Average Saturation Research Articles

Data saturation in qualitative research: A literature review in entrepreneurship study from 2004–2024

This systematic literature review examines data saturation in qualitative research within the context of entrepreneurship studies from 2004 to 2024. Data saturation, a critical concept in ensuring the rigor of qualitative research, remains inadequately defined in terms of sample size and assessment criteria across various studies. This review synthesizes 11 empirical studies, focusing on strategies such as stopping criterion, code frequency counts, and comparative methods for determining saturation. It identifies sample sizes ranging from 7 to 39 interviews, with an average saturation occurring between 10 and 12 interviews. Furthermore, the study explores the influence of different sampling methods and homogeneity of study populations on saturation outcomes. Despite the reliability of existing methods, the findings underscore the need for greater transparency and consistency in reporting saturation criteria. The review offers valuable insights for entrepreneurial researchers aiming to design qualitative studies, emphasizing the importance of tailored saturation standards based on research objectives and methodologies. This research contributes to a clearer understanding of data saturation in entrepreneurial studies and highlights the necessity for further empirical investigation into saturation across diverse qualitative methods.

Effect Of Level 1 Progressive Mobilization On Oxygen Saturation In Patients With Decreased Consciousness

Background: Patients in the intensive care unit are individuals who are in critical condition due to failure of function of one or more organs, with hemodynamic instability. They require special care and intensive monitoring, in the hope that their condition can improve through appropriate medical action (Setiyawan, 2016). The incidence of stroke is increasing every year, there are 11 million stroke cases in the world, especially in low-income countries, especially in South Asian states and it causes 4 million deaths every year, around 30% of them in Southeastern countries. In addition, stroke is one of the leading causes of death and disability in adults in the United States. Every year, nearly 795,000 people in the country experience a stroke, either new or recurrent, and this causes approximately 130,000 deaths annually. (WHO, 2016). Research Objective: To understand the effect of level 1 progressive mobilization on changes in oxygen saturation in patients with decreased consciousness. Methodology: This research uses quantitative methods. The approach is quasi-experimental with a utilitarian design, where the intervention is applied to one group, then observations are made on the independent variables. Research Results and Discussion: Before progressive mobilization measures were carried out, the level 1 oxygen saturation value in patients with impaired consciousness at Grandmed Lubuk Pakam Hospital, of the 24 respondents, 2 respondents had oxygen saturation of 92% (8.3%), 4 respondents 93% (16, 7%), 7 respondents 94% (29.2%), 7 respondents 95% (29.2%), 3 respondents 96% (12.5%) and 7 respondents had oxygen saturation 98% (4.2%) . Conclusion: The average O2 saturation value in patients with decreased consciousness before doing level 1 progressive exercise was 93.33, whereas after it increased it was 95.67.

Comparing the effects of oral sucrose and kangaroo mother care on selected physiological variables and pain resulting from venipuncture in premature newborns admitted to neonatal intensive care units

BackgroundPremature newborns admitted to neonatal intensive care units (NICUs) undergo numerous painful interventions during care and treatment. The purpose of this study was to compare the effects of using sucrose and kangaroo mother care by on selected physiological variables and pain resulting from venipuncture in premature infants admitted to NICUs affiliated with Shiraz University of Medical Sciences.MethodsThis clinical trial included premature infants admitted to 2 NICUs. The sample size consisted of 66 neonates, with 22 newborns in each group. Randomization was performed using the block allocation method. Data collection involved a demographic questionnaire, the neonatal infant pain scale, and a pulse oximetry device. Friedman, Kruskal–Wallis, and Dunn’s post hoc tests employed for data analysis, with a significance level of P < 0.05.ResultsThe use of oral sucrose and kangaroo care demonstrated significant differences in breathing rate, heart rate, and average arterial blood oxygen saturation during and after venipuncture (P < 0.05). Oral sucrose was found to be significantly more effective than kangaroo care. Neonates under kangaroo care exhibited more regular heart rates compared to the other group (P < 0.05). The utilization of oral sucrose and kangaroo care had varying effects on the average pain score resulting from venipuncture in premature neonates (P < 0.05).ConclusionsBoth methods proved effective in reducing pain and improving physiological variables. However, due to the superior effectiveness of sucrose administration, it is recommended as a cost-effective and easily implementable method in NICUs.Trial registration: Iranian Registry of Clinical Trials IRCT20191215045749N1. (29/03/2020).

