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2. Hospital-level volume in extracorporeal membrane oxygenation cases and death or disability at 6 months

Author

Hodgson, Carol, Fulcher, Bentley, Linke, Natalie, Board, Jasmin, Buhr, Heidi, Cooper, Jamie, Fraser, John, Bernard, Stephen, Brodie, Daniel, Pilcher, David, Fan, Eddy, Udy, Andrew, Gattas, David, Pellegrino, Vincent, Hopper, Ingrid, Litton, Ed, Nair, Priya, Orford, Neil, Parke, Rachael, Stub, Dion, Higgins, Alisa M., Burrell, Aidan, McGuiness, Shay, Reddi, Benjamin, Trapani, Tony, Huckson, Sue, Anderson, Shannah, Dicker, Craig, Jones, Annalie, Martin, Emma, McCracken, Phoebe, Sheldrake, Jayne, Vallance, Shirley, Young, Meredith, Bellomo, Rinaldo, Eastwood, Glenn, Hilton, Andrew, Peck, Leah, Dyett, John, Hunter, Stephanie, Liew, Cheelim, Heard, Joshua, Lijo, Sebastian, Nourse, Mary, Rai, Sumeet, Singh, Manoj, Veerendra, Hemanth, Xu, Tina, Barrett, Jonathan, Brooks, Kyle, Hanlon, Gabrielle, Allen, Chris, Bizzell, Samantha, Eroglu, Ege, Palermo, Annamaria, Pellicano, Susan, Bersten, Andrew, Bihari, Shailesh, Brown, Julia, Comerford, Sharon, Grear, Laura, McIntyre, Joanne, Jin, Xia, Wiersema, Ubbo, Figures, Dee, Gough, Maimoonbe, Pitman, Julie, Tallott, Mandy, Winearls, James, Brieva, Jorge, Hopkins, Madeleine, Jayarman, Nanda, Poulter, Amber-Louise, Quarello, Kate, Aneman, Anders, Austin, Danielle, McCanny, Peter, Miller, Jennene, Murfin, Brendan, Cox, Yolanda, Guo, Stephanie, Shehabi, Yayha, Brown, Amanda, Butt, Pamela, Bushell, Rachel, Lavana, Jayshree, Lockwood, Dawn, Pearce, India, Salt, Gavin, Thambiraj, Solomon, Howard, Meg, Joyce, Chris, Meyer, Jason, Walsham, James, Brown, Nerissa, Glasby, Kathleen, O'Connor, Stephanie, Rivett, Justine, Yap, Joannies, Bristow, Debra, Pincus, Jason, Stuart, Janine, Anstey, James, Barge, Deborah, Butler, Menoly, Gebbie, Bradley, Bass, Frances, Janin, Pierre, Hammond, Naomi, Potger, Kieron, Yarad, Elizabeth, Carey, Ruaidhri, Coles, Jennifer, Totaro, Richard, Anstey, Matthew, Endemann, Anthadene, Hardy, Sarah, Popa, Roxana, Richards, Stephen, Rock, Lara, Wibrow, Bradley, Barbazza, Leanne, Dixon, Barry, Holmes, Jennifer, Hurune, Patricia, O'Brien, Yvette, Buscher, Hergen, Newman, Sally, Reynolds, Claire, Henson, Gail, Senthuran, Siva, Win, April, Breguet, Samantha, Horton, Michelle, McCaffrey, Joe, Trickey, Jemma, Bannerjee, Ashoke, Davidson, Benjamin, Joy, Jenyfer, Kong, Jing, Ertugrul, Atacan D., Neto, Ary Serpa, Fulcher, Bentley J., Charles-Nelson, Anaïs, Bailey, Michael, Burrell, Aidan J.C., Board, Jasmin V., Cooper, D. James, Fraser, John F., Gattas, David J., Hopper, Ingrid K., Linke, Natalie J., Litton, Edward, McGuinness, Shay P., Parke, Rachael L., Pellegrino, Vincent A., Pilcher, David V., Udy, Andrew A., Reddi, Benjamin A.J., Trapani, Tony V., and Hodgson, Carol L.

