Publications by authors named "Alhazzani W"
Importance: The impact of awake prone positioning (APP) on clinical outcomes in patients with COVID-19 and acute hypoxemic respiratory failure (AHRF) remains uncertain.
Objective: To assess the association of APP with improved clinical outcomes among patients with COVID-19 and AHRF, and to identify potential effect modifiers.
Data Sources: PubMed, Embase, the Cochrane Library, and ClinicalTrials.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) presents a significant global health challenge, with the Arab region exhibiting a markedly higher prevalence. We aim to evaluate MASLD research output, collaboration patterns, and funding impact in the Arab region over the last decade.
Methods: We conducted a bibliometric analysis of MASLD research in 22 Arab countries (2014-2023) using Clarivate Analytics' InCites.
This review aims to explore the clinical and research applications of artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), in understanding, predicting, and managing obesity. It assesses the use of AI tools to identify obesity-related risk factors, predict outcomes, personalize treatments, and improve healthcare interventions for obesity. A comprehensive literature search was conducted using PubMed and Google Scholar, with keywords including "artificial intelligence", "machine learning", "deep learning", "obesity", "obesity management", and related terms.
View Article and Find Full Text PDFThe 2024 European Society of Intensive Care Medicine clinical practice guideline provide clinicians with evidence-based recommendations on intravenous fluid in critically ill adults across a range of common conditions. These guidelines aim to improve the practices of fluid therapy by adopting a global perspective that considers both clinical efficacy and resource utilization in diverse healthcare settings. The guidelines address three key questions: (1) albumin versus crystalloids, (2) balanced crystalloids versus isotonic saline, and (3) small-volume hypertonic solutions versus isotonic crystalloids.
View Article and Find Full Text PDFBackground: Feeding intolerance is common in critically ill patients and can lead to malnutrition. Prokinetic agents may be used to enhance the uptake of nutrition. However, the evidence on the effectiveness and safety of prokinetic agents is sparse, and there is a lack of data on their use in intensive care units (ICU).
View Article and Find Full Text PDFArticle Synopsis
- The Rapid Practice Guideline (RPG) was created to evaluate the effectiveness of ketamine for sedation in ICU patients on mechanical ventilation compared to other sedatives or usual care, while also highlighting areas for further research.
- A panel of 23 experts, including a patient representative, conducted a systematic review and meta-analysis to gather data, using a structured approach to assess the reliability and implications of the evidence collected.
- The findings indicated considerable uncertainty regarding the effects of ketamine, with low certainty about its benefits on reducing opioid use or mechanical ventilation duration; adjunct ketamine therapy did not significantly affect mortality within 28 days.
Background: This Rapid Practice Guideline (RPG) aimed to provide evidence-based recommendations for ketamine analgo-sedation (monotherapy and adjunct) versus non-ketamine sedatives or usual care in adult intensive care unit (ICU) patients on invasive mechanical ventilation (iMV) and to identify knowledge gaps for future research.
Methods: The RPG panel comprised 23 multinational multidisciplinary panelists, including a patient representative. An up-to-date systematic review and meta-analysis constituted the evidence base.
Article Synopsis
- - The Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) provides evidence-based recommendations for using small-volume versus conventional blood collection tubes in adult ICU patients.
- - A systematic review of 23 panelists across 8 countries revealed high certainty that small-volume tubes minimize blood sampling volume and show moderate certainty in reducing transfusion risks, despite some imprecision in the data.
- - The panel strongly recommends small-volume tubes due to their benefits, including reduced waste and successful implementation in various countries, although there are initial costs related to validating these tubes for laboratory use.
Article Synopsis
- Critically ill adults can suffer from stress-related mucosal damage leading to upper gastrointestinal bleeding (UGIB), necessitating preventive measures in ICU settings.
- A panel of 18 international experts developed evidence-based guidelines using the GRADE methodology to provide recommendations for reducing UGIB risk in adult ICU patients.
- The panel's findings indicate several risk factors for UGIB, such as coagulopathy and shock, and recommend using proton pump inhibitors or histamine-2 receptor antagonists for at-risk patients, while emphasizing that enteral nutrition may help mitigate risk.
Article Synopsis
- A study was conducted to evaluate the effects of the proton-pump inhibitor pantoprazole on critically ill patients undergoing invasive ventilation, comparing it to a placebo.
- The trial included 4,821 patients and found that pantoprazole significantly reduced the incidence of clinically important upper gastrointestinal bleeding compared to placebo (1.0% vs. 3.5%).
- However, there was no significant difference in overall mortality rates at 90 days between the pantoprazole group (29.1%) and the placebo group (30.9%).
Background: The goal of this systematic review was to examine the efficacy and safety of proton-pump inhibitors for stress ulcer prophylaxis in critically ill patients.
Methods: We included randomized trials comparing proton-pump inhibitors versus placebo or no prophylaxis in critically ill adults, performed meta-analyses, and assessed certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations approach. To explore the effect of proton-pump inhibitors on mortality based on disease severity, a subgroup analysis was conducted combining within-trial subgroup data from the two largest trials and assessed credibility using the Instrument for Assessing the Credibility of Effect Modification Analyses.
