Azadeh Fayazi

All Publications

• Effectiveness of Iterative Practice in Pediatric Simulation at a Community Hospital. Cureus Fayazi, A., Hopkins, S. 2026; 18 (3): e105834

  Abstract

  Objective The goal of this study was to improve knowledge and teamwork within a limited simulation period. We hypothesized that implementing iterative practice will increase pediatric resuscitation knowledge and specific team behaviors by 10%. Methodology We implemented an in situ, multidisciplinary, high-fidelity simulation curriculum, in which the scenario was repeated. This study tracked improvements through three multiple-choice questionnaires. Data collected over two years were analyzed using McNemar's test to compare paired binary variables and the Wilcoxon signed-rank test to compare paired ordinal variables. Results A total of 99 questionnaires were completed. Knowledge of indications for cardiopulmonary resuscitation in children improved by 12% (n = 12, p = 0.008); chest compression-to-ventilation ratio in adolescents increased by 16% (n = 16, p = 0.005); chest compression-to-ventilation ratio in children improved by 11% (n = 11, p = 0.03); and ventilation rate with an advanced airway increased after both simulations by 22% (n = 22, p < 0.001) and then by 13% (n = 13, p = 0.004). Statistically significant improvements were not observed for choosing the correct shockable rhythms. All team behaviors improved: information was "always" received by 81% (n = 80) of participants and increased to 94% (n = 93, p < 0.001); self-identification improved from 66% (n = 65) of participants to 87% (n = 86, p < 0.001); and leader identification was noted by 73% (n = 72) of non-leader participants and increased to 88% (n = 87, p < 0.001). Conclusion Iterative simulation practice effectively enhances proximal knowledge and pediatric resuscitation team performance in community hospitals. Future research should explore the simulation frequency needed to retain this knowledge and these skills.

  View details for DOI 10.7759/cureus.105834

  View details for PubMedID 42037854

  View details for PubMedCentralID PMC13108618

• Hyperoxemia among Pediatric Intensive Care Unit Patients Receiving Oxygen Therapy. Journal of pediatric intensive care Fayazi, A. R., Sesia, M., Anand, K. J. 2024; 13 (2): 184-191

  Abstract

  Supratherapeutic oxygen levels consistently cause oxygen toxicity in the lungs and other organs. The prevalence and severity of hyperoxemia among pediatric intensive care unit (PICU) patients remain unknown. This was the first study to examine the prevalence and duration of hyperoxemia in PICU patients receiving oxygen therapy. This is a retrospective chart review. This was performed in a setting of 36-bed PICU in a quaternary-care children's hospital. All the patients were children aged <18 years, admitted to the PICU for ≥24 hours, receiving oxygen therapy for ≥12 hours who had at least one arterial blood gas during this time. There was no intervention. Of 5,251 patients admitted to the PICU, 614 were included in the study. On average, these patients received oxygen therapy for 91% of their time in the PICU and remained hyperoxemic, as measured by pulse oximetry, for 65% of their time on oxygen therapy. Patients on oxygen therapy remained hyperoxemic for a median of 38 hours per patient and only 1.1% of patients did not experience any hyperoxemia. Most of the time (87.5%) patients received oxygen therapy through a fraction of inspired oxygen (FiO 2 )-adjustable device. Mean FiO 2 on noninvasive support was 0.56 and on invasive support was 0.37. Mean partial pressure of oxygen (PaO 2 ) on oxygen therapy was 108.7 torr and 3,037 (42.1%) of PaO 2 measurements were >100 torr. Despite relatively low FiO 2 , PICU patients receiving oxygen therapy are commonly exposed to prolonged hyperoxemia, which may contribute to ongoing organ injury.

  View details for DOI 10.1055/s-0041-1740586

  View details for PubMedID 38919694

  View details for PubMedCentralID PMC11196156

• Hyperoxemia among Pediatric Intensive Care Unit Patients Receiving Oxygen Therapy JOURNAL OF PEDIATRIC INTENSIVE CARE Fayazi, A. R., Sesia, M., Anand, K. J. S. 2021

  View details for DOI 10.1055/s-0041-1740586

  View details for Web of Science ID 000733595800002

• Maintaining Social Distancing: Video and Just-in-Time In Situ Simulation During the COVID-19 Pandemic. Simulation in healthcare : journal of the Society for Simulation in Healthcare Han, P. K., Fayazi, A. R., Wiryawan, B., Berg, M. D. 2021

  Abstract

  ABSTRACT: Respiratory failure and cardiopulmonary arrest in patients with SARS-CoV-2 infection require life-saving procedures that aerosolize virus and increase risk of transmission. To educate faculty, trainees, and staff on safe practices, a video with embedded questions was created demonstrating intubation and cardiopulmonary resuscitation in pediatric SARS-CoV-2+ patients. Just-in-time in situ simulations of these scenarios were also carried out while adhering to isolation and social distancing protocols. We demonstrated that use of simulation to train physicians and staff during the COVID-19 pandemic is possible and effective in improving confidence in performance of the procedures.

  View details for DOI 10.1097/SIH.0000000000000607

  View details for PubMedID 34381006

• WEANING OXYGEN THERAPY WITH COMPUTER-ASSISTED ADAPTIVE CONTROL MODEL: A FEASIBILITY STUDY Bhargava, V., Fayazi, A., Anand, K. LIPPINCOTT WILLIAMS & WILKINS. 2020

  View details for Web of Science ID 000530000201602

• Criteria for Critical Care Infants and Children: PICU Admission, Discharge, and Triage Practice Statement and Levels of Care Guidance PEDIATRIC CRITICAL CARE MEDICINE Frankel, L. R., Hsu, B. S., Yeh, T. S., Simone, S., Agus, M. S. D., Arca, M. J., Coss-Bu, J. A., Fallat, M. E., Foland, J., Gadepalli, S., Gayle, M. O., Harmon, L. A., Hill, V., Joseph, C. A., Kessel, A. D., Kissoon, N., Moss, M., Mysore, M. R., Papo, M. E., Rajzer-Wakeham, K. L., Rice, T. B., Rosenberg, D. L., Wakeham, M. K., Conway, E. E., Bernard, P. A., Bettencourt, A. P., Bishop, J. M., Carpenter, T., Castello, F. V., Czaja, A., Fayazi, A. R., Kelly, R. B., Kiragu, A. W., Lai, Y., Leonard, C., Lowrie, L. H., Markovitz, B. P., McCrory, M. C., Mehta, R., Nakagawa, T. A., Odetola, F., Parker, M. M., Paulson, T. E., Powel, V. A., Relvas, M. S., Rozenfeld, R. A., Sanders, R. C., Serrao, K., Shankar, V., Shein, S., Stockwell, D., Stryjewski, G., Vats, A., Williamson, J., Voting Panel 2019; 20 (9): 847–87

  Abstract

  To update the American Academy of Pediatrics and Society of Critical Care Medicine's 2004 Guidelines and levels of care for PICU.A task force was appointed by the American College of Critical Care Medicine to follow a standardized and systematic review of the literature using an evidence-based approach. The 2004 Admission, Discharge and Triage Guidelines served as the starting point, and searches in Medline (Ovid), Embase (Ovid), and PubMed resulted in 329 articles published from 2004 to 2016. Only 21 pediatric studies evaluating outcomes related to pediatric level of care, specialized PICU, patient volume, or personnel. Of these, 13 studies were large retrospective registry data analyses, six small single-center studies, and two multicenter survey analyses. Limited high-quality evidence was found, and therefore, a modified Delphi process was used. Liaisons from the American Academy of Pediatrics were included in the panel representing critical care, surgical, and hospital medicine expertise for the development of this practice guidance. The title was amended to "practice statement" and "guidance" because Grading of Recommendations, Assessment, Development, and Evaluation methodology was not possible in this administrative work and to align with requirements put forth by the American Academy of Pediatrics.The panel consisted of two groups: a voting group and a writing group. The panel used an iterative collaborative approach to formulate statements on the basis of the literature review and common practice of the pediatric critical care bedside experts and administrators on the task force. Statements were then formulated and presented via an online anonymous voting tool to a voting group using a three-cycle interactive forecasting Delphi method. With each cycle of voting, statements were refined on the basis of votes received and on comments. Voting was conducted between the months of January 2017 and March 2017. The consensus was deemed achieved once 80% or higher scores from the voting group were recorded on any given statement or where there was consensus upon review of comments provided by voters. The Voting Panel was required to vote in all three forecasting events for the final evaluation of the data and inclusion in this work. The writing panel developed admission recommendations by level of care on the basis of voting results.The panel voted on 30 statements, five of which were multicomponent statements addressing characteristics specific to PICU level of care including team structure, technology, education and training, academic pursuits, and indications for transfer to tertiary or quaternary PICU. Of the remaining 25 statements, 17 reached consensus cutoff score. Following a review of the Delphi results and consensus, the recommendations were written.This practice statement and level of care guidance manuscript addresses important specifications for each PICU level of care, including the team structure and resources, technology and equipment, education and training, quality metrics, admission and discharge criteria, and indications for transfer to a higher level of care. The sparse high-quality evidence led the panel to use a modified Delphi process to seek expert opinion to develop consensus-based recommendations where gaps in the evidence exist. Despite this limitation, the members of the Task Force believe that these recommendations will provide guidance to practitioners in making informed decisions regarding pediatric admission or transfer to the appropriate level of care to achieve best outcomes.

  View details for DOI 10.1097/PCC.0000000000001963

  View details for Web of Science ID 000485040200015

  View details for PubMedID 31483379