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Omar AS, Labib A, Hanoura SE, Rahal A, Kaddoura R, Chughtai TS, Karic E, Shaikh MS, Hamad WJ, Hassan ME, AlHashemi A, Khatib MY, AlKhulaifi A. Impact of extracorporeal membrane oxygenation service on burnout development in intensive care units. A national cross-sectional study in eight intensive care units. J Cardiothorac Vasc Anesth 2022; 36:2891-2899. [PMID: 35300897 DOI: 10.1053/j.jvca.2022.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 11/11/2022]
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Maksoud M, Omar AS, Sivadasan P, Abdalghafoor T, Rahhal A, Abdalla T, Shoman B, Taha R, AlKhulaifi A. Could Selective Re-look Angiography Improve the Outcome of Cardiogenic Shock in Patients Under Veno-arterial Extracorporeal Membrane Oxygenator? J Cardiovasc Transl Res 2022; 15:268-278. [PMID: 35075606 DOI: 10.1007/s12265-022-10205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
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Omar AS, Hanoura S, Shouman Y, Sivadasan PC, Sudarsanan S, Osman H, Pattath AR, Singh R, AlKhulaifi A. Intensive care outcome of left main stem disease surgery: A single center three years’ experience. World J Crit Care Med 2021; 10:12-21. [PMID: 33505869 PMCID: PMC7805253 DOI: 10.5492/wjccm.v10.i1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Left main coronary artery (LMCA) supplies more than 80% of the left ventricle, and significant disease of this artery carries a high mortality unless intervened surgically. However, the influence of coronary artery bypass grafting (CABG) surgery on patients with LMCA disease on morbidity intensive care unit (ICU) outcomes needs to be explored. However, the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring.
AIM To determine whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome.
METHODS Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG. Patients were divided into 2 groups; those with LMCA disease as group 1 (75 patients) and those without LMCA disease as group 2 (324 patients). We correlated ICU outcome parameters including ICU length of stay, post-operative atrial fibrillation, acute kidney injury, re-exploration, perioperative myocardial infarction, post-operative bleeding in both groups.
RESULTS Patients with LMCA disease had a significantly higher prevalence of diabetes (43.3% vs 29%, P = 0.001). However, we did not find a statistically significant difference with regards to ICU stay, or other morbidity and mortality outcome measures.
CONCLUSION Post-operative performance of Patients with LMCA disease who underwent CABG were comparable to those without LMCA involvement. Diabetes was more prevalent in patients with LMCA disease. These findings may help in guiding decision making for future practice and stratifying the patients’ care.
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Affiliation(s)
- Amr S Omar
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Unit, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Medicine, Weill Cornell Medical College in Qatar, Doha 3050, DA, Qatar
- Department of Critical Care Medicine, Beni Suef University, Beni Suef 62511, Egypt
| | - Samy Hanoura
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Anesthesia, Alazhar University, Cairo 11651, Egypt
| | - Yasser Shouman
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Praveen C Sivadasan
- Department of Cardiothoracic Surgery/Intensive Care Unit Section, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Suraj Sudarsanan
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Hany Osman
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Anesthesia, Alazhar University, Cairo 11651, Egypt
| | - Abdul Rasheed Pattath
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Rajvir Singh
- Department of Medical Research, Hamad Medical Corporation, Doha 3050, DA, Qatar
| | - Abdulaziz AlKhulaifi
- Department of Cardiothoracic Surgery, Hamad Medical Corporation, Doha 3050, DA, Qatar
- Department of Cardiothoracic Surgery, Qatar University, Doha 3050, DA, Qatar
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Omar AS, Sudarsanan S, AlKhulaifi A. Unusual bronchoscopic value in percutaneous dilatational tracheostomy: A case report. World J Anesthesiol 2020; 9:3-6. [DOI: 10.5313/wja.v9.i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The usage of bronchoscopy during percutaneous dilatational tracheostomy remains under debate. The proponents of bronchoscopy advocating safety of the procedure, whereas the critics raising the concerns about the cost, possible delay in the procedure, and waiting for the device.
