A5103045326- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Ultrasound in Clinical Applications
- Cardiac Structural Anomalies and Repair
- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Central Venous Catheters and Hemodialysis
- Trauma and Emergency Care Studies
- Sepsis Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Clinical Reasoning and Diagnostic Skills
- Renal function and acid-base balance
- Thermoregulation and physiological responses
- Long-Term Effects of COVID-19
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Disaster Response and Management
- Climate Change and Health Impacts
- Healthcare Technology and Patient Monitoring
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Simulation-Based Education in Healthcare
- Patient Safety and Medication Errors
- Healthcare Systems and Public Health
- Blood donation and transfusion practices
- Animal testing and alternatives
Edinburgh Royal Infirmary
2023-2024
NHS Lothian
2024
Queen Elizabeth University Hospital
2017-2019
Guy's and St Thomas' NHS Foundation Trust
2015-2016
St Bartholomew's Hospital
2014
University College London
2014
King's College Hospital
2014
Austin Health
2012-2013
King's College Hospital NHS Foundation Trust
2013
For patients supported with veno-venous extracorporeal membrane oxygenation, the occurrence of intracranial hemorrhage is associated a high mortality. It unclear whether consequence intervention or underlying severe respiratory pathology. In cohort transferred to regional failure center that routinely employs admission brain imaging, we sought 1) prevalence hemorrhage; 2) survival and neurologic outcomes; 3) factors hemorrhage.A single-center, retrospective, observational study.Tertiary...
Cannulation is a potentially complex event in the conduct of venovenous extracorporeal membrane oxygenation (VV-ECMO) for patients with severe respiratory failure. The purpose this article to describe our approach cannulation and its complications. A single-center, retrospective, observational cohort, electronic note review study commenced on VV-ECMO We identified 348 cannulae placed 179 from December 2011 March 2015. All cannulations were successful. There no deaths related cannulation,...
We aimed to describe the use of venovenous extracorporeal carbon dioxide removal (ECCO2R) in patients with hypercapnic respiratory failure. performed a retrospective case note review admitted our tertiary regional intensive care unit and commenced on ECCO2R from August 2013 February 2015. Fourteen received ECCO2R. Demographic data, physiologic data (including pH partial pressure arterial blood [PaCO2]) when starting (t = 0), at 4 hourly intervals for first 24 hours, then hour until cessation...
• Recently there has been increased focus on improved detection and management of deteriorating patients in Australian hospitals. Since the introduction medical emergency team (MET) model an role for intensive care unit staff responding to deterioration hospital wards. Review MET differs from traditional ward patient review, as ICU may not know patient. Furthermore, assessment intervention is often time-critical must occur simultaneously. Finally, about 10% require care-level interventions...
Summary The use of extracorporeal membrane oxygenation for respiratory failure is high risk and resource intensive. In England, five centres provide this service patients who are referred have four possible outcomes: declined transfer due to perceived futility; accepted in principle but remain at the referring centre with ongoing surveillance; retrieved using conventional ventilation; or on support. decision‐making process leading these outcomes has not previously been examined. We evaluated...
Extracorporeal membrane oxygenation (ECMO) is an advanced form of organ support indicated in selected cases severe cardiovascular and respiratory failure. Echocardiography invaluable diagnostic monitoring tool all aspects ECMO support. The unique nature ECMO, its distinct effects upon cardio-respiratory physiology, requires the echocardiographer to have a sound understanding technology interaction with patient. In this article, we introduce key concepts underpinning commonly used modes...
A cross-sectional survey GENERATE (GEospatial aNalysis of ExtRacorporeal membrane oxygenATion in Europe) initiated on behalf the European chapter Extracorporeal Life Support Organization (EuroELSO), aims to provide a systematic, detailed description contemporary (ECLS) provision Europe, map spatial distribution ECLS centers, and accessibility ECLS.Structured data collection forms were used create narrative EuroELSO affiliated countries. This consisted both center-specific relevant national...
The use of echocardiography, whilst well established in cardiology, is a relatively new concept critical care medicine. However, recent years echocardiography's potential as both diagnostic tool and form advanced monitoring the critically ill patient has been increasingly recognised. In this series Critical Care Echo Rounds, we explore role echocardiography illness, beginning here with haemodynamic instability. We discuss pathophysiology shock state, techniques available to manage...
Veno-venous extracorporeal membrane oxygenation is an increasingly used form of advanced respiratory support, but its effects on the physiology right heart are incompletely understood. We seek to illustrate impact veno-venous return blood flow upon atrium by considering physiologic during interatrial shunting.Two patients in whom induced right-to-left shunt appears have created a barrier liberation from support.Veno-venous generates high-pressure jet that has potential exert focal pressure...
Background: Despite high rates of cardiovascular disease in Scotland, the prevalence and outcomes patients with cardiogenic shock are unknown. Methods: We undertook a prospective observational cohort study consecutive admitted to intensive care unit (ICU) or coronary at 13 hospitals Scotland for 6-month period. Denominator data from Scottish Intensive Care Society Audit Group were used estimate ICU prevalence; units unavailable. multivariable logistic regression identify factors associated...
Misdiagnosis of the cause illness in critically ill patients is common, and a major morbidity mortality. We reflect upon misdiagnosis that occurred intensive care unit metropolitan teaching hospital, highlight susceptibility medical decision making to error. examine recent advances cognitive theory how these apply diagnosis. discuss vulnerability such processes — with particular reference our case why even knowledgeable diligent clinicians are prone misdiagnose. Finally, we review potential...
An extensive caval thrombus was incidentally detected in a neurosurgical patient by clinician-delivered critical care echocardiography. Recent intracranial haemorrhage prevented therapeutic anticoagulation; the very proximal nature of precluded standard deployment an inferior vena cava filter. We describe novel radiological technique employed to manage thrombus, and examine whether thermoregulatory central venous catheter inserted as part neuro-critical may have contributed risk extent thrombus.
The last 25 years have witnessed significant change in the approach to deteriorating patient. This article reviews and discusses merits drawbacks of various systems used across world.
Echocardiography, once the exclusive domain of cardiologists, is increasingly found in hands front-line clinicians from a variety specialties. This article explores role echocardiography within acute care and discusses existing opportunities for training.