Brian Soto, Louis Costanzo, Anoop Puskoor, Nada Akkari, Patrick Geraghty
{"title":"The implications of Vitamin E acetate in E-cigarette, or vaping, product use-associated lung injury.","authors":"Brian Soto, Louis Costanzo, Anoop Puskoor, Nada Akkari, Patrick Geraghty","doi":"10.4103/atm.atm_144_22","DOIUrl":"10.4103/atm.atm_144_22","url":null,"abstract":"<p><p>In the summer of 2019, a cluster of cases were observed with users of battery-operated or superheating devices presenting with multiple symptoms, such as dyspnea, cough, fever, constitutional symptoms, gastrointestinal upset, and hemoptysis, that is now termed e-cigarette, or vaping, product use-associated lung injury (EVALI). The Centers for Disease Control and Prevention reported 2807 cases within the USA leading to at least 68 deaths as of February 18, 2020. The heterogeneous presentations of EVALI make diagnosis and treatment difficult; however, treatment focused on identifying and removal of the noxious substance and providing supportive care. Vitamin E acetate (VEA) is a likely cause of this lung injury, and others have reported other components to play a possible role, such as nicotine and vegetable glycerin/propylene glycol. EVALI is usually observed in adolescents, with a history of vaping product usage within 90 days typically containing tetrahydrocannabinol, and presenting on chest radiograph with pulmonary infiltrates or computed tomography scan with ground-glass opacities. Diagnosis requires a high degree of suspicion to diagnose and exclusion of other possible causes of lung disease. Here, we review the current literature to detail the major factors contributing to EVALI and primarily discuss the potential role of VEA in EVALI. We will also briefly discuss other constituents other than just VEA, as a small number of EVALI cases are reported without the detection of VEA, but with the same clinical diagnosis.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/47/ATM-18-1.PMC10034821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Alaklabi, Shouq Mohammed AlNujaim, Sarah Mohammed Alghaihab, Sadeem Ahmed AlDakhil, Obeid Mohammed AlKethami, Rajkumar Rajendram
{"title":"Measurement of the awareness of venous thromboembolism in the Saudi population.","authors":"Ali Alaklabi, Shouq Mohammed AlNujaim, Sarah Mohammed Alghaihab, Sadeem Ahmed AlDakhil, Obeid Mohammed AlKethami, Rajkumar Rajendram","doi":"10.4103/atm.atm_147_22","DOIUrl":"10.4103/atm.atm_147_22","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) causes significant morbidity and mortality. International studies have suggested poor public awareness of VTE, with a few data from Saudi Arabia. The aim of this study was to investigate the knowledge and awareness of VTE in the Saudi population. Awareness of other important diseases was also investigated to allow contextualization.</p><p><strong>Methods: </strong>A cross-sectional survey study was conducted throughout Saudi Arabia from April to June 2021. A nonprobability, purposive, social media-driven, snowballing sampling technique was used to distribute a validated online questionnaire to Saudi adults (aged over 18 years) from the general population.</p><p><strong>Results: </strong>Of 1226 respondents, 214 were excluded as they were health-care professionals. The majority of the participants were unaware and unconcerned about VTE. They were more aware of other medical conditions such as hypertension. Immobility and old age were frequently recognized as risk factors for VTE. While less than half of the participants were aware that thrombosis is the cause of VTE, most participants correctly identified leg pain and tenderness as symptoms of deep venous thrombosis. The majority of the participants identified chest pain and breathlessness as symptoms of pulmonary embolism. However, leg paralysis and slow, shallow breathing were frequently identified as symptoms of VTE. The majority of subjects disagreed with the statement, \"having a blood clot is not considered a medical emergency.\" Awareness of VTE varied significantly with age.</p><p><strong>Conclusion: </strong>In Saudi Arabia, the public awareness of VTE is poor. To improve outcomes, public health initiatives must increase awareness, introduce preventive measures, encourage early diagnosis, and ensure compliance with treatment.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"15-22"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/95/ATM-18-15.PMC10034823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Al Shammari, Aida Saad, Lama Tareq Saif, Safy A. Othman, Mohammad J. Ghosheh, Ghadir M. Khdeir, Omniyah Alashgar, Mohammed A. Abu-Rayya, Mohamed Hussein Ahmed, Khaled AlKattan, Waleed Saleh