Switchable Camouflage via Reflective Display

In nature, dynamic camouflage is performed by cephalopods and reptiles. Humans attempt to perform dynamic camouflage by employing display devices to show the surrounding background. In this work, a switchable camouflage device based on an electrophoretic display (EPD) is proposed. Color‐filter EPDs display colors by reflecting light through the color filters and black‐and‐white EPDs. The number of subpixels is found to be an important factor on color performance. To improve the poor saturation of color‐filter EPDs, the number of color filter subpixels is reduced. Compared with filters with three and four subpixels, a dual‐subpixel filter proposed in this work significantly improves the average saturation of red, green, and blue colors, with increases of 49% and 112%, respectively. Subsequently, the spectral characteristics of the color filter and black‐and‐white EPD are optimized by using genetic algorithm to reduce the average color difference between the display and the switchable target color, which can be reduced as low as 0.18. To visually demonstrate the color reproduction capability of the dual‐subpixel EPD, sample applications including the switchable vegetation and digital camouflages are designed and have a high degree of agreement with the background. In this work, an innovative and effective approach is introduced to dynamic camouflage.

Seasonal dynamics and regional distribution patterns of CO2 and CH4 in the north-eastern Baltic Sea

Abstract. Significant research has been carried out in the last decade to describe the CO2 system dynamics in the Baltic Sea. However, there is a lack of knowledge in this field in the NE Baltic Sea, which is the main focus of the present study. We analysed the physical forcing and hydrographic background in the study year (2018) and tried to elucidate the observed patterns of surface water CO2 partial pressure (pCO2) and methane concentrations (cCH4). Surface water pCO2 and cCH4 were continuously measured during six monitoring cruises onboard R/V Salme, covering the Northern Baltic Proper (NBP), the Gulf of Finland (GoF), and the Gulf of Riga (GoR) and all seasons in 2018. The general seasonal pCO2 pattern showed oversaturation in autumn–winter (average relative CO2 saturation 1.2) and undersaturation in spring–summer (average relative CO2 saturation 0.5), but it locally reached the saturation level during the cruises in April, May, and August in the GoR and in August in the GoF. The cCH4 was oversaturated during the entire study period, and the seasonal course was not well exposed on the background of high variability. Surface water pCO2 and cCH4 distributions showed larger spatial variability in the GoR and GoF than in the NBP for all six cruises. We linked the observed local maxima to river bulges, coastal upwelling events, fronts, and occasions when vertical mixing reached the seabed in shallow areas. Seasonal averaging over the CO2 flux suggests a weak sink for atmospheric CO2 for all basins, but high variability and the long periods between cruises (temporal gaps in observation) preclude a clear statement.

Lumped-element SNAIL parametric amplifier with two-pole matching network

Broadband impedance-matched Josephson parametric amplifiers are key components for high-fidelity single-shot multi-qubit readout. Nowadays, several types of impedance matched parametric amplifiers have been proposed: the first is an impedance-matched parametric amplifier based on a Klopfenstein taper, and the second is the impedance-matched parametric amplifier based on auxiliary resonators. Here, we present the quantum-limited 3-wave-mixing lumped-element SNAIL parametric amplifier with two-pole impedance matching transformer. A two-pole Chebyshev matching network with shunted resonators is based on parallel-plate capacitors and superconducting planar coil. Operating in a flux-pumped mode, we experimentally demonstrate an average gain of 15 dB across a 600 MHz bandwidth, along with an average saturation power of −107 dBm and quantum-limited noise temperature.

Individual heart failure patient variability in nocturnal hypoxia and arrhythmias.

