Search

Your search keyword '"Nawar Al-Rawas"' showing total 17 results
Start Over Author "Nawar Al-Rawas"
17 results on '"Nawar Al-Rawas"'

1. Impact of Hemoglobin Levels on Composite Cardiac Arrest or Stroke Outcome in Patients With Respiratory Failure Due to COVID-19

Author

Shi Nan Feng, BSPH, Thu-Lan Kelly, PhD, John F. Fraser, MD, PhD, Gianluigi Li Bassi, MD, PhD, Jacky Suen, PhD, Akram Zaaqoq, MD, MPH, Matthew J. Griffee, MD, Rakesh C. Arora, MD, Nicole White, PhD, Glenn Whitman, MD, Chiara Robba, MD, PhD, Denise Battaglini, MD, PhD, Sung-Min Cho, DO, MHS, on behalf of COVID-19 Critical Care Consortium (CCCC), Robert Bartlett, John F. Fraser, Gianluigi Li Bassi, Jacky Y. Suen, Heidi J. Dalton, John Laffey, Daniel Brodie, Eddy Fan, Antoni Torres, Davide Chiumello, Alyaa Elhazm, Carol Hodgson, Shingo Ichiba, Carlos Luna, Srinivas Murthy, Alistair Nichol, Pauline Yeung Ng, Mark Ogino, Aidan Burrell, Antonio Pesenti, Tala Al-Dabbous, Huda Alfoudri, Mohammed Shamsah, Subbarao Elapavaluru, Ashley Berg, Christina Horn, Yunis Mayasi, Stephan Schroll, Dan Meyer, Jorge Velazco, Ludmyla Ploskanych, Wanda Fikes, Rohini Bagewadi, Marvin Dao, Haley White, Alondra Berrios Laviena, Ashley Ehlers Maysoon, Shalabi-McGuire, Trent Witt, Lorenzo Grazioli, Luca Lorini, E. Wilson Grandin, Jose Nunez, Tiago Reyes, Diarmuid O’Briain, Stephanie Hunter, Mahesh Ramanan, Julia Affleck, Hemanth Hurkadli Veerendra, Sumeet Rai, Josie Russell-Brown, Mary Nourse, Mark Joseph, Brook Mitchell, Martha Tenzer, Ryuzo Abe, Hwa Jin Cho, In Seok Jeong, Nadeem Rahman, Vivek Kakar, Andres Oswaldo Razo Vazquez, Nicolas Brozzi, Omar Mehkri, Sudhir Krishnan Abhijit, Duggal Stuart Houltham, Jerónimo Graf, Roderigo Diaz, Roderigo Orrego, Camila Delgado, Joyce González, Maria Soledad Sanchez, Michael Piagnerelli, Josefa Valenzuela Sarrazin, A/Prof. Gustavo Zabert, Lucio Espinosa, Paulo Delgado, Victoria Delgado, Diego Fernando, Bautista Rincón, Angela Maria Marulanda Yanten, Melissa Bustamante Duque, Alyaa Elhazmi, Abdullah Al-Hudaib, Maria Callahan, M. Azhari Taufik, Elizabeth Yasmin Wardoyo, Margaretha Gunawan, Nurindah S Trisnaningrum, Vera Irawany, Muhammad Rayhan, Mauro Panigada, Alberto Zanella, Giacomo Grasselli, Sebastiano Colombo, Chiara Martinet, Gaetano Florio, Massimo Antonelli, Simone Carelli, Domenico L. Grieco, Motohiro Asaki, Kota Hoshino, Leonardo Salazar, Mary Alejandra Mendoza Monsalve, Bairbre McNicholas, David Cosgrave, Joseph McCaffrey, Allison Bone, Yusuff Hakeem, James Winearls, Mandy Tallott, David Thomson, Christel Arnold-Day, Jerome Cupido, Zainap Fanie, Malcom Miller, Lisa Seymore, Dawid van Straaten, Ali Ait Hssain, Jeffrey Aliudin, Al-Reem Alqahtani, Khoulod Mohamed, Ahmed Mohamed, Darwin Tan, Joy Villanueva, Ahmed Zaqout, Ethan Kurtzman, Arben Ademi, Ana Dobrita, Khadija El Aoudi, Juliet Segura, Gezy Giwangkancana, Shinichiro Ohshimo, Javier Osatnik, Anne Joosten, Minlan Yang, Ana Motos, Francisco Arancibia, Virginie Williams, Alexandre Noel, Nestor Luque, Marina Fantini, Ruth Noemi Jorge García, Enrique Chicote Alvarez, Anna Greti, Adrian Ceccato, Angel Sanchez, Ana Loza Vazquez, Ferran Roche-Campo, Diego Franch-Llasat, Divina Tuazon, Marcelo Amato, Luciana Cassimiro, Flavio Pola, Francis Ribeiro, Guilherme Fonseca, Heidi Dalton, Mehul Desai, Erik Osborn Hala Deeb, Antonio Arcadipane, Gennaro Martucci, Giovanna Panarello, Chiara Vitiello, Claudia Bianco, Giovanna Occhipinti, Matteo Rossetti, Raffaele Cuffaro, Sung-Min Cho, Glenn Whitman, Hiroaki Shimizu, Naoki Moriyama, Jae-Burm Kim, Nobuya Kitamura, Johannes Gebauer, Toshiki Yokoyama, Abdulrahman Al-Fares, Sarah Buabbas, Esam Alamad, Fatma Alawadhi, Kalthoum Alawadi, Hiro Tanaka, Satoru Hashimoto, Masaki Yamazaki, Tak-Hyuck Oh, Mark Epler, Cathleen Forney, Louise Kruse, Jared Feister, Joelle Williamson, Katherine Grobengieser, Eric Gnall, Sasha Golden, Mara Caroline, Timothy Shapiro, Colleen Karaj, Lisa Thome, Lynn Sher, Mark Vanderland, Mary Welch, Sherry McDermott, Matthew Brain, Sarah Mineall, Dai Kimura, Luca Brazzi, Gabriele Sales, Giorgia Montrucchio, Tawnya Ogston, Dave Nagpal, Karlee Fischer, Roberto Lorusso, Rajavardhan Rangappa, Sujin Rai, Argin Appu, Mariano Esperatti, Nora Angélica Fuentes, Maria Eugenia Gonzalez, Edmund G. Carton, Ayan Sen, Amanda Palacios, Deborah Rainey, Gordan Samoukoviv, Josie Campisi, Lucia Durham, Emily Neumann, Cassandra Seefeldt, Octavio Falcucci, Amanda Emmrich, Jennifer Guy, Carling Johns, Kelly Potzner, Catherine Zimmermann, Angelia Espinal, Nina Buchtele, Michael Schwameis, Andrea Korhnfehl, Roman Brock, Thomas Staudinger, Stephanie-Susanne, Stecher Michaela Barnikel, Sófia Antón, Alexandra Pawlikowski, Akram Zaaqoq, Lan Anh Galloway, Caitlin Merley, Marc Csete, Luisa Quesada, Isabela Saba, Daisuke Kasugai, Hiroaki Hiraiwa, Taku Tanaka, Eva Marwali, Yoel Purnama, Santi Rahayu Dewayanti, Ardiyan, Dafsah Arifa Juzar, Debby Siagian, Yih-Sharng Chen, Indrek Ratsep, Andra-Maris Post, Piret Sillaots, Anneli Krund, Merili-Helen Lehiste, Tanel Lepik, Frank Manetta, Effe Mihelis, Iam Claire Sarmiento, Mangala Narasimhan, Michael Varrone, Mamoru Komats, Julia Garcia-Diaz, Catherine Harmon, S. Veena Satyapriya, Amar Bhatt, Nahush A. Mokadam, Alberto Uribe, Alicia Gonzalez, Haixia Shi, Johnny McKeown, Joshua Pasek, Juan Fiorda, Marco Echeverria, Rita Moreno, Bishoy Zakhary, Marco Cavana, Alberto Cucino, Giuseppe Foti, Marco Giani, Benedetta Fumagalli, Valentina Castagna, Andrea Dell’Amore, Paolo Navalesi, Hoi-Ping Shum, Alain Vuysteke, Asad Usman, Andrew Acker, Benjamin Smood, Blake Mergler, Federico Sertic, Madhu Subramanian, Alexandra Sperry, Nicolas Rizer, Erlina Burhan, Menaldi Rasmin, Ernita Akmal, Faya Sitompul, Navy Lolong, Bhat Naivedh, Simon Erickson, Peter Barrett, David Dean, Julia Daugherty, Antonio Loforte, Irfan Khan, Mohammed Abraar Quraishi, Olivia DeSantis, Dominic So, Darshana Kandamby, Jose M. Mandei, Hans Natanael, Eka