Charles R. Wira
Yale University
Internal medicineSurgeryLogistic regressionOdds ratioHealth careCardiologyRetrospective cohort studyIntensive care medicineEmergency medicineIntracerebral hemorrhageSeptic shockSepsisThrombolysisEmergency departmentIschemic strokeIv thrombolysisAnesthesiaStrokeReceiver operating characteristicMedicineBiology
94Publications
18H-index
1,646Citations
Publications 89
Newest
#1Mercy H Mazurek (Yale University)H-Index: 1
#2Bradley A Cahn (Yale University)H-Index: 1
Last. Laura SacolickH-Index: 14
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Radiological examination of the brain is a critical determinant of stroke care pathways. Accessible neuroimaging is essential to detect the presence of intracerebral hemorrhage (ICH). Conventional magnetic resonance imaging (MRI) operates at high magnetic field strength (1.5–3 T), which requires an access-controlled environment, rendering MRI often inaccessible. We demonstrate the use of a low-field MRI (0.064 T) for ICH evaluation. Patients were imaged using conventional neuroimaging (non-contr...
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#1Eric Boccio (Yale University)H-Index: 2
#2Adrian D. Haimovich (Yale University)H-Index: 15
Last. Justin B. Belsky (Yale University)H-Index: 7
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BACKGROUND Emergency physicians express concern administering a 30-cc/kg fluid bolus to septic shock patients with pre-existing congestive heart failure (CHF), end-stage renal disease (ESRD), or obesity, due to the perceived risk of precipitating a fluid overload state. OBJECTIVE Our aim was to determine whether there is a difference in fluid administration to septic shock patients with these pre-existing conditions in the emergency department (ED). Secondary objectives focused on whether compli...
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#1Xiao Wu (Yale University)H-Index: 13
#2Charles R. Wira (Yale University)H-Index: 18
Last. Ajay Malhotra (Yale University)H-Index: 21
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BackgroundTriage for suspected acute stroke has two main options (1) transport to the closest primary stroke center (PSC) and then to the nearest comprehensive stroke center (CSC) (Drip-and-Ship) or (2) transport the patient to the nearest CSC, bypassing a closer PSC (mothership). The purpose was to evaluate the effectiveness of drip-and-ship versus mothership models for acute stroke patients.MethodsA Markov decision-analytic model was constructed. All model parameters were derived from recent m...
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#1Krithika Umesh Peshwe (WVU: West Virginia University)H-Index: 1
#2Cindy Khanh Nguyen (Yale University)H-Index: 2
Last. Nils H Petersen (Yale University)H-Index: 18
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Objective: To evaluate relation of blood pressure (BP) reductions during hyperacute period of large vessel occlusion (LVO) stroke with infarct progression and functional outcome. Background: BP reductions during endovascular therapy (EVT) have been associated with infarct progression and worse outcome after LVO stroke. However, BP trajectories in the hyperacute phase prior to EVT have not been well characterized. We used high-frequency BP and hemodynamic monitoring to study timing of BP reductio...
#1Susan AshcraftH-Index: 1
#2Susan WilsonH-Index: 4
Last. Tamika M. BurrusH-Index: 1
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The year 2020 was the year of the nurse, celebrating nurse scholarship, innovation, and leadership by promoting scientific nursing research, improving nursing practice, advancing nursing education, and providing leadership to influence health policy. As architects of stroke care, neuroscience nurses play a vital role in collaborating and coordinating care between multiple health professionals. Nurses improve accessibility and equity through telestroke, emergency medical services, and mobile stro...
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#1Krithika Umesh Peshwe (WVU: West Virginia University)H-Index: 1
#2Cindy Khanh Nguyen (Yale University)H-Index: 2
Last. Nils H Petersen (Yale University)H-Index: 18
view all 10 authors...
Introduction: Decreases in blood pressure (BP) during endovascular therapy (EVT) have been associated with infarct progression and worse outcome after large vessel occlusion (LVO) stroke. However, ...
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#1Matthew M Yuen (Yale University)H-Index: 1
#2Mercy H Mazurek (Yale University)H-Index: 1
Last. Kevin N. Sheth (Yale University)H-Index: 56
view all 26 authors...
Background and Aims: Advances in low-field MRI have enabled image acquisition at the point-of-care (POC). We aim to characterize ischemic lesions in low-field, POC MRI and assess its relationship w...
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#1Mayank GoyalH-Index: 16
#2Julie KrommH-Index: 5
Last. Aha
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A health care crisis such as the coronavirus disease 2019 (COVID-19) pandemic requires allocation of hospital staff and resources on short notice. Thus, new and sometimes less experienced team members might join the team to fill in the gaps. This scenario can be particularly challenging in endovascular stroke treatment, which is a highly specialized task that requires seamless cooperation of numerous health care workers across various specialties and professions. This document is intended for st...
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#1Phavalan Rajendram (Sunnybrook Health Sciences Centre)H-Index: 3
#2Lowyl Notario (Sunnybrook Health Sciences Centre)H-Index: 2
Last. Houman Khosravani (Sunnybrook Health Sciences Centre)H-Index: 23
view all 7 authors...
Background and purpose Management of stroke patients in the acute setting is a high-stakes task with several challenges including the need for rapid assessment and treatment, maintenance of high-performing team dynamics, management of cognitive load affecting providers, and factors impacting team communication. Crisis resource management (CRM) provides a framework to tackle these challenges and is well established in other resuscitative disciplines. The current Coronavirus Disease 2019 (COVID-19...
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