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14 results on '"Jinah, Rehman"'

2. qSOFA does not predict bacteremia in patients with severe manifestations of sepsis

Author

Cheng, Matthew P, Paquette, Katryn, Lawandi, Alexander, Stabler, Sarah N, Akhter, Murtaza, Davidson, Adam C, Gavric, Marko, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Sangsari, Sassan, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Rush, Barret, Wong, Titus, Stenstrom, Robert, Sweet, David, and Yansouni, Cedric P

Subjects
Microbiology (medical), Infectious Diseases, Brief Report
Abstract

BACKGROUND: Bloodstream infections in septic patients may be missed due to preceding antibiotic therapy prior to obtaining blood cultures. We leveraged the FABLED cohort study to determine if the quick Sequential Organ Failure Assessment (qSOFA) score could reliably identify patients at higher risk of bacteremia in patients who may have false negative blood cultures due to previously administered antibiotic therapy. METHODS: We conducted a multi-centre diagnostic study among adult patients with severe manifestations of sepsis. Patients were enrolled in one of seven participating centres between November 2013 and September 2018. All patients from the FABLED cohort had two sets of blood cultures drawn prior to the administration of antimicrobial therapy, as well as additional blood cultures within 4 hours of treatment initiation. Participants were categorized according to qSOFA score, with a score ≥2 being considered positive. RESULTS: Among 325 patients with severe manifestations of sepsis, a positive qSOFA score (defined as a score ≥2) on admission was 58% sensitive (95% CI 48% to 67%) and 41% specific (95% CI 34% to 48%) for predicting bacteremia. Among patients with negative post-antimicrobial blood cultures, a positive qSOFA score was 57% sensitive (95% CI 42% to 70%) and 42% specific (95% CI 35% to 49%) to detect patients who were originally bacteremic prior to the initiation of therapy. CONCLUSIONS: Our results suggest that the qSOFA score cannot be used to identify patients at risk for occult bacteremia due to the administration of antibiotics pre-blood culture.

Published
2022
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4. New onset atrial fibrillation after TAVR

Author

Ryan, Tammy, Vadakken, Maria, McIntyre, William, Jinah, Rehman, Grindal, Alexander, Healey, Jeff, Belley-Côté, Emilie, and Jaffer, Iqbal

Subjects
Medicine and Health Sciences
Abstract

New-onset atrial fibrillation (NOAF) is a common complication after transcatheter aortic vlave implantation (TAVR). The reported incidence of NOAF after TAVR is varied and the associated outcomes and risk factors are not fully understood. We plant to complete a systematic review of NOAF after TAVR, including an analysis of associated patient outcomes and risk factors.

Published
2022
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7. Helmet noninvasive ventilation compared to facemask noninvasive ventilation and high-flow nasal cannula in acute respiratory failure: a systematic review and meta-analysis

Author

Chaudhuri, Dipayan, primary, Jinah, Rehman, additional, Burns, Karen E.A., additional, Angriman, Federico, additional, Ferreyro, Bruno L., additional, Munshi, Laveena, additional, Goligher, Ewan, additional, Scales, Damon, additional, Cook, Deborah J., additional, Mauri, Tommaso, additional, and Rochwerg, Bram, additional

Published
2021
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8. Neither Blood Culture Positivity nor Time to Positivity Is Associated With Mortality Among Patients Presenting With Severe Manifestations of Sepsis: The FABLED Cohort Study

Author

Paquette, Katryn, primary, Sweet, David, additional, Stenstrom, Robert, additional, Stabler, Sarah N, additional, Lawandi, Alexander, additional, Akhter, Murtaza, additional, Davidson, Adam C, additional, Gavric, Marko, additional, Jinah, Rehman, additional, Saeed, Zahid, additional, Demir, Koray, additional, Sangsari, Sassan, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Wong, Titus, additional, Yansouni, Cedric P, additional, and Cheng, Matthew P, additional

