ORCID Profile
0000-0002-3680-7338
Current Organisations
King Abdulaziz Medical City
,
Jordan University of Science and Technology
,
King Saud bin Abdulaziz University for Health Sciences
,
King Abdullah International Medical Research Center
,
University of Jordan
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Publications
Patterns of intravenous fluid resuscitation use in adult intensive care patients between 2007 and 2014: An international cross-sectional study
Publisher: Public Library of Science (PLoS)
Date: 12-05-2017
Statistical analysis plan for the Erythropoietin in Traumatic Brain Injury trial: a randomised controlled trial of erythropoietin versus placebo in moderate and severe traumatic brain injury
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-beta1b (MIRACLE trial): study protocol for a randomized controlled trial
Publisher: Springer Science and Business Media LLC
Date: 30-01-2018
Global Survey of Outcomes of Neurocritical Care Patients: Analysis of the PRINCE Study Part 2
Publisher: Springer Science and Business Media LLC
Date: 04-09-2019
DOI: 10.1007/S12028-019-00835-Z
Abstract: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and in-hospital mortality of neurocritically ill patients worldwide. We addressed these issues in the Point PRevalence In Neurocritical CarE (PRINCE) study, a prospective, cross-sectional, observational study. We recruited patients from various intensive care units (ICUs) admitted on a pre-specified date, and the investigators recorded specific clinical care activities they performed on the subjects during their first 7 days of admission or discharge (whichever came first) from their ICUs and at hospital discharge. In this manuscript, we analyzed the final data set of the study that included patient admission characteristics, disease type and severity, ICU resources, ICU and hospital length of stay, and in-hospital mortality. We present descriptive statistics to summarize data from the case report form. We tested differences between geographically grouped data using parametric and nonparametric testing as appropriate. We used a multivariable logistic regression model to evaluate factors associated with in-hospital mortality. We analyzed data from 1545 patients admitted to 147 participating sites from 31 countries of which most were from North America (69%, N = 1063). Globally, there was variability in patient characteristics, admission diagnosis, ICU treatment team and resource allocation, and in-hospital mortality. Seventy-three percent of the participating centers were academic, and the most common admitting diagnosis was subarachnoid hemorrhage (13%). The majority of patients were male (59%), a half of whom had at least two comorbidities, and median Glasgow Coma Scale (GCS) of 13. Factors associated with in-hospital mortality included age (OR 1.03 95% CI, 1.02 to 1.04) lower GCS (OR 1.20 95% CI, 1.14 to 1.16 for every point reduction in GCS) pupillary reactivity (OR 1.8 95% CI, 1.09 to 3.23 for bilateral unreactive pupils) admission source (emergency room versus direct admission [OR 2.2 95% CI, 1.3 to 3.75] admission from a general ward versus direct admission [OR 5.85 95% CI, 2.75 to 12.45 and admission from another ICU versus direct admission [OR 3.34 95% CI, 1.27 to 8.8]) and the absence of a dedicated neurocritical care unit (NCCU) (OR 1.7 95% CI, 1.04 to 2.47). PRINCE is the first study to evaluate care patterns of neurocritical patients worldwide. The data suggest that there is a wide variability in clinical care resources and patient characteristics. Neurological severity of illness and the absence of a dedicated NCCU are independent predictors of in-patient mortality.
Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose-associated 90-Day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE III)
Publisher: American Thoracic Society
Date: 04-2023
Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1
Publisher: Springer Science and Business Media LLC
Date: 07-06-2019
Profile, outcome and predictors of mortality of abdomino-pelvic trauma patients in a tertiary intensive care unit in Saudi Arabia
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.INJURY.2014.07.025
Abstract: The Kingdom of Saudi Arabia (KSA) is one of countries with the world's highest number of deaths per 100,000 populations from road traffic accidents (RTAs). Numerous trauma victims sustain abdomino-pelvic injuries, which are associated with considerable morbidity and mortality. The purpose of this study was to describe profile, outcomes and predictors of mortality of patients with abdomino-pelvic trauma admitted to the intensive care unit (ICU) in a tertiary care trauma centre in Riyadh, KSA. This was a retrospective analysis of prospectively collected ICU database. All consecutive patients older than 14 years with abdomino-pelvic trauma from March 1999 to June 2013 were included. The followings were extracted: demographics, injury severity, mechanism and type of injury, associated injuries, use of vasopressors and mechanical ventilation, and worst laboratory results in the first 24h. The primary outcome was hospital mortality. We compared profile and outcomes between survivors and non-survivors and reported predictors of mortality. Of the 11,374 trauma patients who were admitted to the hospital during the study period, 2120 (18.6%) patients had abdomino-pelvic injuries, out of which 702 (33.1%) patients were admitted to the ICU. The mean age was 30.7 (SD 14.4) years and the majority was male (89.5%). RTA was the most common cause of abdomino-pelvic trauma (70.4%). Pelvis (46.2%), liver (25.8%), and spleen (23.1%) were the most frequently injured organs and chest (55.6%), head (41.9%), and lower extremities (27.5%) were the most commonly associated injuries. Mechanical ventilation was required in 89.6% with a mean duration of 9.1 (SD 9.2) days and emergency surgery was performed in 45.0% of the patients with prolonged ICU and hospital length of stay (10.8 [SD 10.8], 56.9 [SD 96.7] days respectively). Of the 702 patients with abdomino-pelvic trauma, 115 (16.4%) patients did not survive. Associated head trauma and retroperitoneal haematoma, higher level of lactic acid on admission and ISS, and advanced age were potential risk factors for hospital mortality. Abdomino-pelvic injuries are common in trauma patients, affecting mainly young male victims, and are associated with significant morbidity and mortality, and resource utilisation.
Macrolides in critically ill patients with Middle East Respiratory Syndrome
Publisher: Elsevier BV
Date: 04-2019
Type I interferon autoantibodies in hospitalized patients with Middle East respiratory syndrome and association with outcomes and treatment effect of interferon beta‐1b in MIRACLE clinical trial
Publisher: Wiley
Date: 03-2023
DOI: 10.1111/IRV.13116
Abstract: Type I interferons (IFNs) are essential antiviral cytokines induced upon respiratory exposure to coronaviruses. Defects in type I IFN signaling can result in severe disease upon exposure to respiratory viral infection and are associated with worse clinical outcomes. Neutralizing autoantibodies (auto‐Abs) to type I IFNs were reported as a risk factor for life‐threatening COVID‐19, but their presence has not been evaluated in patients with severe Middle East respiratory syndrome (MERS). We evaluated the prevalence of type I IFN auto‐Abs in a cohort of hospitalized patients with MERS who were enrolled in a placebo‐controlled clinical trial for treatment with IFN‐β1b and lopinavir‐ritonavir (MIRACLE trial). S les were tested for type I IFN auto‐Abs using a multiplex particle‐based assay. Among the 62 enrolled patients, 15 (24.2%) were positive for immunoglobulin G auto‐Abs for at least one subtype of type I IFNs. Auto‐Abs positive patients were not different from auto‐Abs negative patients in age, sex, or comorbidities. However, the majority (93.3%) of patients who were auto‐Abs positive were critically ill and admitted to the ICU at the time of enrollment compared to 66% in the auto‐Abs negative patients. The effect of treatment with IFN‐β1b and lopinavir‐ritonavir did not significantly differ between the two groups. This study demonstrates the presence of type I IFN auto‐Abs in hospitalized patients with MERS.
