A5061986473- Mechanical Circulatory Support Devices
- Respiratory Support and Mechanisms
- Kawasaki Disease and Coronary Complications
- Neonatal Respiratory Health Research
- Cardiac Arrest and Resuscitation
- COVID-19 Clinical Research Studies
- Sepsis Diagnosis and Treatment
- Airway Management and Intubation Techniques
- Respiratory viral infections research
- Science Education and Perceptions
- Conferences and Exhibitions Management
- Congenital Diaphragmatic Hernia Studies
- Museums and Cultural Heritage
- Media Studies and Communication
- Pneumonia and Respiratory Infections
- Inflammasome and immune disorders
- Congenital Heart Disease Studies
- COVID-19 Impact on Reproduction
- Cardiac Arrhythmias and Treatments
- Cardiac Structural Anomalies and Repair
- Cardiovascular Issues in Pregnancy
- Digital and Traditional Archives Management
- Heparin-Induced Thrombocytopenia and Thrombosis
- Metabolism and Genetic Disorders
- Autopsy Techniques and Outcomes
Evelina London Children's Healthcare
2018-2025
King's College London
2022-2025
Harvard University
2024
Guy's and St Thomas' NHS Foundation Trust
2020-2023
University College London
2022-2023
University of London
2023
Intensive Care Society
2020-2022
Foundation for Ichthyosis and Related Skin Types
2022
National Health Service
2021
Loyola University Maryland
2011-2018
In April, 2020, clinicians in the UK observed a cluster of children with unexplained inflammation requiring admission to paediatric intensive care units (PICUs). We aimed describe clinical characteristics, course, management, and outcomes patients admitted PICUs this condition, which is now known as inflammatory multisystem syndrome temporally associated SARS-CoV-2 (PIMS-TS).We did multicentre observational study (aged <18 years), between April 1 May 10, fulfilling case definition PIMS-TS...
The optimal target for systemic oxygenation in critically ill children is unknown. Liberal widely practiced, but has been associated with harm paediatric patients. We aimed to evaluate whether conservative would reduce duration of organ support or incidence death compared standard care.
<h3>Importance</h3> The optimal first-line mode of noninvasive respiratory support following extubation critically ill children is not known. <h3>Objective</h3> To evaluate the noninferiority high-flow nasal cannula (HFNC) therapy as extubation, compared with continuous positive airway pressure (CPAP), on time to liberation from support. <h3>Design, Setting, and Participants</h3> This was a pragmatic, multicenter, randomized, trial conducted at 22 pediatric intensive care units in United...
Multisystem Inflammatory Syndrome in Children by COVID-19 Vaccination Status of Adolescents France
To study the prevalence, evolution, and clinical factors associated with acute kidney injury in children admitted to PICUs pediatric inflammatory multisystem syndrome temporally severe respiratory coronavirus-2.Multicenter observational study.Fifteen across United Kingdom.Patients Kingdom coronavirus-2 between March 14, 2020, May 20, 2020.None.Deidentified data collected as part of routine care were analyzed. All diagnosed staged for based on level serum creatinine above upper limit...
Rationale: Few data exist to guide early adjunctive therapy use in pediatric acute respiratory distress syndrome (PARDS).Objectives: To describe contemporary of therapies for PARDS as a framework future investigations.Methods: This was preplanned substudy prospective, international, cross-sectional observational study children with from 100 centers over 10 weeks.Measurements and Main Results: We investigated six PARDS: continuous neuromuscular blockade, corticosteroids, inhaled nitric oxide...
Since the declaration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic,1 a small percentage children with disease 2019 (COVID-19) infection have required intensive care unit (ICU) admission an even smaller needing extracorporeal membrane oxygenation (ECMO) support.2,3 To provide contemporaneous data on ECMO utilization and activity during COVID-19 pandemic, European Chapter Extracorporeal Life Support Organization (EuroELSO) established prospective survey among...
Abstract Background Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk ventilator-induced lung injury than individual ventilator management components. We sought evaluate if mechanical ventilation with high associated fewer ventilator-free days (VFD) in children pediatric acute distress syndrome (PARDS). Methods Retrospective analysis of prospective observational international cohort study. Results There were 306...
A conservative oxygenation strategy, targeting peripheral oxygen saturations (Sp o2 ) between 88% and 92% in mechanically ventilated children PICU, was associated with a shorter duration of organ support greater survival compared Sp than 94% our recent Oxy-PICU trial. monitors may overestimate arterial saturation (Sa patients higher levels skin pigmentation those less pigmentation. We investigated if ethnicity changes distributions F io2 outcome.
Neonates with respiratory failure are ideally supported veno-venous rather than veno-arterial extracorporeal membrane oxygenation due to the reduced rate of neurologic complications. However, proportion neonates is declining. We report multisite oxygenation, accessing neck, returning inferior vena cava via common femoral vein in and children less 10 kg.Retrospective case series 1 year minimum follow-up.Patients kg jugular vein.A 30-bed pediatric intensive care delivering approximately 20...
