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Discharging patients home from the intensive care unit:A new trend

World Journal of Clinical Cases 2024年第23期12卷 5313-5319页

作者： Esraa M Hassan Abbas B Jama Ahmed Sharaf asim shaikh Mohamad El Labban Salim Surani Syed A Khan Department of Critical Care Medicine Mayo Clinic Health systemMankatoMN 56001United States Department of Internal Medicine Baptist Hospital of Southeast TexasBeaumontTX 77701United States Department of Medicine Aga Khan UniversityKarachi 74200SindhPakistan Department of Internal Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States Department of Anaesthesiology Mayo Clinic Health SystemRochesterMN 55905United States

Discharging patients directly to home from the intensive care unit(ICU)is becoming a new *** review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU *** analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare *** practice of direct discharge from the ICU presents both opportunities and *** it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support *** this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the *** critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal *** insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare ***,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.

关键词： Intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery

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Driving pressure in mechanical ventilation:A review

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World Journal of Critical Care Medicine 2024年第1期13卷 15-27页

作者： Syeda Farheen Zaidi asim shaikh Daniyal Aziz Khan Salim Surani Iqbal Ratnani Department of Medicine Queen Mary UniversityLondon E14NSUnited Kingdom Department of Medicine Aga Khan UniversitySindhKarachi 74500Pakistan Department of Medicine Jinnah Postgraduate Medical CenterSindhKarachi 75510Pakistan Department of Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States Department of Anesthesiology and Critical Care Houston Methodist HospitalHoustonTX 77030United States

Driving pressure(ΔP)is a core therapeutic component of mechanical ventilation(MV).Varying levels ofΔP have been employed during MV depending on the type of underlying pathology and severity of ***,ΔP levels have also been shown to closely impact hard endpoints such as *** this,conducting an in-depth review ofΔP as a unique,outcome-impacting therapeutic modality is extremely *** is a need to understand the subtleties involved in making sureΔP levels are optimized to enhance outcomes and minimize *** performed this narrative review to further explore the various uses ofΔP,the different parameters that can affect its use,and how outcomes vary in different patient populations at different pressure *** better utilizeΔP in MV-requiring patients,additional large-scale clinical studies are needed.

关键词： Driving pressure Acute respiratory distress syndrome Mortality Positive end-expiratory pressure Ventilator induced lung injury Mechanical ventilation

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Diabetes among Muslims during Ramadan:A narrative review

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世界临床病例杂志 2023年第26期11卷 6031-6039页

作者： Rohan Kumar Ochani asim shaikh Simran Batra Gauri Pikale Salim Surani Internal Medicine SUNY Upstate Medical University HospitalSyracuseNY 13210United States Medicine Aga Khan UniversitySindhKarachi 74500Pakistan Internal Medicine Dow University of Health SciencesSindhKarachi 74200Pakistan Internal Medicine Chicago Medical School at Rosalind Franklin UniversityChicagoIL 60064United States Medicine and Pharmacology Texas A and M UniversityCollege StationTX 77843United States Medicine Aga Khan UniversityNairobi 00100Kenya

Fasting during the month of Ramadan is one of the five fundamental principles of Islam,and it is obligatory for healthy Muslim adults and *** the fasting month,Muslims usually have two meals a day,suhur(before dawn)and iftar(after dusk).However,diabetic patients may face difficulties when fasting,so it is important for medical staff to educate them on safe fasting *** strict fasting can increase the risk of hypoglycemia and diabetic ketoacidosis,but with proper knowledge,careful planning,and medication adjustment,diabetic Muslim patients can fast during *** this review,a literature search was conducted using PubMed and Google Scholar until May *** other than the English language were *** strategies for managing blood sugar levels during Ramadan include a combination of patient education on nutrition,regular monitoring of blood glucose,medications,and insulin *** therapy can be continued during fasting if properly titrated to the patients’needs,and finger prick blood sugar levels should be assessed *** certain symptoms such as hypoglycemia,hyperglycemia,dehydration,or acute illness occur,or blood glucose levels become too high(>300 mg/dL)or too low(<70 mg/dL),the fast should be *** insulin formulations such as pegylated insulin and medications like tirzepatide,a dual agonist of gastric-inhibitory peptideand glucagonlike-peptide 1 receptors,have shown promise in managing blood sugar levels during ***-insulin dependent medications like sodium-glucose-cotransporter-2 inhibitors,including the Food and Drug Administration-approved ertugliflozin,are also being used to provide additional cardiovascular benefits in patients with type 2 diabetes.

关键词： Ramadan Fasting Diabetes Complications Insulin therapy Newer advances Hypoglyccemia

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