scholarly journals Pediatric Chronic Critical Illness: Protocol for a Scoping Review

10.2196/30582 ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. e30582
Author(s):  
David Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Scoping Review ◽  
Clinical Characteristics ◽  
Case Definition ◽  
Critically Ill Children ◽  
Data Abstraction ◽  
Chronic Critical Illness ◽  
Scoping Reviews ◽  
Citation Screening

Background Improvements in the delivery of intensive care have increased survival among even the most critically ill children, thereby leading to a growing number of children with chronic complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at a significant risk of recurrent and prolonged critical illness, with higher morbidity and mortality, making them a unique population described as having chronic critical illness (CCI). To date, pediatric CCI has been understudied and lacks an accepted consensus case definition. Objective This study aims to describe the protocol and methodology used to perform a scoping review that will describe how pediatric CCI has been defined in the literature, including the concept of prolonged PICU admission and the methodologies used to develop any existing definitions. It also aims to describe patient characteristics and outcomes evaluated in the included studies. Methods We will search four electronic databases for studies that evaluated children admitted to any PICU identified with CCI. We will also search for studies describing prolonged PICU admission, as this concept is related to pediatric CCI. Furthermore, we will develop a hybrid crowdsourcing and machine learning (ML) methodology to complete citation screening. Screening and data abstraction will be performed by 2 reviewers independently and in duplicate. Data abstraction will include the details of population definitions, demographic and clinical characteristics of children with CCI, and evaluated outcomes. Results The database search, crowd reviewer recruitment, and ML algorithm development began in March 2021. Citation screening and data abstraction were completed in April 2021. Final data verification is ongoing, with analysis and results anticipated to be completed by fall 2021. Conclusions This scoping review will describe the existing or suggested definitions of pediatric CCI and important demographic and clinical characteristics of patients to whom these definitions have been applied. This review’s results will help inform the development of a consensus case definition for pediatric CCI and set a priority agenda for future research. We will use and demonstrate the validity of crowdsourcing and ML methodologies for improving the efficiency of large scoping reviews. International Registered Report Identifier (IRRID) DERR1-10.2196/30582

scholarly journals Pediatric Chronic Critical Illness: Protocol for a Scoping Review (Preprint)

2021 ◽  
Author(s):  
David Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Scoping Review ◽  
Clinical Characteristics ◽  
Case Definition ◽  
Critically Ill Children ◽  
Data Abstraction ◽  
Chronic Critical Illness ◽  
Scoping Reviews ◽  
Citation Screening

BACKGROUND Improvements in the delivery of intensive care have increased survival among even the most critically ill children, thereby leading to a growing number of children with chronic complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at a significant risk of recurrent and prolonged critical illness, with higher morbidity and mortality, making them a unique population described as having chronic critical illness (CCI). To date, pediatric CCI has been understudied and lacks an accepted consensus case definition. OBJECTIVE This study aims to describe the protocol and methodology used to perform a scoping review that will describe how pediatric CCI has been defined in the literature, including the concept of prolonged PICU admission and the methodologies used to develop any existing definitions. It also aims to describe patient characteristics and outcomes evaluated in the included studies. METHODS We will search four electronic databases for studies that evaluated children admitted to any PICU identified with CCI. We will also search for studies describing prolonged PICU admission, as this concept is related to pediatric CCI. Furthermore, we will develop a hybrid crowdsourcing and machine learning (ML) methodology to complete citation screening. Screening and data abstraction will be performed by 2 reviewers independently and in duplicate. Data abstraction will include the details of population definitions, demographic and clinical characteristics of children with CCI, and evaluated outcomes. RESULTS The database search, crowd reviewer recruitment, and ML algorithm development began in March 2021. Citation screening and data abstraction were completed in April 2021. Final data verification is ongoing, with analysis and results anticipated to be completed by fall 2021. CONCLUSIONS This scoping review will describe the existing or suggested definitions of pediatric CCI and important demographic and clinical characteristics of patients to whom these definitions have been applied. This review’s results will help inform the development of a consensus case definition for pediatric CCI and set a priority agenda for future research. We will use and demonstrate the validity of crowdsourcing and ML methodologies for improving the efficiency of large scoping reviews. CLINICALTRIAL INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30582

scholarly journals Pediatric Chronic Critical Illness: A Protocol for a Scoping Review

2021 ◽  
Author(s):  
David J Zorko ◽  
James Dayre McNally ◽  
Bram Rochwerg ◽  
Neethi Pinto ◽  
Rachel Couban ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Scoping Review ◽  
Significant Risk ◽  
Pediatric Intensive Care ◽  
Case Definition ◽  
Future Research ◽  
High Risk Population ◽  
Working Definition ◽  
Chronic Critical Illness