Novel Genes Associated with Colorectal Cancer Are Revealed by High Resolution Cytogenetic Analysis in a Patient Specific Manner
Publisher: Public Library of Science (PLoS)
Date: 30-10-2013
Early Sedation with Dexmedetomidine in Critically Ill Patients
Publisher: Massachusetts Medical Society
Date: 27-06-2019
Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome
Publisher: American Thoracic Society
Date: 15-03-2018
Computerized physician order entry of a sedation protocol is not associated with improved sedation practice or outcomes in critically ill patients
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Permissive Underfeeding or Standard Enteral Feeding in Critically Ill Adults
Publisher: Massachusetts Medical Society
Date: 18-06-2015
Psychometric properties of the Arabic version of the confusion assessment method for the intensive care unit (CAM-ICU)
Publisher: Springer Science and Business Media LLC
Date: 06-04-2018
PubMed-cited research articles on the Middle East respiratory syndrome
Publisher: Medknow
Date: 2016
Colorectal cancer driver genes identified by patient specific comparison of cytogenetic microarray
Publisher: Elsevier BV
Date: 12-2014
Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis
Publisher: Massachusetts Medical Society
Date: 04-04-2019
Treatment of Middle East respiratory syndrome with a combination of lopinavir/ritonavir and interferon-β1b (MIRACLE trial): statistical analysis plan for a recursive two-stage group sequential randomi
Publisher: Springer Science and Business Media LLC
Date: 03-01-2020
DOI: 10.1186/S13063-019-3846-X
Abstract: The MIRACLE trial (MERS-CoV Infection tReated with A Combination of Lopinavir/ritonavir and intErferon-β1b) investigates the efficacy of a combination therapy of lopinavir/ritonavir and recombinant interferon-β1b provided with standard supportive care, compared to placebo provided with standard supportive care, in hospitalized patients with laboratory-confirmed MERS. The MIRACLE trial is designed as a recursive, two-stage, group sequential, multicenter, placebo-controlled, double-blind randomized controlled trial. The aim of this article is to describe the statistical analysis plan for the MIRACLE trial. The primary outcome is 90-day mortality. The primary analysis will follow the intention-to-treat principle. The MIRACLE trial is the first randomized controlled trial for MERS treatment. ClinicalTrials.gov, NCT02845843 . Registered on 27 July 2016.
Heterogeneity of treatment effect of interferon-β1b and lopinavir–ritonavir in patients with Middle East respiratory syndrome by cytokine levels
Publisher: Springer Science and Business Media LLC
Date: 28-10-2022
DOI: 10.1038/S41598-022-22742-8
Abstract: Animal and human data indicate variable effects of interferons in treating coronavirus infections according to inflammatory status and timing of therapy. In this sub-study of the MIRACLE trial (MERS-CoV Infection Treated with a Combination of Lopinavir–Ritonavir and Interferon β-1b), we evaluated the heterogeneity of treatment effect of interferon-β1b and lopinavir–ritonavir versus placebo among hospitalized patients with MERS on 90-day mortality, according to cytokine levels and timing of therapy. We measured plasma levels of 17 cytokines at enrollment and tested the treatment effect on 90-day mortality according to cytokine levels (higher versus lower levels using the upper tertile (67%) as a cutoff point) and time to treatment (≤ 7 days versus 7 days of symptom onset) using interaction tests. Among 70 included patients, 32 received interferon-β1b and lopinavir–ritonavir and 38 received placebo. Interferon-β1b and lopinavir–ritonavir reduced mortality in patients with lower IL-2, IL-8 and IL-13 plasma concentrations but not in patients with higher levels (p-value for interaction = 0.09, 0.07, and 0.05, respectively) and with early but not late therapy (p = 0.002). There was no statistically significant heterogeneity of treatment effect according to other cytokine levels. Further work is needed to evaluate whether the assessment of inflammatory status can help in identifying patients with MERS who may benefit from interferon-β1b and lopinavir–ritonavir. Trial registration: This is a sub-study of the MIRACLE trial (ClinicalTrials.gov number, NCT02845843).
