Pierre Cardinal's research while affiliated with University of Ottawa and other places

Publications (37)

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Background: Decisions about organ donation are stressful for family members of potential organ donors. We sought to comprehensively explore the donation process from interviews conducted with family members of patients admitted to pediatric and adult intensive care units in Canada. Methods: We conducted a qualitative study using semistructured,...
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Although maintaining some amount of positive end-expiratory pressure (PEEP) seems essential, selecting and titrating a specific level for patients with the acute respiratory distress syndrome (ARDS) remains challenging despite extensive research on the subject. While an “open lung” approach to ventilation is popular and has some degree of biologica...
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PurposeSystematic review and network meta-analysis to investigate the efficacy of noninvasive respiratory strategies, including noninvasive positive pressure ventilation (NIPPV) and high-flow nasal cannula (HFNC), in reducing extubation failure among critically ill adults.Methods We searched databases from inception through October 2021 for randomi...
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Importance Growing interest in microbial dysbiosis during critical illness has raised questions about the therapeutic potential of microbiome modification with probiotics. Prior randomized trials in this population suggest that probiotics reduce infection, particularly ventilator-associated pneumonia (VAP), although probiotic-associated infections...
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Purpose This article shares our experience developing an integrated curriculum for the ACES (Acute Critical Event Simulation) program. The purpose of the ACES program is to ensure that health care providers develop proficiency in the early management of critically ill patients. The program includes multiple different types of educational interventi...
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Introduction In a patient-centred and family-centred approach to organ donation, compassion is paramount. Recent guidelines have called for more research, interventions and approaches aimed at improving and supporting the families of critically ill patients. The objective of this study is to help translate patient-centred and family-centred care in...
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Background: The demand for solid organ transplantation has spurred countries around the world to search for innovative policies and practices to increase the supply of organs. Spain has become a global reference point for organ donation with the highest transplantation rates. In Ontario, Canada the Ontario Trillium Gift of Life (TGLN) has sought t...
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Background: Rapid response teams (RRTs) respond to hospitalized patients experiencing clinical deterioration and help determine subsequent management and disposition. We sought to evaluate and compare the prognostic accuracy of the Hamilton Early Warning Score (HEWS) and the National Early Warning Score 2 (NEWS2) for prediction of in-hospital mort...
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Objective To better understand the potential of a needs assessment approach using qualitative data from manikin-based and virtual patient simulation debriefing sessions compared with traditional data collection methods (ie, focus groups and interviews). Design Original data from simulation debrief sessions was compared and contrasted with data fro...
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Background: Organ donation research has centered on improving donation rates rather than focusing on the experience and impact on substitute decision makers. The purpose of this study was to document donor and nondonor family experiences, as well as lasting impacts of donation. Methods: We used a qualitative exploratory design. Semistructured in...
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Purpose: To describe critical care medicine residents' training, expertise, and skills regarding organ and tissue donation processes and procedures. Methods: We undertook a qualitative multicentre study and employed a purposive sample of program directors, physicians, nurses, residents, and organ donation leaders from all nine academic intensive...
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Introduction: The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literatu...
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Introduction Evaluation capacity building (ECB) is a topic of great interest to many organizations as they face increasing demands for accountability and evidence-based practices. ECB is about building the knowledge, skills, and attitudes of organizational members, the sustainability of rigorous evaluative practices, and providing the resources and...
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Acute respiratory distress syndrome (ARDS), characterized by hypoxemic respiratory failure, is associated with a mortality of 30–50% and is precipitated by both direct and indirect pulmonary insults. Treatment is largely supportive, consisting of lung protective ventilation and thereby necessitating Intensive Care Unit (ICU) admission. The most com...
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Objectives Conceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme. Setting The context for this study was...
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It has been argued that Canada contains two solitudes, based primarily upon its European founding languages: English and French.1,2 Bringing these solitudes closer requires effort and empathy. It also requires common words and phrases. This is the goal of this modest language primer for acute care practitioners. Many medical practitioners treat lan...
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It has been reported that suboptimal communication represents the largest source of preventable error during acute medical care. Because a significant proportion of ongoing care relies heavily on verbal communication, it is incumbent on clinicians to develop, hone and maintain these skills in the interests of their patients and, at the same time, c...
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To design and implement a needs assessment process that identifies gaps in caring for critically ill patients in a community hospital. This mixed-method study was conducted between June 2011 and February 2012. A conceptual framework, centered on the critically ill patient, guided the design and selection of the data collection instruments. Differen...
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A 2-year residency must prepare family physicians to provide a broad range of services. In many settings, especially rural and remote practices, family physicians provide emergency and inpatient care and thus encounter critically ill patients. Evidence of the importance of early recognition and aggressive intervention in critical illness is growing...
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Insertion of central venous catheters (CVCs) is an essential competency for emergency physicians. Ultrasound-guided (USG) insertion of CVCs has been shown to be safer than the traditional landmark technique. There is no clear consensus on effective methods for training physicians in USG insertion of CVCs. We developed and evaluated a novel educatio...
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Crisis resource management (CRM) skills are a set of nonmedical skills required to manage medical emergencies. There is currently no gold standard for evaluation of CRM performance. A prior study examined the use of a global rating scale (GRS) to evaluate CRM performance. This current study compared the use of a GRS and a checklist as formal rating...
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Weaning predictors are often incorporated in protocols to predict weaning outcome for patients on mechanical ventilation. The predictors are used as a decision point in protocols to determine whether a patient may advance to a spontaneous breathing trial. The impact of including predictors in a weaning protocol has not been previously studied. We d...
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Resuscitation of critically ill patients requires medical knowledge, clinical skills, and nonmedical skills, or crisis resource management (CRM) skills. There is currently no gold standard for evaluation of CRM performance. The primary objective was to examine the use of high-fidelity simulation as a medium to evaluate CRM performance. Since no gol...
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The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement. Few institutions have timely access to direct measurement of ethylene glycol. As a result, diagnosis sometimes can be delayed and therapy initiated late. We present two cases of ethylene glycol poisoning. Th...

