A5031981118- Sepsis Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Respiratory Support and Mechanisms
- COVID-19 Clinical Research Studies
- Cardiac Arrest and Resuscitation
- Emergency and Acute Care Studies
- Hemodynamic Monitoring and Therapy
- Blood transfusion and management
- Cardiac, Anesthesia and Surgical Outcomes
- SARS-CoV-2 and COVID-19 Research
- Nosocomial Infections in ICU
- Renal function and acid-base balance
- Immune Response and Inflammation
- Family and Patient Care in Intensive Care Units
- Long-Term Effects of COVID-19
- Hemoglobin structure and function
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Antibiotic Use and Resistance
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac Ischemia and Reperfusion
- Antibiotics Pharmacokinetics and Efficacy
- Anesthesia and Sedative Agents
- Clinical Nutrition and Gastroenterology
- Organ Donation and Transplantation
- Palliative Care and End-of-Life Issues
Western University
2016-2025
London Health Sciences Centre
2016-2025
Lawson Health Research Institute
2016-2025
St Joseph's Health Care
2025
Methodist Hospital
2024
Victoria Hospital
1997-2024
University of Toronto
1999-2024
Sunnybrook Health Science Centre
2006-2024
North York General Hospital
2024
Monash Medical Centre
2024
To determine whether a restrictive strategy of red-cell transfusion and liberal produced equivalent results in critically ill patients, we compared the rates death from all causes at 30 days severity organ dysfunction.
Morbidity and mortality for critically ill patients with infections remains a global healthcare problem. We aimed to determine whether β-lactam antibiotic dosing in achieves concentrations associated maximal activity affect patient outcome.This was prospective, multinational pharmacokinetic point-prevalence study including 8 antibiotics. Two blood samples were taken from each during single interval. The primary pharmacokinetic/pharmacodynamic targets free above the minimum inhibitory...
Objective To compare a restrictive red blood cell transfusion strategy with more liberal in volume-resuscitated critically ill patients cardiovascular disease. Setting Twenty-two academic and three community critical care units across Canada. Study Design Randomized controlled clinical trial. Population Three hundred fifty-seven diseases from the Transfusion Requirements Critical Care trial who had hemoglobin concentration of <90 g/L within 72 hrs admission to intensive unit. Interventions...
Long-COVID is characterized by prolonged, diffuse symptoms months after acute COVID-19. Accurate diagnosis and targeted therapies for are lacking. We investigated vascular transformation biomarkers in patients.
Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment uncertain.
We hypothesized that normotensive sepsis affects the ability of microcirculation to appropriately regulate microregional red blood cell (RBC) flux. An extensor digitorum longus muscle preparation for intravital study was used compare distribution RBC flux and functional hyperemic response in SHAM rats made septic by cecal ligation perforation (CLP). Using microscopy, we found associated with a 36% reduction perfused capillary density (from 35.3 +/- 1.5 22.5 1.0 capillaries/mm test line) 265%...
In 4,470 critically ill patients, we examined the impact of transfusion practice on mortality rates. As compared with survivors, patients who died in intensive care units (ICU) had lower hemoglobin values (95 +/- 26 versus 104 23 g/L, p < 0.0001) and were transfused red cells more frequently (42.6% 28.0%, 0.0001). cardiac disease, there was a trend toward an increased when 95 g/L (55% 42%, = 0.09) as anemic other diagnoses. Patients anemia, high APACHE II score (> 20), diagnosis...
Previous studies have suggested that a patient's sex may influence the provision and outcomes of critical care. Our objective was to determine whether age are associated with differences in admission practices, processes care clinical for critically ill patients.We used retrospective cohort 466,792 patients, including 24,778 admitted consecutively adult hospitals Ontario between Jan. 1, 2001, Dec. 31, 2002. We measured associations intensive unit (ICU); use mechanical ventilation, dialysis...
To determine whether the time that red blood cells are stored in citrate phosphate dextrose adenine-1 solution before transfusion alters ability to improve tissue oxygenation.Prospective, randomized, controlled study.University research institute laboratory.Male Sprague-Dawley rats (350 450 g).Twenty-four hours after randomization sham laparotomy (n = 21) or cecal ligation and perforation 16)1 supply-dependency of systemic oxygen uptake (VO2) was induced by isovolemic hemodilution. Rats were...
Renal dysfunction is a complication of coronary artery bypass graft (CABG) surgery performed with cardiopulmonary (CPB) that associated increased morbidity and mortality. N-acetylcysteine, an antioxidant vasodilator, counteracts renal ischemia hypoxia.To determine whether perioperative intravenous (IV) N-acetylcysteine preserves function in high-risk patients undergoing CABG CPB compared placebo.Randomized, quadruple blind, placebo-controlled trial (October 2003-September 2004) operating...
Rationale: The systemic inflammatory response syndrome has low specificity to identify infected patients at risk of worsening severe sepsis or shock. Objective: To examine the incidence and factors for in patients. Methods: A 1-year inception cohort study 28 intensive care units (n = 1,531) having a first episode infection on admission during stay. Measurements main results: cumulative progression shock was 20% 24% Days 10 30, respectively. Variables independently associated (hazard ratio...
To characterize the contemporary red cell transfusion practice in critically ill and to define clinical factors that influence these practices.Scenario-based national survey.Canadian critical care practitioners.We evaluated thresholds before number of units ordered, under given conditions. Of 254 Canadian physicians, 193 (76%) responded survey. The primary specialty most respondents was internal medicine (56%). Internal were for an average 8.4 +/- 5.7 (SD) yrs, worked often combined...
To determine the location of acquisition, timing, and outcomes associated with severe sepsis in community teaching hospital critical care units.Prospective, observational study.Twelve Canadian units.All patients admitted between March 17, 2003, November 30, 2004 to study units at least a 24-hr length stay or identified during first 24 hrs.Daily monitoring for sepsis.We recorded data describing characteristics patients, infections, systemic responses, organ dysfunction. Severe occurred 1238...
Coronavirus disease 2019 continues to spread rapidly with high mortality. We performed metabolomics profiling of critically ill coronavirus patients understand better the underlying pathologic processes and pathways, identify potential diagnostic/prognostic biomarkers.Blood was collected at predetermined ICU days measure plasma concentrations 162 metabolites using both direct injection-liquid chromatography-tandem mass spectrometry proton nuclear magnetic resonance.Tertiary-care academic...
Objectives: Coronavirus disease 2019 is caused by the novel severe acute respiratory syndrome coronavirus 2 virus. Patients admitted to ICU suffer from microvascular thrombosis, which may contribute mortality. Our aim was profile plasma thrombotic factors and endothelial injury markers in critically ill patients help understand their mechanisms. Design: Daily blood coagulation factor profiling with immunoassays vitro experiments on human pulmonary cells. Setting: Tertiary care academic...