{"title":"Clinicodemographic characteristics and prognostic role of myasthenia gravis in thymoma: Experience from a Saudi population","authors":"Abdullah Al Shammari, Aida Saad, Lama Tareq Saif, Safy A. Othman, Mohammad J. Ghosheh, Ghadir M. Khdeir, Omniyah Alashgar, Mohammed A. Abu-Rayya, Mohamed Hussein Ahmed, Khaled AlKattan, Waleed Saleh","doi":"10.4103/atm.atm_61_23","DOIUrl":"https://doi.org/10.4103/atm.atm_61_23","url":null,"abstract":"Abstract: OBJECTIVES: The objectives of the study were to determine the clinicodemographic characteristics and the prognostic role of myasthenia gravis (MG) in thymoma. METHODS: The records of patients who underwent surgical resection of thymoma at King Faisal Specialist Hospital and Research Center in the past 23 years were reviewed. Seventy thymoma patients were finally included and were then categorized based on MG status into the MG group (39 patients) and the non-MG group (31 patients). Collected data included patients’ demographic characteristics, tumor characteristics, and postoperative clinical outcomes. All analyses were conducted using SPSS. The comparison between both groups was tested using the Student t -test and Chi-square test for continuous and categorical variables, respectively. A P = 0.05 or less indicated statistical significance. RESULTS: Patients’ age ranged from 11 to 76 years, and female predominance was observed (55.7%). Compared to the non-MG group, no difference in patients’ gender was observed ( P = 0.058); however, MG patients had a younger age (39.30 vs. 48.77, P = 0.0095). No difference was noted between both groups based on the World Health Organization classification ( P = 0.398), but MG patients tended to present with less-advanced tumors based on the TNM classification ( P = 0.039) and lower stage based on the MASAOKA staging system ( P = 0.017). No significant change in tumor size ( P = 0.077), resectability ( P = 0.507), and adjuvant therapy ( P = 0.075) were observed. MG was not significantly associated with postoperative complications, morbidity, or mortality. However, it exhibited a prognostic protective role in terms of lower recurrence (2.56% vs. 35.48%, P = 0.0001) and longer survival duration (18.62 vs. 10.21 years, P < 0.001) as compared to non-MG patients. CONCLUSIONS: MG occurrence in thymoma patients is more likely to occur at a younger age, higher TNM classification, and advanced MASAOKA stage. Although no significant association was noted between MG and complications and mortality, MG exhibited a protective role in thymoma by providing a lower recurrence rate and longer survival duration.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135009506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"General rehabilitation for the Post-COVID-19 condition: A narrative review.","authors":"Dian Marta Sari, Laurentia Cindy Gani Wijaya","doi":"10.4103/atm.atm_286_22","DOIUrl":"10.4103/atm.atm_286_22","url":null,"abstract":"COVID-19 significantly impacts the acute phase or the period after being infected by severe acute respiratory syndrome coronavirus-2. Studies have shown it has affected multiorgan and needs continuous care by a multidisciplinary team. Nowadays, guidance is required to assist the recovery process of survivors who reported at least one symptom as a residual effect. This study aims to describe the rehabilitation management of post-COVID-19 conditions. As the number of survivors seems to be increasing, it is expected that COVID-19 survivors will recover through a holistic approach by all physicians. Comprehensive rehabilitation for long COVID or COVID-19-related illnesses includes exercising, nutrition, education, managing voice, breathlessness, neurocognitive problems, mental health, feeding problems, and daily activities. Specific recommendations have already been published to support rehabilitation for survivors in every targeted organ. Supportive care, especially rehabilitation programs, is recently an urgent knowledge in this pandemic.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"10-14"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/fe/ATM-18-10.PMC10034826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Elena Toubes-Navarro, Francisco Gude-Sampedro, José Manuel Álvarez-Dobaño, Francisco Reyes-Santias, Carlos Rábade-Castedo, Carlota Rodríguez-García, Óscar Lado-Baleato, Raquel Lago-Fidalgo, Noelia Sánchez-Martínez, Jorge Ricoy-Gabaldón, Ana Casal-Mouriño, Romina Abelleira-Paris, Vanessa Riveiro-Blanco, Carlos Zamarrón-Sanz, Nuria Rodríguez-Núñez, Adriana Lama-López, Lucía Ferreiro-Fernández, Luis Valdés-Cuadrado
