Saudi Critical Care Journal最新文献

{"title":"High-Flow Nasal Cannula for Patients with COVID-19 Acute Hypoxemic Respiratory Failure","authors":"Hassan M. Alshaqaq, Z. A. Al Aseri, M. Alshahrani","doi":"10.4103/sccj.sccj_42_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_42_20","url":null,"abstract":"High-flow nasal cannula (HFNC) is a noninvasive oxygenation modality that delivers heated and humidified oxygen. It possesses several advantages due to the unique physiological effects on the lung and ventilation mechanics compared to other modes of oxygen therapy. The use of HFNC is tolerable, comfortable, and easy to set up. Current evidence indicates that the use of HFNC in critically ill patients with coronavirus disease 2019 (COVID-19)-acute hypoxemic respiratory failure (AHRF) is noninferior to noninvasive ventilation in the reduction of endotracheal intubation rate. Early identification of HFNC failure is vital to avoid delaying intubation. However, multiple knowledge gaps exist, and unpowered observational studies limit HFNC incorporation into strong recommendations. The low dispersion of particles demonstrates the feasibility of HFNC; yet, an appropriate setting and precautions should be maximized. Here, we review the recent evidence of HFNC implications in the management of patients with COVID-19-AHRF.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116694377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Psychological Stress and Optimizing the Psychological Support for the Acute-Care Health-Care Workers during the COVID-19 Pandemic","authors":"M. Temsah, S. Alenezi","doi":"10.4103/sccj.sccj_62_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_62_20","url":null,"abstract":"In this narrative review, we examined the psychological issues related to healthcare workers (HCWs) in acute-care areas during the COVID-19 pandemic. PubMed was searched on 18 Aug 2020 for published articles, with the following keywords: “COVID-19”, “mental health”, “health-care workers”, “front-lines”, “psychology”, “anxiety”, “depression”, “burnout” and “stress” in various combinations. We identified 23 studies, out of which 15 were selected. Data from several international studies indicate that HCWs are prone to developing mental health problems such as anxiety, depression, and substance abuse; thus, screening and supporting the HCWs who are at bigger risk for such psychological distress is warranted. We conclude that the healthcare system should have processes for providing support to minimize possible post-traumatic consequences among HCWs.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127731173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Use of Anti-IL6 and Corticosteroids in COVID-19 Patients with Cytokine-Release Syndrome","authors":"M. Amer, M. Bawazeer, T. Dahhan, E. Kseibi, A. Butt, M. Abujazar, R. Alghunaim, M. Rabee, S. Khurshid","doi":"10.4103/sccj.sccj_38_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_38_20","url":null,"abstract":"Cytokine-release syndrome (CRS) includes overproduction of inflammatory cytokines, termed a “cytokine storm,” which has been observed in a large proportion of critically ill COVID-19 patients. Patients diagnosed with CRS rapidly progress to cardiovascular collapse and multi-organ failure and carry a high mortality rate. Therefore, early detection, treatment, and prevention of cytokine storms are important. Immunomodulators, such as interleukin-6 (IL-6) antagonists, have recently emerged as an alternative therapeutic option for COVID-19 patients with cytokine storms. In preparation for a clinical trial, we searched the PUBMED, EMBASE, and COCHRANE databases to obtain related publications on the use of immunotherapies in CRS and CRS with COVID-19. We also included major review articles and recent guidelines. In our proposal, we aim to evaluate the efficacy and safety of anti-IL-6 alone versus anti-IL-6 and corticosteroid combination in COVID-19 critically ill patients with CRS. Our primary outcomes are duration of mechanical ventilation and 28-day ventilator-free days.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114731835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Rapid Deployment of Intensive Care Services in Response to the COVID-19 Pandemic: A Case Study in Saudi Arabia","authors":"Awad Al-omari, A. Al Mutair, A. Elhazmi, Khalid. Alobeiwi., Amin K. Khattab, A. Rabaan","doi":"10.4103/sccj.sccj_44_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_44_20","url":null,"abstract":"The coronavirus disease-2019 (COVID-19) pandemic has triggered a significant demand to support the most affected areas of severe and acute cases inside Saudi Arabia including the application of telemedicine. During the pandemic, the intensive care unit (ICU) staff from the largest private health-care sector were deployed to support the national critical care services and overcome the shortage of ICU staff in the greatest affected regions in Saudi Arabia. This study aims to describe the administrative actions taken to manage and treat the severe cases of COVID-19 that required ICU services and the deployment of the ICU services provided by private health-care providers to the most affected areas. The ICU staff have been rapidly deployed from the largest private health-care