A worldwide assessment of the mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Analysis of the VENTILAGROUP over time. A retrospective, multicenter study.

Background: The trend over time and across different geographical areas of outcomes and management with noninvasive ventilation or invasive mechanical ventilation in patients admitted for acute exacerbations of chronic obstructive pulmonary disease and treated with ventilatory support is unknown. The purpose of this study was to describe outcomes and identify variables associated with survival for patients admitted to an intensive care unit (ICU) with acute exacerbation of chronic obstructive pulmonary disease [aeCOPD] who received noninvasive or invasive mechanical ventilation worldwide.

Methods: Retrospective, multi-national, and multicenter studies, including four observational cohort studies, were carried out in 1998, 2004, 2010, and 2016 for the VENTILAGROUP following the same methodology.

Dialysis disequilibrium syndrome: A case report.

The dialysis disequilibrium syndrome is a severe, but rare complication that can occur during or after hemodialysis. It primarily arises from an osmotic gradient, between the plasma and the brain, resulting from the rapidity of the dialysis. This gradient leads to the development of cerebral edema and an increase in intracranial pressure, manifesting as various neurological symptoms.

[Care offered to people living with HIV: the social representations of nurses in a Moroccan university hospital].

Introduction: The social representations (SRs) of nurses on HIV/AIDS and the care provided to people living with HIV are diverse and different depending on the context. This study aims to understand the SRs of nurses on the disease and on the care provided.

Method: A qualitative study conducted in 2018 with 50 nurses practicing in 11 specialized departments, belonging to seven Moroccan university hospitals.

Driving Pressure Is a Risk Factor for ARDS in Mechanically Ventilated Subjects Without ARDS.

Background: Driving pressure (ΔP) has been described as a risk factor for mortality in patients with ARDS. However, the role of ΔP in the outcome of patients without ARDS and on mechanical ventilation has received less attention. Our objective was to evaluate the association between ΔP on the first day of mechanical ventilation with the development of ARDS.

Machine learning predicts mortality based on analysis of ventilation parameters of critically ill patients: multi-centre validation.

Background: Mechanical Ventilation (MV) is a complex and central treatment process in the care of critically ill patients. It influences acid-base balance and can also cause prognostically relevant biotrauma by generating forces and liberating reactive oxygen species, negatively affecting outcomes. In this work we evaluate the use of a Recurrent Neural Network (RNN) modelling to predict outcomes of mechanically ventilated patients, using standard mechanical ventilation parameters.

Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients.

Background: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation.

Multicenter International Cohort Validation of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-sedation Scale.

Objective: In a multicenter, international cohort, we aimed to validate a modified Sequential Organ Failure Assessment (mSOFA) using the Richmond Agitation-Sedation Scale, hypothesized as comparable to the Glasgow Coma Scale (GCS)-based Sequential Organ Failure Assessment (SOFA).

Summary Background Data: The SOFA score, whose neurologic component is based on the GCS, can predict intensive care unit (ICU) mortality. But, GCS is often missing in lieu of other assessments, such as the also reliable and validated Richmond Agitation Sedation Scale (RASS).

Health-related Quality of Life Evaluated by MOS SF-36 in the Elderly Patients 1 Month before ICU Admission and 3 Months after ICU Discharge.

Objectives: The aims of this study were to evaluate changes in health-related quality of life (HRQoL) before ICU admission and after ICU discharge in elderly patients and to determine predictors of this HRQoL.

Materials And Methods: This prospective study has been realized in the medical ICU (August 2012-March 2013). All patients 65 years of age or older who were hospitalized for ≥48 hours in our medical ICU have been included.

Inter-country variability over time in the mortality of mechanically ventilated patients.

Purpose: Variations in clinical characteristics and management and in the mortality of mechanically ventilated patients have not been sufficiently evaluated. We hypothesized that mortality shows a variability associated with country after adjustment for clinical characteristics and management.

Methods: Analysis of four studies carried out at 6-year intervals over an 18-year period.

Easy prognostic assessment of concomitant organ failure in critically ill patients undergoing mechanical ventilation.

Background: Acute respiratory distress syndrome (ARDS) is a life-threatening disease. We evaluated the prognostic utility of Model for End-stage Liver Disease excluding INR (MELD-XI) score for predicting mortality in a cohort of critically ill patients on mechanical ventilation.

Methods: In total, 11,091 mechanically ventilated patients were included in our post-hoc retrospective analysis, a subgroup of the VENTILA study (NCT02731898).

International Analgesia, Sedation, and Delirium Practices: a prospective cohort study.

Background: While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions.

Methods: We performed a retrospective analysis of two multicenter, international, prospective cohort studies.

Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.

Purpose: To analyze the relationship between hypercapnia developing within the first 48 h after the start of mechanical ventilation and outcome in patients with acute respiratory distress syndrome (ARDS).

