Publications by authors named "Z Sadique"
Background: Peripheral oxygen saturation (SpO) above 94% is typical in children in paediatric intensive critical care units (PICUs) who are receiving invasive ventilation and supplemental oxygen. In a previous report from the Oxy-PICU trial, we showed that lower (conservative) oxygenation targets (SpO 88-92%) are beneficial, showing small but statistically significant differences in duration of organ support and large but non-significant cost reductions at 30 days. In this pre-specified analysis of the Oxy-PICU trial, we compare longer-term outcomes and cost-effectiveness of conservative versus liberal (SpO >94%) oxygenation targets in children with emergency PICU admission.
View Article and Find Full Text PDFBackground: High flow nasal cannula therapy (HFNC) and continuous positive airway pressure (CPAP) are two widely used modes of non-invasive respiratory support in paediatric critical care units. The FIRST-ABC randomised controlled trials (RCTs) evaluated the clinical and cost-effectiveness of HFNC compared with CPAP in two distinct critical care populations: acutely ill children ('step-up' RCT) and extubated children ('step-down' RCT). Clinical effectiveness findings (time to liberation from all forms of respiratory support) showed that HFNC was non-inferior to CPAP in the step-up RCT, but failed to meet non-inferiority criteria in the step-down RCT.
View Article and Find Full Text PDFArticle Synopsis
- - The study aims to compare the cost-effectiveness of high flow nasal cannula (HFNC) therapy and continuous positive airway pressure (CPAP) for acutely ill children needing respiratory support, using data from a large UK trial involving 600 participants.
- - Methods included causal forest analysis and seemingly unrelated regression to evaluate variations in cost-effectiveness across different patient subgroups, focusing on factors like age and sex.
- - Results showed that HFNC was more cost-effective for certain subgroups, particularly younger boys and those without severe respiratory issues, indicating that patient characteristics significantly influence the therapy's effectiveness in terms of cost.
Article Synopsis
- The study aimed to investigate the cost-effectiveness of high-flow nasal cannula (HFNC) therapy versus continuous positive airway pressure (CPAP) in children after they were extubated, using data from the FIRST-ABC trial.
- It utilized advanced statistical methods, specifically a causal forest approach and seemingly unrelated regression (SUR), to identify variability in effectiveness at individual and subgroup levels.
- The results showed that HFNC may be more cost-effective for less severely ill patients, as its overall incremental net monetary benefit (INB) was lower compared to those with better initial health status.
Background: In the United Kingdom, around 184,000 adults are admitted to an intensive care unit (ICU) each year with over 30% receiving mechanical ventilation. Oxygen is the commonest therapeutic intervention provided to these patients but it is unclear how much oxygen should be administered for the best clinical outcomes.
Methods: The UK-ROX trial will evaluate the clinical and cost-effectiveness of conservative oxygen therapy (the minimum oxygen concentration required to maintain an oxygen saturation of 90% ± 2%) versus usual oxygen therapy in critically ill adults receiving supplemental oxygen when invasively mechanically ventilated in ICUs in England, Wales and Northern Ireland.