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Article ; Online: Geo-economic Influence on the Effect of Fluid Volume for Sepsis Resuscitation: A Meta-Analysis.

Gendreau, Ségolène / Frapard, Thomas / Carteaux, Guillaume / Kwizera, Arthur / Adhikari, Neill K J / Mer, Mervyn / Hernandez, Glenn / Mekontso Dessap, Armand

American journal of respiratory and critical care medicine

2024 Volume 209, Issue 5, Page(s) 517–528

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Humans ; Databases, Factual ; Fluid Therapy ; Income ; Sepsis/therapy ; Shock, Septic ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2024-01-23
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Meta-Analysis
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202309-1617OC
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Article ; Online: COVID-19: a heavy toll on health-care workers.

Mehta, Sangeeta / Machado, Flavia / Kwizera, Arthur / Papazian, Laurent / Moss, Marc / Azoulay, Élie / Herridge, Margaret

The Lancet. Respiratory medicine

2021 Volume 9, Issue 3, Page(s) 226–228

MeSH term(s)	COVID-19 ; Health Personnel/psychology ; Humans ; Occupational Stress/psychology ; SARS-CoV-2 ; Workload/psychology ; Workplace/psychology
Language	English
Publishing date	2021-02-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2686754-0
ISSN	2213-2619 ; 2213-2600
ISSN (online)	2213-2619
ISSN	2213-2600
DOI	10.1016/S2213-2600(21)00068-0
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Article ; Online: A Global Perspective on Acute Respiratory Distress Syndrome and the Truth about Hypoxia in Resource-limited Settings.

Kwizera, Arthur / Dünser, Martin W

American journal of respiratory and critical care medicine

2016 Volume 193, Issue 1, Page(s) 5–7

MeSH term(s)	Female ; Humans ; Male ; Respiratory Distress Syndrome, Adult/epidemiology
Language	English
Publishing date	2016-01-01
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201509-1819ED
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Article ; Online: Does the implementation of a trauma system affect injury-related morbidity and economic outcomes? A systematic review.

Bath, Michael F / Hobbs, Laura / Kohler, Katharina / Kuhn, Isla / Nabulyato, William / Kwizera, Arthur / Walker, Laura E / Wilkins, Tom / Stubbs, Daniel / Burnstein, R M / Kolias, Angelos / Hutchinson, Peter John / Clarkson, P John / Halimah, Sara / Bashford, Tom

Emergency medicine journal : EMJ

2024

Abstract: Background: Trauma accounts for a huge burden of disease worldwide. Trauma systems have been implemented in multiple countries across the globe, aiming to link and optimise multiple aspects of the trauma care pathway, and while they have been shown to ... ...

Abstract	Background: Trauma accounts for a huge burden of disease worldwide. Trauma systems have been implemented in multiple countries across the globe, aiming to link and optimise multiple aspects of the trauma care pathway, and while they have been shown to reduce overall mortality, much less is known about their cost-effectiveness and impact on morbidity. Methods: We performed a systematic review to explore the impact the implementation of a trauma system has on morbidity, quality of life and economic outcomes, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All comparator study types published since 2000 were included, both retrospective and prospective in nature, and no limits were placed on language. Data were reported as a narrative review. Results: Seven articles were identified that met the inclusion criteria, all of which reported a pre-trauma and post-trauma system implementation comparison in high-income settings. The overall study quality was poor, with all studies demonstrating a severe risk of bias. Five studies reported across multiple types of trauma patients, the majority describing a positive impact across a variety of morbidity and health economic outcomes following trauma system implementation. Two studies focused specifically on traumatic brain injury and did not demonstrate any impact on morbidity outcomes. Discussion: There is currently limited and poor quality evidence that assesses the impact that trauma systems have on morbidity, quality of life and economic outcomes. While trauma systems have a fundamental role to play in high-quality trauma care, morbidity and disability data can have large economic and cultural consequences, even if mortality rates have improved. The sociocultural and political context of the surrounding healthcare infrastructure must be better understood before implementing any trauma system, particularly in resource-poor and fragile settings. Prospero registration number: CRD42022348529 LEVEL OF EVIDENCE: Level III.
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2023-213782
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Article ; Online: The Impact of Trauma System Implementation on Patient Quality of Life and Economic Burden: A Systematic Review Study Protocol.

Bath, Michael F / Kohler, Katharina / Hobbs, Laura / Kuhn, Isla / Nabulyato, William M / Kwizera, Arthur / Walker, Laura E / Wilkins, Tom / Stubbs, Daniel / Halimah, Sara / Burnstein, Rowan / Kolias, Angelos G / Hutchinson, Peter / Clarkson, John / Bashford, Tom

International journal of surgery protocols

2023 Volume 27, Issue 1, Page(s) 84–89

Abstract: Background: Trauma accounts for 10% of global mortality, with increasing rates disproportionally affecting low- and middle-income countries. In an attempt to improve clinical outcomes after injury, trauma systems have been implemented in multiple ... ...