OBJECTIVES: Management of mechanically ventilated patients with bronchiolitis is not standardized and duration mechanical ventilation has been shown to vary widely between centers. The aim this study was examine practice in a large number U.K. PICUs view identify if early management choices relating fluid prescription, sedative agent use, endotracheal tube (ETT) placement were associated differences invasive (IMV). DESIGN: Retrospective multicenter cohort study. Primary outcome IMV. A...
Background To describe the characteristics of cardiac-related neonatal collapses referred to a critical care transport service and evaluate diagnostic accuracy management at referral retrieval. Methods Retrospective cohort analysis who were transferred by paediatric intensive retrieval team based in London, UK between 2013 2021. Patients with antenatal diagnoses excluded. Results There 71 neonates identified whom 49 (69%) had structural heart defect, 12 (17%) arrhythmia 10 (14%)...
To 1) analyze the short-term biochemical improvements and clinical outcomes following treatment of children with post-severe acute respiratory syndrome coronavirus-2 inflammatory (multisystem in children/pediatric multisystem temporally associated severe coronavirus-2) admitted to U.K. PICUs 2) collate current guidance from PICUs.Multicenter observational study.Twenty-one PICUs.Children (< 18 yr) between April 1, 2020, May 10, fulfilling case definition pediatric coronavirus-2.None.Routinely...
Coronavirus disease 2019 (COVID-19) in adults has been associated with thrombosis. Multisystem inflammatory syndrome children (MIS-C) COVID-19 case series have reported high fibrinogen levels, but it is not known whether this causes thrombophilia. We report two patients needing extracorporeal membrane oxygenation (ECMO) who both suffered thrombotic complications. retrospectively reviewed MIS-C ECMO support admitted to a single Paediatric and Cardiac Intensive Care Unit within regional center...
Objectives Patients from ethnic minority groups and key workers are over-represented among adults hospitalised or dying COVID-19. In this population-based retrospective cohort, we describe the association of ethnicity, socioeconomic family worker status with incidence severity Paediatric Inflammatory Multisystem Syndrome Temporally associated SARS-CoV-2 (PIMS-TS). Setting Evelina London Children’s Hospital (ELCH), tertiary paediatric hospital for South Thames Retrieval Service (STRS) region....
Objectives: Neonates with respiratory failure are ideally supported venovenous rather than venoarterial extracorporeal membrane oxygenation due to the reduced rate of neurologic complications. However, proportion neonates is declining. We aimed explore factors behind this decline. Design: conducted a survey in order understand current practice across United Kingdom, exploring barriers neonatal addition collecting U.K.-wide retrospective data from 2000 onwards. Patients: Kingdom. Setting: All...
Bronchiolitis is a leading cause of PICU admission and major contributor to resource utilization during the winter season. Management in mechanically ventilated patients with bronchiolitis not standardized. We aimed assess whether variations exist management between centers then if differences outcomes are found.Retrospective cohort study.Three tertiary PICUs (Centers A, B, C) London, United Kingdom.Patients under 1 year age (n = 462) who received invasive mechanical ventilation for acute...
This article takes a cultural studies approach to analyzing what could be termed the ‘cultural uptake’ of new commercial visual technology, mobile-to-mobile picture messaging, in three key interdependent areas: user adoption, political economic contexts, and textual representation. Nokia’s early investment marketing multimedia messaging service (MMS) is juxtaposed actual trends adoption appropriation, which turn encouraged company deploy narrative practices based on perceived needs later...
Objective To understand the impact of National Institute for Health and Care Excellence (NICE) bronchiolitis guidelines on management children referred to paediatric intensive care unit (PICU) with bronchiolitis. Design setting Data were collected all a regional PICU transport service clinical diagnosis during winter prior NICE consultation period (2011–2012) after publication (2015–2016). Management initiated by referring hospital was assessed. Results There 165 infants in epoch 1 187 2....
Pertussis immunization programs aim to prevent severe infant disease. We investigated temporal trends in pertussis deaths and pediatric intensive care unit (PICU) admissions associations of changes disease detection vaccines used with death PICU admission rates.Using national data from New Zealand (NZ), we described 1991 2013, over which time coverage at 2 years age increased <80% 92%. In NZ, became a notifiable polymerase chain reaction (PCR) diagnosis available 1997 acellular replaced...
In January 2020, the British Society for Paediatric Endocrinology and Diabetes (BSPED) published new guidance management of children <18 years with diabetic ketoacidosis (DKA).1 Fluid is significantly different from their previous guideline2 current National Institute Health Care Excellence (NICE) guidance.3 The 2020 guideline moved away concept cautious fluid replacement towards a liberal approach resuscitation maintenance fluids. It recommends that all patients receive an initial 10 mL/kg...