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Article: Continous renal replacement therapy and intermittent hemodialysis in acute kidney injury: equivalent or complementary?

Gibney, R T Noel

2016 Volume 8, Issue 9, Page(s) 2397–2399

Language	English
Publishing date	2016-07-04
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.2016.08.98
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Can this patient be safely weaned from RRT?

Klouche, Kada / Gibney, R T Noel / Forni, Lui G

Intensive care medicine

2017 Volume 44, Issue 5, Page(s) 639–642

MeSH term(s)	Humans ; Renal Replacement Therapy
Language	English
Publishing date	2017-10-20
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/s00134-017-4948-0
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Zs.A 1089: Show issues

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Article ; Online: A modified Delphi process to identify, rank and prioritize quality indicators for continuous renal replacement therapy (CRRT) care in critically ill patients.

Rewa, Oleksa G / Eurich, Dean T / Noel Gibney, R T / Bagshaw, Sean M

Journal of critical care

2018 Volume 47, Page(s) 145–152

Abstract: Background: Continuous renal replacement therapy (CRRT) is a complex and life-sustaining therapy, reserved for our most acutely ill patients, and should be delivered in a safe, consistent and high-quality manner. However valid evidence-based quality ... ...

Abstract	Background: Continuous renal replacement therapy (CRRT) is a complex and life-sustaining therapy, reserved for our most acutely ill patients, and should be delivered in a safe, consistent and high-quality manner. However valid evidence-based quality indicators (QIs) for CRRT care are lacking. The objective of this study was to develop a prioritized list of QIs for CRRT care that may be used in any CRRT program. Method: We conducted a modified three stage Delphi process. This consisted of two web-based rounds followed by an in-person meeting. We recruited an interdisciplinary panel of critical care nephrology experts and knowledge users. In each stage of the Delphi process panelists responded on whether a QI should be included in our final list. In the third round, any QI for which there was uncertainty to include was discussed and a final decision on whether to include was made. Results: Forty-one panelists participated (18 from nephrology, 11 from intensive care, 7 educators, 2 decision-makers, 2 industry representatives and 1 pharmacist) from North America, Europe, Australasia and South America. Following the third Delphi round, 13 QIs for CRRT care were identified; 10 QIs were identified with a high level of agreement for face validity while 3 QIs were identified with a moderate level of agreement for face validity among panelists. Conclusions: We developed a prioritized list of 13 QIs for CRRT care. Future work should focus on developing validated benchmarks for these QIs and implementing them into CRRT programs.
MeSH term(s)	Critical Care ; Critical Illness/therapy ; Delivery of Health Care/standards ; Delphi Technique ; Humans ; Quality Indicators, Health Care/classification ; Renal Replacement Therapy
Language	English
Publishing date	2018-06-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2018.06.023
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Zs.A 2152: Show issues

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Article ; Online: The Evolution of Critical Care Nephrology in Edmonton.

Bagshaw, Sean M / Gibney, R T Noel

Blood purification

2016 Volume 41, Issue 4, Page(s) I–V

Abstract: The University of Alberta (UofA) in Edmonton, Canada has a rich and productive history supporting the development of critical care medicine, nephrology and the evolving subspecialty of critical care nephrology. The first hemodialysis program for patients ...

