Farid Zand

Shiraz University of Medical Sciences | SUMS · Department of Anesthesia and Critical Care

Background Traumatic Brain Injury (TBI) is a leading cause of hospitalization and disability in young and middle-aged adults. This study aims to survey the efficacy of oral modafinil, a low-side-effect central nervous system stimulant, in the enhancement of consciousness recovery in moderate to severe TBI patients in the ICUs of a referral trauma c...

In our previous study, we focused on vancomycin pharmacokinetic in critically ill patients and vancomy-cin-induced acute kidney injury (AKI) (1). Now, we have new findings regarding the key role of volume of distribution (V d) in AKI prediction in this group. The changes in vancomycin pharmacokinetic parameters would be expectable in special groups...

Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials.

Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treate...

Purpose This study was conducted to determine whether critically ill patients admitted to the intensive care unit (ICU) with sepsis and septic shock may benefit from extended infusion of ampicillin/sulbactam compared with those receiving intermittent infusion. Material and methods This randomized assessor-blinded clinical trial was conducted in th...

Background The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. Methodology The present non-interventional study was performed by a pre and a post surve...

Background: Management of anticoagulant therapy in COVID-19 patients is a critical role. Low Molecular Weight Heparin (LMWH) thromboprophylaxis is already recommended and anti-Factor Xa (anti-FXa) monitoring has been used to titrate LMWH doses. Methods: Through a cross-sectional study, we evaluated anti-FXa activity in patients admitted to ICU,...

Objectives: The worldwide emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a major therapeutic concern to medical institutions. To date, no study has determined the frequency and risk factors of inpatients with CRE fecal carriage in Southern Iran. We studied the features of carbapenemase-producing Enterobacteriaceae (CPE) coll...

Objective This prospective study reports the epidemiological and clinical characteristics of Guillain-Barré syndrome (GBS) patients admitted to the intensive care units of Namazi Hospital, the largest referral center in the south of Iran, between March 20, 2016, to March 19, 2021. Results One hundred and thirty-two GBS patients were identified wit...

PurposeTo describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control.Methods Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including...

Background: The coronavirus disease 2019 (COVID-19) has become the leading source of pneumonia outbreaks in the world. The present study aimed to compare the condition of intensive care unit (ICU) and non-ICU COVID-19 patients in terms of epidemiological and clinical features, laboratory findings, and outcomes in three cities across Iran. Methods...

Introduction: Therapeutic drug monitoring (TDM) and pharmacokinetic assessments of vancomycin would be essential to avoid vancomycin-associated nephrotoxicity and obtain optimal therapeutic and clinical responses. Different pharmacokinetic parameters, including trough concentration and area under the curve (AUC), have been proposed to assess the sa...

Background: Prioritizing the patients requiring intensive care may decrease the fatality of coronavirus disease-2019 (COVID-19). Aims and objectives: To develop, validate, and compare two models based on machine-learning methods for predicting patients with COVID-19 requiring intensive care. Materials and methods: In 2021, 506 suspected COVID-...

Introduction: This study was done to extract the evaluation criteria to assess the effects of decision support systems integrated with computerized provider order entry (CPOE) systems. Methods: A Scoping review search was carried out on papers published in nine electronic databases, including PubMed, Embase, ProQuest, Scopus, Web of Science, Cochra...

Background One of the challenging decision-making tasks in healthcare centers is the interpretation of blood gas tests. One of the most effective assisting approaches for the interpretation of blood gas analysis (BGA) can be artificial intelligence (AI)-based decision support systems. A primary step to develop intelligent systems is to determine in...

Background The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. Covid-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. Methodology The present non-interventional study was performed by a pre and a post surve...

There is a considerable gap between standard care and routine practice for venous thromboembolism (VTE) prophylaxis in hospitalized surgical patients. In this case series study, we aimed to determine the appropriate use of VTE prophylaxis in surgical patients admitted to three ICUs of the largest referral hospital in Shiraz, Iran. Appropriate VTE p...

