2022 – Logic

2022-09-14by logicPublications

Worldwide Clinical Intensive Care Registries Response To The Pandemic: An International Survey

Dave A Dongelmans¹, Amanda Quintairos², Eirik Alnes Buanes³, Diptesh Aryal⁴, Sean Bagshaw⁵, Stepani Bendel⁶, Joe Bonney⁷, Gaston Burghi⁸, Eddy Fan⁹, Bertrand Guidet¹⁰, Rashan Haniffa¹¹, Madiha Hashimi¹², Satoru Hashimoto¹³, Nao Ichihara¹⁴, Bharath Kumar Tirupakuzhi Vijayaraghavan¹⁵, Nazir Lone¹⁶, Maria Del Pilar Arias Lopez¹⁷, Mohd Zulfakar Mazlam¹⁸, Hiroshi Okamoto¹⁹, Andreas Perren²⁰, Kathy Rowan²¹, Martin Sigurdsson²², Wangari Silka²³, Marcio Soares²⁴, Grazielle Viana²⁵, David Pilcher²⁶, Abigail Beane²⁷, Jorge I F Salluh²⁴

No abstract available

Conflict Of Interest Statement

Declaration of Competing Interest Drs Salluh and Soares are co-founders and shareholders of Epimed Solutions, a cloud-based analytics company. Dr. D.A. Dongelmans is unpaid chair of NICE foundation. The other authors declare that they have no conflicts of interest.

Brazilian ICUs project http://www.utisbrasileiras.com.br/uti-adulto/caracteristicas-das-utis-pa… Available from. (accessed on March 20th, 2022)
Estenssoro E., Loudet C.I., Ríos F.G., Kanoore Edul V.S., Plotnikow G., Andrian M., et al. Dubin a; SATI-COVID-19 study group. Clinical characteristics and outcomes of invasively ventilated patients with COVID-19 in Argentina (SATICOVID): a prospective, multicentre cohort study. Lancet Respir Med. 2021 Sep;9(9):989–998. – PMC – PubMed
CRIT Care Asia, Hashmi M., Beane A., Murthy S., Dondorp A.M., Haniffa R. Leveraging a cloud-based critical care registry for COVID-19 pandemic surveillance and research in low- and middle-income countries. JMIR Public Health Surveill. 2020 Nov 23;6(4) e21939. – PMC – PubMed
https://www.icubenchmarking.com/#wowheare (accessed on March 20th, 2022)
Aryal D., Beane A., Dondorp A.M., Green C., Haniffa R., Hashmi M., et al. Operationalisation of the Randomized Embedded Multifactorial Adaptive Platform for COVID-19 trials in a low and lower-middle income critical care learning health system. Wellcome Open Res. 2021 Jan 28;6:14. – PMC – PubMed

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2022-09-14by logicPublications

Learning Systems As A Path To Improve ICU Staff Wellbeing

Joanne McPeake¹, Theodore J Iwashyna², Jorge I F Salluh³

References

Endacott R., Pearce S., Rae P., et al. How COVID-19 has affected staffing models in intensive care: a qualitative study examining alternative staffing models (SEISMIC) J Adv Nurs. 2022;78(4):1075–1088. – PubMed
Azoulay E., Pochard F., Reignier J., et al. Symptoms of mental health disorders in critical care physicians facing the second COVID-19 wave: a cross sectional study. Chest. 2021;160(3):944–955. – PMC – PubMed
Lone N., McPeake J., Stewart N.I., et al. Influences of socioeconomic deprivation on interventions and outcomes for patients admitted with COVID-19 to critical care unit in Scotland: a national cohort study. Lancet Reg Health Eur. 2021;1:100005. – PMC – PubMed
Lobo S.M., Creutzfeldt C.J., Maia I.S., et al. Perceptions of critical care shortages, resource use and provider well-being during the COVID-19 pandemic: a survey of 1,985 health care providers in Brazil. Chest. 2022;161(6):1526–1542. – PMC – PubMed
Kerlin M.P., McPeake J., Mikkelsen M.E. Burnout and joy in the profession of critical care medicine. Crit Care. 2020;24:98. – PMC – PubMed

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2022-02-04by logicNews

Get To Know LOGIC: The World’s Largest Intensive Care Benchmarking Platform

LOGIC (Linking of Global Intensive Care) is an independent consortium of databases of large ICU networks and national records of quality in intensive care medicine. LOGIC aims to connect ICUs to promote quality improvement through international benchmarking and collaborative research, assisting in data-driven decision-making.

The project brings together some of the largest national records databases in the world. Through a shared online platform, researchers and ICU networks have easy access to aggregated data on ICU admissions worldwide, and to information updated annually.

LOGIC’s international benchmarking is a powerful assessment tool in intensive care and quality improvement, where all users of participating networks can compare the performance of ICUs and thus, increase epidemiology and outcome knowledge.

Logic is currently present in more than 13 countries, such as Brazil, Uruguay, The Netherlands, India, Australia, France, among others, with more than 2,000 ICUs monitored, adding more than 7 million admissions to these units since the beginning of the project, which offers an international approach to ICU benchmarking in a pragmatic and valuable way for physicians and researchers.

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2022-02-04by logicPublications

A Pooled Analysis Of Four Observational Studies

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies.
Pisani L, Algera AG, Neto AS, Azevedo L, Pham T, Paulus F, de Abreu MG, Pelosi P, Dondorp AM, Bellani G, Laffey JG, Schultz MJ; ERICC study investigators; LUNG SAFE study investigators; PRoVENT study investigators; PRoVENT-iMiC study investigators.

Abstract

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.

Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.

Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H₂O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001).

Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status.

Funding: No funding.