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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 6 of 6 Research Studies Displayed
Daigle CH, Fiadjoe JE, Laverriere EK
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
This study looked at the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children. The prevalence and risk factors are described as well as its association with adverse tracheal intubation-associated events and oxygen desaturation in PICU patients. This retrospective review used observational data collected from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018 from 46 international PICUs. Difficult bag-mask ventilation was reported in 9.5% of 15,810 patients undergoing tracheal intubation with bag-mask ventilation. Difficult bag-mask ventilation was more commonly reported with increasing age, those with a primary respiratory diagnosis/indication for tracheal intubation, presence of difficulty airway features, more experienced provider level, and tracheal intubations without use of neuromuscular blockade. Specific intubation-associated or oxygen desaturation events occurred in 40.2% of patients with reported difficult bag-mask ventilation versus 19.8% in patients without difficult bag-mask ventilation.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Daigle CH, Fiadjoe JE, Laverriere EK . Difficult bag-mask ventilation in critically ill children is independently associated with adverse events. Crit Care Med 2020 Sep;48(9):e744-e52. doi: 10.1097/ccm.0000000000004425..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Risk
Hartman ME, Williams CN, Hall TA
Post-intensive-care syndrome for the pediatric neurologist.
The investigators are working to create awareness and help mitigate post-intensive-care syndrome in pediatric patients who had experienced primary neurological injury and also help their parents and siblings. In this paper they review current knowledge regarding post-intensive-care syndrome in pediatrics and its risk factors. They describe their experience establishing Pediatric Neurocritical Care Recovery Programs at two large academic centers. They also provide a battery of validated tests to identify and manage the different aspects of post-intensive-care syndrome in pediatrics.
Citation: Hartman ME, Williams CN, Hall TA . Post-intensive-care syndrome for the pediatric neurologist. Pediatr Neurol 2020 Jul;108:47-53. doi: 10.1016/j.pediatrneurol.2020.02.003..
Keywords: Children/Adolescents, Neurological Disorders, Intensive Care Unit (ICU), Critical Care, Risk
Kitsios GD, Yang L, Manatakis DV
Host-response subphenotypes offer prognostic enrichment in patients with or at risk for acute respiratory distress syndrome.
This study examined whether certain plasma biomarkers can be used to help classify mechanically ventilated ICU patients with acute respiratory distress syndrome into hyper- and hypoinflammatory subphenotypes to facilitate more effective targeted therapy. The researchers performed longitudinal measures of 10 plasma biomarkers of host injury and inflammation. They were able to demonstrate that two-class models (hyper- vs hypoinflammatory subphenotypes) fit better than one-class models in patients with acute respiratory distress syndrome or patients at risk for acute respiratory distress (ARFA). Hyperinflammatory classification was associated higher severity of illness, worse clinical outcomes, and persistently elevated biomarkers of host injury and inflammation compared with hypoinflammatory patients.
Citation: Kitsios GD, Yang L, Manatakis DV . Host-response subphenotypes offer prognostic enrichment in patients with or at risk for acute respiratory distress syndrome. Crit Care Med 2019 Dec;47(12):1724-34. doi: 10.1097/ccm.0000000000004018..
Keywords: Respiratory Conditions, Critical Care, Intensive Care Unit (ICU), Risk
Khandelwal N, Hough CL, Downey L
Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness.
The objective was to describe the prevalence of financial stress among critically ill patients and their families and explore associations between financial stress and psychologic distress. It found that factors associated with financial stress included female sex, young children at home, and baseline financial discomfort. Also, financial stress after critical illness was common and associated with symptoms of anxiety and depression.
Citation: Khandelwal N, Hough CL, Downey L . Prevalence, risk factors, and outcomes of financial stress in survivors of critical illness. Crit Care Med 2018 Jun;46(6):e530-e39. doi: 10.1097/ccm.0000000000003076.
Keywords: Critical Care, Healthcare Costs, Risk, Patient-Centered Outcomes Research, Stress
Hakkarainen TW, Arbabi S, Willis MM
Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations.
This study evaluated previously independent older patients discharged to skilled nursing facilities (SNFs) and identified risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. It found that a large proportion of older patients discharging to SNFs never return home.
Citation: Hakkarainen TW, Arbabi S, Willis MM . Outcomes of patients discharged to skilled nursing facilities after acute care hospitalizations. Ann Surg 2016 Feb;263(2):280-5. doi: 10.1097/sla.0000000000001367..
Keywords: Critical Care, Hospitalization, Risk, Elderly, Mortality
Patel RB, Mathur MB, Gould M
Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases.
The researchers for this international study sought to model individuals at highest risk of mortality from HPAI N5N1 virus infection in order to inform preventive and therapeutic interventions. They found that age, health expenditure, delay from symptom onset to hospitalization and country are significant predictors of mortality.
Citation: Patel RB, Mathur MB, Gould M . Demographic and clinical predictors of mortality from highly pathogenic avian influenza A (H5N1) virus infection: CART analysis of international cases. PLoS One. 2014 Mar 25;9(3):e91630. doi: 10.1371/journal.pone.0091630..
Keywords: Influenza, Mortality, Critical Care, Hospitalization, Risk