Research Topics
| Deborah M SteinSummaryAffiliation: University of Maryland Country: USA Publications
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Publications
Hyperacute adrenal insufficiency after hemorrhagic shock exists and is associated with poor outcomesDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
J Trauma Acute Care Surg 74:363-70; discussion 370. 2013..Adrenal insufficiency (AI) has been extensively described in sepsis but not in acute hemorrhage. We sought to determine the incidence of hyperacute AI (HAI) immediately after hemorrhage and its association with mortality...- Use of serum biomarkers to predict secondary insults following severe traumatic brain injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
Shock 37:563-8. 2012..Given the morbidity of ICH and CH, minimizing the effects of these secondary insults may have a significant impact on outcome and help guide decisions about timing of interventions... - Use of serum biomarkers to predict cerebral hypoxia after severe traumatic brain injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Neurotrauma 29:1140-9. 2012..Given the morbidity of CH, early intervention and prevention may have a significant impact on outcomes and help guide decisions about the timing of interventions... 
Emergency neurological life support: traumatic spine injuryDeborah M Stein
University of Maryland School of Medicine, Baltimore, MD, USA
Neurocrit Care 17:S102-11. 2012..The initial emergency department clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered...- Capillary leak syndrome in trauma: what is it and what are the consequences?Deborah M Stein
University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA
Adv Surg 46:237-53. 2012..Whether these result in better outcomes remains to be seen and the authors anxiously await the results of well-designed prospective trials... - Reversal of coagulopathy in critically ill patients with traumatic brain injury: recombinant factor VIIa is more cost-effective than plasmaDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 66:63-72; discussion 73-5. 2009..We hypothesized that the use of rFVIIa in this patient population would prove to be cost-effective as well as demonstrate clinical benefit... - Blunt cerebrovascular injuries: does treatment always matter?Deborah M Stein
Division of Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 66:132-43; discussion 143-4. 2009..The purpose of this study is to describe a single institution's large experience in patients with BCVI in an effort to provide insight into the diagnosis and management of these injuries... - Association of CSF biomarkers and secondary insults following severe traumatic brain injuryDeborah M Stein
Division of Critical Care Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA
Neurocrit Care 14:200-7. 2011..This pilot study was undertaken to investigate the relationship of S100β and NSE to clinical markers of severity and poor outcome: intracranial hypertension (ICH), and cerebral hypoperfusion (CH)... - Brief episodes of intracranial hypertension and cerebral hypoperfusion are associated with poor functional outcome after severe traumatic brain injuryDeborah M Stein
Division of Critical Care Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 71:364-73; discussion 373-4. 2011..The purpose of this study was to establish whether a relationship exists between brief episodes of ICH and CH and outcome after severe TBI... - Risk factors for organ dysfunction and failure in patients with acute traumatic cervical spinal cord injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
Neurocrit Care 13:29-39. 2010..We also sought to determine if certain patient or injury characteristics were associated with the development of organ dysfunction and failure... - Occupant and crash characteristics for case occupants with cervical spine injuries sustained in motor vehicle collisionsDeborah M Stein
Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 70:299-309. 2011.... - Relationship of serum and cerebrospinal fluid biomarkers with intracranial hypertension and cerebral hypoperfusion after severe traumatic brain injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 70:1096-103. 2011..This study was undertaken to investigate the relationship of cytokine levels with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with severe TBI... - Low-dose recombinant factor VIIa for trauma patients with coagulopathyDeborah M Stein
R Adams Cowley Shock Trauma Centress, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Injury 39:1054-61. 2008..Expense has limited use. Recently, we began administering low dose FVIIa (1.2mg) to patients with mild to moderate coagulopathy after trauma, hypothetising that it would be effective and safe... - Recombinant factor VIIa: decreasing time to intervention in coagulopathic patients with severe traumatic brain injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
J Trauma 64:620-7; discussion 627-8. 2008..We hypothesized that the off-label use of recombinant factor VIIa (rFVIIa) to normalize the coagulation profile would allow for earlier intervention than conventional therapy... - Determinants of futility of administration of recombinant factor VIIa in traumaDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 59:609-15. 2005..We hypothesized that retrospective review of FVIIa use would identify variables associated with clinical futility... - Accuracy of computed tomography (CT) scan in the detection of penetrating diaphragm injuryDeborah M Stein
Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 63:538-43. 2007..With the increasing use of multidetector row CT (MDCT), we hypothesized that CT would be an accurate detection modality to identify patients with diaphragm injuries... - Nonoperative management of spleen and liver injuriesDeborah M Stein
Division of Critical Care Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Intensive Care Med 21:296-304. 2006..This review will discuss current concepts in nonoperative management of liver and spleen, including diagnosis, patient selection, nonoperative management strategies, benefits, risks, and complications... - Risk factors associated with pelvic fractures sustained in motor vehicle collisions involving newer vehiclesDeborah M Stein
Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 61:21-30; discussion 30-1. 2006..We utilized the Crash Injury Research Engineering Network (CIREN) database to identify these risk factors in newer vehicles... - Computational gene mapping to analyze continuous automated physiologic monitoring data in neuro-trauma intensive careDeborah M Stein
University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Shock Trauma and Anesthesia Research Center, Baltimore, Maryland, USA
J Trauma Acute Care Surg 73:419-24; discussion 424-5. 2012.... - Traditional systolic blood pressure targets underestimate hypotension-induced secondary brain injuryMegan Brenner
Division of Critical Care Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA
J Trauma Acute Care Surg 72:1135-9. 2012..We investigated the utility of automated continuously recorded vital signs to predict outcomes after sTBI... - Dynamic three-dimensional scoring of cerebral perfusion pressure and intracranial pressure provides a brain trauma index that predicts outcome in patients with severe traumatic brain injurySibel Kahraman
Shock Trauma and Anesthesia Research Center, R Adams Cowley Shock Truma Center, Baltimore, Maryland 21201, USA
J Trauma 70:547-53. 2011.... - Controversy in trauma resuscitation: do ratios of plasma to red blood cells matter?Lynn G Stansbury
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, USA
Transfus Med Rev 23:255-65. 2009..In this review, the authors examine the findings of these initial studies, highlighting the epidemiologic and analytic methodologies used, and the likely influence of these methodologies on the reported outcomes... - Induced hypothermia after cardiac arrest in trauma patients: a case seriesMazin A Tuma
R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA
J Trauma 71:1524-7. 2011..To characterize recent experience with this technique at our center, we undertook a detailed chart review of acute trauma patients managed with induced hypothermia after cardiac arrest... - Automated measurement of "pressure times time dose" of intracranial hypertension best predicts outcome after severe traumatic brain injurySibel Kahraman
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 69:110-8. 2010..We assessed the accuracy and utility of high-resolution automated intracranial pressure (ICP) and cerebral perfusion pressure (CPP) recording and their analysis in patients with severe TBI... - Pulmonary embolism after injury: more common than we think?Jay Menaker
R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland 21201, USA
J Trauma 67:1244-9. 2009..We hypothesized that an increased awareness of early PE would result in an increased incidence, an earlier diagnosis, and a decreased mortality of PE after injury... - Thromboembolic complications associated with factor VIIa administrationG O Rhys Thomas
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, MD 21201, USA
J Trauma 62:564-9. 2007..FVIIa is associated with thromboembolic complications, but the incidence is not known, nor is which patients are at risk. We examined our experience with FVIIa to better understand this issue... 
Blood product use in trauma resuscitation: plasma deficit versus plasma ratio as predictors of mortality in trauma (CME)Andreas R de Biasi
Department of Anesthesia, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
Transfusion 51:1925-32. 2011..However, demonstration of a benefit is confounded by survivor bias, and past work from our group has been unable to demonstrate a benefit...- Angiointervention: high rates of failure following blunt renal injuriesJay Menaker
Department of Surgery, University of Maryland School of Medicine, Division Trauma Critical Care, R Adams Cowley Shock Trauma Center, 22 South Greene Street, T1R60, Baltimore, MD 21201, USA
World J Surg 35:520-7. 2011..Recently, angioembolization (AE) has been used to extend NOM. Few data exist on evaluating NOM of blunt renal injuries (BRIs). We sought to determine the overall efficacy of NOM as well as the outcome of AE in patients with BRI... - 40-slice multidetector CT: is MRI still necessary for cervical spine clearance after blunt trauma?Jay Menaker
Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, T1R60 Baltimore, MD 21201, USA
Am Surg 76:157-63. 2010..Overall, MRI changed clinical practice in 17.8 per cent of all patients. Despite newer 40-slice CT technology, MRI continues to be necessary for CS clearance in patients with unreliable examinations or persistent symptoms... - Chyloperitoneum after blunt abdominal injuryJames M Haan
University of Maryland, R Adams Cowley Shock Trauma Center, Baltimore, Maryland 21201, USA
Am Surg 73:811-3. 2007..Open ligation or clipping of the injured ducts seems effective. Tube feeds with medium chain triglycerides may enhance efficacy of operative treatment... - Major hepatic necrosis: a common complication after angioembolization for treatment of high-grade liver injuriesDanielle N Dabbs
Division of Critical Care, Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
J Trauma 66:621-7; discussion 627-9. 2009..This study will examine the risk factors and outcomes of patients with high-grade liver injures managed with AE who developed the complication of MHN... - Treatment of major hepatic necrosis: lobectomy versus serial debridementDanielle N Dabbs
R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland 21201, USA
J Trauma 69:562-7. 2010..Major hepatic necrosis (MHN) is a common complication after angioembolization (AE) for severe liver injuries. We compared the outcomes of two treatment modalities... - Incidence of early pulmonary embolism after injuryJay Menaker
R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA
J Trauma 63:620-4. 2007..PE is generally thought to occur days after the acute injury. Hypoxia early after injury is often ascribed to other causes. We hypothesized that PE often occurs early after injury and we sought to elucidate the timing of PE after trauma... - Heart rate and pulse pressure variability are associated with intractable intracranial hypertension after severe traumatic brain injurySibel Kahraman
