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Peer Review of “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study”

Peer Review of “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study”

In addition, authors should discuss the type of mechanical ventilation, because studies show that invasive ventilation (intubation) creates VAP (ventilator-associated pneumonia), and a lot of people intubated for COVID-19 died from this problem rather than COVID-19. Countries that have reduced mortality, such as Germany and New Zealand, used mainly noninvasive ventilation, which can better treat patients and avoid mortality with new technology. See suggested papers.

Mario Coccia

JMIRx Med 2024;5:e59638

Author’s Response to Peer Reviews of “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study”

Author’s Response to Peer Reviews of “Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study”

In addition, authors should discuss the type of mechanical ventilation, because studies show that invasive ventilation (intubation) creates VAP (ventilator-associated pneumonia), and a lot of people intubated for COVID-19 died from this problem rather than COVID-19. Countries that have reduced mortality, such as Germany and New Zealand, used mainly noninvasive ventilation, which can better treat patients and avoid mortality with new technology.

Theodore Lytras

JMIRx Med 2024;5:e59637

Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study

Health Care System Overstretch and In-Hospital Mortality of Intubated Patients With COVID-19 in Greece From September 2020 to April 2022: Updated Retrospective Cohort Study

Briefly, we obtained anonymized patient data from the Greek National Public Health Organization (NPHO) for all cases intubated between September 1, 2020, and April 3, 2022, including vaccination status (number of doses received); dates of intubation, extubation, intensive care unit (ICU) admission, and discharge; and outcome at discharge (alive or dead); we followed these cases up to May 17, 2022.

Theodore Lytras

JMIRx Med 2024;5:e43341

A Hybrid Decision Tree and Deep Learning Approach Combining Medical Imaging and Electronic Medical Records to Predict Intubation Among Hospitalized Patients With COVID-19: Algorithm Development and Validation

A Hybrid Decision Tree and Deep Learning Approach Combining Medical Imaging and Electronic Medical Records to Predict Intubation Among Hospitalized Patients With COVID-19: Algorithm Development and Validation

The decision to intubate a patient with COVID-19 and the timings of intubation are very challenging, and there remains significant clinical uncertainty. Currently, clinical judgment, patient’s choice, and advance directives regarding IMV are the main drivers of the decision to intubate. Clinical markers such as respiratory rate, oxygen saturation, dyspnea, arterial blood gases, and radiographic observations are the primary markers routinely being used to identify candidates for intubation [11].

Kim-Anh-Nhi Nguyen, Pranai Tandon, Sahar Ghanavati, Satya Narayana Cheetirala, Prem Timsina, Robert Freeman, David Reich, Matthew A Levin, Madhu Mazumdar, Zahi A Fayad, Arash Kia

JMIR Form Res 2023;7:e46905

Left Head Rotation as an Alternative to Difficult Tracheal Intubation: Randomized Open Label Clinical Trial

Left Head Rotation as an Alternative to Difficult Tracheal Intubation: Randomized Open Label Clinical Trial

However, in some studies, the sniffing position did not improve glottic visualization, the success rate on first intubation, or intubation time [14,15]. These inconsistent findings with sniffing position pose a challenge for tracheal intubation in cases where alternate intubation techniques and devices, such as video laryngoscopes and flexible bronchoscopes, especially in low- and middle-income settings where advanced techniques may not be readily available in all hospitals.

Danya P Chan, George Carlos Rosendo M Jularbal III, Ismael Julius R Mapili

Interact J Med Res 2023;12:e42500

Assessing Barriers to Implementation of Machine Learning and Artificial Intelligence–Based Tools in Critical Care: Web-Based Survey Study

Assessing Barriers to Implementation of Machine Learning and Artificial Intelligence–Based Tools in Critical Care: Web-Based Survey Study

We have recently reported a deep learning algorithm to predict the need for intubation in patients at risk of respiratory failure in the intensive care unit (ICU) [6]. This algorithm was validated on multiple data sets and was shown to outperform expert clinicians as well as an established predictive model [7]. However, this algorithm is not yet widely implemented.

Eric Mlodzinski, Gabriel Wardi, Clare Viglione, Shamim Nemati, Laura Crotty Alexander, Atul Malhotra

JMIR Perioper Med 2023;6:e41056

Use of Robots in Critical Care: Systematic Review

Use of Robots in Critical Care: Systematic Review

Studies were included if they were RCTs and observational studies reporting robotic use on human participants in critical care settings (intensive care unit [ICU], burns unit, high-dependency unit, critical care, and neonatal ICU [NICU]) or during procedures required in critical care settings (intubation, ventilation, tracheostomy, cannulation, resuscitation, and dialysis).

Rachel Teng, Yichen Ding, Kay Choong See

J Med Internet Res 2022;24(5):e33380

Machine Learning Approaches for Predicting Difficult Airway and First-Pass Success in the Emergency Department: Multicenter Prospective Observational Study

Machine Learning Approaches for Predicting Difficult Airway and First-Pass Success in the Emergency Department: Multicenter Prospective Observational Study

In the emergency department (ED), achieving successful tracheal intubation at the initial attempt (ie, first-pass success) is essential [1]. The literature has shown that repeated intubation attempts are associated with a higher rate of adverse events [2-4]. However, recent studies have also reported first-pass success rates of 74%-84% in the ED [5,6], suggesting that there are still occasions where repeated intubation attempts are required.

Syunsuke Yamanaka, Tadahiro Goto, Koji Morikawa, Hiroko Watase, Hiroshi Okamoto, Yusuke Hagiwara, Kohei Hasegawa

Interact J Med Res 2022;11(1):e28366

Authors’ Responses to Peer Reviews of “Utility of the ROX Index in Predicting Intubation for Patients With COVID-19–Related Hypoxemic Respiratory Failure Receiving High-Flow Nasal Therapy: Retrospective Cohort Study”

Authors’ Responses to Peer Reviews of “Utility of the ROX Index in Predicting Intubation for Patients With COVID-19–Related Hypoxemic Respiratory Failure Receiving High-Flow Nasal Therapy: Retrospective Cohort Study”

This is the authors’ response to peer-review reports for the paper “Utility of the ROX Index in Predicting Intubation for Patients With COVID-19–Related Hypoxemic Respiratory Failure Receiving High-Flow Nasal Therapy: Retrospective Cohort Study”. Thank you, Reviewer G [1], for your comments on our paper [2]. We appreciate your wonderful feedback. The Methods section was modified to clarify the inclusion criteria further.

Maulin Patel, Junad Chowdhury, Nicole Mills, Robert Marron, Andrew Gangemi, Zachariah Dorey-Stein, Ibraheem Yousef, Matthew Zheng, Lauren Tragesser, Julie Giurintano, Rohit Gupta, Parth Rali, Gilbert D'Alonzo, Huaqing Zhao, Nicole Patlakh, Nathaniel Marchetti, Gerard Criner, Matthew Gordon

JMIRx Med 2021;2(3):e31892