YudhaLantang, Anastasia Lantang, Surya Oto Wijaya, Anna Jung, George Ng, Wing Yiu Ng, Shu Fang, Alexis Tabah, Megan Ratcliffe, Maree Duroux, Shingo Adachi, Shota Nakao, Pablo Blanco, Ana Prieto, Jesús Sánchez, Meghan Nicholson, Warwick Butt, Alyssa Serratore, Carmel Delzoppo, Pierre Janin, Elizabeth Yarad, Richard Totaro, Jennifer Coles, Bambang Pujo, Robert Balk, Andy Vissing, Esha Kapania, James Hays, Samuel Fox, Garrett Yantosh, Pavel Mishin, Saptadi Yuliarto, Kohar Hari Santoso, Susanthy Djajalaksana, Arie Zainul Fatoni, Masahiro Fukuda, Keibun Liu, Paolo Pelosi, Denise Battaglini, Juan Fernando Masa Jiménez, Diego Bastos, Sérgio Gaião, Desy Rusmawatiningtyas, Young-Jae Cho, Su Hwan Lee, Tatsuya Kawasaki, Laveena Munshi, Pranya Sakiyalak, Prompak Nitayavardhana, Tamara Seitz, Rakesh Arora, David Kent, Daniel Marino, Swapnil Parwar, Andrew Cheng, Jennene Miller, Shigeki Fujitani, Naoki Shimizu, Jai Madhok, Clark Owyang, Hergen Buscher, Claire Reynolds, Olavi Maasikas, Aleksan Beljantsev, Vladislav Mihnovits, Takako Akimoto, Mariko Aizawa, Kanako Horibe, Ryota Onodera, Meredith Young, Timothy George, Kiran Shekar, Niki McGuinness, Lacey Irvine, Brigid Flynn, Tomoyuki Endo, Kazuhiro Sugiyama, Keiki Shimizu, Kathleen Exconde, Leslie Lussier, Gösta Lotz, Maximilian Malfertheiner, Lars Maier, Esther Dreier, Neurinda Permata Kusumastuti, Colin McCloskey, Al-Awwab Dabaliz, Tarek B Elshazly, Josiah Smith, Konstanty S. Szuldrzynski, Piotr Bielański, Keith Wille, Ken Kuljit, S. Parhar, Kirsten M. Fiest, Cassidy Codan, Anmol Shahid, Mohamed Fayed, Timothy Evans, Rebekah Garcia, Ashley Gutierrez, Tae Song, Rebecca Rose, Suzanne Bennett, Denise Richardson, Giles Peek, Lovkesh Arora, Kristina Rappapport, Kristina Rudolph, Zita Sibenaller, Lori Stout, Alicia Walter, Daniel Herr, Nazli Vedadi, Shaun Thompson, Julie Hoffman, Xiaonan Ying, Ryan Kennedy, Muhammed Elhadi, Matthew Griffee, Anna Ciullo, Yuri Kida, Ricard Ferrer Roca, JordI Riera, Sofia Contreras, Cynthia Alegre, Christy Kay, Irene Fischer, Elizabeth Renner, Hayato Taniguci, John Fraser, Jacky Suen, Adrian Barnett, Nicole White, Kristen Gibbons, Simon Forsyth, Amanda Corley, India Pearse, Samuel Hinton, Gabriella Abbate, Halah Hassan, Silver Heinsar, Varun A Karnik, Katrina Ki, Hollier F. O’Neill, Nchafatso Obonyo, Leticia Pretti Pimenta, Janice D. Reid, Kei Sato, Aapeli Vuorinen, Karin S. Wildi, Emily S. Wilson, Stephanie Yerkovich, James Lee, Daniel Plotkin, Barbara Wanjiru Citarella, Laura Merson, Emma Hartley, Bastian Lubis, Takanari Ikeyama, Balu Bhaskar, Jae-Seung Jung, Shay McGuinness, Glenn Eastwood, Sandra Rossi Marta, Fabio Guarracino, Stacy Gerle, Emily Coxon, Bruno Claro, Daniel Loverde, Namrata Patil, Vieri Parrini, Angela McBride, Kathryn Negaard, Angela Ratsch, Ahmad Abdelaziz, Juan David Uribe, Adriano Peris, Mark Sanders, Dominic Emerson, Muhammad Kamal, Pedro Povoa, Roland Francis, Ali Cherif, Sunimol Joseph, Matteo Di Nardo, Micheal Heard, Kimberly Kyle, Ray A Blackwell, Patrick Biston, Hye Won Jeong, Reanna Smith, Yogi Prawira, Arturo Huerta Garcia, Nahikari Salterain, Bart Meyns, Marsha Moreno, Rajat Walia, Amit Mehta, Annette Schweda, Moh Supriatna, Cenk Kirakli, Melissa Williams, Kyung Hoon Kim, Alexandra Assad, Estefania Giraldo, Wojtek Karolak, Martin Balik, Elizabeth Pocock, Evan Gajkowski, Kanamoto Masafumi, Nicholas Barrett, Yoshihiro Takeyama, Sunghoon Park, Faizan Amin, Fina Meilyana Andriyani, Serhii Sudakevych, Magdalena Vera, Rodrigo Cornejo, Patrícia Schwarz, Ana Carolina Mardini, Thais de Paula, Ary Serpa Neto, Andrea Villoldo, Alexandre Siciliano Colafranceschi, Alejandro Ubeda Iglesias, Juan Granjean, Lívia Maria Garcia Melro, Giovana Fioravante Romualdo, Diego Gaia, Helmgton Souza, Filomena Galas, Rafael Máñez Mendiluce, Alejandra Sosa, Ignacio Martinez, Hiroshi Kurosawa, Juan Salgado, Beate Hugi-Mayr, Eric Charbonneau, Vitor Salvatore Barzilai, Veronica Monteiro, Rodrigo Ribeiro de Souza, Michael Harper, Hiroyuki Suzuki, Celina Adams, Jorge Brieva, George Nyale, Faisal Saleem Eltatar, Jihan Fatani, Husam Baeissa, Ayman AL Masri, Ahmed Rabie, Mok Yee Hui, Masahiro Yamane, Hanna Jung, Ayorinde Mojisola Margaret, Newell Nacpil, Katja Ruck, Rhonda Bakken, Claire Jara, Tim Felton, Lorenzo Berra, Bobby Shah, Arpan Chakraborty, Monika Cardona, Gerry Capatos, Bindu Akkanti, Abiodun Orija, Harsh Jain, Asami Ito, Brahim Housni, Sennen Low, Koji Iihara, Joselito Chavez, Kollengode Ramanathan, Gustavo Zabert, Krubin Naidoo, Ian Seppelt, Marlice VanDyk, Sarah MacDonald, Randy McGregor, Teka Siebenaler, Hannah Flynn, Kristi Lofton, Toshiyuki Aokage, Kazuaki Shigemitsu, Andrea Moscatelli, Giuseppe Fiorentino, Matthias Baumgaertel, Serge Eddy Mba, Jana Assy, Amelya Hutahaean, Holly Roush, Kay A Sichting, Francesco Alessandri, Debra Burns, Gavin Salt, Carl P. Garabedian, Jonathan Millar, Malcolm Sim, Adrian Mattke, Danny McAuley, Jawad Tadili, Tim Frenzel, Yaron Bar-Lavie, Aaron Blandino Ortiz, Jackie Stone, Antony Attokaran, Michael Farquharson, Brij Patel, Derek Gunning, Kenneth Baillie, Pia Watson, Kenji Tamai, Gede Ketut Sajinadiyasa, Dyah Kanyawati, Marcello Salgado, Assad Sassine, Bhirowo Yudo, Scott McCaul, Bongjin Lee, Sang Min Lee, Arnon Afek, Yoshiaki Iwashita, Bambang Pujo Semedi, Jack Metiva, Nicole Van Belle, Ignacio Martin-Loeches, Lenny Ivatt, Chia Yew Woon, Hyun Mi Kang, Timothy Smith, Erskine James, Nawar Al-Rawas, Yudai Iwasaki, Kenny Chan King-Chung, Vadim Gudzenko, Fabio Taccone, Fajar Perdhana, Yoan Lamarche, Joao Miguel Ribeiro, Nikola Bradic, Klaartje Van den Bossche, Oude Lansink, Gurmeet Singh, Gerdy Debeuckelaere, Henry T. Stelfox, Cassia Yi, Jennifer Elia, Thomas Tribble, Shyam Shankar, Raj Padmanabhan, Bill Hallinan, Luca Paoletti, Yolanda Leyva, Tatuma Fykuda, Jenelle Badulak, Jillian Koch, Amy Hackman, Lisa Janowaik, Deb Hernandez, Jennifer Osofsky, Katia Donadello, Aizah Lawang, Josh Fine, and Benjamin Davidson