Abstract	The University of Alberta (UofA) in Edmonton, Canada has a rich and productive history supporting the development of critical care medicine, nephrology and the evolving subspecialty of critical care nephrology. The first hemodialysis program for patients with chronic renal failure in Canada was developed at the University of Alberta Hospital. The UofA is also recognized for its early pioneering work on the diagnosis, etiology and outcomes associated with acute kidney injury (AKI), the development of a diagnostic scheme renal allograft rejection (Banff classification), and contributions to the Renal Disaster Relief Task Force. Edmonton was one of the first centers in Canada to provide continuous renal replacement therapy. This has grown into a comprehensive clinical, educational and research center for critical care nephrology. Critical care medicine in Edmonton now leads and participates in numerous critical care nephrology initiatives dedicated to AKI, renal replacement therapy, renal support in solid organ transplantation, and extracorporeal blood purification. Critical care medicine in Edmonton is recognized across Canada and across the globe as a leading center of excellence in critical care nephrology, as an epicenter for research innovation and for training a new generation of clinicians with critical care nephrology expertise.
MeSH term(s)	Acute Kidney Injury/history ; Acute Kidney Injury/pathology ; Acute Kidney Injury/therapy ; Alberta ; Critical Care/history ; Critical Care/methods ; History, 20th Century ; History, 21st Century ; Humans ; Kidney Failure, Chronic/history ; Kidney Failure, Chronic/pathology ; Kidney Failure, Chronic/therapy ; Kidney Transplantation/history ; Kidney Transplantation/methods ; Kidney Transplantation/utilization ; Nephrology/history ; Nephrology/instrumentation ; Nephrology/methods ; Renal Dialysis/history ; Renal Dialysis/instrumentation ; Renal Dialysis/methods
Language	English
Publishing date	2016
Publishing country	Switzerland
Document type	Editorial ; Historical Article ; Research Support, Non-U.S. Gov't
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000441440
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Zs.A 1872: Show issues

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Article ; Online: COVID-19 pandemic

R.T. Noel Gibney / Cynthia Blackman / Melanie Gauthier / Eddy Fan / Robert Fowler / Curtis Johnston / R. Jeremy Katulka / Samuel Marcushamer / Kusum Menon / Tracey Miller / Bojan Paunovic / Teddie Tanguay

FACETS, Vol 7, Iss , Pp 1411-

the impact on Canada’s intensive care units

2022 Volume 1472

Abstract: The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity. The impact of the pandemic ... ...

Abstract	The COVID-19 pandemic has exposed the precarious demand-capacity balance in Canadian hospitals, including critical care where there is an urgent need for trained health care professionals to dramatically increase ICU capacity. The impact of the pandemic on ICUs varied significantly across the country with provinces that implemented public health measures later and relaxed them sooner being impacted more severely. Pediatric ICUs routinely admitted adult patients. Non-ICU areas were converted to ICUs and staff were redeployed from other essential service areas. Faced with a lack of critical care capacity, triage plans for ICU admission were developed and nearly implemented in some provinces. Twenty eight percent of patients in Canadian ICUs who required mechanical ventilation died. Surviving patients have required prolonged ICU admission, hospitalization and extensive ongoing rehabilitation. Family members of patients were not permitted to visit, resulting in additional psychological stresses to patients, families, and healthcare teams. ICU professionals also experienced extreme psychological stresses from caring for such large numbers of critically ill patients, often in sub-standard conditions. This resulted in large numbers of health workers leaving their professions. This pandemic is not yet over, and it is likely that new pandemics will follow. A review and recommendations for the future are provided.
Keywords	COVID-19 ; critical care ; pediatric intensive care ; intensive care units ; public health ; critical care nursing ; Education ; L ; Science ; Q
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Canadian Science Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Disaster nephrology: crush injury and beyond.

Gibney, R T Noel / Sever, Mehmet S / Vanholder, Raymond C

Kidney international

2014 Volume 85, Issue 5, Page(s) 1049–1057

Abstract: Disasters result in a substantial number of renal challenges, either by the creation of crush injury in victims trapped in collapsed buildings or by the destruction of existing dialysis facilities, leaving chronic dialysis patients without access to ... ...

