Impact of critical care medicine publications from intensive care department at King Abdulaziz Medical City, Riyadh in the last two decades.

Introduction: The volume and quality of biomedical research publications from an institution are considered adequate indicators of the quality of medical care in that institute. King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia (KSA), is one of the oldest and most distinguished medical centers in the country.

Methods: In this study, we analyzed the number of publications from the Critical Care Unit of the hospital in the past two decades, from 1996 to 2016.

The Saudi Thoracic Society guidelines for diagnosis and management of noncystic fibrosis bronchiectasis.

This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources.

The Saudi Thoracic Society pneumococcal vaccination guidelines-2016.

Streptococcus pneumoniae (pneumococcus) is the leading cause of morbidity and mortality worldwide. Saudi Arabia is a host to millions of pilgrims who travel annually from all over the world for Umrah and the Hajj pilgrimages and are at risk of developing pneumococcal pneumonia or invasive pneumococcal disease (IPD). There is also the risk of transmission of S.

Effect of age and gender in the prevalence of excessive daytime sleepiness among a sample of the Saudi population.

The aim of this study is to assess whether the effect of gender on the excessive daytime sleepiness (EDS) is influenced by two confounders (age and hours of sleep per night). A cross-sectional study was conducted at King Abdulaziz Medical City-Riyadh (KAMC-R). A total of 2095 respondents answered a questionnaire that included questions regarding gender, age, hours of sleep per night, and daytime sleepiness using the Epworth Sleepiness Scale (ESS).

Validation of the Arabic version of the Epworth sleepiness scale.

Background: The Epworth Sleepiness Scale (ESS) is a questionnaire widely used in developed countries to measure daytime sleepiness and diagnose sleep disorders.

Objective: This study aimed to develop an ESS questionnaire for the Arabic population (ArESS), to determine ArESS internal consistency, and to measure ArESS test-retest reproducibility. It also investigated whether the normal range of ESS scores of healthy people in different cultures are similar.

Therapeutic hypothermia after cardiac arrest.

Prognosis following out-of-hospital cardiac arrest is generally poor, which is mostly due to the severity of neuronal damage. Recently, the use of therapeutic hypothermia has gradually occupied an important role in managing neuronal injuries in some cases of cardiac arrests. Some of the clinical trials conducted in comatose post-resuscitation cardiac arrest patients within the last decade have shown induced hypothermia to be effective in facilitating neuronal function recovery.

Demographics and outcomes of critically ill patients transferred from other hospitals to a tertiary care academic referral center in Saudi Arabia.

Background: The objective of this study was to examine the outcomes of critically ill patients who were transferred from other hospitals to a tertiary care center in Saudi Arabia as a quality improvement project.

Methods: This was a retrospective study of adult patients admitted to the medical-surgical intensive care unit (ICU) of a tertiary care hospital. Patients were divided according to the source of referral into three groups: transfers from other hospitals, and direct admissions from emergency department (ED) and from hospital wards.

The impact of time to tracheostomy on mechanical ventilation duration, length of stay, and mortality in intensive care unit patients.

Introduction: This study examined the potential effects of time to tracheostomy on mechanical ventilation duration, intensive care unit (ICU), and hospital length of stay (LOS), and ICU and hospital mortality.

Methods: Cohort observational study was conducted in a tertiary care medical-surgical ICU based on a prospectively collected ICU database. We included 531 consecutive patients who were admitted between March 1999 and February 2005, and underwent tracheostomy during their ICU stay.

Intensive versus conventional insulin therapy: a randomized controlled trial in medical and surgical critically ill patients.

Objective: The role of intensive insulin therapy in medical surgical intensive care patients remains unclear. The objective of this study was to examine the effect of intensive insulin therapy on mortality in medical surgical intensive care unit patients.

Design: Randomized controlled trial.

Information disclosure and decision-making: the Middle East versus the Far East and the West.

Objectives: to assess physicians' and patients' views in Saudi Arabia (KSA) towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan.

Design: A self-completion questionnaire (used previously to study these issues in Japan and the USA) was translated to Arabic and validated.

Participants: Physicians (n = 321) from different specialties and ranks and patients (n = 264) in a hospital or attending outpatient clinics from 6 different regions in KSA.

Changing sedation practices in the intensive care unit--protocol implementation, multifaceted multidisciplinary approach and teamwork.

Introduction: Sedation protocols have demonstrated effectiveness in improving ICU sedation practices. However, the importance of multifaceted multidisciplinary approach on the success of such protocols has not been fully examined.

