Acute Tubular Necrosis | Montefiore Einstein

Dr. Shiloh is the Director of the Critical Care Medicine Consult Service and Professor of Medicine at Montefiore Medical Center/Albert Einstein College of Medicine. As a clinician-educator he serves as the director of critical care ultrasonography.  
After receiving his medical degree from the Medical School for International Health at Ben Gurion University of the Negev in 2005, he completed both his Internal Medicine residency and Critical Care Medicine fellowship at Montefiore Medical Center/Albert Einstein College of Medicine. Dr. Shiloh joined the Montefiore/Einstein Critical Care faculty in 2010. 
 Dr. Shiloh is board-certified in: 
·         Internal Medicine
·         Critical Care Medicine
·         Neurocritical Care
·         Hospice and Palliative Medicine
As an active member of CHEST, Dr. Shiloh serves as faculty leader and co-chair for the Critical Care Ultrasound: Integration Into Clinical Practice course.  He is an active contributor to CHEST’s “Better with Ultrasound” and “Ultrasound Corner” series and a recipient of the “Distinguished Chest Educator” award. Award recipients represent the top 4% of CHEST’s international faculty and are recognized for their achievements and long-term contributions to the design and delivery of CHEST education.
Dr. Shiloh has authored over 50 original articles, co-edited the “The 5-Minute ICU Consult” published by Lippincott Williams & Wilkins, and has authored over 15 book chapters. His areas of interest and research include use of point of care ultrasonography, early identification of critical illness, and critical care education and simulation training.

Research Areas

Point of care ultrasonography, Early identification of critical illness, Critical care education and simulation training

Research Profile

https://einsteinmed.edu/faculty/12325/Ariel-Shiloh

Clinical Profile

https://montefioreeinstein.org/profiles/1346561891/ariel-l-shiloh

CHAM Provider

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Professional Title

M.D.

Clinical Focus

Early Detection and Treatment of Critical Illness, Point Of Care Ultrasonography For The Evaluation Of Critical Illness, Advanced Airway Management

Research Focus

Dr. Shiloh's research includes the clinical use of point-of-care ultrasonography in critical illness, improvement of airway management, and cardiopulmonary resuscitation.

Elsevier Profile

https://einstein.pure.elsevier.com/en/persons/8d2b5a69-f92d-4934-92c8-f17a064f1…

Selected Publications

1: Shah TE, Vij R, Kim YH, Shiloh AL. Sudden Unilateral Vision Loss in a Patient
Who Received Intravenous Thrombolytic Therapy. Chest. 2021 Dec;160(6):e669-e672.
doi: 10.1016/j.chest.2021.03.074. PMID: 34872684.
 
2: Nauka PC, Chen JT, Shiloh AL, Eisen LA, Fein DG. Practice, Outcomes, and
Complications of Emergent Endotracheal Intubation by Critical Care Practitioners
During the COVID-19 Pandemic. Chest. 2021 Dec;160(6):2112-2122. doi:
10.1016/j.chest.2021.06.008. Epub 2021 Jun 15. PMID: 34139207; PMCID:
PMC8204844.
 
3: Savel RH, Shiloh AL, Kupfer Y, Hope AA. The Complex Issue of Race and
Coronavirus Disease 2019 in the ICU. Crit Care Med. 2021 Mar 1;49(3):532-535.
doi: 10.1097/CCM.0000000000004766. PMID: 33616353.
 
4: Jabbour E, Malik D, Shiloh AL. Sudden Cardiopulmonary Collapse in a Patient
With Coronavirus Disease 2019. Chest. 2021 Feb;159(2):e127-e129. doi:
10.1016/j.chest.2020.05.618. PMID: 33563455; PMCID: PMC7859694.
 
5: Savel RH, Kupfer Y, Shiloh AL. Steady As She Goes: Practicing Evidence-Based
Critical Care When the Evidence Is Limited. Chest. 2021 Jan;159(1):7-8. doi:
10.1016/j.chest.2020.09.245. PMID: 33422231; PMCID: PMC7787062.
 