Critically Ill Patients With the Middle East Respiratory Syndrome: A Multicenter Retrospective Cohort Study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
DOI: 10.1097/CCM.0000000000002621
Abstract: To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. Retrospective cohort study. Patients admitted to ICUs in 14 Saudi Arabian hospitals. Critically ill patients with laboratory-confirmed Middle East respiratory syndrome severe acute respiratory infection ( n = 330) admitted between September 2012 and October 2015 were compared to consecutive critically ill patients with community-acquired severe acute respiratory infection of non–Middle East respiratory syndrome etiology (non–Middle East respiratory syndrome severe acute respiratory infection) ( n = 222). None. Although Middle East respiratory syndrome severe acute respiratory infection patients were younger than those with non–Middle East respiratory syndrome severe acute respiratory infection (median [quartile 1, quartile 3] 58 yr [44, 69] vs 70 [52, 78] p 0.001), clinical presentations and comorbidities overlapped substantially. Patients with Middle East respiratory syndrome severe acute respiratory infection had more severe hypoxemic respiratory failure (Pa o 2 /F io 2 : 106 [66, 160] vs 176 [104, 252] p 0.001) and more frequent nonrespiratory organ failure (nonrespiratory Sequential Organ Failure Assessment score: 6 [4, 9] vs 5 [3, 7] p = 0.002), thus required more frequently invasive mechanical ventilation (85.2% vs 73.0% p 0.001), oxygen rescue therapies (extracorporeal membrane oxygenation 5.8% vs 0.9% p = 0.003), vasopressor support (79.4% vs 55.0% p 0.001), and renal replacement therapy (48.8% vs 22.1% p 0.001). After adjustment for potential confounding factors, Middle East respiratory syndrome was independently associated with death compared to non–Middle East respiratory syndrome severe acute respiratory infection (adjusted odds ratio, 5.87 95% CI, 4.02–8.56 p 0.001). Substantial overlap exists in the clinical presentation and comorbidities among patients with Middle East respiratory syndrome severe acute respiratory infection from other etiologies therefore, a high index of suspicion combined with diagnostic testing is essential component of severe acute respiratory infection investigation for at-risk patients. The lack of distinguishing clinical features, the need to rely on real-time reverse transcription polymerase chain reaction from respiratory s les, variability in viral shedding duration, lack of effective therapy, and high mortality represent substantial clinical challenges and help guide ongoing clinical research efforts.
A Post Hoc Analysis of Osmotherapy Use in the Erythropoietin in Traumatic Brain Injury Study—Associations With Acute Kidney Injury and Mortality
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-01-2021
DOI: 10.1097/CCM.0000000000004853
Abstract: Mannitol and hypertonic saline are used to treat raised intracerebral pressure in patients with traumatic brain injury, but their possible effects on kidney function and mortality are unknown. A post hoc analysis of the erythropoietin trial in traumatic brain injury (ClinicalTrials.gov NCT00987454) including daily data on mannitol and hypertonic saline use. Twenty-nine university-affiliated teaching hospitals in seven countries. A total of 568 patients treated in the ICU for 48 hours without acute kidney injury of whom 43 (7%) received mannitol and 170 (29%) hypertonic saline. None. We categorized acute kidney injury stage according to the Kidney Disease Improving Global Outcome classification and defined acute kidney injury as any Kidney Disease Improving Global Outcome stage-based changes from the admission creatinine. We tested associations between early (first 2 d) mannitol and hypertonic saline and time to acute kidney injury up to ICU discharge and death up to 180 days with Cox regression analysis. Subsequently, acute kidney injury developed more often in patients receiving mannitol (35% vs 10% p 0.001) and hypertonic saline (23% vs 10% p 0.001). On competing risk analysis including factors associated with acute kidney injury, mannitol (hazard ratio, 2.3 95% CI, 1.2–4.3 p = 0.01), but not hypertonic saline (hazard ratio, 1.6 95% CI, 0.9–2.8 p = 0.08), was independently associated with time to acute kidney injury. In a Cox model for predicting time to death, both the use of mannitol (hazard ratio, 2.1 95% CI, 1.1–4.1 p = 0.03) and hypertonic saline (hazard ratio, 1.8 95% CI, 1.02–3.2 p = 0.04) were associated with time to death. In this post hoc analysis of a randomized controlled trial, the early use of mannitol, but not hypertonic saline, was independently associated with an increase in acute kidney injury. Our findings suggest the need to further evaluate the use and choice of osmotherapy in traumatic brain injury.
Related Organisations
King Saud Bin Abdulaziz University For Health Sciences
Location: Saudi Arabia
King Abdullah International Medical Research Center
Location: Saudi Arabia
Related Funding Activities
No related grants have been discovered for Ahmad Deeb.