A5054908825- Clinical Nutrition and Gastroenterology
- Nutrition and Health in Aging
- Intensive Care Unit Cognitive Disorders
- Electrolyte and hormonal disorders
- Diet and metabolism studies
- Respiratory Support and Mechanisms
- Muscle metabolism and nutrition
- Abdominal Surgery and Complications
- Hip and Femur Fractures
- Enhanced Recovery After Surgery
- Child Nutrition and Feeding Issues
- Vitamin C and Antioxidants Research
- Long-Term Effects of COVID-19
- Dialysis and Renal Disease Management
- Mechanical Circulatory Support Devices
- Pharmacological Effects and Toxicity Studies
- Delphi Technique in Research
- Cerebral Palsy and Movement Disorders
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Family and Patient Care in Intensive Care Units
- Frailty in Older Adults
- Body Composition Measurement Techniques
- Muscle and Compartmental Disorders
- Mitochondrial Function and Pathology
- Machine Learning in Healthcare
Guy's and St Thomas' NHS Foundation Trust
2016-2025
King's College London
2018-2025
St Thomas' Hospital
2017-2024
King's College - North Carolina
2023
National Institute for Health Research
2018
NIHR Biomedical Research Centre at The Royal Marsden and the ICR
2018
Uncertainty exists about the most effective route for delivery of early nutritional support in critically ill adults. We hypothesized that through parenteral is superior to enteral route.
Gastrointestinal (GI) dysfunction is frequent in the critically ill but can be overlooked as a result of lack standardization diagnostic and therapeutic approaches. We aimed to develop research agenda for GI future research. systematically reviewed current knowledge on broad range subtopics from specific viewpoint dysfunction, highlighting remaining areas uncertainty suggesting studies.This systematic scoping review was conducted following successive steps: (1) identify clinically important...
Abstract Background Delivering higher doses of protein to mechanically ventilated critically ill patients did not improve patient outcomes and may have caused harm. Longitudinal urea measurements could provide additional information about the treatment effect doses. We hypothesised that values over time explain potential harmful effects protein. Methods conducted a reanalysis randomised controlled trial in critical illness (EFFORT Protein). applied Bayesian joint models estimate strength...
To characterise the sketetal muscle metabolic phenotype during early critical illness.Vastus lateralis biopsies and serum samples (days 1 7) were obtained from 63 intensive care patients (59% male, 54.7±18.0 years, Acute Physiology Chronic Health Evaluation II score 23.5±6.5).From day to 7, there was a reduction in mitochondrial beta-oxidation enzyme concentrations, biogenesis markers (PGC1α messenger mRNA expression (-27.4CN (95% CI -123.9 14.3); n=23; p=0.025) DNA copy number (-1859CN (IQR...
Background Malnutrition is a common problem in critically ill patients UK NHS critical care units. Early nutritional support therefore recommended to address deficiencies state and related disorders metabolism. However, evidence conflicting regarding the optimum route (parenteral or enteral) of delivery. Objectives To estimate effect early via parenteral compared with enteral on mortality at 30 days incremental cost-effectiveness 1 year. Secondary objectives were compare duration organ...
Malnutrition is common in patients with acute kidney injury (AKI) and the risk of mortality high, especially if renal replacement therapy needed. Between April 2013 through 2014, we recruited critically ill adult (≥18 years) severe AKI two University hospitals London, UK, measured serial plasma concentrations vitamin B1, B6, B12, C D, folate, selenium, zinc, copper, iron, carnitine 22 amino acids for six consecutive days. In receiving continuous (CRRT), same nutrients effluent were also...
Many Intensive Care Unit (ICU) survivors suffer from a multi- system disability, termed the post-intensive care syndrome. There is no current national coordination of either rehabilitation pathways or related data collection for them. In last year, need tools to systematically identify multidisciplinary needs severely affected COVID-19 has become clear. Such offer opportunity improve all critical illness through provision personalised Rehabilitation Prescription (RP). The initial development...
Background Patients who have had prolonged stays in intensive care ongoing rehabilitation needs. This is especially true of COVID-19 ICU patients, can suffer diverse long-term ill effects. Currently there no systematic data collection to guide the needs for therapy input either these groups nor inform planning and development services. These issues could be resolved part by use a clinical tool support decision-making as patients progress from Intensive Care Unit (ICU), through acute hospital...
Background Respiratory management of obesity hypoventilation syndrome (OHS) focusses on the control sleep-disordered breathing rather than treatment obesity. Currently, there are no data from randomised trials weight loss targeted rehabilitation programmes for patients with OHS. Intervention A 3-month multimodal hybrid inpatient–outpatient motivation, exercise and nutrition programme, in addition to non invasive ventilation (NIV), would result greater per cent compared standard care. Methods...
Despite the presumed importance of preventing and treating micronutrient mineral deficiencies, it is still not clear how to optimize measurement administration in critically ill patients. In order design future comparative trials aimed at optimizing management, an important first step gain insight current practice micronutrient, phosphate magnesium monitoring administration.Within metabolism-endocrinology-nutrition (MEN) section European Society Intensive Care Medicine (ESICM), working group...