Due to improvements in the delivery of intensive care, survival of even the most critically ill of children has increased, leading to a growing proportion of children with chronic and/or complex medical conditions in the pediatric intensive care unit (PICU). Some of these children are at significant risk of recurrent critical illness and persistent long-term morbidity, and become ‘superusers’ of PICU resources. These children are increasingly recognized as a unique high-risk population in the PICU referred to as children with chronic critical illness (CCI). To date, this population has been understudied, in part due to pediatric CCI being a novel concept without an accepted definition to consistently identify these children. This scoping review is the first step in the development of a consensus case definition for pediatric CCI. This comprehensive literature review will seek to first evaluate existing or suggested definitions of pediatric CCI, and in their absence, identify key terms and constructs to inform the development of a working definition of pediatric CCI for future research.

scholarly journals Antimicrobial Use in COVID-19 Patients in the First Phase of the SARS-CoV-2 Pandemic: A Scoping Review

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 745
Author(s):  
Wenjuan Cong ◽  
Ak Narayan Poudel ◽  
Nour Alhusein ◽  
Hexing Wang ◽  
Guiqing Yao ◽  
...  
Keyword(s):  
Critical Illness ◽  
Scoping Review ◽  
Clinical Evidence ◽  
Length Of Hospital Stay ◽  
Severity Of Illness ◽  
Antibiotic Prescribing ◽  
Antimicrobial Use ◽  
Clinical Scenarios ◽  
Scoping Reviews ◽  
The Impact

This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9.5% vs. 13.1%), higher discharge rates (80.9% vs. 69.3%), and shorter length of hospital stay (9.3 days vs. 12.2 days). In the first 6 months of the pandemic, antibiotics were prescribed for COVID-19 patients regardless of severity of illness. A large proportion of antibiotic prescribing for mild and moderate COVID-19 patients did not have clinical evidence of a bacterial co-infection. Antibiotics may not be beneficial to COVID-19 patients without clinical evidence of a bacterial co-infection.

scholarly journals Persistent inflammation, immunosuppression and catabolism syndrome: mechanisms of sarcopenia and ways of correction

2021 ◽  
Vol 16 (7-8) ◽  
pp. 110-117
Author(s):  
S.M. Chuklin ◽  
S.S. Chuklin ◽  
G.V. Shershen
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Necrotizing Pancreatitis ◽  
Clinical Manifestations ◽  
Severe Trauma ◽  
Significant Loss ◽  
Mild Degree ◽  
Persistent Inflammation ◽  
Chronic Critical Illness ◽  
Severe Pathology

Due to advances in intensive care, many patients with severe pathology are discharged from intensive care units. However, prolonged mild degree inflammation persists in some patients, recovery is protracted, and chronic critical illness develops in them. In addition, persistent inflammation, immunosuppression and catabolism arise. In 2012, this condition was identified as a separate syndrome, which can be observed after severe trauma and burns, sepsis, necrotizing pancreatitis. Significant loss of muscle mass that is difficult to correct is one of the leading clinical manifestations in this case. Using literature from the MEDLINE database, modern ideas about the mechanisms of sarcopenia in the persistent inflammation, immunosuppression and catabolism syndrome and possible ways of optimal anabolic support are described.

Pediatric Chronic Critical Illness, Prolonged ICU Admissions, and Clinician Distress

2021 ◽  
Author(s):  
Alison H. Miles ◽  
Cynda H. Rushton ◽  
Brian M. Wise ◽  
Aka Moore ◽  
Renee D. Boss
Keyword(s):  
Intensive Care Unit ◽  
Content Analysis ◽  
Intensive Care ◽  
Critical Illness ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Goals Of Care ◽  
Chronic Critical Illness ◽  
Conventional Content Analysis ◽  
Clinical Interactions

AbstractTo gain an in-depth understanding of the experience of pediatric intensive care unit (PICU) clinicians caring for children with chronic critical illness (CCI), we conducted, audiotaped, and transcribed in-person interviews with PICU clinicians. We used purposive sampling to identify five PICU patients who died following long admissions, whose care generated substantial staff distress. We recruited four to six interdisciplinary clinicians per patient who had frequent clinical interactions with the patient/family for interviews. Conventional content analysis was applied to the transcripts resulting in the emergence of five themes: nonbeneficial treatment; who is driving care? Elusive goals of care, compromised personhood, and suffering. Interventions directed at increasing consensus, clarifying goals of care, developing systems allowing children with CCI to be cared for outside of the ICU, and improving communication may help to ameliorate this distress.