Published
2024
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3. Comparison of baseline characteristics, treatment and clinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Author

Burrell, Aidan JC, Neto, Ary Serpa, Broadley, Tessa, Trapani, Tony, Begum, Husna, Campbell, Lewis T, Cheng, Allen C, Cheung, Winston, Cooper, D James, Erickson, Simon J, French, Craig J, Kaldor, John M, Litton, Edward, Murthy, Srinivas, McAllister, Richard E, Nichol, Alistair D, Palermo, Annamaria, Plummer, Mark P, Ramanan, Mahesh, Reddi, Benjamin AJ, Reynolds, Claire, Webb, Steve A, and Udy, Andrew A

Published
2021

4. Correction: High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

Author

Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, and Maas, Andrew I. R.

Subjects
Brain -- Injuries, Health care industry
Abstract

Author(s): Emanuele Rezoagli [sup.1] [sup.2], Matteo Petrosino [sup.3], Paola Rebora [sup.3], David K. Menon [sup.4], Stefania Mondello [sup.5], D. James Cooper [sup.6] [sup.7], Andrew I. R. Maas [sup.8], Eveline J. [...]

Published
2023
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5. High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

Author

Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, and Maas, Andrew I. R.

Subjects
Medical research -- Analysis, Medicine, Experimental -- Analysis, Mortality -- Norway -- Lithuania -- United Kingdom -- Spain -- Germany -- Belgium -- Hungary -- Denmark -- Sweden -- France -- Australia -- Netherlands -- Romania, Brain -- Injuries, Health care industry, University of Cambridge, Monash University
Abstract

Purpose The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO.sub.2) and the oxygen inspired fraction (FiO.sub.2). We explored the association between high PaO.sub.2 and FiO.sub.2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO.sub.2 and FiO.sub.2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO.sub.2 ranged from 93 to 166 mmHg. Exposure to higher PaO.sub.2 and FiO.sub.2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO.sub.2 and FiO.sub.2 levels, which remained independently associated with 6-month mortality. Conclusions In two large prospective multicenter cohorts of critically ill patients with TBI, levels of PaO.sub.2 and FiO.sub.2 varied widely across centers during the first seven days after ICU admission. Exposure to high arterial blood oxygen or high supplemental oxygen was independently associated with 6-month mortality in the CENTER-TBI cohort, and the severity of brain injury did not modulate this relationship. Due to the limited sample size, the findings were not wholly validated in the external OzENTER-TBI cohort. We cannot exclude the possibility that the worse outcomes associated with higher PaO.sub.2 were due to use of higher FiO.sub.2 in patients with more severe injury or physiological compromise. Further, these findings may not apply to patients in whom FiO.sub.2 and PaO.sub.2 are titrated to brain tissue oxygen monitoring (PbtO.sub.2) levels. However, at minimum, these findings support the need for caution with oxygen therapy in TBI, particularly since titration of supplemental oxygen is immediately applicable at the bedside., Author(s): Emanuele Rezoagli [sup.1] [sup.2], Matteo Petrosino [sup.3], Paola Rebora [sup.3], David K. Menon [sup.4], Stefania Mondello [sup.5], D. James Cooper [sup.6] [sup.7], Andrew I. R. Maas [sup.8], Eveline J. [...]