Abstract	Disasters result in a substantial number of renal challenges, either by the creation of crush injury in victims trapped in collapsed buildings or by the destruction of existing dialysis facilities, leaving chronic dialysis patients without access to their dialysis units, medications, or medical care. Over the past two decades, lessons have been learned from the response to a number of major natural disasters that have impacted significantly on crush-related acute kidney injury and chronic dialysis patients. In this paper we review the pathophysiology and treatment of the crush syndrome, as summarized in recent clinical recommendations for the management of crush syndrome. The importance of early fluid resuscitation in preventing acute kidney injury is stressed, logistic difficulties in disaster conditions are described, and the need for an implementation of a renal disaster relief preparedness program is underlined. The role of the Renal Disaster Relief Task Force in providing emergency disaster relief and the logistical support required is outlined. In addition, the importance of detailed education of chronic dialysis patients and renal unit staff in the advance planning for such disasters and the impact of displacement by disasters of chronic dialysis patients are discussed.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/mortality ; Acute Kidney Injury/physiopathology ; Acute Kidney Injury/prevention & control ; Crush Syndrome/diagnosis ; Crush Syndrome/mortality ; Crush Syndrome/physiopathology ; Crush Syndrome/therapy ; Delivery of Health Care, Integrated ; Disaster Planning/organization & administration ; Emergencies ; Fluid Therapy ; Health Services Accessibility/organization & administration ; Humans ; Mass Casualty Incidents ; Nephrology/methods ; Nephrology/organization & administration ; Renal Dialysis ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/physiopathology ; Renal Insufficiency, Chronic/therapy ; Risk Factors ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2014-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1038/ki.2013.392
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Zs.A 797: Show issues

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Article ; Online: Restricting resident work hours: the learner/employee tension.

Hudson, Darren A / McDermid, Robert C / Gibney, Noel

Critical care medicine

2012 Volume 40, Issue 9, Page(s) 2739; author reply 2739–40

MeSH term(s)	Humans ; Internship and Residency/statistics & numerical data ; Quality of Health Care/standards ; Workload/statistics & numerical data
Language	English
Publishing date	2012-09
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e318258ebd8
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Zs.A 1261: Show issues

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Article ; Online: Five-Year Two-Center Retrospective Comparison of Central Laboratory Glucose to GEM 4000 and ABL 800 Blood Glucose: Demonstrating the (In)adequacy of Blood Gas Glucose.

Cembrowski, George / Jung, Joanna / Mei, Junyi / Xu, Eric / Curic, Tihomir / Gibney, Rt Noel / Jacka, Michael / Sadrzadeh, Hossein

Journal of diabetes science and technology

2019 Volume 14, Issue 3, Page(s) 535–545

Abstract: Purpose: To evaluate the glucose assays of two blood gas analyzers (BGAs) in intensive care unit (ICU) patients by comparing ICU BGA glucoses to central laboratory (CL) glucoses of almost simultaneously drawn specimens.: Methods: Data repositories ... ...

Abstract	Purpose: To evaluate the glucose assays of two blood gas analyzers (BGAs) in intensive care unit (ICU) patients by comparing ICU BGA glucoses to central laboratory (CL) glucoses of almost simultaneously drawn specimens. Methods: Data repositories provided five years of ICU BGA glucoses and contemporaneously drawn CL glucoses from a Calgary, Alberta ICU equipped with IL GEM 4000 and CL Roche Cobas 8000-C702, and an Edmonton, Alberta ICU equipped with Radiometer ABL 800 and CL Beckman-Coulter DxC. Blood glucose analyzer and CL glucose differences were evaluated if they were both drawn either within ±15 or ±5 minutes. Glucose differences were assessed graphically and quantitatively with simple run charts and the surveillance error grid (SEG) and quantitatively with the 2016 Food and Drug Administration guidance document, with ISO 15197 and SEG statistical summaries. As the GEM glucose exhibits diurnal variation, CL-arterial blood gas (ABG) differences were evaluated according to time of day. Results: Compared to the GEM glucoses measured between 0200 and 0800, the run charts of (GEM-CL) glucose demonstrate significant outliers between 0800 and 0200 which are identified as moderate to severe clinical outliers by SEG analysis ( Discussion: The GEM ABG glucose is associated with a higher frequency of moderate to severe glucose clinical outliers, especially between 0800 and 0200, increased CL testing and higher average patient glucoses.
MeSH term(s)	Alberta ; Biomarkers/blood ; Blood Gas Analysis/instrumentation ; Blood Glucose/metabolism ; Equipment Design ; Humans ; Intensive Care Units ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies
Chemical Substances	Biomarkers ; Blood Glucose
Language	English
Publishing date	2019-11-05
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study
ISSN	1932-2968
ISSN (online)	1932-2968
DOI	10.1177/1932296819883260
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Article ; Online: Renal support in critically ill patients with acute kidney injury.

