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Book ; Online ; E-Book: Principles and practice of maternal critical care

Einav, Sharon / Weiniger, Carolyn F. / Vano, Ruth L. Landau

2020

Abstract: This book contains a collection of the most recent insights regarding maternal morbidity and mortality and optimization of the care processes during acute critical illness. The volume represents a practical resource to be used in real-time by medical ... ...

Author's details	edited by Sharon Einav, Carolyn F. Weiniger, and Ruth Landau
Abstract	"This book contains a collection of the most recent insights regarding maternal morbidity and mortality and optimization of the care processes during acute critical illness. The volume represents a practical resource to be used in real-time by medical practitioners faced with a woman who is critically ill during pregnancy and the peripartum period. By providing concise tools for disease identifiers and management flow-charts, the Editors aimed to increase awareness and improve processes of care for this population. Many care paradigms for obstetric patients are currently unstandardized, unfocused and often do not follow a pre-determined path. Each chapter will provide the practitioner with updated information on how to identify specific critical conditions and how to manage them once they have been identified, to enhance recognition and readiness. This book should be used as a resource to improve the quality of care administered to obstetric patients, to reduce fragmented care processes and to improve interdisciplinary co-ordination and communication, with the overall aim of decreasing maternal morbidity and mortality. Therefore, this book represents an invaluable guide to specialists in critical care, anesthesia and obstetrics as well as to intensive care nurses and midwives.".
Keywords	Obstetrical emergencies ; Anesthesiology ; Critical care medicine
Subject code	616.028
Language	English
Size	1 online resource (XLIII, 585 p. 85 illus., 63 illus. in color.)
Edition	1st ed. 2020.
Publisher	Springer
Publishing place	Cham, Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	3-030-43477-X ; 3-030-43476-1 ; 978-3-030-43477-9 ; 978-3-030-43476-2
DOI	10.1007/978-3-030-43477-9
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Inexorable.

Einav, Sharon

Intensive care medicine

2020 Volume 46, Issue 6, Page(s) 1252–1253

Language	English
Publishing date	2020-05-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-020-06056-9
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Article ; Online: Resource allocation.

McConnell, Paul / Einav, Sharon

Current opinion in anaesthesiology

2023 Volume 36, Issue 2, Page(s) 246–251

Abstract: Purpose of review: The coronavirus disease 2019 pandemic and recent global recessions have brought to the forefront of the medical-political discussion the fact that medical resources are finite and have focused a spotlight on fair allocation and ... ...

Abstract	Purpose of review: The coronavirus disease 2019 pandemic and recent global recessions have brought to the forefront of the medical-political discussion the fact that medical resources are finite and have focused a spotlight on fair allocation and prioritization of healthcare resources describe why this review is timely and relevant. Recent findings: This review presents past and present concepts related to the ethics of resource allocation. Included are discussions regarding the topics of who should determine resource allocation, what types of research require allocation, methods currently in use to determine what resources are appropriate and which should be prioritized.describe the main themes in the literature covered by the article. Summary: Models for resource allocation must differentiate between different types of resources, some of which may require early preparation or distribution. Local availability of specific resources, supplies and infrastructure must be taken into consideration during preparation. When planning for long durations of limited resource availability, the limitations of human resilience must also be considered. Preparation also requires information regarding the needs of the specific population at hand (e.g. age distributions, disease prevalence) and societal preferences must be acknowledged within possible limits.
MeSH term(s)	Humans ; COVID-19 ; Resource Allocation
Language	English
Publishing date	2023-02-23
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	645203-6
ISSN	1473-6500 ; 0952-7907
ISSN (online)	1473-6500
ISSN	0952-7907
DOI	10.1097/ACO.0000000000001254
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Article ; Online: Effects of fatigue on anaesthetist well-being and patient safety: a narrative review.

Ippolito, Mariachiara / Einav, Sharon / Giarratano, Antonino / Cortegiani, Andrea

British journal of anaesthesia

2024

Abstract: The elements that render anaesthesia a captivating profession can also foster stress and fatigue. Professionals considering anaesthesia as a career choice should have a comprehensive understanding of the negative consequences of fatigue and its ... ...

Abstract	The elements that render anaesthesia a captivating profession can also foster stress and fatigue. Professionals considering anaesthesia as a career choice should have a comprehensive understanding of the negative consequences of fatigue and its implications for clinical performance and of the available preventive measures. Available evidence suggests that factors unrelated to patient characteristics or condition can affect clinical outcomes where anaesthetists are involved. Workload, nighttime work, and fatigue are persistent issues in anaesthesia and are perceived as presenting greater perioperative risks to patients. Fatigue seems to negatively affect both physical and mental health of anaesthetists. Existing evidence justifies specific interventions by institutions, stakeholders, and scientific societies to address the effects of anaesthetist fatigue. This narrative review summarises current knowledge regarding the effects of fatigue on anaesthetist well-being and patient safety, and discusses potential preventive solutions.
Language	English
Publishing date	2024-04-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2024.03.017
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Article: Antibiotic Stewardship: Dead Bugs do not Mutate.