6: Tirumandas M, Gendlina I, Figueredo J, Shiloh A, Trachuk P, Jain R, Corpuz M,
Spund B, Maity A, Shmunko D, Garcia M, Barthelemy D, Weston G, Madaline T.
Analysis of catheter utilization, central line associated bloodstream
infections, and costs associated with an inpatient critical care-driven vascular
access model. Am J Infect Control. 2021 May;49(5):582-585. doi:
10.1016/j.ajic.2020.10.006. Epub 2020 Oct 17. PMID: 33080360.
 
7: Fein DG, Zhao D, Swartz K, Nauka P, Andrea L, Aboodi M, Shiloh AL, Eisen LA.
The Impact of Nighttime on First Pass Success During the Emergent Endotracheal
Intubation of Critically Ill Patients. J Intensive Care Med. 2021
Dec;36(12):1498-1506. doi: 10.1177/0885066620965166. Epub 2020 Oct 15. PMID:
33054483.
 
8: Kapoor S, Chand S, Dieiev V, Fazzari M, Tanner T, Lewandowski DC, Nalla A,
Abdulfattah O, Aboodi MS, Shiloh AL, Gong MN. Thromboembolic Events and Role of
Point of Care Ultrasound in Hospitalized Covid-19 Patients Needing Intensive
Care Unit Admission. J Intensive Care Med. 2021 Dec;36(12):1483-1490. doi:
10.1177/0885066620964392. Epub 2020 Oct 6. PMID: 33021131; PMCID: PMC7539230.
 
9: Emami N, Tanner T, Ogundipe F, Hawn VS, Rubin R, Skae CC, Shiloh AL, Keene
AB. Drape to prevent disease transmission during endotracheal intubation. Am J
Infect Control. 2021 Mar;49(3):387-388. doi: 10.1016/j.ajic.2020.06.212. Epub
2020 Jul 3. PMID: 32628982; PMCID: PMC7333628.
 
10: Millington SJ, Colvin MO, Shiloh AL, Koenig S. How I Do It: Ultrasound-
Guided Internal Jugular and Femoral Central Venous Catheter Insertion. Chest.
2020 Dec;158(6):2425-2430. doi: 10.1016/j.chest.2020.06.026. Epub 2020 Jun 26.
PMID: 32599065.
 
11: Savel RH, Shiloh AL, Saunders PC, Kupfer Y. Mechanical Ventilation During
the Coronavirus Disease 2019 Pandemic: Combating the Tsunami of Misinformation
From Mainstream and Social Media. Crit Care Med. 2020 Sep;48(9):1398-1400. doi:
10.1097/CCM.0000000000004462. PMID: 32496274; PMCID: PMC7302097.
 
12: Shiloh AL, McPhee C, Eisen L, Koenig S, Millington SJ. Better With
Ultrasound: Detection of DVT. Chest. 2020 Sep;158(3):1122-1127. doi:
10.1016/j.chest.2020.01.038. Epub 2020 Feb 20. PMID: 32087215.
 
13: Islam M, Levitus M, Eisen L, Shiloh AL, Fein D. Lung Ultrasound for the
Diagnosis and Management of Acute Respiratory Failure. Lung. 2020
Feb;198(1):1-11. doi: 10.1007/s00408-019-00309-1. Epub 2020 Jan 1. PMID:
31894411.
 
14: Fein DG, Mastroianni F, Murphy CG, Aboodi M, Malik R, Emami N, Abramowitz M,
Shiloh AL, Eisen L. Impact of a Critical Care Specialist Intervention on First
Pass Success for Emergency Airway Management Outside the ICU. J Intensive Care
Med. 2021 Jan;36(1):80-88. doi: 10.1177/0885066619886816. Epub 2019 Nov 10.
PMID: 31707906.
 
