Mojtaba Mokhber Dezfuli; Omid Mosafaeii Rad; Fariba Ghorbani; Behrooz Farzanegan; Elham Mir-Moeini; Mohammad Behgam Shadmehr
Volume 24, Issue 7 , 2022
Abstract
Background: Making decisions and planning about tracheostomy is not clear yet.
Objectives: This study aimed to report intensive care unit (ICU) admission, intubation, and tracheostomy rates among patients in different settings and compare the outcomes of surgical and Percutaneous dilational tracheostomy ...
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Background: Making decisions and planning about tracheostomy is not clear yet.
Objectives: This study aimed to report intensive care unit (ICU) admission, intubation, and tracheostomy rates among patients in different settings and compare the outcomes of surgical and Percutaneous dilational tracheostomy (PDT) techniques between COVID-19 and non-COVID patients.
Methods: Patients admitted to Masih Daneshvary hospital were assessed from February 2020 to May 2021 for intubation and tracheostomy rates. Different aspects and outcomes of two methods of tracheostomy, including surgical and PDT tracheostomy, were compared. Among non-COVID patients, 15 ICU admitted patients with different etiologies of pneumonia who required mechanical ventilation and tracheostomy were randomly selected and compared to COVID-19 patients.
Results: A total of 7,748 COVID-19 patients were admitted, with 12.7% admitted to ICU with an intubation rate of 5.13%. Tracheostomy was performed for a total of 36 patients (0.46%) for prolonged intubation with a trend of 0.1% to 1.45% in 16 months. Regarding the technique of tracheostomy, 24% and 33.3% of patients survived in surgical and PDT groups, respectively (P=0.44). Surgical tracheostomy and PDT were performed in 26.5% and 40% of non-COVID patients, respectively (P=0.5). The mortality rate was 72.2% and 20% in the surgical tracheostomy and PDT groups, respectively (P=0.003).
Conclusion: Given the study results, both surgical and percutaneous techniques are feasible for COVID-19 patients, and the decision about the optimal timing of intubation needs more inquiry.
Yazdan Abdolmohammadi; Mahla Nabi; Keihan Mostafavi; Mojtaba Mokhber Dezful; Seyed Mohammad Reza Nejatollahi; Fariba Ghorbani
Volume 24, Issue 3 , 2022
Abstract
Background: In our organ procurement unit, based on empirical evidence, the chance of turning a potential donor into an actual one is less than 30 percent and nursing plays a crucial role in this regard.
Objectives: We aimed to clarify nursing viewpoints and probe limitations that affect the organ donation ...
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Background: In our organ procurement unit, based on empirical evidence, the chance of turning a potential donor into an actual one is less than 30 percent and nursing plays a crucial role in this regard.
Objectives: We aimed to clarify nursing viewpoints and probe limitations that affect the organ donation process.
Methods: In this cross-sectional study, a self-constructed 28-item questionnaire including information regarding hospital characteristics, nursing attitudes, and level of knowledge was prepared. Our study population was all nurses who consented to fill in the questionnaire using the Quota sampling method.
After content validity, the questionnaire was circulated in cyberspace and the nursing society was invited to complete it. After one month, the response rate was 46 percent and the completed forms were analyzed.
Results: The majority of participants had not attended any organ donation training program (67%). Also, only 30% of nurses were aware of their crucial role in the donation process. In total, 61.7% of the participants had a high level of knowledge regarding brain death definition and donor maintenance. A positive attitude was observed in 59.1% of nurses with a significant difference in the high record of services (p=0.04). It was also, significantly higher in whom with the experience of working in private hospital (64% vs. 54%, p=0.05); hospitals with neurosurgery-ward (67.7% vs. 54.7%, p=0.01), transplant ward (67.4% vs. 54.9%, p=0.03). Attending training programs had a considerable impact (67.7% vs. 50.8%, p=0.03) but, being in ICU didn't affect nursing attitudes.
Conclusion: Hospital characteristics affect the nursing attitude toward organ donation and transplantation. It is recommended that all health staff obtain appropriate working experience in transplantation wards of the hospitals.