Traditional heart failure research often uses daytime population parameter estimates to assess hypoxia and arrhythmias. This approach might not accurately represent heart failure patients as nighttime cardiac behaviors offer crucial insights into their health, especially regarding oxygen levels and heart rhythms. We conducted a prospective study on nocturnal oxygen saturation and heart rate in home-dwelling heart failure patients over 6 nights. Patients were recruited from the Walter Reed National Military Medical Center heart failure clinic. Criteria included a clinical diagnosis of heart failure, a New York Heart Association (NYHA) classification of I to III, ages between 21 to 90, cognitive intactness, capability to use the wearable device, and willingness to use the device for 6 consecutive nights. Average oxygen saturation was 92% with individual readings ranging from 40% to 100%. The mean heart rate was 72 beats per minute (bpm), but individual rates ranged from 18 bpm to a high of 296 bpm. A significant drop in oxygen levels and sleep arrhythmias were consistently observed among participants. Heart failure patients demonstrate notable and variable desaturations and arrhythmias across multiple nights. A single-night sleep study or a 24-hour heart rate monitor may not comprehensively depict patients' oxygenation and heart rate irregularities. Our research highlights wearable devices' potency in medical research for capturing essential nocturnal data. In only 6 nights, we gleaned invaluable clinical insights for optimizing patient care. This study is pioneering, being the first to intensively examine nighttime oxygen levels and heart rates in home-based heart failure patients.

Role of capillary pressure on carbon dioxide sequestration: mathematical analysis

ABSTRACT Geological disposal of CO2 after capturing the gas from large emitting sources is one of the safest and most prominent methods to eliminate CO2 from the atmosphere and mitigate climate change. The heterogeneities in porosity, permeability and capillary pressure in various underground formations impact gas distribution, affecting their storage capacity. Therefore, a numerical model is developed to study the plume migration under various physical heterogeneities by upscaling the variation in capillary pressure. Accordingly, homogeneous, heterogeneous and layered formations have been considered. The influence of capillary pressure and field-scale heterogeneities, such as porosity and permeability, is incorporated using the Leverett J function. The impact of variations in capillary pressure on gas migration is calibrated in different formations for ten years of injection. The analysis project that plume evolution in different formations highly deviates and a plume length of 3410 m is obtained for layered formation. A sensitivity analysis was conducted to understand the influence of interfacial tension in formations with differing heterogeneity. The change in interfacial tension impacts the average saturation of CO2, ranging from 0.287 to 0.155 in heterogeneous aquifers. The plume migration decreases in layered and increases in homogenous and heterogeneous media with decreased interfacial tension.

A retrospective evaluation of SwePEWS use in paediatric patients with COVID-19 and RSV infection.

As early detection of deterioration is a challenge in children, the Swedish Paediatric Early Warning Score (SwePEWS) is used to systematically assess paediatric patients' clinical state. Here, we aimed to evaluate the use and predictive ability of SwePEWS. Electronic health records of paediatric patients admitted due to respiratory syncytial virus infection or COVID-19 were reviewed retrospectively. Registered vital signs were compared to the assigned SwePEWS score and monitored vital sign values to identify discrepancies. Additionally, SwePEWS's ability to predict transfer to the paediatric intensive care unit (PICU) was assessed. Among 1374 SwePEWS assessments, one-third were either incomplete or contained errors. Incomplete SwePEWS assessments were more frequent during night-time. Single measurements of oxygen saturation presented lower values compared to average saturation from continuous monitoring. SwePEWS's ability to predict PICU transfer was low. There was a surprisingly high occurrence of underestimated SwePEWS scores. This study provides new insights into pitfalls when developing and implementing paediatric early warning scores for systematic re-evaluations in paediatric patients.

Evaluation of wakefulness electroencephalogram in OSA patients.

