-19 from May 2020 to March 2021 as part of the IMPACC study. Methods: We characterized the clinical outcomes, as defined by severity trajectory groups reflecting the degree of respiratory support required, virus loads, and antibody titers of COVID-19 infections in IMPACC participants in relation to molecular and cellular markers of T2 immune responses through multiple assays, including, (1) IL-4, IL-5, and IL-13 levels in serum Olink data, (2) T2 cellular signatures in blood cytometry by time of flight data, (3) relative quantification of T2 signaling gene pathways in airway RNA sequencing data, and/or (4) T2 pathways in peripheral blood mononuclear cell RNA sequencing data. We also investigated the outcomes of individuals with self-reported asthma and evidence of T2 immune responses. Results: The diagnosis of asthma (odd ratio = 1.27), elevated serum T2 cytokine levels (median fold change = 1.06), and a higher frequency of TH2 cells (difference = +2%) were associated with less severe clinical disease during hospitalization. Distinct T2-related transcriptomic changes in nasal and blood samples were associated with reduced virus loads. This included the expression of T2-regulated genes implicated in T-/B-cell activation and apoptosis in nasal samples and the expression of T2-regulated genes implicated in myeloid differentiation and reactive oxygen species signaling in blood. Among these, several canonical T2-regulated genes that were increased in less severe disease were identified to have antiviral properties in large high-throughput screens. Conclusion: T2 immune responses were associated with lower virus loads and more favorable clinical outcomes, suggesting that T2 inflammation related to asthma and allergic diseases may have a direct protective effect against SARS-CoV-2.
• Jain, S., Chowdhury, B., Mosier, J., Subbian, V., Hughes, K., & Son, Y. (2025). Design and Development of an Integrated Virtual Reality (VR)-based Training System for Difficult Airway Management. IEEE Journal of Translational Engineering in Health and Medicine, 13. doi:10.1109/JTEHM.2025.3529748
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  Objective: For over 40 years, airway management simulation has been a cornerstone of medical training, aiming to reduce procedural risks for critically ill patients. However, existing simulation technologies often lack the versatility and realism needed to replicate the cognitive and physical challenges of complex airway management scenarios. Technology or Method: We developed a novel Virtual Reality (VR)-based simulation system designed to enhance immersive airway management training and research. This system integrates physical and virtual environments with an external sensory framework to capture high-fidelity data on user performance. Advanced calibration techniques ensure precise positional tracking and realistic physics-based interactions, providing a cohesive mixed-reality experience. Results: Validation studies conducted in a dedicated medical training center demonstrated the system's effectiveness in replicating real-world conditions. Positional calibration accuracy was achieved within 0.1 cm, with parameter calibrations showing no significant discrepancies. Validation using Pre- and post-simulation surveys indicated positive feedback on training aspects, perceived usefulness, and ease of use. These results suggest that the system offers a significant improvement in procedural and cognitive training for high-stakes medical environments.
• Lewis, N. M., Harker, E. J., Cleary, S., Zhu, Y., Grijalva, C. G., Chappell, J. D., Rhoads, J. P., Baughman, A., Casey, J. D., Blair, P. W., Jones, I. D., Johnson, C. A., Halasa, N. B., Lauring, A. S., Martin, E. T., Gaglani, M., Ghamande, S., Columbus, C., Steingrub, J. S., , Duggal, A., et al. (2025). Vaccine Effectiveness Against Influenza A(H1N1), A(H3N2), and B-Associated Hospitalizations, United States, 1 September 2023 to 31 May 2024. Journal of Infectious Diseases, 232(Issue 4). doi:10.1093/infdis/jiaf185
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  Background The 2023-2024 influenza season included sustained elevated activity from December 2023 to February 2024 and continued activity through May 2024. Influenza A(H1N1), A(H3N2), and B viruses circulated during the season. Methods During 1 September 2023 to 31 May 2024, a multistate sentinel surveillance network of 24 medical centers in 20 US states enrolled adults aged ≥18 years hospitalized with acute respiratory illness. Consistent with a test-negative design, cases tested positive for influenza viruses by molecular or antigen test, and controls tested negative for influenza viruses and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccine effectiveness (VE) against influenza-associated hospitalization was calculated as (1 - adjusted odds ratio for vaccination) × 100%. Results Among 7690 patients, including 1170 influenza cases (33% vaccinated) and 6520 controls, VE was 40% (95% confidence interval [CI], 31%-48%) with varying estimates by age: 18-49 years, 53% (95% CI, 34%-67%); 50-64 years, 47% (95% CI, 31%-60%); ≥ 65 years, 31% (95% CI, 16%-43%). Protection was similar among immunocompetent patients (40%; 95% CI, 30%-49%) and immunocompromised patients (32%; 95% CI, 7%-50%). VE was statistically significant against influenza B (67%; 95% CI, 35%-84%) and A(H1N1) (36%; 95% CI, 21%-48%) and crossed the null against A(H3N2) (19%; 95% CI, -8% to 39%). VE was higher for patients 14-60 days from vaccination (54%; 95% CI, 40%-65%) than >120 days (18%; 95% CI, -1% to 33%). Conclusions During 2023-2024, influenza vaccination reduced the risk of influenza A(H1N1)- and influenza B-associated hospitalizations among adults; effectiveness was lower in patients vaccinated >120 days prior to illness onset compared with those vaccinated 14-60 days prior.
• Lewis, N., Harker, E., Leis, A., Zhu, Y., Talbot, H., Grijalva, C., Halasa, N., Chappell, J., Johnson, C., Rice, T., Casey, J., Lauring, A., Gaglani, M., Ghamande, S., Columbus, C., Steingrub, J., Shapiro, N., Duggal, A., Felzer, J., , Prekker, M., et al. (2025). Assessment and mitigation of bias in influenza and COVID-19 vaccine effectiveness analyses — IVY Network, September 1, 2022–March 30, 2023. Vaccine, 43(Issue). doi:10.1016/j.vaccine.2024.126492
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  Background: In test-negative studies of vaccine effectiveness (VE), including patients with co-circulating, vaccine-preventable, respiratory pathogens in the control group for the pathogen of interest can introduce a downward bias on VE estimates. Methods: A multicenter sentinel surveillance network in the US prospectively enrolled adults hospitalized with acute respiratory illness from September 1, 2022–March 31, 2023. We evaluated bias in estimates of VE against influenza–associated and COVID-19–associated hospitalization based on: inclusion vs exclusion of patients with a co-circulating virus among VE controls; observance of VE against the co-circulating virus (rather than the virus of interest), unadjusted and adjusted for vaccination against the virus of interest; and observance of influenza or COVID-19 against a sham outcome of respiratory syncytial virus (RSV). Results: Overall VE against influenza–associated hospitalizations was 6 percentage points lower when patients with COVID-19 were included in the control group, and overall VE against COVID-19–associated hospitalizations was 2 percentage points lower when patients with influenza were included in the control group. Analyses of VE against the co-circulating virus and against the sham outcome of RSV showed that downward bias was largely attributable the correlation of vaccination status across pathogens, but also potentially attributable to other sources of residual confounding in VE models. Conclusion: Excluding cases of confounding respiratory pathogens from the control group in VE analysis for a pathogen of interest can reduce downward bias. This real-world analysis demonstrates that such exclusion is a helpful bias mitigation strategy, especially for measuring influenza VE, which included a high proportion of COVID-19 cases among controls.
• Link-Gelles, R., Chickery, S., Webber, A., Ong, T. C., Rowley, E. A., DeSilva, M. B., Dascomb, K., Irving, S. A., Klein, N. P., Grannis, S. J., Barron, M. A., Reese, S. E., McEvoy, C., Sheffield, T., Naleway, A. L., Zerbo, O., Rogerson, C., Self, W. H., Zhu, Y., , Lauring, A. S., et al. (2025). Interim Estimates of 2024-2025 COVID-19 Vaccine Effectiveness Among Adults Aged ≥18 Years - VISION and IVY Networks, September 2024-January 2025. Morbidity and Mortality Weekly Report, 74(Issue 6). doi:10.15585/mmwr.mm7406a1
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  COVID-19 vaccination averted approximately 68,000 hospitalizations during the 2023-24 respiratory season. In June 2024, CDC and the Advisory Committee on Immunization Practices (ACIP) recommended that all persons aged ≥6 months receive a 2024-2025 COVID-19 vaccine, which targets Omicron JN.1 and JN.1-derived sublineages. Interim effectiveness of 2024-2025 COVID-19 vaccines was estimated against COVID-19-associated emergency department (ED) or urgent care (UC) visits during September 2024-January 2025 among adults aged ≥18 years in one CDC-funded vaccine effectiveness (VE) network, against COVID-19-associated hospitalization in immunocompetent adults aged ≥65 years in two networks, and against COVID-19-associated hospitalization among adults aged ≥65 years with immunocompromising conditions in one network. Among adults aged ≥18 years, VE against COVID-19-associated ED/UC visits was 33% (95% CI = 28%-38%) during the first 7-119 days after vaccination. Among immunocompetent adults aged ≥65 years from two CDC networks, VE estimates against COVID-19-associated hospitalization were 45% (95% CI = 36%-53%) and 46% (95% CI = 26%-60%) during the first 7-119 days after vaccination. Among adults aged ≥65 years with immunocompromising conditions in one network, VE was 40% (95% CI = 21%-54%) during the first 7-119 days after vaccination. These findings demonstrate that vaccination with a 2024-2025 COVID-19 vaccine dose provides additional protection against COVID-19-associated ED/UC encounters and hospitalizations compared with not receiving a 2024-2025 dose and support current CDC and ACIP recommendations that all persons aged ≥6 months receive a 2024-2025 COVID-19 vaccine dose.
• Surie, D., Yuengling, K. A., Safdar, B., Ginde, A. A., Peltan, I. D., Brown, S. M., Gaglani, M., Ghamande, S., Gottlieb, R. L., Columbus, C., Mohr, N. M., Gibbs, K. W., Hager, D. N., O'Rourke, M., Gong, M. N., Mohamed, A., Johnson, N. J., Steingrub, J. S., Khan, A., , Duggal, A., et al. (2025). Patient- and Community-Level Characteristics Associated With Respiratory Syncytial Virus Vaccination. JAMA Network Open. doi:10.1001/jamanetworkopen.2025.2841
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  Importance: In 2023, the first respiratory syncytial virus (RSV) vaccines were recommended for US adults 60 years or older, but few data are available about which patients were most likely to receive vaccine to inform future RSV vaccine outreach efforts. Objective: To assess patient- and community-level characteristics associated with RSV vaccine receipt and patient knowledge and attitudes related to RSV disease and RSV vaccines. Design, Setting, and Participants: During the first season of RSV vaccine use from October 1, 2023, to April 30, 2024, adults 60 years or older hospitalized with RSV-negative acute respiratory illness were enrolled in this cross-sectional study from 26 hospitals in 20 US states. Sociodemographic and clinical data were abstracted from health records, and structured interviews were conducted for knowledge and attitudes about RSV disease and RSV vaccines. Exposures: Age, sex, race and ethnicity, pulmonary disease, immunocompromised status, long-term care facility residence, medical insurance, social vulnerability index (SVI), and educational level. Main Outcomes and Measures: The exposures were identified a priori as possible factors associated with RSV vaccine receipt and were entered into a modified Poisson regression model accounting for state clustering, to assess for association with RSV vaccine receipt. Knowledge and attitudes were summarized with frequencies and proportions. Results: Among 6746 hospitalized adults 60 years or older, median age was 73 (IQR, 66-80) years and 3451 (51.2%) were female. Among the 6599 patients with self-reported race and ethnicity, 699 (10.6%) were Hispanic, 1288 (19.5%) were non-Hispanic Black, 4299 (65.1%) were non-Hispanic White, and 313 (4.7%) were other race or ethnicity. There were 700 RSV-vaccinated (10.4%) and 6046 unvaccinated (89.6%) adults. Among 3219 unvaccinated adults who responded to RSV knowledge questions, 1519 (47.2%) had not heard of RSV or were unsure; 2525 of 3218 (78.5%) were unsure if they were eligible for RSV vaccine or thought they were not. In adjusted analyses, characteristics associated with RSV vaccination were being 75 years or older (adjusted risk ratio [ARR], 1.23; 95% CI, 1.10-1.38, P
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2024). Early trajectories of virological and immunological biomarkers and clinical outcomes in patients admitted to hospital for COVID-19: an international, prospective cohort study. The Lancet Microbe, 5(6). doi:10.1016/S2666-5247(24)00015-6
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  Background: Serial measurement of virological and immunological biomarkers in patients admitted to hospital with COVID-19 can give valuable insight into the pathogenic roles of viral replication and immune dysregulation. We aimed to characterise biomarker trajectories and their associations with clinical outcomes. Methods: In this international, prospective cohort study, patients admitted to hospital with COVID-19 and enrolled in the Therapeutics for Inpatients with COVID-19 platform trial within the Accelerating COVID-19 Therapeutic Interventions and Vaccines programme between Aug 5, 2020 and Sept 30, 2021 were included. Participants were included from 108 sites in Denmark, Greece, Poland, Singapore, Spain, Switzerland, Uganda, the UK, and the USA, and randomised to placebo or one of four neutralising monoclonal antibodies: bamlanivimab (Aug 5 to Oct 13, 2020), sotrovimab (Dec 16, 2020, to March 1, 2021), amubarvimab-romlusevimab (Dec 16, 2020, to March 1, 2021), and tixagevimab-cilgavimab (Feb 10 to Sept 30, 2021). This trial included an analysis of 2149 participants with plasma nucleocapsid antigen, anti-nucleocapsid antibody, C-reactive protein (CRP), IL-6, and D-dimer measured at baseline and day 1, day 3, and day 5 of enrolment. Day-90 follow-up status was available for 1790 participants. Biomarker trajectories were evaluated for associations with baseline characteristics, a 7-day pulmonary ordinal outcome, 90-day mortality, and 90-day rate of sustained recovery. Findings: The study included 2149 participants. Participant median age was 57 years (IQR 46–68), 1246 (58·0%) of 2149 participants were male and 903 (42·0%) were female; 1792 (83·4%) had at least one comorbidity, and 1764 (82·1%) were unvaccinated. Mortality to day 90 was 172 (8·0%) of 2149 and 189 (8·8%) participants had sustained recovery. A pattern of less favourable trajectories of low anti-nucleocapsid antibody, high plasma nucleocapsid antigen, and high inflammatory markers over the first 5 days was observed for high-risk baseline clinical characteristics or factors related to SARS-CoV-2 infection. For example, participants with chronic kidney disease demonstrated plasma nucleocapsid antigen 424% higher (95% CI 319–559), CRP 174% higher (150–202), IL-6 173% higher (144–208), D-dimer 149% higher (134–165), and anti-nucleocapsid antibody 39% lower (60–18) to day 5 than those without chronic kidney disease. Participants in the highest quartile for plasma nucleocapsid antigen, CRP, and IL-6 at baseline and day 5 had worse clinical outcomes, including 90-day all-cause mortality (plasma nucleocapsid antigen hazard ratio (HR) 4·50 (95% CI 3·29–6·15), CRP HR 3·37 (2·30–4·94), and IL-6 HR 5·67 (4·12–7·80). This risk persisted for plasma nucleocapsid antigen and CRP after adjustment for baseline biomarker values and other baseline factors. Interpretation: Patients admitted to hospital with less favourable 5-day biomarker trajectories had worse prognosis, suggesting that persistent viral burden might drive inflammation in the pathogenesis of COVID-19, identifying patients that might benefit from escalation of antiviral or anti-inflammatory treatment. Funding: US National Institutes of Health.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2024). Features of acute COVID-19 associated with post-acute sequelae of SARS-CoV-2 phenotypes: results from the IMPACC study. Nature Communications, 15(1). doi:10.1038/s41467-023-44090-5
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  Post-acute sequelae of SARS-CoV-2 (PASC) is a significant public health concern. We describe Patient Reported Outcomes (PROs) on 590 participants prospectively assessed from hospital admission for COVID-19 through one year after discharge. Modeling identified 4 PRO clusters based on reported deficits (minimal, physical, mental/cognitive, and multidomain), supporting heterogenous clinical presentations in PASC, with sub-phenotypes associated with female sex and distinctive comorbidities. During the acute phase of disease, a higher respiratory SARS-CoV-2 viral burden and lower Receptor Binding Domain and Spike antibody titers were associated with both the physical predominant and the multidomain deficit clusters. A lower frequency of circulating B lymphocytes by mass cytometry (CyTOF) was observed in the multidomain deficit cluster. Circulating fibroblast growth factor 21 (FGF21) was significantly elevated in the mental/cognitive predominant and the multidomain clusters. Future efforts to link PASC to acute anti-viral host responses may help to better target treatment and prevention of PASC.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2024). IgM N-glycosylation correlates with COVID-19 severity and rate of complement deposition. Nature Communications, 15(1). doi:10.1038/s41467-023-44211-0
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  The glycosylation of IgG plays a critical role during human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, activating immune cells and inducing cytokine production. However, the role of IgM N-glycosylation has not been studied during human acute viral infection. The analysis of IgM N-glycosylation from healthy controls and hospitalized coronavirus disease 2019 (COVID-19) patients reveals increased high-mannose and sialylation that correlates with COVID-19 severity. These trends are confirmed within SARS-CoV-2-specific immunoglobulin N-glycan profiles. Moreover, the degree of total IgM mannosylation and sialylation correlate significantly with markers of disease severity. We link the changes of IgM N-glycosylation with the expression of Golgi glycosyltransferases. Lastly, we observe antigen-specific IgM antibody-dependent complement deposition is elevated in severe COVID-19 patients and modulated by exoglycosidase digestion. Taken together, this work links the IgM N-glycosylation with COVID-19 severity and highlights the need to understand IgM glycosylation and downstream immune function during human disease.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2024). Measurement of circulating viral antigens post-SARS-CoV-2 infection in a multicohort study. Clinical Microbiology and Infection, 30(12). doi:10.1016/j.cmi.2024.09.001
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  Objectives: To determine the proportion of individuals with detectable antigen in plasma or serum after SARS-CoV-2 infection and the association of antigen detection with postacute sequelae of COVID-19 (PASC) symptoms. Methods: Plasma and serum samples were collected from adults participating in four independent studies at different time points, ranging from several days up to 14 months post-SARS-CoV-2 infection. The primary outcome measure was to quantify SARS-CoV-2 antigens, including the S1 subunit of spike, full-length spike, and nucleocapsid, in participant samples. The presence of 34 commonly reported PASC symptoms during the postacute period was determined from participant surveys or chart reviews of electronic health records. Results: Of the 1569 samples analysed from 706 individuals infected with SARS-CoV-2, 21% (95% CI, 18–24%) were positive for either S1, spike, or nucleocapsid. Spike was predominantly detected, and the highest proportion of samples was spike positive (20%; 95% CI, 18–22%) between 4 and 7 months postinfection. In total, 578 participants (82%) reported at least one of the 34 PASC symptoms included in our analysis ≥1 month postinfection. Cardiopulmonary, musculoskeletal, and neurologic symptoms had the highest reported prevalence in over half of all participants, and among those participants, 43% (95% CI, 40–45%) on average were antigen-positive. Among the participants who reported no ongoing symptoms (128, 18%), antigen was detected in 28 participants (21%). The presence of antigen was associated with the presence of one or more PASC symptoms, adjusting for sex, age, time postinfection, and cohort (OR, 1.8; 95% CI, 1.4–2.2). Discussion: The findings of this multicohort study indicate that SARS-CoV-2 antigens can be detected in the blood of a substantial proportion of individuals up to 14 months after infection. While approximately one in five asymptomatic individuals was antigen-positive, roughly half of all individuals reporting ongoing cardiopulmonary, musculoskeletal, and neurologic symptoms were antigen-positive.
• DeCuir, J., Payne, A., Self, W., Rowley, E., Dascomb, K., DeSilva, M., Irving, S., Grannis, S., Ong, T., Klein, N., Weber, Z., Reese, S., Ball, S., Barron, M., Naleway, A., Dixon, B., Essien, I., Bride, D., Natarajan, K., , Fireman, B., et al. (2024). Interim Effectiveness of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years — VISION and IVY Networks, September 2023–January 2024. Morbidity and Mortality Weekly Report, 73(8). doi:10.15585/mmwr.mm7308a5
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  In September 2023, CDC’s Advisory Committee on Immunization Practices recommended updated 2023–2024 (monovalent XBB.1.5) COVID-19 vaccination for all persons aged ≥6 months to prevent COVID-19, including severe disease. However, few estimates of updated vaccine effectiveness (VE) against medically attended illness are available. This analysis evaluated VE of an updated COVID-19 vaccine dose against COVID-19–associated emergency department (ED) or urgent care (UC) encounters and hospitalization among immunocompetent adults aged ≥18 years during September 2023–January 2024 using a test-negative, case-control design with data from two CDC VE networks. VE against COVID-19–associated ED/ UC encounters was 51% (95% CI = 47%–54%) during the first 7–59 days after an updated dose and 39% (95% CI = 33%–45%) during the 60–119 days after an updated dose. VE estimates against COVID-19–associated hospitalization from two CDC VE networks were 52% (95% CI = 47%–57%) and 43% (95% CI = 27%–56%), with a median interval from updated dose of 42 and 47 days, respectively. Updated COVID-19 vaccine provided increased protection against COVID-19–associated ED/UC encounters and hospitalization among immunocompetent adults. These results support CDC recommendations for updated 2023–2024 COVID-19 vaccination. All persons aged ≥6 months should receive updated 2023–2024 COVID-19 vaccine.
• DeCuir, J., Surie, D., Zhu, Y., Lauring, A. S., Gaglani, M., McNeal, T., Ghamande, S., Peltan, I. D., Brown, S. M., Ginde, A. A., Steinwand, A., Mohr, N. M., Gibbs, K. W., Hager, D. N., Ali, H., Frosch, A., Gong, M. N., Mohamed, A., Johnson, N. J., , Srinivasan, V., et al. (2024). Effectiveness of Original Monovalent and Bivalent COVID-19 Vaccines Against COVID-19-Associated Hospitalization and Severe In-Hospital Outcomes Among Adults in the United States, September 2022–August 2023. Influenza and other Respiratory Viruses, 18(11). doi:10.1111/irv.70027
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  Background: Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes. Methods: During September 8, 2022 to August 31, 2023, adults aged ≥ 18 years hospitalized with COVID-19-like illness were enrolled at 26 hospitals in 20 US states. Using a test-negative case–control design, we estimated vaccine effectiveness (VE) with multivariable logistic regression adjusted for age, sex, race/ethnicity, admission date, and geographic region. Results: Among 7028 patients, 2924 (41.6%) were COVID-19 case patients, and 4104 (58.4%) were control patients. Compared to unvaccinated patients, absolute VE against COVID-19-associated hospitalization was 6% (−7%–17%) for original monovalent doses only (median time since last dose [IQR] = 421 days [304–571]), 52% (39%–61%) for a bivalent dose received 7–89 days earlier, and 13% (−10%–31%) for a bivalent dose received 90–179 days earlier. Absolute VE against COVID-19-associated invasive mechanical ventilation or death was 51% (34%–63%) for original monovalent doses only, 61% (35%–77%) for a bivalent dose received 7–89 days earlier, and 50% (11%–71%) for a bivalent dose received 90–179 days earlier. Conclusion: Bivalent vaccination provided protection against COVID-19-associated hospitalization and severe in-hospital outcomes within 3 months of receipt, followed by a decline in protection to a level similar to that remaining from previous original monovalent vaccination by 3–6 months. These results underscore the benefit of remaining up to date with recommended COVID-19 vaccines.
• DeMasi, S., Donohue, M., Merck, L., & Mosier, J. (2024). Extracorporeal cardiopulmonary resuscitation for refractory out‐of‐hospital cardiac arrest: Lessons learned from recent clinical trials. Journal of the American College of Emergency Physicians Open, 5(2). doi:10.1002/emp2.13129
• Fisher, J. M., Subbian, V., Essay, P., Pungitore, S., Bedrick, E. J., & Mosier, J. M. (2024). Acute Respiratory Failure From Early Pandemic COVID-19: Noninvasive Respiratory Support vs Mechanical Ventilation. CHEST Critical Care, 2(Issue 1). doi:10.1016/j.chstcc.2023.100030
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  Background: The optimal strategy for initial respiratory support in patients with respiratory failure associated with COVID-19 is unclear, and the initial strategy may affect outcomes. Research Question: Which initial respiratory support strategy is associated with improved outcomes in patients with COVID-19 with acute respiratory failure? Study Design and Methods: All patients with COVID-19 requiring respiratory support and admitted to a large health care network were eligible for inclusion. We compared patients treated initially with noninvasive respiratory support (NIRS; noninvasive positive pressure ventilation by facemask or high-flow nasal oxygen) with patients treated initially with invasive mechanical ventilation (IMV). The primary outcome was time to in-hospital death analyzed using an inverse probability of treatment weighted Cox model adjusted for potential confounders. Secondary outcomes included unweighted and weighted assessments of mortality, lengths of stay (ICU and hospital), and time to intubation. Results: Nearly one-half of the 2,354 patients (47%) who met inclusion criteria received IMV first, and 53% received initial NIRS. Overall, in-hospital mortality was 38% (37% for IMV and 39% for NIRS). Initial NIRS was associated with an increased hazard of death compared with initial IMV (hazard ratio, 1.42; 95% CI, 1.03-1.94), but also an increased hazard of leaving the hospital sooner that waned with time (noninvasive support by time interaction: hazard ratio, 0.97; 95% CI, 0.95-0.98). Interpretation: Patients with COVID-19 with acute hypoxemic respiratory failure initially treated with NIRS showed an increased hazard of in-hospital death.
• Frutos, A., Price, A., Harker, E., Reeves, E., Ahmad, H., Murugan, V., Martin, E., House, S., Saade, E., Zimmerman, R., Gaglani, M., Wernli, K., Walter, E., Michaels, M., Staat, M., Weinberg, G., Selvarangan, R., Boom, J., Klein, E., , Halasa, N., et al. (2024). Interim Estimates of 2023-24 Seasonal Influenza Vaccine Effectiveness - United States. Morbidity and Mortality Weekly Report, 73(8). doi:10.15585/mmwr.mm7308a3
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  In the United States, annual influenza vaccination is rec¬ommended for all persons aged ≥6 months. Using data from four vaccine effectiveness (VE) networks during the 2023- 24 influenza season, interim influenza VE was estimated among patients aged ≥6 months with acute respiratory ill¬ness-associated medical encounters using a test-negative case-control study design. Among children and adolescents aged 6 months-17 years, VE against influenza-associated outpatient visits ranged from 59% to 67% and against influenza-associ¬ated hospitalization ranged from 52% to 61%. Among adults aged ≥18 years, VE against influenza-associated outpatient visits ranged from 33% to 49% and against hospitalization from 41% to 44%. VE against influenza A ranged from 46% to 59% for children and adolescents and from 27% to 46% for adults across settings. VE against influenza B ranged from 64% to 89% for pediatric patients in outpatient settings and from 60% to 78% for all adults across settings. These findings demonstrate that the 2023-24 seasonal influenza vaccine is effective at reducing the risk for medically attended influenza virus infection. CDC recommends that all persons aged ≥6 months who have not yet been vaccinated this season get vaccinated while influenza circulates locally.
