The effect of intermittent inflation of an arm tourniquet (remote ischaemic preconditioning) on patient outcomes after surgery for intra-abdominal cancer (RIPCa)- a pilot study

2021 ◽  
Author(s):  
Kat Papadopoulou ◽  
Matt Dickinson
Keyword(s):  
Pilot Study ◽  
Patient Outcomes ◽  
Ischaemic Preconditioning ◽  
Remote Ischaemic Preconditioning

scholarly journals Seven-day remote ischaemic preconditioning improves endothelial function in patients with type 2 diabetes mellitus: a randomised pilot study

2019 ◽  
Vol 181 (6) ◽  
pp. 659-669
Author(s):  
Joseph D Maxwell ◽  
Howard H Carter ◽  
Ylva Hellsten ◽  
Gemma D Miller ◽  
Victoria S Sprung ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pilot Study ◽  
Endothelial Function ◽  
Sample Size ◽  
Ischaemic Preconditioning ◽  
Cerebrovascular Function ◽  
Remote Ischaemic Preconditioning

Background Remote ischaemic preconditioning (rIPC) may improve cardiac/cerebrovascular outcomes of ischaemic events. Ischaemic damage caused by cardiovascular/cerebrovascular disease are primary causes of mortality in type 2 diabetes mellitus (T2DM). Due to the positive effects from a bout of rIPC within the vasculature, we explored if daily rIPC could improve endothelial and cerebrovascular function. The aim of this pilot study was to obtain estimates for the change in conduit artery and cerebrovascular function following a 7-day rIPC intervention. Methods Twenty-one patients with T2DM were randomly allocated to either 7-day daily upper-arm rIPC (4 × 5 min 220 mmHg, interspaced by 5-min reperfusion) or control. We examined peripheral endothelial function using flow mediated dilation (FMD) before and after ischemia-reperfusion injury (IRI, 20 min forearm ischaemic-20 min reperfusion) and cerebrovascular function, assessed by dynamic cerebral autoregulation (dCA) at three time points; pre, post and 8 days post intervention. Results For exploratory purposes, we performed statistical analysis on our primary comparison (pre-to-post) to provide an estimate of the change in the primary and secondary outcome variables. Using pre-intervention data as a covariate, the change from pre-post in FMD was 1.3% (95% CI: 0.69 to 3.80; P = 0.09) and 0.23 %cm/s %/mmHg mmHg/% (−0.12, 0.59; P = 0.18) in dCA normalised gain with rIPC versus control. Based upon this, a sample size of 20 and 50 for FMD and normalised gain, respectively, in each group would provide 90% power to detect statistically significant (P < 0.05) between-group difference in a randomised controlled trial. Conclusion We provide estimates of sample size for a randomised control trial exploring the impact of daily rIPC for 7 days on peripheral endothelial and cerebrovascular function. The directional changes outline from our pilot study suggest peripheral endothelial function can be enhanced by daily rIPC in patients with T2DM.

InHouse Call: Streamlining Communication to Optimize Efficiency and Patient Care in a Hospital (Preprint)

2021 ◽  
Author(s):  
George Schilling
Keyword(s):  
Pilot Study ◽  
Patient Outcomes ◽  
Economic Burden ◽  
Team Member ◽  
Average Amount ◽  
Traditional Methods ◽  
Poor Patient ◽  
Net Promoter Score ◽  
The Mean ◽  
Net Promoter

BACKGROUND Communication failures disrupt physician workflow, lead to poor patient outcomes, and are associated with significant economic burden. To increase efficiency with contacting a team member in a hospital, we designed an information directory app, InHouse Call. OBJECTIVE To describe the design of InHouse Call, objectively compare the usefulness of the app versus traditional methods (operator or pocket cards, etc.), and determine its subjective usefulness through user surveys and Net Promoter Score (NPS). METHODS Pilot study utilizing Before-After trials. The effectiveness of InHouse Call in connecting the user with a contact in the hospital was measured through timed trials comparing the amount of time spent in attempting to make the connection using traditional methods versus the app. Usability was measured through exit surveys and NPS. RESULTS The average time spent connecting to the correct contact using traditional methods was 59.5 seconds compared to 13.8 seconds when using InHouse Call. The degree of variance when using traditional methods was 1544.2 compared to 19.7 with InHouse Call. A call made using the traditional methods deviated from the mean by 39.3 seconds compared to 4.4 seconds when using InHouse Call. InHouse Call achieved an NPS of 95. CONCLUSIONS InHouse Call significantly reduced the average amount of time spent connecting with the correct contact as well as the variability to complete the task. The app garnered a high NPS and positive subjective feedback.

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