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  1. Article ; Online: Burnout of healthcare providers during COVID-19.

    Bradley, Meredith / Chahar, Praveen

    Cleveland Clinic journal of medicine

    2020  

    Abstract: Physician burnout is not new, but the COVID-19 pandemic is accelerating the many negative repercussions of uncertainty and inadequate support, and the consequences are being felt by patients, physicians, and healthcare systems. ...

    Abstract Physician burnout is not new, but the COVID-19 pandemic is accelerating the many negative repercussions of uncertainty and inadequate support, and the consequences are being felt by patients, physicians, and healthcare systems.
    Keywords covid19
    Language English
    Publishing date 2020-07-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.87a.ccc051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.212: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Cardiopulmonary resuscitation in COVID-19 patients.

    Chahar, Praveen / Marciniak, Donn

    Cleveland Clinic journal of medicine

    2020  

    Abstract: COVID-19 is extremely transmissible. Cardiopulmonary resuscitation (CPR) is associated with multiple aerosol-generating procedures including chest compression, positive pressure ventilation, and airway manipulation. Healthcare providers who perform CPR ... ...

    Abstract COVID-19 is extremely transmissible. Cardiopulmonary resuscitation (CPR) is associated with multiple aerosol-generating procedures including chest compression, positive pressure ventilation, and airway manipulation. Healthcare providers who perform CPR are at high risk of contracting COVID-19. CPR in patients with suspected or proven COVID-19 must be performed without compromising the safety of healthcare providers. An overview of special considerations.
    Keywords covid19
    Language English
    Publishing date 2020-06-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.87a.ccc040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ua VI Zs.212: Show issues Location:
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  3. Article ; Online: Postoperative delirium and neurocognitive disorders.

    Migirov, Allan / Chahar, Praveen / Maheshwari, Kamal

    Current opinion in critical care

    2021  Volume 27, Issue 6, Page(s) 686–693

    Abstract: Purpose of review: Postoperative neurocognitive disorders (NCD) are significant causes of morbidity and mortality. In this paper, we will review our understanding and potential management of postoperative NCD.: Recent findings: Postoperative delirium, ...

    Abstract Purpose of review: Postoperative neurocognitive disorders (NCD) are significant causes of morbidity and mortality. In this paper, we will review our understanding and potential management of postoperative NCD.
    Recent findings: Postoperative delirium, delayed neurocognitive recovery and postoperative cognitive dysfunction (POCD) are recognized as a part of the continuous spectrum of postoperative NCD. Although the pathophysiology is still poorly understood, there is renewed focus on improving neurocognitive outcomes of aging surgical population. Novel methods of neurocognitive screening are developed and research in the prevention and management of NCD has gained traction.
    Summary: A spectrum of NCD exists in surgical patients ranging from postoperative delirium, delayed neurocognitive recovery, and POCD. Identification of patients at-risk for developing NCD can help target appropriate perioperative intervention. Also, specialized care teams and the implementation of standardized protocols are crucial for the successful management perioperative NCD. Finally, large, randomized, multicenter studies are needed to confirm benefits of preventive and treatment strategies.
    MeSH term(s) Aging ; Delirium/diagnosis ; Delirium/etiology ; Delirium/therapy ; Humans ; Neurocognitive Disorders ; Postoperative Complications/etiology ; Postoperative Period
    Language English
    Publishing date 2021-10-19
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000882
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 4999: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Airway management considerations in patients with COVID-19.

    Chahar, Praveen / Dugar, Sidharth / Marciniak, Donn

    Cleveland Clinic journal of medicine

    2020  

    Abstract: Approximately 12% to 15% of hospitalized patients with COVID-19 infection require invasive ventilation via endotracheal intubation. The key to minimizing risk of disease transmission during this aerosol-generating procedure is careful preparation, which ... ...

    Abstract Approximately 12% to 15% of hospitalized patients with COVID-19 infection require invasive ventilation via endotracheal intubation. The key to minimizing risk of disease transmission during this aerosol-generating procedure is careful preparation, which includes having necessary equipment and medications on hand as well as an experienced intubation team who can troubleshoot any unforeseen complications. Personal protective equipment should be donned and doffed in the presence of an assistant (ie, "buddy" system).
    Keywords covid19
    Language English
    Publishing date 2020-05-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.87a.ccc033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ua VI Zs.212: Show issues Location:
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  5. Article: Cardiopulmonary resuscitation in COVID-19 patients

    Chahar, Praveen / Marciniak, Donn

    Clevel. clin. j. med

    Abstract: COVID-19 is extremely transmissible. Cardiopulmonary resuscitation (CPR) is associated with multiple aerosol-generating procedures including chest compression, positive pressure ventilation, and airway manipulation. Healthcare providers who perform CPR ... ...