Poor usability of clinical decision support system impact negative on healthcare professionals, decrease usage and quality of clinical decision support system and result in a negative effect on patient outcome. Therefore, the objective of this study was the usability evaluation of the venous thromboembolism prophylaxis recommendation system. This s...

Objective: To compare clinical and paraclinical similarities between trauma patients with positive RT-PCR tests (PCR+ve) and the RT-PCR negative ones (PCR -ve). Methods: This a case-control study, where cases had a PCR+ve and controls had a negative result. Two groups were compared regarding (para) clinical values. Multivariable binary logistic...

Background and objective The overridden rate of Drug-Drug Interaction Alerts (DDIAs) in the Intensive Care Unit (ICU) is very high. Therefore, this study aimed to design, develop, implement, and evaluate a severe Drug-Drug Alert System (DDIAS) in ICU and measure the override rate of DDIAs. Methods This is a cross-sectional study for the design, de...

Background and objective: There is a gap between expert recommendations and clinical practice in (Venous Thromboembolism) VTE prophylaxis among nonsurgical patients worldwide. Rate of adherence to evidence-based practice is inadequate in the nonsurgical population. Therefore, this study aimed to determine The effect of Clinical Decision Support Sys...

Background Administration of an optimal dose of anesthetic agent to ensure adequate depth of hypnosis with the lowest risk of adverse effects to the fetus is highly important in cesarean section. Sodium thiopental (STP) is still the first choice for induction of anesthesia in some countries for this obstetric surgery. We aimed to compare two doses...

Background: Efforts to reduce inappropriate hospital stay, including alternatives such as homecare, are important to improve patient care and reduce health care costs. Aims: This study evaluated inappropriate hospital stay in Shiraz, Islamic Republic of Iran and the extent to which these stays were due to lack of homecare services and others fac...

Background: As the COVID-19 pandemic continues, determining hospital demands has become a vital priority. Heart rate variability (HRV) has been linked to both the presence of viral infection and its severity. We investigate the possibility of using HRV parameters in comparison to other clinical parameters for predicting the hospital length of stay...

Objectives: To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU). Methods: This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour...

Critical illness could result in altered pharmacokinetic profiles of many commonly administered medications in ICU settings. Pharmacokinetic, which consists of a multistage process containing absorption, distribution, metabolism, and elimination, could be significantly altered in critically ill patients that emphasize the importance of individualiz...

Background: We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific. Methods: Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance...

Background: Clinical decision support (CDS) functionalities in Computerized Provider Order Entry system (CPOE) need to be identified by the institutional healthcare providers in developing countries. In this regard, CDS functionalities should be a priority for the execution in CPOE. Objectives: Thus, our study was done to identify and prioritize th...

Background and purpose: Vancomycin is a glycopeptide antibiotic which is the drug of choice against methicillin-resistant Staphylococcus aureus. It has a narrow therapeutic index, and thus therapeutic drug monitoring (TDM), and clinical pharmacokinetic assessment are necessary in order to prevent adverse drug reactions such as nephrotoxicity. In t...

Candiduria is common among patients admitted to intensive care units (ICUs); however, clinical and microbiological data are limited, which accounts for non-compliance with international guidelines, including over treatment of asymptomatic candiduria that promotes antifungal resistance. This prospective study included adult patients admitted to ICUs...

Background Diagnosis of COVID-19 can be challenging in trauma patients, especially those with chest trauma and lung contusion. Methods We present a case series of patients from February and March 2020 who were admitted to our trauma center at Rajaee Hospital Trauma Center, in Shiraz, Iran and had positive SARS-CoV-2 PCR test or chest CT scan sugge...

: The COVID-19 pandemic has raised a huge sense of anxiety in people and health care staff. Yet, there are concerns regarding the exact routes of transmission and the best protective measures in health centers. It seems that a major route of transmission is via respiratory droplets, but it could be spread in an airborne mode in some airborne-produc...

Introduction: Electronic documentation in the intensive care unit (ICU) has a significant effect on the quality of data. In addition, using structured data and standard formats can facilitate documentation of progress note data. Therefore, the aim of this study was to create a minimum data set for an effective design and implementation of electroni...