Published
2021
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10. Real-world Time to Positivity of 2 Widely Used Commercial Blood Culture Systems in Patients With Severe Manifestations of Sepsis: An Analysis of the FABLED Study

Author

Butler-Laporte, Guillaume, primary, Yansouni, Cedric P, additional, Paquette, Katryn, additional, Lawandi, Alexander, additional, Stabler, Sarah N, additional, Akhter, Murtaza, additional, Davidson, Adam C, additional, Gavric, Marko, additional, Jinah, Rehman, additional, Saeed, Zahid, additional, Demir, Koray, additional, Sangsari, Sassan, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Wong, Titus, additional, Lee, Todd C, additional, Stenstrom, Robert, additional, Sweet, David, additional, and Cheng, Matthew P, additional

Published
2020
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11. 847. The Effect of Antimicrobial Administration on Blood Culture Positivity in Patients with Severe Manifestations of Sepsis

Author

Cheng, Matthew P, primary, Stenstrom, Robert, additional, Paquette, Katryn, additional, Stabler, Sarah, additional, Akhter, Murtaza, additional, Davidson, Adam, additional, Gavric, Marko, additional, Lawandi, Alexander, additional, Jinah, Rehman, additional, Saheed, Zahid, additional, Demir, Koray, additional, Huang, Kelly, additional, Mahpour, Amirali, additional, Shamatutu, Chris, additional, Caya, Chelsea, additional, Troquet, Jean-Marc, additional, Clark, Greg, additional, Yansouni, Cedric, additional, and Sweet, David, additional

Published
2019
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12. Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis A Diagnostic Study

Author

Cheng, Matthew P., Stenstrom, Robert, Paquette, Katryn, Stabler, Sarah N., Akhter, Murtaza, Davidson, Adam C., Gavric, Marko, Lawandi, Alexander, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Yansouni, Cedric P., Sweet, David, Davidson, Adam, Yansouni, Cedric, Ryan, Emily, Kadatz, Matthew J., Sekhon, Myphinder, Sangsari, Sassan, Osati, Farzaneh, Cheng, Matthew P., Stenstrom, Robert, Paquette, Katryn, Stabler, Sarah N., Akhter, Murtaza, Davidson, Adam C., Gavric, Marko, Lawandi, Alexander, Jinah, Rehman, Saeed, Zahid, Demir, Koray, Huang, Kelly, Mahpour, Amirali, Shamatutu, Chris, Caya, Chelsea, Troquet, Jean-Marc, Clark, Greg, Yansouni, Cedric P., Sweet, David, Davidson, Adam, Yansouni, Cedric, Ryan, Emily, Kadatz, Matthew J., Sekhon, Myphinder, Sangsari, Sassan, and Osati, Farzaneh

Abstract

Background: Administering antimicrobial agents before obtaining blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear how this strategy affects diagnostic sensitivity. Objective: To determine the sensitivity of blood cultures obtained shortly after initiation of antimicrobial therapy in patients with severe manifestations of sepsis. Design: Patient-level, single-group, diagnostic study. (Clinical Trials.gov: NCT01867905) Setting: 7 emergency departments in North America. Participants: Adults with severe manifestations of sepsis, including systolic blood pressure less than 90 mm Hg or a serum lactate level of 4 mmol/L or more. Intervention: Blood cultures were obtained before and within 120 minutes after initiation of antimicrobial treatment. Measurements: Sensitivity of blood cultures obtained after initiation of antimicrobial therapy. Results: Of 3164 participants screened, 325 were included in the study (mean age, 65.6 years; 62.8% men) and had repeated blood cultures drawn after initiation of antimicrobial therapy (median time, 70 minutes [interquartile range, 50 to 110 minutes]). Preantimicrobial blood cultures were positive for 1 or more microbial pathogens in 102 of 325 (31.4%) patients. Post-antimicrobial blood cultures were positive for 1 or more microbial pathogens in 63 of 325 (19.4%) patients. The absolute difference in the proportion of positive blood cultures between pre- and postantimicrobial testing was 12.0% (95% CI, 5.4% to 18.6%; P < 0.001). Sensitivity of postantimicrobial culture was 52.9% (CI, 42.8% to 62.9%). When the results of other microbiological cultures were included, microbial pathogens were found in 69 of 102 (67.6% [CI, 57.7% to 76.6%]) patients. Limitation: Only a proportion of screened patients were recruited. Conclusion: Among patients with severe manifestations of sepsis, initiation of empirical antimicrobial therapy significantly reduces the sensitivity of blood cultures drawn shortly

