A5027602652- Respiratory Support and Mechanisms
- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Neonatal Respiratory Health Research
- Disaster Response and Management
- Neutrophil, Myeloperoxidase and Oxidative Mechanisms
- Clinical Reasoning and Diagnostic Skills
- Clinical Nutrition and Gastroenterology
- Anesthesia and Sedative Agents
- Health Policy Implementation Science
- Long-Term Effects of COVID-19
- Health and Medical Research Impacts
- Hemodynamic Monitoring and Therapy
- Vitamin C and Antioxidants Research
- Intestinal and Peritoneal Adhesions
- Meta-analysis and systematic reviews
- Healthcare Decision-Making and Restraints
- Family and Patient Care in Intensive Care Units
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Injury Epidemiology and Prevention
- Nosocomial Infections in ICU
- Vitamin D Research Studies
- Heart Failure Treatment and Management
Royal Victoria Hospital
2014-2025
University of Ulster
2010-2024
Queen's University Belfast
2014-2023
Royal Victoria Eye and Ear Hospital
2022
Belfast Health and Social Care Trust
2017-2021
Royal Hospital
2016
Antrim Area Hospital
2006
University Hospital Galway
2004
Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients sepsis.
<h3>Importance</h3> In patients who require mechanical ventilation for acute hypoxemic respiratory failure, further reduction in tidal volumes, compared with conventional low volume ventilation, may improve outcomes. <h3>Objective</h3> To determine whether lower using extracorporeal carbon dioxide removal improves outcomes failure. <h3>Design, Setting, and Participants</h3> This multicenter, randomized, allocation-concealed, open-label, pragmatic clinical trial enrolled 412 adult receiving...
Acute respiratory distress syndrome (ARDS) is a common clinical with high mortality and long-term morbidity. To date there no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but effect aspirin on established ARDS unknown.In single large regional medical surgical ICU between December 2010 July 2012, all patients were prospectively identified demographic, clinical, laboratory variables recorded retrospectively. usage, both...
<h3>Rationale</h3> Platelets play an active role in the pathogenesis of acute respiratory distress syndrome (ARDS). Animal and observational studies have shown aspirin9s antiplatelet immunomodulatory effects may be beneficial ARDS. <h3>Objective</h3> To test hypothesis that aspirin reduces inflammation clinically relevant human models recapitulate pathophysiological mechanisms implicated development <h3>Methods</h3> Healthy volunteers were randomised to receive placebo or 75 1200 mg (1:1:1)...
Importance For hospitalized critically ill adults with suspected sepsis, procalcitonin (PCT) and C-reactive protein (CRP) monitoring protocols can guide the duration of antibiotic therapy, but evidence effect safety these remains uncertain. Objective To determine whether decisions based on assessment CRP or PCT safely results in a reduction therapy. Design, Setting, Participants A multicenter, intervention-concealed randomized clinical trial, involving 2760 (≥18 years), 41 UK National Health...
BackgroundDead space and respiratory system elastance (Ers) may influence the clinical benefit of a ventilation strategy combining very low tidal volume (VT) with extracorporeal carbon dioxide removal (ECCO2R) in patients acute hypoxemic failure. We sought to evaluate whether effect ECCO2R on mortality varies according ventilatory ratio (VR; composite variable reflective dead shunt) Ers.MethodsSecondary analysis trial VT low-flow planned before availability results. Bayesian logistic...
OBJECTIVES: In patients with acute hypoxemic respiratory failure (AHRF), the use of lower tidal volume ventilation facilitated by veno-venous extracorporeal C O 2 removal (vv-ECCO R) does not improve clinical outcomes. The primary objective this analysis was to evaluate for differences in indices systemic inflammation and ventilator-induced lung injury between treated vv-ECCO R standard care. Secondary objectives included an evaluation heterogeneity treatment effect. DESIGN: Substudy a...
Background Recovery following critical illness is complex due to the many challenges patients face which influence their long-term outcomes. We explored patients’ views about facilitators of recovery after could be used inform components and timing specific rehabilitation interventions. Aims To explore discharge from an intensive care unit (ICU) factors that facilitated recovery, determine additional services felt were missing during recovery. Methods Qualitative study involving individual...
Lower tidal volume ventilation (targeting 3 mL/kg predicted body weight, PBW) facilitated by extracorporeal carbon dioxide removal (ECCO
Background: Acute Physiology and Chronic Health Evaluation (APACHE) III scores have been shown to correlate with outcomes for patients burn injuries. It is unknown whether they can be used compare between intensive care units that admit burns in Australia New Zealand. Objective: To assess the APACHE III-j score as a predictor of mortality use it riskadjusted different ICUs. Design, setting participants: Retrospective cohort study all listed Australian Zealand Intensive Care Society Adult...
Introduction Extracorporeal membrane carbon dioxide removal may have a role in treatment of patients with hypercapnic respiratory failure and refractory hypoxaemia and/or hypercapnia. Methods We report on the use, outcomes complications United Kingdom intensive care units reporting Extracorporal Life Support Organisation register. Results Of 60 patients, 42 (70%) had primarily hypoxic 18 (30%) failure. Use veno-venous procedures increased compared to arterio-venous procedures. Following...
Introduction Lower tidal volume ventilation, facilitated by veno-venous extracorporeal carbon dioxide removal (vv-ECCO 2 R), does not improve 90-day mortality in patients with acute hypoxaemic respiratory failure (AHRF). The aim of this analysis was to evaluate the effect therapeutic strategy on long-term outcomes. Methods This a prespecified REST trial, UK-wide multicentre randomised clinical trial that compared lower vv-ECCO R (intervention), standard care treatment moderate-to-severe...
Acute hypoxaemic respiratory failure requiring mechanical ventilation is a major cause of morbidity and mortality has significant resource implications in terms intensive care unit hospital stay.To assess the cost-effectiveness extracorporeal carbon dioxide removal compared to alone patients with acute failure.A cost-utility analysis embedded within pragmatic, multicentre, allocation-concealed, open-label, randomised controlled trial.Four hundred twelve (of planned sample size 1120) adult...