{"title":"A pulmonary rehabilitation program reduces hospitalizations in chronic obstructive pulmonary disease patients: A cost-effectiveness study","authors":"Maria Elena Toubes-Navarro, Francisco Gude-Sampedro, José Manuel Álvarez-Dobaño, Francisco Reyes-Santias, Carlos Rábade-Castedo, Carlota Rodríguez-García, Óscar Lado-Baleato, Raquel Lago-Fidalgo, Noelia Sánchez-Martínez, Jorge Ricoy-Gabaldón, Ana Casal-Mouriño, Romina Abelleira-Paris, Vanessa Riveiro-Blanco, Carlos Zamarrón-Sanz, Nuria Rodríguez-Núñez, Adriana Lama-López, Lucía Ferreiro-Fernández, Luis Valdés-Cuadrado","doi":"10.4103/atm.atm_70_23","DOIUrl":"https://doi.org/10.4103/atm.atm_70_23","url":null,"abstract":"Abstract: BACKGROUND: Although pulmonary rehabilitation (PR) is recommended in patients with chronic obstructive pulmonary disease (COPD), there is a scarcity of data demonstrating the cost-effectiveness and effectiveness of PR in reducing exacerbations. METHODS: A quasi-experimental study in 200 patients with COPD was conducted to determine the number of exacerbations 1 year before and after their participation in a PR program. Quality of life was measured using the COPD assessment test and EuroQol-5D. The costs of the program and exacerbations were assessed the year before and after participation in the PR program. The incremental cost-effectiveness ratio (ICER) was estimated in terms of quality-adjusted life years (QALYs). RESULTS: The number of admissions, length of hospital stay, and admissions to the emergency department decreased after participation in the PR program by 48.2%, 46.6%, and 42.5%, respectively ( P < 0.001 for all). Results on quality of life tests improved significantly ( P < 0.001 for the two tests). The cost of PR per patient and the cost of pre-PR and post-PR exacerbations were €1867.7 and €7895.2 and €4201.9, respectively. The PR resulted in a cost saving of €1826 (total, €365,200) per patient/year, and the gain in QALYs was+0.107. ICER was −€17,056. The total cost was <€20,000/QALY in 78% of patients. CONCLUSIONS: PR contributes to reducing the number of exacerbations in patients with COPD, thereby slowing clinical deterioration. In addition, it is cost-effective in terms of QALYs.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed Ayaz Khan, Nahed Sherbini, Sami Alyami, Abdullah Al-Harbi, Majed Al-Ghamdi, Suliman Alrajhi, Rajkumar Rajendram, Hamdan Al-Jahdali
{"title":"Nintedanib and pirfenidone for idiopathic pulmonary fibrosis in King Abdulaziz Medical City, Riyadh: Real-life data.","authors":"Mohammed Ayaz Khan, Nahed Sherbini, Sami Alyami, Abdullah Al-Harbi, Majed Al-Ghamdi, Suliman Alrajhi, Rajkumar Rajendram, Hamdan Al-Jahdali","doi":"10.4103/atm.atm_206_22","DOIUrl":"10.4103/atm.atm_206_22","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic progressive age-related lung disease causing relentless fibrosis of the lung parenchyma. Currently, pirfenidone and nintedanib are the two antifibrotic drugs, approved for the treatment of IPF. Both are shown to slow progression by preserving lung functions from rapid decline compared to a placebo. We are reporting a real-life patient experience using these two antifibrotic medications (AFMs) in our tertiary care hospital.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted for all IPF cases diagnosed in multidisciplinary meetings between 2015 and 2020 at KAMC, Riyadh (Saudi Arabia). We are reporting patients' demographics, lung function, survival, tolerance, side effects, or death in patients taking AFMs.</p><p><strong>Results: </strong>A total of 81 cases were identified. The majority of patients aged 67 years (68%) were men with a median age of 68 years. Late presentation, severe disease, and definite usual interstitial pneumonia patterns were reported in 60% of our patients. The average number of hospital admissions before starting treatment was 1 (range: 0-3) in the nintedanib group and 1.4 (range: 1.2-5) in the pirfenidone group. There was an increase in the number of hospital admissions in the group started on pirfenidone 1.7 (range: 1.9-8) compared to nintedanib 0.5 (range: 0-3), <i>P</i> = 0.001. The observed mortality outcome in this cohort was 4 (11%) and 12 (27%) for nintedanib and pirfenidone, respectively. The predominant side effects were gastrointestinal symptoms for both the groups 18 (22%).</p><p><strong>Conclusions: </strong>Pirfenidone and nintedanib are the available approved antifibrotic agents used for many years to treat IPF patients. Real-life data showed better tolerability than reported in the West, good compliance, and a manageable side effect profile in this group of elderly and severe IPF patients.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"45-51"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/2f/ATM-18-45.PMC10034822.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Albina Guri, Lauren Groner, Joanna Escalon, Anthony Saleh
