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  1. Article ; Online: The authors reply.

    Parhar, Ken Kuljit S / Doig, Christopher

    Critical care medicine

    2023  Volume 51, Issue 9, Page(s) e188–e189

    Language English
    Publishing date 2023-08-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005971
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    Zs.A 1261: Show issues Location:
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  2. Article ; Online: Caution-Do Not Attempt This at Home. Airway Pressure Release Ventilation Should Not Routinely Be Used in Patients With or at Risk of Acute Respiratory Distress Syndrome Outside of a Clinical Trial.

    Parhar, Ken Kuljit S / Doig, Christopher

    Critical care medicine

    2023  

    Language English
    Publishing date 2023-01-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000005776
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    Zs.A 1261: Show issues Location:
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  3. Article ; Online: Awake prone position in patients with acute hypoxic respiratory failure: A narrative review.

    Al Duhailib, Zainab / Parhar, Ken Kuljit S / Solverson, Kevin / Alhazzani, Waleed / Weatherald, Jason

    Respiratory medicine and research

    2023  Volume 84, Page(s) 101037

    MeSH term(s) Humans ; COVID-19/therapy ; Hypoxia/therapy ; Prone Position ; Respiratory Distress Syndrome/therapy ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; Wakefulness ; Patient Positioning/methods
    Language English
    Publishing date 2023-06-30
    Publishing country France
    Document type Journal Article ; Review
    ISSN 2590-0412
    ISSN (online) 2590-0412
    DOI 10.1016/j.resmer.2023.101037
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  4. Article ; Online: Awake prone positioning in COVID-19: is tummy time ready for prime time?

    Weatherald, Jason / Norrie, John / Parhar, Ken Kuljit S

    The Lancet. Respiratory medicine

    2021  Volume 9, Issue 12, Page(s) 1347–1349

    MeSH term(s) COVID-19 ; Humans ; Patient Positioning ; Prone Position ; SARS-CoV-2 ; Wakefulness
    Language English
    Publishing date 2021-08-20
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(21)00368-4
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    Zs.A 7041: Show issues Location:
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  5. Article: Early neuromuscular blockade in acute respiratory distress syndrome: to personalize or paralyze?

    Parhar, Ken Kuljit S / Solverson, Kevin / Zochios, Vasileios

    Journal of thoracic disease

    2020  Volume 11, Issue 12, Page(s) 5701–5705

    Language English
    Publishing date 2020-01-22
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2019.12.101
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  6. Article ; Online: Protecting the Right Ventricle Network (PRORVNet): Time to Defend the "Forgotten Ventricle"?

    Zochios, Vasileios / Lau, Gary / Conway, Hannah / Parhar, Ken Kuljit S

    Journal of cardiothoracic and vascular anesthesia

    2021  Volume 35, Issue 6, Page(s) 1565–1567

    MeSH term(s) Heart Ventricles/diagnostic imaging ; Humans
    Language English
    Publishing date 2021-01-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2021.01.002
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    Zs.A 2203: Show issues Location:
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    Zs.MO 31: Show issues

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  7. Article ; Online: Tolerability and safety of awake prone positioning COVID-19 patients with severe hypoxemic respiratory failure.

    Solverson, Kevin / Weatherald, Jason / Parhar, Ken Kuljit S

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2020  Volume 68, Issue 1, Page(s) 64–70

    Abstract: Purpose: Prone positioning of non-intubated patients with coronavirus disease (COVID-19) and hypoxemic respiratory failure may prevent intubation and improve outcomes. Nevertheless, there are limited data on its feasibility, safety, and physiologic ... ...

    Title translation Tolérabilité et sécurité de la position ventrale éveillée chez des patients atteints de la COVID-19 et d’insuffisance respiratoire hypoxémique grave.
    Abstract Purpose: Prone positioning of non-intubated patients with coronavirus disease (COVID-19) and hypoxemic respiratory failure may prevent intubation and improve outcomes. Nevertheless, there are limited data on its feasibility, safety, and physiologic effects. The objective of our study was to assess the tolerability and safety of awake prone positioning in COVID-19 patients with hypoxemic respiratory failure.
    Methods: This historical cohort study was performed across four hospitals in Calgary, Canada. Included patients had suspected COVID-19 and hypoxic respiratory failure requiring intensive care unit (ICU) consultation, and underwent awake prone positioning. The duration, frequency, tolerability, and adverse events from prone positioning were recorded. Respiratory parameters were assessed before, during, and after prone positioning. The primary outcome was the tolerability and safety of prone positioning.
    Results: Seventeen patients (n = 12 ICU, n = 5 hospital ward) were included between April and May 2020. The median (range) number of prone positioning days was 1 (1-7) and the median number of sessions was 2 (1-6) per day. The duration of prone positioning was 75 (30-480) min, and the peripheral oxygen saturation was 91% (84-95) supine and 98% (92-100) prone. Limitations to prone position duration were pain/general discomfort (47%) and delirium (6%); 47% of patients had no limitations. Seven patients (41%) required intubation and two patients (12%) died.
    Conclusions: In a small sample, prone positioning non-intubated COVID-19 patients with severe hypoxemia was safe; however, many patients did not tolerate prolonged durations. Although patients had improved oxygenation and respiratory rate in the prone position, many still required intubation. Future studies are required to determine methods to improve the tolerability of awake prone positioning and whether there is an impact on clinical outcomes.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; COVID-19/therapy ; Canada ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Patient Positioning ; Prone Position ; Respiratory Insufficiency/therapy ; Respiratory Insufficiency/virology ; Wakefulness
    Keywords covid19
    Language English
    Publishing date 2020-08-14
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-020-01787-1
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    Zs.A 109: Show issues Location:
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  8. Article ; Online: Designing a Behaviour Change Wheel guided implementation strategy for a hypoxaemic respiratory failure and ARDS care pathway that targets barriers.

