Publications by authors named "Ryan R Ling"
The environmental impact and sustainability of infection control practices: a systematic scoping review.
Antimicrob Resist Infect Control
December 2024
Infection prevention and control (IPC) programs form the basis of minimizing spread of pathogens in the healthcare setting and beyond. The COVID-19 pandemic amplified the demand for IPC. However, the environmental impact of IPC practices has yet to be addressed and attempts to quantify its climate implications have been sparse.
View Article and Find Full Text PDFBackground: Ankle osteoarthritis affects 1-3 % of all adults. Contemporary evidence is equivocal when comparing the outcomes and complications of TAA and AA. This review aims to compare the complications between TAA and AA to provide surgeons with an additional perspective when managing ESAO.
View Article and Find Full Text PDFObjectives: Persistent critical illness (PerCI) occurs when the patient's prolonged intensive care unit (ICU) stay results in complications that become the primary drivers of their condition, rather than the initial reason for their admission. Patients with frailty have a higher risk of developing and dying from PerCI. We aimed to investigate the interplay of frailty and PerCI in critically ill patients with COVID-19.
View Article and Find Full Text PDFBackground: As the global population ages, hearing loss becomes increasingly prevalent, and is associated with neurocognitive and psychiatric comorbidities, impacting quality of life. Early screening and timely intervention might prevent or delay cognitive decline, a gap in care that can potentially be addressed by self-administered smartphone hearing tests.
Objective: This study aims to evaluate the accuracy of Mimi™ (Berlin, Germany), a commercially available self-administered smartphone hearing test compared to pure tone audiogram (PTA) in terms of both hearing levels and hearing thresholds in our local geriatric population > 65 years-old.
Article Synopsis
- * Key questions have emerged regarding differences between COVID-19 and non-COVID-19 respiratory failures, the role of personalized therapy, and alternative respiratory support options to intubation.
- * The chapter discusses advances in understanding respiratory failure, the significance of international collaboration among medical professionals, and the need for skepticism when evaluating rapidly evolving medical evidence during a pandemic.
Frailty in Critically Ill Patients with COVID-19: The Lessons Learned.
Adv Exp Med Biol
September 2024
The coronavirus disease 2019 (COVID-19) pandemic has unquestionably transformed the field of intensive care medicine. Never have we witnessed millions of patients develop acute respiratory failure in such a short span of time. This led to extensive resource constraints and difficulty in treating patients.
View Article and Find Full Text PDFIntroduction: Myopericarditis is a rare but serious coronavirus disease 2019 (COVID-19) vaccine-related adverse event primarily affecting adolescents. Given recent approvals for childhood vaccination, we performed a meta-analysis investigating myopericarditis following messenger ribonucleic acid COVID-19 vaccination in children aged <19 years, focusing on its overall risk and high-risk subgroups.
Methods: We searched MEDLINE via PubMed, Embase and Scopus from inception to 1 August 2022 for observational studies reporting myopericarditis in temporal relation to paediatric COVID-19 vaccination.
Article Synopsis
- Acute hypoxaemic respiratory failure (AHRF) is a significant cause for ICU admissions, comprising over 52% of patients, with differing mortality rates based on severity.
- A study from 2005 to 2022 revealed that the survival rate has improved overall in ICUs, with in-hospital mortality decreasing from 13.3% to 8.2%, even amidst the high risks associated with severe AHRF.
- Researchers emphasize the need for better identification of AHRF patients to manage and reduce the risk of deterioration effectively, as the healthcare impact of AHRF may be larger than previously understood.
Article Synopsis
- A study analyzed data from over 7,000 COVID-19 patients on ECMO from 2020 to 2021 to investigate the impact of different immunomodulator treatments on mortality rates.
- Results showed that patients receiving no immunomodulators had the highest 90-day survival rate (58.1%), while those getting only corticosteroids had the lowest (50.7%), and patients on other immunomodulators alone had better outcomes (62.2%).
- The study concluded that using corticosteroids alone or with other immunomodulators leads to shorter survival, while other immunomodulators alone may improve survival, but all immunomodulator treatments were linked to increased secondary infections.
Article Synopsis
- * Results showed that factor Xa inhibitors significantly reduced VTE risk compared to low-molecular-weight heparin (LMWH), while other medications like unfractionated heparin (UFH) and warfarin were linked to increased VTE risk.