• Karamchandani, K., Nasa, P., Jarzebowski, M., Brewster, D., De Jong, A., Bauer, P., Berkow, L., Brown, C., Cabrini, L., Casey, J., Cook, T., Divatia, J., Duggan, L., Ellard, L., Ergan, B., Jonsson Fagerlund, M., Gatward, J., Greif, R., Higgs, A., , Jaber, S., et al. (2024). Tracheal intubation in critically ill adults with a physiologically difficult airway. An international Delphi study. Intensive Care Medicine, 50(10). doi:10.1007/s00134-024-07578-2
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  Purpose: Our study aimed to provide consensus and expert clinical practice statements related to airway management in critically ill adults with a physiologically difficult airway (PDA). Methods: An international Steering Committee involving seven intensivists and one Delphi methodology expert was convened by the Society of Critical Care Anaesthesiologists (SOCCA) Physiologically Difficult Airway Task Force. The committee selected an international panel of 35 expert clinician–researchers with expertise in airway management in critically ill adults. A Delphi process based on an iterative approach was used to obtain the final consensus statements. Results: The Delphi process included seven survey rounds. A stable consensus was achieved for 53 (87%) out of 61 statements. The experts agreed that in addition to pathophysiological conditions, physiological alterations associated with pregnancy and obesity also constitute a physiologically difficult airway. They suggested having an intubation team consisting of at least three healthcare providers including two airway operators, implementing an appropriately designed checklist, and optimizing hemodynamics prior to tracheal intubation. Similarly, the experts agreed on the head elevated laryngoscopic position, routine use of videolaryngoscopy during the first attempt, preoxygenation with non-invasive ventilation, careful mask ventilation during the apneic phase, and attention to cardiorespiratory status for post-intubation care. Conclusion: Using a Delphi method, agreement among a panel of international experts was reached for 53 statements providing guidance to clinicians worldwide on safe tracheal intubation practices in patients with a physiologically difficult airway to help improve patient outcomes. Well-designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.
• Meurer, W., Schmitzberger, F., Yeatts, S., Ramakrishnan, V., Abella, B., Aufderheide, T., Barsan, W., Benoit, J., Berry, S., Black, J., Bozeman, N., Broglio, K., Brown, J., Brown, K., Carlozzi, N., Caveney, A., Cho, S., Chung-Esaki, H., Clevenger, R., , Conwit, R., et al. (2024). Influence of Cooling duration on Efficacy in Cardiac Arrest Patients (ICECAP): study protocol for a multicenter, randomized, adaptive allocation clinical trial to identify the optimal duration of induced hypothermia for neuroprotection in comatose, adult survivors of after out-of-hospital cardiac arrest. Trials, 25(1). doi:10.1186/s13063-024-08280-w
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  Background: Cardiac arrest is a common and devastating emergency of both the heart and brain. More than 380,000 patients suffer out-of-hospital cardiac arrest annually in the USA. Induced cooling of comatose patients markedly improved neurological and functional outcomes in pivotal randomized clinical trials, but the optimal duration of therapeutic hypothermia has not yet been established. Methods: This study is a multi-center randomized, response-adaptive, duration (dose) finding, comparative effectiveness clinical trial with blinded outcome assessment. We investigate two populations of adult comatose survivors of cardiac arrest to ascertain the shortest duration of cooling that provides the maximum treatment effect. The design is based on a statistical model of response as defined by the primary endpoint, a weighted 90-day mRS (modified Rankin Scale, a measure of neurologic disability), across the treatment arms. Subjects will initially be equally randomized between 12, 24, and 48 h of therapeutic cooling. After the first 200 subjects have been randomized, additional treatment arms between 12 and 48 h will be opened and patients will be allocated, within each initial cardiac rhythm type (shockable or non-shockable), by response adaptive randomization. As the trial continues, shorter and longer duration arms may be opened. A maximum sample size of 1800 subjects is proposed. Secondary objectives are to characterize: the overall safety and adverse events associated with duration of cooling, the effect on neuropsychological outcomes, and the effect on patient-reported quality of life measures. Discussion: In vitro and in vivo studies have shown the neuroprotective effects of therapeutic hypothermia for cardiac arrest. We hypothesize that longer durations of cooling may improve either the proportion of patients that attain a good neurological recovery or may result in better recovery among the proportion already categorized as having a good outcome. If the treatment effect of cooling is increasing across duration, for at least some set of durations, then this provides evidence of the efficacy of cooling itself versus normothermia, even in the absence of a normothermia control arm, confirming previous RCTs for OHCA survivors of shockable rhythms and provides the first prospective controlled evidence of efficacy in those without initial shockable rhythms. Trial registration: ClinicalTrials.gov NCT04217551. Registered on 30 December 2019.
• Mosier, J. (2024). The Physiologically Difficult Airway and Management Considerations. Current Anesthesiology Reports, 14(3). doi:10.1007/s40140-024-00629-w
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  Purpose of Review: This paper evaluates the recent literature regarding the physiologically difficult airway. Recent Findings: Adverse events mainly desaturation, cardiovascular collapse, and cardiac arrest remain common complications. This risk is greatly increased in patients with altered physiology prior to intubation. Studies published over the last 5 years have explored many aspects surrounding the epidemiology, risks, and approach to managing the physiologically difficult airway. Summary: Important work has been done to identify directly modifiable risks of complications related to the physiologically difficult airway, but a large percentage of patients remain at high risk despite optimizing induction agents, preoxygenation, and first attempt success.
• Mosier, J., Subbian, V., Pungitore, S., Prabhudesai, D., Essay, P., Bedrick, E., Stocking, J., & Fisher, J. (2024). Noninvasive vs invasive respiratory support for patients with acute hypoxemic respiratory failure. PLoS ONE, 19(9). doi:10.1371/journal.pone.0307849
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  Background Noninvasive respiratory support modalities are common alternatives to mechanical ventilation in acute hypoxemic respiratory failure. However, studies historically compare noninvasive respiratory support to conventional oxygen rather than mechanical ventilation. In this study, we compared outcomes in patients with acute hypoxemic respiratory failure treated initially with noninvasive respiratory support to patients treated initially with invasive mechanical ventilation. Methods This is a retrospective observational cohort study between January 1, 2018 and December 31, 2019 at a large healthcare network in the United States. We used a validated phenotyping algorithm to classify adult patients (≥18 years) with eligible International Classification of Diseases codes into two cohorts: those treated initially with noninvasive respiratory support or those treated invasive mechanical ventilation only. The primary outcome was time-to-in-hospital death analyzed using an inverse probability of treatment weighted Cox model adjusted for potential confounders. Secondary outcomes included time-to-hospital discharge alive. A secondary analysis was conducted to examine potential differences between noninvasive positive pressure ventilation and nasal high flow. Results During the study period, 3177 patients met inclusion criteria (40% invasive mechanical ventilation, 60% noninvasive respiratory support). Initial noninvasive respiratory support was not associated with a decreased hazard of in-hospital death (HR: 0.65, 95% CI: 0.35–1.2), but was associated with an increased hazard of discharge alive (HR: 2.26, 95% CI: 1.92–2.67). In-hospital death varied between the nasal high flow (HR 3.27, 95% CI: 1.43–7.45) and noninvasive positive pressure ventilation (HR 0.52, 95% CI 0.25–1.07), but both were associated with increased likelihood of discharge alive (nasal high flow HR 2.12, 95 CI: 1.25–3.57; noninvasive positive pressure ventilation HR 2.29, 95% CI: 1.92–2.74). Conclusions These data show that noninvasive respiratory support is not associated with reduced hazards of in-hospital death but is associated with hospital discharge alive.
• Munroe, E., Prevalska, I., Hyer, M., Meurer, W., Mosier, J., Tidswell, M., Prescott, H., Wei, L., Wang, H., & Fung, C. (2024). High-Flow Nasal Cannula Versus Noninvasive Ventilation as Initial Treatment in Acute Hypoxia: A Propensity Score-Matched Study. Critical Care Explorations, 6(5). doi:10.1097/CCE.0000000000001092
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  IMPORTANCE: Patients presenting to the emergency department (ED) with hypoxemia often have mixed or uncertain causes of respiratory failure. The optimal treatment for such patients is unclear. Both high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) are used. OBJECTIVES: We sought to compare the effectiveness of initial treatment with HFNC versus NIV for acute hypoxemic respiratory failure. DESIGN, SETTING, AND PARTICIPANTS: We conducted a retrospective cohort study of patients with acute hypoxemic respiratory failure treated with HFNC or NIV within 24 hours of arrival to the University of Michigan adult ED from January 2018 to December 2022. We matched patients 1:1 using a propensity score for odds of receiving NIV. MAIN OUTCOMES AND MEASURES: The primary outcome was major adverse pulmonary events (28-d mortality, ventilator-free days, noninvasive respiratory support hours) calculated using a win ratio. RESULTS: A total of 1154 patients were included. Seven hundred twenty-six (62.9%) received HFNC and 428 (37.1%) received NIV. We propensity score matched 668 of 1154 (57.9%) patients. Patients on NIV versus HFNC had lower 28-day mortality (16.5% vs. 23.4%, p = 0.033) and required noninvasive treatment for fewer hours (median 7.5 vs. 13.5, p < 0.001), but had no difference in ventilator-free days (median [interquartile range]: 28 [26, 28] vs. 28 [10.5, 28], p = 0.199). Win ratio for composite major adverse pulmonary events favored NIV (1.38; 95% CI, 1.15-1.65; p < 0.001). CONCLUSIONS AND RELEVANCE: In this observational study of patients with acute hypoxemic respiratory failure, initial treatment with NIV compared with HFNC was associated with lower mortality and fewer composite major pulmonary adverse events calculated using a win ratio. These findings underscore the need for randomized controlled trials to further understand the impact of noninvasive respiratory support strategies.
• Pickkers, P., Angus, D., Bass, K., Bellomo, R., van den Berg, E., Bernholz, J., Bestle, M., Doi, K., Doig, C., Ferrer, R., Francois, B., Gammelager, H., Pedersen, U., Hoste, E., Iversen, S., Joannidis, M., Kellum, J., Liu, K., Meersch, M., , Mehta, R., et al. (2024). Correction: Phase-3 trial of recombinant human alkaline phosphatase for patients with sepsis-associated acute kidney injury (REVIVAL) (Intensive Care Medicine, (2024), 50, 1, (68-78), 10.1007/s00134-023-07271-w). Intensive Care Medicine, 50(4). doi:10.1007/s00134-024-07357-z
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  After the publication of the article, we have been informed that the name of a contributor in the list of REVIVAL investigators was given incomplete. He was given as “Patrick Honore” or “Honore P” but he should have been cited as “Patrick M. Honore” or “Honore PM”. Additionally, there are two mistakes in the contributors list: “ElisabethDiltoer” should read “Elisabeth Dewaele, Marc Diltoer” and “Craig French” should be also added. The original publication and the supplementary Excel file have been updated. The Authors apologize for these mistakes.
• Pickkers, P., Angus, D., Bass, K., Bellomo, R., van den Berg, E., Bernholz, J., Bestle, M., Doi, K., Doig, C., Ferrer, R., Francois, B., Gammelager, H., Pedersen, U., Hoste, E., Iversen, S., Joannidis, M., Kellum, J., Liu, K., Meersch, M., , Mehta, R., et al. (2024). Phase-3 trial of recombinant human alkaline phosphatase for patients with sepsis-associated acute kidney injury (REVIVAL). Intensive Care Medicine, 50(1). doi:10.1007/s00134-023-07271-w
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  Purpose: Ilofotase alfa is a human recombinant alkaline phosphatase with reno-protective effects that showed improved survival and reduced Major Adverse Kidney Events by 90 days (MAKE90) in sepsis-associated acute kidney injury (SA-AKI) patients. REVIVAL, was a phase-3 trial conducted to confirm its efficacy and safety. Methods: In this international double-blinded randomized-controlled trial, SA-AKI patients were enrolled < 72 h on vasopressor and < 24 h of AKI. The primary endpoint was 28-day all-cause mortality. The main secondary endpoint was MAKE90, other secondary endpoints were (i) days alive and free of organ support through day 28, (ii) days alive and out of the intensive care unit (ICU) through day 28, and (iii) time to death through day 90. Prior to unblinding, the statistical analysis plan was amended, including an updated MAKE90 definition. Results: Six hundred fifty patients were treated and analyzed for safety; and 649 for efficacy data (ilofotase alfa n = 330; placebo n = 319). The observed mortality rates in the ilofotase alfa and placebo groups were 27.9% and 27.9% at 28 days, and 33.9% and 34.8% at 90 days. The trial was stopped for futility on the primary endpoint. The observed proportion of patients with MAKE90A and MAKE90B were 56.7% and 37.4% in the ilofotase alfa group vs. 64.6% and 42.8% in the placebo group. Median [interquartile range (IQR)] days alive and free of organ support were 17 [0–24] and 14 [0–24], number of days alive and discharged from the ICU through day 28 were 15 [0–22] and 10 [0–22] in the ilofotase alfa and placebo groups, respectively. Adverse events were reported in 67.9% and 75% patients in the ilofotase and placebo group. Conclusion: Among critically ill patients with SA-AKI, ilofotase alfa did not improve day 28 survival. There may, however, be reduced MAKE90 events. No safety concerns were identified.
• Surie, D., Yuengling, K. A., DeCuir, J., Zhu, Y., Lauring, A. S., Gaglani, M., Ghamande, S., Peltan, I. D., Brown, S. M., Ginde, A. A., Martinez, A., Mohr, N. M., Gibbs, K. W., Hager, D. N., Ali, H., Prekker, M. E., Gong, M. N., Mohamed, A., Johnson, N. J., , Srinivasan, V., et al. (2024). Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults. JAMA Network Open, 7(4), e244954. doi:10.1001/jamanetworkopen.2024.4954
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  Importance: On June 21, 2023, the Centers for Disease Control and Prevention recommended the first respiratory syncytial virus (RSV) vaccines for adults aged 60 years and older using shared clinical decision-making. Understanding the severity of RSV disease in adults can help guide this clinical decision-making. Objective: To describe disease severity among adults hospitalized with RSV and compare it with the severity of COVID-19 and influenza disease by vaccination status. Design, Setting, and Participants: In this cohort study, adults aged 18 years and older admitted to the hospital with acute respiratory illness and laboratory-confirmed RSV, SARS-CoV-2, or influenza infection were prospectively enrolled from 25 hospitals in 20 US states from February 1, 2022, to May 31, 2023. Clinical data during each patient's hospitalization were collected using standardized forms. Data were analyzed from August to October 2023. Exposures: RSV, SARS-CoV-2, or influenza infection. Main Outcomes and Measures: Using multivariable logistic regression, severity of RSV disease was compared with COVID-19 and influenza severity, by COVID-19 and influenza vaccination status, for a range of clinical outcomes, including the composite of invasive mechanical ventilation (IMV) and in-hospital death. Results: Of 7998 adults (median [IQR] age, 67 [54-78] years; 4047 [50.6%] female) included, 484 (6.1%) were hospitalized with RSV, 6422 (80.3%) were hospitalized with COVID-19, and 1092 (13.7%) were hospitalized with influenza. Among patients with RSV, 58 (12.0%) experienced IMV or death, compared with 201 of 1422 unvaccinated patients with COVID-19 (14.1%) and 458 of 5000 vaccinated patients with COVID-19 (9.2%), as well as 72 of 699 unvaccinated patients with influenza (10.3%) and 20 of 393 vaccinated patients with influenza (5.1%). In adjusted analyses, the odds of IMV or in-hospital death were not significantly different among patients hospitalized with RSV and unvaccinated patients hospitalized with COVID-19 (adjusted odds ratio [aOR], 0.82; 95% CI, 0.59-1.13; P =.22) or influenza (aOR, 1.20; 95% CI, 0.82-1.76; P =.35); however, the odds of IMV or death were significantly higher among patients hospitalized with RSV compared with vaccinated patients hospitalized with COVID-19 (aOR, 1.38; 95% CI, 1.02-1.86; P =.03) or influenza disease (aOR, 2.81; 95% CI, 1.62-4.86; P
• Villarroel, L., Arabia, F., Tams, E., Hu, C., Smith, L., Dalton, H., Molitor, M., Chapital, A., Padiyar, J., Riley, R., & Mosier, J. (2024). Fair and Just Opportunity: Streamlining COVID-19 Extracorporeal Membrane Oxygenation Referrals on a Statewide Platform to Enhance Equity. Annals of the American Thoracic Society, 21(10). doi:10.1513/AnnalsATS.202310-907IP
• Zhang, T., Mosier, J., Campbell, E. S., & Subbian, V. (2024). To NIRS or not: understanding clinical decision-making of respiratory support management related to acute respiratory failure using Critical Decision Method. IISE Transactions on Healthcare Systems Engineering, 14(4), 1-12. doi:10.1080/24725579.2024.2335988
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  Clinical decisions related to noninvasive respiratory support (NIRS) for acute respiratory failure patients are complex. NIRS strategies have favorable benefits for patients when successful but NIRS failure comes with longer ICU stays, increased mortality, and more intubation-related and mechanical ventilator-associated complications. Our goal is to understand how physicians make decisions regarding NIRS and explore the differences between emergency physicians and critical care physicians—who commonly make these decisions. We used the critical decision method to conduct ten semi-structured interviews with five emergency physicians and five critical care physicians from ten different healthcare systems across the United States. We found that physicians similarly use objective and subjective clinical cues but differentially use temporal and contextual cues in their decision-making. Several insights identified in our study can be helpful in the design and development of clinical decision support systems for respiratory support decision-making. Specifically, we recommend two customized distinct clinical decision support systems for respiratory support decision-making, one for each designated clinical setting (i.e., ED and ICU) with tailored designs that support the different decision-making processes.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2023). Efficacy and adverse events profile of videolaryngoscopy in critically ill patients: subanalysis of the INTUBE study. British Journal of Anaesthesia, 131(3). doi:10.1016/j.bja.2023.04.022
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  Background: Tracheal intubation is a high-risk procedure in the critically ill, with increased intubation failure rates and a high risk of other adverse events. Videolaryngoscopy might improve intubation outcomes in this population, but evidence remains conflicting, and its impact on adverse event rates is debated. Methods: This is a subanalysis of a large international prospective cohort of critically ill patients (INTUBE Study) performed from 1 October 2018 to 31 July 2019 and involving 197 sites from 29 countries across five continents. Our primary aim was to determine the first-pass intubation success rates of videolaryngoscopy. Secondary aims were characterising (a) videolaryngoscopy use in the critically ill patient population and (b) the incidence of severe adverse effects compared with direct laryngoscopy. Results: Of 2916 patients, videolaryngoscopy was used in 500 patients (17.2%) and direct laryngoscopy in 2416 (82.8%). First-pass intubation success was higher with videolaryngoscopy compared with direct laryngoscopy (84% vs 79%, P=0.02). Patients undergoing videolaryngoscopy had a higher frequency of difficult airway predictors (60% vs 40%, P
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2023). Relationship of Heterologous Virus Responses and Outcomes in Hospitalized COVID-19 Patients. Journal of Immunology, 211(8). doi:10.4049/jimmunol.2300391
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  The clinical trajectory of COVID-19 may be influenced by previous responses to heterologous viruses. We examined the relationship of Abs against different viruses to clinical trajectory groups from the National Institutes of Health IMPACC (Immunophenotyping Assessment in a COVID-19 Cohort) study of hospitalized COVID-19 patients. Whereas initial Ab titers to SARS-CoV-2 tended to be higher with increasing severity (excluding fatal disease), those to seasonal coronaviruses trended in the opposite direction. Initial Ab titers to influenza and parainfluenza viruses also tended to be lower with increasing severity. However, no significant relationship was observed for Abs to other viruses, including measles, CMV, EBV, and respiratory syncytial virus. We hypothesize that some individuals may produce lower or less durable Ab responses to respiratory viruses generally (reflected in lower baseline titers in our study), and that this may carry over into poorer outcomes for COVID-19 (despite high initial SARS-CoV-2 titers). We further looked at longitudinal changes in Ab responses to heterologous viruses, but found little change during the course of acute COVID-19 infection. We saw significant trends with age for Ab levels to many of these viruses, but no difference in longitudinal SARS-CoV-2 titers for those with high versus low seasonal coronavirus titers. We detected no difference in longitudinal SARS-CoV-2 titers for CMV seropositive versus seronegative patients, although there was an overrepresentation of CMV seropositives among the IMPACC cohort, compared with expected frequencies in the United States population. Our results both reinforce findings from other studies and suggest (to our knowledge) new relationships between the response to SARS-CoV-2 and Abs to heterologous viruses.
• Acquisto, N. M., Mosier, J. M., Bittner, E. A., Patanwala, A. E., Hirsch, K. G., Hargwood, P., Oropello, J. M., Bodkin, R. P., Groth, C. M., Kaucher, K. A., Slampak-Cindric, A. A., Manno, E. M., Mayer, S. A., Peterson, L. N., Fulmer, J., Galton, C., Bleck, T. P., Chase, K., Heffner, A. C., , Gunnerson, K. J., et al. (2023). Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. Critical care medicine, 51(10), 1411-1430.
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  Controversies and practice variations exist related to the pharmacologic and nonpharmacologic management of the airway during rapid sequence intubation (RSI).
• Acquisto, N. M., Mosier, J. M., Bittner, E. A., Patanwala, A. E., Hirsch, K. G., Hargwood, P., Oropello, J. M., Bodkin, R. P., Groth, C. M., Kaucher, K. A., Slampak-Cindric, A. A., Manno, E. M., Mayer, S. A., Peterson, L. N., Fulmer, J., Galton, C., Bleck, T. P., Chase, K., Heffner, A. C., , Gunnerson, K. J., et al. (2023). Society of Critical Care Medicine Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient: Executive Summary. Critical care medicine, 51(10), 1407-1410.
• Anesi, G. L., Andrews, A., Bai, H. J., Bhatraju, P. K., Brett-Major, D. M., Broadhurst, M. J., Campbell, E. S., Cobb, J. P., Gonzalez, M., Homami, S., Hypes, C. D., Irwin, A., Kratochvil, C. J., Krolikowski, K., Kumar, V. K., Landsittel, D. P., Lee, R. A., Liebler, J. M., Lutrick, K., , Marts, L. T., et al. (2023). Perceived Hospital Stress, Severe Acute Respiratory Syndrome Coronavirus 2 Activity, and Care Process Temporal Variance During the COVID-19 Pandemic. Critical care medicine, 51(4), 445-459.
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  The COVID-19 pandemic threatened standard hospital operations. We sought to understand how this stress was perceived and manifested within individual hospitals and in relation to local viral activity.
• Brown, S. M., Barkauskas, C. E., Grund, B., Sharma, S., Phillips, A. N., Leither, L., Peltan, I. D., Lanspa, M., Gilstrap, D. L., Mourad, A., Lane, K., Beitler, J. R., Serra, A. L., Garcia, I., Almasri, E., Fayed, M., Hubel, K., Harris, E. S., Middleton, E. A., , Barrios, M. A., et al. (2023). Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial. The Lancet. Respiratory medicine, 11(9), 791-803.
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  There is a clinical need for therapeutics for COVID-19 patients with acute hypoxemic respiratory failure whose 60-day mortality remains at 30-50%. Aviptadil, a lung-protective neuropeptide, and remdesivir, a nucleotide prodrug of an adenosine analog, were compared with placebo among patients with COVID-19 acute hypoxaemic respiratory failure.
• Diray-Arce, J., Fourati, S., Doni Jayavelu, N., Patel, R., Maguire, C., Chang, A., Dandekar, R., Qi, J., Lee, B., van Zalm, P., Schroeder, A., Chen, E., Konstorum, A., Brito, A., Gygi, J., Kho, A., Chen, J., Pawar, S., Gonzalez-Reiche, A., , Hoch, A., et al. (2023). Multi-omic longitudinal study reveals immune correlates of clinical course among hospitalized COVID-19 patients. Cell Reports Medicine, 4(6). doi:10.1016/j.xcrm.2023.101079
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  The IMPACC cohort, composed of >1,000 hospitalized COVID-19 participants, contains five illness trajectory groups (TGs) during acute infection (first 28 days), ranging from milder (TG1–3) to more severe disease course (TG4) and death (TG5). Here, we report deep immunophenotyping, profiling of >15,000 longitudinal blood and nasal samples from 540 participants of the IMPACC cohort, using 14 distinct assays. These unbiased analyses identify cellular and molecular signatures present within 72 h of hospital admission that distinguish moderate from severe and fatal COVID-19 disease. Importantly, cellular and molecular states also distinguish participants with more severe disease that recover or stabilize within 28 days from those that progress to fatal outcomes (TG4 vs. TG5). Furthermore, our longitudinal design reveals that these biologic states display distinct temporal patterns associated with clinical outcomes. Characterizing host immune responses in relation to heterogeneity in disease course may inform clinical prognosis and opportunities for intervention.
• Essay, P., Mosier, J. M., Nayebi, A., Fisher, J. M., & Subbian, V. (2023). Predicting Failure of Noninvasive Respiratory Support Using Deep Recurrent Learning. Respiratory Care, 68(4). doi:https://doi.org/10.4187/respcare.10382
• Essay, P., Zhang, T., Mosier, J., & Subbian, V. (2023). Managed critical care: impact of remote decision-making on patient outcomes. The American journal of managed care, 29(7), e208-e214.
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  Tele-intensive care unit (tele-ICU) use has become increasingly common as an extension of bedside care for critically ill patients. The objective of this work was to illustrate the degree of tele-ICU involvement in critical care processes and evaluate the impact of tele-ICU decision-making authority.
• Hughes, K. E., Islam, M. T., Co, B., Lopido, M., McNinch, N. L., Biffar, D., Subbian, V., Son, Y. J., & Mosier, J. M. (2023). Comparison of Force During the Endotracheal Intubation of Commercial Simulation Manikins. Cureus, 15(8), e43808.
