National Emergency Tele-Critical Care in a Pandemic: Barriers and Solutions.

The COVID-19 pandemic caused tremendous disruption to the U.S. healthcare system and nearly crippled some hospitals during large patient surges.

Epidemiology and Outcome of Sepsis in Adults and Children in a Rural, Sub-Sahara African Setting.

Objectives: To identify the epidemiology and outcome of adults and children with and without sepsis in a rural sub-Sahara African setting.

Design: A priori planned substudy of a prospective, before-and-after trial.

Setting: Rural, sub-Sahara African hospital.

The inability to walk unassisted at hospital admission as a valuable triage tool to predict hospital mortality in Rwandese patients with suspected infection.

Objective: To assess the value of the inability to walk unassisted to predict hospital mortality in patients with suspected infection in a resource-limited setting.

Methods: This is a post hoc study of a prospective trial performed in rural Rwanda. Patients hospitalized because of a suspected acute infection and who were able to walk unassisted before this disease episode were included.

A Machine Learning-Based Triage Tool for Children With Acute Infection in a Low Resource Setting.

Objectives: To deploy machine learning tools (random forests) to develop a model that reliably predicts hospital mortality in children with acute infections residing in low- and middle-income countries, using age and other variables collected at hospital admission.

Design: Post hoc analysis of a single-center, prospective, before-and-after feasibility trial.

Setting: Rural district hospital in Rwanda, a low-income country in Sub-Sahara Africa.

VV-ECMO for surgical cure of a critical central airway obstruction.

Extracorporeal membrane oxygenation (ECMO) is a form of prolonged cardiopulmonary bypass that has extensively been used in critically ill patients in an intensive care setting. Both veno-venous (VV-) and veno-arterial (VA-) ECMO have been described as a perioperative rescue or replacement of endotracheal intubation in the setting of extrinsic airway compression due to a mediastinal mass. In this paper, we will outline the utility of ECMO in the context of extrinsic airway compression and will use an illustrative case to examine how ECMO can be useful during severe airway obstruction.

Important Administrative Aspects of Critical Care Telemedicine Programs.

Conceptualizing, designing, implementing, and sustaining a successful critical care telemedicine program is a complex undertaking. All of these steps must be fully accomplished as a joint effort between a host facility and the telemedicine service provider. Important administrative considerations that must be incorporated into planning and execution steps include managing change.

Increasing Evidence-Based Interventions in Patients with Acute Infections in a Resource-Limited Setting: A Before-and-After Feasibility Trial in Gitwe, Rwanda.

Objective: To evaluate whether a focused education program and implementation of a treatment bundle increases the rate of early evidence-based interventions in patients with acute infections.

Design: Single-center, prospective, before-and-after feasibility trial.

Setting: Emergency department of a sub-Saharan African district hospital.

Increasing evidence-based interventions in patients with acute infections in a resource-limited setting: a before-and-after feasibility trial in Gitwe, Rwanda.

Objective: To evaluate whether a focused education program and implementation of a treatment bundle increases the rate of early evidence-based interventions in patients with acute infections.

Design: Single-center, prospective, before-and-after feasibility trial.

Setting: Emergency department of a sub-Saharan African district hospital.

The use of an electronic medical record based automatic calculation tool to quantify risk of unplanned readmission to the intensive care unit: a validation study.

Objective: The aim of this study was to refine and validate an automatic risk of unplanned readmission (Stability and Workload Index for Transfer, or SWIFT) calculator in a prospective cohort of consecutive medical intensive care unit (ICU) patients in a teaching hospital with comprehensive electronic medical records (EMRs).

Design: A 2-phase (derivation and validation) prospective cohort study was conducted.

Settings: The study was conducted in an academic medical ICU.

Treatment of sudden sensorineural hearing loss with systemic steroids and valacyclovir.

Objective: To determine if the addition of an antiviral medication to systemic steroids improves recovery in the treatment of idiopathic sudden sensorineural hearing loss.

Study Design: Randomized, double-blind, placebo-controlled prospective multicenter clinical trial.

Setting: The study was administrated from a tertiary care center and clinical research institute; patients were enrolled by otolaryngologists in academic and private practice outpatient settings.