Obstructive sleep apnea (OSA) has been associated with an elevated cardiovascular risk, increased daytime sleepiness, cognitive decline, and slower electroencephalographic activity (EEG). This study assesses EEG patterns during wakefulness in OSA patients compared to those without sleep-disordered breathing. This retrospective study analyzed 30 OSA patients with an Apnea/Hypopnea Index (AHI) of 15 or higher, as well as 29 individuals without sleep-disordered breathing (AHI of 5 or lower) who underwent hospital polysomnography and met all inclusion criteria. Sociodemographic and EEG data were obtained from the sleep laboratory database. Blinded EEG analysis was conducted by two observers, assessing activity in the frontal, central, and occipital regions. No significant differences were observed in EEG activity between OSA and non-OSA patients. However, a weak correlation was found between decreased C3 EEG frequency and higher AHI (p = 0.033), as well as increased total sleep time and higher O2 EEG frequency (p = 0.038). Lower amplitudes in C3 (p = 0.043) and O1 (p = 0.031) were correlated with reduced average oxygen saturation. Our findings suggest that OSA-related hypoxemia may impact neuronal activity, highlighting the need to address this sleep-disordered breathing in order to potentially prevent the cognitive decline observed in OSA patients.

Associations between quantitative susceptibility mapping with male obstructive sleep apnea clinical and imaging markers

PurposeTo quantitatively measure and compare whole-brain iron deposition between OSA patients and a healthy control group, we initially utilized QSM and evaluated its correlation with PSG results and cognitive function. Materials and methodsA total of 28 OSA patients and 22 healthy control subjects matched in age, education level, and BMI were enrolled in our study. Each participant underwent scanning with 3D T1 and multi-echo GRE sequences. Additionally, PSG results were collected from OSA patients, and they underwent simple cognitive assessments. Finally, we analyzed the relationship between iron content in different brain regions, PSG results, and cognitive ability. ResultsIn OSA patients, iron content increased in the left temporal-pole-sup and right putamen, while it decreased in the left fusiform gyrus, left middle temporal gyrus, right inferior occipital gyrus, and right superior temporal gyrus. The correlation analysis between brain iron content and PSG results/cognitive scales is as follows: left fusiform gyrus and MMSE (r = −0.416, p = 0.028); right superior temporal gyrus and MMSE (r = 0.422, p = 0.025); left middle temporal gyrus and average oxygen saturation (r = −0.418, p = 0.027); left temporal-pole-sup and REM stage (rs = 0.466, p = 0.012); the right putamen and N1 stage (rs = 0.393. p = 0.039). Moreover, both MoCA (r = 0.598, p = 0.001) and MMSE (r = 0.456, p = 0.015) show a positive correlation with average oxygen saturation. ConclusionThis study is the first to use QSM technology to show abnormal brain iron levels in OSA. Correlations between brain iron content, PSG, and cognition in OSA may reveal neuropathological mechanisms, aiding OSA diagnosis.

Predictors of spontaneous pregnancy loss in single ventricle physiology

BackgroundPregnant patients with single ventricle (SV) physiology carry a high risk of spontaneous pregnancy loss (SPL), yet the clinical factors contributing to this risk are not well defined.MethodsSingle-centre retrospective study...

Geochemistry and geochronology of 1.7-1.8 Ga peraluminous A-type granites and granite-gneiss from the Mahakoshal Basin, Central Indian Tectonic Zone (CITZ): implications for an accretionary orogen for the evolution of CITZ

ABSTRACT Here, we report petrography, whole-rock geochemistry, and zircon U-Pb geochronology to understand the origin, source, geodynamic setting, and evolution of A-type granite and granite gneiss as well as establish their emplacement age from Mahakoshal Basin. Mineralogically, Sidhi granite gneiss and Madanmahal granite of the Mahakoshal Basin dominantly consist of quartz, K-feldspar, and plagioclase. Geochemically, Sidhi granite gneiss and Madanmahal granite are ferroan in nature. The studied rocks are akin to peraluminous A-type granites and have average zircon saturation temperatures of 955°C and 977°C, respectively. The studied rock types are derived from partial melting of pre-existing crust indicated by (Y/Nb)N >0.18, (Th/Nb)N >2, (Ce/Pb)N <1, and (La/Nb)N >2 accompanied by the Eu, Ba, Sr, Ti, and Nb negative anomalies. The zircon U-Pb geochronology yielded emplacement ages of 1723 ± 16 Ma for the Sidhi granite gneiss and 1801 ± 64 Ma for the Madanmahal granite. Based on similar geochemical characteristics such as rare earth element patterns, Eu anomalies, and Ce/Pb, La/Nb, and Th/Nb ratios, we propose that the Sidhi granite gneiss and Madanmahal granite are derived from the same source i.e. Bundelkhand gneisses and granites, and formed in a post-orogenic rift environment of the accretionary orogen setting.

