Publications by authors named "Hasan M Al Dorzi"
Objective: To evaluate characteristics and outcomes in critically ill patients with Guillain-Barré syndrome (GBS).
Methods: Consecutive adults with GBS who required intensive care unit (ICU) admission at a tertiary-care hospital between 1999 and 2020 were enrolled into this retrospective cohort study. Demographics, clinical data and patient outcomes were compared between patients who did or did not receive mechanical ventilation (MV).
Background: The systolic shock index (SSI) is used to direct management and predict outcomes, but its utility in patients requiring rapid response team (RRT) activation is unclear.
Objectives: We explored whether SSI can predict the outcomes of ward patients experiencing clinical deterioration and compared its performance with other parameters.
Methods: This retrospective study included adult patients in medical/surgical wards who required RRT activation.
Importance: Sepsis screening is recommended among hospitalized patients but is supported by limited evidence of effectiveness.
Objective: To evaluate the effect of electronic sepsis screening, compared with no screening, on mortality among hospitalized ward patients.
Design, Setting, And Participants: In a stepped-wedge, cluster randomized trial at 5 hospitals in Saudi Arabia, 45 wards (clusters) were randomized into 9 sequences, 5 wards each, to have sepsis screening implemented at 2-month periods.
Background: Influenza is a common cause of hospital admissions globally with regional variations in epidemiology and clinical profile. We evaluated the characteristics and outcomes of patients with influenza admitted to a tertiary-care center in Riyadh, Saudi Arabia.
Methods: This was a retrospective cohort of adult patients admitted with polymerase chain reaction-confirmed influenza to King Abdulaziz Medical City-Riyadh between January 1, 2018, and May 31, 2022.
Background: The diagnostic performance of the available risk assessment models for VTE in patients who are critically ill receiving pharmacologic thromboprophylaxis is unclear.
Research Question: For patients who are critically ill receiving pharmacologic thromboprophylaxis, do risk assessment models predict who would develop VTE or who could benefit from adjunctive pneumatic compression for thromboprophylaxis?
Study Design And Methods: In this post hoc analysis of the Pneumatic Compression for Preventing VTE (PREVENT) trial, different risk assessment models for VTE (ICU-VTE, Kucher, Intermountain, Caprini, Padua, and International Medical Prevention Registry on VTE [IMPROVE] models) were evaluated. Receiver-operating characteristic curves were constructed, and the sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated.
Article 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.
Rationale: The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality.
Methods: We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care.
Introduction: The objective of this study was to describe Do-Not-Resuscitate (DNR) practices in a tertiary-care intensive care unit (ICU) in Saudi Arabia, and determine the predictors and outcomes of patients who had DNR orders.
Methods: This retrospective cohort study was based on a prospectively collected database for a medical-surgicalIntensive CareDepartment in a tertiary-care center in Riyadh, Saudi Arabia (1999-2017). We compared patients who had DNR orders during the ICU stay with those with "full code.
Quality indicators are increasingly used in the intensive care unit (ICU) to compare and improve the quality of delivered healthcare. Numerous indicators have been developed and are related to multiple domains, most importantly patient safety, care timeliness and effectiveness, staff well-being, and patient/family-centered outcomes and satisfaction. In this review, we describe pertinent ICU quality indicators that are related to organizational structure (such as the availability of an intensivist 24/7 and the nurse-to-patient ratio), processes of care (such as ventilator care bundle), and outcomes (such as ICU-acquired infections and standardized mortality rate).
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- The REPLENISH trial aims to determine if higher protein supplementation in critically ill patients improves 90-day survival rates compared to moderate protein intake.
- The study will involve randomizing 2,502 mechanically ventilated patients to receive either higher (2-2.4 g/kg/day) or moderate (0.8-1.2 g/kg/day) protein levels, with a focus on all-cause mortality and quality of life outcomes.
- The research has received ethical approval and will share findings through journals and conferences to influence future clinical practices.
Article Synopsis
- The study investigates the safety and feasibility of different VTE prophylactic treatments in critically ill burn patients admitted to the ICU.
- Conducted as a pilot randomized controlled trial, patients received either high-dose or standard-dose enoxaparin or unfractionated heparin, with various outcomes related to bleeding assessed.
- Results showed a low recruitment rate but high consent rate, with some instances of bleeding, indicating no major safety issues with the prophylaxis options tested.
Tocilizumab (TCZ) is recommended in patients with COVID-19 who require oxygen therapy or ventilatory support. Despite the wide use of TCZ, little is known about its safety and effectiveness in patients with COVID-19 and renal impairment. Therefore, this study evaluated the safety and effectiveness of TCZ in critically ill patients with COVID-19 and renal impairment.
View Article and Find Full Text PDFBackground: Protein intake is recommended in critically ill patients to mitigate the negative effects of critical illness-induced catabolism and muscle wasting. However, the optimal dose of enteral protein remains unknown. We hypothesize that supplemental enteral protein (1.
View Article and Find Full Text PDFBackground: Intravenous infusions of neuromuscular blocking agents (NMBAs) and prone positioning are recommended for acute respiratory distress syndrome (ARDS) due to COVID-19. The safety of enteral nutrition (EN) during these treatments is unclear. This study assessed EN tolerance and safety during NMBA infusion in proned and nonproned patients with ARDS due to COVID-19.