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  Background  Medical simulation allows clinicians to safely practice the procedural skill of endotracheal intubation. Applied force to oropharyngeal structures increases the risk of patient harm, and video laryngoscopy (VL) requires less force to obtain a glottic view. It is unknown how much force is required to obtain a glottic view using commercially available simulation manikins and if variability exists. This study compares laryngoscopy force for a modified Cormack-Lehane (CL) grade I view in both normal and difficult airway scenarios between three commercially available simulation manikins. Methods Experienced clinicians (≥2 years experience) were recruited to participate from critical care, emergency medicine, and anesthesia specialties. A C-MAC size 3 VL blade was equipped with five force resistor reading (FSR) sensors (four concave surfaces, one convex), measuring resistance (Ohms) in response to applied pressure (1-100 Newtons). The study occurred in a university simulation lab. Using a randomized sequence, 49 physicians performed intubations on three manikins (Laerdal SimMan 3GPlus, Gaumard Hal S3201, CAE Apollo) in normal and difficult airway scenarios. The outcomes were sensor mean pressure, peak force, and CL grade. Summary statistics were calculated. Generalized estimating equations (GEEs) conducted for both scenarios assessed changes in pressure measured in three manikins while accounting for correlated responses of individuals assigned in random order. Paired t-test assessed for the in-manikin difference between scenarios. STATA/BE v17 (R) was used for analysis; results interpreted at type I error alpha is 0.05.  Results Participants included 49 experienced clinicians. Mean years' experience was 4(±6.6); median prior intubations were 80 (IQR 50-400). Mean individual sensor pressure varied within scenarios depending on manikin (p
• Jergović, M., Watanabe, M., Bhat, R., Coplen, C. P., Sonar, S. A., Wong, R., Castaneda, Y., Davidson, L., Kala, M., Wilson, R. C., Twigg, H. L., Knox, K., Erickson, H. E., Weinkauf, C. C., Bime, C., Bixby, B. A., Parthasarathy, S., Mosier, J. M., LaFleur, B. J., , Bhattacharya, D., et al. (2023). T-cell cellular stress and reticulocyte signatures, but not loss of naïve T lymphocytes, characterize severe COVID-19 in older adults. GeroScience, 45(3), 1713-1728.
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  In children and younger adults up to 39 years of age, SARS-CoV-2 usually elicits mild symptoms that resemble the common cold. Disease severity increases with age starting at 30 and reaches astounding mortality rates that are ~330 fold higher in persons above 85 years of age compared to those 18-39 years old. To understand age-specific immune pathobiology of COVID-19, we have analyzed soluble mediators, cellular phenotypes, and transcriptome from over 80 COVID-19 patients of varying ages and disease severity, carefully controlling for age as a variable. We found that reticulocyte numbers and peripheral blood transcriptional signatures robustly correlated with disease severity. By contrast, decreased numbers and proportion of naïve T-cells, reported previously as a COVID-19 severity risk factor, were found to be general features of aging and not of COVID-19 severity, as they readily occurred in older participants experiencing only mild or no disease at all. Single-cell transcriptional signatures across age and severity groups showed that severe but not moderate/mild COVID-19 causes cell stress response in different T-cell populations, and some of that stress was unique to old severe participants, suggesting that in severe disease of older adults, these defenders of the organism may be disabled from performing immune protection. These findings shed new light on interactions between age and disease severity in COVID-19.
• Mosier, J. M. (2023). Individualized Treatment Effects: Machine Learning Can Revolutionize Observations, but Let's Understand What We Are Observing. American journal of respiratory and critical care medicine, 207(12), 1550-1551.
• Mosier, J. M., Sammani, S., Kempf, C., Unger, E., & Garcia, J. G. (2023). The impact of intravenous dodecafluoropentane on a murine model of acute lung injury. Intensive care medicine experimental, 11(1), 33.
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  Intravenous oxygen therapeutics present an appealing option for improving arterial oxygenation in patients with acute hypoxemic respiratory failure, while limiting iatrogenic injury from conventional respiratory management.
• Munroe, E. S., Prevalska, I., Hyer, M., Meurer, W. J., Mosier, J. M., Tidswell, M. A., Prescott, H. C., Wei, L., Wang, H., & Fung, C. M. (2023). High-flow nasal cannula vs non-invasive ventilation in acute hypoxia: Propensity score matched study. medRxiv : the preprint server for health sciences.
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  The optimal treatment for early hypoxemic respiratory failure is unclear, and both high-flow nasal cannula and non-invasive ventilation are used. Determining clinically relevant outcomes for evaluating non-invasive respiratory support modalities remains a challenge.
• Munroe, E., Prevalska, I., Meurer, W., Mosier, J., Tidswell, M., Prescott, H., Wang, H., & Fung, C. (2023). 1154: HIGH-FLOW VERSUS NONINVASIVE VENTILATION IN HYPOXIC RESPIRATORY FAILURE: A PROPENSITY-MATCHED STUDY. Critical Care Medicine, 52(1), S549-S549. doi:10.1097/01.ccm.0001002780.36567.0d
• Pungitore, S., Olorunnisola, T., Mosier, J., & Subbian, V. (2023). Computable Phenotypes for Post-acute sequelae of SARS-CoV-2: A National COVID Cohort Collaborative Analysis. AMIA ... Annual Symposium proceedings. AMIA Symposium, 2023(Issue).
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  Post-acute sequelae of SARS-CoV-2 (PASC) is an increasingly recognized yet incompletely understood public health concern. Several studies have examined various ways to phenotype PASC to better characterize this heterogeneous condition. However, many gaps in PASC phenotyping research exist, including a lack of the following: 1) standardized definitions for PASC based on symptomatology; 2) generalizable and reproducible phenotyping heuristics and meta-heuristics; and 3) phenotypes based on both COVID-19 severity and symptom duration. In this study, we defined computable phenotypes (or heuristics) and meta-heuristics for PASC phenotypes based on COVID-19 severity and symptom duration. We also developed a symptom profile for PASC based on a common data standard. We identified four phenotypes based on COVID-19 severity (mild vs. moderate/severe) and duration of PASC symptoms (subacute vs. chronic). The symptoms groups with the highest frequency among phenotypes were cardiovascular and neuropsychiatric with each phenotype characterized by a different set of symptoms.
• Stocking, J. C., Taylor, S. L., Fan, S., Wingert, T., Drake, C., Aldrich, J. M., Ong, M. K., Amin, A. N., Marmor, R. A., Godat, L., Cannesson, M., Gropper, M. A., Utter, G. H., Sandrock, C. E., Bime, C., Mosier, J., Subbian, V., Adams, J. Y., Kenyon, N. J., , Albertson, T. E., et al. (2023). A Least Absolute Shrinkage and Selection Operator-Derived Predictive Model for Postoperative Respiratory Failure in a Heterogeneous Adult Elective Surgery Patient Population. CHEST Critical Care, 1(Issue 3). doi:10.1016/j.chstcc.2023.100025
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  Background: Postoperative respiratory failure (PRF) is associated with increased hospital charges and worse patient outcomes. Reliable prediction models can help to guide postoperative planning to optimize care, to guide resource allocation, and to foster shared decision-making with patients. Research Question: Can a predictive model be developed to accurately identify patients at high risk of PRF? Study Design and Methods: In this single-site proof-of-concept study, we used structured query language to extract, transform, and load electronic health record data from 23,999 consecutive adult patients admitted for elective surgery (2014-2021). Our primary outcome was PRF, defined as mechanical ventilation after surgery of > 48 h. Predictors of interest included demographics, comorbidities, and intraoperative factors. We used logistic regression to build a predictive model and the least absolute shrinkage and selection operator procedure to select variables and to estimate model coefficients. We evaluated model performance using optimism-corrected area under the receiver operating curve and area under the precision-recall curve and calculated sensitivity, specificity, positive and negative predictive values, and Brier scores. Results: Two hundred twenty-five patients (0.94%) demonstrated PRF. The 18-variable predictive model included: operations on the cardiovascular, nervous, digestive, urinary, or musculoskeletal system; surgical specialty orthopedic (nonspine); Medicare or Medicaid (as the primary payer); race unknown; American Society of Anesthesiologists class ≥ III; BMI of 30 to 34.9 kg/m2; anesthesia duration (per hour); net fluid at end of the operation (per liter); median intraoperative FIO2, end title CO2, heart rate, and tidal volume; and intraoperative vasopressor medications. The optimism-corrected area under the receiver operating curve was 0.835 (95% CI, 0.808-0.862) and the area under the precision-recall curve was 0.156 (95% CI, 0.105-0.203). Interpretation: This single-center proof-of-concept study demonstrated that a structured query language extract, transform, and load process, based on readily available patient and intraoperative variables, can be used to develop a prediction model for PRF. This PRF prediction model is scalable for multicenter research. Clinical applications include decision support to guide postoperative level of care admission and treatment decisions.
• Subbian, V., Fisher, J. M., Nayebi, A., Mosier, J. M., & Essay, P. (2022). Predicting Failure of Noninvasive Respiratory Support Using Deep Recurrent Learning. Respiratory Care, 68(3). doi:https://doi.org/10.4187/respcare.10382
• Thaweethai, T., Jolley, S. E., Karlson, E. W., Levitan, E. B., Levy, B., McComsey, G. A., McCorkell, L., Nadkarni, G. N., Parthasarathy, S., Singh, U., Walker, T. A., Selvaggi, C. A., Shinnick, D. J., Schulte, C. C., Atchley-Challenner, R., Alba, G. A., Alicic, R., Altman, N., Anglin, K., , Argueta, U., et al. (2023). Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection. JAMA, 329(22), 1934-1946.
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  SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2022). Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. Critical Care Medicine, 50(10). doi:10.1097/CCM.0000000000005627
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  OBJECTIVES: To determine the association of prior use of renin-angiotensin-aldosterone system inhibitors (RAASIs) with mortality and outcomes in hospitalized patients with COVID-19. DESIGN: Retrospective observational study. SETTING: Multicenter, international COVID-19 registry. SUBJECTS: Adult hospitalized COVID-19 patients on antihypertensive agents (AHAs) prior to admission, admitted from March 31, 2020, to March 10, 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were compared between three groups: patients on RAASIs only, other AHAs only, and those on both medications. Multivariable logistic and linear regressions were performed after controlling for prehospitalization characteristics to estimate the effect of RAASIs on mortality and other outcomes during hospitalization. Of 26,652 patients, 7,975 patients were on AHAs prior to hospitalization. Of these, 1,542 patients (19.3%) were on RAASIs only, 3,765 patients (47.2%) were on other AHAs only, and 2,668 (33.5%) patients were on both medications. Compared with those taking other AHAs only, patients on RAASIs only were younger (mean age 63.3 vs 66.9 yr; p < 0.0001), more often male (58.2% vs 52.4%; p = 0.0001) and more often White (55.1% vs 47.2%; p < 0.0001). After adjusting for age, gender, race, location, and comorbidities, patients on combination of RAASIs and other AHAs had higher in-hospital mortality than those on RAASIs only (odds ratio [OR] = 1.28; 95% CI [1.19-1.38]; p < 0.0001) and higher mortality than those on other AHAs only (OR = 1.09; 95% CI [1.03-1.15]; p = 0.0017). Patients on RAASIs only had lower mortality than those on other AHAs only (OR = 0.87; 95% CI [0.81-0.94]; p = 0.0003). Patients on ACEIs only had higher mortality compared with those on ARBs only (OR = 1.37; 95% CI [1.20-1.56]; p < 0.0001). CONCLUSIONS: Among patients hospitalized for COVID-19 who were taking AHAs, prior use of a combination of RAASIs and other AHAs was associated with higher in-hospital mortality than the use of RAASIs alone. When compared with ARBs, ACEIs were associated with signifcantly higher mortality in hospitalized COVID-19 patients.
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2022). Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19: A Randomized Controlled Trial. Annals of Internal Medicine, 175(9), 1266-1274. doi:10.7326/m22-1503
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2022). Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial. The Lancet Infectious Diseases, 22(5). doi:10.1016/S1473-3099(21)00751-9
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  Background: We aimed to assess the efficacy and safety of two neutralising monoclonal antibody therapies (sotrovimab [Vir Biotechnology and GlaxoSmithKline] and BRII-196 plus BRII-198 [Brii Biosciences]) for adults admitted to hospital for COVID-19 (hereafter referred to as hospitalised) with COVID-19. Methods: In this multinational, double-blind, randomised, placebo-controlled, clinical trial (Therapeutics for Inpatients with COVID-19 [TICO]), adults (aged ≥18 years) hospitalised with COVID-19 at 43 hospitals in the USA, Denmark, Switzerland, and Poland were recruited. Patients were eligible if they had laboratory-confirmed SARS-CoV-2 infection and COVID-19 symptoms for up to 12 days. Using a web-based application, participants were randomly assigned (2:1:2:1), stratified by trial site pharmacy, to sotrovimab 500 mg, matching placebo for sotrovimab, BRII-196 1000 mg plus BRII-198 1000 mg, or matching placebo for BRII-196 plus BRII-198, in addition to standard of care. Each study product was administered as a single dose given intravenously over 60 min. The concurrent placebo groups were pooled for analyses. The primary outcome was time to sustained clinical recovery, defined as discharge from the hospital to home and remaining at home for 14 consecutive days, up to day 90 after randomisation. Interim futility analyses were based on two seven-category ordinal outcome scales on day 5 that measured pulmonary status and extrapulmonary complications of COVID-19. The safety outcome was a composite of death, serious adverse events, incident organ failure, and serious coinfection up to day 90 after randomisation. Efficacy and safety outcomes were assessed in the modified intention-to-treat population, defined as all patients randomly assigned to treatment who started the study infusion. This study is registered with ClinicalTrials.gov, NCT04501978. Findings: Between Dec 16, 2020, and March 1, 2021, 546 patients were enrolled and randomly assigned to sotrovimab (n=184), BRII-196 plus BRII-198 (n=183), or placebo (n=179), of whom 536 received part or all of their assigned study drug (sotrovimab n=182, BRII-196 plus BRII-198 n=176, or placebo n=178; median age of 60 years [IQR 50–72], 228 [43%] patients were female and 308 [57%] were male). At this point, enrolment was halted on the basis of the interim futility analysis. At day 5, neither the sotrovimab group nor the BRII-196 plus BRII-198 group had significantly higher odds of more favourable outcomes than the placebo group on either the pulmonary scale (adjusted odds ratio sotrovimab 1·07 [95% CI 0·74–1·56]; BRII-196 plus BRII-198 0·98 [95% CI 0·67–1·43]) or the pulmonary-plus complications scale (sotrovimab 1·08 [0·74–1·58]; BRII-196 plus BRII-198 1·00 [0·68–1·46]). By day 90, sustained clinical recovery was seen in 151 (85%) patients in the placebo group compared with 160 (88%) in the sotrovimab group (adjusted rate ratio 1·12 [95% CI 0·91–1·37]) and 155 (88%) in the BRII-196 plus BRII-198 group (1·08 [0·88–1·32]). The composite safety outcome up to day 90 was met by 48 (27%) patients in the placebo group, 42 (23%) in the sotrovimab group, and 45 (26%) in the BRII-196 plus BRII-198 group. 13 (7%) patients in the placebo group, 14 (8%) in the sotrovimab group, and 15 (9%) in the BRII-196 plus BRII-198 group died up to day 90. Interpretation: Neither sotrovimab nor BRII-196 plus BRII-198 showed efficacy for improving clinical outcomes among adults hospitalised with COVID-19. Funding: US National Institutes of Health and Operation Warp Speed
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , , ., et al. (2022). Phenotypes of disease severity in a cohort of hospitalized COVID-19 patients: Results from the IMPACC study. eBioMedicine, 83(Issue). doi:10.1016/j.ebiom.2022.104208
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  Background: Better understanding of the association between characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19) and outcome is needed to further improve upon patient management. Methods: Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) is a prospective, observational study of 1164 patients from 20 hospitals across the United States. Disease severity was assessed using a 7-point ordinal scale based on degree of respiratory illness. Patients were prospectively surveyed for 1 year after discharge for post-acute sequalae of COVID-19 (PASC) through quarterly surveys. Demographics, comorbidities, radiographic findings, clinical laboratory values, SARS-CoV-2 PCR and serology were captured over a 28-day period. Multivariable logistic regression was performed. Findings: The median age was 59 years (interquartile range [IQR] 20); 711 (61%) were men; overall mortality was 14%, and 228 (20%) required invasive mechanical ventilation. Unsupervised clustering of ordinal score over time revealed distinct disease course trajectories. Risk factors associated with prolonged hospitalization or death by day 28 included age ≥ 65 years (odds ratio [OR], 2.01; 95% CI 1.28–3.17), Hispanic ethnicity (OR, 1.71; 95% CI 1.13–2.57), elevated baseline creatinine (OR 2.80; 95% CI 1.63– 4.80) or troponin (OR 1.89; 95% 1.03–3.47), baseline lymphopenia (OR 2.19; 95% CI 1.61–2.97), presence of infiltrate by chest imaging (OR 3.16; 95% CI 1.96–5.10), and high SARS-CoV2 viral load (OR 1.53; 95% CI 1.17–2.00). Fatal cases had the lowest ratio of SARS-CoV-2 antibody to viral load levels compared to other trajectories over time (p=0.001). 589 survivors (51%) completed at least one survey at follow-up with 305 (52%) having at least one symptom consistent with PASC, most commonly dyspnea (56% among symptomatic patients). Female sex was the only associated risk factor for PASC. Interpretation: Integration of PCR cycle threshold, and antibody values with demographics, comorbidities, and laboratory/radiographic findings identified risk factors for 28-day outcome severity, though only female sex was associated with PASC. Longitudinal clinical phenotyping offers important insights, and provides a framework for immunophenotyping for acute and long COVID-19. Funding: NIH.
• Baker, P., Behringer, E., Feinleib, J., Foley, L., Mosier, J., Roth, P., Wali, A., & O'Sullivan, E. (2022). Formation of an Airway Lead Network: an essential patient safety initiative. British Journal of Anaesthesia, 128(2). doi:10.1016/j.bja.2021.11.013
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  We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway management are published and revised regularly, uniform implementation of such guidelines are applied sporadically throughout the hospital and prehospital settings. The primary roles of an Airway Lead are to ensure supply, quality and storage of airway equipment, promote the use of current practice guidelines as well as the organisation of training and audits. Locally, the Airway Lead may chair a multi-disciplinary airway committee within their organisation; an Airway Lead Network enables Airway Leads to share common problems and solutions to promote optimal airway management on a national level. Support from governing bodies is an essential part of this structure.
• Bjornstad, E. C., Cutter, G., Guru, P., Menon, S., Aldana, I., House, S., M Tofil, N., St Hill, C. A., Tarabichi, Y., Banner-Goodspeed, V. M., Christie, A. B., Mohan, S. K., Sanghavi, D., Mosier, J. M., Vadgaonkar, G., Walkey, A. J., Kashyap, R., Kumar, V. K., Bansal, V., , Boman, K., et al. (2022). SARS-CoV-2 infection increases risk of acute kidney injury in a bimodal age distribution. BMC nephrology, 23(1), 63.
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  Hospitalized patients with SARS-CoV2 develop acute kidney injury (AKI) frequently, yet gaps remain in understanding why adults seem to have higher rates compared to children. Our objectives were to evaluate the epidemiology of SARS-CoV2-related AKI across the age spectrum and determine if known risk factors such as illness severity contribute to its pattern.
• Bohula, E. A., Berg, D. D., Lopes, M. S., Connors, J. M., Babar, I., Barnett, C. F., Chaudhry, S. P., Chopra, A., Ginete, W., Ieong, M. H., Katz, J. N., Kim, E. Y., Kuder, J. F., Mazza, E., McLean, D., Mosier, J. M., Moskowitz, A., Murphy, S. A., O'Donoghue, M. L., , Park, J. G., et al. (2022). Anticoagulation and Antiplatelet Therapy for Prevention of Venous and Arterial Thrombotic Events in Critically Ill Patients With COVID-19: COVID-PACT. Circulation, 146(18), 1344-1356.
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  The efficacy and safety of prophylactic full-dose anticoagulation and antiplatelet therapy in critically ill COVID-19 patients remain uncertain.
• Essay, P., Fisher, J. M., Mosier, J. M., & Subbian, V. (2022). Validation of an Electronic Phenotyping Algorithm for Patients With Acute Respiratory Failure. Critical care explorations, 4(3), e0645.
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  Acute respiratory failure is a common reason for ICU admission and imposes significant strain on patients and the healthcare system. Noninvasive positive-pressure ventilation and high-flow nasal oxygen are increasingly used as an alternative to invasive mechanical ventilation to treat acute respiratory failure. As such, there is a need to accurately cohort patients using large, routinely collected, clinical data to better understand utilization patterns and patient outcomes. The primary objective of this retrospective observational study was to externally validate our computable phenotyping algorithm for patients with acute respiratory failure requiring various sequences of respiratory support in real-world data from a large healthcare delivery network.
• Essay, P., Fisher, J. M., Mosier, J. M., & Subbian, V. (2022). Validation of an Electronic Phenotyping Algorithm for Patients with Acute Respiratory Failure. Critical Care Explorations.
• Essay, P., Mosier, J. M., Nayebi, A., Fisher, J. M., & Subbian, V. (2022). Predicting Failure of Noninvasive Respiratory Support Using Deep Recurrent Learning. Respiratory care.
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  Noninvasive respiratory support is increasingly used to support patients with acute respiratory failure. However, noninvasive support failure may worsen outcomes compared to primary support with invasive mechanical ventilation. Therefore, there is a need to identify patients where noninvasive respiratory support is failing so that treatment can be reassessed and adjusted. The objective of this study was to develop and evaluate three recurrent neural network models to predict noninvasive respiratory support failure.
• Fisher, J. M., Subbian, V., Essay, P., Pungitore, S., Bedrick, E. J., & Mosier, J. M. (2022). Outcomes in Patients with Acute Hypoxemic Respiratory Failure Secondary to COVID-19 Treated with Noninvasive Respiratory Support versus Invasive Mechanical Ventilation. medRxiv : the preprint server for health sciences.
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  The goal of this study was to compare noninvasive respiratory support to invasive mechanical ventilation as the initial respiratory support in COVID-19 patients with acute hypoxemic respiratory failure.
• Jergović, M., Watanabe, M., Bhat, R., Coplen, C. P., Sonar, S. A., Wong, R., Castaneda, Y., Davidson, L., Kala, M., Wilson, R. C., Twigg, H. L., Knox, K., Erickson, H. E., Weinkauf, C. C., Bime, C., Bixby, B. A., Parthasarathy, S., Mosier, J. M., LaFleur, B. J., , Bhattacharya, D., et al. (2022). T-cell cellular stress and reticulocyte signatures, but not loss of naïve T lymphocytes, characterize severe COVID-19 in older adults. bioRxiv : the preprint server for biology.
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  In children and younger adults up to 39 years of age, SARS-CoV-2 usually elicits mild symptoms that resemble the common cold. Disease severity increases with age starting at 30 and reaches astounding mortality rates that are ~330 fold higher in persons above 85 years of age compared to those 18-39 years old. To understand age-specific immune pathobiology of COVID-19 we have analyzed soluble mediators, cellular phenotypes, and transcriptome from over 80 COVID-19 patients of varying ages and disease severity, carefully controlling for age as a variable. We found that reticulocyte numbers and peripheral blood transcriptional signatures robustly correlated with disease severity. By contrast, decreased numbers and proportion of naïve T-cells, reported previously as a COVID-19 severity risk factor, were found to be general features of aging and not of COVID-19 severity, as they readily occurred in older participants experiencing only mild or no disease at all. Single-cell transcriptional signatures across age and severity groups showed that severe but not moderate/mild COVID-19 causes cell stress response in different T-cell populations, and some of that stress was unique to old severe participants, suggesting that in severe disease of older adults, these defenders of the organism may be disabled from performing immune protection. These findings shed new light on interactions between age and disease severity in COVID-19.
• Kazui, T., Hsu, C. H., Lick, S. D., Hypes, C. D., Natt, B., Malo, J., Mosier, J. M., & Bull, D. A. (2022). Outcomes of Venovenous Extracorporeal Membrane Oxygenation in Viral Acute Respiratory Distress Syndrome. ASAIO journal (American Society for Artificial Internal Organs : 1992), 68(11), 1399-1406.
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  Our study assessed the relationship between the duration of venovenous extracorporeal membrane oxygenation (V-V ECMO) and patient outcomes. We studied patients undergoing V-V ECMO support for acute respiratory distress syndrome (ARDS) between 2009 and 2017 who were reported to the Extracorporeal Life Support Organization registry. We evaluated survival, major bleeding, renal failure, pulmonary complications, mechanical complications, neurologic complications, infection, and duration of V-V ECMO support. Multivariable regression modeling assessed risk factors for adverse events. Of the 4,636 patients studied, the mean support duration was 12.2 ± 13.7 days. There was a progressive increase in survival after the initiation of V-VECMO, peaking at a survival rate of 73% at 10 days of support. However, a single-day increase in V-V ECMO duration was associated with increased bleeding events (odds ratio [OR] 1.038; 95% confidence interval [CI]: 1.029-1.047; p < 0.0001), renal failure (OR 1.018; 95% CI: 1.010-1.027; p < 0.0001), mechanical complications (OR 1.065; 95% CI: 1.053-1.076; p < 0.0001), pulmonary complications (OR 1.04; 95% CI: 1.03-1.05; p < 0.0001), and infection (OR 1.04; 95% CI: 1.03-1.05; p < 0.0001). V-V ECMO progressively increases survival for ARDS over the first 10 days of support. Thereafter, rising complications associated with prolonged durations of support result in a progressive decline in survival.
• Subbian, V., Fisher, J. M., Nodoushan, A., Mosier, J. M., & Essay, P. (2022). Predicting Failure of Noninvasive Respiratory Support Using Deep Recurrent Learning. Respiratory Care.