provider in the Middle East, from Riyadh province in the Central Region of Saudi Arabia for Madinah province in the Western region. Within 10 weeks, a total of 309 patients have received ICU and tele-ICU services. Approximately, 208 ICU staff, including intensivists, nurses, respiratory therapists, clinical nutritionists, and clinical pharmacists, have been providing ICU services 24 h a day, 7 days a week. The tele-ICU command center has provided valuable support, including the expert clinical guidance and consultation from the expert ICU consultants, utilizing audio-visual telecommunication networks, and governance of quality of the ICU among other many functions. With an average of 11.82% mortality rate, no accidental re-intubation reported cases, a zero re-intubation and re-admission rate within 48 h, this approach can be successfully followed and implemented in the future for risk and crisis management at local and international levels.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114162887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Simulation in Health-Care Response to COVID-19","authors":"S. Aldekhyl, David Elbling, Y. Arabi","doi":"10.4103/sccj.sccj_43_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_43_20","url":null,"abstract":"In preparation for the COVID-19 pandemic, simulation came in handy in aiding health-care facilities around the world to establish strategies to manage its personnel, space, and processes through experiential learning. Simulation bloomed during the epidemic due to its flexibility and capacity to train large number of health-care professionals at different levels in a timely manner while maintaining high safety profile. This brief review aims at providing some examples of simulation use in the era of COVID-19 pandemic around the world. In addition, we will address some of the limitations that faced simulation-based learning and provide a glimpse to the future of simulation in addressing global pandemics.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133647647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation in COVID-19: The Saudi ECLS-Chapter perspective","authors":"H. Mufti, Hussam Bahudden, Z. A. Al Aseri, Mohamed H. Azzam","doi":"10.4103/sccj.sccj_55_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_55_20","url":null,"abstract":"","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134379953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Herpes zoster coinfection and the current COVID-19 pandemic","authors":"I. Altaf","doi":"10.4103/sccj.sccj_45_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_45_20","url":null,"abstract":"Clinical presentation of COVID-19 infection can be variable in the current pandemic, even in patients presenting to the clinic with mild history of upper respiratory complaints. Various cutaneous manifestations have been noticed in COVID-19 patients with herpes zoster (HZ) being one among them. HZ is an infection that results when varicella zoster virus reactivates from its latent state in a posterior dorsal root ganglion. Here, we aim to expand our knowledge by reporting three cases of associated zoster infection in COVID-19 patients admitted to our intensive care unit in view of respiratory complaints. All the three patients admitted had revealed lymphocytopenia at the time of HZ diagnosis and were managed conservatively throughout the course. In all the cases, acyclovir/valacyclovir led to the resolution of lesions in 10 days. No postherpetic sequelae were observed. We hereby suggest that the clinical presentation of HZ at the time of current pandemic should be considered as an alarming sign for a latent subclinical SARS-CoV-2 infection and thorough follow-up of such patients should be adopted.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129551407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of critical care nursing research in Saudi Arabia: 10 years' perspective","authors":"A. Deeb, M. Aljuaid","doi":"10.4103/sccj.sccj_56_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_56_20","url":null,"abstract":"Nursing research is a scientific method that provides evidence to support nursing practices. Investigation of the critical care nursing research in Saudi Arabia has not been well established. This review aims to examine the numbers, and the characteristics of PubMed-cited critical care nursing articles contributed from Saudi Arabia over the past decade. We conducted a PubMed search to analyze nursing publications in the field of critical care published or contributed in Saudi Arabia for over 10 years (2010–2019). We investigated the number of publications per year, specialty, study design, journal impact factor, and international collaboration. A total of 94 critical care nursing publications were included in this review. International collaborations were noted in 49 (52.1%) articles. The majority 53 (56.4%) of the critical care nursing publications were related to the nursing field and 66 (70.2%) of these articles were classified as clinical practice topics. Observation cohort study was the most used study design 64 (68.1%). The median impact factor for the journals of these publications was 1.76 (1.48, 2.52). Despite the lower rate of published researches, critical care nursing research in Saudi Arabia is increasing over the years. International collaborations had contributed dramatically in the published articles. Developing local strategy for critical care nursing research and promoting local and international collaboration to conduct and use research according to the critical care nursing priority are also warranted. More interventional nursing researches are needed in critical care settings in Saudi Arabia.