Evaluation of efficacy of non-invasive ventilation in Non-COPD and non-trauma patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis

Non-invasive ventilation [NIV] has been widely supported in the past two decades as an effective application in avoiding the need for endotracheal intubation [ETI] and reducing associated mortality in acute hypoxemic respiratory failure [AHRF] patients. However, the efficacy of NIV in AHRF patients, non-related to chronic obstructive pulmonary disease [COPD] and trauma is still controversial in the field of medical research. This retrospective study aimed to evaluate the efficacy of NIV as an adjunctive therapy in non-COPD and non-traumatic AHRF patients. Data of 11 randomized control trials [RCTs], which were conducted between 1990 and 2010 to determine the efficacy of NIV in non-COPD and non-traumatic AHRF patients, were reviewed from the PUBMED, MEDLINE, Cochrane Library, and EMBASE databases. Parameters monitored in this study included the ETI rate, fatal complications, mortality rate of patients, and their ICU and hospital duration of stay. Overall results showed a statistically significant decrease in the rate of ETI, mortality, and fatal complications along with reduced ICU and hospital length of stay in non-COPD and non-trauma AHRF patients of various etiologies. This systematic review suggests that non-COPD and non-trauma AHRF patients can potentially benefit from NIV as compared with conventional treatment methods. Observations from various cohort studies, observational studies, and previously published literature advocate on the efficacy of NIV for treating non-COPD and non-traumatic AHRF patients. However, considering the diversity of studied populations, further studies and more specific trials on less heterogeneous AHRF patient groups are needed to focus on this aspect

Establishing a clinical simulation centre: recommendations from an expert panel from the international conference on advanced clinical simulation, Dhahran, Saudi Arabia

Establishing a simulation centre remains a real challenge for many experts in the field of clinical simulation. A panel of experts presented some guidelines during the International Conference on Advanced Clinical Simulation that was held in Prince Sultan Military College of Health Sciences, Dhahran, Kingdom of Saudi Arabia, in October 2014. The round table discussion addressed eight themes: The planning stage, stakeholders' involvement, strategic planning, centre design, partnership development, faculty development, curriculum development and establishing a research strategy. The conclusions are presented in this paper