Quality Report: Postoperative Guideline Implementation Reduces Length of Stay after Fontan Procedure.

Introduction: Patients following the Fontan procedure have a physiology that results in prolonged pleural effusion, often delaying hospital discharge. The hospital length of stay (LOS) of patients following the Fontan procedure at our institution was significantly longer than the Society of Thoracic Surgery benchmark. This quality improvement project aimed to decrease hospital LOS in patients following the Fontan procedure from a baseline of 23 days to 7 days by January 1, 2021, and sustain indefinitely.

Quality Review of Prone Patient Transport Protocol.

Objective: This is a retrospective quality review of LifeFlight Nova Scotia's prone patient transport protocol.

Methods: Electronic patient care records were queried for acute respiratory distress syndrome, prone position, proning, supine to prone, and prone to prone between February 2017 and June 2022. Eligible electronic patient care records were reviewed for demographics (sex, age, and weight); method of transports (ambulance, rotor wing, or fixed wing); duration of transports; mechanical ventilation parameters; medication infusions; arterial blood gases; occurrences of mild hypoxemia (any oxygen saturation [SpO] < 88% or decrease in SpO > 5%); hypotension (any episode of MAP < 65 mm Hg); severe hypoxemia (any SpO < 80% or decrease in SpO > 10%); refractory hypotension (mean arterial pressure < 65 mm Hg not responsive to vasopressor/inotropes); cardiac arrests; and displacement of central lines, arterial lines, and endotracheal tubes.

Operative options for extracranial nasal dermoid cysts: A meta-analysis.

Background: Nasal dermoid cysts are surgically treated using external incision, open rhinoplasty, transnasal endoscopy, or combined approaches. It is unclear how these approaches differ with regard to the incidence of adverse events.

Methods: We conducted a systematic review of studies on the surgical management of midline nasal dermoids.

A ROTEM-guided algorithm aimed to reduce blood product utilization during neonatal and infant cardiac surgery.

Background: Neonates and infants undergoing cardiac surgery tend to receive high volumes of blood products. The use of rotational thromboelastometry (ROTEM) has been shown to reduce the administration of blood products in adults after cardiac surgery. We sought to develop a targeted administration of blood products based on ROTEM to reduce blood product utilization during and after neonatal and infant cardiac surgery.

Partnering with health sciences libraries to address challenges in bioimaging data management and sharing.

Federal mandates, publishing requirements, and an interest in open science have all generated renewed attention on research data management and, in particular, data sharing practices. Due to the size and types of data they produce, bioimaging researchers confront specific challenges in aligning their data with FAIR principles, ensuring that it is findable, accessible, interoperable, and reusable. Although not always recognized by researchers, libraries can, and have been, offering support for data throughout its lifecycle by assisting with data management planning, acquisition, processing and analysis, and sharing and reuse of data.

Preemptive stenting of the left pulmonary artery during comprehensive stage 2 procedure does not influence Fontan candidacy.

Objective: Pulmonary artery reconstruction during comprehensive stage 2 (CS2) procedure can be challenging. Since 2017, we have employed preemptive left pulmonary artery (LPA) stenting. We hypothesized that LPA stenting promotes adequate growth and without compromising Fontan candidacy.

The interrelationship between food security, climate change, and gender-based violence: A scoping review with system dynamics modeling.

Gender-based violence (GBV) is a global public health and human rights problem that is exacerbated by social and environmental stressors for a multitude of interpersonal, cultural, and economic reasons. Through sudden disruptions in the microclimate of a region, climate shocks often have a negative impact on food security, which correlates with increases in GBV. Associations between the various combinations of GBV, climate change, and food insecurity have been documented in the growing international literature, but questions remain about these associations that require further clarification.

Left- vs right-sided migraine: a scoping review.

Background: Migraine is a historically unilateral head pain condition, the cause of which is not currently known. A growing body of literature suggests individuals who experience migraine with left-sided headache ("left-sided migraine") may be distinguished from those who experience migraine with right-sided headache ("right-sided migraine").