15: Millington SJ, Hendin A, Shiloh AL, Koenig S. Better With Ultrasound:
Peripheral Intravenous Catheter Insertion. Chest. 2020 Feb;157(2):369-375. doi:
10.1016/j.chest.2019.04.139. Epub 2019 Oct 22. PMID: 31654617.
 
16: Wang A, Hendin A, Millington SJ, Koenig S, Eisen LA, Shiloh AL. Better With
Ultrasound: Arterial Line Placement. Chest. 2020 Mar;157(3):574-579. doi:
10.1016/j.chest.2019.08.2209. Epub 2019 Oct 18. PMID: 31634448.
 
17: Savel RH, Shiloh AL, Simon RJ, Kupfer Y. Getting It Right for Our Patients:
The Importance of Collaborative Leadership in the ICU. Crit Care Med. 2019
Sep;47(9):1279-1281. doi: 10.1097/CCM.0000000000003880. PMID: 31415316.
 
18: Islam M, Bangar M, Shiloh AL. A Woman in Her 70s on Anticoagulation With
Sudden Shock. Chest. 2019 May;155(5):e123-e126. doi:
10.1016/j.chest.2018.10.052. PMID: 31060707.
 
19: Patrawalla P, Narasimhan M, Eisen L, Shiloh AL, Koenig S, Mayo P. A
Regional, Cost-Effective, Collaborative Model for Critical Care Fellows'
Ultrasonography Education. J Intensive Care Med. 2020 Dec;35(12):1447-1452. doi:
10.1177/0885066619828951. Epub 2019 Feb 12. PMID: 30755062.
 
20: Shiloh AL. Smooth Transitions in Critical Care. J Emerg Trauma Shock. 2018
Jul-Sep;11(3):154-155. doi: 10.4103/JETS.JETS_44_17. PMID: 30429619; PMCID:
PMC6182967.
 
21: Savel RH, Shiloh AL. Are We Really Doing More With Less: The Value of Half-
Dose Alteplase in Pulmonary Embolism Therapy. Crit Care Med. 2018
Oct;46(10):1696-1697. doi: 10.1097/CCM.0000000000003303. PMID: 30216306.
 
22: Savel RH, Borgia D, Shiloh AL. A Path to High-Quality Care: Implementing
Flexible Visitation While Avoiding Staff Burnout. Crit Care Med. 2018
Jul;46(7):1203-1204. doi: 10.1097/CCM.0000000000003167. PMID: 29912108.
 
23: Ferenchick HR, Chua AT, Carlese AJ, Shiloh AL. A Woman With Recent Stroke
Presenting With Respiratory Failure and Shock. Chest. 2018 May;153(5):e101-e103.
doi: 10.1016/j.chest.2017.11.048. PMID: 29731049.
 
24: Savel RH, Shiloh AL, Simon RJ, Kupfer Y. Using Big Data to See the Big
Picture in Sepsis. Crit Care Med. 2018 Apr;46(4):640-641. doi:
10.1097/CCM.0000000000002976. PMID: 29538113.
 
25: Kumarasamy N, Tishbi N, Mukundan S, Shiloh A, Levsky JM, Haramati LB.
Cardiothoracic MRI in the ICU: A 10-Year Experience. Acad Radiol. 2018
Mar;25(3):359-364. doi: 10.1016/j.acra.2017.09.017. Epub 2018 Feb 6. PMID:
29426683.
 
26: Lishmanov A, Bellamkonda TT, Shiloh AL. A Woman in Her 20s With
Cardiopulmonary Failure. Chest. 2017 Jun;151(6):e123-e125. doi:
10.1016/j.chest.2017.01.040. PMID: 28599944.
 
27: Shiloh AL, Sobolev M, Di Biase L, Slovut DP. A call for safety during
electrophysiological procedures: US in, why not US out? Authors' reply.
Europace. 2017 Dec 1;19(12):2048-2049. doi: 10.1093/europace/eux007. PMID:
28340047.
 