{"title":"Algorithmic approach in the management of COVID-19 patients with residual pulmonary symptoms","authors":"Albina Guri, Lauren Groner, Joanna Escalon, Anthony Saleh","doi":"10.4103/atm.atm_83_23","DOIUrl":"https://doi.org/10.4103/atm.atm_83_23","url":null,"abstract":"Abstract: Coronavirus-19 emerged about 3 years ago and has proven to be a devastating disease, crippling communities worldwide and accounting for more than 6.31 million deaths. The true disease burden of COVID-19 will come to light in the upcoming years as we care for COVID-19 survivors with post-COVID-19 syndrome (PCS) with residual long-term symptoms affecting every organ system. Pulmonary fibrosis is the most severe long-term pulmonary manifestation of PCS, and due to the high incidence of COVID-19 infection rates, PCS-pulmonary fibrosis has the potential of becoming the next large-scale respiratory health crisis. To confront the potentially devastating effects of emerging post-COVID-19 pulmonary fibrosis, dedicated research efforts are needed to focus on surveillance, understanding pathophysiologic mechanisms, and most importantly, an algorithmic approach to managing these patients. We have performed a thorough literature review on post-COVID-19 pulmonary symptoms/imaging/physiology and present an algorithmic approach to these patients based on the best available data and extensive clinical experience.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Turgut Bora Cengiz, Ahmed Abdelrahman, Scott A. Rohren, John Doucette, Munir Ghesani
{"title":"The diagnostic accuracy of perfusion-only scan in the diagnosis of pulmonary embolism in the era of COVID-19: A single-center study of 434 patients","authors":"Turgut Bora Cengiz, Ahmed Abdelrahman, Scott A. Rohren, John Doucette, Munir Ghesani","doi":"10.4103/atm.atm_42_23","DOIUrl":"https://doi.org/10.4103/atm.atm_42_23","url":null,"abstract":"Abstract: INTRODUCTION: There is a paucity of data in the literature regarding the diagnostic accuracy of perfusion (Q)-only studies in the absence of ventilation images. This study aims to assess the diagnostic accuracy of Q-only imaging in the pandemic era. METHODS: Patients who underwent Q-only imaging for pulmonary embolism between March 2020 and February 2021 were analyzed. Patients who underwent lung quantification analysis were excluded. Q-only test results were reported as per modified PIOPED II criteria and single positron emission tomography/computed tomography (SPECT/CT) imaging was performed as needed. Patients were considered concordant or discordant by correlating the Q-only results with CT angiogram (CTA) or clinical diagnosis made through chart review. The diagnostic accuracy was calculated after excluding intermediate probability and nondiagnostic studies. RESULTS: Four hundred and thirty-four patients were identified. One hundred and twenty-eight patients (29.4%) underwent ultrasound Doppler, 37 patients (8.5%) underwent CTA, and 16 patients (3.6%) underwent both. After excluding patients with intermediate probability or nondiagnostic studies and who did not have follow-up (a total of 87 patients [20%]), 347 patients were enrolled in the final analysis. The combined planar and SPECT/CT sensitivity and specificity were 85.4% (72.2%–93.9% confidence interval [CI]) and 98.7% (96.9%–98.6% CI), respectively. The positive predictive value (PPV) of the Q-only imaging was 89.1% (77.3%–95.1% CI) and the negative predictive value (NPV) was 98.2% (96.4%–99% CI). The sensitivity with SPECT/CT reached 100% (CI: 71.5%–100%) with a specificity of 92.3% (CI: 64%–99.8%). The PPV was 85.7% (CI: 62.1%–95.6%) and the NPV was 100%. CONCLUSION: Q-only imaging provides clinically acceptable results. The sensitivity of the Q-only scan is increased when coupled with SPECT/CT.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmad A Bamagoos, Shahad A Alshaynawi, Atheer S Gari, Atheer M Badawi, Mudhawi H Alhiniah, Asma A Alshahrani, Renad R Rajab, Reem K Bahaj, Faris Alhejaili, Siraj O Wali