Systematic candidemia studies, especially in southern Iran, are scarce. In the current prospective study, we investigated candidemia in three major healthcare centers of Shiraz, the largest city in southern Iran. Yeast isolates from blood and other sterile body fluids were identified by matrix-assisted laser desorption/ionization time-of-flight mas...

PurposeThe DIANA study aimed to evaluate how often antimicrobial de-escalation (ADE) of empirical treatment is performed in the intensive care unit (ICU) and to estimate the effect of ADE on clinical cure on day 7 following treatment initiation.Methods Adult ICU patients receiving empirical antimicrobial therapy for bacterial infection were studied...

Background & Aims Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its’ efficacy in the Intensive Care Units (ICUs) of Iran. Methods This cross-sectional study assessed 50 ICU...

Background Short-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied, and data on their incidence by number of device-days is not available. Methods Prospective, surveillance study on PVCR-BSI conducted from September 1st, 2013 to 31st Mays, 2019 in 246 intensive care units (ICUs),...

Background Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available. Methods Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 int...

Purpose: Vancomycin is a glycopeptide antibiotic which is drug of choice against MRSA-induced infections. It has a narrow therapeutic index which may cause adverse effects such as nephrotoxicity and ototoxicity. Therapeutic drug monitoring (TDM) is highly essential to achieve enough efficacy and prevent adverse reactions. Although many studies have...

Remaining co-authors of this study: Bahrain: Saeed, N.K.; Abdul-Aziz, S.; ALSayegh, S.; Humood, M.Z., Mohamed-Ali, K.; Swar, S., Magray, T.A.S. Egypt: Bayani, V.; Ahmed, S.A.; Alansary, A.M.; Hassan, A.R.; Abdullorziz-Ghazi, I.; El-Fattah, M.A.; Hala, A.; Ahmed-Fouad, H.; Mounir-Agha, H.; Hamza, H.S.; Salah, Z.; Abdel-Aziz, D.M.; Ibrahim, S.B.; Hel...

Remaining co-authors of this study: Bahrain: Saeed, N.K.; Abdul-Aziz, S.; ALSayegh, S.; Humood, M.Z., Mohamed-Ali, K.; Swar, S., Magray, T.A.S. Egypt: Bayani, V.; Ahmed, S.A.; Alansary, A.M.; Hassan, A.R.; Abdullorziz-Ghazi, I.; El-Fattah, M.A.; Hala, A.; Ahmed-Fouad, H.; Mounir-Agha, H.; Hamza, H.S.; Salah, Z.; Abdel-Aziz, D.M.; Ibrahim, S.B.; Hel...

Objective: Although regional anesthesia is the most frequently used method for selected surgical approaches, general anesthesia (GA) is still common. Awareness and recall of events are among the main hazards during GA, particularly in Caesarean Section (C/S). In this study, we decided to compare depth of anesthesia, that was measured by Bispectral...

Background: Extra corporeal membrane oxygenation (ECMO) has been considered as a crucial modality for the management of acute respiratory distress syndrome (ARDS). Since ECMO is considered to be an invasive modality and may be associated with some complications, there are strict indications for its use. Here we report successful treatment of a case...

Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, prospective da...

Introduction and aim: Malnutrition is a complication of hospitalization in critically ill patients. This event is occurred because of disease and therapeutic processes for curing the patients. Determination of nutritional status helps physicians and clinical nutritionists decide on the best regimen which should be prescribed for a patient. In the...

Background: Many risk factors are associated with death and discharge from the Intensive Care Unit (ICU). This study aimed to evaluate the risk factors associated with death and discharge among ICU patients. Methods: This historical cohort study was conducted on 712 patients admitted to the ICU of Namazi hospital in Shiraz between 2013 and 2015. T...

Background: The risk of healthcare-associated infections (HAIs) in the developing countries can be up to 20 times greater than the developed countries. Objectives: As the prevalence of HAIs varies even in different wards of a hospital, this study aimed to estimate the prevalence of HAIs in pediatric wards and to compare it with the whole hospital....