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

OBJECTIVES:. Anemia has been associated with an increased risk of both cardiac arrest and stroke, frequent complications of COVID-19. The effect of hemoglobin level at ICU admission on a composite outcome of cardiac arrest or stroke in an international cohort of COVID-19 patients was investigated. DESIGN:. Retrospective analysis of prospectively collected database. SETTING:. A registry of COVID-19 patients admitted to ICUs at over 370 international sites was reviewed for patients diagnosed with cardiac arrest or stroke up to 30 days after ICU admission. Anemia was defined as: normal (hemoglobin ≥ 12.0 g/dL for women, ≥ 13.5 g/dL for men), mild (hemoglobin 10.0–11.9 g/dL for women, 10.0–13.4 g/dL for men), moderate (hemoglobin ≥ 8.0 and < 10.0 g/dL for women and men), and severe (hemoglobin < 8.0 g/dL for women and men). PATIENTS:. Patients older than 18 years with acute COVID-19 infection in the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Of 6926 patients (median age = 59 yr, male = 65%), 760 patients (11.0%) experienced stroke (2.0%) and/or cardiac arrest (9.4%). Cardiac arrest or stroke was more common in patients with low hemoglobin, occurring in 12.8% of patients with normal hemoglobin, 13.3% of patients with mild anemia, and 16.7% of patients with moderate/severe anemia. Time to stroke or cardiac arrest by anemia status was analyzed using Cox proportional hazards regression with death as a competing risk. Covariates selected through clinical knowledge were age, sex, comorbidities (diabetes, hypertension, obesity, and cardiac or neurologic conditions), pandemic era, country income, mechanical ventilation, and extracorporeal membrane oxygenation. Moderate/severe anemia was associated with a higher risk of cardiac arrest or stroke (hazard ratio, 1.32; 95% CI, 1.05–1.67). CONCLUSIONS:. In an international registry of ICU patients with COVID-19, moderate/severe anemia was associated with increased hazard of cardiac arrest or stroke.

Published
2024
Full Text
View/download PDF

2. Survival and Recovery From Postmyocardial Infarction Apical Wall Rupture With a Complex Course

Author

Hussam Al Hennawi, Angad Bedi, Jesse Cheng, Philip Lim, Nawar Al-Rawas, Mauricio Garrido, Aswin Mathew, and Jennifer A. Mazzoni

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Ventricular wall rupture is associated with poor outcomes subsequent to an acute myocardial infarction. We describe a case of postmyocardial infarction apical wall rupture following percutaneous coronary intervention. Our case emphasizes the importance of swift evaluation, diagnosis, and management to enhance survival in individuals confronting this critical condition.