Article Synopsis
- During the COVID-19 pandemic, many ICUs paused ongoing research to prioritize studies related to the virus, but the REVISE trial continued investigating stress ulcer prophylaxis in mechanically ventilated patients.
- The trial, which compares pantoprazole against a placebo, enrolled 2,961 patients across 59 centers, despite facing disruptions in enrollment during the pandemic.
- Changes in the informed consent process included a shift to a 'consent to continue' model and an increase in telephone consent due to restrictions, leading to a slight rise in overall consent rates.
Objectives: To describe the productivity, performance, and impact of medical research in the Arab world countries.
Methods: We carried out a bibliometric analysis using Clarivate Analytics databases from January 2017 to March 2023. We reported research productivity, national and international research collaboration patterns, impact of Arab medical research output compared to the global average, top medical journals publishing Arab-affiliated research, and performance of the most productive Arab institutions.
Purpose: The ordering of routine blood test panels in advance is common in intensive care units (ICUs), with limited consideration of the pretest probability of finding abnormalities. This practice contributes to anemia, false positive results, and health care costs. We sought to understand practices and attitudes of Canadian adult intensivists regarding ordering of blood tests in critically ill patients.
View Article and Find Full Text PDFObjectives: To conduct a systematic review and meta-analysis assessing whether the use of antipsychotic medications in critically ill adult patients with delirium impacts patient-important outcomes.
Data Sources: A medical librarian searched Ovid MEDLINE, EMBASE, APA PsycInfo, and Wiley's Cochrane Library as well as clinicaltrials.gov and the World Health Organization International Clinical Trials Registry Platform up to November 2023.
Article Synopsis
- The GRADE approach is a widely recognized framework used to summarize evidence in systematic reviews and to create clinical practice guidelines.
- This overview outlines the application of GRADE in developing clinical practice guidelines, targeting clinicians and researchers involved in this process.
- Key aspects discussed include guideline endorsement, handling conflicts of interest, prioritizing outcomes, rating evidence certainty, and the overall development and implementation of trustworthy guidelines.
Article Synopsis
- The GRADE approach evaluates the certainty of evidence in systematic reviews and meta-analyses, catering to clinicians and researchers involved in these processes.
- The text explains the methods of using GRADE, including evidence assessment, summarization with profiles or tables, and communication of results while highlighting related challenges and benefits.
- The overview serves as a guide for systematic review developers, methodologists, and users of evidence, illustrating how GRADE can be effectively applied in evidence synthesis.
Article Synopsis
- Some recent studies found that benzodiazepines might help prevent nausea and vomiting after surgery, but doctors haven't added them to the official guidelines yet because they worry about side effects.
- Researchers reviewed lots of studies and found that using benzodiazepines before or after surgery can lower the chances of feeling sick or throwing up.
- The results from this research will help update future guidelines for doctors on how to prevent nausea and vomiting after surgery.
The aim of this Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) was to provide evidence-based clinical guidance about the use of higher versus lower oxygenation targets for adult patients in the intensive care unit (ICU). The guideline panel comprised 27 international panelists, including content experts, ICU clinicians, methodologists, and patient representatives. We adhered to the methodology for trustworthy clinical practice guidelines, including the use of the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of evidence, and used the Evidence-to-Decision framework to generate recommendations.
View Article and Find Full Text PDFBackground: The REVISE (Re-Evaluating the Inhibition of Stress Erosions in the ICU) trial will evaluate the impact of the proton pump inhibitor pantoprazole compared to placebo in invasively ventilated critically ill patients.
Objective: To outline the statistical analysis plan for the REVISE trial.
Methods: REVISE is a randomized clinical trial ongoing in intensive care units (ICUs) internationally.
Introduction: The e-aluating the nhibition of tress rosions (REVISE) Trial aims to determine the impact of the proton pump inhibitor pantoprazole compared with placebo on clinically important upper gastrointestinal (GI) bleeding in the intensive care unit (ICU), 90-day mortality and other endpoints in critically ill adults. The objective of this report is to describe the rationale, methodology, ethics and management of REVISE.
Methods And Analysis: REVISE is an international, randomised, concealed, stratified, blinded parallel-group individual patient trial being conducted in ICUs in Canada, Australia, Saudi Arabia, UK, US, Kuwait, Pakistan and Brazil.
Article Synopsis
- Fever often indicates infection and needs thorough diagnostic evaluation in ICU patients.
- An updated guideline was created by IDSA and SCCM for diagnosing fever in adult ICU patients, using the GRADE method.
- A panel of 12 experts reviewed evidence and made 12 recommendations, including the use of central temperature monitoring for accurate assessments.
Importance: Blood collection for laboratory testing in intensive care unit (ICU) patients is a modifiable contributor to anemia and red blood cell (RBC) transfusion. Most blood withdrawn is not required for analysis and is discarded.
Objective: To determine whether transitioning from standard-volume to small-volume vacuum tubes for blood collection in ICUs reduces RBC transfusion without compromising laboratory testing procedures.