Publications by authors named "Arianna Shirk"
Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study.
View Article and Find Full Text PDFPediatric critical care has continued to advance since our last article, " was written just 3 years ago. In that article, we reviewed the history, current state, and gaps in level of care between low- and middle-income countries (LMICs) and high-income countries (HICs). In this article, we have highlighted recent advancements in pediatric critical care in LMICs in the areas of research, training and education, and technology.
View Article and Find Full Text PDFObjectives: Three decades ago, in North America, pediatric emergency medicine was an evolving subspecialty of pediatrics, contributing in valuable and life-saving ways to the care of children. Currently, in LMICs (low middle-income countries) pediatric programs are expanding training and education in the subspecialty of pediatric emergency medicine. We aim to determine if care provided by a single institution with dedicated pediatric emergency resources and personnel in Kenya can change mortality rates in children with similar mRISC scores suffering from respiratory illness, as compared to previously published data from the same region of Eastern Africa.
View Article and Find Full Text PDFArticle Synopsis
- High-flow nasal cannula (HFNC) is being explored as a respiratory support option in rural Kenya for children with acute lower respiratory diseases, marking its first reported use in sub-Saharan Africa.
- A feasibility study at Kijabe Hospital found no significant differences in clinical outcomes between patients using HFNC and historical controls, despite challenges such as technical issues with equipment and increased workload for staff.
- The small sample size and variability in patient conditions limit generalizability to other low- and middle-income countries, indicating that while HFNC can be useful, more research is needed to address implementation challenges.
Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-for-profit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike.
View Article and Find Full Text PDFPediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment.
View Article and Find Full Text PDFBackground: Screening for atrial fibrillation (AF), a major risk factor for stroke that is on the rise in Africa, is becoming increasingly critical.
Objectives: This study sought to examine the feasibility of using mobile electrocardiogram (ECG) recording technology to detect AF.
Methods: In this prospective observational study, we used a mobile ECG recorder to screen 50 African adults (66% women; mean age 54.