28: Sobolev M, Shiloh AL, Di Biase L, Slovut DP. Ultrasound-guided cannulation
of the femoral vein in electrophysiological procedures: a systematic review and
meta-analysis. Europace. 2017 May 1;19(5):850-855. doi: 10.1093/europace/euw113.
PMID: 27207813.
 
29: Shiloh AL, Lominadze G, Gong MN, Savel RH. Early Warning/Track-and-Trigger
Systems to Detect Deterioration and Improve Outcomes in Hospitalized Patients.
Semin Respir Crit Care Med. 2016 Feb;37(1):88-95. doi: 10.1055/s-0035-1570352.
Epub 2016 Jan 28. PMID: 26820276.
 
30: Patrawalla P, Eisen LA, Shiloh A, Shah BJ, Savenkov O, Wise W, Evans L, Mayo
P, Szyld D. Development and Validation of an Assessment Tool for Competency in
Critical Care Ultrasound. J Grad Med Educ. 2015 Dec;7(4):567-73. doi:
10.4300/JGME-D-14-00613.1. PMID: 26692968; PMCID: PMC4675413.
 
31: Hena KM, Eisen LA, Shiloh AL. A Man in His 60s With Renal Failure and Shock
Refractory to Vasopressors. Chest. 2015 Dec;148(6):e171-e174. doi:
10.1378/chest.15-0160. PMID: 26621295.
 
32: Bernier-Jean A, Albert M, Shiloh AL, Eisen LA, Williamson D, Beaulieu Y. The
Diagnostic and Therapeutic Impact of Point-of-Care Ultrasonography in the
Intensive Care Unit. J Intensive Care Med. 2017 Mar;32(3):197-203. doi:
10.1177/0885066615606682. Epub 2016 Jul 9. PMID: 26423745.
 
33: Shiloh AL, Adrish M. A Man in His 60s With Cirrhosis, Encephalopathy, and
Shock. Chest. 2015 Jul;148(1):e5-e7. doi: 10.1378/chest.14-2201. PMID: 26149567.
 
34: Sobolev M, Slovut DP, Lee Chang A, Shiloh AL, Eisen LA. Ultrasound-Guided
Catheterization of the Femoral Artery: A Systematic Review and Meta-Analysis of
Randomized Controlled Trials. J Invasive Cardiol. 2015 Jul;27(7):318-23. PMID:
26136279.
 
35: Adrish M, Shiloh AL. A woman in her 50s with recent coronary artery bypass
grafting presenting with right-sided chest pain. Chest. 2015
May;147(5):e171-e174. doi: 10.1378/chest.14-0457. PMID: 25940259.
 
36: Shiloh AL, Ari Eisen L, Savel RH. The unplanned intensive care unit
admission. J Crit Care. 2015 Apr;30(2):419-20. doi: 10.1016/j.jcrc.2014.12.010.
Epub 2014 Dec 24. PMID: 25579373.
 
37: Eisen LA, Savel RH, Shiloh AL. Video laryngoscopy in the intensive care
unit. A clearer view? Ann Am Thorac Soc. 2014 Oct;11(8):1254-5. doi:
10.1513/AnnalsATS.201408-386ED. PMID: 25343195.
 
38: Chung M, Shiloh AL, Carlese A. Monitoring of the adult patient on
venoarterial extracorporeal membrane oxygenation. ScientificWorldJournal.
2014;2014:393258. doi: 10.1155/2014/393258. Epub 2014 Apr 3. PMID: 24977195;
PMCID: PMC3998007.
 
39: Karakitsos D, El Barbary M, Gillman LM, Papalois A, Shiloh A. Critical care
and perioperative monitoring. ScientificWorldJournal. 2014;2014:737628. doi:
10.1155/2014/737628. Epub 2014 May 4. PMID: 24892082; PMCID: PMC4032705.
 