Martin-Loeches, Ignacio / Leone, Marc / Einav, Sharon

Journal of translational internal medicine

2023 Volume 10, Issue 4, Page(s) 290–293

Language	English
Publishing date	2023-01-13
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2861892-0
ISSN	2224-4018 ; 2450-131X
ISSN (online)	2224-4018
ISSN	2450-131X
DOI	10.2478/jtim-2022-0059
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Article ; Online: The unseen pandemic: treatment delays and loss to follow-up due to fear of COVID.

Einav, Sharon / Tankel, James

Journal of Anesthesia, Analgesia and Critical Care (Online)

2022 Volume 2, Issue 1, Page(s) 5

Abstract: Background: Fear of contracting SARS-CoV-2 has transformed public interaction with healthcare professionals and hospitals alike. In turn, this has resulted in a collateral impact on patients' health across medical and surgical paradigms. Understanding ... ...

Abstract	Background: Fear of contracting SARS-CoV-2 has transformed public interaction with healthcare professionals and hospitals alike. In turn, this has resulted in a collateral impact on patients' health across medical and surgical paradigms. Understanding the causative factors of this fear, and tackling it head on, is vital to return to pre-pandemic levels of healthcare. Main body: In this editorial, we explore the evidence base behind the fear of healthcare professionals and facilities that has developed during the course of the SARS-CoV-2pandemic. We also reflect on the ways in which these fears have affected the general public. In so doing, we review a recent article from Montalto et al. that has explored fear of SARS-CoV-2 among patients undergoing surgery in Italy. Conclusion: While fear of SARS-CoV-2 is uncommon among surgical patients, there are still those who delay or avoiding seeking medical care due to fear of transmission. Physicians must lead the fight against this fear in a hope to regain the trust of the public.
Language	English
Publishing date	2022-01-28
Publishing country	England
Document type	Editorial
ISSN	2731-3786
ISSN (online)	2731-3786
DOI	10.1186/s44158-021-00032-5
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Article ; Online: Medical and obstetric comorbidities and delivery outcomes in overweight and obese parturients: a retrospective analysis.

Gat, Roi / Hadar, Eran / Orbach-Zinger, Sharon / Einav, Sharon

Journal of Anesthesia, Analgesia and Critical Care (Online)

2023 Volume 3, Issue 1, Page(s) 21

Abstract: Background: Research on obesity in women of reproductive age is heterogeneous in gestational age and body mass index (BMI) classification and focused mostly on pregnancy-related rather than medical comorbidities. We studied the prevalences of pre- ... ...

Abstract	Background: Research on obesity in women of reproductive age is heterogeneous in gestational age and body mass index (BMI) classification and focused mostly on pregnancy-related rather than medical comorbidities. We studied the prevalences of pre-pregnancy BMI, chronic maternal and obstetric comorbidities, and delivery outcomes. Methods: Retrospective analysis of real-time data collected during deliveries in a single tertiary medical center. Pre-pregnancy BMI was classified into seven groups (kg/m Results: Included were 13,726 women aged 18-50 years, with a gestational age of 24 Conclusions: We identified a potential association between pre-pregnancy obesity and morbid obesity and higher rates of obstetric comorbidities, less natural conception and spontaneous labor, and more cesarean deliveries and adverse delivery outcomes. It remains to be seen if these findings remain after adjustment and whether they are related to obesity, treatment, or both.
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Journal Article
ISSN	2731-3786
ISSN (online)	2731-3786
DOI	10.1186/s44158-023-00105-7
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Article ; Online: Sepsis and antibiotics: When should we deploy a parachute?

Einav, Sharon / Leone, Marc / Martin-Loeches, Ignacio

International journal of antimicrobial agents

2023 Volume 61, Issue 4, Page(s) 106732

Abstract: In sepsis and septic shock, guidelines recommend administering antimicrobial therapy within the first hour following diagnosis. This recommendation is based on observational studies suggesting that early antimicrobial therapy is associated with improved ... ...

Abstract	In sepsis and septic shock, guidelines recommend administering antimicrobial therapy within the first hour following diagnosis. This recommendation is based on observational studies suggesting that early antimicrobial therapy is associated with improved outcomes. Consequently, front-line physicians are under pressure to quickly decide on the need for antibiotics in patients for whom the diagnosis of sepsis remains uncertain. However, overuse of antibiotics is associated with emergence of multidrug-resistant bacteria, which constitutes a major health issue worldwide. Front-line physicians may be thought to have been responsible for antibiotic overuse in the same patients. This article reports the situation of physicians who are criticised for using unnecessarily antibiotics or those who are criticised for not timeously using antibiotics; it then discusses several options to help the clinician at the bedside.
MeSH term(s)	Humans ; Anti-Bacterial Agents/pharmacology ; Sepsis/diagnosis ; Sepsis/drug therapy ; Sepsis/microbiology ; Shock, Septic/drug therapy ; Uncertainty ; Drug Resistance, Multiple, Bacterial
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2023-01-20
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2023.106732
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Article ; Online: Emergency Department Admission Rates, Waiting Times, and Mortality: An Observational Study in the Tertiary Center Most Proximal to Gaza During a Military Conflict.