Methods: The study was conducted in a tertiary care medical-surgical ICU as a prospective, 4-pronged, observational study describing a quality improvement initiative that employs 2 types of controlled comparisons: a "before and after" comparison related to intense education of ICU clinicians and nurses about sedation and analgesia in the ICU, and a comparison of protocolized versus non-protocolized care.

Perception of the role of inhaled corticosteroids and factors affecting compliance among asthmatic adult patients.

Objective: To examine the patient characteristics linked with reduced adherence to inhaled corticosteroids (ICS) use.

Methods: A prospective study of adult asthmatic patients who were prescribed with ICS and are under regular follow-up at the pulmonary outpatient clinics between June 1st, and December 31st, 2001, at King Fahad National Guard Hospital in Riyadh. All patients underwent structured interviews with an investigator.

Sleep disorders in Saudi health care workers.

Background: The objective of the study was to screen for sleep habits and various sleep disorders, using a standard questionnaire.

Patients And Methods: The questionnaire was designed to assess sleep habits, the degree of daytime sleepiness using the Epworth Sleepiness Scale (ESS), and specific sleep problems. A random sample of Saudi employees working as medical or paramedical personnel was selected.

Effect of corticosteroids on adult varicella pneumonia: cohort study and literature review.

Background: Varicella pneumonia (VP) is a serious entity associated with morbidity and mortality. There have been sporadic reports using corticosteroids in life-threatening VP. We report a case series of VP to examine the outcome and the effect of corticosteroid use.

Weekend and weeknight admissions have the same outcome of weekday admissions to an intensive care unit with onsite intensivist coverage.

Objective: Several reports have indicated increased mortality for weekend and nighttime admissions to the intensive care unit. This increase has been attributed to differences in staffing levels. The impact of onsite 24-hr/7-day intensivist staffing on weekend and weeknight outcomes has not been examined before.

Nosocomial infective endocarditis in critically ill patients: a report of three cases and review of the literature.

Nosocomial infective endocarditis (NIE) is a relatively uncommon but nevertheless a serious complication affecting critically ill hospitalized patients who are frequently exposed to life-saving invasive procedures. We report three cases of NIE in a tertiary-care hospital encountered during a period of two years. The first case developed in a 50% burn-injured patient; the second in a liver transplant recipient; and the third in a renal transplant recipient.

Outcome predictors of cirrhosis patients admitted to the intensive care unit.

Objective: To evaluate outcome predictors of patients with cirrhosis admitted to an intensive care unit (ICU).

Methods: One hundred and twenty-nine consecutive patients with cirrhosis admitted to the ICU at a tertiary care transplant centre in Saudi Arabia between March 1999 and December 2000 were entered prospectively in an ICU database. Liver transplantation patients and readmissions to the ICU were excluded.

Diagnostic yield of closed pleural biopsy in exudative pleural effusion.

Objective: Closed pleural biopsy is known to be diagnostic in approximately 75% of pleural effusion undiagnosed by thoracocentesis or pleural fluid evaluation. The purpose of this study was to determine the efficacy of closed pleural biopsy in a Saudi tertiary care teaching hospital.

Methods: We retrospectively reviewed the diagnostic utility of all closed pleural biopsies performed from January 1988 to December 1997 at the King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.

Improving resource utilization in the intensive care units. A challenge for Saudi Hospitals.

In the face of increasing demand of intensive care services in the Kingdom of Saudi Arabia, as well as the high cost of delivering such services, systematic steps must be undertaken in order to ensure optional utilization and fair allocation of resources. Strategies start prior to intensive care units (ICU) admission by the proper selection of patients who are likely to benefit from ICU. Less resource-demanding alternatives, such as intermediate care units, should be used for low-risk patients.

Can we predict prognosis using mortality probability model IIo?

Objective: To evaluate Mortality Probability Model (MPM) IIo as a tool to predict very poor prognosis after intensive care unit admission.

Methods: The study was conducted as a prospective observational study in a medical-surgical intensive care unit in a tertiary care teaching hospital, Riyadh, Kingdom of Saudi Arabia. Data necessary to calculate MPM IIo predicted mortality was collected from March 1999 through to February 2000 on all intensive care unit admissions.

Assessment of performance of four mortality prediction systems in a Saudi Arabian intensive care unit.

Introduction: The purpose of this study is to assess the performance of Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Mortality Probability Model MPM II0 and MPM II24 systems in a major tertiary care hospital in Riyadh, Saudi Arabia.

Methods: The following data were collected prospectively on all consecutive patients admitted to the Intensive Care Unit between 1 March 1999 and 31 December 2000: demographics, APACHE II and SAPS II scores, MPM variables, ICU and hospital outcome. Predicted mortality was calculated using original regression formulas.