Patients And Methods: We performed a secondary analysis of three prospective non-interventional cohort studies focusing on ARDS patients from 927 intensive care units (ICUs) in 40 countries. These patients received mechanical ventilation for more than 12 h during 1-month periods in 1998, 2004, and 2010.

Association between ventilatory settings and development of acute respiratory distress syndrome in mechanically ventilated patients due to brain injury.

Purpose: In neurologically critically ill patients with mechanical ventilation (MV), the development of acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality, but the role of ventilatory management has been scarcely evaluated. We evaluate the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury.

Materials And Methods: We performed a secondary analysis of a prospective, observational study on mechanical ventilation.

Practices and perceived barriers regarding pain management among Emergency Department physicians: a nationwide multicenter survey in Moroccan hospitals.

Aim: To describe pain management practices in Moroccan emergency departments, and to identify perceived barriers among emergency department physicians regarding pain management.

Methods: Eleven Moroccan emergency departments participated in the study. A nationwide survey was administered to physicians.

Impact of sedation and analgesia during noninvasive positive pressure ventilation on outcome: a marginal structural model causal analysis.

Purpose: There are limited data available about the role of sedation and analgesia during noninvasive positive pressure ventilation (NPPV). The objective of study was to estimate the effect of analgesic or sedative drugs on the failure of NPPV.

Methods: We studied patients who received at least 2 h of NPPV as first-line therapy in a prospective observational study carried out in 322 intensive care units from 30 countries.

Factors associated to unrelieved pain in a Morrocan Emergency Department.

Background: In the light of the impact that pain has on patients, emergency department (ED) physicians need to be well versed in its management, particularly in its acute presentation. The goal of the present study was to evaluate the prevalence of unrelieved acute pain during ED stay in a Moroccan ED, and to identify risk factors of unrelieved pain.

Methods: Prospective survey of patients admitted to the emergency department of Ibn Sina teaching university hospital in Rabat (Morocco).

Preventability of death in a medical intensive care unit at a university hospital in a developing country.

Objective: To determine the incidence and characteristics of preventable in-ICU deaths.

Materials And Methods: A one-year observational study was conducted in a medical ICU of a teaching hospital. All patients who died in medical ICU beyond 24 h were analyzed and reviewed during daily medical meeting.

Self-perceived sleepiness in emergency training physicians: prevalence and relationship with quality of life.

Introduction: Sleep deprivation among training physicians is of growing concern; training physicians are susceptible due to their prolonged work hours and rotating work schedules. The aim of this study was to determine the prevalence of self-perceived sleepiness in emergency training physicians, and to establish a relationship between self-perceived sleepiness, and quality of life.

Methods: Prospective survey in Ibn Sina University hospital Center in Morocco from January to April 2011 was conducted.

Patient satisfaction in a Moroccan emergency department.

Background: Measuring healthcare quality and improving patient satisfaction have become increasingly prevalent, especially among healthcare providers and purchasers of healthcare. Currently, research is interested to the satisfaction in several areas, and in various cultures. The aim of this study was; to confirm the reliability and validity of the Arabic version of the Emergency Department Quality Study (EDQS), to evaluate patient satisfaction with emergency care, and to determine associated factors with patient satisfaction.

Evolution of mortality over time in patients receiving mechanical ventilation.

Rationale: Baseline characteristics and management have changed over time in patients requiring mechanical ventilation; however, the impact of these changes on patient outcomes is unclear.

Objectives: To estimate whether mortality in mechanically ventilated patients has changed over time.

Methods: Prospective cohort studies conducted in 1998, 2004, and 2010, including patients receiving mechanical ventilation for more than 12 hours in a 1-month period, from 927 units in 40 countries.

A simple diagnostic aid for tuberculous meningitis in adults in Morocco by use of clinical and laboratory features.

Background: The delay in diagnosis and treatment of tuberculous meningitis (TBM) is a major factor in the high mortality observed with this pathology. The distinction between bacterial meningitis (BM) and TBM by clinical features alone is often impossible, and the available biological resources remain inadequate or inaccessible, especially in developing countries. We attempted to develop a simple diagnostic algorithm on the basis of clinical and laboratory findings that could be used as an early predictor of TBM in adult patients in Morocco.

[Development and validation of an assay method of the paraphenylene diamine by gas chromatography-mass spectrometry].

Paraphenylenediamine is an aromatic amine used as a hair dye; it is responsible for poisoning characterized by respiratory distress involving life-threatening. The objective of this work is the development and validation of an assay of para-phenylenediamine in the whole blood. The method is based on the determination of paraphenylene diamine in whole blood by gas chromatography-mass spectrometry after liquid-liquid extraction and derivatization.

Determinants and outcomes associated with decisions to deny or to delay intensive care unit admission in Morocco.

Purpose: To report determinants and outcomes associated with decisions to deny or to delay intensive care unit (ICU) admission in critically ill patients.

Methods: An observational prospective study over a 6-month period. All adult patients triaged for admission to a medical ICU were included prospectively.