• Valley, T. S., Schutz, A., Peltan, I. D., Vranas, K. C., Mathews, K. S., Jolley, S. E., Palakshappa, J. A., Hough, C. L., Steingrub, J. S., Tidswell, M. A., Kozikowski, L. A., Kardos, C., DeSouza, L., Baron, R. M., Pinilla-Vera, M., Rubins, D. M., Arciniegas, A., Riker, R., Lord, C., , Elie, M. C., et al. (2022). Organization of Outpatient Care After COVID-19 Hospitalization. Chest, 161(Issue 6). doi:10.1016/j.chest.2022.01.034
• , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., , ., Tripathi, S., Christison, A., Levy, E., McGravery, J., , Tekin, A., et al. (2021). The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19. Hospital Pediatrics, 11(11). doi:10.1542/hpeds.2021-006087
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  OBJECTIVE: To describe the impact of obesity on disease severity and outcomes of coronavirus disease 2019 (COVID-19) among hospitalized children. METHODS: This retrospective cohort study from the Society of Critical Care Medicine Viral Respiratory Illness Universal Study registry included all children hospitalized with COVID-19 from March 2020 to January 2021. Obesity was defined by Centers for Disease Control and Prevention BMI or World Health Organization weight for length criteria. Critical illness definition was adapted from National Institutes of Health criteria of critical COVID. Multivariate mixed logistic and linear regression was performed to calculate the adjusted odds ratio of critical illness and the adjusted impact of obesity on hospital length of stay. RESULTS: Data from 795 patients (96.4% United States) from 45 sites were analyzed, including 251 (31.5%) with obesity and 544 (68.5%) without. A higher proportion of patients with obesity were adolescents, of Hispanic ethnicity, and had other comorbidities. Those with obesity were also more likely to be diagnosed with multisystem inflammatory syndrome in children (35.7% vs 28.1%, P = .04) and had higher ICU admission rates (57% vs 44%, P < .01) with more critical illness (30.3% vs 18.3%, P < .01). Obesity had more impact on acute COVID-19 severity than on multisystem inflammatory syndrome in children presentation. The adjusted odds ratio for critical illness with obesity was 3.11 (95% confidence interval: 1.8–5.3). Patients with obesity had longer adjusted length of stay (exponentiated parameter estimate 1.3; 95% confidence interval: 1.1–1.5) compared with patients without obesity but did not have increased mortality risk due to COVID-19 (2.4% vs 1.5%, P = .38). CONCLUSION: In a large, multicenter cohort, a high proportion of hospitalized children from COVID-19 had obesity as comorbidity. Furthermore, obesity had a significant independent association with critical illness.
• Abraham, L., Alonso, J. L., Amsbaugh, A. L., Bansal, V., Becker, T., Bienstock, K., Bime, C., Cartin-ceba, R., Checkley, W., Desai, M., Elie, M., Erickson, H., Festic, E., Fogelson, L. A., Frank, E., Fung, J. Y., Gajic, O., Gentile, N. T., Gilstrap, D., , Halilovic, A., et al. (2021). The ARREST Pneumonia Clinical Trial. Rationale and Design.. Annals of the American Thoracic Society, 18(4), 698-708. doi:10.1513/annalsats.202009-1115sd
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  Patients hospitalized for pneumonia are at high risk for mortality. Effective therapies are therefore needed. Recent randomized clinical trials suggest that systemic steroids can reduce the length of hospital stays among patients hospitalized for pneumonia. Furthermore, preliminary findings from a feasibility study demonstrated that early treatment with a combination of an inhaled corticosteroid and a bronchodilator can improve oxygenation and reduce risk of respiratory failure in patients at risk of acute respiratory distress syndrome. Whether such a combination administered early is effective in reducing acute respiratory failure (ARF) among patients hospitalized with pneumonia is unknown. Here we describe the ARREST Pneumonia (Arrest Respiratory Failure due to Pneumonia) trial designed to address this question. ARREST Pneumonia is a two-arm, randomized, double-blinded, placebo-controlled trial designed to test the efficacy of a combination of an inhaled corticosteroid and a β-agonist compared with placebo for the prevention of ARF in hospitalized participants with severe pneumonia. The primary outcome is ARF within 7 days of randomization, defined as a composite endpoint of intubation and mechanical ventilation; need for high-flow nasal cannula oxygen therapy or noninvasive ventilation for >36 hours (each alone or combined); or death within 36 hours of being placed on respiratory support. The planned enrollment is 600 adult participants at 10 academic medical centers. In addition, we will measure selected plasma biomarkers to better understand mechanisms of action. The trial is funded by the U.S. National Heart Lung and Blood Institute.Clinical trial registered with www.clinicaltrials.gov (NCT04193878).
• Amer, M., Kamel, A. M., Bawazeer, M., Maghrabi, K., Butt, A., Dahhan, T., Kseibi, E., Khurshid, S. M., Abujazar, M., Alghunaim, R., Rabee, M., Abualkhair, M., Al-Janoubi, A., AlFirm, A. T., Gajic, O., Walkey, A. J., Mosier, J. M., Zabolotskikh, I. B., Gavidia, O. Y., , Teruel, S. Y., et al. (2021). Clinical characteristics and outcomes of critically ill mechanically ventilated COVID-19 patients receiving interleukin-6 receptor antagonists and corticosteroid therapy: a preliminary report from a multinational registry. European journal of medical research, 26(1), 117.
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  Interleukin-6 receptor antagonists (IL-6RAs) and steroids are emerging immunomodulatory therapies for severe and critical coronavirus disease (COVID-19). In this preliminary report, we aim to describe the epidemiology, clinical characteristics, and outcomes of adult critically ill COVID-19 patients, requiring invasive mechanical ventilation (iMV), and receiving IL-6RA and steroids therapy over the last 11 months.
• Baker, P. A., Behringer, E. C., Feinleib, J., Foley, L. J., Mosier, J., Roth, P., Wali, A., & O'Sullivan, E. P. (2021). Formation of an Airway Lead Network: an essential patient safety initiative. British journal of anaesthesia.
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  We outline the history, implementation and clinical impact of the formation of an Airway Lead Network. Although recommendations to improve patient safety in airway management are published and revised regularly, uniform implementation of such guidelines are applied sporadically throughout the hospital and prehospital settings. The primary roles of an Airway Lead are to ensure supply, quality and storage of airway equipment, promote the use of current practice guidelines as well as the organisation of training and audits. Locally, the Airway Lead may chair a multi-disciplinary airway committee within their organisation; an Airway Lead Network enables Airway Leads to share common problems and solutions to promote optimal airway management on a national level. Support from governing bodies is an essential part of this structure.
• Borg, B. A., & Mosier, J. M. (2021). Mode of Arrival to the Emergency Department and Outcomes in Nontraumatic Critically Ill Adults. Critical care explorations, 3(3), e0350.
• Cairns, C. B., Lutrick, K., Campbell, B., Bedrick, E. J., Hypes, C., Fisher, J. M., & Mosier, J. M. (2020). A Target for Increased Mortality Risk in Critically Ill Patients: The Concept of Perpetuity. Journal of the Intensive Care Society.
• Cairns, C. B., Lutrick, K., Campbell, E. S., Bedrick, E. J., Hypes, C., Fisher, J. M., & Mosier, J. M. (2021). A Target for Increased Mortality Risk in Critically Ill Patients: The Concept of Perpetuity. Journal of Clinical Medicine.
• Donovan, F. M., Ramadan, F. A., Khan, S. A., Bhaskara, A., Lainhart, W. D., Narang, A. T., Mosier, J. M., Ellingson, K. D., Bedrick, E. J., Saubolle, M. A., & Galgiani, J. N. (2021). Comparison of a Novel Rapid Lateral Flow Assay to Enzyme Immunoassay Results for Early Diagnosis of Coccidioidomycosis. Clinical Infectious Diseases, 73(Issue 9). doi:10.1093/cid/ciaa1205
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  Background: Coccidioidomycosis (CM) is a common cause of community-acquired pneumonia where CM is endemic. Manifestations include self-limited pulmonary infection, chronic fibrocavitary pulmonary disease, and disseminated coccidioidomycosis. Most infections are identified by serological assays including enzyme-linked immunoassay (EIA), complement fixation, and immunodiffusion. These are time-consuming and take days to result, impeding early diagnosis. A new lateral flow assay (LFA; Sōna; IMMY, Norman, OK) improves time-to-result to 1 hour. Methods: We prospectively enrolled 392 patients with suspected CM, compared the LFA with standard EIA and included procalcitonin evaluation. Results: Compared with standard EIA, LFA demonstrates 31% sensitivity (95% confidence interval [CI], 20-44%) and 92% specificity (95% CI, 88-95%). Acute pulmonary disease (74%) was the most common clinical syndrome. Hospitalized patients constituted 75% of subjects, and compared with outpatients, they more frequently had ≥3 previous healthcare facility visits (P=.05), received antibacterials (P3 antibacterial courses (P
• Essay, P., Mosier, J., & Subbian, V. (2021). Phenotyping COVID-19 Patients by Ventilation Therapy: Data Quality Challenges and Cohort Characterization. Studies in health technology and informatics, 281, 198-202.
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  The COVID-19 pandemic introduced unique challenges for treating acute respiratory failure patients and highlighted the need for reliable phenotyping of patients using retrospective electronic health record data. In this study, we applied a rule-based phenotyping algorithm to classify COVID-19 patients requiring ventilatory support. We analyzed patient outcomes of the different phenotypes based on type and sequence of ventilation therapy. Invasive mechanical ventilation, noninvasive positive pressure ventilation, and high flow nasal insufflation were three therapies used to phenotype patients leading to a total of seven subgroups; patients treated with a single therapy (3), patients treated with either form of noninvasive ventilation and subsequently requiring intubation (2), and patients initially intubated and then weaned onto a noninvasive therapy (2). In addition to summary statistics for each phenotype, we highlight data quality challenges and importance of mapping to standard terminologies. This work illustrates potential impact of accurate phenotyping on patient-level and system-level outcomes including appropriate resource allocation under resource constrained circumstances.
• Harris, D. T., Badowski, M., Jernigan, B., Sprissler, R., Edwards, T., Cohen, R., Paul, S., Merchant, N., Weinkauf, C. C., Bime, C., Erickson, H. E., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., El Aini, T., Rischard, F., Campion, J., , Chopra, M., et al. (2021). SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus. Biomedicines, 9(5).
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  SARS-CoV-2, the cause of COVID19, has caused a pandemic that has infected more than 80 M and killed more than 1.6 M persons worldwide. In the US as of December 2020, it has infected more than 32 M people while causing more than 570,000 deaths. As the pandemic persists, there has been a public demand to reopen schools and university campuses. To consider these demands, it is necessary to rapidly identify those individuals infected with the virus and isolate them so that disease transmission can be stopped. In the present study, we examined the sensitivity of the Quidel Rapid Antigen test for use in screening both symptomatic and asymptomatic individuals at the University of Arizona from June to August 2020. A total of 885 symptomatic and 1551 asymptomatic subjects were assessed by antigen testing and real-time PCR testing. The sensitivity of the test for both symptomatic and asymptomatic persons was between 82 and 90%, with some caveats.
• Kirkup, C., Pawlowski, C., Puranik, A., Conrad, I., O'Horo, J. C., Gomaa, D., Banner-Goodspeed, V. M., Mosier, J. M., Zabolotskikh, I. B., Daugherty, S. K., Bernstein, M. A., Zaren, H. A., Bansal, V., Pickering, B., Badley, A. D., Kashyap, R., Venkatakrishnan, A. J., & Soundararajan, V. (2021). Healthcare disparities among anticoagulation therapies for severe COVID-19 patients in the multi-site VIRUS registry. Journal of medical virology, 93(7), 4303-4318.
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  Here we analyze hospitalized andintensive care unit coronavirus disease 2019 (COVID-19) patient outcomes from the international VIRUS registry (https://clinicaltrials.gov/ct2/show/NCT04323787). We find that COVID-19 patients administered unfractionated heparin but not enoxaparin have a higher mortality-rate (390 of 1012 = 39%) compared to patients administered enoxaparin but not unfractionated heparin (270 of 1939 = 14%), presenting a risk ratio of 2.79 (95% confidence interval [CI]: [2.42, 3.16]; p = 4.45e-52). This difference persists even after balancing on a number of covariates including demographics, comorbidities, admission diagnoses, and method of oxygenation, with an increased mortality rate on discharge from the hospital of 37% (268 of 733) for unfractionated heparin versus 22% (154 of 711) for enoxaparin, presenting a risk ratio of 1.69 (95% CI: [1.42, 2.00]; p = 1.5e-8). In these balanced cohorts, a number of complications occurred at an elevated rate for patients administered unfractionated heparin compared to patients administered enoxaparin, including acute kidney injury, acute cardiac injury, septic shock, and anemia. Furthermore, a higher percentage of Black/African American COVID patients (414 of 1294 [32%]) were noted to receive unfractionated heparin compared to White/Caucasian COVID patients (671 of 2644 [25%]), risk ratio 1.26 (95% CI: [1.14, 1.40]; p = 7.5e-5). After balancing upon available clinical covariates, this difference in anticoagulant use remained statistically significant (311 of 1047 [30%] for Black/African American vs. 263 of 1047 [25%] for White/Caucasian, p = .02, risk ratio 1.18; 95% CI: [1.03, 1.36]). While retrospective studies cannot suggest any causality, these findings motivate the need for follow-up prospective research into the observed racial disparity in anticoagulant use and outcomes for severe COVID-19 patients.
• Kornas, R. L., Owyang, C. G., Sakles, J. C., Foley, L. J., & Mosier, J. M. (2021). In Response. Anesthesia and analgesia, 133(1), e12.
• Kornas, R. L., Owyang, C. G., Sakles, J. C., Foley, L. J., Mosier, J. M., & , S. f. (2021). Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesthesia and analgesia, 132(2), 395-405.
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  Multiple international airway societies have created guidelines for the management of the difficult airway. In critically ill patients, there are physiologic derangements beyond inadequate airway protection or hypoxemia. These risk factors contribute to the "physiologically difficult airway" and are associated with complications including cardiac arrest and death. Importantly, they are largely absent from international guidelines. Thus, we created management recommendations for the physiologically difficult airway to provide practical guidance for intubation in the critically ill. Through multiple rounds of in-person and telephone conferences, a multidisciplinary working group of 12 airway specialists (Society for Airway Management's Special Projects Committee) over a time period of 3 years (2016-2019) reviewed airway physiology topics in a modified Delphi fashion. Consensus agreement with the following recommendations among working group members was generally high with 80% of statements showing agreement within a 10% range on a sliding scale from 0% to 100%. We limited the scope of this analysis to reflect the resources and systems of care available to out-of-operating room adult airway providers. These recommendations reflect the practical application of physiologic principles to airway management available during the analysis time period.
• Mosier, J. M., Fisher, J. M., Hypes, C. D., Bedrick, E. J., Campbell, E. S., Lutrick, K., & Cairns, C. B. (2021). A Target for Increased Mortality Risk in Critically Ill Patients: The Concept of Perpetuity. Journal of clinical medicine, 10(17).
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  Emergency medicine is acuity-based and focuses on time-sensitive treatments for life-threatening diseases. Prolonged time in the emergency department, however, is associated with higher mortality in critically ill patients. Thus, we explored management after an acuity-based intervention, which we call perpetuity, as a potential mechanism for increased risk. To explore this concept, we evaluated the impact of each hour above a lung-protective tidal volume on risk of mortality.
• Mosier, J., Natt, B., & Malo, J. (2021). ARDS in COVID-19 and beyond: Let's keep our eyes on the goal instead of the straw man. Journal of the Intensive Care Society, 22(4), 267-269.
• Natt, B., & Mosier, J. (2021). Airway Management in the Critically Ill Patient. Current anesthesiology reports, 1-12.
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  This paper will evaluate the recent literature and best practices in airway management in critically ill patients.
• Pacheco, G. S., Hurst, N. B., Patanwala, A. E., Hypes, C., Mosier, J. M., & Sakles, J. C. (2021). First Pass Success Without Adverse Events Is Reduced Equally with Anatomically Difficult Airways and Physiologically Difficult Airways. The western journal of emergency medicine, 22(2), 360-368.
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  The goal of emergency airway management is first pass success without adverse events (FPS-AE). Anatomically difficult airways are well appreciated to be an obstacle to this goal. However, little is known about the effect of the physiologically difficult airway with regard to FPS-AE. This study evaluates the effects of both anatomically and physiologically difficult airways on FPS-AE in patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).
• Qadir, N., Bartz, R. R., Cooter, M. L., Hough, C. L., Lanspa, M. J., Banner-Goodspeed, V. M., Chen, J. T., Giovanni, S., Gomaa, D., Sjoding, M. W., Hajizadeh, N., Komisarow, J., Duggal, A., Khanna, A. K., Kashyap, R., Khan, A., Chang, S. Y., Tonna, J. E., Anderson, H. L., , Liebler, J. M., et al. (2021). Variation in Early Management Practices in Moderate-to-Severe ARDS in the United States: The Severe ARDS: Generating Evidence Study. Chest, 160(4), 1304-1315.
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  Although specific interventions previously demonstrated benefit in patients with ARDS, use of these interventions is inconsistent, and patient mortality remains high. The impact of variability in center management practices on ARDS mortality rates remains unknown.
• Sakles, J. C., Mosier, J. M., Hypes, C., Patanwala, A., Hurst, N. B., & Pacheco, G. (2021). First Pass Success Without Adverse Events is Reduced Equally with Anatomically Difficult Airways and Physiologically Difficult Airways. Western Journal of Emergency Medicine.
• Zhang, T., Mosier, J., & Subbian, V. (2021). Identifying Barriers to and Opportunities for Telehealth Implementation Amidst the COVID-19 Pandemic by Using a Human Factors Approach: A Leap Into the Future of Health Care Delivery?. JMIR human factors, 8(2), e24860.
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  The extensive uptake of telehealth has considerably transformed health care delivery since the beginning of the COVID-19 pandemic and has imposed tremendous challenges to its large-scale implementation and adaptation. Given the shift in paradigm from telehealth as an alternative mechanism of care delivery to telehealth as an integral part of the health system, it is imperative to take a systematic approach to identifying barriers to, opportunities for, and the overall impact of telehealth implementation amidst the current pandemic. In this work, we apply a human factors framework, the Systems Engineering Initiative for Patient Safety model, to guide our holistic analysis and discussion of telehealth implementation, encompassing the health care work system, care processes, and outcomes.
• Brindley, P. G., Hicks, C. M., & Mosier, J. M. (2020). Pandemic airway management: A cognitive aid to increase safety and team cohesion during intubation, donning, and doffing. The journal of the Intensive Care Society, 24(3_suppl), 175114372093161. doi:10.1177/1751143720931614
• Brown, C. A., Mosier, J. M., Carlson, J. N., & Gibbs, M. A. (2020). Pragmatic recommendations for intubating critically ill patients with suspected COVID-19. Journal of the American College of Emergency Physicians open.
• Bull, D. A., Hsu, C. H., Hypes, C., Kazui, T., Lick, S. D., Malo, J., Mogan, C., Mosier, J., Natt, B., & Smith, R. G. (2020). Interfacility Transfer via a Mobile Intensive Care Unit Following a Double Lumen Catheter Cannulation at the Referring Facility for Veno-Venous Extracorporeal Membrane Oxygenation.. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 39(4S), S419. doi:10.1016/j.healun.2020.01.194
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  Assess the feasibility of interfacility transfer via a mobile intensive care unit (MOBI) after a double lumen catheter cannulation at a referring facility for veno-venous extracorporeal membrane oxygenation (VV-ECMO)..This single center retrospective data analysis utilized our institutional data from January 2015-September 2019. We divided patients into 2 groups: Group A had a double lumen cannulation for in-hospital VV-ECMO; Group B had the same procedure for interfacility transfer via an MOBI. Cannulation was performed with fluoroscopic guidance at the referring facility by either one of its surgeons or the MOBI team. The MOBI consisted of an ECMO physician (either a surgeon or an intensivist), a respiratory therapist, an ECMO nurse, and a transport nurse. The 2 groups were compared in terms of pre support, complications during the ECMO support, and survival..There were no complications related to cannulation at the referring facility nor transfer. Group A had 33 patients (average age was 45.1 ± 18.0). Group B had 20 patients (average age was 48.4 ± 13.5). Pre ECMO pH, PCO2, PO2, and SaO2 were 7.2 ± 0.2, 7.3 ± 0.2 (p=0.08), 65.0 ± 21.6mmHg, 59.3 ± 24.2mmHg (p=0.27), 69.8 ± 26.3mmHg, 66.6 ± 45.0mmHg (p=0.18), 85.7 ± 9.7%, 82.5 ± 14.4% (p=0.61) in Group A and B, respectively. During ECMO support, Group A had 18 complications; Group B had 13 (p=0.57), including circuit component clots [5 and 4 (p=0.72)], circuit exchange [3 and 2 (p=1.00)], creatinine 1.5 - 3.0 [5 and 1 (p=0.39)], creatinine >3.0 [2 and 3 (p=0.35)], and renal replacement therapy [6 and 4 (p=1.00)]. Respectively, 69.7% and 50.0% of patients came off ECMO support, and 45.4% and 50.0% of patients survived to discharge (p=0.18)..Double lumen catheter cannulation at the referring facility with MOBI demonstrated equivalent results to in-house cannulation.
• Donovan, F. M., Ramadan, F. A., Khan, S. A., Bhaskara, A., Lainhart, W. D., Narang, A. T., Mosier, J. M., Ellingson, K. D., Bedrick, E. J., Saubolle, M. A., & Galgiani, J. N. (2020). Comparison of a Novel Rapid Lateral Flow Assay to Enzyme Immunoassay Results for Early Diagnosis of Coccidioidomycosis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.
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  Coccidioidomycosis (CM) is a common cause of community acquired pneumonia (CAP) where CM is endemic. Manifestations include self-limited pulmonary infection, chronic fibrocavitary pulmonary disease, and disseminated coccidioidomycosis (DCM). Most infections are identified by serological assays including enzyme-linked immunoassay (EIA), complement fixation (CF) and immunodiffusion (IMDF). These are time-consuming and take days to result, impeding early diagnosis. A new lateral flow assay (LFA, Sōna, IMMY, Norman OK) improves time-to-result to one hour.
• Driver, B. E., Mosier, J. M., & Brown, C. A. (2020). The Importance of the Intubation Process for the Safety of Emergency Airway Management. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 27(12), 1362-1365.
• Essay, P., Mosier, J., & Subbian, V. (2020). Rule-Based Cohort Definitions for Acute Respiratory Failure: Electronic Phenotyping Algorithm. JMIR medical informatics, 8(4), e18402.
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  Acute respiratory failure is generally treated with invasive mechanical ventilation or noninvasive respiratory support strategies. The efficacies of the various strategies are not fully understood. There is a need for accurate therapy-based phenotyping for secondary analyses of electronic health record data to answer research questions regarding respiratory management and outcomes with each strategy.
• Hurst, N. B., Hypes, C., Mosier, J., Pacheco, G. S., Patanwala, A. E., & Sakles, J. C. (2020). Adverse Events in Patients with Physiologically Difficult and Anatomically Difficult Airways in the Emergency Department. Trends in Anaesthesia and Critical Care, 30, e112. doi:10.1016/j.tacc.2019.12.275
• Kornas, R. L., Owyang, C. G., Sakles, J. C., Foley, L. J., & Mosier, J. M. (2020). Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesthesia & Analgesia, 132(2), 395-405. doi:10.1213/ane.0000000000005233
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  Multiple international airway societies have created guidelines for the management of the difficult airway. In critically ill patients, there are physiologic derangements beyond inadequate airway protection or hypoxemia. These risk factors contribute to the "physiologically difficult airway" and are associated with complications including cardiac arrest and death. Importantly, they are largely absent from international guidelines. Thus, we created management recommendations for the physiologically difficult airway to provide practical guidance for intubation in the critically ill. Through multiple rounds of in-person and telephone conferences, a multidisciplinary working group of 12 airway specialists (Society for Airway Management's Special Projects Committee) over a time period of 3 years (2016-2019) reviewed airway physiology topics in a modified Delphi fashion. Consensus agreement with the following recommendations among working group members was generally high with 80% of statements showing agreement within a 10% range on a sliding scale from 0% to 100%. We limited the scope of this analysis to reflect the resources and systems of care available to out-of-operating room adult airway providers. These recommendations reflect the practical application of physiologic principles to airway management available during the analysis time period.
• Malo, J., Mosier, J., & Natt, B. (2020). ARDS in COVID-19 and beyond: Let’s keep our eyes on the goal instead of the straw man. The journal of the Intensive Care Society, 22(4), 175114372097352. doi:10.1177/1751143720973527
• Miller, D. C., Beamer, P., Billheimer, D., Subbian, V., Sorooshian, A., Campbell, B. S., & Mosier, J. M. (2020). Aerosol Risk with Noninvasive Respiratory Support in Patients with COVID-19. Journal of the American College of Emergency Physicians open.
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  This study evaluates aerosol production with high flow nasal cannula () and noninvasive positive pressure ventilation () compared to six liters per minute by low-flow nasal cannula.
• Miller, D. C., Bime, C., Partharsarathy, S., & Mosier, J. M. (2020). High-Flow Oxygen Therapy Concepts: Time to Standardize Nomenclature and Avoid Confusion. Journal of intensive care medicine, 35(5), 519-523.
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  High-flow nasal oxygen systems are rapidly being adopted as an initial noninvasive treatment for acute respiratory failure. However, the term "high-flow nasal cannula" is nonspecific and leads to imprecise communication between physicians, respiratory therapists, and nurses with the potential for patient harm. In this viewpoint and a brief review of the technology, we argue for a change in nomenclature in order to reduce the chance for future clinical, administrative, and research misunderstanding surrounding high-flow nasal oxygen systems.
• Mosier, J. M. (2020). Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation.. British journal of anaesthesia, 125(1), e1-e4. doi:10.1016/j.bja.2019.12.001
• Mosier, J. M., Sakles, J. C., Law, J. A., Brown, C. A., & Brindley, P. G. (2020). Tracheal Intubation in the Critically Ill: Where We Came From and Where We Should Go. American journal of respiratory and critical care medicine.
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  Tracheal intubation is commonly performed in critically ill patients. Unfortunately, this procedure also carries a high risk of complications; half of critically ill patients with difficult airways experiencing life threatening complications. The high complication rates stem from difficulty with laryngoscopy and tube placement, consequences of physiologic derangement, and human factors including failure to recognize and reluctance to manage the failed airway. The last 10 years have seen a rapid expansion in devices available that help overcome anatomic difficulties with laryngoscopy and provide rescue oxygenation in the setting of failed attempts. Recent research in critically ill patients has highlighted other important considerations for critically ill patients and evaluated interventions to reduce the risks with repeated attempts, desaturation, and cardiovascular collapse during emergency airway management. There are three actions that should be implemented to reduce the risk of danger and include: 1. Preintubation assessment for potential difficulty (e.g. MACOCHA score), 2. Preparation and optimization of the patient and team for difficulty-including using a checklist, acquiring necessary equipment, maximizing preoxygenation, and hemodynamic optimization, and 3. Recognition and management of failure to restore oxygenation and reduce the risk of cardiopulmonary arrest. This review describes the history of emergency airway management and explores the challenges with modern emergency airway management in critically ill patients. We offer clinically relevant recommendations based on current evidence, guidelines, and expert opinion.