40: Tischenkel BR, Gong MN, Shiloh AL, Pittignano VC, Keschner YG, Glueck JA,
Cohen HW, Eisen LA. Daytime Versus Nighttime Extubations: A Comparison of
Reintubation, Length of Stay, and Mortality. J Intensive Care Med. 2016
Feb;31(2):118-26. doi: 10.1177/0885066614531392. Epub 2014 Apr 24. PMID:
24763118.
 
41: Shiloh AL, Kazzi MG, Mathew R, Eisen LA, Carlese AJ. A man in his 40s with a
history of hypertension and alcohol dependency presenting to the ED with
respiratory distress: septic shock in the setting of ARDS. Chest. 2014
Feb;145(2):e3-e6. doi: 10.1378/chest.13-2089. PMID: 24493554.
 
42: Shiloh AL, Sobolev M, Eisen LA. A woman in her 30s in respiratory distress
with a history of gestational diabetes and hypertension. Chest. 2014
Jan;145(1):e1-e2. doi: 10.1378/chest.13-1850. PMID: 24394849.
 
43: Lahiri S, Boro AD, Shiloh AL, Milstein MJ, Savel RH. Periodic Epileptiform
Discharges Clarified for the Nonneurologist Intensivist: Clinical Implications
and Current Management. J Intensive Care Med. 2015 Oct;30(7):385-91. doi:
10.1177/0885066613513411. Epub 2013 Dec 9. PMID: 24323590.
 
44: Eisen LA, Janowski W, Shiloh AL. Ultrasound diagnosis of shock in a woman
with metastatic renal cell carcinoma. Chest. 2013 Sep;144(3):e1-e3. doi:
10.1378/chest.13-0964. PMID: 24008972.
 
45: Savel RH, Shiloh AL, Eisen LA. Tackling the tough questions: what was this
patient like before they were critically ill? Crit Care Med. 2013
Jan;41(1):327-8. doi: 10.1097/CCM.0b013e318267a8ad. PMID: 23269133.
 
46: Shiloh AL, Eisen LA, Yee M, Langner JB, LeDonne J, Karakitsos D. Ultrasound-
guided subclavian and axillary vein cannulation via an infraclavicular approach:
In the tradition of Robert Aubaniac. Crit Care Med. 2012 Oct;40(10):2922-3. doi:
10.1097/CCM.0b013e31825cea64. PMID: 22986669.
 
47: Keene AB, Shiloh AL, Dudaie R, Eisen LA, Savel RH. Online testing from
Google Docs™ to enhance teaching of core topics in critical care: a pilot study.
Med Teach. 2012;34(12):1075-7. doi: 10.3109/0142159X.2012.716553. Epub 2012 Aug
30. PMID: 22931149.
 
48: Stefanidis K, Pentilas N, Dimopoulos S, Nanas S, Savel RH, Shiloh AL,
Poularas J, Slama M, Karakitsos D. Echogenic Technology Improves Cannula
Visibility during Ultrasound-Guided Internal Jugular Vein Catheterization via a
Transverse Approach. Crit Care Res Pract. 2012;2012:306182. doi:
10.1155/2012/306182. Epub 2012 May 10. PMID: 22649715; PMCID: PMC3357505.
 
49: Stefanidis K, Fragou M, Pentilas N, Kouraklis G, Nanas S, Savel RH, Shiloh
AL, Slama M, Karakitsos D. Optimization of Cannula Visibility during Ultrasound-
Guided Subclavian Vein Catheterization, via a Longitudinal Approach, by
Implementing Echogenic Technology. Crit Care Res Pract. 2012;2012:617149. doi:
10.1155/2012/617149. Epub 2012 Apr 23. PMID: 22593825; PMCID: PMC3347863.
 