Objective: In this scoping review, we explore migraine unilaterality by summarizing what is currently known about left- and right-sided migraine.

Systematic review on chronic non-communicable disease in disaster settings.

Background: Non-communicable diseases (NCDs) constitute the leading cause of mortality globally. Low and middle-income countries (LMICs) not only experience the largest burden of humanitarian emergencies but are also disproportionately affected by NCDs, yet primary focus on the topic is lagging. We conducted a systematic review on the effect of humanitarian disasters on NCDs in LMICs assessing epidemiology, interventions, and treatment.

A review of interventions for noncommunicable diseases in humanitarian emergencies in low- and middle-income countries.

Objective: Noncommunicable diseases (NCDs) are of increasing prevalence in low- and middle-income countries (LMICs), affected by disasters. Humanitarian actors are increasingly confronted with how to effectively manage NCDs, yet primary focus on this topic is lacking. We conducted a systematic review on the effects of disasters on NCDs in LMICs.

Impact of Viral PCR Positive Nasal Swabs (Non Covid-19) on Outcomes Following Cardiac Surgery.

Viral bronchiolitis is a relative contraindication to elective pediatric cardiac surgery. Nasopharyngeal swab utilizing polymerase chain reaction (PCR) screening for viruses known to cause bronchiolitis are commonly available. The objective of this study was to evaluate clinical outcomes in patients with nasopharyngeal viral PCR positive findings at the time of cardiac surgery.

Systematic review on epidemiology, interventions and management of noncommunicable diseases in acute and emergency care settings in Kenya.

Introduction: Mortality and morbidity from Non-Communicable Diseases (NCDs) in Africa are expected to worsen if the status quo is maintained. Emergency care settings act as a primary point of entry into the health system for a spectrum of NCD-related illnesses, however, there is a dearth of literature on this population. We conducted a systematic review assessing available evidence on epidemiology, interventions and management of NCDs in acute and emergency care settings in Kenya, the largest economy in East Africa and a medical hub for the continent.

Coupling neuroscience and driving simulation: A systematic review of studies on crash-risk behaviors in young drivers.

Objective: Motor vehicle crashes are a leading cause of death for adolescents and young adults. The aim of this study is to examine and discuss the state-of-the-art literature which uses neuroscience methods in the context of driving simulation to study adolescent and young adult drivers.

Methods: We conducted a systematic English-language literature search of Ovid MEDLINE (1946-2020), PsycINFO (1967-2020), PubMed, Web of Science, SCOPUS, and CINAHL using keywords and MeSH terms.

Initial fetal to initial postnatal echocardiogram in uncomplicated atrioventricular septal defects: Do significant changes occur?

Background: Yield of serial echocardiography in fetuses with atrioventricular septal defects (fAVSD) has not been well defined. The goal of this study was to document if any major changes occurred from initial fetal to initial postnatal echocardiogram in uncomplicated fAVSD.

Methods: fAVSD were excluded if initial fetal scan documented complex CHD or any concerns.

"Is My Heart Healing?" A Meta-synthesis of Patients' Experiences After Acute Myocardial Infarction.

Background: Recovery from acute myocardial infarction (AMI) has been primarily understood in a narrow medical sense. For patients who survive, secondary prevention focuses largely on enhancing clinical outcomes. As a result, there is a lack of descriptive accounts of patients' experiences after AMI and little is known about how people go about the challenge of recovering from such an event.

Quality Improvement Project in Congenital Cardiothoracic Surgery Patients: Reducing Surgical Site Infections.

Background: Healthcare-associated infections are a major focus for quality improvement in hospitals today. Surgical site infections (SSIs), a postoperative complication in cardiac surgery, are associated with increased morbidity, mortality, hospital length of stay, and financial burden.

Methods: A recent increase in cardiothoracic surgery SSIs (CT-SSIs) at our institution instigated a multidisciplinary team to explore infection prevention, bundle element compliance, and to identify interventions to reduce the CT-SSI rate.

Branched-Chain Amino Acids and Seizures: A Systematic Review of the Literature.