CASE SUMMARY We are highlighting a case of percutaneous dilatational tracheostomy where bronchoscopy aided in diagnosing a rare situation of wire entrapment within the endotracheal tube, treated by withdrawing the wire from the endotracheal tube with good outcome.
CONCLUSION The bronchoscopy guided approach permitted early diagnosis and helped to end the procedure without complication or possible major surgery in a case of accidental wire puncture of the endotracheal tube.
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Affiliation(s)
- Amr Salah Omar
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and Intensive Care Units, Hamad Medical Corporation, Doha 3050, Qatar
| | - Suraj Sudarsanan
- Cardiothoracic surgery, Hamad medical corporation, Doha 3050, Qatar
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Omar AS, AlKhulaifi A. Rhythm control for post-operative atrial fibrillation. Still a promising future? J Atr Fibrillation 2017; 9:1529. [PMID: 29250286 DOI: 10.4022/jafib.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 02/11/2017] [Accepted: 03/14/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Amr S Omar
- Department of Cardiothoracic Surgery/ ICU Section,Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar.,Department of Cardiothoracic Surgery/ ICU Section,Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar.,Department of Cardiothoracic Surgery/ ICU Section,Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar
| | - Abdulaziz AlKhulaifi
- Department of Cardiothoracic Surgery/ ICU Section,Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar
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Omar AS, Mahmoud K, Hanoura S, Osman H, Sivadasan P, Sudarsanan S, Shouman Y, Singh R, AlKhulaifi A. Acute kidney injury induces high-sensitivity troponin measurement changes after cardiac surgery. BMC Anesthesiol 2017; 17:15. [PMID: 28143401 PMCID: PMC5282923 DOI: 10.1186/s12871-017-0307-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 01/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS Single center observational retrospective study. Based on the AKI Network, patients divided into 2 groups, group I without AKI (259 patients) and group II with AKI (100 patients) where serial testing of hsTnT and creatine kinase (CK)-MB were followed in both groups. Patients with (ESRD) were excluded. RESULTS The mean age in our study was 55.1 ± 10.2 years. High association of AKI (27.8%) was found in our patients. Both groups were matched regarding the age, gender, body mass index, the association of diabetes or hypertension, and Euro score. AKI group had significantly higher mortality 5% vs group I 1.1% (p = 0.03). The hsTnt showed a significant sustained rise in the AKI group as compared to the non-AKI group, however CK-MB changes were significant initially but not sustained. The AKI group was more associated with heart failure 17.9% vs 4.9% (p = 0.001); and post-operative atrial fibrillation, 12.4% vs 2.9% (p = 0.005). Lengths of ventilation, stays in ICU and in hospital were significantly higher in the AKI group. CONCLUSIONS Unlike the CK-MB profile, the hsTnT showed significant changes between both groups all over the course denoting possible delayed clearance in patients with AKI.
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Affiliation(s)
- Amr S Omar
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar. .,Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt. .,Weill Cornell Medical College-Qatar, Doha, Qatar.