• Mosier, J. M., Salvagio Campbell, B., Sorooshian, A., Subbian, V., Billheimer, D. D., Beamer, P., & Miller, D. (2020). Aerosol risk with noninvasive respiratory support in patients with COVID‐19. Journal of the American College of Emergency Physicians Open.
• Mosier, J., Reardon, R. F., DeVries, P. A., Stang, J. L., Nelsen, A., Prekker, M. E., & Driver, B. E. (2020). Time to Loss of Preoxygenation in Emergency Department Patients. The Journal of emergency medicine, 59(5), 637-642.
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  In patients requiring emergency rapid sequence intubation (RSI), 100% oxygen is often delivered for preoxygenation to replace alveolar nitrogen with oxygen. Sometimes, however, preoxygenation devices are prematurely removed from the patient prior to the onset of apnea, which can lead to rapid loss of preoxygenation.
• Ripperger, T. J., Uhrlaub, J. L., Watanabe, M., Wong, R., Castaneda, Y., Pizzato, H. A., Thompson, M. R., Bradshaw, C., Weinkauf, C. C., Bime, C., Erickson, H. L., Knox, K., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., Aini, T. E., Rischard, F., , Campion, J., et al. (2020). Detection, prevalence, and duration of humoral responses to SARS-CoV-2 under conditions of limited population exposure. medRxiv : the preprint server for health sciences.
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  We conducted an extensive serological study to quantify population-level exposure and define correlates of immunity against SARS-CoV-2. We found that relative to mild COVID-19 cases, individuals with severe disease exhibited elevated authentic virus-neutralizing titers and antibody levels against nucleocapsid (N) and the receptor binding domain (RBD) and the S2 region of spike protein. Unlike disease severity, age and sex played lesser roles in serological responses. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. RBD- and S2-specific and neutralizing antibody titers remained elevated and stable for at least 2-3 months post-onset, whereas those against N were more variable with rapid declines in many samples. Testing of 5882 self-recruited members of the local community demonstrated that 1.24% of individuals showed antibody reactivity to RBD. However, 18% (13/73) of these putative seropositive samples failed to neutralize authentic SARS-CoV-2 virus. Each of the neutralizing, but only 1 of the non-neutralizing samples, also displayed potent reactivity to S2. Thus, inclusion of multiple independent assays markedly improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the viral antigen. In contrast to other reports, we conclude that immunity is durable for at least several months after SARS-CoV-2 infection.
• Ripperger, T. J., Uhrlaub, J. L., Watanabe, M., Wong, R., Castaneda, Y., Pizzato, H. A., Thompson, M. R., Bradshaw, C., Weinkauf, C. C., Bime, C., Erickson, H. L., Knox, K., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., El Aini, T., Rischard, F., , Campion, J., et al. (2020). Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity, 53(5), 925-933.e4.
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  We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks after PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months after onset, whereas α-N titers diminished. Testing 5,882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low-seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
• Sakles, J. C., Pacheco, G. S., Kovacs, G., & Mosier, J. M. (2020). The difficult airway refocused. British journal of anaesthesia, 125(1), e18-e21.
• Self, W. H., Semler, M. W., Leither, L. M., Casey, J. D., Angus, D. C., Brower, R. G., Chang, S. Y., Collins, S. P., Eppensteiner, J. C., Filbin, M. R., Files, D. C., Gibbs, K. W., Ginde, A. A., Gong, M. N., Harrell, F. E., Hayden, D. L., Hough, C. L., Johnson, N. J., Khan, A., , Lindsell, C. J., et al. (2020). Effect of Hydroxychloroquine on Clinical Status at 14 Days in Hospitalized Patients With COVID-19: A Randomized Clinical Trial. JAMA, 324(21), 2165-2176.
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  Data on the efficacy of hydroxychloroquine for the treatment of coronavirus disease 2019 (COVID-19) are needed.
• Basken, R., Cosgrove, R., Malo, J., Romero, A., Patanwala, A., Finger, J., Kazui, T., Khalpey, Z., & Mosier, J. (2019). Predictors of Oxygenator Exchange in Patients Receiving Extracorporeal Membrane Oxygenation. The journal of extra-corporeal technology, 51(2), 61-66.
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  Thrombosis within the membrane oxygenator (MO) during extracorporeal membrane oxygenation (ECMO) can lead to sudden oxygenator dysfunction with deleterious effects to the patient. The purpose of this study was to identify predictors of circuit exchange during ECMO. This is a single-center, retrospective study of all patients who received ECMO at our institution from January 2010 to December 2015. Changes in potential markers were compared on Day 3 vs. Day 0 before MO exchange. Of the 150 patients who received ECMO, there were 58 MO exchanges in 35 patients. Mean ECMO duration was 21.1 (±12.7) days. D-dimer (DD) (μg/mL) (mean difference -2.6; 95% confidence interval [CI]: -4.2 to -1.1; = .001) increased significantly in the 3 days leading up to MO exchange, whereas fibrinogen (mg/dL) (mean difference 90.7; 95% CI: 41.8-139.6; = .001), platelet (PLT) count (1,000/μL) (mean difference 23.3; 95% CI: 10.2-36.4; = .001), and heparin dose (units/h) (mean difference 261.7; 95% CI: 46.3-477.1; = .02) decreased. Increasing DD or decreasing fibrinogen, PLT count, or heparin dose may indicate an impending need for MO exchange in patients receiving ECMO. Early identification of these changes may help prevent sudden MO dysfunction.
• Driver, B. E., Reardon, R. F., & Mosier, J. (2019). Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time. The western journal of emergency medicine, 20(6), 970-971.
• Driver, B. E., Reardon, R. F., & Mosier, J. (2019). Ketamine as Monotherapy in Difficult Airways Is Not Ready for Prime Time. WESTERN JOURNAL OF EMERGENCY MEDICINE, 20(6), 970-971.
• Essay, P., Shahin, T. B., Balkan, B., Mosier, J., & Subbian, V. (2019). The Connected Intensive Care Unit Patient: Exploratory Analyses and Cohort Discovery From a Critical Care Telemedicine Database. JMIR MEDICAL INFORMATICS, 7(1).
• Essay, P., Shahin, T. B., Balkan, B., Mosier, J., & Subbian, V. (2019). The Connected Intensive Care Unit Patient: Exploratory Analyses and Cohort Discovery From a Critical Care Telemedicine Database. JMIR medical informatics, 7(1), e13006.
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  Many intensive care units (ICUs) utilize telemedicine in response to an expanding critical care patient population, off-hours coverage, and intensivist shortages, particularly in rural facilities. Advances in digital health technologies, among other reasons, have led to the integration of active, well-networked critical care telemedicine (tele-ICU) systems across the United States, which in turn, provide the ability to generate large-scale remote monitoring data from critically ill patients.
• Fuller, B. M., Roberts, B. W., Mohr, N. M., Knight, W. A., Adeoye, O., Pappal, R. D., Marshall, S., Alunday, R., Dettmer, M., Goyal, M., Gibson, C., Levine, B. J., Gardner-Gray, J. M., Mosier, J., Dargin, J., Mackay, F., Johnson, N. J., Lokhandwala, S., Hough, C. L., , Tonna, J. E., et al. (2019). The ED-SED Study: A Multicenter, Prospective Cohort Study of Practice Patterns and Clinical Outcomes Associated With Emergency Department SEDation for Mechanically Ventilated Patients. CRITICAL CARE MEDICINE, 47(11), 1539-1548.
• Insel, M., Natt, B., Mosier, J., Malo, J., & Bime, C. (2019). The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis. RESPIRATORY CARE, 64(3), 279-284.
• Insel, M., Natt, B., Mosier, J., Malo, J., & Bime, C. (2019). The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis. Respiratory care, 64(3), 279-284.
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  The 2009 H1N1 influenza epidemic saw a rise in the use of extracorporeal membrane oxygenation (ECMO) as a supportive therapy for refractory ARDS. We sought to determine whether ECMO utilization follows a seasonal pattern that matches the influenza season, and whether it can further be explained by the incidence of each influenza subtype.
• Mosier, J. M. (2019). Physiologically difficult airway in critically ill patients: winning the race between haemoglobin desaturation and tracheal intubation. British journal of anaesthesia.
• Mosier, J. M., & Hypes, C. D. (2019). Mechanical Ventilation Strategies for the Patient with Severe Obstructive Lung Disease. EMERGENCY MEDICINE CLINICS OF NORTH AMERICA, 37(3), 445-+.
• Mosier, J. M., & Hypes, C. D. (2019). Mechanical Ventilation Strategies for the Patient with Severe Obstructive Lung Disease. Emergency medicine clinics of North America, 37(3), 445-458.
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  Patients with respiratory failure due to obstructive lung disease present a challenge to the emergency physician. These patients have physiologic abnormalities that prevent adequate gas exchange and lung mechanics which render them at increased risk of cardiopulmonary decompensation when managed with invasive mechanical ventilation. This article addresses key principles when managing these challenging patients: patient-ventilator synchrony, air trapping and auto-positive end-expiratory pressure, and airway pressures. This article provides a practical workflow for the emergency physician responsible for managing these patients.
• Mosier, J. M., Stolz, U., Milligan, R., Roy-Chaudhury, A., Lutrick, K., Hypes, C. D., Billheimer, D., & Cairns, C. B. (2019). Impact of Point-of-Care Ultrasound in the Emergency Department on Care Processes and Outcomes in Critically Ill Nontraumatic Patients. Critical care explorations, 1(6), e0019.
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  Outcomes data on point-of-care ultrasound (POCUS) in critically ill patients are lacking. This study examines the association between POCUS in the emergency department and outcomes in critically ill patients.
• Sakles, J. C., Augustinovich, C. C., Patanwala, A. E., Pacheco, G. S., & Mosier, J. M. (2019). Improvement in the Safety of Rapid Sequence Intubation in the Emergency Department with the Use of an Airway Continuous Quality Improvement Program. WESTERN JOURNAL OF EMERGENCY MEDICINE, 20(4), 610-618.
• Sakles, J., Augustinovich, C., Patanwala, A., Pacheco, G., & Mosier, J. (2019). Improvement in the safety of rapid sequence intubation in the emergency department with the use of an airway continuous quality improvement program. Western Journal of Emergency Medicine, 20(4). doi:10.5811/westjem.2019.4.42343
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  Introduction: Airway management in the critically ill is associated with a high prevalence of failed first attempts and adverse events which negatively impacts patient care. The purpose of this investigation is to describe an airway continuous quality improvement (CQI) program and its effect on the safety of rapid sequence intubation (RSI) in the emergency department (ED) over a 10-year period. Methods: An airway CQI program with an ongoing airway registry was initiated in our ED on July 1, 2007 (Academic Year 1) and continued through June 30, 2017 (Academic Year 10). Data were prospectively collected on all patients intubated in the ED during this period using a structured airway data collection form. Key data points included method of intubation, drugs and devices used for intubation, operator specialty and level of training, number of intubation attempts, and adverse events. Adult patients who underwent RSI in the ED with an initial intubation attempt by emergency medicine (EM) resident were included in the analysis. The primary outcome was first pass success which was defined as successful tracheal intubation with a single laryngoscope insertion. The secondary outcome was the prevalence of adverse events associated with intubation. Educational and clinical interventions were introduced throughout the study period with the goal of optimizing these outcomes. Data were analyzed by academic year and are reported descriptively with 95% confidence intervals (CI) of the difference of means. Results: EM residents performed RSI on 342 adult patients during Academic Year 1 and on 445 adult patients during Academic Year 10. Over the 10-year study period, first pass success increased from 73.1% to 92.4% (difference = 19.3%, 95% CI 14.0% to 24.6%). The percentage of patients who experienced an adverse event associated with intubation decreased from 22.5% to 14.4% (difference = -7.9%, 95% CI -13.4% to -2.4%). The percentage of patients with first pass success without an adverse event increased from 64.0% to 80.9% (difference = 16.9%, 95% CI 10.6% to 23.1%). Conclusion: The use of an airway CQI program with an ongoing airway registry resulted in a substantial improvement in the overall safety of RSI in the ED as evidenced by an increase in first pass success and a decrease in adverse events.
• Acuna, J., Situ-LaCasse, E., & Mosier, J. (2018). A 33-Year-Old Woman With Progressive Dyspnea and Fatigue. CHEST, 154(3), E65-E67.
• Acuña, J., Situ-LaCasse, E., & Mosier, J. (2018). A 33-Year-Old Woman With Progressive Dyspnea and Fatigue. Chest, 154(3), e65-e67.
• Adhikari, S., Cairns, C. B., Crabbe, S., Hypes, C., Milligan, R., Mosier, J., Roy-chaudhury, A., & Stolz, L. A. (2018). 317: EARLY POINT-OF-CARE ULTRASOUND IN CRITICAL CARE. Critical Care Medicine, 46(1), 141-141. doi:10.1097/01.ccm.0000528336.02121.15
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  Roy-Chaudhury, Akshay; Milligan, Rebecca; Crabbe, Stephen; Hypes, Cameron; Adhikari, Srikar; Stolz, Lori; Cairns, Charles; Mosier, Jarrod Author Information
• Bime, C., Malo, J., Mosier, J. M., Natt, B., & Insel, M. (2018). The Association of Non-Cardiac ECMO With Influenza Incidence: A Time Series Analysis.. Respiratory Care.
• Crabbe, S., Malo, J., Natt, B., Kazui, T., Khalpey, Z., Roy-Chaudhury, A., Mosier, J., & Hypes, C. (2018). DURATION OF MECHANICAL VENTILATION AND PATIENT OUTCOMES FOR EXTRACORPOREAL MEMBRANE OXYGENATION. CRITICAL CARE MEDICINE, 46(1), 514-514.
• Crabbe, S., Malo, J., Natt, B., Khalpey, Z., Kazui, T., Roy-Chaudhury, A., Mosier, J., & Hypes, C. (2018). EVALUATION OF THE RESP SCORE FOR SURVIVAL PREDICTION IN VENOVENOUS ECMO. CRITICAL CARE MEDICINE, 46(1), 532-532.
• Gabe, L. M., Coffman, N., Mosier, J. M., & Bime, C. (2018). Do Lactated Ringers and Early Insulin Bolus Change the Clinical Course of Diabetic Ketoacidosis? A Single Center, Retrospective Review. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 197.
• Kovacs, G., Law, J. A., Mosier, J., & Sakles, J. C. (2018). The dangerous airway: reframing airway management in the critically ill. Southwest Journal of Pulmonary and Critical Care, 16(2), 99-102. doi:10.13175/swjpcc004-18
• Milligan, R., Roy-Chaudhury, A., Adhikari, S., Stolz, L., Hypes, C., Cairns, C., & Mosier, J. (2018). UTILIZATION OF POINT-OF-CARE ULTRASOUND IN THE MANAGEMENT OF CRITICALLY ILL PATIENTS IN THE. CRITICAL CARE MEDICINE, 46(1), 138-138.
• Morrissette, K., Hypes, C. D., & Mosier, J. M. (2018). Effect of Implementation of Emergency Department Critical Care Response System on Patient Disposition and Outcome. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 197.
• Morrissette, K., Mosier, J., Hypes, C., Milligan, R., & Sakles, J. (2018). INTERVENTIONS FOR HEMODYNAMIC INSTABILITY IN CRITICALLY ILL PATIENTS DO NOT REDUCE RISK OF MORTALITY. CRITICAL CARE MEDICINE, 46(1), 607-607.
• Mosier, J., Martin, J., Andrus, P., Clinton, M., Demla, V., Dinh, V., Saul, T., Schott, C., & Tayal, V. (2018). Advanced hemodynamic and cardiopulmonary ultrasound for critically ill patients in the emergency department. Emergency Medicine, 50(1). doi:10.12788/emed.2018.0078
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  Focused echocardiography, advanced hemodynamic, and cardiopulmonary point-of-care ultrasound studies provide time-sensitive evaluation of critically ill patients, guiding and facilitating earlier implementation of life-preserving treatment and supportive therapies.
• Park, P. K., Qadir, N., Bartz, R. R., Cooter, M., Lanspa, M. J., Chen, J., Banner-Goodspeed, V., Gomaa, D., Sjoding, M. W., Duggal, A., Khanna, A., Hajizadeh, N., Kashyap, R., Khan, A., Chang, S. Y., Tonna, J. E., Anderson, H., Liebler, J. M., Mosier, J. M., , Louh, I. K., et al. (2018). Variation in US Management Practices in Moderate-to-Severe ARDS: The Severe ARDS: Generating Evidence (SAGE) Study. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 197.
• Qadir, N., Park, P. K., Bartz, R. R., Cooter, M., Lanspa, M. J., Chen, J., Banner-Goodspeed, V., Gomaa, D., Sjoding, M. W., Duggal, A., Khanna, A., Hajizadeh, N., Kashyap, R., Khan, A., Chang, S. Y., Tonna, J. E., Anderson, H., Liebler, J. M., Mosier, J. M., , Louh, I. K., et al. (2018). Use of Adjunctive Therapy in ARDS: Results from the Severe ARDS Generating Evidence (SAGE) Study. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 197.
• Rao, P., Ali, H., Hypes, C., Natt, B., Kazui, T., Khalpey, Z., Cairns, C., & Mosier, J. (2018). RIGHT VENTRICULAR DYSFUNCTION IN ACUTE RESPIRATORY DISTRESS SYNDROME. CRITICAL CARE MEDICINE, 46(1), 67-67.
• Rao, P., Mosier, J., Malo, J., Dotson, V., Mogan, C., Smith, R., Keller, R., Slepian, M., & Khalpey, Z. (2018). Peripheral VA-ECMO with direct biventricular decompression for refractory cardiogenic shock. PERFUSION-UK, 33(6), 493-495.
• Rao, P., Mosier, J., Malo, J., Dotson, V., Mogan, C., Smith, R., Keller, R., Slepian, M., & Khalpey, Z. (2018). Peripheral VA-ECMO with direct biventricular decompression for refractory cardiogenic shock. Perfusion, 33(6), 493-495.
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  Cardiogenic shock and cardiac arrest are life-threatening emergencies that result in high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via peripheral cannulation is an option for patients who do not respond to conventional therapies. Left ventricular (LV) distention is a major limitation with peripheral VA-ECMO and is thought to contribute to poor recovery and the inability to wean off VA-ECMO. We report on a novel technique that combines peripheral VA-ECMO with off-pump insertion of a trans-apical LV venting cannula and a right ventricular decompression cannula.
• Roy-Chaudhury, A., Milligan, R., Crabbe, S., Hypes, C., Adhikari, S., Stolz, L., Cairns, C., & Mosier, J. (2018). EARLY POINT-OF-CARE ULTRASOUND IN CRITICAL CARE: HELPFUL, CRITICAL, OR RECREATING THE SWAN PROBLEM?. CRITICAL CARE MEDICINE, 46(1), 141-141.
• Roy-Chaudhury, A., Milligan, R., Crabbe, S., Hypes, C., Adhikari, S., Stolz, L., Cairns, C., & Mosier, J. (2018). EARLY POINT-OF-CARE ULTRASOUND IN CRITICAL CARE: HELPFUL, CRITICAL, OR RECREATING THE SWAN PROBLEM?. JOURNAL OF INVESTIGATIVE MEDICINE, 66(1), 218-218.
• Swazo, R., Cairns, C., & Mosier, J. (2018). THE INCOMPLETE APPRECIATION OF ACUITY IN FEDERALLY FUNDED ACUTE LUNG INJURY RESEARCH. CRITICAL CARE MEDICINE, 46(1), 526-526.
• Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2017). Reply: Did Video Kill the Direct Laryngoscopy Star? Not Yet!. Annals of the American Thoracic Society, 14(4), 610-611.
• Hypes, C., Sakles, J., Joshi, R., Greenberg, J., Natt, B., Malo, J., Bloom, J., Chopra, H., & Mosier, J. (2017). Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications. INTERNAL AND EMERGENCY MEDICINE, 12(8), 1235-1243.
• Jaber, S., Bellani, G., Blanch, L., Demoule, A., Esteban, A., Gattinoni, L., Guerin, C., Hill, N., Laffey, J. G., Maggiore, S. M., Mancebo, J., Mayo, P. H., Mosier, J. M., Navalesi, P., Quintel, M., Vincent, J. L., & Marini, J. J. (2017). The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation. INTENSIVE CARE MEDICINE, 43(9), 1352-1365.
• Jaber, S., Bellani, G., Blanch, L., Demoule, A., Esteban, A., Gattinoni, L., Guérin, C., Hill, N., Laffey, J. G., Maggiore, S. M., Mancebo, J., Mayo, P. H., Mosier, J. M., Navalesi, P., Quintel, M., Vincent, J. L., & Marini, J. J. (2017). The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation. Intensive care medicine, 43(9), 1352-1365.
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  In an important sense, support of the respiratory system has been a defining characteristic of intensive care since its inception. The pace of basic and clinical research in this field has escalated over the past two decades, resulting in palpable improvement at the bedside as measured by both efficacy and outcome. As in all medical research, however, novel ideas built upon observations are continually proposed, tested, and either retained or discarded on the basis of the persuasiveness of the evidence. What follows are concise descriptions of the current standards of management practice in respiratory support, the areas of present-day uncertainty, and our suggested agenda for the near future of research aimed at testing current assumptions, probing uncertainties, and solidifying the foundation on which to base our progress to the next level.
• Joshi, R., Hypes, C., Greenberg, J., Snyder, L., Malo, J., Bloom, J., Chopra, H., Sakles, J., & Mosier, J. (2017). Difficult airway characteristics associated with first-attempt failure at intubation using video laryngoscopy in the intensive care unit. Annals of the American Thoracic Society, 14(3). doi:10.1513/AnnalsATS.201606-472OC
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  Rationale: Video laryngoscopy has overcome the need to align the anatomic axes to obtain a view of the glottic opening to place a tracheal tube. However, despite this advantage, a large number of attempts are unsuccessful. There are no existing data on anatomic characteristics in critically ill patients associated with a failed first attempt at laryngoscopy when using video laryngoscopy. Objectives: To identify characteristics associated with first-attempt failure at intubation when using video laryngoscopy in the intensive care unit (ICU). Methods: This is an observational study of 906 consecutive patients intubated in the ICUwith a video laryngoscope between January 2012 and January 2016 in a single-center academic medical ICU. After each intubation, the operator completed a data collection form, which included information on difficult airway characteristics, device used, and outcome of each attempt. Multivariable regression models were constructed to determine the difficult airway characteristics associated with a failed first attempt at intubation. Measurements and Main Results: There were no significant differences in sex, age, reason for intubation, or device used between first-attempt failures and first-attempt successes. First-attempt successes more commonly reported no difficult airway characteristics were present (23.9%; 95% confidence interval [CI], 20.7-27.0% vs. 13.3%; 95% CI, 8.0-18.8%). In logistic regression analysis of the entire 906-patient database, blood in the airway (odds ratio [OR], 2.63; 95% CI, 1.64-4.20), airway edema (OR, 2.85; 95% CI, 1.48-5.45), and obesity (OR, 1.59; 95% CI, 1.08-2.32) were significantly associated with first-attempt failure. Data collection on limited mouth opening and secretions began after the first 133 intubations, and we fit a second logistic model to examine cases in which these additional difficult airway characteristics were collected. In this subset (n = 773), the presence of blood (OR, 2.73; 95% CI, 1.60-4.64), cervical immobility (OR, 3.34; 95% CI, 1.28-8.72), and airway edema (OR, 3.10; 95% CI, 1.42-6.70) were associated with first-attempt failure. Conclusions: In this single-center study, presence of blood in the airway, airway edema, cervical immobility, and obesity are associated with higher odds of first-attempt failure, when intubation was performed with video laryngoscopy in an ICU.
• Malo, J., Bloom, J. W., Chopra, H., Greenberg, J., Hypes, C. D., Joshi, R., Mosier, J. M., Sakles, J. C., & Snyder, L. (2017). Difficult Airway Characteristics Associated with First-Attempt Failure at Intubation Using Video Laryngoscopy in the Intensive Care Unit.. Annals of the American Thoracic Society, 14(3), 368-375. doi:10.1513/annalsats.201606-472oc
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  Video laryngoscopy has overcome the need to align the anatomic axes to obtain a view of the glottic opening to place a tracheal tube. However, despite this advantage, a large number of attempts are unsuccessful. There are no existing data on anatomic characteristics in critically ill patients associated with a failed first attempt at laryngoscopy when using video laryngoscopy..To identify characteristics associated with first-attempt failure at intubation when using video laryngoscopy in the intensive care unit (ICU)..This is an observational study of 906 consecutive patients intubated in the ICU with a video laryngoscope between January 2012 and January 2016 in a single-center academic medical ICU. After each intubation, the operator completed a data collection form, which included information on difficult airway characteristics, device used, and outcome of each attempt. Multivariable regression models were constructed to determine the difficult airway characteristics associated with a failed first attempt at intubation..There were no significant differences in sex, age, reason for intubation, or device used between first-attempt failures and first-attempt successes. First-attempt successes more commonly reported no difficult airway characteristics were present (23.9%; 95% confidence interval [CI], 20.7-27.0% vs. 13.3%; 95% CI, 8.0-18.8%). In logistic regression analysis of the entire 906-patient database, blood in the airway (odds ratio [OR], 2.63; 95% CI, 1.64-4.20), airway edema (OR, 2.85; 95% CI, 1.48-5.45), and obesity (OR, 1.59; 95% CI, 1.08-2.32) were significantly associated with first-attempt failure. Data collection on limited mouth opening and secretions began after the first 133 intubations, and we fit a second logistic model to examine cases in which these additional difficult airway characteristics were collected. In this subset (n = 773), the presence of blood (OR, 2.73; 95% CI, 1.60-4.64), cervical immobility (OR, 3.34; 95% CI, 1.28-8.72), and airway edema (OR, 3.10; 95% CI, 1.42-6.70) were associated with first-attempt failure..In this single-center study, presence of blood in the airway, airway edema, cervical immobility, and obesity are associated with higher odds of first-attempt failure, when intubation was performed with video laryngoscopy in an ICU.
• Mosier, J. M., Hypes, C. D., & Sakles, J. C. (2017). Understanding preoxygenation and apneic oxygenation during intubation in the critically ill. INTENSIVE CARE MEDICINE, 43(2), 226-228.
