Mahmoud Elbarbary | King Saud Bin Abdulaziz University for Health Sciences (original) (raw)
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Papers by Mahmoud Elbarbary
Critical Ultrasound Journal, 2010
Journal of the Saudi Heart Association
Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the card... more Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL). Material and methods: A prospective pilot study has been conducted in Pediatric Cardiac ICU (PCICU) at King Abdulaziz Cardiac Center (KACC) from the 1st of June 2009 till the end of July 2010. Patients who had cardiac surgery and manifested with significant signs of upper airway obstruction were included. Each procedure was performed by different operators who were blinded to each other report. Results of invasive (FL) and non-invasive ultrasonography (US) investigations were compared. Results: Ten patients developed persistent significant upper airway obstruction after cardiac surgery were included in the study...
Abstract Background: Traditional use of trans-annular patch (TAP) to release right ventricular ou... more Abstract Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tract (RVOT) obstruction during tetralogy of Fallot (TOF) repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve (PV) function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function. Methods: A retrospective study of all TOF cases repaired in our institute between March 2002 and December 2007 was conducted. Cases were classified into two groups; group I included patients that had a TAP, while group II included cases that had simple TOF repair without TAP. Group I was subdivided into two groups, group (A) which include patients who had TAP without a valve. Group (B) includes those who had TAP with a monocuspid valve (Contegra). We compared po...
Journal of the Saudi Heart Association, 2010
Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tra... more Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tract (RVOT) obstruction during tetralogy of Fallot (TOF) repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve (PV) function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function.
Pediatric Emergency Critical Care and Ultrasound, 2014
European Heart Journal Supplements, 2014
ABSTRACT With the recent introduction of a high-quality, reasonably priced, and completely port-a... more ABSTRACT With the recent introduction of a high-quality, reasonably priced, and completely port-able pediatric/neonatal ultrasound (US) machines, a new philosophy of US imaging emerged which is the 'critical ultrasound'. This is a paradigm shift from being organ-based, systematic, comprehensive diagnostic exam done by radiologists to a new concept of problem-based, goal-directed, focused multi-organ, time-dependent, exam done by the treating intensivist. Based on this concept, the US exam is not done for an organ (e.g. US for abdomen or chest) but rather done to enhance the management of a problem (US for hypotension, US for hypoxia, US for sepsis, etc.). Certain problem-based US exams can involve scanning of multiple organs to enhance the management of certain patient's problem. The US within this concept is not considered just as diagnostic tool but rather as an integral part of pediatric cardiac intensive care (PCICU) management that involves diagnosis, tailored treatment, monitoring effects, goal-directed therapy, ruling out pos-sible complications, and to guide most of PCICU procedures. This article describes some of the applications of this innovative program over a 6-year period in a PCICU and its impact on patient care.
Journal of the Saudi Heart Association, 2014
Introduction: Safely obtaining vascular access in the pediatric population is challenging. This r... more Introduction: Safely obtaining vascular access in the pediatric population is challenging. This report highlights our real-world experience in developing a safer approach to obtaining vascular access using ultrasound guidance in children and infants with congenital heart disease.
Journal of the Saudi Heart Association, 2012
Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the card... more Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL).
Journal of the Saudi Heart Association, 2010
Pediatric Cardiology, 2010
The arterial switch operation (ASO) for neonates is the standard management for transposition of ... more The arterial switch operation (ASO) for neonates is the standard management for transposition of the great arteries (TGA) with an intact ventricular septum (IVS). Patients presenting for late ASO are at risk due to the possibility of left ventricle (LV) involution. This study aimed to assess the early postoperative course and outcome for children with TGA/IVS and still conditioned LV presenting for late primary ASO. A retrospective study of all TGA/IVS patients who underwent a primary ASO between
Journal of Clinical Epidemiology, 2013
This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GR... more This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its undesirable effects. Alternative terms for a weak recommendation include conditional, discretionary, or qualified. The strength of a recommendation has specific implications for patients, the public, clinicians, and policy makers. Occasionally, guideline developers may choose to make ''only-in-research'' recommendations. Although panels may choose not to make recommendations, this choice leaves those looking for answers from guidelines without the guidance they are seeking. GRADE therefore encourages panels to, wherever possible, offer recommendations. Ó
Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, m... more Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum. of Hindawi Publishing Corporation
Intensive Care Medicine, 2012
Writing committee: G Volpicelli (Emergency Medicine,
Critical Ultrasound Journal, 2010
Journal of the Saudi Heart Association
Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the card... more Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL). Material and methods: A prospective pilot study has been conducted in Pediatric Cardiac ICU (PCICU) at King Abdulaziz Cardiac Center (KACC) from the 1st of June 2009 till the end of July 2010. Patients who had cardiac surgery and manifested with significant signs of upper airway obstruction were included. Each procedure was performed by different operators who were blinded to each other report. Results of invasive (FL) and non-invasive ultrasonography (US) investigations were compared. Results: Ten patients developed persistent significant upper airway obstruction after cardiac surgery were included in the study...