Telemedicine in Pediatric Respiratory Care: Benefits, Challenges, and Future Directions

This study explores the impact of telemedicine on pediatric respiratory care, focusing on its benefits, challenges, and future directions. A mixed-methods approach was employed, involving 150 pediatric patients with chronic respiratory conditions such as asthma and cystic fibrosis, who were randomly assigned to either telemedicine or traditional care groups. The telemedicine group used a digital platform for video consultations, remote monitoring, and health management over a 12-month period. Quantitative data on clinical outcomes, including emergency department visits and hospitalizations, were collected from electronic health records, while patient-reported outcomes were assessed through surveys. Qualitative data were gathered via semi-structured interviews with patients and caregivers. Results indicated that the telemedicine group experienced significantly fewer emergency visits and hospitalizations, higher quality of life scores, better treatment adherence, and greater patient satisfaction compared to the traditional care group. Average oxygen saturation and peak flow rates were also higher in the telemedicine group, and more frequent monitoring alerts were noted.

Solar photovoltaic fed synchronous reluctance motor with optimized rotor flux barriers: Design and performance optimization

This paper focuses on enhancing the design of a synchronous reluctance motor (SyRM) specifically tailored for solar photovoltaic (PV) water pumping applications. With growing adoption of green technologies and renewable energy sources, particularly solar power, there is a need to boost the motor's efficiency to meet the demands of such applications. Utilizing renewable energy for water pumping offers significant advantages in terms of sustainability, scalability, and environmentally friendly energy generation. Achieving optimal efficiency and reliability is paramount, as it reduces overall system cost and enhances reliability. SyRM design methodology in this study integrates both analytical and finite element (FE) procedures. Unlike other motor types, the rotor structure of the SyRM does not include any cages, magnets, or windings, resulting in a robust, reliable, and cost-effective manufacturing process. In SyRM, the rotor is constructed solely with barriers, which significantly impact torque shaping, torque ripple content, and power factor. This paper primarily examines the influence of various air-barrier shapes on different motor performance parameters, such as average torque, torque ripple, saturation, cross-section, and saliency ratio. The selected motor configuration for this investigation is a 4-pole, 100 Hz synchronous reluctance motor with 24 stator slots. The accuracy of the FE analysis findings is validated through a prototype of designed SyRM, followed by comprehensive performance evaluations conducted in a controlled laboratory environment. Additionally, this paper addresses an improved control strategy for a SyRM-based photovoltaic (PV) water pumping system. It eliminates the need for a speed controller in the position sensor-less field-oriented control (FOC) of SyRM. The solar water pump drive involves two stages of power conversion.

Performance of Wrist-Worn Pulse Oximeter for the Screening of Obstructive Sleep Apnea.