- * Additionally, factor Xa inhibitors did not significantly increase major bleeding and were likely not associated with higher mortality, establishing their efficacy in VTE prevention without adverse effects compared to LMWH and aspirin.
Article Synopsis
- A study was conducted to explore how frailty affects long-term survival in patients who were admitted to the ICU due to COVID-19, focusing on those discharged alive.
- Researchers analyzed data from 4028 patients across 118 ICUs in New Zealand and Australia, categorizing them based on their frailty levels using the Clinical Frailty Scale (CFS).
- The results indicated that both mildly frail and moderately-to-severely frail patients had significantly higher mortality rates within two years post-discharge compared to those who were not frail, highlighting the importance of recognizing frailty in ICU care.
Objectives: A nontrivial number of patients in ICUs experience persistent critical illness (PerCI), a phenomenon in which features of the ICU course more consistently predict mortality than the initial indication for admission. We aimed to describe PerCI among patients with critical illness caused by COVID-19, and these patients' short- and long-term outcomes.
Design: Multicenter retrospective cohort study.
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) may reduce mortality and improve neurological outcomes in patients with cardiac arrest. We updated our existing meta-analysis and trial sequential analysis to further evaluate ECPR compared to conventional CPR (CCPR).
Methods: We searched three international databases from 1 January 2000 through 1 November 2023, for randomised controlled trials or propensity score matched studies (PSMs) comparing ECPR to CCPR in both out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA).
Background: The association between frailty and short-term and long-term outcomes in patients receiving elective surgery for cancer remains unclear, particularly in those admitted to the ICU.
Methods: In this multicentre retrospective cohort study, we included adults ≥16 yr old admitted to 158 ICUs in Australia from January 1, 2018 to March 31, 2022 after elective surgery for cancer. We investigated the association between frailty and survival time up to 4 yr (primary outcome), adjusting for a prespecified set of covariates.
Objective: The impact of obesity on long-term survival after intensive care unit (ICU) admission with severe coronavirus disease 2019 (COVID-19) is unclear. We aimed to quantify the impact of obesity on time to death up to two years in patients admitted to Australian and New Zealand ICUs.
Design: Retrospective multicentre study.
Purpose: Cardiogenic shock is associated with high mortality. In refractory shock, it is unclear if mechanical circulatory support (MCS) devices improve survival. We conducted a network meta-analysis to determine which MCS devices confers greatest benefit.
View Article and Find Full Text PDFBackground: The use of extracorporeal membrane oxygenation (ECMO) for high-risk pulmonary embolism (HRPE) with haemodynamic instability or profound cardiogenic shock has been reported. Guidelines currently support the use of ECMO only in patients with cardiac arrest or circulatory collapse and in conjunction with other curative therapies. We aimed to characterise the mortality of adults with HRPE treated with ECMO, identify factors associated with mortality, and compare different adjunct curative therapies.
View Article and Find Full Text PDFBackground: Recent advances in cancer therapeutics have improved outcomes, resulting in increasing candidacy of patients with metastatic cancer being admitted to intensive care units (ICUs). A large proportion of patients also have frailty, predisposing them to poor outcomes, yet the literature reporting on this is scarce. We aimed to assess the impact of frailty on survival in patients with metastatic cancer admitted to the ICU.
View Article and Find Full Text PDFArtificial intelligence (AI) and its application in classification of blood cells in the peripheral blood film is an evolving field in haematology. We performed a rapid review of the literature on AI and peripheral blood films, evaluating the condition studied, image datasets, machine learning models, training set size, testing set size and accuracy. A total of 283 studies were identified, encompassing 6 broad domains: malaria (n = 95), leukemia (n = 81), leukocytes (n = 72), mixed (n = 25), erythrocytes (n = 15) or Myelodysplastic syndrome (MDS) (n = 1).
View Article and Find Full Text PDFPurpose: We aimed to conduct a systematic review and meta-analysis to assess the effects of anemia and anemia severity on patient outcomes in cardiac surgery and determine whether preoperative treatments confer postoperative benefit.
Source: We searched four international databases for observational and randomized studies published until 1 October 2022. Study quality was assessed via Newcastle-Ottawa scores and the Cochrane Risk-of-Bias 2 tool and certainty of evidence was rated with the Grading of Recommendations, Assessment, Development and Evaluations approach.