Citations

... PEEP titration methods, such as transpulmonary pressure (TPP) [9] and bioelectrical impedance (EIT) [10,11] have been used to optimize PEEP, these approaches seem to be promising, but the requirement of specific equipment limited their utilization in clinical daily practice. Compared to EIT and TPP, the respiratory mechanics (driving pressure or respiratory system compliance [Crs])-guided PEEP titration is a relatively simple and straightforward strategy that does not require unusual equipment for optimizing PEEP, and equally valid approaches exist [12]. ...
... Although recent advances in critical care technology have significantly improved the prognosis and survival of patients receiving ventilator support (26), extubation failure still occurs in approximately 10-15% of patients (27). Previous studies have shown that extubation failure may be associated with higher rates of tracheotomies, increased mortality, prolonged stay in the intensive care unit, and impaired functional outcome after recovery (28)(29)(30). ...
... are associated with a reduction in infections, particularly in patients with ventilator-associated pneumonia (VAP) and treated with antibiotics, but not to increased survival [118]. Conversely, a more recent study did not confirm the beneficial role of Lactobacillus rhamnosus GG in reducing VAP incidence in ICU patients [156]. Another meta-analysis, which analyzed 4893 patients, has shown that probiotics reduce VAP, ICU length of stay, and duration of antibiotic therapy; however, the high variability in treatments and type of patients prevents the introduction of the use of probiotics as VAP prophylaxis [116]. ...
... With research in this context focussing on enabling informed decisions and increasing donation rates (Ashkenazi & Cohen, 2015;Marck et al., 2016), connections between in-hospital experiences and ongoing adjustment are under-explored, especially in relation to Donation after Circulatory Determination of Death (DCDD, Dimo, 2019;Naef et al., 2020;Sque et al., 2018;Takaoka et al., 2020;Zheng et al., 2020). Identifying and responding to family and staff needs in this complex environment are challenging tasks for HCPs (Kerstis & Widarsson, 2020;Shariff et al., 2017;Simonsson et al., 2020;Walker & Sque, 2019;Zellweger et al., 2017), highlighting the need for training to improve end-of-life care and peer support (Chan et al., 2020;Crawshaw et al., 2019;Witjes et al., 2017Witjes et al., , 2019aWitjes et al., , 2019b. ...
... Therefore, this stage, the fourth phase of the life cycle of crisis, is the goal of all the efforts of the managers. Once the signs of the crisis are diagnosed, the manager must regain control as soon as possible and decide on the most effective and efficient way to resolve and normalize the situation [15]. At the stage of resolution, the smooth operation of the business gradually returns. ...
... Verktøyet er beskrevet å vaere bedre egnet til å oppdage sepsis enn qSOFA og SIRS (9)(10)(11)14). Sammenligning av skåringsverktøyene for sepsisdiagnostikk på sengepost i norske sykehus er så vidt vi vet ikke publisert tidligere, selv om det foreligger data internasjonalt (15). ...
... If a seriously injured patient reaches the hospital, their family's experiences will include interaction with healthcare professionals (HCPs) in an unfamiliar environment (Imanipour et al., 2019;Kentish-Barnes et al., 2015), and if doctors find that treatment would be futile, organ donation (OD) may be raised (Ahmadian et al., 2019a(Ahmadian et al., , 2019bDa Silva Knihs et al., 2020). Although time at the hospital is stressful, opportunities for family members to gather, support each other, and be with the patient (Downar et al., 2020;Fernandes et al., 2015;Kentish-Barnes et al., 2019b;Sarti et al., 2018), while receiving support and guidance from staff, can foster later adjustment (Wiegand, 2012;Wijngaards-de Meij et al., 2008). ...
... In addition, a survey of Canadian intensivists, nurses, and donation coordinators identified these educational gaps as barriers to organ donation after DCD (11). Finally, despite inclusion in Royal College of Physicians and Surgeons of Canada training objectives, Canadian Critical Care Medicine trainees demonstrate knowledge gaps in NDD, DCD, and donor referral criteria owing to limited exposure to donation and simulation and lack of formal assessment (12). ...
... The 'super achiever' status was predominantly achieved by the less experienced ANMs. Multiple studies have documented conflicting effect of years of experience and age on knowledge and skills in the area of medical as well as paramedical trainin g [24][25][26][27]. Research on alternative training methods or strategies for elderly personnel would be desirable to achieve optimal increase in their essential skills. ...
... While there needs to be continuous evaluation on nutrition, these vets have put into practice what they have learned to improve the work done by their home organizations. An important outcome of any capacity development is to increase participants belief that they can effect change (Berrian et al., 2018;Copsey, 2017;Sarti et al., 2017). This nutrition example illustrates the focus of empowering participants and creating ownership of the issues and work undertaken so that it remains relevant to them although we acknowledge that there is no data on the direct impact of the improve nutrition plan on orangutan health and welfare. ...