Published
2019

13. The Usefulness of the Rapid Shallow Breathing Index in Predicting Successful Extubation

Author

Trivedi, Vatsal, Chaudhuri, Dipayan, Jinah, Rehman, Piticaru, Joshua, Agarwal, Arnav, Liu, Kuan, McArthur, Eric, Sklar, Michael C., Friedrich, Jan O., Rochwerg, Bram, and Burns, Karen E.A.

Abstract

Clinicians use several measures to ascertain whether individual patients will tolerate liberation from mechanical ventilation, including the rapid shallow breathing index (RSBI).

Published
2021
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14. Helmet noninvasive ventilation compared to facemask noninvasive ventilation and high-flow nasal cannula in acute respiratory failure: a systematic review and meta-analysis.

Author

Chaudhuri D, Jinah R, Burns KEA, Angriman F, Ferreyro BL, Munshi L, Goligher E, Scales D, Cook DJ, Mauri T, and Rochwerg B

Subjects
Cannula, Head Protective Devices, Humans, Oxygen Inhalation Therapy, Noninvasive Ventilation, Respiratory Distress Syndrome, Respiratory Insufficiency therapy
Abstract

Background: Although small randomised controlled trials (RCTs) and observational studies have examined helmet noninvasive ventilation (NIV), uncertainty remains regarding its role. We conducted a systematic review and meta-analysis to examine the effect of helmet NIV compared to facemask NIV or high-flow nasal cannula (HFNC) in acute respiratory failure., Methods: We searched multiple databases to identify RCTs and observational studies reporting on at least one of mortality, intubation, intensive care unit (ICU) length of stay, NIV duration, complications or comfort with NIV therapy. We assessed study risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the Ottawa-Newcastle Scale for observational studies, and rated certainty of pooled evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) framework., Results: We separately pooled data from 16 RCTs (n=949) and eight observational studies (n=396). Compared to facemask NIV, based on low certainty of evidence, helmet NIV may reduce mortality (relative risk 0.56, 95% CI 0.33-0.95) and intubation (relative risk 0.35, 95% CI 0.22-0.56) in both hypoxic and hypercapnic respiratory failure, but may have no effect on duration of NIV. There was an uncertain effect of helmet NIV on ICU length of stay and development of pressure sores. Data from observational studies were consistent with the foregoing findings but of lower certainty. Based on low and very low certainty data, helmet NIV may reduce intubation compared to HFNC, but its effect on mortality is uncertain., Conclusions: Compared to facemask NIV, helmet NIV may reduce mortality and intubation; however, the effect of helmet NIV compared to HFNC remains uncertain., Competing Interests: Conflict of interest: D. Chaudhuri has nothing to disclose. Conflict of interest: R. Jinah has nothing to disclose. Conflict of interest: K.E.A. Burns has nothing to disclose. Conflict of interest: F. Angriman has nothing to disclose. Conflict of interest: B.L. Ferreyro is supported by a Vanier Canada Graduate Scholarship. Conflict of interest: L. Munshi has nothing to disclose. Conflict of interest: E. Goligher has nothing to disclose. Conflict of interest: D. Scales has nothing to disclose. Conflict of interest: D.J. Cook has nothing to disclose. Conflict of interest: T. Mauri received personal fees from Drager, Fisher & Paykel and BBraun, all outside of the submitted work. Conflict of interest: B. Rochwerg has nothing to disclose., (Copyright ©The authors 2022. For reproduction rights and permissions contact permissions@ersnet.org.)

Published
2022
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