R Adams Cowley Shock Trauma Center, University of Maryland Shock Trauma Anesthesia Research Organized Research Center, Baltimore, MD, USA
J Neurosurg Anesthesiol 22:296-302. 2010..5]. Our data show that HRVi and PPVi can be monitored and calculated automatically and can provide useful prognostic information in patients with severe traumatic brain injury, particularly when combined into a single index... - Use of recombinant factor VIIa to facilitate organ donation in trauma patients with devastating neurologic injuryDeborah M Stein
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
J Am Coll Surg 208:120-5. 2009..We report on a series of patients with nonsurvivable TBI and severe coagulopathy or active hemorrhage who went on to successful organ donation with the use of recombinant factor VIIa (rFVIIa)... - Isolated severe traumatic brain injuries sustained during combat operations: demographics, mortality outcomes, and lessons to be learned from contrasts to civilian counterpartsJoseph J Dubose
University of Maryland Medical Center, R Adams Cowley Shock Trauma Center, Baltimore, Maryland 21201, USA
J Trauma 70:11-6; discussion 16-8. 2011..We reviewed the epidemiology of these injuries from the Joint Trauma Theater Registry (JTTR), contrasting these results with civilian counterparts from the National Trauma Databank (NTDB)... - Traumatic hemoptysis treated with recombinant human factor VIIaJames V O'Connor
Department of Thoracic and Vascular Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland 21201, USA
Ann Thorac Surg 81:1485-7. 2006..We report a case of the successful use of factor VIIa in the treatment of life-threatening hemoptysis secondary to blunt force thoracic injury and traumatic coagulopathy... - Uses of recombinant factor VIIa in traumaDeborah M Stein
Division of Critical Care Program in Trauma, Department of Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, Maryland 21201
Curr Opin Crit Care 10:520-8. 2004..Recombinant factor VIIa, developed for the treatment of patients with hemophilia, has been used with some success in acute bleeding associated with injuries... - Intracranial pressure dose and outcome in traumatic brain injuryKevin N Sheth
Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Neurocrit Care 18:26-32. 2013..The aim of this study was to determine the association between area under the curve measurement of elevated ICP and clinical outcome... - Autoresuscitation after asystole in patients being considered for organ donationKevin N Sheth
Departments of Neurology, The University of Maryland Medical Center, Baltimore, MD, USA
Crit Care Med 40:158-61. 2012..This study tested the hypothesis that a 2-min observation period after asystole is sufficient for the declaration of death in patients being considered for organ donation after circulatory death... - MDCT diagnosis of penetrating diaphragm injuryUttam K Bodanapally
Department of Diagnostic Radiology, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201, USA
Eur Radiol 19:1875-81. 2009..Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries... - Crash and occupant predictors of pulmonary contusionJames V O'Connor
R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
J Trauma 66:1091-5. 2009..The crash and occupant characteristics of PC in motor vehicle collisions are currently unknown. Additionally, the clinical significance and the impact on mortality have not been determined... - Pro/con debate: does recombinant factor VIIa have a role to play in the treatment of patients with acute nontraumatic hemorrhage?Paola Pieri
Division of Critical Care Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
Crit Care 10:214. 2006..Perhaps this product promotes additional discussion given that its ability to control bleeding can be dramatic, yet its costs and potential for complications high... - Cocaine-induced agitated delirium with associated hyperthermia: a case reportJay Menaker
R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, USA
J Emerg Med 41:e49-53. 2011..The incidence of the disease is not known, however, it is believed to have markedly increased since the late 1980s with widespread popularity of crack cocaine... - Cellular alterations in human traumatic brain injury: changes in mitochondrial morphology reflect regional levels of injury severityIrina S Balan
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
J Neurotrauma 30:367-81. 2013..These quantitative observations may be useful in guiding the translation of mitochondrial-based neuroprotective interventions to clinical implementation... - Infectious complications in GSW's through the gastrointestinal tract into the spineRonald P Rabinowitz
Department of Medicine, University of Maryland School of Medicine, Infectious Diseases, R Adams Cowley Shock Trauma Center, Room T3N11, 22 S Greene Street, Baltimore, MD 21201, USA
Injury 43:1058-60. 2012..Trans-gastrointestinal tract GSW's to the spine are devastating injuries with significant potential for infectious complications. We sought to address antimicrobial management of these injuries... - Ultrasound-guided peripheral intravenous access in the intensive care unitShea C Gregg
Division of Surgical Critical Care, R Adams Cowley Shock Trauma Center, Baltimore, MD 21201, USA
J Crit Care 25:514-9. 2010.... - Recombinant factor VIIa and thromboembolic eventsRichard P Dutton
JAMA 296:43-4; author reply 44. 2006 - The use of factor VIIa in haemorrhagic shock and intracerebral bleedingRichard P Dutton
R Adams Cowley Shock Trauma Center, University of Maryland Medical System, United States
Injury 37:1172-7. 2006.... - Posttraumatic cerebral infarction: incidence, outcome, and risk factorsIsaac Tawil
Division of Trauma Critical Care, Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA
J Trauma 64:849-53. 2008..We suspected that recent advances in imaging modalities and treatment might affect incidence and outcome. We sought to define the incidence and mortality impact of PTCI. We also identified risk factors associated with PTCI...