A5065939822- Cardiac, Anesthesia and Surgical Outcomes
- Anesthesia and Pain Management
- Enhanced Recovery After Surgery
- Hemodynamic Monitoring and Therapy
- Sepsis Diagnosis and Treatment
- Nausea and vomiting management
- Pain Management and Opioid Use
- Acute Kidney Injury Research
- Hepatocellular Carcinoma Treatment and Prognosis
- Metabolomics and Mass Spectrometry Studies
- Colorectal Cancer Surgical Treatments
- Frailty in Older Adults
- Cardiac Arrest and Resuscitation
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Anesthesia and Sedative Agents
- Intensive Care Unit Cognitive Disorders
- Family and Patient Care in Intensive Care Units
- Blood Pressure and Hypertension Studies
- Non-Invasive Vital Sign Monitoring
- Gut microbiota and health
- Health Sciences Research and Education
- Classical Antiquity Studies
- Heart Rate Variability and Autonomic Control
- Gastric Cancer Management and Outcomes
Royal Blackburn Teaching Hospital
2015-2023
East Lancashire Hospitals NHS Trust
2012-2021
University of Central Lancashire
2019-2021
Blackburn College
2014-2019
Dysregulated host responses to infection can lead organ dysfunction and sepsis, causing millions of global deaths each year. To alleviate this burden, improved prognostication biomarkers response are urgently needed. We investigated the use whole-blood transcriptomics for stratification patients with severe by integrating data from 3149 samples sepsis due community-acquired pneumonia or fecal peritonitis admitted intensive care healthy individuals into a gene expression reference map. used...
Sepsis, the dysregulated host response to infection causing life-threatening organ dysfunction, is a global health challenge requiring better understanding of pathophysiology and new therapeutic approaches. Here, we applied high-throughput tandem mass spectrometry delineate plasma proteome for sepsis comparator groups (noninfected critical illness, postoperative inflammation, healthy volunteers) involving 2612 samples (from 1611 patients) 4553 liquid chromatography–mass analyses acquired...
Thoracic epidural analgesia (TEA) is recommended for post-operative pain relief in patients undergoing major abdominal surgery via a midline incision. However, the effectiveness of TEA variable with high failure rates reported post-operatively. Common side effects such as low blood pressure and motor block can reduce mobility hinder recovery, number rare but serious complications also occur following their use. Rectus sheath catheters (RSC) may provide novel alternative approach to somatic...
Objective Augmented renal clearance (ARC) is associated with sub-therapeutic antibiotic, anti-epileptic, and anticoagulant serum concentrations leading to adverse patient outcomes. We aimed describe the prevalence risk factors for ARC development in a large, single-centre cohort United Kingdom. Methods conducted retrospective observational study of critically unwell patients admitted intensive care between 2014 2016. Urinary creatinine was used determine during first 7 days admission....
Sepsis is a clinical syndrome of life-threatening organ dysfunction caused by dysregulated response to infection, for which disease heterogeneity major obstacle developing targeted treatments. We have previously identified gene-expression-based patient subgroups (sepsis signatures [SRS]) informative outcome and underlying pathophysiology. Here, we aimed investigate the role genetic variation in determining host transcriptomic delineate regulatory networks SRS. Using genotyping RNA-sequencing...
Rectus sheath catheter analgesia (RSCA) and thoracic epidural (TEA) are both used for following laparotomy. The aim was to compare the analgesic effectiveness of RSCA with TEA after laparotomy elective colorectal urological surgery.Patients undergoing midline were randomized in a non-blinded fashion receive or postoperative at single UK teaching hospital. primary quantitative outcome measure dynamic pain score 24 h surgery. A nested qualitative study (reported elsewhere) explored dual...
Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are predict the need subsequent loading. This requires device that can measure CO changes rapidly. The Vigileo™ monitor, using third-generation software, allows continuous monitoring. aim of this study was compare (measured with Vigileo device) manoeuvre calculate accuracy predicting prospective 20-bedded mixed general...
Summary Adequate postoperative analgesia is a key element of enhanced recovery programmes. Thoracic epidural associated with superior but can lead to complications. Rectus sheath catheter may provide an alternative. In nested qualitative study (within two‐year randomised controlled trial) focussing on the acceptability, expectations and experiences receiving interventions, participants (n = 20) were interviewed 4 weeks post‐intervention using grounded theory approach. Constant comparative...
At least 270 000 patients are admitted to intensive care units (ICUs) each year,1 and up 27% of these develop post-ICU post-traumatic stress disorder (PTSD).2 This may be due a variety factors resulting in cumulative trauma: fear dying, invasive treatment, pain, delirium, inability communicate, provision withdrawal sedation, experience physical illness, immobility, sensory sleep deprivation.2,3 Patients’ families also at risk developing PTSD. One study suggested that the was as high 33% for...
This article illustrates the regional experience of participation in research following introduction National Institute for Health Research (NIHR) Comprehensive Local Networks (CLRNs) and Critical Care Specialty Groups. Prior to this, was focused academic centres tertiary hospitals. Clinicians smaller hospitals had little opportunity or support participate clinical trials other important studies. CLRNs were introduced ensure that NHS funding is spread widely throughout NHS, ensuring all...
<h3>Introduction</h3> The Enhanced Recovery Programme (ERP) has been shown to improve postoperative complications and reduce hospital stay in patients undergoing major HPB surgical oncological resections.<sup>1</sup>The ERP should allow more patient autonomy their care extend beyond the current admission. benefits of following discharge are unclear, particularly with regards adjuvant chemotherapy completion rates. <h3>Method</h3> A retrospective study was designed looking at effect on rates...
Summary Cardiopulmonary exercise testing is commonly used in the pre‐operative assessment of patients due to have major elective surgery. The measurement anaerobic threshold has been shown be an accurate predictor mortality abdominal Pre‐operative lifestyle changes and aerobic training may improve results reduce hospital length stay, morbidity mortality. We discuss a patient with poor cardiopulmonary who was scheduled for anterior resection surgery sigmoid colon carcinoma. Surgery considered...