• Natt, B., Hypes, C., Basekn, R., Malo, J., Kazui, T., & Mosier, J. M. (2017). The use of extracorporeal membrane oxygenation in the bronchoscopic management of critical upper airway obstruction. Journal of Extra Corporeal Technology, 49(1), 54-58.
• Natt, B., Hypes, C., Basken, R., Malo, J., Kazui, T., & Mosier, J. (2017). Suspected Heparin-Induced Thrombocytopenia in Patients Receiving Extracorporeal Membrane Oxygenation. The journal of extra-corporeal technology, 49(1), 54-58.
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  Heparin-induced thrombocytopenia (HIT) is an immune reaction usually secondary to unfractionated heparin. Anticoagulation management is critical in patients while on extracorporeal membrane oxygenation (ECMO) to prevent thromboembolism and for the optimal functioning of the circuit. We identified five patients with respiratory failure at our hospital managed with ECMO in the last 2 years that were treated for HIT. A brief clinical course and their management are discussed. We also briefly review the literature for best evidence for management of such patients.
• Natt, B., Knepler, J. L., Kazui, T., & Mosier, J. M. (2017). The use of extracorporeal membrane oxygenation in the bronchoscopic management of critical upper airway obstruction. J Bronchology Interv Pulmonol, 24(1), e12-e14.
• Natt, B., Knepler, J., Kazui, T., & Mosier, J. M. (2017). The Use of Extracorporeal Membrane Oxygenation in the Bronchoscopic Management of Critical Upper Airway Obstruction. Journal of bronchology & interventional pulmonology, 24(1), e12-e14.
• Rao, P., Skaria, R., Mosier, J., Malo, J., Smith, R., & Khalpey, Z. (2017). Temporary Mechanical Circulatory Support Using a Novel Minimally-Invasive Approach for Central VA-ECMO. CIRCULATION, 136.
• Sakles, J. C., Corn, G. J., Hollinger, P., Arcaris, B., Patanwala, A. E., & Mosier, J. M. (2017). The Impact of a Soiled Airway on Intubation Success in the Emergency Department When Using the GlideScope or the Direct Laryngoscope. ACADEMIC EMERGENCY MEDICINE, 24(5), 628-636.
• Sakles, J. C., Corn, G. J., Hollinger, P., Arcaris, B., Patanwala, A. E., & Mosier, J. M. (2017). The Impact of a Soiled Airway on Intubation Success in the Emergency Department When Using the GlideScope or the Direct Laryngoscope. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 24(5), 628-636.
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  The objective was to determine the impact of a soiled airway on firstpass success when using the GlideScope video laryngoscope or the direct laryngoscope for intubation in the emergency department (ED).
• Sakles, J. C., Douglas, M. J., Hypes, C. D., Patanwala, A. E., & Mosier, J. M. (2017). Management of Patients with Predicted Difficult Airways in an Academic Emergency Department. The Journal of emergency medicine, 53(2), 163-171.
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  Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management.
• Sakles, J. C., Douglas, M., Hypes, C. D., Patanwala, A. E., & Mosier, J. M. (2017). MANAGEMENT OF PATIENTS WITH PREDICTED DIFFICULT AIRWAYS IN AN ACADEMIC EMERGENCY DEPARTMENT. JOURNAL OF EMERGENCY MEDICINE, 53(2), 163-170.
• Ahmad, I., Ahmad, I., Ambardekar, A., Arcaris, B., Balasubramanian, K., Batsari, K., Beament, T., Bennet, K., Berkow, L. C., Berkow, L., Beverly, A., Bhoja, R., Bidwai, A., Blunt, M., Callies, A., Cavus, E., Cecconi, M., Cheong, G., Chin, K. Y., , Choonoo, J., et al. (2016). Selected abstracts presented at the World Airway Management Meeting, 12–14 November 2015, Dublin, Ireland. BJA: British Journal of Anaesthesia, 117, i104-i120. doi:10.1093/bja/aew183
• Baalachandran, R., Trutter, L. R., Raz, Y., Mosier, J., Kazui, T., & Malo, J. (2016). Successful Use Of Extracorporeal Membrane Oxygenation In A Patient With Pulmonary Coccidioidomycosis-Related Acute Respiratory Distress Syndrome. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 193.
• Chase, P. B., Hawkins, J., Mosier, J., Jimenez, E., Boesen, K., Logan, B. K., & Walter, F. G. (2016). Differential physiological and behavioral cues observed in individuals smoking botanical marijuana versus synthetic cannabinoid drugs. CLINICAL TOXICOLOGY, 54(1), 14-19.
• Chase, P. B., Hawkins, J., Mosier, J., Jimenez, E., Boesen, K., Logan, B. K., & Walter, F. G. (2016). Differential physiological and behavioral cues observed in individuals smoking botanical marijuana versus synthetic cannabinoid drugs. Clinical toxicology (Philadelphia, Pa.), 54(1), 14-9.
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  Synthetic cannabinoid use has increased in many states, and medicinal and/or recreational marijuana use has been legalized in some states. These changes present challenges to law enforcement drug recognition experts (DREs) who determine whether drivers are impaired by synthetic cannabinoids or marijuana, as well as to clinical toxicologists who care for patients with complications from synthetic cannabinoids and marijuana. Our goal was to compare what effects synthetic cannabinoids and marijuana had on performance and behavior, including driving impairment, by reviewing records generated by law enforcement DREs who evaluated motorists arrested for impaired driving.
• Cristan, E., Greenberg, J., Hypes, C., Milligan, R., Morrissette, K., Mosier, J., Natt, B., & Sakles, J. C. (2016). 1180: FLEXIBLE FIBEROPTIC VERSUS VIDEO LARYGOSCOPY. Critical Care Medicine, 44(12), 370-370. doi:10.1097/01.ccm.0000509854.00689.42
• Cristan, E., Greenberg, J., Hypes, C., Milligan, R., Morrissette, K., Mosier, J., Natt, B., & Sakles, J. C. (2016). 278: RETHINKING NIV. Critical Care Medicine, 44(12), 146-146. doi:10.1097/01.ccm.0000508958.82084.d5
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  Greenberg, Jeremy; Mosier, Jarrod; Natt, Bhupinder; Morrissette, Katelin; Cristan, Elaine; Sakles, John; Milligan, Rebecca; Hypes, Cameron
• Cristan, E., Mosier, J., Hypes, C., Greenberg, J., Morrissette, K., Milligan, R., Sakles, J., & Malo, J. (2016). IMPROVEMENT IN TRACHEAL INTUBATION OVER TIME WITH THE INSTITUTION OF A QUALITY IMPROVEMENT PROGRAM. CRITICAL CARE MEDICINE, 44(12).
• Greenberg, J., Mosier, J., Malo, J., Morrissette, K., Cristan, E., Milligan, R., Sakles, J., & Hypes, C. (2016). REINTUBATION IN THE INTENSIVE CARE UNIT: IS IT TRULY AS DIFFICULT AS ASSUMED?. CRITICAL CARE MEDICINE, 44(12).
• Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Reply: From the Authors. Annals of the American Thoracic Society, 13(Issue 7). doi:10.1513/annalsats.201604-284le
• Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Reply: Video Laryngoscopy: Take It to the Floor. Annals of the American Thoracic Society, 13(7), 1193-4.
• Hypes, C., Sakles, J., Joshi, R., Greenberg, J., Natt, B., Malo, J., Bloom, J., Chopra, H., & Mosier, J. (2016). Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications. Internal and emergency medicine.
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  The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first attempt success. This was a prospective observational study of consecutive intubations performed with video laryngoscopy at an academic medical Intensive Care Unit. Operator, procedural, and complication data were collected. Multivariable logistic regression was used to examine the relationship between the intubation attempts and the occurrence of one or more complications. A total of 905 patients were intubated using a video laryngoscope. First attempt success occurred in 739 (81.7 %), whereas >1 attempt was needed in 166 (18.3 %). One or more complications occurred in 146 (19.8 %) of those intubated on the first attempt versus 107 (64.5 %, p 1 attempt is associated with 6.4 (95 % CI 4.4-9.3) times the adjusted odds of at least one complication. Pre-intubation predictors of at least one complication despite first attempt success include vomit or edema in the airway as well as the presence of hypoxemia or hypotension. There are increased odds of complications with even a second attempt at intubation in the Intensive Care Unit. Complications occur frequently despite a successful first attempt, and as such, the goal of airway management should not be simply first attempt success, but instead first attempt success without complications.
• Joshi, R., Hypes, C. D., Greenberg, J., Snyder, L., Malo, J., Bloom, J. W., Chopra, H., Sakles, J. C., & Mosier, J. M. (2016). Difficult Airway Characteristics Associated with First Attempt Failure at Intubation Using Video Laryngoscopy in the Intensive Care Unit. Annals of the American Thoracic Society.
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  Video laryngoscopy has overcome the need to align the anatomic axes to obtain a view of the glottic opening in order to place a tracheal tube. However, despite this advantage, a large number of attempts are unsuccessful. There are no existing data on anatomic characteristics in critically ill patients associated with a failed first attempt at laryngoscopy when using video laryngoscopy.
• Milligan, R., Mosier, J., Greenberg, J., Morrissette, K., Cristan, E., Natt, B., Saldes, J., & Hypes, C. (2016). A COMPARISON OF C-MAC AND GLIDESCOPE VIDEO LARYNGOSCOPES FOR INTUBATION IN THE INTENSIVE CARE UNIT. CRITICAL CARE MEDICINE, 44(12).
• Minckler, M. R., Curry, M., & Mosier, J. M. (2016). First Time Seizure in the Setting of a Congenital Heart Abnormality and MCA Mycotic Aneurysms. Journal of clinical medicine, 5(4).
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  A 37 year-old man presented to the Emergency Department (ED) with new onset seizure and fall from standing.[...].
• Morrissette, K., Mosier, J., Cristan, E., Milligan, R., Greenberg, J., Natt, B., Sakles, J., & Hypes, C. (2016). FLEXIBLE FIBEROPTIC VERSUS VIDEO LARYGOSCOPY: INSIGHTS ON DIFFICULT AIRWAY SUCCESS AND COMPLICATIONS. CRITICAL CARE MEDICINE, 44(12).
• Mosier, J. M., Hypes, C. D., & Sakles, J. C. (2016). Understanding preoxygenation and apneic oxygenation during intubation in the critically ill. Intensive care medicine.
• Natt, B. S., Malo, J., Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Strategies to improve first attempt success at intubation in critically ill patients. BRITISH JOURNAL OF ANAESTHESIA, 117, 60-68.
• Natt, B. S., Malo, J., Hypes, C. D., Sakles, J. C., & Mosier, J. M. (2016). Strategies to improve first attempt success at intubation in critically ill patients. British journal of anaesthesia, 117 Suppl 1, i60-i68.
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  Tracheal intubation in critically ill patients is a high-risk procedure. The risk of complications increases with repeated or prolonged attempts, making expedient first attempt success the goal for airway management in these patients. Patient-related factors often make visualization of the airway and placement of the tracheal tube difficult. Physiologic derangements reduce the patient's tolerance for repeated or prolonged attempts at laryngoscopy and, as a result, hypoxaemia and haemodynamic deterioration are common complications. Operator-related factors such as experience, device selection, and pharmacologic choices affect the odds of a successful intubation on the first attempt. This review will discuss the 'difficult airway' in critically ill patients and highlight recent advances in airway management that have been shown to improve first attempt success and decrease adverse events associated with the intubation of critically ill patients.
• Natt, B., Malo, J., Hypes, C., Sakles, J. C., Mosier, J. M., Natt, B., Malo, J., Hypes, C., Sakles, J. C., & Mosier, J. M. (2016). Strategies to improve first attempt success at intubation in critically ill patients.. British Journal of Anaesthesia, 117, i60-i68.
• Natt, B., Mosier, J., Lutrick, K., Hypes, C., Malo, J., Kazui, T., & Cairns, C. (2016). DEMOGRAPHICS OF SEVERE INFLUENZA DURING THE 2016 SEASON: A TERTIARY CARE HOSPITAL EXPERIENCE. CRITICAL CARE MEDICINE, 44(12).
• Sakles, J. C., & Mosier, J. M. (2016). COMPARATIVE PERFORMANCE OF GLIDESCOPE VIDEOLARYNGOSCOPE WITH DIRECT LARYNGOSCOPE FOR EMERGENCY INTUBATION REPLY. JOURNAL OF EMERGENCY MEDICINE, 51(2), 188-189.
• Sakles, J. C., & Mosier, J. M. (2016). Reply. The Journal of emergency medicine, 51(2), 188-9.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., & Dicken, J. M. (2016). Apneic oxygenation is associated with a reduction in the incidence of hypoxemia during the RSI of patients with intracranial hemorrhage in the emergency department. INTERNAL AND EMERGENCY MEDICINE, 11(7), 983-992.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., & Dicken, J. M. (2016). Apneic oxygenation is associated with a reduction in the incidence of hypoxemia during the RSI of patients with intracranial hemorrhage in the emergency department. Internal and emergency medicine, 11(7), 983-92.
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  Critically ill patients undergoing emergent intubation are at risk of oxygen desaturation during the management of their airway. Patients with intracranial hemorrhage (ICH) are particularly susceptible to the detrimental effects of hypoxemia. Apneic oxygenation (AP OX) may be able to reduce the occurrence of oxygen desaturation during the emergent intubation of these patients. We sought to assess the effect AP OX on oxygen desaturation during the rapid sequence intubation (RSI) of patients with ICH in the emergency department (ED). We prospectively collected data on all patients intubated in an urban academic ED over the 2-year period from July 1, 2013 to June 30, 2015. Following each intubation, the operator completed a standardized continuous quality improvement (CQI) data form, which included information on patient, operator and intubation characteristics. Operators recorded data on the use of AP OX, the oxygen flow rate used for AP OX, and the starting and lowest saturations during intubation. Adult patients with ICH who underwent RSI by emergency medicine (EM) residents were included in the analyses. The primary outcome variable was any oxygen saturation
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). First Pass Success Without Hypoxemia Is Increased With the Use of Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department. ACADEMIC EMERGENCY MEDICINE, 23(6), 703-710.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). First Pass Success Without Hypoxemia Is Increased With the Use of Apneic Oxygenation During Rapid Sequence Intubation in the Emergency Department. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 23(6), 703-10.
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  The objective was to determine the effect of apneic oxygenation (AP OX) on first pass success without hypoxemia (FPS-H) in adult patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). THE UTILITY OF THE C-MAC AS A DIRECT LARYNGOSCOPE FOR INTUBATION IN THE EMERGENCY DEPARTMENT. JOURNAL OF EMERGENCY MEDICINE, 51(4), 349-357.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Arcaris, B., & Dicken, J. M. (2016). The Utility of the C-MAC as a Direct Laryngoscope for Intubation in the Emergency Department. The Journal of emergency medicine, 51(4), 349-357.
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  Although the C-MAC (Karl Storz, Tuttlingen, Germany) is a video laryngoscope (VL), it can also be used as a direct laryngoscope (DL).
• Sakles, J., Arcaris, B., Patanwala, A., & Mosier, J. (2016). First-pass success without hypoxaemia is increased with the use of apnoeic oxygenation with rapid sequence induction in the emergency department. BRITISH JOURNAL OF ANAESTHESIA, 117, 108-108.
• Bloom, J. W., Hypes, C., Johnston, D., Joshi, R., Malo, J., Mosier, J., & Sakles, J. C. (2015). 154: Reason for Failed Attempts at Laryngoscopy Differs Between Video and Direct Laryngoscopes. Critical Care Medicine, 43, 40. doi:10.1097/01.ccm.0000473982.21643.4b
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  Copyright © by 2015 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
• Chopra, H., Mosier, J. M., Sackles, J. C., Malo, J., & Bloom, J. W. (2015). NEUROMUSCULAR BLOCKADE IMPROVES FIRST ATTEMPT SUCCESS FOR INTUBATION IN THE INTENSIVE CARE UNIT. JOURNAL OF INVESTIGATIVE MEDICINE, 63(1), 192-193.
• Gaither, J. B., Stolz, U., Ennis, J., Moiser, J., & Sakles, J. C. (2015). Association Between Difficult Airway Predictors and Failed Prehosptial Endotracheal Intubation. Air medical journal, 34(6), 343-7.
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  Difficult airway predictors (DAPs) are associated with failure of endotracheal intubation (ETI) in the emergency department (ED). The purpose of this study was to determine if DAPs are associated with failure of prehospital ETI.
• Greenberg, J., Mosier, J., Joshi, R., Bloom, J., Malo, J., Sakles, J., & Hypes, C. (2015). FIRST ATTEMPT SUCCESS AT INTUBATION IS ASSOCIATED WITH A LOWER ODDS OF ADVERSE EVENTS IN THE ICU.. CRITICAL CARE MEDICINE, 43(12).
• Hypes, C. D., Stolz, U., Sakles, J. C., Joshi, R. R., Natt, B., Malo, J., Bloom, J. W., & Mosier, J. M. (2015). Video Laryngoscopy Improves Odds of First Attempt Success at Intubation in the ICU: A Propensity-Matched Analysis. Annals of the American Thoracic Society.
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  Urgent tracheal intubation is performed frequently in intensive care units and incurs higher risk than when intubation is performed under more controlled circumstances. Video laryngoscopy may improve the chances of successful tracheal intubation on the first attempt; however existing comparative data on outcomes are limited.
• Johnston, D., Mosier, J., Joshi, R., Malo, J., Sakles, J., Bloom, J., & Hypes, C. (2015). REASON FOR FAILED ATTEMPTS AT LARYNGOSCOPY DIFFERS BETWEEN VIDEO AND DIRECT LARYNGOSCOPES. CRITICAL CARE MEDICINE, 43(12).
• Joshi, R., Hypes, C., Malo, J., Bloom, J., Sakles, J., & Mosier, J. (2015). PREDICTORS OF DIFFICULT INTUBATION WHEN USING VIDEO LARYNGOSCOPY IN THE ICU. CRITICAL CARE MEDICINE, 43(12).
• Joshi, R., de Witt, B., & Mosier, J. M. (2015). OPTIMIZING OXYGEN DELIVERY IN THE CRITICALLY ILL: THE UTILITY OF LACTATE AND CENTRAL VENOUS OXYGEN SATURATION (SCVO2) AS A ROADMAP OF RESUSCITATION IN SHOCK. JOURNAL OF EMERGENCY MEDICINE, 47(4), 493-500.
• Kelsey, M., Hypes, C., Joshi, R., Malo, J., Bloom, J., Sakles, J., & Mosier, J. (2015). DERIVATION OF A BUNDLE TO IMPROVE FIRST ATTEMPT SUCCESS AT INTUBATION IN THE ICU. CRITICAL CARE MEDICINE, 43(12).
• Marcolini, E., & Mosier, J. M. (2015). An alternative perspective regarding the "myth of the workforce crisis".. American journal of respiratory and critical care medicine, 191(6), 717-8. doi:10.1164/rccm.201412-2297le
• Michailidou, M., O'Keeffe, T., Mosier, J. M., Friese, R. S., Joseph, B., Rhee, P., & Sakles, J. C. (2015). A comparison of video laryngoscopy to direct laryngoscopy for the emergency intubation of trauma patients. World journal of surgery, 39(3), 782-8.
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  Direct laryngoscopy (DL) has long been the gold standard for tracheal intubation in emergency and trauma patients. Video laryngoscopy (VL) is increasingly used in many settings and the purpose of this study was to compare its effectiveness to direct laryngoscopy in trauma patients. Our hypothesis was that the success rate of VL would be higher than that of DL.
• Mosier, J. M., Hypes, C., Joshi, R., Whitmore, S., Parthasarathy, S., & Cairns, C. B. (2015). Ventilator Strategies and Rescue Therapies for Management of Acute Respiratory Failure in the Emergency Department. Annals of emergency medicine, 66(5), 529-41.
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  Acute respiratory failure is commonly encountered in the emergency department (ED), and early treatment can have effects on long-term outcome. Noninvasive ventilation is commonly used for patients with respiratory failure and has been demonstrated to improve outcomes in acute exacerbations of chronic obstructive lung disease and congestive heart failure, but should be used carefully, if at all, in the management of asthma, pneumonia, and acute respiratory distress syndrome. Lung-protective tidal volumes should be used for all patients receiving mechanical ventilation, and FiO2 should be reduced after intubation to achieve a goal of less than 60%. For refractory hypoxemia, new rescue therapies have emerged to help improve the oxygenation, and in some cases mortality, and should be considered in ED patients when necessary, as deferring until ICU admission may be deleterious. This review article summarizes the pathophysiology of acute respiratory failure, management options, and rescue therapies including airway pressure release ventilation, continuous neuromuscular blockade, inhaled nitric oxide, and extracorporeal membrane oxygenation.
• Mosier, J. M., Joshi, R., Hypes, C., Pacheco, G. S., Valenzuela, T. D., & Sakles, J. C. (2015). The Physiologically Difficult Airway. Western Journal of Emergency Medicine, 16(7), 1109-1117.
• Mosier, J. M., Joshi, R., Hypes, C., Pacheco, G., Valenzuela, T. D., & Sakles, J. C. (2015). The physiologically difficult airway. Western Journal of Emergency Medicine, 16(7), 1109-1117.
• Mosier, J. M., Joshi, R., Hypes, C., Pacheco, G., Valenzuela, T., & Sakles, J. C. (2015). The Physiologically Difficult Airway. The western journal of emergency medicine, 16(7), 1109-17.
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  Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation.
• Mosier, J. M., Kelsey, M., Raz, Y., Gunnerson, K. J., Meyer, R., Hypes, C. D., Malo, J., Whitmore, S. P., & Spaite, D. W. (2015). Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Critical care (London, England), 19, 431.
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  Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal life support that augments oxygenation, ventilation and/or cardiac output via cannulae connected to a circuit that pumps blood through an oxygenator and back into the patient. ECMO has been used for decades to support cardiopulmonary disease refractory to conventional therapy. While not robust, there are promising data for the use of ECMO in acute hypoxemic respiratory failure, cardiac arrest, and cardiogenic shock and the potential indications for ECMO continue to increase. This review discusses the existing literature on the potential use of ECMO in critically ill patients within the emergency department.
• Mosier, J. M., Malo, J., Sakles, J. C., Hypes, C. D., Natt, B., Snyder, L., Knepler, J., Bloom, J. W., Joshi, R., & Knox, K. (2015). The impact of a comprehensive airway management training program for pulmonary and critical care medicine fellows. A three-year experience. Annals of the American Thoracic Society, 12(4), 539-48.
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  Airway management in the intensive care unit (ICU) is challenging, as many patients have limited physiologic reserve and are at risk for clinical deterioration if the airway is not quickly secured. In academic medical centers, ICU intubations are often performed by trainees, making airway management education paramount for pulmonary and critical care trainees.
• Mosier, J. M., Sakles, J. C., Stolz, U., Hypes, C. D., Chopra, H., Malo, J., & Bloom, J. W. (2015). Neuromuscular blockade improves first-attempt success for intubation in the intensive care unit. A propensity matched analysis. Annals of the American Thoracic Society, 12(5), 734-41.
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  The use of neuromuscular blocking agents (NMBAs) has been shown to be valuable in improving successful tracheal intubation in the operating room and emergency department. However, data on NMBA use in critically ill intensive care unit (ICU) patients are lacking. Furthermore, there are no data on NMBA use with video laryngoscopy.
• Mosier, J. M., Sakles, J. C., Whitmore, S. P., Hypes, C. D., Hallett, D. K., Hawbaker, K. E., Snyder, L. S., & Bloom, J. W. (2015). Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications. ANNALS OF INTENSIVE CARE, 5, 1-9.
• Mosier, J. M., Sakles, J. C., Whitmore, S. P., Hypes, C. D., Hallett, D. K., Hawbaker, K. E., Snyder, L. S., & Bloom, J. W. (2015). Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications. Annals of intensive care, 5, 4.
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  Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU).
• Mosier, J., & Marcolini, E. (2015). An alternative perspective regarding the "myth of the workforce crisis". American Journal of Respiratory and Critical Care Medicine, 191(6). doi:10.1164/rccm.201412-2297LE
• Mosier, J., Itty, A., Sanders, A., Mohler, J., Wendel, C., Poulsen, J., Shellenberger, J., Clark, L., & Bobrow, B. (2015). Cardiocerebral Resuscitation Is Associated With Improved Survival and Neurologic Outcome from Out-of-hospital Cardiac Arrest in Elders. ACADEMIC EMERGENCY MEDICINE, 17(3), 269-275.
• Pacheco, G., Hypes, C., Joshi, R., & Mosier, J. (2015). EMERGENCY DEPARTMENT RECOGNITION OF CRITICAL ILLNESS-RELATED CORTICOSTEROID INSUFFICIENCY. CRITICAL CARE MEDICINE, 43(12).
• Panchal, A. R., Satyanarayan, A., Bahadir, J. D., Hays, D., & Mosier, J. (2015). EFFICACY OF BOLUS-DOSE PHENYLEPHRINE FOR PERI-INTUBATION HYPOTENSION. JOURNAL OF EMERGENCY MEDICINE, 49(4), 488-494.
• Panchal, A. R., Satyanarayan, A., Bahadir, J. D., Hays, D., & Mosier, J. (2015). Efficacy of Bolus-dose Phenylephrine for Peri-intubation Hypotension. The Journal of emergency medicine, 49(4), 488-94.
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  Intubation in hypotensive emergency department (ED) patients may increase the risk of life-threatening complications such as hypoperfusion and cardiovascular collapse. Peripherally administered, diluted "push-dose" phenylephrine has been advocated to treat peri-intubation hypotension, however, its effectiveness is unknown.
• Prescher, H., Grover, E., Mosier, J., Stolz, U., Biffar, D. E., Hamilton, A. J., & Sakles, J. C. (2015). Telepresent Intubation Supervision Is as Effective as In-Person Supervision of Procedurally Naive Operators. TELEMEDICINE AND E-HEALTH, 21(3), 170-175.
• Prescher, H., Grover, E., Mosier, J., Stolz, U., Biffar, D. E., Hamilton, A. J., & Sakles, J. C. (2015). Telepresent intubation supervision is as effective as in-person supervision of procedurally naive operators. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 21(3), 170-5.
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  Telepresence is emerging in clinical and educational settings as a potential modality to provide expert guidance during remote airway management. This study aimed to compare the effectiveness of telepresent versus in-person supervision of tracheal intubation.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Dicken, J. M., Kalin, L., & Javedani, P. P. (2015). The C-MAC® video laryngoscope is superior to the direct laryngoscope for the rescue of failed first-attempt intubations in the emergency department. The Journal of emergency medicine, 48(3), 280-6.