    Abstract COVID-19 is extremely transmissible. Cardiopulmonary resuscitation (CPR) is associated with multiple aerosol-generating procedures including chest compression, positive pressure ventilation, and airway manipulation. Healthcare providers who perform CPR are at high risk of contracting COVID-19. CPR in patients with suspected or proven COVID-19 must be performed without compromising the safety of healthcare providers. An overview of special considerations.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #566416
    Database COVID19

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  6. Article: Burnout of healthcare providers during COVID-19

    Bradley, Meredith / Chahar, Praveen

    Clevel. clin. j. med

    Abstract: Physician burnout is not new, but the COVID-19 pandemic is accelerating the many negative repercussions of uncertainty and inadequate support, and the consequences are being felt by patients, physicians, and healthcare systems. ...

    Abstract Physician burnout is not new, but the COVID-19 pandemic is accelerating the many negative repercussions of uncertainty and inadequate support, and the consequences are being felt by patients, physicians, and healthcare systems.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #622160
    Database COVID19

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  7. Article ; Online: Point-of-care ultrasonography for the hospitalist.

    Thind, Guramrinder Singh / Fox, Steven / Gupta, Mohit / Chahar, Praveen / Jones, Robert / Dugar, Siddharth

    Cleveland Clinic journal of medicine

    2021  Volume 88, Issue 6, Page(s) 345–359

    Abstract: Point-of-care ultrasonography (POCUS) has emerged as a vital tool in medicine. Initially used for procedural guidance, POCUS is now used for diagnostics and monitoring of the lung, heart, abdomen, and deep vein thrombosis. This wide applicability makes ... ...

    Abstract Point-of-care ultrasonography (POCUS) has emerged as a vital tool in medicine. Initially used for procedural guidance, POCUS is now used for diagnostics and monitoring of the lung, heart, abdomen, and deep vein thrombosis. This wide applicability makes it an essential tool for hospitalists in daily clinical practice. This article provides an overview of the clinical integration of POCUS and basic image interpretation.
    MeSH term(s) Heart ; Hospitalists ; Humans ; Lung/diagnostic imaging ; Point-of-Care Systems ; Ultrasonography
    Language English
    Publishing date 2021-06-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639116-3
    ISSN 1939-2869 ; 0891-1150
    ISSN (online) 1939-2869
    ISSN 0891-1150
    DOI 10.3949/ccjm.88a.20141
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.212: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  8. Article: Airway management considerations in patients with COVID-19

    Chahar, Praveen / Dugar, Sidharth / Marciniak, Donn

    Clevel. clin. j. med

    Abstract: Approximately 12% to 15% of hospitalized patients with COVID-19 infection require invasive ventilation via endotracheal intubation. The key to minimizing risk of disease transmission during this aerosol-generating procedure is careful preparation, which ... ...

    Abstract Approximately 12% to 15% of hospitalized patients with COVID-19 infection require invasive ventilation via endotracheal intubation. The key to minimizing risk of disease transmission during this aerosol-generating procedure is careful preparation, which includes having necessary equipment and medications on hand as well as an experienced intubation team who can troubleshoot any unforeseen complications. Personal protective equipment should be donned and doffed in the presence of an assistant (ie, "buddy" system).
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #272837
    Database COVID19

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    Inter-library loan at ZB MED

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  9. Article: Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery.

    Galway, Ursula / Chahar, Praveen / Schmidt, Marc T / Araujo-Duran, Jorge A / Shivakumar, Jeevan / Turan, Alparslan / Ruetzler, Kurt

    World journal of diabetes

    2021  Volume 12, Issue 8, Page(s) 1255–1266

    Abstract: Prediabetes and diabetes are important disease processes which have several perioperative implications. About one third of the United States population is considered to have prediabetes. The prevalence in surgical patients is even higher. This is due to ... ...