50: Savel RH, Shiloh AL, Eisen LA. Educational impact of continuous chest
compression cardiopulmonary resuscitation: the confidence to "pay it forward"*.
Crit Care Med. 2012 Mar;40(3):992-3. doi: 10.1097/CCM.0b013e31823878b1. PMID:
22343848.
 
51: Shiloh AL, Eisen LA, Savel RH. Goal-directed ultrasonography in the
intensive care unit: no more excuses! Crit Care Med. 2011 Apr;39(4):879-80. doi:
10.1097/CCM.0b013e318208e393. PMID: 21613832.
 
52: Rosenberg JB, Shiloh AL, Savel RH, Eisen LA. Non-invasive methods of
estimating intracranial pressure. Neurocrit Care. 2011 Dec;15(3):599-608. doi:
10.1007/s12028-011-9545-4. PMID: 21519957.
 
53: Kory PD, Pellecchia CM, Shiloh AL, Mayo PH, DiBello C, Koenig S. Accuracy of
ultrasonography performed by critical care physicians for the diagnosis of DVT.
Chest. 2011 Mar;139(3):538-542. doi: 10.1378/chest.10-1479. Epub 2010 Oct 28.
PMID: 21030490.
 
54: Shiloh AL, Savel RH, Paulin LM, Eisen LA. Ultrasound-guided catheterization
of the radial artery: a systematic review and meta-analysis of randomized
controlled trials. Chest. 2011 Mar;139(3):524-529. doi: 10.1378/chest.10-0919.
Epub 2010 Aug 19. PMID: 20724734.
 
55: Shiloh AL, Eisen LA, Savel RH. Selective decontamination of the digestive
tract: what outcomes matter? Crit Care Med. 2010 May;38(5):1386-7. doi:
10.1097/CCM.0b013e3181da47d1. PMID: 20404637.
 
56: Shiloh AL, Eisen LA. Ultrasound-guided arterial catheterization: a narrative
review. Intensive Care Med. 2010 Feb;36(2):214-21. doi:
10.1007/s00134-009-1699-6. Epub 2009 Oct 31. PMID: 19882140.
 
57: Li M, Chen D, Shiloh A, Luo J, Nikolaev AY, Qin J, Gu W. Deubiquitination of
p53 by HAUSP is an important pathway for p53 stabilization. Nature. 2002 Apr
11;416(6881):648-53. doi: 10.1038/nature737. Epub 2002 Mar 31. PMID: 11923872.

EMR ID

4723

Biography

Ariel L Shiloh, MD, is Director, Critical Care Consult Services, Professor, Medicine and Associate Professor, Neurology at Montefiore Einstein. Dr. Shiloh’s clinical interests include the early detection and treatment of critical illness, point-of-care ultrasonography for the evaluation of critical illness and advanced airway management.After earning his Bachelor of Arts from Yeshiva University, Dr. Shiloh attended the Medical School for International Health at Ben Gurion University, Be’er Sheva, Israel, earning his Doctor of Medicine in 2005. He came to Montefiore for his postdoctoral training, completing his internship and residency in internal medicine in 2008, followed by his fellowship in critical care medicine in 2010.Dr. Shiloh's research includes the clinical use of point-of-care ultrasonography in critical illness, improvement of airway management, and cardiopulmonary resuscitation. He has shared his work through peer-reviewed journals, invited presentations, books, abstracts and poster presentations at national conferences. He has also been a reviewer for several journals including Chest, the American Journal of Critical Care and the European Journal of Anesthesiology.Dr. Shiloh is board certified in Internal Medicine, Critical Care Medicine and Neurocritical Care and Hospice & Palliative Medicine. He is a Fellow of the American College of Chest Physicians and a member of the Society of Critical Care Medicine. Dr. Shiloh has been recognized by the American College of Chest Physicians as a Distinguished CHEST Educator, among the top 5% of CHEST’s international faculty recognized for long-term contributions to the design and delivery of CHEST education

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