Published
2024
Full Text
View/download PDF

3. Assessment of 28-Day In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019: An International Cohort Study

Author

Gianluigi Li Bassi, MD, PhD, Jacky Y. Suen, BSc, PhD, Nicole White, PhD, Heidi J. Dalton, MD, MCCM, Jonathon Fanning, BSc, MBBS, PhD, FANZCA, FCICM, Amanda Corley, RN, Sally Shrapnel, MBBS, BMedSc, MSc, PhD, FRACGP, Samuel Hinton, PhD, Simon Forsyth, PhD, Rex Parsons, BSc, MMedStats, John G. Laffey, MD, Eddy Fan, MD, PhD, Robert Bartlett, MD, Daniel Brodie, MD, Aidan Burrell, MD, PhD, Davide Chiumello, MD, Alyaa Elhazmi, MD, Giacomo Grasselli, MD, Carol Hodgson, PT, PhD, Shingo Ichiba, MD, Carlos Luna, MD, Eva Marwali, MD, Laura Merson, Bsc, Srinivas Murthy, MD, Alistair Nichol, MD, PhD, Mauro Panigada, MD, Paolo Pelosi, MD, FERS, Antoni Torres, MD, PhD, FERS, Pauline Yeung Ng, MD, Mark Ogino, MD, John F. Fraser, MBChB, PhD, FRCP(Glas), FFARCSI, FRCA, FCICM, on behalf of the COVID-19 Critical Care Consortium, Tala Al-Dabbous, Huda Alfoudri, Mohammed Shamsah, Subbarao Elapavaluru, Ashley Berg, Christina Horn, Stephan Schroll, Jorge Velazco, Ludmyla Ploskanych, Wanda Fikes, Dan Meyer, Ashley Ehlers, Maysoon Shalabi-McGuire, Trent Witt, Lorenzo Grazioli, Luca Lorini, E. Wilson Grandin, Jose Nunez, Tiago Reyes, Diarmuid O’Briain, Stephanie Hunter, Mahesh Ramanan, Julia Affleck, Hemanth Hurkadli Veerendra, Sumeet Rai, Josie Russell-Brown, Mary Nourse, Mark Joseph, Brook Mitchell, Martha Tenzer, Carilion Clinic, Ryuzo Abe, Hwa Jin Cho, In Seok Jeong, Nicolas Brozzi, Omar Mehkri, Sudhir Krishnan, Abhijit Duggal, Stuart Houltham, Jerónimo Graf, Roderigo Diaz, Camila Delgado, Joyce González, Maria Soledad Sanchez, Diego Fernando Bautista Rincón, Angela Maria Marulanda Yanten, Melissa Bustamante Duque, Daniel Brodie, Desy Rusmawatiningtyas, Maria Callahan, M. Azhari Taufik, Elizabeth Yasmin Wardoyo, Margaretha Gunawan, Nurindah S Trisnaningrum, Vera Irawany, Muhammad Rayhan, Mauro Panigada, Antonia Pesenti, Alberto Zanella, Michela Leone, Giacomo Grasselli, Silvia Coppola, Sebastiano Colombo, Massimo Antonelli, Simone Carelli, Domenico L. Grieco, Motohiro Asaki, Kota Hoshino, Leonardo Salazar, Laura Duarte, John Laffey, Bairbre McNicholas, David Cosgrave, Joseph McCaffrey, Allison Bone, Yusuff Hakeem, James Winearls, Mandy Tallott, David Thomson, Christel Arnold-Day, Jerome Cupido, Zainap Fanie, Malcom Miller, Lisa Seymore, Dawid van Straaten, Ali Ait Hssain, Jeffrey Aliudin, Al-Reem Alqahtani, Khoulod Mohamed, Ahmed Mohamed, Darwin Tan, Joy Villanueva, Ahmed Zaqout, Ethan Kurtzman, Arben Ademi, Ana Dobrita, Khadija El Aoudi, Juliet Segura, Gezy Giwangkancana, Shinichiro Ohshimo, Koji Hoshino, Saito Hitoshi, Javier Osatnik, Anne Joosten, Antoni Torres, Minlan Yang, Ana Motos, Carlos Luna, Francisco Arancibia, Virginie Williams, Alexandre Noel, Nestor Luque, Trieu Huynh Trung, Sophie Yacoub, Marina Fantini, Ruth Noemi Jorge García, Enrique Chicote Alvarez, Anna Greti, Adrian Ceccato, Angel Sanchez, Ana Loza Vazquez, Ferran Roche-Campo, Diego Franch-Llasat, Divina Tuazon, Marcelo Amato, Luciana Cassimiro, Flavio Pola, Francis Ribeiro, Guilherme Fonseca, Heidi Dalton, Mehul Desai, Erik Osborn, Hala Deeb, Antonio Arcadipane, Gennaro Martucci, Giovanna Panarello, Chiara Vitiello, Claudia Bianco, Giovanna Occhipinti, Matteo Rossetti, Raffaele Cuffaro, Sung-Min Cho Johns, Hiroaki Shimizu, Naoki Moriyama, Jae-Burm Kim, Nobuya Kitamura, Alyaa Elhazmi, Abdullah Al-Hudaib, Johannes Gebauer, Toshiki Yokoyama, Abdulrahman Al-Fares, Sarah Buabbas, Esam Alamad, Fatma Alawadhi, Kalthoum Alawadi, Hiro Tanaka, Satoru Hashimoto, Masaki Yamazaki, Tak-Hyuck Oh, Mark Epler, Cathleen Forney, Louise Kruse, Jared Feister, Joelle Williamson, Katherine Grobengieser, Eric Gnall, Sasha Golden, Mara Caroline, Timothy Shapiro, Colleen Karaj, Lisa Thome, Lynn Sher, Mark Vanderland, Mary Welch, Sherry McDermott, Matthew Brain, Sarah Mineall, Dai Kimura, Luca Brazzi, Gabriele Sales, Tawnya Ogston, Dave Nagpal, Karlee Fischer, Roberto Lorusso, Mariano Esperatti, Edmund G. Carton, Ayan Sen, Amanda Palacios, Deborah Rainey, Gordan Samoukoviv, Josie Campisi, Emily Neumann, Cassandra Seefeldt, Lucia Durham, Octavio Falcucci, Amanda Emmrich, Jennifer Guy, Carling Johns, Nina Buchtele, Michael Schwameis, Stephanie-Susanne Stecher, Delila Singh, Michaela Barnikel, Lukas Arenz, Akram Zaaqoq, Lan Anh Galloway, Caitlin Merley, Marc Csete, Luisa Quesada, Isabela Saba, Daisuke Kasugai, Hiroaki Hiraiwa, Taku Tanaka, Eva Marwali, Yoel Purnama, Santi Rahayu Dewayanti, Ardiyan, Dafsah Arifa Juzar, Debby Siagian, Kita Jakarta, Yih-Sharng Chen, Mark Ogino, Indrek Ratsep, Getter Oigus, Kristo Erikson, Andra-Maris Post, Lauri Enneveer, Piret Sillaots, Frank Manetta, Effe Mihelis, Iam Claire Sarmiento, Mangala Narasimhan, Michael Varrone, Mamoru Komats, S. Veena Satyapriya, Amar Bhatt, Nahush A. Mokadam, Alberto Uribe, Alicia Gonzalez, Haixia Shi, Johnny McKeown, Joshua Pasek, Juan Fiorda, Marco Echeverria, Rita Moreno, Bishoy Zakhary, Marco Cavana, Alberto Cucino, Giuseppe Foti, Marco Giani, Vincenzo Russotto, Davide Chiumello, Valentina Castagna, Andrea Dell’Amore, Paolo Navalesi, Hoi-Ping Shum, Alain Vuysteke, Asad Usman, Andrew Acker, Benjamin Smood, Blake Mergler, Federico Sertic, Madhu Subramanian, Alexandra Sperry, Nicolas Rizer, Erlina Burhan, Menaldi Rasmin, Ernita Akmal, Faya Sitompul, Navy Lolong, Bhat Naivedh, Simon Erickson, Peter Barrett, David Dean, Julia Daugherty, Antonio Loforte, Irfan Khan, Mohammed Abraar Quraishi, Olivia DeSantis, Dominic So, Darshana Kandamby, Jose M. Mandei, Hans Natanael, Eka YudhaLantang, Anastasia Lantang, Surya Oto Wijaya, Anna Jung, George Ng, Wing Yiu Ng, Pauline Yeung Ng, Alexis Tabah, Megan Ratcliffe, Maree Duroux, Shingo Adachi, Shota Nakao, Pablo Blanco, Ana Prieto, Jesús Sánchez, Meghan Nicholson, Warwick