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AHRQ Research Studies Date
Topics
- (-) Adverse Events (5)
- Antimicrobial Stewardship (1)
- Cardiovascular Conditions (2)
- Care Management (1)
- Children/Adolescents (4)
- Critical Care (1)
- Healthcare-Associated Infections (HAIs) (1)
- Heart Disease and Health (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 5 of 5 Research Studies DisplayedMathis MR, Duggal NM, Likosky DS
Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery.
In this study, the authors hypothesized that a bundled intraoperative protective ventilation strategy was independently associated with decreased odds of pulmonary complications after cardiac surgery. They identified an intraoperative lung-protective ventilation bundle as independently associated with pulmonary complications after cardiac surgery. Their findings offer insight into components of protective ventilation associated with adverse outcomes and may serve as targets for future prospective interventional studies investigating the impact of specific protective ventilation strategies on postoperative outcomes after cardiac surgery.
AHRQ-funded; HS022535.
Citation: Mathis MR, Duggal NM, Likosky DS .
Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery.
Anesthesiology 2019 Nov;131(5):1046-62. doi: 10.1097/aln.0000000000002909..
Keywords: Adverse Events, Cardiovascular Conditions, Patient Safety, Respiratory Conditions, Surgery
Sanders R, Edwards L, Nishisaki A
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
This editorial discusses a research study on outcomes of performing pediatric trachael intubations (TIs) and how the results can be applied to performing intubations on critically ill children in the United Kingdom outside of specialized centers. One of the authors is from a U.S. site that submits its airway management data to the National Emergency Airway Registry for Children (NEAR4KIDS). The results from the registry were compared to the results from the study. A total of 1,051 patients out of 1,237 eligible patients were analyzed. The results came from 47 nonspecialized local hospitals in the North Thames and East Anglia region of the UK. Adverse TI-associated events (TIAEs) occurred in 22.7% of the patients, which is higher than those in PICUs and cardiac ICUs. The majority of intubations were performed by the anesthesiologist in the team. The results were similar to those in the NEAR4KIDS registry. There were more complications with children with a higher grade of airway difficulties and comorbidities. The authors believe that pediatric airway management for acutely ill children would benefit from new strategies. They recommend a system change using Plan, Do, Study, Act (PDSA) cycles.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Sanders R, Edwards L, Nishisaki A .
Tracheal intubations for critically Ill children outside specialized centers in the United Kingdom-patient, provider, practice factors, and adverse events.
Pediatr Crit Care Med 2019 Jun;20(6):572-73. doi: 10.1097/pcc.0000000000001946..
Keywords: Adverse Events, Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Outcomes, Patient Safety, Registries, Respiratory Conditions
Mokhateb-Rafii T, Bakar A, Gangadharan S
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
The objective of this study was to determine a level of oxygen desaturation associated with increased risk of tracheal intubation events in children in a pediatric or cardiac ICU with cyanotic and noncyanotic heart disease. Oxygen desaturation was measured by a fall in pulse oximetry from baseline after pre-oxygenation. The primary outcome was occurrence of hemodynamic tracheal intubation associated events defined as cardiac arrest, hypotension, or dysrhythmia. Results indicate that oxygen desaturation by 30% or more is associated with increased odds for adverse hemodynamic events, after adjusting for confounders. Oxygen desaturation was observed more often in children with cyanotic than those with noncyanotic heart disease, but hemodynamic tracheal intubation associated event rates were similar.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Mokhateb-Rafii T, Bakar A, Gangadharan S .
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
Pediatr Crit Care Med 2019 Jan;20(1):19-26. doi: 10.1097/pcc.0000000000001766..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Heart Disease and Health, Respiratory Conditions, Intensive Care Unit (ICU), Patient Safety, Risk
Lee JH, Nuthall G, Ikeyama T
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Researchers hypothesized that there would be differences in the process of care and adverse outcomes for tracheal intubation across pediatric ICUs (PICUs) in six different geographical regions: Germany, Japan, Singapore, India, New Zealand, and North America. Adverse tracheal intubation-associated events and desaturation occurrences in PICUS in these regions were evaluated, and the international PICUs compared with those in North America. The proportion of tracheal intubations for endotracheal tube change was greater in international PICUs, and the median age for international tracheal intubations was younger when compared with North America PICUs. Occurrences of adverse tracheal intubation-associated events were slightly lower for international than for North American PICUs, except for Germany and Japan, which were slightly higher.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Lee JH, Nuthall G, Ikeyama T .
Tracheal intubation practice and safety across international PICUs: a report from national emergency airway registry for children.
Pediatr Crit Care Med 2019 Jan;20(1):1-8. doi: 10.1097/pcc.0000000000001782..
Keywords: Adverse Events, Care Management, Children/Adolescents, Intensive Care Unit (ICU), Respiratory Conditions, Outcomes, Patient Safety
Karandikar MV, Coffin SE, Priebe GP
Variability in antimicrobial use in pediatric ventilator-associated events.
This article describes a study which assesses variability in antimicrobial use and associations with infection testing in pediatric ventilator-associated events (VAEs). 192 patients with ventilator-associated conditions were identified in neonatal, pediatric, and cardiac ICUs in six hospitals. Type and duration of antimicrobial use varied by ICU type. The authors conclude that antimicrobial use is common in pediatric ventilator-associated conditions, but pediatric VAP is uncommon; prolonged usage of antimicrobials in spite of low pediatric VAP rates or positive laboratory testing for infection suggests that pediatric ventilator-associated conditions with antimicrobial use for >/= 4 days may provide a lever for antimicrobial stewardship programs to improve utilization.
AHRQ-funded; HS021636.
Citation: Karandikar MV, Coffin SE, Priebe GP .
Variability in antimicrobial use in pediatric ventilator-associated events.
Infect Control Hosp Epidemiol 2019 Jan;40(1):32-39. doi: 10.1017/ice.2018.264..
Keywords: Adverse Events, Antimicrobial Stewardship, Children/Adolescents, Healthcare-Associated Infections (HAIs), Respiratory Conditions