Publications by authors named "K M Fiest"
Objective: To better understand critically ill children's lived experiences with family presence in the pediatric intensive care unit (PICU).
Study Design: This qualitative, interpretive phenomenological study is grounded in a Childhood Ethics ontology. We recruited children (aged 6-17 years) admitted to one of four participating Canadian PICUs between November 2021-July 2022 using maximum variation sampling.
Article Synopsis
- Intravenous vasopressors are commonly used for unstable patients in critical care, but the potential of oral vasopressors like midodrine is still being explored.
- A study was conducted at the University of Alberta Hospital to assess the feasibility of using midodrine in ICU patients who were reliant on IV vasopressors, involving random assignment to midodrine or placebo.
- Results showed that midodrine had a slightly shorter ICU stay and lower hospital mortality compared to the placebo, indicating a need for further research on oral vasopressors in critically ill patients.
Objectives: To summarize the efficacy of midodrine as an adjunctive therapy in critically ill patients. Safety of midodrine was assessed as a secondary outcome.
Data Sources: We performed a systematic review and meta-analysis using a peer-reviewed search strategy combining the themes of vasopressor-dependent shock, critical care, and midodrine and including MEDLINE, Ovid Embase, CINAHL, and Cochrane library databases until September 14, 2023.
Purpose: There is significant variability in the application of positive end-expiratory pressure (PEEP) in patients undergoing invasive mechanical ventilation. There are numerous studies assessing methods of determining optimal PEEP, but many methods, patient populations, and study settings lack high-quality evidence. Guidelines make no recommendations about the use of a specific method because of equipoise and lack of high-quality evidence.
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- ICU patients often undergo a stressful process of weaning from sedation and ventilation, and a study pilot-tested a coaching tool led by family members to help ease this transition for both patients and their families.
- Conducted in Calgary, the study involved 25 family-patient dyads from two ICUs, with surveys assessing family demographics, anxiety, tool feedback, and attitudes towards family presence during weaning trials.
- Results showed that 60% of families found the coaching tool useful, 70% reported positive experiences with family involvement, and family anxiety significantly decreased after using the tool.