Published
2022
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6. Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure

Author

Myles, Paul, Gan, T.J., Kurz, Andrea, Peyton, Phil, Sessler, Dan, Tramèr, Martin, Cyna, Alan, De Oliveira, Gildasio S., Jr., Wu, Christopher, Jensen, Mark, Kehlet, Henrik, Botti, Mari, Boney, Oliver, Haller, Guy, Grocott, Mike, Cook, Tim, Fleisher, Lee, Neuman, Mark, Story, David, Gruen, Russell, Bampoe, Sam, Evered, Lis, Scott, David, Silbert, Brendan, van Dijk, Diederik, Kalkman, Cor, Chan, Matthew, Grocott, Hilary, Eckenhoff, Rod, Rasmussen, Lars, Eriksson, Lars, Beattie, Scott, Wijeysundera, Duminda, Landoni, Giovanni, Leslie, Kate, Biccard, Bruce, Howell, Simon, Nagele, Peter, Richards, Toby, Lamy, Andre, Lalu, Manoj, Pearse, Rupert, Mythen, Monty, Canet, Jaume, Moller, Ann, Gin, Tony, Schultz, Marcus, Pelosi, Paolo, Gabreu, Marcelo, Futier, Emmanuel, Creagh-Brown, Ben, Abbot, Tom, Klein, Andy, Corcoran, Tomas, Cooper, D. Jamie, Dieleman, Stefan, Diouf, Elisabeth, McIlroy, David, Bellomo, Rinaldo, Shaw, Andrew, Prowle, John, Karkouti, Keyvan, Billings, Josh, Mazer, David, Jayarajah, Mohindas, Murphy, Michael, Bartoszko, Justyna, Sneyd, Rob, Morris, Steve, George, Ron, Moonesinghe, Ramani, Shulman, Mark, Lane-Fall, Meghan, Nilsson, Ulrica, Stevenson, Nathalie, van Klei, Wilton, Cabrini, Luca, Miller, Tim, Jackson, Sandy, Buggy, Donal, Short, Tim, Riedel, Bernhard, Gottumukkala, Vijay, Pace, Nathan, Alkhaffaf, Bilal, Johnson, Mark, Jackson, Alexander I.R., Pearse, Rupert M., Cooper, D. James, van Klei, Wilton A., Miller, Timothy E., Moonesinghe, S. Ramani, Myles, Paul S., and Grocott, Michael P.W.

Published
2023
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7. Anti-Factor-Xa and Activated Partial Thromboplastin Time Concordance and Outcomes in Adults Undergoing Extracorporeal Membrane Oxygenation: A Secondary Analysis of the Pilot Low-Dose Heparin in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation Randomized Trial

Author

Aubron, Cécile, Chapalain, Xavier, Bailey, Michael, Board, Jasmin, Buhr, Heidi, Cartwright, Bruce, Dennis, Mark, Hodgson, Carol, Forrest, Paul, McIlroy, David, Murphy, Deirdre, Murray, Lynne, Pellegrino, Vincent, Pilcher, David, Sheldrake, Jayne, Tran, Huyen, Vallance, Shirley, Cooper, D. James, and McQuilten, Zoe

Published
2023
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8. Incidence of death or disability at 6 months after extracorporeal membrane oxygenation in Australia: a prospective, multicentre, registry-embedded cohort study

Author

Hodgson, Carol L, Higgins, Alisa M, Bailey, Michael J, Anderson, Shannah, Bernard, Stephen, Fulcher, Bentley J, Koe, Denise, Linke, Natalie J, Board, Jasmin V, Brodie, Daniel, Buhr, Heidi, Burrell, Aidan J C, Cooper, D James, Fan, Eddy, Fraser, John F, Gattas, David J, Hopper, Ingrid K, Huckson, Sue, Litton, Edward, McGuinness, Shay, Nair, Priya, Orford, Neil, Parke, Rachael L, Pellegrino, Vincent A, Pilcher, David V, Sheldrake, Jayne Sheldrake, Reddi, Benjamin A J, Stub, Dion, Trapani, Tony V, Udy, Andrew A, Serpa Neto, Ary, McGuinness, Shay P, and Sheldrake, Jayne

Published
2022
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11. Characteristics, management and outcomes of patients with severe traumatic brain injury in Victoria, Australia compared to United Kingdom and Europe: A comparison between two harmonised prospective cohort studies

