A5044985897- Cardiac, Anesthesia and Surgical Outcomes
- Esophageal Cancer Research and Treatment
- Hemodynamic Monitoring and Therapy
- Lung Cancer Diagnosis and Treatment
- Nutrition and Health in Aging
- Cancer survivorship and care
- Head and Neck Cancer Studies
- Delphi Technique in Research
- Cardiovascular and exercise physiology
- Blood transfusion and management
- Gastric Cancer Management and Outcomes
- Hip and Femur Fractures
- Enhanced Recovery After Surgery
- Anesthesia and Pain Management
- Artificial Intelligence in Healthcare and Education
- Heart Rate Variability and Autonomic Control
- Cardiac Health and Mental Health
- Iron Metabolism and Disorders
- Erythropoietin and Anemia Treatment
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Speech and dialogue systems
- Aortic aneurysm repair treatments
- Body Composition Measurement Techniques
- Cardiac and Coronary Surgery Techniques
- Frailty in Older Adults
Newcastle upon Tyne Hospitals NHS Foundation Trust
2018-2024
Royal Victoria Infirmary
2016-2023
Northumbria Specialist Emergency Care Hospital
2021
Newcastle upon Tyne Hospital
2015
James Cook University Hospital
2009-2011
Royal Derby Hospital
2006
Nottingham University Hospitals NHS Trust
2005
Introduction Operable oesophagogastric adenocarcinoma management in the UK includes three cycles of neoadjuvant chemotherapy (NAC) followed by resection. Determination oxygen uptake at anaerobic threshold (AT) with cardiopulmonary exercise testing (CPET) is used to objectively measure cardiorespiratory reserve. Oxygen AT predicts perioperative risk, low values associated increased morbidity. Previous studies indicate NAC may have a detrimental impact on Methods CPET was completed 30 patients...
Neoadjuvant chemotherapy may have a detrimental impact on cardiorespiratory reserve. Determination of oxygen uptake at the anaerobic threshold by cardiopulmonary exercise testing (CPET) provides an objective measure Anaerobic can be used to predict perioperative risk. A low is associated with increased morbidity after oesophagogastrectomy. The aim this study was establish whether neoadjuvant has adverse effect fitness, and there recovery fitness before surgery for oesophageal gastric...
Oesophagectomy is a technically-demanding operation associated with high level of morbidity. We analysed the association pre-operative variables, including those from cardiopulmonary exercise testing, complications (logistic regression) and survival length stay (Cox after scheduled transthoracic oesophagectomy in 273 adults, isolation on multivariate testing (maximum Akaike information criterion). On analysis, any postoperative complication was ventilatory equivalents for carbon dioxide,...
Objectives Preoperative exercise training can improve cardiorespiratory fitness before major surgery. However, little is known about what influences participation and adherence in high-risk patient groups. We identified barriers facilitators to uptake, engagement a presurgical, home-based physical activity intervention called ChemoFit delivered during chemotherapy oesophagogastric Design A qualitative study using focus group discussions individual semi-structured interviews was conducted....
Abstract Background Treatment for locally advanced oesophagogastric adenocarcinoma involves neoadjuvant chemotherapy which has a negative impact on patient fitness. Using ‘prehabilitation’ to increase activity levels and fitness may affect physiology, postoperative outcomes improve wellbeing quality of life. The aims the trial were address feasibility acceptability recruiting participants home-based prehabilitation programme provide data allow design future studies. Methods We recruited...
Thoracic epidural (TE) analgesia has been the standard of care for transthoracic esophagectomy patients since 1990s. Multimodal anesthesia using intrathecal diamorphine, local anesthetic infusion catheters (LAC) into paravertebral space and rectus sheaths intravenous opioid postoperatively represent an alternative option postoperative analgesia. While TE can provide excellent pain control, it may inhibit early recovery by causing hypotension reducing mobilization. The aim this study is to...
Summary The variability between observers in the interpretation of cardiopulmonary exercise tests may impact upon clinical decision making and affect risk stratification peri‐operative management a patient. purpose this study was to quantify inter‐reader determination anaerobic threshold (V‐slope method). A series 21 from patients attending surgical pre‐operative assessment clinic were read independently by nine experienced clinicians regularly involved making. grand mean for 10.5 ml O 2 .kg...
Abstract Background Treatment of locally advanced oesophago-gastric adenocarcinoma usually entails neo-adjuvant chemotherapy (NAC) and surgery. Surgery is associated with high morbidity mortality. Cardiopulmonary reserve patients having major surgery related to postoperative outcomes. Complications are poorer quality life may affect prognosis. Preventing complications be beneficial both these have cost implications. Prehabilitation improve recovery from by increasing a patients’ fitness...
Abstract Background Esophagectomy is associated with a high rate of morbidity and mortality. Preoperative cardiopulmonary fitness has been correlated outcomes major surgery. Variables derived from exercise testing (CPET) have postoperative outcomes. It unclear whether preoperative cardiorespiratory patients undergoing esophagectomy long-term survival. This study aimed to evaluate any the CPET variables routinely esophageal cancer may aid in predicting survival after esophagectomy. Methods...
Summary Preoperative cardiopulmonary exercise testing (CPET) provides an objective assessment of aerobic fitness in patients undergoing surgery. While peak oxygen uptake during (VO2peak) and anaerobic threshold have demonstrated a moderate correlation with the development complications following esophagectomy, no clinically useful values been defined. By pooling patient level data from existing studies, we aimed to define optimal thresholds for preoperative CPET parameters predict at high...
Ferric derisomaltose (FDI; Monofer) is used in clinical practice to treat iron deficiency, but the safety and efficacy of FDI has not been robustly evaluated a large real-world study. This retrospective, multicentre, audit-based, observational study provides pragmatic information about responses with across therapy areas patient populations, helping facilitate treatment decisions. Participating sites provided data from medical records adults who had received ≥ 1 infusion. The primary outcome...
Abstract Background Emergency laparotomy carries a significant risk profile around the time of surgery. This research aimed to establish feasibility recruitment study using validated scoring tools assess complications after surgery; and patient-reported outcome measures (PROMs) quality life recovery up year following emergency (EL). Methods We used our local National Laparotomy Audit (NELA) register identify potential participants at single NHS centre in England. Complications were assessed...
Abstract Background Thoracic epidural analgesia (TEA) has been regarded as the standard of care after oesophagectomy for pain control, but several side-effects. Multimodal (intrathecal diamorphine, paravertebral and rectus sheath catheters) (MA) may facilitate postoperative mobilization by reducing hypotensive episodes need vasopressors, uncertainty exists about whether it provides comparable analgesia. This study aimed to determine MA TEA following transthoracic oesophagectomy. Methods...
Hip fracture care is a major activity in the majority of NHS acute hospitals. Almost all patients undergo surgery and around 3600 hospital beds are occupied every day by hip patients. Anaemia common finding these In recent report, 44% were anaemic on admission to 87% after [1]. Reviews suggest that anaemia this population associated with increased mortality [2] peri-operative blood transfusion common. Uncorrected may impede functional recovery group [3, 4] appears have lasting effect quality...
Optimising preoperative haemoglobin (Hb) before elective surgery is recommended by the National Institute of Clinical Excellence. We have used a quality improvement (QI) approach to treat iron deficiency anaemia in patients presenting assessment clinic (PAC) major oesophagogastric surgery. Through series three QI cycles, we treated deficiency, improved and reduced rate postoperative blood transfusion. Our methods included early diagnosis at PAC attendance, development implementation new...