Butt, Alyssa Serratore, Carmel Delzoppo, Pierre Janin, Elizabeth Yarad, Richard Totaro, Jennifer Coles, Bambang Pujo, Robert Balk, Andy Vissing, Esha Kapania, James Hays, Samuel Fox, Garrett Yantosh, Pavel Mishin, Saptadi Yuliarto, Kohar Hari Santoso, Susanthy Djajalaksana, Arie Zainul Fatoni, Masahiro Fukuda, Keibun Liu, Paolo Pelosi, Denise Battaglini, Diego Bastos, Sérgio Gaião, Jessica Buchner, Young-Jae Cho, Su Hwan Lee, Pranya Sakiyalak, Prompak Nitayavardhana, Tamara Seitz, Rakesh Arora, David Kent, Swapnil Parwar, Andrew Cheng, Jennene Miller, Shigeki Fujitani, Naoki Shimizu, Jai Madhok, Clark Owyang, Hergen Buscher, Claire Reynolds, Olavi Maasikas, Aleksan Beljantsev, Vladislav Mihnovits, Takako Akimoto, Mariko Aizawa, Kanako Horibe, Ryota Onodera, Carol Hodgson, Aidan Burrell, Meredith Young, Kiran Shekar, Niki McGuinness, Lacey Irvine, Brigid Flynn, Kazuhiro Sugiyama, Keiki Shimizu, Eddy Fan, Kathleen Exconde, Shingo Ichiba, Leslie Lussier, Gösta Lotz, Lars Maier, Esther Dreier, Neurinda Permata Kusumastuti, Colin McCloskey, Al-Awwab Dabaliz, Tarek B Elshazly, Josiah Smith, Konstanty S. Szuldrzynski, Piotr Bielański, Keith Wille, Srinivas Murthy, Ken Kuljit S. Parhar, Kirsten M. Fiest, Cassidy Codan, Anmol Shahid, Mohamed Fayed, Timothy Evans, Rebekah Garcia, Ashley Gutierrez, Tae Song, Rebecca Rose, Suzanne Bennett, Denise Richardson, Lovkesh Arora, Kristina Rappapport, Kristina Rudolph, Zita Sibenaller, Lori Stout, Alicia Walter, Daniel Herr, Nazli Vedadi, Robert Bartlett, Antonio Pesenti, Shaun Thompson, Lace Sindt, Sean Rajnic, Cale Ewald, Julie Hoffman, Matthew Griffee, Anna Ciullo, Yuri Kida, Ricard Ferrer Roca, JordI Riera, Sofia Contreras, Cynthia Alegre, Christy Kay, Irene Fischer, Elizabeth Renner, Hayato Taniguci, John Fraser, Gianluigi Li Bassi, Jacky Suen, Adrian Barnett, Nicole White, Kristen Gibbons, Simon Forsyth, Amanda Corley, India Pearse, Samuel Hinton, Gabriella Abbate, Halah Hassan, Silver Heinsar, Varun A Karnik, Katrina Ki, Hollier F. O’Neill, Nchafatso Obonyo, Janice D. Reid, Kei Sato, Aapeli Vuorinen, Karin S. Wildi, Emily S. Wood, Stephanie Yerkovich, James Lee, Daniel Plotkin, Laura Merson, Emma Hartley, Bastian Lubis, Takanari Ikeyama, Balu Bhaskar, Jae-Seung Jung, Shay McGuinness, Glenn Eastwood, Sandra Rossi Marta, Fabio Guarracino, Stacy Gerle, Emily Coxon, Bruno Claro, Gonzo Gonzalez-Stawinski, Daniel Loverde, Namrata Patil, Vieri Parrini, Angela McBride, Kathryn Negaard, Angela Ratsch, Ahmad Abdelaziz, Juan David Uribe, Adriano Peris, Mark Sanders, Dominic Emerson, Muhammad Kamal, Pedro Povoa, Roland Francis, Ali Cherif, Sunimol Joseph, Matteo Di Nardo, Micheal Heard, Kimberly Kyle, Ray A Blackwell, Michael Piagnerelli, Patrick Biston, Hye Won Jeong, Reanna Smith, Yogi Prawira, Giorgia Montrucchio, Nadeem Rahman, Vivek Kakar, Josefa Valenzuela Sarrazin, Arturo Huerta Garcia, Nahikari Salterain, Bart Meyns, Marsha Moreno, Rajat Walia, Amit Mehta, Annette Schweda, Moh Supriatna, Bhirowo Yudo, Cenk Kirakli, Melissa Williams, Kyung Hoon Kim, Alexandra Assad, Estefania Giraldo, Wojtek Karolak, Martin Balik, Elizabeth Pocock, Evan Gajkowski, Kanamoto Masafumi, Nicholas Barrett, Yoshihiro Takeyama, Sunghoon Park, Faizan Amin, Fina Meilyana Andriyani, Serhii Sudakevych, Magdalena Vera, Rodrigo Cornejo, Patrícia Schwarz, Ana Carolina Mardini, Ary Serpa Neto, Andrea Villoldo, Alexandre Siciliano Colafranceschi, Alejandro Ubeda, Juan Granjean, Lívia Maria Garcia Melro, Giovana Fioravante Romualdo, Diego Gaia, Helmgton Souza, Filomena Galas, Rafael Máñez Mendiluce, Alejandra Sosa, Ignacio Martinez, Hiroshi Kurosawa, Juan Salgado, Beate Hugi-Mayr, Eric Charbonneau, Vitor Salvatore Barzilai, Veronica Monteiro, Rodrigo Ribeiro de Souza, Michael Harper, Hiroyuki Suzuki, Celina Adams, Jorge Brieva, George Nyale, Faisal Saleem Eltatar, Jihan Fatani, Husam Baeissa, Ayman AL Masri, Ahmed Rabie, Mok Yee Hui, Masahiro Yamane, Hanna Jung, Ayorinde Mojisola, Margaret, Newell Nacpil, Katja Ruck, Rhonda Bakken, Claire Jara, Tim Felton, Lorenzo Berra, Bobby Shah, Arpan Chakraborty, Monika Cardona, Gerry Capatos, Bindu Akkanti, Abiodun Orija, Harsh Jain, Asami Ito, Brahim Housni, Sennen Low, Koji Iihara, Joselito Chavez, Kollengode Ramanathan, Gustavo Zabert, Krubin Naidoo, Ian Seppelt, Marlice VanDyk, Sarah MacDonald, Randy McGregor, Teka Siebenaler, Hannah Flynn, Julia Garcia-Diaz, Catherine Harmon, Kristi Lofton, Toshiyuki Aokage, Kazuaki Shigemitsu, Andrea Moscatelli, Giuseppe Fiorentino, Matthias Baumgaertel, Serge Eddy Mba, Jana Assy, Amelya Hutahaean, Holly Roush, Kay A Sichting, Francesco Alessandri, Debra Burns, Gavin Salt, Carl P. Garabedian, Jonathan Millar, Malcolm Sim, Adrian Mattke, Danny McAuley, Jawad Tadili, Tim Frenzel, Yaron Bar-Lavie, Aaron Blandino Ortiz, Jackie Stone, Antony Attokaran, Michael Farquharson, Brij Patel, Derek Gunning, Kenneth Baillie, Pia Watson, Kenji Tamai, Gede Ketut Sajinadiyasa, Dyah Kanyawati, Marcello Salgado, Assad Sassine, Scott McCaul, Bongjin Lee, Sang Min Lee, Arnon Afek, Yoshiaki Iwashita, Laveena Munshi, Bambang Pujo Semedi, Neurinda Permata, Kusumastuti, Jack Metiva, Nicole Van Belle, Daniel Marino, Ignacio Martin-Loeches, Lenny Ivatt, Chia Yew Woon, Hyun Mi Kang, Timothy Smith, Erskine James, Nawar Al-Rawas, Tomoyuki Endo, Yudai Iwasaki, Kenny Chan King-Chung, Vadim Gudzenko, Fabio Taccone, Fajar Perdhana, Yoan Lamarche, Joao Miguel Ribeiro, Nikola Bradic, Klaartje Van den Bossche, Oude Lansink, Gurmeet Singh, Gerdy Debeuckelaere, Henry T. Stelfox, Cassia Yi, Jennifer Elia, Shu Fang, Thomas Tribble, Shyam Shankar, Raj Padmanabhan, Bill Hallinan, Luca Paoletti, Yolanda Leyva, Tatuma Fykuda, Jenelle Badulak, Jillian Koch, Amy Hackman, Lisa Janowaik, Deb Hernandez, Jennifer Osofsky, Katia Donadello, Aizah Lawang, Josh Fine, Benjamin Davidson, and Andres Oswaldo Razo Vazquez

