The Experts below are selected from a list of 8181 Experts worldwide ranked by ideXlab platform
Kerri A Johannson - One of the best experts on this subject based on the ideXlab platform.
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Oxygen for interstitial lung diseases
Current Opinion in Pulmonary Medicine, 2020Co-Authors: Yet H Khor, Kerri A Johannson, David J F Smith, Elisabetta A RenzoniAbstract:Purpose of review Supplemental Oxygen therapy is prescribed for management of hypoxaemia in patients with interstitial lung disease (ILD). This review summarizes current evidence and implications of the use of Supplemental Oxygen therapy at home and during exercise training in ILD. Recent findings Despite the significance of hypoxaemia in patients with ILD, there is a lack of high-quality evidence to guide the use of Oxygen therapy in this population. Recent studies suggest that ambulatory Oxygen may improve symptoms and health-related quality of life in patients with ILD. Long-term Oxygen therapy for resting hypoxaemia in ILD is recommended by international guidelines. Supplemental Oxygen during exercise may augment training effects, whereas therapeutic effects of nocturnal Oxygen therapy are yet to be evaluated in patients with ILD. Nevertheless, it is important to consider the potential burden imposed by Oxygen therapy on patients' daily activities of living. Summary Ambulatory Oxygen may be considered in ILD patients with exertional hypoxaemia, with long-term Oxygen therapy being a standard care for resting hypoxaemia. Trials are currently underway to clarify therapeutic potentials of Supplemental Oxygen for exertional hypoxaemia and during exercise training in ILD patients, with additional research needed for the evaluation of nocturnal Oxygen therapy.
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Oxygen in patients with fibrotic interstitial lung disease an international delphi survey
European Respiratory Journal, 2019Co-Authors: Rachel Lim, Anne E Holland, Christopher J Humphreys, Julie Morisset, Kerri A JohannsonAbstract:Rationale Patients with fibrotic interstitial lung disease (ILD) frequently develop resting or exertional hypoxaemia. There is heterogeneity in clinical practice and a paucity of evidence guiding Supplemental Oxygen use in this patient population. The objectives of this study were to build international expert-based consensus on the indications and goals of Supplemental Oxygen from the perspective of healthcare providers, and identify potential barriers to its access. Methods Semistructured interviews and a comprehensive literature search informed items for the Delphi survey, with items not meeting consensus included in round 2. Round 3 contained survey questions regarding regional funding coverage for Oxygen therapy. A priori definitions of consensus were median scores of 4 (agree) to 5 (strongly agree) for “agreement”, 1 (strongly disagree) to 2 (disagree) for “disagreement” or 3 (unsure) with an interquartile range of 0–1. Results 42 out of 45 (93%) experts completed all three survey rounds, representing 17 countries. 20 out of 36 items met consensus for agreement or disagreement, 10 items met consensus for unsure and four items did not meet consensus. Experts agreed that Oxygen should be recommended for patients with severe resting hypoxaemia and in cases of exertional desaturation to Conclusions Experts achieved consensus on 20 items guiding Supplemental Oxygen use in fibrotic ILD. These findings may inform research, clinical recommendations and funding policy.
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Supplemental Oxygen in interstitial lung disease an art in need of science
Annals of the American Thoracic Society, 2017Co-Authors: Kerri A Johannson, Sachin R Pendharkar, Kirk Mathison, Charlene D Fell, Jordan A Guenette, Meena Kalluri, Martin Kolb, Christopher J RyersonAbstract:Interstitial lung disease (ILD) comprises a large and heterogeneous group of disorders that often lead to progressive fibrosis and premature death. Oxygen supplementation is typically used in patients with advanced lung disease with resting hypoxemia; however, there is a paucity of evidence guiding the use of Supplemental Oxygen in ILD, and significant heterogeneity in clinical practice. It remains unclear whether Supplemental Oxygen improves clinically meaningful outcomes, and the role of ambulatory Oxygen supplementation in isolated exertional hypoxemia is particularly controversial. In some regions, the lack of robust data creates barriers to funding support and access to Supplemental Oxygen for patients with ILD. Further research into the role of Oxygen supplementation is needed to optimize the comprehensive care of this patient population.
Regina Leung - One of the best experts on this subject based on the ideXlab platform.
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a randomised controlled trial of Supplemental Oxygen versus medical air during exercise training in people with chronic obstructive pulmonary disease Supplemental Oxygen in pulmonary rehabilitation trial support protocol
BMC Pulmonary Medicine, 2016Co-Authors: Jennifer A Alison, Zoe J Mckeough, Sue Jenkins, Anne E Holland, Kylie Hill, Norman R Morris, Regina LeungAbstract:Background Oxygen desaturation during exercise is common in people with chronic obstructive pulmonary disease (COPD). The aim of the study is to determine, in people with COPD who desaturate during exercise, whether Supplemental Oxygen during an eight-week exercise training program is more effective than medical air (sham intervention) in improving exercise capacity and health-related quality of life both at the completion of training and at six-month follow up.