Author

Wiegers, Eveline J.A., Trapani, Tony, Gabbe, Belinda J., Gantner, Dashiell, Lecky, Fiona, Maas, Andrew I.R., Menon, David K., Murray, Lynnette, Rosenfeld, Jeffrey V., Vallance, Shirley, Lingsma, Hester F., Steyerberg, Ewout W., and Cooper, D. James

Published
2021
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13. Hospital-level volume in extracorporeal membrane oxygenation cases and death or disability at 6 months

Author

Ertugrul, Atacan D., Neto, Ary Serpa, Fulcher, Bentley J., Charles-Nelson, Anaïs, Bailey, Michael, Burrell, Aidan J.C., Anderson, Shannah, Bernard, Stephen, Board, Jasmin V., Brodie, Daniel, Buhr, Heidi, Cooper, D. James, Dicker, Craig, Fan, Eddy, Fraser, John F., Gattas, David J., Hopper, Ingrid K., Huckson, Sue, Linke, Natalie J., Litton, Edward, McGuinness, Shay P., Nair, Priya, Orford, Neil, Parke, Rachael L., Pellegrino, Vincent A., Pilcher, David V., Stub, Dion, Udy, Andrew A., Reddi, Benjamin A.J., Trapani, Tony V., Jones, Annalie, Higgins, Alisa M., Hodgson, Carol L., Hodgson, Carol, Fulcher, Bentley, Linke, Natalie, Board, Jasmin, Buhr, Heidi, Cooper, Jamie, Fraser, John, Bernard, Stephen, Brodie, Daniel, Pilcher, David, Fan, Eddy, Udy, Andrew, Gattas, David, Pellegrino, Vincent, Hopper, Ingrid, Litton, Ed, Nair, Priya, Orford, Neil, Parke, Rachael, Stub, Dion, Higgins, Alisa M., Burrell, Aidan, McGuiness, Shay, Reddi, Benjamin, Trapani, Tony, Huckson, Sue, Anderson, Shannah, Dicker, Craig, Jones, Annalie, Board, Jasmin, Jones, Annalie, Martin, Emma, McCracken, Phoebe, Pellegrino, Vincent, Sheldrake, Jayne, Vallance, Shirley, Young, Meredith, Bellomo, Rinaldo, Eastwood, Glenn, Hilton, Andrew, Peck, Leah, Dyett, John, Hunter, Stephanie, Liew, Cheelim, Heard, Joshua, Lijo, Sebastian, Nourse, Mary, Rai, Sumeet, Singh, Manoj, Veerendra, Hemanth, Xu, Tina, Barrett, Jonathan, Brooks, Kyle, Hanlon, Gabrielle, Allen, Chris, Bizzell, Samantha, Eroglu, Ege, Litton, Ed, Palermo, Annamaria, Pellicano, Susan, Bersten, Andrew, Bihari, Shailesh, Brown, Julia, Comerford, Sharon, Grear, Laura, McIntyre, Joanne, Jin, Xia, Wiersema, Ubbo, Figures, Dee, Gough, Maimoonbe, Pitman, Julie, Tallott, Mandy, Winearls, James, Brieva, Jorge, Hopkins, Madeleine, Jayarman, Nanda, Poulter, Amber-Louise, Quarello, Kate, Aneman, Anders, Austin, Danielle, McCanny, Peter, Miller, Jennene, Murfin, Brendan, Cox, Yolanda, Guo, Stephanie, Shehabi, Yayha, Brown, Amanda, Butt, Pamela, Bushell, Rachel, Fraser, John, Lavana, Jayshree, Lockwood, Dawn, Pearce, India, Salt, Gavin, Thambiraj, Solomon, Howard, Meg, Joyce, Chris, Meyer, Jason, Walsham, James, Brown, Nerissa, Glasby, Kathleen, O'Connor, Stephanie, Reddi, Benjamin, Rivett, Justine, Yap, Joannies, Bristow, Debra, Pincus, Jason, Stuart, Janine, Anstey, James, Barge, Deborah, Butler, Menoly, Gebbie, Bradley, Bass, Frances, Janin, Pierre, Hammond, Naomi, Potger, Kieron, Yarad, Elizabeth, Buhr, Heidi, Carey, Ruaidhri, Coles, Jennifer, Gattas, David, Totaro, Richard, Anstey, Matthew, Endemann, Anthadene, Hardy, Sarah, Popa, Roxana, Richards, Stephen, Rock, Lara, Wibrow, Bradley, Barbazza, Leanne, Dixon, Barry, Holmes, Jennifer, Hurune, Patricia, O'Brien, Yvette, Buscher, Hergen, Nair, Priya, Newman, Sally, Reynolds, Claire, Henson, Gail, Senthuran, Siva, Win, April, Breguet, Samantha, Horton, Michelle, McCaffrey, Joe, Orford, Neil, Trickey, Jemma, Bannerjee, Ashoke, Davidson, Benjamin, Joy, Jenyfer, and Kong, Jing