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

IMPORTANCE:. Factors associated with mortality in coronavirus disease 2019 patients on invasive mechanical ventilation are still not fully elucidated. OBJECTIVES:. To identify patient-level parameters, readily available at the bedside, associated with the risk of in-hospital mortality within 28 days from commencement of invasive mechanical ventilation or coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Prospective observational cohort study by the global Coronavirus Disease 2019 Critical Care Consortium. Patients with laboratory-confirmed coronavirus disease 2019 requiring invasive mechanical ventilation from February 2, 2020, to May 15, 2021. MAIN OUTCOMES AND MEASURES:. Patient characteristics and clinical data were assessed upon ICU admission, the commencement of invasive mechanical ventilation and for 28 days thereafter. We primarily aimed to identify time-independent and time-dependent risk factors for 28-day invasive mechanical ventilation mortality. RESULTS:. One-thousand five-hundred eighty-seven patients were included in the survival analysis; 588 patients died in hospital within 28 days of commencing invasive mechanical ventilation (37%). Cox-regression analysis identified associations between the hazard of 28-day invasive mechanical ventilation mortality with age (hazard ratio, 1.26 per 10-yr increase in age; 95% CI, 1.16–1.37; p < 0.001), positive end-expiratory pressure upon commencement of invasive mechanical ventilation (hazard ratio, 0.81 per 5 cm H2O increase; 95% CI, 0.67–0.97; p = 0.02). Time-dependent parameters associated with 28-day invasive mechanical ventilation mortality were serum creatinine (hazard ratio, 1.28 per doubling; 95% CI, 1.15–1.41; p < 0.001), lactate (hazard ratio, 1.22 per doubling; 95% CI, 1.11–1.34; p < 0.001), Paco2 (hazard ratio, 1.63 per doubling; 95% CI, 1.19–2.25; p < 0.001), pH (hazard ratio, 0.89 per 0.1 increase; 95% CI, 0.8–14; p = 0.041), Pao2/Fio2 (hazard ratio, 0.58 per doubling; 95% CI, 0.52–0.66; p < 0.001), and mean arterial pressure (hazard ratio, 0.92 per 10 mm Hg increase; 95% CI, 0.88–0.97; p = 0.003). CONCLUSIONS AND RELEVANCE:. This international study suggests that in patients with coronavirus disease 2019 on invasive mechanical ventilation, older age and clinically relevant variables monitored at baseline or sequentially during the course of invasive mechanical ventilation are associated with 28-day invasive mechanical ventilation mortality hazard. Further investigation is warranted to validate any causative roles these parameters might play in influencing clinical outcomes.

Published
2021
Full Text
View/download PDF

4. Cardiac transplantation after heparin‐induced thrombocytopenia: A systematic review

Author

Diana C. Jimenez, Eric D. Warner, Danial Ahmad, Jake L. Rosen, Nawar Al‐Rawas, Rohinton J. Morris, Rene Alvarez, J. Eduardo Rame, John W. Entwistle, H. Todd Massey, and Vakhtang Tchantchaleishvili

Subjects
Male, Transplantation, Heparin, Anticoagulants, Heart Transplantation, Humans, Thrombosis, Thrombocytopenia
Abstract

Heparin-induced thrombocytopenia (HIT) presents a unique challenge in patients requiring orthotopic heart transplantation (OHT). We sought to pool the existing evidence in a systematic review.Electronic search was performed to identify all relevant studies on OHT in patients with HIT. Patient-level data for 33 patients from 21 studies were extracted for statistical analysis.Median patient age was 51 [IQR 41, 55] years, with 75.8% (25/33) males. All patients had a clinical diagnosis of HIT, and anti-PF4/Heparin antibodies were positive in 87.9% (29/33). Median lowest reported platelet count was 46 × 10Heparin use during OHT may be associated with less adverse effects compared to use of other anticoagulants with no difference in 30-day mortality.

Published
2022

5. Real time noninvasive estimation of work of breathing using facemask leak-corrected tidal volume during noninvasive pressure support: validation study

Author

Michael J. Banner, Carl Tams, Nawar Al-Rawas, Andrea Gabrielli, A. Daniel Martin, P Stephan, Neil R. Euliano, and Trevor J. Leavitt

Subjects
medicine.medical_specialty, Validation study, Leak, Acute Lung Injury, Health Informatics, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Work of breathing, 0302 clinical medicine, Computer Systems, Internal medicine, Pressure, Tidal Volume, medicine, Humans, Tidal volume, Monitoring, Physiologic, Work of Breathing, Esophageal balloon, business.industry, 030208 emergency & critical care medicine, Inspiratory muscle, Respiration, Artificial, Expiratory positive airway pressure, Anesthesiology and Pain Medicine, 030228 respiratory system, Anesthesia, Cardiology, Noninvasive ventilation, Neural Networks, Computer, business, Algorithms
Abstract

We describe a real time, noninvasive method of estimating work of breathing (esophageal balloon not required) during noninvasive pressure support (PS) that uses an artificial neural network (ANN) combined with a leak correction (LC) algorithm, programmed to ignore asynchronous breaths, that corrects for differences in inhaled and exhaled tidal volume (VT) from facemask leaks (WOBANN,LC/min). Validation studies of WOBANN,LC/min were performed. Using a dedicated and popular noninvasive ventilation ventilator (V60, Philips), in vitro studies using PS (5 and 10 cm H2O) at various inspiratory flow rate demands were simulated with a lung model. WOBANN,LC/min was compared with the actual work of breathing, determined under conditions of no facemask leaks and estimated using an ANN (WOBANN/min). Using the same ventilator, an in vivo study of healthy adults (n = 8) receiving combinations of PS (3-10 cm H2O) and expiratory positive airway pressure was done. WOBANN,LC/min was compared with physiologic work of breathing/min (WOBPHYS/min), determined from changes in esophageal pressure and VT applied to a Campbell diagram. For the in vitro studies, WOBANN,LC/min and WOBANN/min ranged from 2.4 to 11.9 J/min and there was an excellent relationship between WOBANN,LC/breath and WOBANN/breath, r = 0.99, r(2) = 0.98 (p 0.01). There were essentially no differences between WOBANN,LC/min and WOBANN/min. For the in vivo study, WOBANN,LC/min and WOBPHYS/min ranged from 3 to 12 J/min and there was an excellent relationship between WOBANN,LC/breath and WOBPHYS/breath, r = 0.93, r(2) = 0.86 (p 0.01). An ANN combined with a facemask LC algorithm provides noninvasive and valid estimates of work of breathing during noninvasive PS. WOBANN,LC/min, automatically and continuously estimated, may be useful for assessing inspiratory muscle loads and guiding noninvasive PS settings as in a decision support system to appropriately unload inspiratory muscles.