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  To compare the effectiveness of the C-MAC® video laryngoscope (CMAC) to the direct laryngoscope (DL) when used to rescue a failed first attempt intubation in the emergency department (ED).
• Stolz, L. A., Mosier, J. M., Gross, A. M., Douglas, M. J., Blaivas, M., & Adhikari, S. (2015). Can emergency physicians perform common carotid Doppler flow measurements to assess volume responsiveness?. The western journal of emergency medicine, 16(2), 255-9.
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  Common carotid flow measurements may be clinically useful to determine volume responsiveness. The objective of this study was to assess the ability of emergency physicians (EP) to obtain sonographic images and measurements of the common carotid artery velocity time integral (VTi) for potential use in assessing volume responsiveness in the clinical setting.
• Thajudeen, B., Kamel, M., Arumugam, C., Ali, S. A., John, S. G., Meister, E. E., Mosier, J. M., Raz, Y., Madhrira, M., Thompson, J., & Sussman, A. N. (2015). Outcome of patients on combined extracorporeal membrane oxygenation and continuous renal replacement therapy: a retrospective study. INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, 38(3), 133-137.
• Thajudeen, B., Kamel, M., Arumugam, C., Ali, S. A., John, S. G., Meister, E. E., Mosier, J. M., Raz, Y., Madhrira, M., Thompson, J., & Sussman, A. N. (2015). Outcome of patients on combined extracorporeal membrane oxygenation and continuous renal replacement therapy: a retrospective study. The International journal of artificial organs, 38(3), 133-7.
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  Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy used in the management of cardiopulmonary failure. Continuous renal replacement therapy (CRRT) is often added to the treatment for the correction of fluid and electrolyte imbalance in patients with acute kidney injury. Most of the literature on the use of combined ECMO and CRRT has been on pediatric patients. There are limited outcome data on the use of these combined modalities in adult patients.
• Abraham, I., Cosentino, M., Dicken, J., Mosier, J., Patanwala, A. E., & Sakles, J. C. (2014). The Difficult Airway in the ED: Comparison of Video Laryngoscopy to Direct Laryngoscopy. Journal of Emergency Medicine, 46(2), 279. doi:10.1016/j.jemermed.2013.11.015
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  To compare the efficacy of video laryngoscopy (VL) to direct laryngoscopy (DL) for intubation of emergency department (ED) patients with difficult airways.
• Adhikari, S., Blaivas, M., Douglas, M. J., Gross, A. M., Mosier, J. M., & Stolz, L. A. (2014). 355 Can Emergency Physicians Obtain Measurements Of Common Carotid Doppler Flow To Assess Volume Responsiveness. Annals of Emergency Medicine, 64(4), S125-S126. doi:10.1016/j.annemergmed.2014.07.383
• Adhikari, S., Fiorello, A., Stolz, L., Jones, T., Amini, R., Gross, A., O'Brien, K., Mosier, J., & Blaivas, M. (2014). Ability of emergency physicians with advanced echocardiographic experience at a single center to identify complex echocardiographic abnormalities. AMERICAN JOURNAL OF EMERGENCY MEDICINE, 32(4), 363-366.
• Adhikari, S., Fiorello, A., Stolz, L., Jones, T., Amini, R., Gross, A., O'Brien, K., Mosier, J., & Blaivas, M. (2014). Ability of emergency physicians with advanced echocardiographic experience at a single center to identify complex echocardiographic abnormalities. The American journal of emergency medicine, 32(4), 363-6.
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  To determine the ability of emergency physicians to detect complex abnormalities on point-of-care (POC) echocardiograms.
• Alzoubaidi, M., Bloom, J. W., Mosier, J., & Snyder, L. (2014). Medical image of the week: constrictive pericaditis. Southwest Journal of Pulmonary and Critical Care, 8(5), 280-280. doi:10.13175/swjpcc042-14
• Arteaga, V., Mosier, J., & Strawter, C. (2014). Medical image of the week: asbestosis. Southwest Journal of Pulmonary and Critical Care, 9(6), 309-310. doi:10.13175/swjpcc156-14
• Assar, S., Mosier, J., & Vo, T. (2014). Medical image of the week: acute aortic dissection. Southwest Journal of Pulmonary and Critical Care, 8(4), 234-234. doi:10.13175/swjpcc039-14
• Bloom, J. W., Chopra, H., Hypes, C., Malo, J., Mosier, J., & Sakles, J. C. (2014). 729: NEUROMUSCULAR BLOCKADE IMPROVES TRACHEAL INTUBATION SUCCESS IN THE INTENSIVE CARE UNIT. Critical Care Medicine, 42, A1535-A1536. doi:10.1097/01.ccm.0000458226.17777.65
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  Mosier, Jarrod1; Chopra, Harsharon2; Sakles, John3; Malo, Josh4; Bloom, John5; Hypes, Cameron6 Author Information
• Bloom, J. W., Hypes, C., Joshi, R., Malo, J., Mosier, J., Natt, B., Sakles, J. C., & Stolz, U. (2014). 14: VIDEO LARYNGOSCOPY IMPROVES ODDS OF FIRST ATTEMPT SUCCESS AT INTUBATION IN THE INTENSIVE CARE UNIT. Critical Care Medicine, 42, A1372. doi:10.1097/01.ccm.0000457547.64511.59
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  Rationale: Urgent tracheal intubation is performed frequently in intensive care units and incurs higher risk than when intubation is performed under more controlled circumstances. Video laryngoscopy may improve the chances of successful tracheal intubation on the first attempt; however, existing comparative data on outcomes are limited. Objectives: To compare first-attempt success and complication rates during intubation when using video laryngoscopy compared with traditional direct laryngoscopy in a tertiary academic medical intensive care unit. Methods: We prospectively collected and analyzed data from a continuous quality improvement database of all intubations in one medical intensive care unit between January 1, 2012, and December 31, 2014. Propensity matching and multivariable logistic regression were used to reduce the risk of bias and control for confounding. Measurements and Main Results: A total of 809 intubations took place over the study period. Of these, 673 (83.2%) were performed using video laryngoscopy and 136 (16.8%) using direct laryngoscopy. First-attempt success with video laryngoscopy was 80.4% (95% confidence interval [CI], 77.2–83.3%) compared with 65.4% (95% CI, 56.8–73.4%) for intubations performed with direct laryngoscopy (P ,0.001). In a propensity-matched analysis, the odds ratio for first-attempt success with video laryngoscopy versus direct laryngoscopy was 2.81 (95% CI, 2.27–3.59). The rate of arterial oxygen desaturation events during the first intubation attempt was significantly lower for video laryngoscopy than for direct laryngoscopy (18.3% vs. 25.9%; P = 0.04). The rate of esophageal intubation during any attempt wasalso significantly lowerforvideolaryngoscopy(2.1%vs.6.6%; P = 0.008).
• Cosentino, M., Mosier, J., & Sakles, J. C. (2014). Incidence of Hypoxemia during Rapid Sequence Intubation of Head Injured Patients in the Emergency Department. Journal of Emergency Medicine, 46(2), 278. doi:10.1016/j.jemermed.2013.11.013
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  Previous literature has demonstrated that a single event of hypoxemia in a head-injured patient substantially increases morbidity. During intubation in the emergency department (ED), patients with head injuries are at great risk of oxygen desaturation.
• Dalabih, M., Rischard, F., & Mosier, J. M. (2014). What's new: the management of acute right ventricular decompensation of chronic pulmonary hypertension. Intensive care medicine, 40(12), 1930-3.
• Dicken, J., Mosier, J., Patanwala, A. E., & Sakles, J. C. (2014). 32 Improvement in Laryngoscopy Skills of Emergency Medicine Residents over a Three-Year Residency. Annals of Emergency Medicine, 64(4), S12-S13. doi:10.1016/j.annemergmed.2014.07.057
• Gaither, J. B., Spaite, D. W., Stolz, U., Ennis, J., Mosier, J., & Sakles, J. J. (2014). Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation. The Journal of emergency medicine, 47(3), 294-300.
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  Difficult airway predictors (DAPs) are associated with failed endotracheal intubation (ETI) in the emergency department (ED). However, little is known about the relationship between DAPs and failed prehospital ETI.
• Hallett, D. K., Javedani, P. P., & Mosier, J. (2014). Ultrasound Protocol Use in the Evaluation of an Unstable Patient. Ultrasound Clinics, 9(2), 293-306. doi:10.1016/j.cult.2014.01.006
• Joshi, R., de Witt, B., & Mosier, J. M. (2014). Optimizing oxygen delivery in the critically ill: the utility of lactate and central venous oxygen saturation (ScvO2) as a roadmap of resuscitation in shock. The Journal of emergency medicine, 47(4), 493-500.
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  Resuscitation of any critically ill patient is aimed at restoration of oxygen delivery to maintain aerobic metabolism. Thus, "endpoints" of resuscitation have been sought after as a measure of evaluating the adequacy of resuscitation. This review article describes the most commonly used endpoints, central venous oxygen saturation (ScvO2) and lactate, and provides a clinically useful paradigm for utilizing these endpoints during resuscitation of critically ill patients in the emergency department (ED).
• Michailidou, M., O’Keeffe, T., Mosier, J. M., Friese, R. S., Joseph, B., Rhee, P., & Sakles, J. C. (2014). A Comparison of Video Laryngoscopy to Direct Laryngoscopy for the Emergency Intubation of Trauma Patients. World Journal of Surgery, 39(3), 782-788. doi:10.1007/s00268-014-2845-z
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  Background: Direct laryngoscopy (DL) has long been the gold standard for tracheal intubation in emergency and trauma patients. Video laryngoscopy (VL) is increasingly used in many settings and the purpose of this study was to compare its effectiveness to direct laryngoscopy in trauma patients. Our hypothesis was that the success rate of VL would be higher than that of DL. Methods: Data were collected prospectively on all trauma patients, from January 2008 to June 2011, who were intubated emergently in an academic level I trauma center. After intubation, the physician that performed the intubation completed a structured data collection form that included demographics, complications, and the presence of difficult airway predictors. Our primary outcome measure was overall successful tracheal intubation, which was defined as successful intubation with the first device used. Results: During the study period, 709 trauma patients were intubated by either VL or DL. VL was performed in 55 % of cases. The overall success rate of VL was 88 % compared to 83 % with DL (P = 0.05). Cervical (C-Spine) immobilization was predictive of higher initial success with VL (87 %) than with DL (80 %) (P < 0.05). In multivariate regression analysis DL was associated with higher risk of intubation failure compared to VL (OR 1.82, CI: 1.15-2.86). Conclusions: In trauma patients intubated emergently, VL had a significantly higher success rate than DL. These data suggest that, in select circumstances, VL is superior to DL for the intubation of trauma patients with difficult airways.
• Mosier, J. (2014). Ultrasound for critical care physicians: hypotension. Southwest Journal of Pulmonary and Critical Care, 8(1), 41-43. doi:10.13175/swjpcc176-13
• Mosier, J. M., & Law, J. A. (2014). Airway management in the critically ill. Intensive care medicine, 40(5), 727-9.
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  Successful first attempt intubation of the critically ill patient is of extreme importance. While these patients are anatomically and physiologically complicated, making intubation particularly risky, several important steps have recently been shown to improve the chances of a safe first attempt success. Proper evaluation, planning, positioning, preoxygenation, and in select patients the use of a neuromuscular blocking agent have all been shown to be useful for minimizing the difficult intubation and intubation- related complications. Additionally, although there is significant controversy regarding video laryngoscopy, the use of a video laryngoscope as the primary method of intubation has been shown in all cases to be at least as good as, and often more successful than, direct laryngoscopy.
• Mosier, J. M., Malo, J., Stolz, L. A., Bloom, J. W., Reyes, N. A., Snyder, L. S., & Adhikari, S. (2014). Critical care ultrasound training: a survey of US fellowship directors. Journal of critical care, 29(4), 645-9.
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  The purpose of this study is to describe the current state of bedside ultrasound use and training among critical care (CC) training programs in the United States.
• Mosier, J. M., Stolz, L. A., Bloom, J. W., Malo, J., Snyder, L. S., Fiorello, A. B., Adhikari, S. R., Mosier, J. M., Stolz, L. A., Bloom, J. W., Malo, J., Snyder, L. S., Fiorello, A. B., & Adhikari, S. R. (2014). Resuscitative Echocardiography for the Evaluation and Management of Shock: The RECES protocol. Southwest Journal of Pulmonary and Critical Care, 8(2), 110-25.
• Mosier, J. M., Stolz, U., Chiu, S., & Sakles, J. C. (2014). DIFFICULT AIRWAY MANAGEMENT IN THE EMERGENCY DEPARTMENT: GLIDESCOPE VIDEOLARYNGOSCOPY COMPARED TO DIRECT LARYNGOSCOPY. JOURNAL OF EMERGENCY MEDICINE, 42(6), 629-634.
• Mosier, J., Chiu, S., Patanwala, A. E., & Sakles, J. C. (2014). A Comparison of the GlideScope Video Laryngoscope to the C-MAC Video Laryngoscope for Intubation in the Emergency Department. ANNALS OF EMERGENCY MEDICINE, 61(4), 414-420.
• Mosier, J., Joseph, B., & Sakles, J. C. (2014). Telebation: Next-Generation Telemedicine in Remote Airway Management Using Current Wireless Technologies. TELEMEDICINE AND E-HEALTH, 19(2), 95-98.
• Sakles, J. C., Mosier, J. M., Patanwala, A. E., Dicken, J. M., Kalin, L., & Javedani, P. P. (2014). THE C-MAC (R) VIDEO LARYNGOSCOPE IS SUPERIOR TO THE DIRECT LARYNGOSCOPE FOR THE RESCUE OF FAILED FIRST-ATTEMPT INTUBATIONS IN THE EMERGENCY DEPARTMENT. JOURNAL OF EMERGENCY MEDICINE, 48(3), 280-286.
• Sakles, J. C., Mosier, J., Patanwala, A. E., & Dicken, J. (2014). Improvement in GlideScope (R) Video Laryngoscopy performance over a seven-year period in an academic emergency department. INTERNAL AND EMERGENCY MEDICINE, 9(7), 789-794.
• Sakles, J. C., Mosier, J., Patanwala, A. E., & Dicken, J. (2014). Improvement in GlideScope® Video Laryngoscopy performance over a seven-year period in an academic emergency department. Internal and emergency medicine, 9(7), 789-94.
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  To evaluate the outcomes in first pass success (FPS) of GlideScope (GVL) intubations over a seven-year period in an academic ED. Data were prospectively collected on all patients intubated in an academic ED with a level 1 trauma center over the seven-year period from July 1, 2007 to June 30, 2014. Following each intubation, the operator completed a standardized data collection form that included information on patient, operator and procedure characteristics. The primary outcome was first pass success, defined as successful intubation with a single laryngoscope blade insertion. The secondary outcome was the Cormack-Lehane (CL) view of the airway. To adjust for important confounders, a logistic regression model was used to determine the association between academic year and first pass success. In the first year of the study, the first pass success with the GVL was 75.6% (68/90; 95% CI 65.4-84.0%) and the percentage of patients with CL I/II views was 95.6% (86/90; 95% CI 89.0-98.8%). By the seventh year of the study, the first pass success with the GVL increased to 92.1% (128/139; 95% CI 86.3-96.0%) and the percentage of patients with CL I/II views was 94.2% (131/139; 95% CI 89.0-97.5%). In the logistic regression model, first pass success improved during the seven-year period (aOR 3.1; 95% CI 1.3-7.1; p = 0.008). Over the seven-year period, there was significant improvement in the first pass success of the GVL, without any change in the Cormack-Lehane view, suggesting that there was improvement in the skill of tube delivery with use of the GVL over time.
• Sakles, J. C., Mosier, J., Patanwala, A. E., & Dicken, J. (2014). Learning curves for direct laryngoscopy and GlideScope® video laryngoscopy in an emergency medicine residency. The western journal of emergency medicine, 15(7), 930-7.
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  Our objective is to evaluate the resident learning curves for direct laryngoscopy (DL) and GlideScope® video laryngoscopy (GVL) over the course of an emergency medicine (EM) residency training program.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., & Dicken, J. M. (2014). Comparison of video laryngoscopy to direct laryngoscopy for intubation of patients with difficult airway characteristics in the emergency department. INTERNAL AND EMERGENCY MEDICINE, 9(1), 93-98.
• Sakles, J. C., Patanwala, A. E., Mosier, J. M., & Dicken, J. M. (2014). Comparison of video laryngoscopy to direct laryngoscopy for intubation of patients with difficult airway characteristics in the emergency department. Internal and emergency medicine, 9(1), 93-8.
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  The objective of the study is to compare the efficacy of video laryngoscopy (VL) to direct laryngoscopy (DL) on the first pass intubation success of patients with difficult airway characteristics (DACs) in the emergency department (ED). Over a 6-year period, between July 1 2007 and June 30 2013, all intubations performed in an academic ED were recorded in a continuous quality improvement (CQI) database by the operators. The CQI form included information such as patient demographics, operator level of training, device(s) used, number of attempts and outcome of each attempt. In addition, operators performed a difficult airway assessment and noted the presence or absence of the following difficult airway characteristics (DACs): airway edema, cervical immobility, facial/neck trauma, large tongue, obesity, short neck, small mandible, and blood or vomit in the airway. Patients
• Sakles, J. C., Patanwala, A. E., Mosier, J., Dicken, J., & Holman, N. (2014). Comparison of the reusable standard GlideScope® video laryngoscope and the disposable cobalt GlideScope® video laryngoscope for tracheal intubation in an academic emergency department: a retrospective review. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 21(4), 408-15.
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  The objective was to compare the first-pass success and clinical performance characteristics of the reusable standard GlideScope® video laryngoscope (sGVL) and the disposable Cobalt GlideScope® video laryngoscope (cGVL).
• Stolz, U., Bouska, R., Mosier, J., & Sakles, J. C. (2014). Rapid Sequence Intubation Compared to Sedation Only for Out-of-OR Intubations Using Video Laryngoscopy. Journal of Emergency Medicine, 46(2), 279. doi:10.1016/j.jemermed.2013.11.016
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  Rapid sequence intubation (RSI) has been the preferred technique for out-of-OR (operating room) intubations due to the improved grade of glottic view and overall intubating conditions when using direct laryngoscopy. Given the design of video laryngoscopes (VL), the benefit of RSI may not be as significant, as the view of the glottic inlet is from a camera positioned on the distal undersurface of the blade. To date, no literature exists evaluating the effect of RSI with video laryngoscopy.
• de Witt, B., Joshi, R., Meislin, H., & Mosier, J. M. (2014). Optimizing oxygen delivery in the critically ill: assessment of volume responsiveness in the septic patient. The Journal of emergency medicine, 47(5), 608-15.
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  Assessing volume responsiveness, defined as an increase in cardiac index after infusion of fluids, is important when caring for critically ill patients in septic shock, as both under- and over-resuscitation can worsen outcomes. This review article describes the currently available methods of assessing volume responsiveness for critically ill patients in the emergency department, with a focus on patients in septic shock.
• de, W. B., Joshi, R., Meislin, H., & Mosier, J. M. (2014). OPTIMIZING OXYGEN DELIVERY IN THE CRITICALLY ILL: ASSESSMENT OF VOLUME RESPONSIVENESS IN THE SEPTIC PATIENT. JOURNAL OF EMERGENCY MEDICINE, 47(5), 608-615.
• Adhikari, S., Fiorello, A., Stolz, L., Amini, R., Gross, A., O'Brien, K., Mosier, J., & Blaivas, M. (2013). Can Emergency Physicians Accurately Identify Complex Abnormalities on Point-of-Care Echocardiogram?. ANNALS OF EMERGENCY MEDICINE, 62(4), S78-S78.
• Blood, J., & Mosier, J. (2013). Medical image of the week: purpura fulminans. Southwest Journal of Pulmonary and Critical Care, 6(6), 305-305. doi:10.13175/swjpcc082-13
• Bloom, J. W., & Mosier, J. (2013). Medical image of the week: undulating arterial waveform. Southwest Journal of Pulmonary and Critical Care, 7(5), 315-315. doi:10.13175/swjpcc153-13
• Bloom, J. W., Douglas, M. J., Molloy, M., Mosier, J., Sakles, J. C., & Snyder, L. (2013). 379: ODDS OF ADVERSE EVENTS OF INTUBATION FOLLOWING FAILED NON-INVASIVE POSITIVE PRESSURE VENTILATION. Critical Care Medicine, 41, A90. doi:10.1097/01.ccm.0000439523.21310.52
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  Introduction: Patients requiring intubation following failed noninvasive positive pressure ventilation (NIPPV) have a higher risk of mortality than patients intubated primarily. However, the risk of procedurally related adverse events from intubation after failed NIPPV are unknown. Methods: Each patient intubated was included in a prospective QI registry of ICU airway management in the 20+ bed Medical ICU of a 450+ bed university medical center. After each intubation, the operator completed a standardized airway QI form. Relevant data included: patient demographics, clinical data, difficult airway predictors (DAPs), methods of airway management, medications, outcomes, and complications of each attempt. Medical records for each patient were reviewed and hemodynamic and respiratory data were extracted. All patients intubated after failed NIPPV were eligible for inclusion and a cohort of patients intubated primarily were selected from the database randomly. 240 intubations occurring between January 1, 2012 and June 31, 2013 had complete data available and were eligible for inclusion. 130 patients were intubated after failed NIPPV, 110 were primary intubations. Primary outcome was the odds of any adverse event with intubation. Step-wise multivariate regression was performed to control for potential confounders. Results: There were no differences in age or gender between groups. Median DAPs for primary intubations was 2.2 (IQR 1–3), and 2.1 (IQR 1–3) for failed NIPPV. Patients intubated primarily more frequently had blood in the airway (25% vs 5%, p
• DeLuca, L. A., Shirazi, F., Guisto, J., Denninghoff, K., Mosier, J., Whitmore, S., & Meislin, H. (2013). DEVELOPMENT OF A HOSPITAL CREDENTIALING INSTRUMENT FOR EMERGENCY MEDICINE PHYSICIANS WHO HAVE COMPLETED FELLOWSHIP TRAINING CRITICAL CARE MEDICINE. INTENSIVE CARE MEDICINE, 39, S317-S318.
• Mosier, J. (2013). Medical image of the week: aortic tear. Southwest Journal of Pulmonary and Critical Care, 7(5), 307-307. doi:10.13175/swjpcc152-13
• Mosier, J. (2013). Medical image of the week: maggots. Southwest Journal of Pulmonary and Critical Care, 7(6), 338-338. doi:10.13175/swjpcc154-13
• Mosier, J. M., Whitmore, S. P., Bloom, J. W., Snyder, L. S., Graham, L. A., Carr, G. E., & Sakles, J. C. (2013). Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit. CRITICAL CARE, 17(5).
• Mosier, J. M., Whitmore, S. P., Bloom, J. W., Snyder, L. S., Graham, L. A., Carr, G. E., & Sakles, J. C. (2013). Video laryngoscopy improves intubation success and reduces esophageal intubations compared to direct laryngoscopy in the medical intensive care unit. Critical care (London, England), 17(5), R237.
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  Tracheal intubation in the Intensive Care Unit (ICU) can be challenging as patients often have anatomic and physiologic characteristics that make intubation particularly difficult. Video laryngoscopy (VL) has been shown to improve first attempt success compared to direct laryngoscopy (DL) in many clinical settings and may be an option for ICU intubations.
• Mosier, J., Chiu, S., Patanwala, A. E., & Sakles, J. C. (2013). A comparison of the GlideScope video laryngoscope to the C-MAC video laryngoscope for intubation in the emergency department. Annals of emergency medicine, 61(4), 414-420.e1.
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  There is growing use of video laryngoscopy in US emergency departments (EDs). This study seeks to compare intubation success between the GlideScope video laryngoscope and the C-MAC video laryngoscope (C-MAC) in ED intubations.
• Mosier, J., Joseph, B., & Sakles, J. C. (2013). Telebation: next-generation telemedicine in remote airway management using current wireless technologies. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 19(2), 95-8.
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  Since the first remote intubation with telemedicine guidance, wireless technology has advanced to enable more portable methods of telemedicine involvement in remote airway management.
• Mosier, J., Natt, B., Raz, Y., & Siddiqi, T. (2013). Refractory cardiogenic shock. Southwest Journal of Pulmonary and Critical Care, 7(4), 246-250. doi:10.13175/swjpcc098-13
• Mosier, J., Roper, G., Hays, D., & Guisto, J. (2013). Sedative dosing of propofol for treatment of migraine headache in the emergency department: a case series. The western journal of emergency medicine, 14(6), 646-9.
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  Migraine headaches requiring an emergency department visit due to failed outpatient rescue therapy present a significant challenge in terms of length of stay (LOS) and financial costs. Propofol therapy may be effective at pain reduction and reduce that length of stay given its pharmacokinetic properties as a short acting intravenous sedative anesthetic and pharmacodynamics on GABA mediated chloride flux.
• Sakles, J. C., Chiu, S., Mosier, J., Walker, C., & Stolz, U. (2013). The Importance of First Pass Success When Performing Orotracheal Intubation in the Emergency Department. ACADEMIC EMERGENCY MEDICINE, 20(1), 71-78.
• Sakles, J. C., Chiu, S., Mosier, J., Walker, C., & Stolz, U. (2013). The importance of first pass success when performing orotracheal intubation in the emergency department. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 20(1), 71-8.
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  The goal of this study was to determine the association of first pass success with the incidence of adverse events (AEs) during emergency department (ED) intubations.
• Sakles, J. C., Mosier, J. M., Chiu, S., & Keim, S. M. (2013). TRACHEAL INTUBATION IN THE EMERGENCY DEPARTMENT: A COMPARISON OF GLIDESCOPE (R) VIDEO LARYNGOSCOPY TO DIRECT LARYNGOSCOPY IN 822 INTUBATIONS. JOURNAL OF EMERGENCY MEDICINE, 42(4), 400-405.
• Sakles, J. C., Mosier, J., & Stolz, U. (2013). In reply. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 20(9), 966.
• Sakles, J. C., Mosier, J., Cosentino, M., & Patanwala, A. (2013). Incidence of Hypoxemia During Rapid Sequence Intubation of Head-Injured Patients in the Emergency Department. ANNALS OF EMERGENCY MEDICINE, 62(4), S147-S147.
• Sakles, J. C., Mosier, J., Hadeed, G., Hudson, M., Valenzuela, T., & Latifi, R. (2013). Telemedicine and Telepresence for Prehospital and Remote Hospital Tracheal Intubation Using a GlideScope (TM) Videolaryngoscope: A Model for Tele-Intubation. TELEMEDICINE AND E-HEALTH, 17(3), 185-188.