Dreiher, Jacob / Einav, Sharon / Codish, Shlomi / Frenkel, Amit

Disaster medicine and public health preparedness

2023 Volume 17, Page(s) e463

Abstract: Objectives: Military conflicts may be ongoing and encompass multiple medical facilities. This study investigated the impact of a military conflict ("Protective Edge" PE) on emergency department (ED) function in a tertiary medical center.: Methods: ... ...

Abstract	Objectives: Military conflicts may be ongoing and encompass multiple medical facilities. This study investigated the impact of a military conflict ("Protective Edge" PE) on emergency department (ED) function in a tertiary medical center. Methods: Visits to the ED during PE (July-August 2014) were compared with ED visits during July-August 2013 and 2015 with regard to admission rates, waiting times and 30-d mortality. Odds ratios (ORs) adjusted for confounders were used for the multivariable regression models. Results: There were 32,343 visits during PE and 74,279 visits during the comparison periods. A 13% decrease in the daily number of visits was noted. During PE, longer waiting times were found, on average 0.25 h longer, controlling for confounders. The difference in waiting times was greater in medicine and surgery. Admission rates were on average 10% higher during PE military conflict, controlling for confounders. This difference decreased to 7% controlling for the daily number of visits. Thirty-day mortality was significantly increased during PE (OR = 1.42; 95% CI: 1.18-1.70). ORs for mortality during PE were significantly higher in medicine (OR = 1.45; 95% CI: 1.15-1.81) and pediatrics (OR = 4.40; 95% CI: 1.33-14.5). Conclusions: During an ongoing military conflict, waiting times, admission rates, and mortality were statistically significantly increased.
MeSH term(s)	Humans ; Child ; Military Personnel ; Waiting Lists ; Hospitalization ; Hospitals ; Emergency Service, Hospital
Language	English
Publishing date	2023-08-23
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2023.45
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Article ; Online: Multiorgan failure in patients after out of hospital resuscitation: a retrospective single center study.

Hasin, Yaacov / Helviz, Yigal / Einav, Sharon

Internal and emergency medicine

2023 Volume 19, Issue 1, Page(s) 159–173

Abstract: Background: Information on extracerebral system dysfunction is important for assessing the needs of critically ill patients after cardiac arrest.: Aims: To describe the prevalence of organ dysfunction and patient severity after out of hospital ... ...

Abstract	Background: Information on extracerebral system dysfunction is important for assessing the needs of critically ill patients after cardiac arrest. Aims: To describe the prevalence of organ dysfunction and patient severity after out of hospital cardiac arrest (OHCA) using scores commonly used in intensive care and the association between these and mortality. Methods: Retrospective analysis of observational data collected in real time in a tertiary medical center where care withdrawal is mostly illegal. Adult patients after nontraumatic OHCA with ROSC who survived for more than two hours were included. Primary outcome-prevalence of organ failure, based on common definitions for organ dysfunction, in the 1 days of hospitalization. Secondary outcomes-rates of survival to hospital discharge and survival with a good neurological outcome (CPC 1 or 2), and associations between organ dysfunction SOFA and APACHE-II scores and outcomes. Associations were assessed using fisher's exact test for categorical variables and Mann-Whitney and T test for continuous variables. Multivariable models were also constructed for all measurements showing associations in previous tests. For severity scores compatibility, we used receiver-operating curve (ROC). Results: Overall 369 patients (median age 75 years, 65% male) were included. Most arrests (64%) were witnessed, bystander CPR was provided in 15%. Median call to arrival time was 4 min. The presenting rhythm was asystole in 48% and VT/VF in 22%. Cardiovascular causes of arrest predominated (48%, n = 178). The median length of hospitalization was 5 days. Overall 28% of the patients (n = 98) survived to hospital discharge, mostly with a good neurological status (18.7%, n = 57). The rates of organ dysfunction were: hemodynamic instability 65% (n = 247), respiratory dysfunction 94% (n = 296), kidney dysfunction 70% (n = 259), hepatic dysfunction 14% (n = 50). The median SOFA score on day 1 was 9 and the median APACHE II score was 34. Modeling was limited by missing data. Neurological dysfunction (i.e. GCS and seizures) and kidney injury were consistently correlated with the outcomes in the multivariable models. Severity of critical illness assessed by above scoring systems correlated with mortality (all ROC curves had an AUC ranging between 0.728 and 0.849). Conclusions: Multiorgan failure is common after ROSC (1-4). Therefore, the management of patients after ROSC may require advanced multidisciplinary care. Scores describing the severity of critical illness should be routinely reported in resuscitation research. Our unique setting where withdrawal of care is illegal, allows assessment of extremely ill patients and may assist in defining margins for futility.
MeSH term(s)	Adult ; Humans ; Male ; Aged ; Female ; Cardiopulmonary Resuscitation ; Retrospective Studies ; Multiple Organ Failure/epidemiology ; Multiple Organ Failure/etiology ; Critical Illness ; Hospitals ; Out-of-Hospital Cardiac Arrest ; Emergency Medical Services
Language	English
Publishing date	2023-08-17
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-023-03389-3
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