Aim: Prophylaxis against stress ulcer in mechanically ventilated patients is one of the causes for ventilator-associated pneumonia (VAP). Our aim was evaluating the effect of intravenous pantoprazole and ranitidine in the incidence of VAP in critically ill patients. Materials and Methods: Patients with at least 48 h of expected mechanical ventilati...

Background: Critical illness is associated with oxidative stress and insulin resistance. These conditions affect the clinical outcomes in intensive care unit (ICU). The aim of this study was to determine whether intervention with α-lipoic acid (ALA) influences the oxidative stress, insulin resistance, and clinical outcomes in critically ill patien...

Background: An important application in health care system is computerized physician order entry system (CPOE) which improves the quality of patient's care. Given that the users' satisfaction is necessary in predicting the success of a system, this study aimed to evaluate the satisfaction of CPOE users in Namazi Hospital. Methods: This cross-sectio...

Background and aim Accurate prediction of prognosis of patients admitted to intensive care units (ICUs) is very important for the clinical management of the patients. The present study aims to identify independent factors affecting death and discharge in ICUs using competing risk modeling. Methods This retrospective cohort study was conducted on e...

Background: One way to reduce medical errors associated with physician orders is computerized physician order entry (CPOE) software. This study was conducted to compare prescription orders between 2 groups before and after CPOE implementation in a hospital. Methods: We conducted a before-after prospective study in 2 intensive care unit (ICU) wards...

Alarm fatigue can adversely affect nurses' efficiency and concentration on their tasks, which is a threat to patients' safety. The purpose of the present study was to develop and test the psychometric accuracy of an alarm fatigue questionnaire for nurses. This study was conducted in two stages: in stage one, in order to establish the different aspe...

Background: Clinical assessment of disease severity is an important part of medical practice for prediction of mortality and morbidity in Intensive Care Unit (ICU). A disease severity scoring system can be used as guidance for clinicians for objective assessment of disease outcomes and estimation of the chance of recovery. This study aimed to evalu...

Data for the study on efficacy of APACHE-IV for predicting mortality and length of stay in an intensive care unit in Iran

Background: Transurethral resection of prostate (TURP) is the most common treatment for benign prostatic hyperplasia (BPH). Urinary tract catheter is inserted post-operatively which results in catheter-related bladder discomfort (CRBD) in many patients. The purpose of this study was to assess the preventive effect of hyoscine N-butyl bromide on CR...

Background: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Units (ICUs) which increases the length of ICU stay, duration of mechanical ventilation, and mortality. The present study used an oral care protocol and compared the effects of two different concentrations of chlorhexidine on reduction of or...

Abstract Background: Pain, Agitation and Delirium (PAD) are common in critically ill patients admitted in Intensive Care Units (ICU) being reported in 15-80% of the patients. Control of agitation and delirium in critically ill patients is somehow different and hard to achieve in patients with drug abuse and opium addiction. Aim: We hypothesized i...

Background: Pain, Agitation and Delirium (PAD) are common in critically ill patients admitted in Intensive Care Units (ICU) being reported in 15-80% of the patients. Control of agitation and delirium in critically ill patients is somehow different and hard to achieve in patients with drug abuse and opium addiction. Aim: We hypothesized if a protoco...

Background: Inhaled anesthetics are widely used drugs in health centers and hospitals. However, several side effects concerning inhalational anesthetics have been reported. Liver damage is one of the well-known side effects of inhaled anesthetics and measurement of alkaline phosphatase and alanine aminotransferase serum level is the common method f...

Ventilator associated pneumonia may occur as a complication, in intubated patients under mechanical ventilation. In this study, we investigated the impact of early replacement of conventional endotracheal tube with an endotracheal tube with subglottic suction port on the incidence of ventilator associated events. We designed a randomized clinical t...

Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control a...

Poster

A772 Effects of lipid emulsions based on n-3 polyunsaturated fatty acids on metabolic and infectious complications compared with MCT/LCT lipid emulsion in critically ill patients receiving parenteral nutrition R. del Olmo1, M.J. Esteban2, C. Vaquerizo3, R. Carreño3, V. Gálvez3, G. Kaminsky3, B. Nieto3, M. Fuentes3, M.A. De la Torre3, E. Torres3, A...