scholarly journals Prediction of chronic critical illness in a general intensive care unit

2013 ◽  
Vol 59 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Sérgio H. Loss ◽  
Cláudia B. Marchese ◽  
Márcio M. Boniatti ◽  
Iuri C. Wawrzeniak ◽  
Roselaine P. Oliveira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
General Intensive Care Unit ◽  
Chronic Critical Illness

scholarly journals Telemedicine in Intensive Care Units: Protocol for a Scoping Review (Preprint)

2020 ◽  
Author(s):  
Camille Guinemer ◽  
Martin Boeker ◽  
Bjoern Weiss ◽  
Daniel Fuerstenau ◽  
Felix Balzer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Care Delivery ◽  
Management Tool ◽  
Future Research ◽  
Extensive Literature ◽  
Hospital Organization ◽  
Scoping Reviews ◽  
Implementation Context

BACKGROUND Telemedicine has been deployed to address issues in intensive care delivery, as well as to improve outcome and quality of care. Implementation of this technology has been characterized by high variability. Tele-intensive care unit (ICU) interventions involve the combination of multiple technological and organizational components, as well as interconnections of key stakeholders inside the hospital organization. The extensive literature on the benefits of tele-ICUs has been characterized as heterogeneous. On one hand, positive clinical and economical outcomes have been shown in multiple studies. On the other hand, no tangible benefits could be detected in several cases. This could be due to the diverse forms of organizations and the fact that tele-ICU interventions are complex to evaluate. The implementation context of tele-ICUs has been shown to play an important role in the success of the technology. The benefits derived from tele-ICUs depend on the organization where it is deployed and how the telemedicine systems are applied. There is therefore value in analyzing the benefits of tele-ICUs in relation to the characteristics of the organization where it is deployed. To date, research on the topic has not provided a comprehensive overview of literature taking both the technology setup and implementation context into account. OBJECTIVE We present a protocol for a scoping review of the literature on telemedicine in the ICU and its benefits in intensive care. The purpose of this review is to map out evidence about telemedicine in critical care in light of the implementation context. This review could represent a valuable contribution to support the development of tele-ICU technologies and offer perspectives on possible configurations, based on the implementation context and use case. METHODS We have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist and the recommendations of the Joanna Briggs Institute methodology for scoping reviews. The scoping review and subsequent systematic review will be completed by spring 2021. RESULTS The preliminary search has been conducted. After removing all duplicates, we found 2530 results. The review can now be advanced to the next steps of the methodology, including literature database queries with appropriate keywords, retrieval of the results in a reference management tool, and screening of titles and abstracts. CONCLUSIONS The results of the search indicate that there is sufficient literature to complete the scoping review. Upon completion, the scoping review will provide a map of existing evidence on tele-ICU systems given the implementation context. Findings of this research could be used by researchers, clinicians, and implementation teams as they determine the appropriate setup of new or existing tele-ICU systems. The need for future research contributions and systematic reviews will be identified. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19695

Continuous infusion ketamine as analgesia or sedation in mechanically ventilated adults in the intensive care unit: a scoping review

2021 ◽  
Author(s):  
Nicholas David Richards ◽  
Simon Howell ◽  
Mark Bellamy ◽  
Ruben Mujica-Mota
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Scoping Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Flow Diagram ◽  
Mechanically Ventilated ◽  
Scoping Reviews ◽  
Review Protocol

Abstract IntroductionMechanical ventilation (MV) is a common and often live-saving intervention on the Intensive Care Unit (ICU). In order to facilitate this intervention, the majority of patients require medical sedation. Optimising sedation is one of the fundamentals of ICU care, and inadequate sedation (predominantly too deep) has consistently been associated with worse outcomes for patients.This article presents the protocol for a scoping review of published literature on the use of ketamine as a sedative to facilitate MV on ICU.The scoping review has been designed to answer the question ‘What is known about the use of ketamine as a continuous infusion to provide sedation in mechanically ventilated adults in the intensive care unit, and what gaps in the evidence exist?’ MethodsThe scoping review protocol has been designed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR) checklist and the JBI manual for evidence synthesis. Data will be extracted using a dedicated form, and reviewed by 2 reviewers.Results Results will be tabulated and presented along side descriptive summaries. A PRISMA flow diagram will also be generated.Ethics and DisseminationThis scoping review is designed to map out the literature using existing published articles and does not require ethical approval.Results will be submitted for publication in relevant peer-reviewed journals and to international meetings as well as disseminated to relevant professional groups.

Sign in / Sign up

Export Citation Format

Share Document