Gianfranco Amicucci - One of the best experts on this subject based on the ideXlab platform.
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colorectal infraperitoneal anastomosis the effects of perioperative Supplemental Oxygen administration on the anastomotic dehiscence
Journal of Gastrointestinal Surgery, 2012Co-Authors: M Schietroma, F Carlei, Emanuela Marina Cecilia, Federica Piccione, Zuleyka Bianchi, Gianfranco AmicucciAbstract:BACKGROUND The role of Supplemental Oxygen therapy in the healing of colorectal anastomosis is still very much at an experimental stage. The aim of the present study, prospective randomized, was to assess the effect of administration of perioperative Supplemental Oxygen therapy on infraperitoneal anastomosis, where the risk of leakage is higher. METHODS We enrolled 72 patients between February, 2008 and February, 2011, who underwent elective open infraperitoneal anastomosis for rectal cancer (middle and low). Patients were assigned randomly to an Oxygen/air mixture with a fraction of inspired Oxygen (FiO2) of 30% (n = 37) or 80% (n = 35). Administration was commenced after induction of anesthesia and maintained for 6 h after surgery. RESULTS The overall anastomotic leak rate was 16.6% (12 out of 72); 8 patients (21.6%) had an anastomotic dehiscence in the 30% FiO2 group and 4 (11.4%) in the 80% FiO2 group (p < 0.05). The risk of anastomotic leak was 46% lower in the 80% FiO2 group (RR, 0.63; 95% confidence interval, 0.42–0.98) vs. the 30% FiO2. CONCLUSION Therefore, Supplemental 80% FiO2 during and for 6 h after major rectal cancer surgery, reducing postoperative anastomotic dehiscence, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.
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retraction note colorectal infraperitoneal anastomosis the effects of perioperative Supplemental Oxygen administration on the anastomotic dehiscence
Journal of Gastrointestinal Surgery, 2012Co-Authors: M Schietroma, F Carlei, Emanuela Marina Cecilia, Federica Piccione, Zuleyka Bianchi, Gianfranco AmicucciAbstract:The role of Supplemental Oxygen therapy in the healing of colorectal anastomosis is still very much at an experimental stage. The aim of the present study, prospective randomized, was to assess the effect of administration of perioperative Supplemental Oxygen therapy on infraperitoneal anastomosis, where the risk of leakage is higher. We enrolled 72 patients between February, 2008 and February, 2011, who underwent elective open infraperitoneal anastomosis for rectal cancer (middle and low). Patients were assigned randomly to an Oxygen/air mixture with a fraction of inspired Oxygen (FiO2) of 30% (n = 37) or 80% (n = 35). Administration was commenced after induction of anesthesia and maintained for 6 h after surgery. The overall anastomotic leak rate was 16.6% (12 out of 72); 8 patients (21.6%) had an anastomotic dehiscence in the 30% FiO2 group and 4 (11.4%) in the 80% FiO2 group (p < 0.05). The risk of anastomotic leak was 46% lower in the 80% FiO2 group (RR, 0.63; 95% confidence interval, 0.42–0.98) vs. the 30% FiO2. Therefore, Supplemental 80% FiO2 during and for 6 h after major rectal cancer surgery, reducing postoperative anastomotic dehiscence, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.
Ozan Akca - One of the best experts on this subject based on the ideXlab platform.
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effects of Supplemental Oxygen and dexamethasone on surgical site infection a factorial randomized trial
BJA: British Journal of Anaesthesia, 2015Co-Authors: A Kurz, Ozan Akca, Christian C Apfel, E Fleischmann, D I Sessler, Donal J Buggy, Erol Erdik, Klaus Eredics, Barbara KabonAbstract:Background Tissue Oxygenation is a strong predictor of surgical site infection. Improving tissue Oxygenation should thus reduce wound infection risk. Supplemental inspired Oxygen can improve tissue Oxygenation, but whether it reduces infection risk remains controversial. Low-dose dexamethasone is often given to reduce the risk of postoperative nausea and vomiting, but steroid-induced immunosuppression can increase infection risk. We therefore tested the hypotheses that Supplemental perioperative Oxygen reduces infection risk and that dexamethasone increases it. Methods Using a factorial design, patients having colorectal resections expected to last ≥2 h were randomly assigned to 30% (n=270) or 80% (n=285) inspired Oxygen during and for 1 h after surgery, and to 4 mg intraoperative dexamethasone (n=283) or placebo (n=272). Physicians blinded to group assignments evaluated wounds postoperatively, using US Centers for Disease Control criteria. Results Subject and surgical characteristics were similar among study groups. Surgical site infection incidence was similar among groups: 30% Oxygen 15.6%, 80% Oxygen 15.8% (P=1.00); dexamethasone 15.9%, placebo 15.4%, (P=0.91). Conclusions Supplemental Oxygen did not reduce surgical site infection risk. The preponderance of clinical evidence suggests that administration of 80% Supplemental inspired Oxygen does not reduce infection risk. We did not observe an increased risk of surgical site infection with the use of a single low dose of dexamethasone, indicating that it can be used for nausea and vomiting prophylaxis without promoting wound infections. Clinical trial registration ClinicalTrials.gov number: NCT00273377.