• Sakles, J. C., Mosier, J., Patanwala, A., Cosentino, M., & Dicken, J. (2013). A Comparison of the Reusable Standard GlideScope to the Disposable Cobalt GlideScope. ANNALS OF EMERGENCY MEDICINE, 62(4), S77-S77.
• Sakles, J. C., Patanwala, A. E., Mosier, J., Dicken, J., & Holman, N. (2013). Comparison of the Reusable Standard GlideScope((R)) Video Laryngoscope and the Disposable Cobalt GlideScope((R)) Video Laryngoscope for Tracheal Intubation in an Academic Emergency Department: A Retrospective ReviewComparacion del Videolaringoscopio GlideScope((R)) Estandar Reutilizable y el Videolaringoscopio Cobalt GlideScope((R)) Desechable para la Intubacion Endotraqueal en un Servicio de Urgencias Universitario: Una Revision Retrospectiva. ACADEMIC EMERGENCY MEDICINE, 21(4), 408-415.
• Satyanarayan, A., Panchal, A. R., & Mosier, J. (2013). EFFICACY OF BOLUS-DOSE PHENYLEPHRINE FOR PERI-INTUBATION HYPOTENSION. JOURNAL OF INVESTIGATIVE MEDICINE, 61(1), 213-214.
• Stolz, U., Biffar, D. E., Grover, E., Hamilton, A. J., Mosier, J., Prescher, H., & Sakles, J. C. (2013). Board 342 - Research Abstract Telepresent Intubation Instruction Is As Effective As In-Person When Instructing Naive Intubators (Submission #185). Simulation in healthcare : journal of the Society for Simulation in Healthcare, 8(6), 540. doi:10.1097/01.sih.0000441594.67094.e7
• Stolz, U., Bouska, R., Mosier, J., & Sakles, J. C. (2013). 873: Rapid Sequence Intubation Compared to Non-RSI for Out-of-OR Intubations with Video Laryngoscopy. Critical Care Medicine, 41(12), A218. doi:10.1097/01.ccm.0000440111.34502.7f
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  Introduction: Rapid Sequence Intubation (RSI) has been the preferred technique for out-of-OR intubations due to the improved grade of glottic view and overall intubating conditions when using direct laryngoscopy. Given the design of video laryngoscopes (VL), the benefit of RSI may not be as signific
• Valenzuela, T., Mosier, J., & Sakles, J. (2013). Tunnel vision. JEMS : a journal of emergency medical services, 38(1), 32-4, 36-7.
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  Since 2000, many studies of advanced emergency airway management have appeared in the medical literature. Although most described patients in the operating room, intensive care unit or emergency department, studies of video laryngoscopy in the field are in progress and beginning to appear in the literature. Video laryngoscopy provides better views of the glottis, and it permits more successful intubations with fewer attempts. Price reductions as more devices, some specifically intended for EMS, enter the market will lower the entry costs for adoption. It is my prediction that in five years, video laryngoscopy will be the method of choice for endotracheal intubation in the field.
• Michailidou, M., O'Keeffe, T., Mosier, J. M., Friese, R. S., Joseph, B., Rhee, P., & Sakles, J. C. (2012). A Comparison of Video Laryngoscopy to Direct Laryngoscopy for the Emergency Intubation of Trauma Patients. WORLD JOURNAL OF SURGERY, 39(3), 782-788.
• Mosier, J. M., Malo, J., Stolz, L. A., Bloom, J. W., Reyes, N. A., Snyder, L. S., & Adhikari, S. (2012). Critical care ultrasound training: A survey of US fellowship directors. JOURNAL OF CRITICAL CARE, 29(4), 645-649.
• Mosier, J. M., Stolz, U., Chiu, S., & Sakles, J. C. (2012). Difficult airway management in the emergency department: GlideScope videolaryngoscopy compared to direct laryngoscopy. The Journal of emergency medicine, 42(6), 629-34.
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  Videolaryngoscopy has become a popular method of intubation in the Emergency Department (ED), however, little research has compared this technique with direct laryngoscopy (DL).
• Mosier, J., Graham, L., Sakles, J., & Carr, G. (2012). VIDEO LARYNGOSCOPY IMPROVES FIRST ATTEMPT SUCCESS AND QUALITY OF LARYNGOSCOPIC VIEW COMPARED TO DIRECT LARYNGOSCOPY IN A MEDICAL INTENSIVE CARE UNIT. CRITICAL CARE MEDICINE, 40(12), U277-U277.
• Sakles, J. C., Mosier, J. M., Chiu, S., & Keim, S. M. (2012). Tracheal intubation in the emergency department: a comparison of GlideScope® video laryngoscopy to direct laryngoscopy in 822 intubations. The Journal of emergency medicine, 42(4), 400-5.
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  Video laryngoscopy has, in recent years, become more available to emergency physicians. However, little research has been conducted to compare their success to conventional direct laryngoscopy.
• Sakles, J. C., Mosier, J., Chiu, S., & Patanwala, A. (2012). A Comparison of the GlideScope (R) Video Laryngoscope to the C-MAC (R) Video Laryngoscope for Tracheal Intubation in the Emergency Department. ANNALS OF EMERGENCY MEDICINE, 60(4), S63-S63.
• Sakles, J. C., Mosier, J., Chiu, S., Cosentino, M., & Kalin, L. (2012). A comparison of the C-MAC video laryngoscope to the Macintosh direct laryngoscope for intubation in the emergency department. Annals of emergency medicine, 60(6), 739-48.
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  We determine the proportion of successful intubations with the C-MAC video laryngoscope (C-MAC) compared with the direct laryngoscope in emergency department (ED) intubations.
• Watt, J., Amini, A., Mosier, J., Gustafson, M., Wynne, J. L., Friese, R., Gruessner, R. W., Rhee, P., & O'Keeffe, T. (2012). Treatment of severe hemolytic anemia caused by Clostridium perfringens sepsis in a liver transplant recipient. Surgical infections, 13(1), 60-2.
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  Clostridium perfringens bacteremia accompanied by extensive intravascular hemolysis is an almost inescapably fatal infection.
• Gaither, J. B., Spaite, D. W., Stolz, U., Ennis, J., Mosier, J., & Sakles, J. J. (2011). PREVALENCE OF DIFFICULT AIRWAY PREDICTORS IN CASES OF FAILED PREHOSPITAL ENDOTRACHEAL INTUBATION. JOURNAL OF EMERGENCY MEDICINE, 47(3), 294-300.
• Mohler, M. J., Wendel, C. S., Mosier, J., Itty, A., Fain, M., Clark, L., Bobrow, B., & Sanders, A. B. (2011). Cardiocerebral Resuscitation Improves Out-of-Hospital Survival in Older Adults. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 59(5), 822-826.
• Mohler, M. J., Wendel, C. S., Mosier, J., Itty, A., Fain, M., Clark, L., Bobrow, B., & Sanders, A. B. (2011). Cardiocerebral resuscitation improves out-of-hospital survival in older adults. Journal of the American Geriatrics Society, 59(5), 822-6.
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  To compare the survival and neurological status of people aged 65 and older receiving cardiocerebral resuscitation (CCR) with that of those receiving standard advanced life support (Std-ALS), as well as predictors of survival.
• Sakles, J. C., Mosier, J., Hadeed, G., Hudson, M., Valenzuela, T., & Latifi, R. (2011). Telemedicine and telepresence for prehospital and remote hospital tracheal intubation using a GlideScope™ videolaryngoscope: a model for tele-intubation. Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 17(3), 185-8.
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  The inability to secure a patient's airway in the prehospital setting is a major cause of potentially preventable death in the field of trauma and emergency medicine.
• Doraiswamy, V. A., Hegde, V., Bhatt, R., Mosier, J., & Ott, P. (2010). Carotid artery puncture, myocardial injury, and ventricular arrhythmia. Southern medical journal, 103(9), 967-8.
• Hiller, K., Jarrod, M. M., Franke, H. A., Degan, J., Boyer, L. V., & Fox, F. M. (2010). Scorpion antivenom administered by alternative infusions. Annals of Emergency Medicine, 56(Issue 3). doi:10.1016/j.annemergmed.2010.04.007
• Mosier, J., Itty, A., Sanders, A., Mohler, J., Wendel, C., Poulsen, J., Shellenberger, J., Clark, L., & Bobrow, B. (2010). Cardiocerebral resuscitation is associated with improved survival and neurologic outcome from out-of-hospital cardiac arrest in elders. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 17(3), 269-75.
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  Recent studies have shown that a new emergency medical services (EMS) protocol for treating patients who suffer out-of-hospital cardiac arrest (OHCA), cardiocerebral resuscitation (CCR), significantly improves survival compared to standard advanced life support (ALS). However, due to their different physiology, it is unclear if all elders, or any subsets of elders who are OHCA victims, would benefit from the CCR protocol.
• Sakles, J. C., Mosier, J., Chiu, S., Cosentino, M., & Kalin, L. (2010). A Comparison of the C-MAC Video Laryngoscope to the Macintosh Direct Laryngoscope for Intubation in the Emergency Department. ANNALS OF EMERGENCY MEDICINE, 60(6), 739-748.
• Watt, J., Amini, A., Mosier, J., Gustafson, M., Wynne, J. L., Friese, R., Gruessner, R. W., Rhee, P., & O'Keeffe, T. (2010). Treatment of Severe Hemolytic Anemia Caused by Clostridium perfringens Sepsis in a Liver Transplant Recipient. SURGICAL INFECTIONS, 13(1), 60-62.
• Mohler, M. J., Wendel, C., Mosier, J., Itty, A., Poulsen, J., Shellenberger, J., Bobrow, B., Clark, L., & Sanders, A. (2009). The Effect of Cardiocerebral Resuscitation in Aging Adults. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 57, S70-S70.
• Mosier, J., & Scott, C. (2008). Elastic bandage ankle bardr. Consultant, 48(10).

Proceedings Publications

• Essay, P., Mosier, J., Subbian, V., & Vicera, C. (2020). Analysis of Acute Respiratory Failure Patient Noninvasive Ventilation Therapy. In A40. CRITICAL CARE: FROM HFNC TO ECMO.

Presentations

• Bull, D. A., Lick, S. D., Hypes, C., Natt, B., Mosier, J. M., Malo, J., & Hsu, C. (2019, May/). Duration and Outcomes of Veno-Venous Extracorporeal Membrane Oxygenation Support in Acute Respiratory Distress Syndrome: Results from ELSO database. American association for thoracic surgery 99th annual meeting. Toronto: American association for thoracic surgery.
• Mosier, J. M., Patanwala, A., Hypes, C., Augustinovich, C., & Sakles, J. C. (2018, May). Use of an Airway Registry to Improve the Safety of Airway Management in the Emergency Department. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Sakles, J. C., Mosier, J. M., Hypes, C., & Pacheco, G. (2018, May). Video Laryngoscopy Improves First Pass Success in Pediatric Intubations in the Emergency Department. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Sakles, J. C., Wolfe, A., Patanwala, A., & Olvera, D. (2018, May). The Importance of First Pass Success in Prehospital Intubation. Society for Academic Emergency Medicine Annual Meeting. Indianapolis, IA: Society for Academic Emergency Medicine.
• Mosier, J. M., O'Keeffe, T., Falvey, D., Joshi, R., & Friedman, L. (2013, March). Emergency Physician Knowledge of Massive Transfusion Protocol in Trauma. Western Society for Academic Emergency Medicine. Long Beach, CA.

Poster Presentations

• Kazui, T., Hsu, C., Malo, J., Mosier, J. M., Natt, B., Hypes, C., Lick, S. D., & Bull, D. A. (2020, April). Interfacility transfer via a mobile intensive care unit following a double lumen catheter cannulation at the referring facility for veno-venous extracorporeal membrane oxygenation. THE INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION 2020 Scientific Program. Montreal, Canada: THE INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION.
• Pacheco, G., Hypes, C., Mosier, J. M., Patanwala, A., Sakles, J. C., & Hurst, N. B. (2019, November). Adverse Events in Patients with Physiologically Difficult and Anatomically Difficult Airways in the Emergency Department.. World Airway Management Meeting. Amsterdam, NE: SAM, EAMS.
• Sakles, J. C., Hypes, C., Mosier, J. M., & Pacheco, G. (2019, November). The Physiologically Difficult Airway is Associated with as Many Adverse Events as the Anatomically Difficult Airway in the Emergency Department. World Airway Management Meeting. Amsterdam: Society For Airway Management.
• Sakles, J. C., Sakles, J. C., Hypes, C., Hypes, C., Mosier, J. M., Mosier, J. M., Pacheco, G., & Pacheco, G. (2019, November). The Physiologically Difficult Airway is Associated with as Many Adverse Events as the Anatomically Difficult Airway in the Emergency Department. World Airway Management Meeting (WAMM). Amsterdam: Society For Airway Management.
• Augustinovich, C., Hypes, C., Patanwala, A. E., Mosier, J. M., & Sakles, J. C. (2017, September). Improvement in the Quality and Safety of Airway Management in the Emergency Department Over a 10-Year Period with the Use of an Airway CQI Program. Society for Airway Management Annual Meeting. Newport Beach, CA.
• Cristan, E., Morrissette, K., Greenberg, J., Natt, B., Mosier, J. M., Sakles, J. C., & Hypes, C. (2017, Feb). Rethinking NIV: when it works, it works. When it doesn't, it really doesn't. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
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  22. Greenberg J, Mosier J, Natt B, Morrissette K, Cristan C, Sakles J, Hypes C; Rethinking NIV: when it works, it works. When it doesn't, it really doesn't [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Douglas, M., Mosier, J. M., Patanwala, A. E., Sakles, J. C., & Hypes, C. (2017, May). The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations [Poster]. Society for Academic Emergency Medicine Annual Meeting. Orlando, FL: Society for Academic Emergency Medicine.
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  25. Sakles J, Douglas M, Hypes C, Patanwala A, Mosier J; The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations [Poster]; Society for Academic Emergency Medicine Annual Meeting; May 2017; Orlando FL.
• Douglas, M., Mosier, J. M., Patanwala, A. E., Sakles, J. C., & Hypes, C. (2017, September). Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation. Society for Airway Management. Newport Beach, CA.: Society for Airway Management.
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  26. Sakles J, Mosier J, Douglas M, Hypes C, Patanwala A; Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation [Poster]; Society for Airway Management; September 2017; Newport Beach, CA.
• Douglas, M., Patanwala, A., Mosier, J. M., Sakles, J. C., & Hypes, C. (2017, May). The Unanticipated Difficult Airway during Emergency Tracheal Intubation [Poster]. Society for Academic Emergency Medicine Annual Meeting. Orlando, FL: Society for Academic Emergency Medicine.
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  24. Hypes C, Mosier J, Douglas M, Patanwala A, Sakles J; The Unanticipated Difficult Airway during Emergency Tracheal Intubation [Poster]; Society for Academic Emergency Medicine Annual Meeting; May 2017; Orlando FL.
• Hypes, C., Hypes, C., Sakles, J. C., Sakles, J. C., Malo, J., Malo, J., Bloom, J. W., Bloom, J. W., Joshi, R., Joshi, R., Mosier, J. M., Mosier, J. M., Greenberg, J., & Greenberg, J. (2016, Spring). First attempt success at intubation is associated with a lower odds of adverse events in the ICU. Society For Academic Emergency Medicine. New Orleans, LA.
• Hypes, C., Mosier, J. M., Patanwala, A. E., & Sakles, J. C. (2017, May). The Unanticipated Difficult Airway During Emergency Tracheal Intubation. SAEM Annual Meeting. Orlando, FL.
• Milligan, R., Cristan, E., Morrissette, K., Jeremy, G., Mosier, J. M., Malo, J., Sakles, J. C., & Hypes, C. (2017, Feb). Re-intubation in the Intensive Care Unit: Is it Truly as Difficult as Assumed? [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
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  23. Greenberg J, Mosier J, Malo J, Morrissette K, Cristan E, Milligan R, Sakles J, Hypes C; Re-intubation in the Intensive Care Unit: Is it Truly as Difficult as Assumed? [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Milligan, R., Greenberg, J., Cristan, E., Morrissette, K., Mosier, J. M., Malo, J., Sakles, J. C., & Hypes, C. (2017, Feb). Flexible Fiberoptic vs Video Larygoscopy: Insights on Difficult Airway Success and Complications [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
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  20. Morrissette K, Mosier J, Cristan E, Greenberg J, Milligan R, Sakles J, Malo J, Hypes C, Flexible Fiberoptic vs Video Larygoscopy: Insights on Difficult Airway Success and Complications [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI.
• Morrissette, K., Greenberg, J., Cristan, E., Milligan, R., Mosier, J. M., Malo, J., Sakles, J. C., & Hypes, C. (2017, Feb). Intubation and First Pass Success, a Comparison of C-MAC and GlideScope in the Intensive Care Unit [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI: Society of Critical Care Medicine.
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  21. Milligan R, Mosier J, Cristan E, Greenberg J, Morrissette K, Sakles J, Malo J, Hypes C; Intubation and First Pass Success, a Comparison of C-MAC and GlideScope in the Intensive Care Unit [Poster]; Society of Critical Care Medicine Annual Congress; February 2017; Honolulu, HI
• Morrissette, K., Milligan, R., Cristan, E., Mosier, J. M., Malo, J., Sakles, J. C., & Hypes, C. (2017, February). Improvement in tracheal intubation over time with the institution of a quality improvement program [Poster]. Society of Critical Care Medicine Annual Congress. Honolulu, HI.: Society of Critical Care Medicine.
• Rao, P., Skaria, R., Mosier, J. M., Malo, J., Smith, R., & Khalpey, Z. I. (2017, November). Temporary Mechanical Circulatory Support Using a Novel Minimally-Invasive Approach for Central VA-ECMO. American Heart Association Annual Meeting. Chicago, IL.
• Sakles, J. C., Douglas, M., Hypes, C., Patanwala, A. E., & Mosier, J. M. (2017, May). The Physiologically Difficult Airway is Associated with a Reduced First Pass Success without Adverse Events During Emergency Department Intubations . SAEM Annual Meeting. Orlando, FL.
• Sakles, J. C., Mosier, J. M., Douglas, M., Hypes, C., & Patanwala, A. E. (2017, September). Measuring FeO2 in the Emergency Department to Optimize Preoxygenation During Rapid Sequence Intubation. Society for Airway Management Annual Meeting. Newport Beach, CA.
• Baalachandran, R., Trutter, L., Raz, Y., Mosier, J. M., Kazui, T., & Malo, J. (2016, Spring). Successful Use of Extracorporeal Membrane Oxygenation in a Patient with Pulmonary Coccidioidomycosis-Related Acute Respiratory Distress Syndrome.. American Thoracic Society Annual Meeting. San Francisco, CA.
• Greenberg, J., Mosier, J. M., Joshi, R., Bloom, J. W., Malo, J., Sakles, J. C., & Hypes, C. (2016, Feb). First Attempt Success at Intubation is Associated with a Lower Odds of Adverse Events in the ICU. Society of Critical Care Medicine Annual Congress. Orlando.
• Hypes, C., Sakles, J. C., Nararro, T., Greenberg, J., Natt, B., Chopra, H., & Mosier, J. M. (2016, Sept). Failure to achieve first attempt success is associated with a higher odds of adverse events during intubation in the Intensive Care Unit using a video laryngoscope. Society for Airway Management. Atlanta.
• Johnston, D., Mosier, J. M., Joshi, R., Malo, J., Bloom, J. W., Sakles, J. C., & Hypes, C. (2016, Feb). Reason For Failed Attempts At Laryngoscopy Differs Between Video And Direct Laryngoscopes. Society of Critical Care Medicine Annual Congress. Orlando.
• Joshi, R., Hypes, C., Malo, J., Bloom, J. W., Sakles, J. C., & Mosier, J. M. (2016, Feb). Predictors of Difficult Intubation When Using Video Laryngoscopy in the Intensive Care Unit. Society of Critical Care Medicine Annual Congress.
• Kelsey, M., Sakles, J. C., Joshi, R., Malo, J., Bloom, J. W., Hypes, C., & Mosier, J. M. (2016, Feb). Derivation of a Bundle to Improve First Attempt Success at Intubation in the Intensive Care Unit. Society of Critical Care Medicine Annual Congress. Orlando.
• Nararro, T., Mosier, J. M., Sakles, J. C., Greenberg, J., Natt, B., Chopra, H., & Hypes, C. (2016, Sept). Predictors of complications of Intensive Care Unit airway management despite first attempt success using video laryngoscopy. Society for Airway Management.
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  This submission won the SAM travel award for Dr. Navarro to present it at the conference. I mentored Dr. Navarro in this activity.
• Natt, B., Malo, J., Hypes, C., Kazui, T., Basken, R., & Mosier, J. M. (2016, August). Outcomes of Patients with Severe Influenza Treated at the Banner-University Medical Center During the 2015-16 Influenza Season. Options IX for the Control of Influenza. Chicago.
• Natt, B., Malo, J., Hypes, C., Kazui, T., Basken, R., & Mosier, J. M. (2016, August/Summer). Outcomes of Patients with Severe Influenza Treated at the Banner-University Medical Center During the 2015-16 Influenza Season. Options IX for the Control of Influenza. Chicago, IL.
• Natt, B., Mosier, J. M., Basken, R., Malo, J., Hypes, C., Kazui, T., Kazui, T., Hypes, C., Basken, R., Malo, J., Mosier, J. M., & Natt, B. (2016, Summer). Outcomes of Patients with Severe Influenza Treated at the Banner-University Medical Center During the 2015-16 Influenza Season. Options IX for the Control of Influenza. Chicago, IL.
• Pacheco, G., Hypes, C., Joshi, R., Mosier, J. M., Pacheco, G. S., Hypes, C., Joshi, R., & Mosier, J. M. (2016, Feb). Emergency Department Recognition of Critical Illness Related Corticosteroid Insufficiency. Society of Critical Care Medicine Annual Congress. Orlando.
• Sakles, J. C., Douglas, M., Hypes, C., Pantawala, A., & Mosier, J. M. (2016, Sept). Incidence, Management and Outcomes of the Difficult Airway in the Emergency Department. Society for Airway Management. Atlanta.
• Sakles, J. C., Douglas, M., Hypes, C., Patanwala, A. E., & Mosier, J. M. (2016, September). Incidence, management and outcomes of the difficult airway in the emergency department. Society for Airway Management. Atlanta.
• Greenberg, J., Mosier, J. M., Joshi, R., Bloom, J. W., Malo, J., Sakles, J. C., & Hypes, C. D. (2016, February). First attempt success at intubation is associated with a lower odds of adverse events in the ICU. SCCM Annual Conference.
• Johnston, D., Mosier, J. M., Joshi, R., Malo, J., Sakles, J. C., Bloom, J. W., & Hypes, C. D. (2016, February). Reason for failed attempts at laryngoscopy differs between video and direct laryngoscopes. SCCM Annual Conference.
• Joshi, R., Hypes, C. D., Malo, J., Bloom, J. W., Sakles, J. C., & Mosier, J. M. (2016, February). Predictors of difficult intubation when using video laryngoscopy in the ICU. SCCM Annual Conference.
• Kelsey, M., Hypes, C. D., Joshi, R., Malo, J., Bloom, J. W., Sakles, J. C., & Mosier, J. M. (2016, February). Derivation of a bundle to improve first attempt success at intubation in the ICU. SCCM Annual Conferece.
• Natt, B., Malo, J., Snyder, L. S., Knepler, J. L., Knox, K. S., & Mosier, J. M. (2015, May/Spring). Advanced Airway Management in Critical Care Fellowship Training. ATS International Conference. Denver, CO.

Reviews

• Mosier, J. M., Kelsey, M., Raz, Y., Gunnerson, K. J., Meyer, R., Hypes, C. D., Malo, J., Whitmore, S. P., & Spaite, D. W. (2015. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions.
• Mosier, J. M., Hypes, C., Joshi, R., Whitmore, S., Parthasarathy, S., & Cairns, C. B. (2012. Ventilator Strategies and Rescue Therapies for Management of Acute Respiratory Failure in the Emergency Department(pp 529-541).

Others

• Mosier, J. M., & Sakles, J. C. (2018, August). Management of the Physiologically Difficult Airway in the Emergency Department. Anesthesiology News.
• Mosier, J. M., & Marcolini, E. (2015). An alternative perspective regarding the "myth of the workforce crisis". American journal of respiratory and critical care medicine.
• Mosier, J. M., & Marcolini, E. (2015, MAR 15). An Alternative Perspective Regarding the "Myth of the Workforce Crisis". AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE.
• Mosier, J., Chopra, H., Sakles, J., Malo, J., Bloom, J., & Hypes, C. (2015, DEC). NEUROMUSCULAR BLOCKADE IMPROVES TRACHEAL INTUBATION SUCCESS IN THE INTENSIVE CARE UNIT. CRITICAL CARE MEDICINE.
• Bouska, R., Stolz, U., Sakles, J., & Mosier, J. (2014, DEC). Rapid Sequence Intubation Compared to Non-RSI for Out-of-OR Intubations with Video Laryngoscopy. CRITICAL CARE MEDICINE.
• Doraiswamy, V. A., Hegde, V., Bhatt, R., Mosier, J., & Ott, P. (2014, SEP). Carotid Artery Puncture, Myocardial Injury, and Ventricular Arrhythmia. SOUTHERN MEDICAL JOURNAL.
• Mosier, J. M., & Law, J. A. (2014, MAY). Airway management in the critically ill. INTENSIVE CARE MEDICINE.
• Sakles, J. C., Mosier, J., & Stolz, U. (2014, SEP). Chicken or Egg? Risks of Misattribution of Cause-Effect Relationships in Studies of Association Reply. ACADEMIC EMERGENCY MEDICINE.
• Hypes, C., Sakles, J., Malo, J., Bloom, J., & Mosier, J. (2013, DEC). VIDEO LARYNGOSCOPY IMPROVES ODDS OF FIRST ATTEMPT SUCCESS AT INTUBATION IN THE INTENSIVE CARE UNIT. CRITICAL CARE MEDICINE.
• Mosier, J., Douglas, M., Molloy, M., Bloom, J., Snyder, L., & Sakles, J. (2013, DEC). Odds of Adverse Events of Intubation Following Failed Non-Invasive Positive Pressure Ventilation. CRITICAL CARE MEDICINE.
• Dalabih, M., Rischard, F., & Mosier, J. M. (2012, DEC). What's new: the management of acute right ventricular decompensation of chronic pulmonary hypertension. INTENSIVE CARE MEDICINE.