| | - Khaled Mahmoud
- Weill Cornell Medical College-Qatar, Doha, Qatar.,Department of Nephrology, Hamad Medical Corporation, Doha, PO 3050, Qatar.,Department of Nephrology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samy Hanoura
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar.,Weill Cornell Medical College-Qatar, Doha, Qatar.,Department of Anesthesia, Al-Azhar University, Cairo, Egypt
| | - Hany Osman
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar.,Department of Anesthesia, Al-Azhar University, Cairo, Egypt
| | - Praveen Sivadasan
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar
| | - Suraj Sudarsanan
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar
| | - Yasser Shouman
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar
| | - Rajvir Singh
- Department of Cardiology Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Abdulaziz AlKhulaifi
- Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, PO 3050, Qatar
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Omar AS, Ewila H, Allam M, Aboulnagah S, Hanoura S, Sivadasan PC, Bilal O, Pattath ARA, AlKhulaifi A. Improving Incidence of Postoperative Atrial Fibrillation After Cardiac Surgery Using Simplified Clinical Practice Guidelines. J Intensive Care Med 2016; 33:481-485. [PMID: 27932513 DOI: 10.1177/0885066616679622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Postoperative atrial fibrillation (POAF) remains a major risk after cardiac surgery. Twelve percent patients admitted to this unit postcardiac surgery experienced POAF, which led to hemodynamic instability, increased risk of stroke, and increased length of postoperative intensive care unit stay. Our aim was to decrease the incidence of POAF in the cardiothoracic intensive care unit by the end of April 2014. METHODS Design-Retrospective data analysis. Settings-Postcardiac surgery intensive care in a tertiary hospital. PARTICIPANTS Postcardiac surgery patients. Intervention-A clinical practice guideline (CPG) was developed to promote early prevention and to improve adherence to POAF prophylaxis recommendations. Patient's charts were our key performance indicator. Primary outcome measure-Percentage of patients who developed episodes of POAF within the first 24 hours of cardiac surgery. Process measures-compliance with the newly developed CPG and early postoperative patient assessment. Balance measure-early administration of β-blocker. RESULTS We were able to decrease POAF to 8% after intervention. Compliance with early assessment improved from 25% to 87%. Compliance with adherence to the CPG was 80%. Adherence to the newly developed paper form was the major challenge that could be overcome by an electronic form. We hope to decrease the incidence of POAF to 6% and develop an electronic form by the end of December 2014. CONCLUSION This quality improvement project changed the strategy and succeeded in decreasing the incidence of POAF after cardiac surgery. It also improved early assessment of risk factors.
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Affiliation(s)
- Amr S Omar
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.,2 Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt.,3 Weill Cornell Medical College-Qatar, Doha, Qatar
| | - Hesham Ewila
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.,4 Department of Anesthesia, Suez Canal University, Ismailia, Egypt
| | - Mahmoud Allam
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.,5 Department of Anesthesia, Al-Azhar University, Cairo, Egypt
| | - Sameh Aboulnagah
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.,6 Department of Anesthesia, Ain Shams University, Cairo, Egypt
| | - Samy Hanoura
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.,3 Weill Cornell Medical College-Qatar, Doha, Qatar.,5 Department of Anesthesia, Al-Azhar University, Cairo, Egypt
| | - Praveen C Sivadasan
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ousama Bilal
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdul Rasheed A Pattath
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdulaziz AlKhulaifi
- 1 Department of Cardiothoracic Surgery/Cardiac Anaesthesia and ICU, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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Abstract
Despite the progress in medical therapy, advanced heart failure (AHF) remains a global epidemic with high morbidity and mortality. Novel cardiac support strategies such as pharmacologic agents, mechanical circulatory support (MCS), and cell- or matrix-based therapies are promising for these patients. The indications, types, and timing of MCS implantation depend to a large extent on the presentation, clinical status of the patient, underlying etiology, and long-term prospects. The presence or absence of end-organ damage has a significant impact on prognosis following MCS initiation. Although many patients with acute AHF may have end-organ damage, their prospect of recovery, once appropriate therapy is instituted, is better than for patients who had AHF for longer periods of time. We consider the multidisciplinary approaches used for the management of AHF and the novel cardiac support strategies (eg, MCS). Appropriate selection of patient, device, time, and end point is essential for better outcomes.
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Affiliation(s)
- Ayman El-Menyar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
- Clinical Research, Hamad General Hospital, Doha, Qatar
- Cardiology Unit, Internal Medicine, Ahmed Maher Teaching Hospital, Cairo, Egypt
| | - Cornelia Carr
- Cardiothoracic Surgery, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
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