A5022739288- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Antibiotics Pharmacokinetics and Efficacy
- Cardiac Structural Anomalies and Repair
- Antibiotic Resistance in Bacteria
- Respiratory Support and Mechanisms
- Heart Failure Treatment and Management
- Anesthesia and Sedative Agents
- Pneumonia and Respiratory Infections
- Pulmonary Hypertension Research and Treatments
- Antimicrobial Resistance in Staphylococcus
- Organ Transplantation Techniques and Outcomes
- Antifungal resistance and susceptibility
- Transplantation: Methods and Outcomes
- Cardiac Ischemia and Reperfusion
- Cardiac Valve Diseases and Treatments
- Intensive Care Unit Cognitive Disorders
- Neuroscience of respiration and sleep
- Vascular Procedures and Complications
- Nitric Oxide and Endothelin Effects
- Anesthesia and Pain Management
- Epilepsy research and treatment
- Antibiotic Use and Resistance
- Clinical Nutrition and Gastroenterology
- Organ Donation and Transplantation
The Alfred Hospital
2017-2025
Monash University
2020-2025
Alfred Health
2017-2025
Baker Heart and Diabetes Institute
2023
Johns Hopkins University
2023
Australian and New Zealand Intensive Care Society
2021-2023
Alfred University
2023
Johns Hopkins Medicine
2023
Johns Hopkins Hospital
2023
Australian Regenerative Medicine Institute
2023
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a complex and high-risk life support modality used in severe cardiorespiratory failure. ECMO survival scores are clinically for patient prognostication outcomes risk adjustment. This study aims to create the first artificial intelligence (AI)-driven score predict in-hospital mortality based on large international cohort.
Rationale: Data suggest that altered antimicrobial concentrations are likely during extracorporeal membrane oxygenation (ECMO). Objectives: The primary aim of this analysis was to describe the pharmacokinetics (PKs) antimicrobials in critically ill adult patients receiving ECMO. Our secondary determine whether current dosing regimens achieve effective and safe exposure. Methods: This study a prospective, open-labeled, PK six ICUs Australia, New Zealand, South Korea, Switzerland. Serial blood...
Abstract Introduction Survival from refractory out of hospital cardiac arrest (OHCA) without timely return spontaneous circulation (ROSC) utilising conventional advanced life support (ACLS) therapies is dismal. CHEER3 was a safety and feasibility study pre-hospital deployed extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) for OHCA in metropolitan Australia. Methods This single jurisdiction, single-arm study. Physicians, with pre-existing ECMO expertise,...
Objectives: The manipulation of arterial carbon dioxide tension is associated with differential mortality and neurologic injury in intensive care cardiac arrest patients; however, few studies have investigated this relationship patients on venoarterial extracorporeal membrane oxygenation. We the association between initial change over 24 hours undergoing oxygenation for refractory cardiogenic shock. Design: Retrospective cohort analysis adult recorded international Extracorporeal Life...
Abstract Background For patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO), a positive cumulative fluid balance at day three has been associated increased mortality. However, there is limited evidence examining this association in requiring cardiopulmonary resuscitation (ECPR). The aims of study were to (1) describe contemporary practice ECPR and (2) assess the relationship between early 28-day Methods This was retrospective, single centre, observational using...
Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is an established rescue therapy for both out-of-hospital cardiac arrest (OHCA) and in-hospital (IHCA). However, there remains significant heterogeneity in populations outcomes across different studies. The primary aim of this study was to compare commonly used selection criteria their effect on survival utilisation Australian ECPR cohort. Methods We performed a retrospective, observational three centres Australia,...
This multicenter study describes the population pharmacokinetics (PK) of fluconazole in critically ill patients receiving concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) includes an evaluation different dosing regimens for achievement target exposure associated with maximal efficacy. Serial blood samples were obtained from on ECMO CRRT fluconazole. Total concentrations measured plasma using a validated chromatographic assay. A PK model...
Membrane oxygenator failure during venovenous (V-V) extracorporeal membrane oxygenation (ECMO) can lead to life-threatening hypoxia, high replacement costs, and may be associated with a hyperfibrinolytic state bleeding. The current understanding of the underlying mechanisms that drive this is limited. primary aim study therefore investigate hematological changes occur before after circuit exchanges (ECMO exchange) in patients severe respiratory managed on V-V ECMO. We analyzed 100...
Traditional indirect calorimetry is unable to capture complete gas exchange in patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO). We aimed determine the feasibility of using a modified protocol VA ECMO, report measured energy expenditure (EE) and compare EE control critically ill patients.Mechanically ventilated adult ECMO were included. was within 72 h commencement (timepoint one [T1]) on approximately day seven Intensive Care Unit (ICU) admission two [T2]). via...
Our study aimed to describe the population pharmacokinetics (PK) of piperacillin and tazobactam in patients on extracorporeal membrane oxygenation (ECMO), with without renal replacement therapy (RRT). We also use dosing simulations identify optimal strategy for these patient groups. Serial plasma concentrations were measured data analyzed using a PK approach that included staged testing treatment covariates. Dosing conducted achieved target exposures 50% 100% fraction time free drug...
Our study aimed to describe the population pharmacokinetics (PK) of vancomycin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO), including those concomitant renal replacement therapy (RRT). Dosing simulations were used recommend maximally effective and safe dosing regimens. Serial plasma concentrations measured analyzed using a PK approach on Pmetrics. The final model was identify regimens that achieved target exposures area under curve (AUC0-24) 400-700 mg ·...
This study aimed to describe the population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) and identify dosing regimens with a high likelihood achieving effective exposures. Serial blood samples were collected over single-dosing interval during ECMO. Total plasma concentrations measured by validated chromatographic assay. A pharmacokinetic model was built Monte Carlo simulations performed using Monolix. The probability target...
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) fundamentally alters patient physiology and blood flow relevant to contrast delivery for computed tomography (CT) imaging. Here, we present a comprehensive guide contrast-enhanced CT scanning in adult ECMO patients, addressing common questions related via the circuit, modifications settings techniques, avoid non-diagnostic scans. The approach is described detail patients supported on VA ECMO, with return cannula sited femoral...
Critically ill patients are at risk of suboptimal beta-lactam antibiotic (beta-lactam) exposure due to the impact altered physiology on pharmacokinetics. Suboptimal concentrations can lead treatment failure or toxicity. Therapeutic drug monitoring (TDM) involves adjusting doses based measured plasma and individualising dosing improve likelihood improving exposure. Despite its potential benefits, adoption has been slow, data implementation, dose adaptation safety sparse. The aim this trial is...
Abstract Purpose: Venoarterial extracorporeal membrane oxygenation (ECMO) is a complex and high-risk life support modality used in severe cardiorespiratory failure. ECMO survival scores are clinically for patient prognostication outcomes risk adjustment. This study aims to create the first artificial intelligence (AI)-driven score based on large international cohort. Methods: A Deep Neural Network: Predictive Algorithm (ECMO PAL) was trained 18,167 patients from Extracorporeal Life Support...