A sleep apnea monitor (BM2000A) is a wrist-worn device that measures oxygen saturation and pulse rate during sleep. This study aimed to evaluate the efficacy of the watch-like BM2000A for screening obstructive sleep apnea (OSA). 102 patients complaining of sleep breathing disorders were included; 81% were men and 19% were women. All participants underwent overnight simultaneous polysomnography (PSG) and BM2000A sleep monitoring. The number of apneas and hypopneas, apnea-hypopnea index (AHI), percentage of time spent with oxygen saturation under 90%, average oxygen saturation, lowest oxygen saturation, and duration of sleep were computed by the BM2000A and PSG. Then, these parameters were compared to validate the BM2000A. All parameters, measured with BM2000A, had a good correlation (r ≥ 0.6, p < 0.0001) with PSG-derived indexes, except for sleep time (r = 0.19, p = 0.061) and hypopnea index (r = 0.4, p < 0.0001). AHI had the strongest correlation (r = 0.87, p < 0.0001). The mean difference between AHI values calculated with PSG and wrist-worn pulse oximeter (WPO) was -17.66 events/h (95% CI: -50.39 to 15.06). In AHI ≥ 5, BM2000A had 90.7% sensitivity, 100% specificity, 91.2% accuracy, and 0.994 area under the curve. Using AHI ≥ 5, ≥ 15, and ≥30 as the screening criteria, optimal WPO-AHI cutoffs to improve the screening accuracy were 3.10, 8.92, and 13.05. BM2000A-derived results properly correlate with PSG and can provide OSA screening with good sensitivity and specificity.

Sleep-disordered breathing increases mortality in patients with diabetes.

Sleep-disordered breathing (SDB) and diabetes mellitus (DM) are often concomitant; however, data on the impact of SDB on mortality in the population with diabetes remain scarce. The population from the Sleep Heart Health Study, a multicenter prospective observational study representing 5780 patients with polysomnography and mortality data, including 453 patients with DM, was analyzed to assess the impact of SDB variables and the presence of DM on all-cause, cardiovascular disease (CVD), and non-CVD associated mortality. Survival analysis and proportional hazard regression models were used to calculate the adjusted hazard ratios (aHR) for mortality. Patients with DM and the average SpO2 >91.4% had significantly lower all-cause (aHR 0.52, CI 0.34-0.80) and CVD mortality risk (aHR 0.44, CI 0.22-0.87) as compared with patients with SpO2 below this value. Apnea-hypopnea index >31 (aHR 1.58, CI 1.10-2.28) and oxygen desaturation index >13.3 (aHR 1.58, CI 1.10-2.25) were associated with increased all-cause mortality in participants with DM on treatment. Sleep efficiency and proportion of rapid-eye movement (REM) sleep did not have any impact on mortality in patients with DM and thus differed significantly from individuals without DM, where increased all-cause mortality was observed in those with sleep efficiency <81.4% (aHR 0.77, CI 0.68-0.87) or REM sleep <14.9% (aHR 0.78, CI 0.68-0.89). Patients with diabetes on treatment and moderate to severe sleep-disordered breathing experience increased all-cause mortality. Reduced average oxygen saturation predicted both all-cause and cardiovascular death in the population with diabetes.

Verbal memory is linked to average oxygen saturation during sleep, not the apnea-hypopnea index nor novel hypoxic load variables

IntroductionThe apnea-hypopnea index (AHI) is the current diagnostic parameter for diagnosing and estimating the severity of obstructive sleep apnea (OSA). It is, however, poorly associated with the main clinical symptom of OSA, excessive daytime sleepiness, and with the often-seen cognitive decline among OSA patients. To better evaluate OSA severity, novel hypoxic load parameters have been introduced that consider the duration and depth of oxygen saturation drops associated with apneas or hypopneas. The aim of this paper was to compare novel hypoxic load parameters and traditional OSA parameters to verbal memory and executive function in OSA patients. MethodA total of 207 adults completed a one-night polysomnography at sleep laboratory and two neuropsychological assessments, the Rey Auditory Verbal Learning Test and Stroop test. Results: Simple linear regression analyses were used to evaluate independent associations between each OSA parameter and cognitive performance. Associations were found between immediate recall and arousal index, hypoxia <90 %, average SpO2 during sleep, and DesSev100+RevSev100. Total recall was associated with all OSA parameters, and no associations were found with the Stroop test. Subsequently, sex, age, and education were included as covariates in multiple linear regression analyses for each OSA parameter and cognitive performance. The main findings of the study were that average SpO2 during sleep was a significant predictor of total recall (p < .007, β = −.188) with the regression model explaining 21.2 % of performance variation. Average SpO2 during sleep was also a significant predictor of immediate recall (p < .022, β = −.171) with the regression model explaining 11.4 % of performance variation. Neither traditional OSA parameters nor novel hypoxic load parameters predicted cognitive performance after adjustment for sex, age, and education. ConclusionThe findings validate that the AHI is not an effective indicator of cognitive performance in OSA and suggest that average oxygen saturation during sleep may be the strongest PSG predictor of cognitive decline seen in OSA. The results also underline the importance of considering age when choosing neurocognitive tests, the importance of including more than one test for each cognitive domain as most tests are not pure measures of a single cognitive factor, and the importance of including tests that cover all cognitive domains as OSA is likely to have diffuse cognitive effects.