Abstract

Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.

Published
2024
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16. Tranexamic acid in coronary artery surgery: One-year results of the Aspirin and Tranexamic Acid for Coronary Artery Surgery (ATACAS) trial

Author

Myles, Paul, Smith, Julian, Cooper, D. James, Silbert, Brendan, McNeil, John, Marasco, Silvana, Esmore, Donald, Krum, Henry, Tonkin, A., Buxton, B., Heritier, S., Merry, A., Liew, D., McNeil, J., Forbes, A., Cooper, D.J., Wallace, S., Meehan, A., Myles, P., Galagher, W., Farrington, C., Ditoro, A., Wutzlhofer, L., Story, D., Peyton, P., Baulch, S., Sidiropoulos, S., Potgieter, D., Baker, R.A., Pesudovs, B., O'Loughlin J Wells, E., Coutts, P., Bolsin, S., Osborne, C., Ives, K., Smith, J., Hulley, A., Christie-Taylor, G., Painter, T., Lang, S., Mackay, H., Cokis, C., March, S., Bannon, P.G., Wong, C., Turner, L., Scott, D., Silbert, B., Said, S., Corcoran, P., de Prinse, L., Bussières, J.S., Gagné, N., Lamy, A., Semelhago, L., Chan, M.T.V., Underwood, M., Choi, G.S.Y., Fung, B., Landoni, G., Lembo, R., Monaco, F., Simeone, F., Marianello, D., Alvaro, G., De Vuono, G., van Dijk, D., Dieleman, J., Numan, S., McGuinness, S., Parke, R., Raudkivi, P., Gilder, E., Byrne, K., Dunning, J., Termaat, J., Mans, G., Jayarajah, M., Alderton, J., Waugh, D., Platt, M.J., Pai, A., Sevillano, A., Lal, A., Sinclair, C., Kunst, G., Knighton, A., Cubas, G.M., Saravanan, P., Millner, R., Vasudevan, V., Patteril, M., Lopez, E., Basu, R., Lu, J., Myles, Paul S., Smith, Julian A., Kasza, Jessica, Jayarajah, Mohandas, Painter, Thomas, Bussières, Jean S., McGuinness, Shay, Byrne, Kelly, Chan, Matthew T.V., Landoni, Giovanni, Wallace, Sophie, and Forbes, Andrew

Published
2019
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19. The Australian Traumatic Brain Injury Initiative: systematic review and consensus process to determine the predictive value of demographic, injury event and social characteristics on outcomes for people with moderate-severe traumatic brain injury

Author

Gabbe, Belinda, primary, Keeves, Jemma, additional, McKimmie, Ancelin, additional, Gadowski, Adelle, additional, Holland, Andrew, additional, Semple, Bridgette D, additional, Young, Jesse, additional, Crowe, Louise Margaret, additional, Ownsworth, Tamara, additional, Bagg, Matthew, additional, Antonic-Baker, Ana, additional, Hicks, Amelia, additional, Hill, Regina, additional, