A5024566519- Cardiac, Anesthesia and Surgical Outcomes
- Liver Disease and Transplantation
- Respiratory Support and Mechanisms
- Organ Transplantation Techniques and Outcomes
- Nitric Oxide and Endothelin Effects
- Neuroscience of respiration and sleep
- Neonatal Respiratory Health Research
- Cardiac Ischemia and Reperfusion
- Hemodynamic Monitoring and Therapy
- Patient Safety and Medication Errors
- Cardiac Arrest and Resuscitation
- Intensive Care Unit Cognitive Disorders
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Healthcare Operations and Scheduling Optimization
- Traumatic Brain Injury and Neurovascular Disturbances
- Anesthesia and Sedative Agents
- Sepsis Diagnosis and Treatment
- Anesthesia and Pain Management
- Renal function and acid-base balance
- Hospital Admissions and Outcomes
- Airway Management and Intubation Techniques
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Acute Ischemic Stroke Management
- Climate Change and Health Impacts
- Anesthesia and Neurotoxicity Research
Great Ormond Street Hospital for Children NHS Foundation Trust
2021
University College London Hospitals NHS Foundation Trust
2021
University College London
2021
University of Washington
2009-2020
Seattle University
2019
Barro Colorado Island
2018
University of Washington Medical Center
2012-2017
NHS Blood and Transplant
2016
Creative Research Enterprises (United States)
2016
University of Alabama at Birmingham
1997-2014
Ischemia/reperfusion (IR) injury in transplanted livers contributes to organ dysfunction and failure is characterized part by loss of NO bioavailability. Inhalation nontoxic at high concentrations (80 ppm) inhibits IR extrapulmonary tissues. In this prospective, blinded, placebo-controlled study, we evaluated the hypothesis that administration inhaled (iNO; 80 patients undergoing orthotopic liver transplantation hepatic injury, resulting improved function. Patients were randomized receive...
Background Transfusion of packed red blood cells (PRBCs) is a risk factor for acute respiratory distress syndrome (ARDS) in trauma patients. Yet, there paucity information regarding the ARDS with incremental PRBCs exposure. Methods For this retrospective analysis, eligible patients from National Study on Costs and Outcomes Trauma were included. Our main exposure was defined as units transfused during first 24 h after admission. The outcome ARDS. Results A total 521 (4.6%) 14070 developed...
Ventilator strategies allowing for increases in carbon dioxide (CO 2 ) tensions (hypercapnia) are being emphasized to ameliorate the consequences of inflammatory-mediated lung injury. Inflammatory responses lead generation reactive species including superoxide (O − ), nitric oxide (·NO), and their product peroxynitrite (ONOO ). The reaction CO ONOO can yield nitrosoperoxocarbonate adduct ONOOCO , a more potent nitrating than . Based on these premises, monolayers fetal rat alveolar epithelial...
Appreciating that CO2 modifies the chemical reactivity of nitric oxide (NO)-derived inflammatory oxidants, we investigated whether hypercapnia would modulate pulmonary responses. Rabbits (n = 72) were ventilated with approximately 7-ml/kg tidal volume for 6 hours. Animals randomized to one following conditions: eucapnia (Pa(CO2) at 35-40 mm Hg), + lipopolysaccharide (LPS), LPS inhaled NO (iNO delivered 20 ppm), 60 LPS, and iNO. The groups compared exposed displayed significantly increased...
Reduced bioavailability of endothelium-derived nitric oxide associated with reperfusion could potentially exacerbate the inflammatory response during reperfusion. Evidence suggests pharmacologic effects inhaled may extend beyond pulmonary vasculature, and this is attributed to oxide-derived complexes in blood that ultimately orchestrate antiinflammatory effects. In study, authors evaluated potential for (80 ppm) attenuate inflammation instigated by ischemia-reperfusion a human model using...
