Browsing by Author "Maddux, Aline"

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    Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)
    (Wolters Kluwer, 2023) Emeriaud, Guillaume; López-Fernández, Yolanda M.; Iyer, Narayan Prabhu; Bembea, Melania M.; Agulnik, Asya; Barbaro, Ryan P.; Baudin, Florent; Bhalla, Anoopindar; de Carvalho, Werther Brunow; Carroll, Christopher L.; Cheifetz, Ira M.; Chisti, Mohammod J.; Cruces, Pablo; Curley, Martha A. Q.; Dahmer, Mary K.; Dalton, Heidi J.; Erickson, Simon J.; Essouri, Sandrine; Fernández, Analía; Flori, Heidi R.; Grunwell, Jocelyn R.; Jouvet, Philippe; Killien, Elizabeth Y.; Kneyber, Martin C. J.; Kudchadkar, Sapna R.; Korang, Steven Kwasi; Lee, Jan Hau; Macrae, Duncan J.; Maddux, Aline; Alapont, Vicent Modesto I.; Morrow, Brenda M.; Nadkarni, Vinay M.; Napolitano, Natalie; Newth, Christopher J. L.; Pons-Odena, Martí; Quasney, Michael W.; Rajapreyar, Prakadeshwari; Rambaud, Jerome; Randolph, Adrienne G.; Rimensberger, Peter; Rowan, Courtney M.; Sanchez-Pinto, L. Nelson; Sapru, Anil; Sauthier, Michael; Shein, Steve L.; Smith, Lincoln S.; Steffen, Katerine; Takeuchi, Muneyuki; Thomas, Neal J.; Tse, Sze Man; Valentine, Stacey; Ward, Shan; Watson, R. Scott; Yehya, Nadir; Zimmerman, Jerry J.; Khemani, Robinder G.; Pediatrics, School of Medicine
    Objectives: We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. Design: International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. Setting: Not applicable. Patients: Patients with or at risk for PARDS. Interventions: None. Measurements and main results: Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. Conclusions: PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.
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    Wellness and Coping of Physicians Who Worked in ICUs During the Pandemic: A Multicenter Cross-Sectional North American Survey
    (Wolters Kluwer, 2022) Burns, Karen E.A.; Moss, Marc; Lorens, Edmund; Jose, Elizabeth Karin Ann; Martin, Claudio M.; Viglianti, Elizabeth M.; Fox-Robichaud, Alison; Mathews, Kusum S.; Akgun, Kathleen; Jain, Snigdha; Gershengorn, Hayley; Mehta, Sangeeta; Han, Jenny E.; Martin, Gregory S.; Liebler, Janice M.; Stapleton, Renee D.; Trachuk, Polina; Vranas, Kelly C.; Chua, Abigail; Herridge, Margaret S.; Tsang, Jennifer L.Y.; Biehl, Michelle; Burnham, Ellen L.; Chen, Jen-Ting; Attia, Engi F.; Mohamed, Amira; Harkins, Michelle S.; Soriano, Sheryll M.; Maddux, Aline; West, Julia C.; Badke, Andrew R.; Bagshaw, Sean M.; Binnie, Alexandra; Carlos, W. Graham; Çoruh, Başak; Crothers, Kristina; D'Aragon, Frederick; Denson, Joshua Lee; Drover, John W.; Eschun, Gregg; Geagea, Anna; Griesdale, Donald; Hadler, Rachel; Hancock, Jennifer; Hasmatali, Jovan; Kaul, Bhavika; Kerlin, Meeta Prasad; Kohn, Rachel; Kutsogiannis, D. James; Matson, Scott M.; Morris, Peter E.; Paunovic, Bojan; Peltan, Ithan D.; Piquette, Dominique; Pirzadeh, Mina; Pulchan, Krishna; Schnapp, Lynn M.; Sessler, Curtis N.; Smith, Heather; Sy, Eric; Thirugnanam, Subarna; McDonald, Rachel K.; McPherson, Katie A.; Kraft, Monica; Spiegel, Michelle; Dodek, Peter M.; Diversity-Related Research Committee of the Women in Critical Care (WICC) Interest Group of the American Thoracic Society; Medicine, School of Medicine
    Objectives: Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic. Design: Cross-sectional survey using four validated instruments. Setting: Sixty-two sites in Canada and the United States. Subjects: Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs. Intervention: None. Measurements and main results: We analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational ( n = 6) or local/institutional ( n = 2) issues or both ( n = 2). Average moral distress (95.6 ± 66.9), professional fulfilment (6.5 ± 2.1), and burnout scores (3.6 ± 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVID-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures. Conclusions: Despite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.