Background: Up to 40% of patients with epilepsy experience seizures despite treatment with antiepileptic drugs; however, branched-chain amino acid (BCAA) supplementation has shown promise in treating refractory epilepsy.

Objectives: The purpose of this systematic review was to evaluate all published studies that investigated the effects of BCAAs on seizures, emphasizing therapeutic efficacy and possible underlying mechanisms.

Methods: On 31 January, 2017, the following databases were searched for relevant studies: MEDLINE (OvidSP), EMBASE (OvidSP), Scopus (Elsevier), the Cochrane Library, and the unindexed material in PubMed (National Library of Medicine/National Institutes of Health).

Use of non-face-to-face modalities for emergency department screening, brief intervention, and referral to treatment (ED-SBIRT) for high-risk alcohol use: A scoping review.

The purpose of this review was to examine and chart the "scope" of strategies reported in ED-SBIRT (emergency department-based screening, brief intervention and referral to treatment) studies that employ non-face-to-face (nFtF) modalities for high-risk alcohol use (i.e., risk for alcohol-related injury, medical condition, use disorder) and to identify research gaps in the scientific literature.

Preoperative chlorhexidine mouthwash to reduce pneumonia after cardiac surgery: A systematic review and meta-analysis.

Objective: Postoperative pneumonia is one of the most common complications after cardiac surgery, entailing increased patient morbidity, mortality, and health care burden. The primary aim of this study was to assess whether preoperative chlorhexidine mouthwash is associated with reduced postoperative pneumonia after cardiac surgery.

Methods: A comprehensive systematic search of NLM Pubmed, Embase, Scopus, and Cumulative Index of Nursing and Allied Health was executed to include the studies since inception to June 27, 2017, which assessed the effects of preoperative chlorhexidine gluconate mouthwash on postoperative pneumonia.

Is palliative care cost-effective in low-income and middle-income countries? A mixed-methods systematic review.

Introduction: Of the 40 million people globally in need of palliative care (PC), just 14% receive it, predominantly in high-income countries. Within fragile health systems that lack PC, incurable illness is often marked by pain and suffering, as well as burdensome costs. In high-income settings, PC decreases healthcare utilisation, thus enhancing value.

Data challenges of biomedical researchers in the age of omics.

Background: High-throughput technologies are rapidly generating large amounts of diverse omics data. Although this offers a great opportunity, it also poses great challenges as data analysis becomes more complex. The purpose of this study was to identify the main challenges researchers face in analyzing data, and how academic libraries can support them in this endeavor.

Subacute combined degeneration of the spinal cord following nitrous oxide anesthesia: A systematic review of cases.

Objective: Vitamin B12 deficiency can lead to subacute combined degeneration (SCD). Nitrous oxide (NO) is an anesthetic which oxidizes the cobalt ion of vitamin B12, interfering with its function as a coenzyme. In this study, we conduct a systematic review of reported cases of SCD following nitrous oxide anesthesia.

Mannitol in Critical Care and Surgery Over 50+ Years: A Systematic Review of Randomized Controlled Trials and Complications With Meta-Analysis.

Objective: Despite clinical use spanning 50+ years, questions remain concerning the optimal use of mannitol. The published reviews with meta-analysis frequently focused on mannitol's effects on a specific physiological aspect such as intracranial pressure (ICP) in sometimes heterogeneous patient populations. A comprehensive review of mannitol's effects, as well as side effects, is needed.

Transport of a Prone Position Acute Respiratory Distress Syndrome Patient.

We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe acute respiratory distress patient prior to transport to an extracorporeal membrane oxygenation capable teaching hospital. With the increasing use of advanced treatments such as extracorporeal membrane oxygenation, prone positioning, and continuous renal replacement therapy for severe acute respiratory distress syndrome (ARDS), the necessity to transport these patients to specialized hospitals will correspondingly increase. Emergency Health Services Life Flight, the primary critical care transport program in Eastern Canada, developed a prone position protocol to meet this clinical need.