    Abstract Prediabetes and diabetes are important disease processes which have several perioperative implications. About one third of the United States population is considered to have prediabetes. The prevalence in surgical patients is even higher. This is due to the associated micro and macrovascular complications of diabetes that result in the need for subsequent surgical procedures. A careful preoperative evaluation of diabetic patients and patients at risk for prediabetes is essential to reduce perioperative mortality and morbidity. This preoperative evaluation involves an optimization of preoperative comorbidities. It also includes optimization of antidiabetic medication regimens, as the avoidance of unintentional hypoglycemic and hyperglycemic episodes during the perioperative period is crucial. The focus of the perioperative management is to ensure euglycemia and thus improve postoperative outcomes. Therefore, prolonged preoperative fasting should be avoided and close monitoring of blood glucose should be initiated and continued throughout surgery. This can be accomplished with either analysis in blood gas samples, venous phlebotomy or point-of-care testing. Although capillary and arterial whole blood glucose do not meet standard guidelines for glucose testing, they can still be used to guide insulin dosing in the operating room. Intraoperative glycemic control goals may vary slightly in different protocols but overall the guidelines suggest a glucose range in the operating room should be between 140 mg/dL to 180 mg/dL. When hyperglycemia is detected in the operating room, blood glucose management may be initiated with subcutaneous rapid-acting insulin, with intravenous infusion or boluses of regular insulin. Fluid and electrolyte management are other perioperative challenges. Notably diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic state are the two most serious acute metabolic complications of diabetes that must be recognized early and treated.
    Language English
    Publishing date 2021-09-02
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2583471-X
    ISSN 1948-9358
    ISSN 1948-9358
    DOI 10.4239/wjd.v12.i8.1255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Association of Pain With Atrial Fibrillation and Delirium After Cardiac Surgery: A DECADE Sub-Study.

    Ince, Ilker / Chiu, Andrew / Sagir, Afrin / Chahar, Praveen / Lin, Jia / Douglas, Aaron / Adi, Ahmad / Fang, Jonathan / Mao, Guangmei / Turan, Alparslan

    Journal of cardiothoracic and vascular anesthesia

    2021  Volume 35, Issue 10, Page(s) 3021–3026

    Abstract: Objective: The authors aimed to evaluate the effects of postoperative pain on the incidence of atrial fibrillation and delirium in patients having surgery with cardiopulmonary bypass (CPB).: Design: Post hoc analysis of the (An investigator-initiated, ...

    Abstract Objective: The authors aimed to evaluate the effects of postoperative pain on the incidence of atrial fibrillation and delirium in patients having surgery with cardiopulmonary bypass (CPB).
    Design: Post hoc analysis of the (An investigator-initiated, multicentre, double-blind trial (ClinicalTrials NCT02004613) (DECADE)), a randomized, placebo-controlled trial.
    Setting: Tertiary, academic hospital.
    Participants: Six hundred five adults from the DECADE enrolled at Cleveland Clinic Main Campus, who had had surgery with CPB.
    Interventions: Dexmedetomidine versus placebo started before surgical incision and postoperatively was maintained until 24 hours.
    Measurements: Primary outcomes were atrial fibrillation, diagnosed by clinicians in the intensive care unit (ICU), presence of delirium assessed with the Confusion Assessment Method for the ICU, data on pain scores, and opioid consumption, occurring between ICU admission and the earlier of postoperative day five or hospital discharge.
    Results: Postoperative pain levels were similar among patients with or without atrial fibrillation. Two hundred six (34%) patients had atrial fibrillation and ninety-two (15%) had delirium before hospital discharge within the first five postoperative days. The risk of atrial fibrillation was not significantly different between groups (hazard ratio: 1.09; 97.5% confidence interval [CI]: 0.99, 1.20, p = 0.039); there were no associations between postoperative pain and the risk of postoperative delirium (hazard ratio: 0.96; 97.5% CI: 0.84-1.11; p = 0.57). Postoperative opioid consumption was neither significantly associated with postoperative atrial fibrillation nor delirium.
    Conclusions: Atrial fibrillation and delirium was not associated with pain after cardiac surgery. Opioid use was not associated with atrial fibrillation and delirium. Because both atrial fibrillation and delirium have a multifactorial nature, further studies should be focused on other plausible mechanisms.
    MeSH term(s) Adult ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/epidemiology ; Cardiac Surgical Procedures/adverse effects ; Delirium/diagnosis ; Delirium/epidemiology ; Delirium/etiology ; Dexmedetomidine ; Humans ; Pain, Postoperative/diagnosis ; Pain, Postoperative/drug therapy ; Pain, Postoperative/epidemiology
    Chemical Substances Dexmedetomidine (67VB76HONO)
    Language English
    Publishing date 2021-05-15
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2021.05.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 31: Show issues

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