{"title":"Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population.","authors":"Ahmad A Bamagoos, Shahad A Alshaynawi, Atheer S Gari, Atheer M Badawi, Mudhawi H Alhiniah, Asma A Alshahrani, Renad R Rajab, Reem K Bahaj, Faris Alhejaili, Siraj O Wali","doi":"10.4103/atm.atm_183_22","DOIUrl":"10.4103/atm.atm_183_22","url":null,"abstract":"<p><strong>Context: </strong>Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations is possible but variable across populations.</p><p><strong>Aims: </strong>We aimed to (1) determine the optimal PAP requirement, (2) determine differences in optimal PAP requirements across OSA severity groups, (3) determine the relationship between optimal PAP requirement and diagnostic polysomnography measurements of OSA severity, and (4) develop a pilot equation to predict the optimal PAP requirement from diagnostic polysomnography in a sample from the Saudi population.</p><p><strong>Methods: </strong>We analyzed records pertaining to adult OSA patients (<i>n</i> = 215; 63% of males) who underwent standardized diagnostic and titration polysomnography in our sleep laboratory between 2015 and 2019. Demographic, anthropometric, and clinical information were also collected for the analysis. Inferential statistics were performed for comparisons between diagnostic and titration studies and between OSA severity groups. Regression analyses were also performed to determine the potential predictors of optimal PAP requirements. Data were presented as the mean (± standard deviation) or median (25<sup>th</sup>-75<sup>th</sup> quartiles) according to normality.</p><p><strong>Results: </strong>The median optimal PAP requirement was 13 (9-17) cmH<sub>2</sub>O. The optimal PAP requirement was significantly greater for male versus female participants (14 [10-17] vs. 12 [8-16] cmH<sub>2</sub>O) and for participants with severe OSA (16 [12-20] cmH<sub>2</sub>O, <i>n</i> = 119) versus those with moderate (11 [8-14] cmH<sub>2</sub>O, <i>n</i> = 63) or mild (9 [7-12] cmH<sub>2</sub>O, <i>n</i> = 33) OSA. When combined, nadir oxygen saturation, oxygen desaturation index, and arousal index could be used to predict the optimal PAP requirement (<i>R</i> <sup>2</sup>= 0.39, <i>F</i> = 34.0, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The optimal PAP requirement in the Saudi population is relatively high and directly correlated with OSA severity. Diagnostic polysomnography measurements of OSA severity predicted the optimal PAP requirement in this sample. Prospective validation is warranted.</p>","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"18 1","pages":"31-38"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/00/ATM-18-31.PMC10034820.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9183361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zohair Al Aseri, Mariam Ali Alansari, Sara Ali Al-Shami, Bayan Alaskar, Dhuha Aljumaiah, Alyaa Elhazmi
{"title":"The advantages of inhalational sedation using an anesthetic-conserving device versus intravenous sedatives in an intensive care unit setting: A systematic review","authors":"Zohair Al Aseri, Mariam Ali Alansari, Sara Ali Al-Shami, Bayan Alaskar, Dhuha Aljumaiah, Alyaa Elhazmi","doi":"10.4103/atm.atm_89_23","DOIUrl":"https://doi.org/10.4103/atm.atm_89_23","url":null,"abstract":"Abstract: BACKGROUND: Sedation is fundamental to the management of patients in the intensive care unit (ICU). Its indications in the ICU are vast, including the facilitating of mechanical ventilation, permitting invasive procedures, and managing anxiety and agitation. Inhaled sedation with halogenated agents, such as isoflurane or sevoflurane, is now feasible in ICU patients using dedicated devices/systems. Its use may reduce adverse events and improve ICU outcomes compared to conventional intravenous (IV) sedation in the ICU. This review examined the effectiveness of inhalational sedation using the anesthetic conserving device (ACD) compared to standard IV sedation for adult patients in ICU and highlights the technical aspects of its functioning. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials, The Cochrane Library, MEDLINE, Web of Science, and Sage Journals databases using the terms “anesthetic conserving device,” “Anaconda,” “sedation” and “intensive care unit” in randomized clinical studies that were performed between 2012 and 2022 and compared volatile sedation using an ACD with IV sedation in terms of time to extubation, duration of mechanical ventilation, and lengths of ICU and hospital stay. RESULTS: Nine trials were included. Volatile sedation (sevoflurane or isoflurane) administered through an ACD shortened the awakening time compared to IV sedation (midazolam or propofol). CONCLUSION: Compared to IV sedation, volatile sedation administered through an ACD in the ICU shortened the awakening and extubation times, ICU length of stay, and duration of mechanical ventilation. More clinical trials that assess additional clinical outcomes on a large scale are needed.","PeriodicalId":50760,"journal":{"name":"Annals of Thoracic Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135008604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}