Abstract	Background: Trauma accounts for 10% of global mortality, with increasing rates disproportionally affecting low- and middle-income countries. In an attempt to improve clinical outcomes after injury, trauma systems have been implemented in multiple countries over recent years. However, whilst many studies have subsequently demonstrated improvements in overall mortality outcomes, less is known about the impact trauma systems have on morbidity, quality of life, and economic burden. This systematic review seeks to assess the existing evidence base for trauma systems with these outcome measures. Methods: This review will include any study that assesses the impact implementation of a trauma system has on patient morbidity, quality of life, or economic burden. Any comparator study, including cohort, case-control, and randomised controlled studies, will be included, both retrospective or prospective in nature. Studies conducted from any region in the world and involving any age of patient will be included. We will collect data on any morbidity outcomes, health-related quality of life measures, or health economic assessments reported. We predict a high heterogeneity in these outcomes used and will therefore keep inclusion criteria broad. Discussion: Previous reviews have shown the significant improvements that can be achieved in mortality outcomes with the implementation of an organised trauma system, however the wider impact they can have on morbidity outcomes, quality of life measures, and the economic burden of trauma, is less well described. This systematic review will present all available data on these outcomes, helping to better characterise both the societal and economic impact of trauma system implementation. Highlights: Trauma systems are known to improve mortality rates, however less in known on the impact they have on morbidity outcomes, quality of life, and economic burdenWe aim to perform a systematic review to identify any comparator study that assesses the impact implementation of a trauma system on these outcomesUnderstanding the impact trauma systems can have on wider parameters, such as economic and quality of life outcomes, is crucial to allow governments globally to appropriately allocate often limited healthcare resources.
Language	English
Publishing date	2023-02-09
Publishing country	England
Document type	Journal Article
ISSN	2468-3574
ISSN (online)	2468-3574
DOI	10.29337/ijsp.187
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Article ; Online: What's new in sepsis recognition in resource-limited settings?

Kwizera, Arthur / Festic, Emir / Dünser, Martin W

Intensive care medicine

2016 Volume 42, Issue 12, Page(s) 2030–2033

MeSH term(s)	Bacterial Infections/diagnosis ; Humans ; Parasitic Diseases/diagnosis ; Sepsis/diagnosis ; Sepsis/microbiology ; Sepsis/parasitology ; Virus Diseases/diagnosis
Language	English
Publishing date	2016-12
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/s00134-016-4222-x
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Article ; Online: Acute Respiratory Distress Syndrome in an African Intensive Care Unit Setting: A Prospective Study of Prevalence and Outcomes.

Kwizera, Arthur / Kateete, David P / Ssenyonga, Ronald / Nakiyingi, Lydia / Nakibuuka, Jane / Namata, Christine / Mwanje, Arthur / Okello, Emmy / Kabatoro, Daphne / Kiwanuka, Noah / Bollinger, Robert C / Tumwine, James / Summers, Charlotte

Annals of the American Thoracic Society

2021 Volume 19, Issue 4, Page(s) 691–694

MeSH term(s)	Humans ; Intensive Care Units ; Prevalence ; Prospective Studies ; Respiration, Artificial ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/therapy
Language	English
Publishing date	2021-10-18
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.202103-270RL
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Article ; Online: Evaluating patient factors, operative management and postoperative outcomes in trauma laparotomy patients worldwide: a protocol for a global observational multicentre trauma study.

BMJ open

2024 Volume 14, Issue 4, Page(s) e083135

Abstract: Introduction: Trauma contributes to the greatest loss of disability-adjusted life-years for adolescents and young adults worldwide. In the context of global abdominal trauma, the trauma laparotomy is the most commonly performed operation. Variation ... ...

Abstract	Introduction: Trauma contributes to the greatest loss of disability-adjusted life-years for adolescents and young adults worldwide. In the context of global abdominal trauma, the trauma laparotomy is the most commonly performed operation. Variation likely exists in how these patients are managed and their subsequent outcomes, yet very little global data on the topic currently exists. The objective of the GOAL-Trauma study is to evaluate both patient and injury factors for those undergoing trauma laparotomy, their clinical management and postoperative outcomes. Methods: We describe a planned prospective multicentre observational cohort study of patients undergoing trauma laparotomy. We will include patients of all ages who present to hospital with a blunt or penetrating injury and undergo a trauma laparotomy within 5 days of presentation to the treating centre. The study will collect system, patient, process and outcome data, following patients up until 30 days postoperatively (or until discharge or death, whichever is first). Our sample size calculation suggests we will need to recruit 552 patients from approximately 150 recruiting centres. Discussion: The GOAL-Trauma study will provide a global snapshot of the current management and outcomes for patients undergoing a trauma laparotomy. It will also provide insight into the variation seen in the time delays for receiving care, the disease and patient factors present, and patient outcomes. For current standards of trauma care to be improved worldwide, a greater understanding of the current state of trauma laparotomy care is paramount if appropriate interventions and targets are to be identified and implemented.
MeSH term(s)	Young Adult ; Adolescent ; Humans ; Prospective Studies ; Laparotomy/methods ; Abdominal Injuries/surgery ; Wounds, Penetrating/surgery ; Retrospective Studies ; Observational Studies as Topic ; Multicenter Studies as Topic
Language	English
Publishing date	2024-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-083135
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Article ; Online: Building Critical Care Capacity in a Low-Income Country.