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- Respiratory syncytial virus (RSV) can lead to community-acquired pneumonia (CAP) in adults, but this condition is not thoroughly researched, prompting a study of hospitalized patients from 2016 to 2019.
- The study found that out of 80 hospitalized adults, 23.8% required ICU admission, with higher severity in ICU patients, including more cases of hypotension and bilateral lung infiltrates.
- Overall mortality was 8.8%, but significantly higher for ICU patients at 31.6%, indicating serious risks associated with CAP from RSV, especially in elderly patients with comorbidities.
Article Synopsis
- This study investigated pulmonary barotrauma in COVID-19 patients admitted to the ICU, focusing on how often it occurs, what factors contribute to it, and its impact on survival rates.
- Out of 481 patients studied, 10.2% experienced barotrauma, primarily linked to the use of invasive mechanical ventilation, which significantly raised the risk compared to noninvasive ventilation.
- The presence of barotrauma was associated with a higher hospital mortality rate (69.4% vs. 37.0%) and extended duration in both mechanical ventilation and ICU stay, highlighting its severity in critical COVID-19 cases.
Background: This study assessed the mobility levels among critically ill patients and the association of early mobility with incident proximal lower-limb deep-vein thrombosis and 90-day mortality.
Methods: This was a post hoc analysis of the multicenter PREVENT trial, which evaluated adjunctive intermittent pneumatic compression in critically ill patients receiving pharmacologic thromboprophylaxis with an expected ICU stay ≥ 72 h and found no effect on the primary outcome of incident proximal lower-limb deep-vein thrombosis. Mobility levels were documented daily up to day 28 in the ICU using a tool with an 8-point ordinal scale.
Article Synopsis
- This study aimed to determine if helmet noninvasive ventilation lowers mortality rates and improves health-related quality of life (HRQoL) for COVID-19 pneumonia patients with acute hypoxemic respiratory failure.
- The research involved a multicenter trial with 320 adult participants, who were randomly assigned to receive either helmet ventilation or standard respiratory support, assessing their outcomes over 180 days.
- The results showed no significant difference in 180-day mortality (39.6% vs. 41.1%) or HRQoL measures between the helmet ventilation and standard support groups, indicating helmet ventilation was not more effective.
This prospective quasi-experimental study from the NASAM (National Approach to Standardize and Improve Mechanical Ventilation) collaborative assessed the impact of evidence-based practices including subglottic suctioning, daily assessment for spontaneous awakening trial (SAT), spontaneous breathing trial (SBT), head of bed elevation, and avoidance of neuromuscular blockers unless otherwise indicated. The study outcomes included VAE (primary) and intensive care unit (ICU) mortality. Changes in daily care process measures and outcomes were evaluated using repeated measures mixed modeling.
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- The study focused on adult patients admitted for community-acquired pneumonia (CAP) caused by human rhinovirus (HRV) at King Abdulaziz Medical City-Riyadh from 2016 to 2019.
- Approximately 106 patients were analyzed, with a median age of 71.5 years; many had comorbidities like hypertension (59%) and diabetes (50%), and about 15% required ICU care.
- Results showed higher complications in ICU patients, including tachypnea and hemoptysis, and a notable difference in mortality rates, highlighting the severity of HRV-related CAP in older adults with underlying health issues.
Background: Thrombotic events are common in critically ill patients with COVID-19 and have been linked with COVID-19- induced hyperinflammatory state. In addition to anticoagulant effects, heparin and its derivatives have various anti-inflammatory and immunomodulatory properties that may affect patient outcomes. This study compared the effectiveness and safety of prophylactic standard-doses of enoxaparin and unfractionated heparin (UFH) in critically ill patients with COVID-19.
View Article and Find Full Text PDFPrevalence and Risk Factors of Venous Thromboembolism in Critically Ill Patients with Severe COVID-19 and the Association between the Dose of Anticoagulants and Outcomes.
J Crit Care Med (Targu Mures)
October 2022
Article Synopsis
- COVID-19 increases the risk of venous and arterial thrombosis in critically ill patients, leading to debates over the appropriate anticoagulant dosages for those without confirmed thrombosis.
- A study involving 310 ICU COVID-19 patients found that 13.2% were diagnosed with venous thromboembolism (VTE), with a notable correlation between higher D-dimer levels and VTE presence.
- The use of intermediate-dose enoxaparin was linked to a significantly lower risk of VTE and hospital mortality compared to standard doses, while the major bleeding rates were similar between groups.
Importance: Helmet noninvasive ventilation has been used in patients with COVID-19 with the premise that helmet interface is more effective than mask interface in delivering prolonged treatments with high positive airway pressure, but data about its effectiveness are limited.
Objective: To evaluate whether helmet noninvasive ventilation compared with usual respiratory support reduces mortality in patients with acute hypoxemic respiratory failure due to COVID-19 pneumonia.
Design, Setting, And Participants: This was a multicenter, pragmatic, randomized clinical trial that was conducted in 8 sites in Saudi Arabia and Kuwait between February 8, 2021, and November 16, 2021.