    Parhar, Ken Kuljit S / Knight, Gwen E / Soo, Andrea / Bagshaw, Sean M / Zuege, Danny J / Niven, Daniel J / Fiest, Kirsten M / Stelfox, Henry T

    BMJ open quality

    2023  Volume 12, Issue 4

    Abstract: Background: A significant gap exists between ideal evidence-based practice and real-world application of evidence-informed therapies for patients with hypoxaemic respiratory failure (HRF) and acute respiratory distress syndrome (ARDS). Pathways can ... ...

    Abstract Background: A significant gap exists between ideal evidence-based practice and real-world application of evidence-informed therapies for patients with hypoxaemic respiratory failure (HRF) and acute respiratory distress syndrome (ARDS). Pathways can improve the quality of care provided by helping integrate and organise the use of evidence informed practices, but barriers exist that can influence their adoption and successful implementation. We sought to identify barriers to the implementation of a best practice care pathway for HRF and ARDS and design an implementation science-based strategy targeting these barriers that is tailored to the critical care setting.
    Methods: The intervention assessed was a previously described multidisciplinary, evidence-based, stakeholder-informed, integrated care pathway for HRF and ARDS. A survey questionnaire (12 open text questions) was administered to intensive care unit (ICU) clinicians (physicians, nurses, respiratory therapists) in 17 adult ICUs across Alberta. The Behaviour Change Wheel, capability, opportunity, motivation - behaviour components, and Theoretical Domains Framework (TDF) were used to perform qualitative analysis on open text responses to identify barriers to the use of the pathway. Behaviour change technique (BCT) taxonomy, and Affordability, Practicality, Effectiveness and cost-effectiveness, Acceptability, Side effects and safety and Equity (APEASE) criteria were used to design an implementation science-based strategy specific to the critical care context.
    Results: Survey responses (692) resulted in 16 belief statements and 9 themes with 9 relevant TDF domains. Differences in responses between clinician professional group and hospital setting were common. Based on intervention functions linked to each belief statement and its relevant TDF domain, 26 candidate BCTs were identified and evaluated using APEASE criteria. 23 BCTs were selected and grouped to form 8 key components of a final strategy: Audit and feedback, education, training, clinical decision support, site champions, reminders, implementation support and empowerment. The final strategy was described using the template for intervention description and replication framework.
    Conclusions: Barriers to a best practice care pathway were identified and were amenable to the design of an implementation science-based mitigation strategy. Future work will evaluate the ability of this strategy to improve quality of care by assessing clinician behaviour change via better adherence to evidence-based care.
    MeSH term(s) Adult ; Humans ; Critical Pathways ; Motivation ; Behavior Therapy ; Physicians ; Respiratory Insufficiency
    Language English
    Publishing date 2023-12-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2023-002461
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: [No title information]

    Parhar, Ken Kuljit S / Lequier, Laurance / Blackwood, Jaime / Zuege, Danny J / Singh, Gurmeet

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2020  Volume 192, Issue 41, Page(s) E1250–E1252

    Title translation Utilisation optimale de l’assistance respiratoire extracorporelle durant la pandémie de COVID-19 : considérations pratiques en contexte canadien.
    Keywords covid19
    Language French
    Publishing date 2020-10-13
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.200448-f
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  10. Article ; Online: Awake prone positioning for COVID-19 hypoxemic respiratory failure: A rapid review.

    Weatherald, Jason / Solverson, Kevin / Zuege, Danny J / Loroff, Nicole / Fiest, Kirsten M / Parhar, Ken Kuljit S

    Journal of critical care

    2020  Volume 61, Page(s) 63–70

    Keywords covid19
    Language English
    Publishing date 2020-08-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632818-0
    ISSN 1557-8615 ; 0883-9441
    ISSN (online) 1557-8615
    ISSN 0883-9441
    DOI 10.1016/j.jcrc.2020.08.018
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