A5047452382- Respiratory Support and Mechanisms
- Nosocomial Infections in ICU
- Intensive Care Unit Cognitive Disorders
- Neonatal Respiratory Health Research
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Healthcare Decision-Making and Restraints
- Delphi Technique in Research
- Immune Response and Inflammation
- Emergency and Acute Care Studies
- Thermal Regulation in Medicine
- Appendicitis Diagnosis and Management
- Chronic Obstructive Pulmonary Disease (COPD) Research
- COVID-19 and healthcare impacts
- Family and Patient Care in Intensive Care Units
- Medical Device Sterilization and Disinfection
- Trauma and Emergency Care Studies
- Clinical practice guidelines implementation
- Healthcare cost, quality, practices
- Cardiac, Anesthesia and Surgical Outcomes
- Antimicrobial Resistance in Staphylococcus
- Mesenchymal stem cell research
- Risk Perception and Management
- Clinical Nutrition and Gastroenterology
- Patient Safety and Medication Errors
University College London
2013-2024
UCL Biomedical Research Centre
2013-2023
University College London Hospitals NHS Foundation Trust
2007-2022
University College Hospital
2005-2021
National Institute for Health Research
2014-2020
Royal London Hospital
2000-2020
NIHR Biomedical Research Centre at The Royal Marsden and the ICR
2016
Bury College
2005-2014
National Health Service
2007-2008
The Royal Free Hospital
2007
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.
The aim of these guidelines is to update the 2017 clinical practice guideline (CPG) European Society Intensive Care Medicine (ESICM). scope this CPG limited adult patients and non-pharmacological respiratory support strategies across different aspects acute distress syndrome (ARDS), including ARDS due coronavirus disease 2019 (COVID-19). These were formulated by an international panel experts, one methodologist patients’ representatives on behalf ESICM. review was conducted in compliance...
Preclinical studies suggest that exogenous surfactant may be of value in the treatment acute respiratory distress syndrome (ARDS), and two phase 2 clinical trials have shown a trend toward benefit. We conducted 3 protein-containing adults with ARDS.In multicenter, randomized, double-blind involving 448 patients ARDS from various causes, we compared standard therapy alone plus up to four intratracheal doses recombinant protein C-based given within period 24 hours.The overall survival rate was...
Background Bloodstream infections from central venous catheters (CVC-BSIs) increase morbidity and costs in intensive care units (ICUs). Substantial reductions CVC-BSI rates have been reported using a combination of technical non-technical interventions. Methods We conducted 2-year, four-cluster, stepped non-randomised study (behavioural) interventions to prevent CVC-BSIs adult paediatric ICUs England. Random-effects Poisson regression modelling was used compare infection rates. A sample...
Abstract Introduction The study aimed to compare the impact of computerised physician order entry (CPOE) without decision support with hand-written prescribing (HWP) on frequency, type and outcome medication errors (MEs) in intensive care unit. Methods Details MEs were collected before, at several time points after, change from HWP CPOE. was conducted a London teaching hospital's 22-bedded general ICU. sampling periods 28 weeks before 2, 10, 25 37 after introduction unit pharmacist...
Hematopoietic prostaglandin D(2) synthase (hPGD(2)S) metabolizes cyclooxygenase (COX)-derived PGH(2) to PGD(2) and 15-deoxyDelta(12-14) PGJ(2) (15d-PGJ(2)). Unlike COX, the role of hPGD(2)S in host defense is ambiguous. can be either pro- or antiinflammatory depending on disease etiology, whereas existence 15d-PGJ(2) its relevance pathophysiology remain controversial. Herein, studies KO mice reveal that synthesized a self-resolving peritonitis, detected by using liquid chromatography-tandem...
Abstract Introduction This paper describes the case mix, outcome and activity for admissions to intensive care units (ICUs) with community-acquired pneumonia (CAP). Methods We conducted a secondary analysis of high quality clinical database, Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme Database, 301,871 172 adult ICUs across England, Wales Northern Ireland, 1995 2004. Cases CAP were identified from excluding nosocomial pneumonias immuno-compromised. It was...
Acute respiratory distress syndrome (ARDS) is associated with high mortality. Interferon (IFN) β-1a may prevent the underlying event of vascular leakage.To determine efficacy and adverse events IFN-β-1a in patients moderate to severe ARDS.Multicenter, randomized, double-blind, parallel-group trial conducted at 74 intensive care units 8 European countries (December 2015-December 2017) that included 301 adults ARDS according Berlin definition. The radiological partial pressure oxygen, arterial...
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...
Triggering receptor expressed on myeloid (TREM)-1 is integral to the inflammatory response occurring during septic shock, although its precise function has yet be determined. Here we show that in vivo silencing of TREM-1 using siRNA duplexes a fecal peritonitis mouse model resulted blunted and increased mortality. This was associated with impaired bacterial clearance related marked inhibition neutrophil oxidative burst. By contrast, TREM-1-silenced mice were highly resistant lethal endotoxin...
Background Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality. Critically ill patients in intensive care units (ICUs) particularly susceptible to these infections. One intervention that has gained much attention reducing HAIs is selective decontamination the digestive tract (SDD). SDD involves application topical non-absorbable antibiotics oropharynx stomach short course intravenous (i.v.) antibiotics. may reduce improve mortality, but not been widely adopted UK...
Bone marrow-derived, allogeneic, multipotent adult progenitor cells demonstrated safety and efficacy in preclinical models of acute respiratory distress syndrome (ARDS). This phase 1/2 trial evaluated the tolerability intravenous patients with moderate-to-severe ARDS 12 UK USA centres. Cohorts 1 2 were open-label, evaluating three subjects receiving 300 or 900 million cells, respectively. Cohort 3 was a randomised, double-blind, placebo-controlled parallel infusing (n = 20) placebo 10)...
Abstract Introduction Selective decontamination of the digestive tract (SDD) is a prophylactic antibiotic regimen that not widely used in practice. We aimed to describe opinions key ‘stakeholders’ about validity existing evidence base, likely consequences implementation, relative importance their influencing overall practice, barriers implementation and perceptions requirement for further research inform decision whether embark on large randomised controlled trial. Methods This was Delphi...
Summary The effectiveness of emergency surgery vs. non‐emergency strategies for admissions with acute appendicitis, gallstone disease, diverticular abdominal wall hernia or intestinal obstruction is unknown. Data on adult patients from 2010 to 2019 at 175 National Health Service hospitals in England were extracted the Hospital Episode Statistics database. Cohort sizes were: 268,144 (appendicitis); 240,977 (gallstone disease); 138,869 (diverticular 106,432 (hernia); and 133,073 (intestinal...