OBJECTIVES: This study investigated the association of intrapartum temperature elevation with cesarean delivery and assisted vaginal delivery. METHODS: Participants were 1233 nulliparous women singleton, term pregnancies in vertex presentations who had spontaneous labors afebrile (temperature: 99.5 degrees F [37.5 C]) at admission for Rates deliveries according to highest examined by epidural status. RESULTS: Women maximum temperatures higher than 3 times as likely experience (25.2% vs 7.2%)...
Human serum albumin is used clinically to maintain colloid osmotic pressure and viewed serve an antioxidant role in the vascular compartment via binding of redox-active metal complexes, transport nitric oxide, oxidant-scavenging reactions single thiol human albumin, cys34. Because these potentially desirable adjunctive actions, we evaluated purity redox state compared relative effects available 25% preparations with a starch-derived colloid, 6% hydroxyethyl starch, vitro models inflammatory...
Opioids play a critical role in acute postoperative pain management. Our objective was to develop machine learning models predict opioid requirements patients undergoing ambulatory surgery. To the models, we used perioperative dataset of 13,700 (≥ 18 years) surgery between years 2016–2018. The data, comprising patient, procedure and provider factors that could influence requirements, randomly split into training (80%) validation (20%) datasets. Machine different classes were developed...
Decreases in endothelial nitric oxide synthase derived (NO) production during liver transplantation promotes injury. We hypothesized that preemptive inhaled NO (iNO) would improve allograft function (primary) and reduce complications post-transplantation (secondary). Patients at two university centers (Center A B) were randomized to receive placebo (n = 20/center) or iNO (80 ppm, n the operative phase of transplantation. Data analyzed set intervals for up 9-months compared between groups....
BACKGROUND: Predictive analytics systems may improve perioperative care by enhancing preparation for, recognition of, and response to high-risk clinical events. Bradycardia is a fairly common unpredictable event with many causes; it be benign or become associated hypotension requiring aggressive treatment. Our aim was build models predict the occurrence of clinically significant intraoperative bradycardia at 3 time points during an operative course utilizing available preoperative electronic...
Liver ischemia-reperfusion injury is a major cause of primary graft non-function or initial function failure post-transplantation. In this study, we examined the effects sodium nitrite supplementation on liver IRI in either Lactated Ringer's (LR) solution University Wisconsin (UW) solution. The syngeneic recipients grafts were also treated with without by intra-peritoneal injection. AST and LDH release significantly reduced both nitrite-supplemented LR UW preservation solutions compared to...
Checklists are commonly used to structure the communication process between anesthesia nursing healthcare providers during transfer of care, or handoff, a patient after surgery. However, intraoperative information is often recalled from memory leading omission critical data incomplete exchange handoff. We describe implementation an electronic tool (T2) for use in handover intubated patients intensive care unit. A pilot observational study auditing handovers against pre-existing checklist was...
Many hospitals have implemented surgical safety checklists based on the World Health Organization checklist, which was associated with improved outcomes. However, execution of is frequently incomplete. We reasoned that aviation-style computerized checklist displayed onto large, centrally located screen and operated by anesthesia provider would improve performance checklist.We performed a prospective before after observational study to evaluate effect system performance. created software...
Ischemia reperfusion injury (IRI) is an inevitable clinical consequence in organ transplantation. It can lead to early graft nonfunction and contribute acute chronic rejection. Advanced molecular biology has revealed the highly complex nature of this phenomenon few definitive therapies exist. This paper reviews factors involved pathophysiology IRI potential ways attenuate it. In recent years, inhaled nitric oxide, carbon monoxide, hydrogen sulfide have been increasingly explored as plausible...
We implemented a previously described barcode-based drug safety system in all of our anesthetizing locations. Providers were instructed to scan the barcode on syringes using Anesthesia Information Management System before administration, but rate provider adherence was low. studied an implementation intervention intended increase scanning.Using and Smart Manager software, we quantified syringe administrations by anesthesia providers with without scanning. use team model which attending...