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115229386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring factors affecting critical care response team service at a tertiary hospital in Riyadh: A retrospective cohort study","authors":"A. Alhaidari, Maram Busuhail, S. Alsultan, S. Alshammari, Abdullah Alshimemeri","doi":"10.4103/sccj.sccj_57_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_57_20","url":null,"abstract":"Background: Critical care response team (CCRT) is a proactive department of intensive care unit (ICU) that consists of an intensivist, a staff physician, a critical care nurse, and a respiratory therapist. The purpose of this team is to manage patients in their wards to avoid unnecessary ICU bed occupancies. The aim of the study is to explore factors affecting CCRT service in terms of patient disposition and mortality rate and to analyze interventions provided to the patients by the team. Materials and Methods: This is a retrospective cohort study conducted at a tertiary hospital in Riyadh. All CCRT event data collection forms from the period between February 2018 and April 2019 were reviewed. Patients meeting our criteria were included. Outcome measures were as follows: (1) patient disposition. (2) mortality rate. Factors that were tested for effect on CCRT service were patient age, activation time, and reasons for activation. All statistical analyses were done using SAS software 9.4. Results: A total of 1088 CCRT events were considered during the period of the study. Out of all deaths, the mean age was 70.90 ± 16.67 compared to the mean age of survivors 61.21 ± 20.65 (P < 0.0001). Furthermore, older patients had higher chances for ICU transfer (P = 0.0399). CCRT service was not affected by activation time as patient disposition and mortality rates were almost the same in activations during and out of work hours. The most common reason for CCRT activation was tachypnea (28.49%). Majority of patients within each reason for activation were not transferred to the ICU, except for low oxygen saturation (50.54% transferred to the ICU) (P = 0.0001), decreased level of consciousness (DLOC) (49.40% transferred to ICU) (P = 0.0001). Patients not transferred to the ICU had lower mortality rate (15.18%) than those transferred to the ICU (55.41%) (P < 0.0001). Conclusion: Given these results, increased vigilance and quick responses to CCRT calls for older patients, and those with low oxygen saturation and DLOC, must be considered. Increased vigilance is also needed for those spending more time in ICUs.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130317187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic use and resistance: Awareness among students of Prince Mohammad Bin Fahd University in Saudi Arabia","authors":"Lina Alzayer, Zainab Ambani, Lucia-Marie Ganendran","doi":"10.4103/sccj.sccj_22_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_22_20","url":null,"abstract":"Background and purpose: Antibiotic misuse in Saudi Arabia is becoming an increasing concern. It leads to the development and acceleration of antibiotic resistance. One of the established approaches to tackle the problem is through improving public awareness of appropriate antibiotic use. This study examined the level of awareness of university students about the correct use of antibiotics and the issue of antibiotic resistance. Methods: A cross-sectional study was designed, using a self-administered online questionnaire that was sent to all students of Prince Mohammad Bin Fahd University in the Eastern Province of Saudi Arabia. Results: The total number of participants was 320 students, of whom 210 were female (65.6%) and 110 were male (34.4%). About a third (34.7%) of the students had poor knowledge regarding the fact that antibiotics should only be used for bacterial infections. In addition, just over half (50.0%–57.5%) of the students could not classify the common viral infections as antibiotic untreatable infections. On the other hand, the majority (84.1%) of the respondents were highly aware of the correct source and the correct use of antibiotic prescriptions. Similarly, 73.4% of students revealed a high awareness level of how to address the issue of antibiotic resistance. However, around one-third (35.3%) of them incorrectly thought that antibiotic-resistant bacteria cannot spread from one person to another. Conclusion: Establishing an educational intervention program is needed in Saudi universities to improve students' awareness of the specific conditions that can be treated with antibiotics. In addition, it is essential for students to know that antibiotic resistance can affect anyone, of any age, in any country, and that it can be accelerated by the improper use of antibiotics.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128961117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}