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Article ; Online: COVID-19 Lessons Learned: Prone Positioning With and Without Invasive Ventilation.

Scott, J Brady / Weiss, Tyler T / Li, Jie

2022 Volume 67, Issue 8, Page(s) 1011–1021

Abstract: Prone positioning (PP) has been used extensively for patients requiring invasive mechanical ventilation for hypoxemic respiratory failure during the COVID-19 pandemic. Evidence suggests that PP was beneficial during the pandemic, as it improves ... ...

Abstract	Prone positioning (PP) has been used extensively for patients requiring invasive mechanical ventilation for hypoxemic respiratory failure during the COVID-19 pandemic. Evidence suggests that PP was beneficial during the pandemic, as it improves oxygenation and might improve chances of survival, especially in those with a continuum of positive oxygenation responses to the procedure. Additionally, the pandemic drove innovation regarding PP, as it brought attention to awake PP (APP) and the value of an interdisciplinary team approach to PP during a pandemic. APP appears to be safe and effective at improving oxygenation; APP may also reduce the need for intubation in patients requiring advanced respiratory support like high-flow nasal cannula or noninvasive ventilation. Teams specifically assembled for PP during a pandemic also appear useful and can provide needed assistance to bedside clinicians in the time of crisis. Complications associated with PP can be mitigated, and a multidisciplinary approach to reduce the incidence of complications is recommended.
MeSH term(s)	COVID-19 ; Humans ; Noninvasive Ventilation/adverse effects ; Pandemics ; Patient Positioning/methods ; Prone Position/physiology ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2022-06-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.10141
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Article ; Online: Evaluation of a Closed Suction System With Integrated Tube-Scraping Technology.

Kaur, Ramandeep / Scott, J Brady / Weiss, Tyler T / Klein, Andrew / Charlton, Megan E / Villanueva, Kimberly A / Balk, Robert A / Vines, David L

Respiratory care

2023 Volume 68, Issue 8, Page(s) 1023–1030

Abstract: Background: Endotracheal tube (ETT) scraping or sweeping refers to mucus removal from an ETT that can increase airway resistance. The study objective was to evaluate the effect of ETT scraping on the duration of mechanical ventilation, time to first ... ...

Abstract	Background: Endotracheal tube (ETT) scraping or sweeping refers to mucus removal from an ETT that can increase airway resistance. The study objective was to evaluate the effect of ETT scraping on the duration of mechanical ventilation, time to first successful spontaneous breathing trial (SBT), duration of hospital stay, and occurrence of ventilator-associated events (VAEs). Methods: This was a single-center, randomized clinical trial of adult subjects intubated between October 2019-October 2021. Subjects were randomly assigned to either ETT suctioning via a standard in-line suction catheter (control group) or ETT suctioning and scraping via a suction catheter with balloon-sweeping technology (experimental group). Airway suctioning was performed as clinically indicated, and the ETT was scraped every time a respiratory therapist suctioned the subject. The study outcome was duration of mechanical ventilation, time to first successful SBT, hospital length of stay, and VAE rate. Intent-to-treat statistical analysis was performed. Results: Of 272 randomized subjects, the median age was 63 (interquartile range [IQR] 52-73) y; 143 (53%) were males, and 154 (57%) had a primary diagnosis of acute respiratory failure. There were no significant differences between the groups in median duration (h) of mechanical ventilation (72 [37-187] vs 70.6 [37-148], Conclusions: ETT suctioning plus scraping, compared to ETT suctioning alone, did not significantly improve the duration of mechanical ventilation, time to first successful SBT, length of hospital stay, and VAEs. These study findings do not support the routine use of ETT scraping for mechanically ventilated patients.
MeSH term(s)	Male ; Adult ; Humans ; Middle Aged ; Female ; Suction/adverse effects ; Respiration, Artificial/adverse effects ; Ventilator Weaning ; Ventilators, Mechanical ; Lung ; Intubation, Intratracheal/adverse effects
Language	English
Publishing date	2023-01-20
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.10830
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Article ; Online: Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19.

Kaur, Ramandeep / Weiss, Tyler T / Perez, Andrew / Fink, James B / Chen, Rongchang / Luo, Fengming / Liang, Zongan / Mirza, Sara / Li, Jie

Critical care (London, England)

2020 Volume 24, Issue 1, Page(s) 571

Abstract: Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East ... ...