Published
2015

6. Wait! Wait! I Am Not Dead Yet!

Author

Yuriy S. Bronshteyn, Nawar Al-Rawas, Quintin J Quinones, and Raquel R. Bartz

Subjects
Time Factors, Waiting Lists, business.industry, Critical Illness, MEDLINE, 030208 emergency & critical care medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Critical illness, Medicine, Humans, Medical emergency, Ultrasonography, business
Published
2017

7. Extracorporeal Membrane Oxygenation and Interfacility Transfer: A Regional Referral Experience

Author

Nawar Al-Rawas, R. M. Gunasingha, John C. Haney, Babatunde A. Yerokun, Michael Weykamp, Desiree Bonadonna, Michael S. Mulvihill, David N. Ranney, Raquel R. Bartz, and Mani A. Daneshmand

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Patient Transfer, medicine.medical_specialty, medicine.medical_treatment, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Risk Assessment, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, Predictive Value of Tests, Cause of Death, Extracorporeal membrane oxygenation, medicine, North Carolina, Humans, Hospital Mortality, Referral and Consultation, Survival analysis, Cause of death, Aged, Retrospective Studies, Analysis of Variance, Respiratory Distress Syndrome, business.industry, Medical record, Retrospective cohort study, Length of Stay, Middle Aged, Survival Analysis, Surgery, surgical procedures, operative, Logistic Models, 030228 respiratory system, Predictive value of tests, Multivariate Analysis, Disease Progression, Female, Cardiology and Cardiovascular Medicine, business, Body mass index, Hospitals, High-Volume, Cohort study, Follow-Up Studies
Abstract

Background The number of adults referred to high-volume centers for extracorporeal membrane oxygenation (ECMO) is increasing. Outcomes of patients requiring transport are not well characterized, and referral guidelines are lacking. This study describes the experience and outcomes of a single high-volume center. Methods A retrospective study was performed that included adults undergoing ECMO between June 2009 and December 2015. Patient characteristics and outcomes were acquired from the medical record. Logistic regression was used to identify predictors of survival to hospital discharge. The Kaplan-Meier method was used to depict rates of survival. Results Of 133 patients, 77 (57.9%) underwent venoarterial (VA) ECMO and 56 (42.1%) underwent venovenous (VV) ECMO. Median transport distance was 88.8 miles (range 0.2–1,434 miles). Median duration of support was 6 days (range, 1–32.5 days). Age older than 60 years, pulmonary hypertension, and body mass index (BMI) greater than 30 were associated with worse survival to discharge for VA ECMO; a history of hypertension and presence of left ventricular (LV) vent were associated with better survival. Age older than 60 years and diabetes were associated with worse survival to hospital discharge for VV ECMO. Survival to decannulation was 66.2% and 76.8%, and to hospital discharge it was 48.1% and 69.6% for VA and VV ECMO, respectively. Of hospital survivors, Kaplan-Meier estimates of 1-year survival were 82.4% and 95.5% for VA and VV, respectively. Conclusions Outcomes are favorable after transport to high-volume ECMO centers. Guidelines and infrastructure for short- and long-distance ECMO transport is imperative for the efficient and successful management of these patients.

Published
2016

8. [Untitled]

Author

Andrea Gabrielli, Michael J. Banner, Carl Tams, Neil R. Euliano, Anatole D. Martin, and Nawar Al-Rawas

Subjects
medicine.medical_specialty, Pulmonary mechanics, law, business.industry, Emergency medicine, Ventilation (architecture), medicine, Critical Care and Intensive Care Medicine, Intensive care medicine, business, Volume control, law.invention
Published
2012

9. 201: OUTCOMES OF VENOARTERIAL ECMO FOR ADULTS WITH POST-CARDIOTOMY CARDIOGENIC SHOCK

Author

Annemarie Thompson, Desiree Bonadonna, Mani A. Daneshmand, Marat Fudim, David N. Ranney, Nawar Al-Rawas, Sade Bell, and Lynn McGugan

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Cardiogenic shock, Internal medicine, medicine, Cardiology, Critical Care and Intensive Care Medicine, Cardiotomy, medicine.disease, business
Published
2016

10. Oxygenation advisor recommends appropriate positive end expiratory pressure and FIO2 settings: retrospective validation study

Author

Andrea Gabrielli, A. Daniel Martin, Michael J. Banner, David Grooms, Neil R. Euliano, and Nawar Al-Rawas

Subjects
Male, medicine.medical_specialty, education, Health Informatics, Critical Care and Intensive Care Medicine, Sensitivity and Specificity, Positive-Pressure Respiration, Plateau pressure, Anesthesiology, medicine, Humans, Oximetry, Positive end-expiratory pressure, Oxygen saturation (medicine), Retrospective Studies, business.industry, Oxygen Inhalation Therapy, Reproducibility of Results, Retrospective cohort study, Oxygenation, respiratory system, Middle Aged, respiratory tract diseases, Anesthesiology and Pain Medicine, Blood pressure, Treatment Outcome, Respiratory failure, Breath Tests, Therapy, Computer-Assisted, Physical therapy, Female, Blood Gas Analysis, business, Respiratory Insufficiency, therapeutics, circulatory and respiratory physiology
Abstract

A decision support, rule-based oxygenation advisor that provides guidance for setting positive end expiratory pressure (PEEP) and fractional inhaled oxygen concentration (FIO2) for patients with respiratory failure is described. The target oxygenation goal is to achieve and maintain pulse oximeter oxygen saturation (SpO2) ≥88 and ≤95 %, as posited by the Acute Respiratory Distress Syndrome Network, by recommending appropriate combinations of PEEP and FIO2. For patient safety, the oxygenation advisor monitors mean arterial blood pressure (MAP) to ensure it is ≥65 mmHg for hemodynamic stability and inspiratory plateau pressure (Pplt) so it is ≤30 cm H2O for lung protection. The purpose of this validation study was to compare attending physicians’ recommendations to those recommendations of the oxygenation advisor for setting PEEP and FIO2. Adults with respiratory failure (n = 117) receiving ventilatory support were studied. PEEP, FIO2, SpO2, MAP, and Pplt are input variables into the advisor. Recommendations to increase, maintain, or decrease PEEP and FIO2 are the oxygenation advisor’s output variables. Physicians’ recommendations for setting PEEP and FIO2 were recorded; the oxygenation advisor’s recommendations were also recorded for comparison. At all times, ventilator settings were based on recommendations from attending physicians. PEEP ranged from 2 to 22 cm H2O and FIO2 ranged from 0.30 to 0.65. A total of 326 recommendations by the oxygenation advisor and attending physicians were made to increase, maintain, or decrease PEEP and FIO2. There was a very significant relationship (p

Published
2013

11. Non-invasive determination of respiratory system mechanics in pressure support ventilation using the expiratory time constant?

