Publications by authors named "K Bosma"
Background: We previously published the protocol and statistical analysis plan for a randomized controlled trial of Proportional Assist Ventilation for Minimizing the Duration of Mechanical Ventilation: the PROMIZING study in Trials ( https://doi.org/10.1186/s13063-023-07163-w ).
View Article and Find Full Text PDFPurpose Of Review: The purpose of this review is to examine the current state of the evidence, including several recent systematic reviews and meta-analyses, to determine if proportional modes of ventilation have the potential to hasten weaning from mechanical ventilation for adult critically ill patients, compared to pressure support ventilation (PSV), the current standard of care during the recovery and weaning phases of mechanical ventilation.
Recent Findings: Proportional assist ventilation (PAV) and neurally adjusted ventilatory assist (NAVA) are two commercially available proportional modes that have been studied in randomized controlled trials (RCTs). Although several feasibility studies were not powered to detect differences in clinical outcomes, emerging evidence suggests that both PAV and NAVA may reduce duration of mechanical ventilation, intensive care unit (ICU) length of stay, and hospital mortality compared to PSV, as shown in some small, primarily single-centre studies.
Timing of Extubation in Adult Patients with Acute Brain Injury.
Am J Respir Crit Care Med
November 2024
Article Synopsis
- The study investigates whether immediate extubation after a successful breathing trial benefits adults with acute brain injuries.
- It analyzed data from 1,406 patients in Toronto, focusing on those who were mechanically ventilated and had successful breathing trials.
- The findings suggest that prompt extubation is linked to an increase in ventilator-free days, indicating that it may be beneficial for recovery in these patients.
Article Synopsis
- The COVID-19 pandemic significantly disrupted clinical trials globally, leading to issues such as premature closures and compromised trial integrity, necessitating changes in research protocols.
- The study aimed to assess challenges faced during interrupted critical care trials, identifying barriers and developing strategies for future trials based on input from principal investigators and project coordinators.
- Results indicated that major challenges included the prioritization of COVID-19 studies and restrictions on hospital visitation, while participants offered various solutions and suggestions to enhance trial conduct moving forward.
Rationale/objectives: Despite plausible pathophysiological mechanisms, research is needed to confirm the relationship between sleep, circadian rhythm and delirium in patients admitted to the intensive care unit (ICU). The objective of this review is to summarise existing studies promoting, in whole or in part, the normalisation of sleep and circadian biology and their impact on the incidence, prevalence, duration and/or severity of delirium in ICU.
Methods: A sensitive search of electronic databases and conference proceedings was completed in March 2023.