Bagshaw, Sean M / Gibney, Noel

The New England journal of medicine

2008 Volume 359, Issue 18, Page(s) 1960–1961

MeSH term(s)	Acute Kidney Injury/mortality ; Acute Kidney Injury/therapy ; Clinical Protocols ; Humans ; Intensive Care Units ; Renal Dialysis/methods ; Research Design ; Survival Rate
Language	English
Publishing date	2008-10-30
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
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Article ; Online: Routine use of post-bronchodilator testing in pulmonary function testing labs.

Agarwal, Joel / Saad, Emad / Fontaine, Geoffrey / Pagliardini, Silvia / Dafoe, William / Killian, Kieran / Gibney, R T Noel / Huston, Jim / Vethanayagam, Dilini

Clinical and investigative medicine. Medecine clinique et experimentale

2019 Volume 41, Issue 4, Page(s) E204–E210

Abstract: Purpose: Pulmonary function tests (PFTs), including spirometry with and without post-bronchodilator (post-BD) testing, are frequently performed in the assessment of asthma, along with other obstructive airway disorders. Multiple publications over the ... ...

Abstract	Purpose: Pulmonary function tests (PFTs), including spirometry with and without post-bronchodilator (post-BD) testing, are frequently performed in the assessment of asthma, along with other obstructive airway disorders. Multiple publications over the past 15 years have noted that one in three physician-diagnosed asthma cases are not in fact asthma. In this quality assurance project, we assess whether PFT labs in Alberta have policies on post-BD testing, as extraneous and unnecessary use of post-BD testing can lead to wasted staff and patient time and unnecessary expenses to the health care system. Methods: We reviewed, in collaboration with the College of Physicians and Surgeons of Alberta and Alberta Medical Association, all PFT labs in the province of Alberta (hospital-based private not-for-profit [NFP] and private for-profit [FP] labs). This health policy study of PFT labs involved identifying the proportions and regional distribution of NFP and private FP labs in the province of Alberta while assessing post-BD policies. Each PFT lab was asked for their policy regarding spirometry and asthma diagnosis from May 1 to August 31, 2017. Results: A total of 92 PFT labs were identified in Alberta, 74 of which were private FP (independent) labs, while 18 were private NFP (public) hospital-based labs. Policies were as follows: (i) post-BD policy existed (and if so routinely performed / not routinely done); (ii) no post-BD policy; and (iii) lab chose not to participate. All 18 hospital labs responded: 10 had no policy; six had a policy or algorithm; one did not perform post-BD testing (exercise testing) and one had multiple testing sites. Of the private FP labs, three had relevant policies and/or algorithm and 10 had none. No information was provided from 61 labs. Access to PFT labs in Northern Alberta was limited. Conclusions: Lab policies surrounding post-BD testing were found to be heterogeneous in Alberta. Low response rates, despite the use of a systems approach and requests in writing and in person from FP labs, were notable. Development of a standardized policy across the province would be beneficial. Further higher-level review of the appropriateness of post-BD use in both FP and NFP PFT labs is needed.
MeSH term(s)	Alberta ; Asthma/diagnosis ; Asthma/physiopathology ; Bronchodilator Agents/administration & dosage ; Female ; Health Policy ; Humans ; Male ; Physicians ; Respiratory Function Tests
Chemical Substances	Bronchodilator Agents
Language	English
Publishing date	2019-01-30
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	434004-8
ISSN	1488-2353 ; 0147-958X
ISSN (online)	1488-2353
ISSN	0147-958X
DOI	10.25011/cim.v41i4.32224
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