Author

Nawar, Al-Rawas, Michael J, Banner, Neil R, Euliano, A Daniel, Martin, Carl, Tarns, and Andrea, Gabrielli

Subjects
Male, Expiratory Time, Respiratory Distress Syndrome, Letter, business.industry, Exhalation, Pressure support ventilation, Pulmonary compliance, Respiratory system mechanics, Critical Care and Intensive Care Medicine, Respiration, Artificial, Continuous mandatory ventilation, Anesthesia, Breathing, Medicine, Humans, Female, business, Constant (mathematics), Lung Compliance
Abstract

In the previous issue of Critical Care, we read with interest the article by Al-Rawas and colleagues [1], who proposed a method for the determination of respiratory system mechanics (RSM) in diff erent ventilatory modes. We have some concerns regarding the applicability of the described method during pressure support ventilation (PSV). In particular, all equations proposed in the article contain a term called ‘inhaled fl ow rate’. Since there is no constant inspiratory fl ow during PSV, it is unclear how the authors determined its exact value. Furthermore, all of these equations are transformations of the equation of motion of the respiratory system and require the knowledge of the inspiratory driving pressure, for which the authors apparently used the inspiratory airway pressure. However, in PSV, the patients’ spontaneous breathing activity contributes to inspiratory driving pressure to a variable degree [2]. It would be interesting to know how the authors took the patients’ muscular eff ort (P mus ) into account. Finally, we would like to know why the numbers of patients in the PSV and in the volume-controlled continuous mandatory ventilation groups diff er from the numbers of measurements plotted in the corresponding fi gures. For example, 23 patients were in the PSV group (according to Table 1), but 25 measure ments are shown in Figure 4a,b and only 14 are shown in Figure 4c. A non-invasive determination of RSM during PSV is certainly helpful in a clinical setting, and we would appreciate if the authors provided a detailed description of how they handled the non-constant qualities of fl ow and P mus during PSV.

Published
2013

13. Noninvasive work of breathing improves prediction of post-extubation outcome

Author

Andrea Gabrielli, A. Daniel Martin, A. Joseph Layon, Michael J. Banner, Neil R. Euliano, and Nawar Al-Rawas

Subjects
Male, Respiratory rate, business.industry, Pressure support ventilation, Middle Aged, Critical Care and Intensive Care Medicine, Spontaneous breathing trial, Work of breathing, Predictive Value of Tests, Positive predicative value, Anesthesia, Breathing, Airway Extubation, Medicine, Humans, Female, Prospective Studies, Treatment Failure, business, Ventilator Weaning, Positive end-expiratory pressure, Tidal volume, Work of Breathing
Abstract

We hypothesized that non-invasively determined work of breathing per minute (WOB(N)/min) (esophageal balloon not required) may be useful for predicting extubation outcome, i.e., appropriate work of breathing values may be associated with extubation success, while inappropriately increased values may be associated with failure.Adult candidates for extubation were divided into a training set (n = 38) to determine threshold values of indices for assessing extubation and a prospective validation set (n = 59) to determine the predictive power of the threshold values for patients successfully extubated and those who failed extubation. All were evaluated for extubation during a spontaneous breathing trial (5 cmH(2)O pressure support ventilation, 5 cmH(2)O positive end expiratory pressure) using routine clinical practice standards. WOB(N)/min data were blinded to attending physicians. Area under the receiver operating characteristic curves (AUC), sensitivity, specificity, and positive and negative predictive values of all extubation indices were determined.AUC for WOB(N)/min was 0.96 and significantly greater (p 0.05) than AUC for breathing frequency at 0.81, tidal volume at 0.61, breathing frequency-to-tidal volume ratio at 0.73, and other traditionally used indices. WOB(N)/min had a specificity of 0.83, the highest sensitivity at 0.96, positive predictive value at 0.84, and negative predictive value at 0.96 compared to all indices. For 95% of those successfully extubated, WOB(N)/min was ≤10 J/min.WOB(N)/min had the greatest overall predictive accuracy for extubation compared to traditional indices. WOB(N)/min warrants consideration for use in a complementary manner with spontaneous breathing pattern data for predicting extubation outcome.

Published
2011

15. [Untitled]

Author

Michael J. Banner, Anatole D. Martin, Andrea Gabrielli, Carl Tams, P Stephan, Neil R. Euliano, and Nawar Al-Rawas

Subjects
medicine.medical_specialty, Work of breathing, business.industry, Internal medicine, medicine, Cardiology, Critical Care and Intensive Care Medicine, business
Published
2014

16. [Untitled]

Author

Anatole D. Martin, Nawar Al-Rawas, Andrea Gabrielli, Sean Kiley, P Stephan, Michael J. Banner, Carl Tams, and Neil R. Euliano

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Breathing, Cardiology, Medicine, Critical Care and Intensive Care Medicine, business, Asynchrony (computer programming)
Abstract

Introduction: Breathing asynchrony events during NIV include ineffective efforts, double triggering, auto-triggering, and other pre- and post-cycling asynchronies (1,2). In some situations, breathing asynchrony events can overly load the inspiratory muscles predisposing to increased work of breathin

Published
2013

17. Expiratory time constant for determinations of plateau pressure, respiratory system compliance, and total resistance

Author

Andrea Gabrielli, Carl Tams, Nawar Al-Rawas, Michael J. Banner, Jeffrey Brown, Neil R. Euliano, and A. Daniel Martin

Subjects
Male, Expiratory Time, Respiratory Distress Syndrome, Intermittent mandatory ventilation, business.industry, Research, Pressure support ventilation, Pulmonary compliance, Critical Care and Intensive Care Medicine, Respiration, Artificial, Plateau pressure, Exhalation, Anesthesia, Breathing, Medicine, Humans, Female, business, Lung Compliance, Tidal volume, Positive end-expiratory pressure
Abstract

Introduction We hypothesized the expiratory time constant (ƬE) may be used to provide real time determinations of inspiratory plateau pressure (Pplt), respiratory system compliance (Crs), and total resistance (respiratory system resistance plus series resistance of endotracheal tube) (Rtot) of patients with respiratory failure using various modes of ventilatory support. Methods Adults (n = 92) with acute respiratory failure were categorized into four groups depending on the mode of ventilatory support ordered by attending physicians, i.e., volume controlled-continuous mandatory ventilation (VC-CMV), volume controlled-synchronized intermittent mandatory ventilation (VC-SIMV), volume control plus (VC+), and pressure support ventilation (PSV). Positive end expiratory pressure as ordered was combined with all aforementioned modes. Pplt, determined by the traditional end inspiratory pause (EIP) method, was combined in equations to determine Crs and Rtot. Following that, the ƬE method was employed, ƬE was estimated from point-by-point measurements of exhaled tidal volume and flow rate, it was then combined in equations to determine Pplt, Crs, and Rtot. Both methods were compared using regression analysis. Results ƬE, ranging from mean values of 0.54 sec to 0.66 sec, was not significantly different among ventilatory modes. The ƬE method was an excellent predictor of Pplt, Crs, and Rtot for various ventilatory modes; r2 values for the relationships of ƬE and EIP methods ranged from 0.94 to 0.99 for Pplt, 0.90 to 0.99 for Crs, and 0.88 to 0.94 for Rtot (P

Published
2013

Catalog

Books, media, physical & digital resources
See catalog results