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perioperative Supplemental Oxygen therapy and surgical site infection a meta analysis of randomized controlled trials
Archives of Surgery, 2009Co-Authors: Motaz Qadan, Ozan Akca, Suhal S Mahid, Carlton A Hornung, Hiram C PolkAbstract:Objective To conduct a meta-analysis of randomized controlled trials in which high inspired Oxygen concentrations were compared with standard concentrations to assess the effect on the development of surgical site infections (SSIs). Data Sources A systematic literature search was conducted using the MEDLINE, EMBASE, and Cochrane databases and included a manual search of references of original articles, poster presentations, and abstracts from major meetings (“gray” literature). Study Selection Twenty-one of 2167 articles met the inclusion criteria. Of these, 5 randomized controlled trials (3001 patients) assessed the effect of perioperative Supplemental Oxygen use on the SSI rate. Studies used a treatment-inspired Oxygen concentration of 80%. Maximum follow-up was 30 days. Data Extraction Data were abstracted by 3 independent reviewers using a standardized data collection form. Relative risks were reported using a fixed-effects model. Results were subjected to publication bias testing and sensitivity analyses. Data Synthesis Infection rates were 12.0% in the control group and 9.0% in the hyperoxic group, with relative risk reduction of 25.3% (95% confidence interval [CI], 8.1%-40.1%) and absolute risk reduction of 3.0% (1.1%-5.3%). The overall risk ratio was 0.742 (95% CI, 0.599-0.919; P = .006). The benefit from increasing Oxygen concentration was greater in colorectal-specific procedures, with a risk ratio of 0.556 (95% CI, 0.383-0.808; P = .002). Conclusions Perioperative Supplemental Oxygen therapy exerts a significant beneficial effect in the prevention of SSIs. We recommend its use along with maintenance of normothermia, meticulous glycemic control, and preservation of intravascular volume perioperatively in the prevention of SSIs.
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ondansetron is no more effective than Supplemental intraoperative Oxygen for prevention of postoperative nausea and vomiting
Anesthesia & Analgesia, 2001Co-Authors: V Goll, Ozan Akca, Robert Greif, Helga Freitag, Cem F Arkilic, Thomas Scheck, Agnes Zoeggeler, Andrea Kurz, Gabriella Krieger, Rainer LenhardtAbstract:UNLABELLED: Supplemental Oxygen maintained during and for 2 h after colon resection halves the incidence of nausea and vomiting. Whether Supplemental Oxygen restricted to the intraoperative period is sufficient remains unknown. Similarly, the relative efficacy of Supplemental Oxygen and ondansetron is unknown. We tested the hypothesis that intraoperative Supplemental Oxygen reduces the incidence of postoperative nausea and vomiting. Patients (n = 240) undergoing gynecological laparoscopy were given a standardized isoflurane anesthetic. After induction, they were randomly assigned to the following three groups: routine Oxygen administration with 30% Oxygen, balance nitrogen (30% Oxygen group), Supplemental Oxygen administration with 80% Oxygen, balance nitrogen (80% Oxygen group), and Ondansetron 8 mg (immediately after induction), combined with 30% Oxygen, balance nitrogen (Ondansetron group). The overall incidence of nausea and/or vomiting during the initial 24 postoperative h was 44% in the patients assigned to 30% Oxygen and 30% in the Ondansetron group, but only 22% in those given 80% Oxygen. The incidence was thus halved by Supplemental Oxygen and was significantly less than with 30% Oxygen. There were, however, no significant differences between the 30% Oxygen and ondansetron groups, or between the ondansetron and 80% Oxygen groups. We conclude that Supplemental Oxygen effectively prevents postoperative nausea and vomiting after gynecological laparoscopic surgery; furthermore, ondansetron is no more effective than Supplemental Oxygen. IMPLICATIONS: Supplemental Oxygen reduces the risk of postoperative nausea and vomiting (PONV) as well or better than 8 mg of ondansetron. Because Oxygen is inexpensive and essentially risk-free, Supplemental Oxygen is a preferable method of reducing PONV.
Jennifer A Alison - One of the best experts on this subject based on the ideXlab platform.
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a randomised controlled trial of Supplemental Oxygen versus medical air during exercise training in people with chronic obstructive pulmonary disease Supplemental Oxygen in pulmonary rehabilitation trial support protocol
BMC Pulmonary Medicine, 2016Co-Authors: Jennifer A Alison, Zoe J Mckeough, Sue Jenkins, Anne E Holland, Kylie Hill, Norman R Morris, Regina LeungAbstract:Background Oxygen desaturation during exercise is common in people with chronic obstructive pulmonary disease (COPD). The aim of the study is to determine, in people with COPD who desaturate during exercise, whether Supplemental Oxygen during an eight-week exercise training program is more effective than medical air (sham intervention) in improving exercise capacity and health-related quality of life both at the completion of training and at six-month follow up.