Abstract	Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.
MeSH term(s)	Aerosols/adverse effects ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Cross Infection/prevention & control ; Humans ; Infection Control/methods ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Meta-Analysis as Topic ; Observational Studies as Topic ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Randomized Controlled Trials as Topic ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; Systematic Reviews as Topic
Chemical Substances	Aerosols
Keywords	covid19
Language	English
Publishing date	2020-09-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-020-03231-8
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Article: Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19

Kaur, Ramandeep / Weiss, Tyler T / Perez, Andrew / Fink, James B / Chen, Rongchang / Luo, Fengming / Liang, Zongan / Mirza, Sara / Li, Jie

Crit Care

Abstract	Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #788736
Database	COVID19

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Article ; Online: Practical strategies to reduce nosocomial transmission to healthcare professionals providing respiratory care to patients with COVID-19

Kaur, Ramandeep / Weiss, Tyler T. / Perez, Andrew / Fink, James B. / Chen, Rongchang / Luo, Fengming / Liang, Zongan / Mirza, Sara / Li, Jie

Critical Care

2020 Volume 24, Issue 1

Abstract: Abstract Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and ... ...

Abstract	Abstract Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, many frontline healthcare workers were infected when performing high-risk aerosol-generating medical procedures as well as when providing basic patient care. Similarly, COVID-19 disease has been reported to infect healthcare workers at a rate of ~ 3% of cases treated in the USA. In this review, we conducted an extensive literature search to develop practical strategies that can be implemented when providing respiratory treatments to COVID-19 patients, with the aim to help prevent nosocomial transmission to the frontline workers.
Keywords	Critical Care and Intensive Care Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2041406-7
ISSN	1364-8535
ISSN	1364-8535
DOI	10.1186/s13054-020-03231-8
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19: a retrospective observational cohort study.

Weiss, Tyler T / Cerda, Flor / Scott, J Brady / Kaur, Ramandeep / Sungurlu, Sarah / Mirza, Sara H / Alolaiwat, Amnah A / Augustynovich, Ashley E / Li, Jie

British journal of anaesthesia

2020 Volume 126, Issue 1, Page(s) 48–55

Abstract: Background: The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear.: Methods: We conducted a retrospective observational cohort study of critically ill intubated ... ...

Abstract	Background: The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear. Methods: We conducted a retrospective observational cohort study of critically ill intubated patients with COVID-19 who were placed in the prone position between March 18, 2020 and March 31, 2020. Exclusion criteria were pregnancy, reintubation, and previous prone positioning at a referring hospital. Patients were followed up until hospital discharge. The primary outcome was oxygenation assessed by partial pressure of oxygen/fraction of inspired oxygen ratio (Pao Results: Forty-two subjects (29 males; age: 59 [52-69] yr) were eligible for analysis. Nine subjects were placed in the prone position only once, with 25 requiring prone positioning on three or more occasions. A total of 31/42 (74%) subjects survived to discharge, with five requiring ECMO; 11/42 (26%) subjects died. After the first prone positioning session, Pao Conclusion: Patients with COVID-19 acute respiratory distress syndrome frequently responded to initial prone positioning with improved oxygenation. Subsequent prone positioning in subjects discharged from hospital was associated with greater improvements in oxygenation.
MeSH term(s)	Aged ; COVID-19/complications ; COVID-19/physiopathology ; COVID-19/therapy ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Intubation, Intratracheal/methods ; Male ; Middle Aged ; Prone Position/physiology ; Respiratory Distress Syndrome/etiology ; Respiratory Distress Syndrome/physiopathology ; Respiratory Distress Syndrome/therapy ; Respiratory Mechanics/physiology ; Retrospective Studies
Keywords	covid19
Language	English
Publishing date	2020-10-10
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2020.09.042
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19: a retrospective observational cohort study

Weiss, Tyler T / Cerda, Flor / Scott, J Brady / Kaur, Ramandeep / Sungurlu, Sarah / Mirza, Sara H / Alolaiwat, Amnah A / Augustynovich, Ashley E / Li, Jie

Br. j. anaesth

Abstract: BACKGROUND: The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear. METHODS: We conducted a retrospective observational cohort study of critically ill intubated patients ... ...