لخصائص الخزانية من سجالت تسجيل اآلبار لتكوين المامونيات، حقل النفط M، منطقة امتياز 115 CN، حوض مرزق الشمالي الغربي، جنوب غرب ليبي

This study is concerned with Reservoir characteristics at M field, concession NC-115 in Murzuq basin sw of Libya. Mamuniyat formation is considered the first reservoir in the studied field M-NC115, sourced and sealed by Tanezzuft formation.Well recording operations have developed at the present time to become an essential and important part of drilling conclusions in addition to productive probing operations, which give us information about the well's productivity. Twelve wells were identified for this work scattered in the study area. A petrophysical assessment was achieved with interactive petrophysics software 2018. The results showed that the study Formation consists of sandstones with a small percentage of shale. The results also showed that the upper part of the studied reservoir at ((zones I and II)) is of higher quality than the lower part (zones IV). The reservoir thickness is about 960 ft in the north flank of the study area, and it is completely absent in the southwest flank of the study area. The results also illustrated that the average water saturation is 40%, the porosity is 12%, and the reservoir thickness is 560 ft.

Outcomes of different steroid dosing regimens in critical Covid-19 pneumonia at a Kenyan hospital: A retrospective cohort study.

Among therapeutic options for severe and critical COVID- 19 infection, dexamethasone six milligrams once daily for ten days has demonstrated mortality benefit and is guideline recommended at this dose. In practice, variable doses of steroids have been used, especially in critical care settings. Our study aimed to determine the pattern of steroid dosing and outcomes in terms of critical care mortality, occurrence of dysglycaemias, and occurrence of superadded infections in patients with critical COVID-19. A retrospective cohort study was carried out on all eligible patients admitted to the Aga Khan University Hospital, Nairobi, with critical COVID-19 between 1st March 2020 and 31st December 2021. The intervention of interest was corticosteroids quantified as the average daily dose in milligrams of dexamethasone. A steroid dose of six milligrams once a day was compared to high dose steroid dosing, which was defined as any dose greater than this. The primary outcome measure was ICU mortality and secondary outcomes included occurrence of dysglycaemias, superadded infections and duration of critical care admission. The study included 288 patients. The median age was 61.2 years (IQR: 49.7, 72.5), with 71.2% of patients being male. The most common comorbidities were diabetes mellitus (60.7%), hypertension (58%), and heart disease (12.2%). The average oxygen saturation and C-reactive protein at admission were 82% [IQR: 70.0-89.0]and 113.0 [IQR: 54.0-186.0], respectively. Fifty-eight percent of patients received a standard dose (6mg) of steroids. The mortality rate was higher in the high-dose group compared to the standard-dose group; however, the difference was not statistically significant (47.9% vs 43.7% p = 0.549). The two most common steroid associated adverse effects were uncomplicated hyperglycemia (62.2%) and superimposed bacterial pneumonia (20.1%). The high-dose group had a higher incidence of uncomplicated hyperglycemia compared to the standard-dose group (63.6% vs 61.1%). However, the incidence of diabetic ketoacidosis was lower in the high dose group (0.6% vs 6.6%). Oxygen saturation at admission was associated with survival where it was lower among non-survivor patients with critical COVID-19. The study found that high-dose steroids in the treatment of critically ill patients with COVID-19 pneumonia did not confer any mortality benefit and were associated with an increased risk of dysglycemia and superimposed infections.