Kwizera, Arthur / Sendagire, Cornelius / Kamuntu, Yewande / Rutayisire, Meddy / Nakibuuka, Jane / Muwanguzi, Patience A / Alenyo-Ngabirano, Anne / Kyobe-Bosa, Henry / Olaro, Charles

Critical care clinics

2022 Volume 38, Issue 4, Page(s) 747–759

Abstract: Critical illness is common throughout the world and is associated with high costs of care and resource intensity. The Corona virus disease 2019 (COVID-19) pandemic created a sudden surge of critically ill patients, which in turn led to devastating ... ...

Abstract	Critical illness is common throughout the world and is associated with high costs of care and resource intensity. The Corona virus disease 2019 (COVID-19) pandemic created a sudden surge of critically ill patients, which in turn led to devastating effects on health care systems worldwide and more so in Africa. This narrative report describes how an attempt was made at bridging the existing gaps in quality of care for critically ill patients at national and regional levels for COVID and the postpandemic era in a low income country.
MeSH term(s)	COVID-19/epidemiology ; Critical Care ; Critical Illness/therapy ; Humans ; Intensive Care Units ; Pandemics
Language	English
Publishing date	2022-09-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1006423-0
ISSN	1557-8232 ; 0749-0704
ISSN (online)	1557-8232
ISSN	0749-0704
DOI	10.1016/j.ccc.2022.07.003
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Article ; Online: Respiratory Support Techniques for COVID-19-Related ARDS in a Sub-Saharan African Country: A Multicenter Observational Study.

Chest

2023 Volume 164, Issue 2, Page(s) 369–380

Abstract: Background: Limited data from low-income countries report on respiratory support techniques in COVID-19-associated ARDS.: Research question: Which respiratory support techniques are used in patients with COVID-19-associated ARDS in Uganda?: Study ... ...

Abstract	Background: Limited data from low-income countries report on respiratory support techniques in COVID-19-associated ARDS. Research question: Which respiratory support techniques are used in patients with COVID-19-associated ARDS in Uganda? Study design and methods: A multicenter, prospective, observational study was conducted at 13 Ugandan hospitals during the pandemic and included adults with COVID-19-associated ARDS. Patient characteristics, clinical and laboratory data, initial and most advanced respiratory support techniques, and 28-day mortality were recorded. Standard tests, log-rank tests, and logistic regression analyses were used for statistical analyses. Results: Four hundred ninety-nine patients with COVID-19-associated ARDS (mild, n = 137; moderate, n = 247; and severe, n = 115) were included (ICU admission, 38.9%). Standard oxygen therapy (SOX), high-flow nasal oxygen (HFNO), CPAP, noninvasive ventilation (NIV), and invasive mechanical ventilation (IMV) was used as the first-line (most advanced) respiratory support technique in 37.3% (35.3%), 10% (9.4%), 11.6% (4.8%), 23.4% (14.4%), and 17.6% (36.6%) of patients, respectively. The first-line respiratory support technique was escalated in 19.8% of patients. Twenty-eight-day mortality was 51.9% (mild ARDS, 13.1%; moderate ARDS, 62.3%; severe ARDS, 75.7%; P < .001) and was associated with respiratory support techniques as follows: SOX, 19.9%; HFNO, 31.9%; CPAP, 58.3%; NIV 61.1%; and IMV, 83.9% (P < .001). Proning was used in 79 patients (15.8%; 59 of 79 awake) and was associated with lower mortality (40.5% vs 54%; P = .03). The oxygen saturation to Fio Interpretation: SOX, HFNO, CPAP, NIV, and IMV were used as respiratory support techniques in patients with COVID-19-associated ARDS in Uganda. Although these data are observational, they suggest that the use of SOX and HFNO therapy as well as awake proning are associated with a lower mortality resulting from COVID-19-associated ARDS in a resource-limited setting.
MeSH term(s)	Adult ; Humans ; COVID-19/complications ; COVID-19/therapy ; Prospective Studies ; Oxygen/therapeutic use ; Noninvasive Ventilation/methods ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/drug therapy ; Africa South of the Sahara/epidemiology
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2023-02-10
Publishing country	United States
Document type	Multicenter Study ; Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2023.01.039
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