Abstract	BACKGROUND: The role of repeated prone positioning in intubated subjects with acute respiratory distress syndrome caused by COVID-19 remains unclear. METHODS: We conducted a retrospective observational cohort study of critically ill intubated patients with COVID-19 who were placed in the prone position between March 18, 2020 and March 31, 2020. Exclusion criteria were pregnancy, reintubation, and previous prone positioning at a referring hospital. Patients were followed up until hospital discharge. The primary outcome was oxygenation assessed by partial pressure of oxygen/fraction of inspired oxygen ratio (Pao2/Fio2) ratio. A positive response to proning was defined as an increase in Pao2/Fio2 ratio ≥20%. Treatment failure of prone positioning was defined as death or requirement for extracorporeal membrane oxygenation (ECMO). RESULTS: Forty-two subjects (29 males; age: 59 [52-69] yr) were eligible for analysis. Nine subjects were placed in the prone position only once, with 25 requiring prone positioning on three or more occasions. A total of 31/42 (74%) subjects survived to discharge, with five requiring ECMO; 11/42 (26%) subjects died. After the first prone positioning session, Pao2/Fio2 (mean (standard deviation)) ratio increased from 17.9 kPa (7.2) to 28.2 kPa (12.2) (P<0.01). After the initial prone positioning session, subjects who were discharged from hospital were more likely to have an improvement in Pao2/Fio2 ratio ≥20%, compared with those requiring ECMO or who died. CONCLUSION: Patients with COVID-19 acute respiratory distress syndrome frequently responded to initial prone positioning with improved oxygenation. Subsequent prone positioning in subjects discharged from hospital was associated with greater improvements in oxygenation.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #846631
Database	COVID19

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Article ; Online: Prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID-19

Weiss, Tyler T. / Cerda, Flor / Scott, J. Brady / Kaur, Ramandeep / Sungurlu, Sarah / Mirza, Sara H. / Alolaiwat, Amnah A. / Augustynovich, Ashley E. / Li, Jie

British Journal of Anaesthesia ; ISSN 0007-0912

a retrospective observational cohort study

2020

Keywords	Anesthesiology and Pain Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.bja.2020.09.042
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Multidisciplinary Team-Based Approach to Improve Communication With Surrogates of Patients With Chronic Critical Illness.

Greenberg, Jared A / Gerhart, James / Horst, Jacqueline N / Chen, Elaine / Hunter, Rebecca L / O'Mahony, Sean / Yeow, Mei-Ean / Fosler, Laura / LaGorio, Lisa A / Meksraityte, Edita / Weiss, Tyler T / Nowak, Kristen / Geddes, Jacqueline / Lambe, Stacy S / Fenton, Kara / Shah, Raj C

The American journal of hospice & palliative care

2019 Volume 37, Issue 3, Page(s) 214–221

Abstract: Background: Clinicians need to deliver prognostic information to surrogates of nondecisional, critically ill patients so that surrogates can make informed medical decisions that reflect the patient's values. Our objective was to implement a new approach ...

Abstract	Background: Clinicians need to deliver prognostic information to surrogates of nondecisional, critically ill patients so that surrogates can make informed medical decisions that reflect the patient's values. Our objective was to implement a new approach for communicating with surrogates of patients with chronic critical illness. Methods: Surrogate decision makers of patients who were difficult to liberate from mechanical ventilation were prospectively enrolled. Surrogates met with different members of the intensive care unit treatment team for sequential 15-minute appointments to receive patient-specific assessments and education on chronic critical illness. The feasibility and acceptability of this approach were determined. A 24-question comprehension instrument was developed to assess a participant's understanding that a family member was displaying features of chronic critical illness. Each question was scored from 1 to 5, with larger scores indicating greater comprehension. Results: Over a 15-week period, educational sessions for 9 mechanically ventilated patients were conducted. On average, 2 surrogates per patient (range: 1-4) and 6 members of the interdisciplinary team (range: 4-6) were at each meeting. Surrogates and clinicians had very positive impressions of the communication intervention. The average preintervention comprehension score was 85 of 120 (standard deviation [SD]: 8, range: 71-101). The postintervention comprehension score was greater by 5 points on average (SD: 9, range: -11 to +20 points, Conclusions: Surrogates of critically ill patients approved of this novel communication approach and had a greater understanding of the patient's medical condition after the intervention.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Chicago ; Chronic Disease/therapy ; Communication ; Critical Illness/therapy ; Decision Making ; Family/psychology ; Female ; Humans ; Male ; Middle Aged ; Patient Advocacy/psychology ; Patient Care Team ; Physicians/psychology ; Professional-Family Relations
Language	English
Publishing date	2019-09-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1074344-3
ISSN	1938-2715 ; 1049-9091
ISSN (online)	1938-2715
ISSN	1049-9091
DOI	10.1177/1049909119876606
Database	MEDical Literature Analysis and Retrieval System OnLINE

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