Abstract Background: Traditional use of trans-annular patch (TAP) to release right ventricular ou... more Abstract Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tract (RVOT) obstruction during tetralogy of Fallot (TOF) repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve (PV) function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function. Methods: A retrospective study of all TOF cases repaired in our institute between March 2002 and December 2007 was conducted. Cases were classified into two groups; group I included patients that had a TAP, while group II included cases that had simple TOF repair without TAP. Group I was subdivided into two groups, group (A) which include patients who had TAP without a valve. Group (B) includes those who had TAP with a monocuspid valve (Contegra). We compared po...
Journal of the Saudi Heart Association, 2010
Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tra... more Background: Traditional use of trans-annular patch (TAP) to release right ventricular outflow tract (RVOT) obstruction during tetralogy of Fallot (TOF) repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve (PV) function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function.
Pediatric Emergency Critical Care and Ultrasound, 2014
European Heart Journal Supplements, 2014
ABSTRACT With the recent introduction of a high-quality, reasonably priced, and completely port-a... more ABSTRACT With the recent introduction of a high-quality, reasonably priced, and completely port-able pediatric/neonatal ultrasound (US) machines, a new philosophy of US imaging emerged which is the 'critical ultrasound'. This is a paradigm shift from being organ-based, systematic, comprehensive diagnostic exam done by radiologists to a new concept of problem-based, goal-directed, focused multi-organ, time-dependent, exam done by the treating intensivist. Based on this concept, the US exam is not done for an organ (e.g. US for abdomen or chest) but rather done to enhance the management of a problem (US for hypotension, US for hypoxia, US for sepsis, etc.). Certain problem-based US exams can involve scanning of multiple organs to enhance the management of certain patient's problem. The US within this concept is not considered just as diagnostic tool but rather as an integral part of pediatric cardiac intensive care (PCICU) management that involves diagnosis, tailored treatment, monitoring effects, goal-directed therapy, ruling out pos-sible complications, and to guide most of PCICU procedures. This article describes some of the applications of this innovative program over a 6-year period in a PCICU and its impact on patient care.
Journal of the Saudi Heart Association, 2014
Introduction: Safely obtaining vascular access in the pediatric population is challenging. This r... more Introduction: Safely obtaining vascular access in the pediatric population is challenging. This report highlights our real-world experience in developing a safer approach to obtaining vascular access using ultrasound guidance in children and infants with congenital heart disease.
Journal of the Saudi Heart Association, 2012
Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the card... more Objectives: Upper airway obstruction after pediatric cardiac surgery is not uncommon. In the cardiac surgical population, an important etiology is vocal cord paresis or paralysis following extubation. In this study, we aimed to evaluate the feasibility and accuracy of ultrasonography (US) assessment of the vocal cords mobility and compare it to fiber-optic laryngoscope (FL).
Journal of the Saudi Heart Association, 2010
Pediatric Cardiology, 2010
The arterial switch operation (ASO) for neonates is the standard management for transposition of ... more The arterial switch operation (ASO) for neonates is the standard management for transposition of the great arteries (TGA) with an intact ventricular septum (IVS). Patients presenting for late ASO are at risk due to the possibility of left ventricle (LV) involution. This study aimed to assess the early postoperative course and outcome for children with TGA/IVS and still conditioned LV presenting for late primary ASO. A retrospective study of all TGA/IVS patients who underwent a primary ASO between
Journal of Clinical Epidemiology, 2013
This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GR... more This article describes the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to classifying the direction and strength of recommendations. The strength of a recommendation, separated into strong and weak, is defined as the extent to which one can be confident that the desirable effects of an intervention outweigh its undesirable effects. Alternative terms for a weak recommendation include conditional, discretionary, or qualified. The strength of a recommendation has specific implications for patients, the public, clinicians, and policy makers. Occasionally, guideline developers may choose to make ''only-in-research'' recommendations. Although panels may choose not to make recommendations, this choice leaves those looking for answers from guidelines without the guidance they are seeking. GRADE therefore encourages panels to, wherever possible, offer recommendations. Ó
Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, m... more Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum. of Hindawi Publishing Corporation
Intensive Care Medicine, 2012
Writing committee: G Volpicelli (Emergency Medicine,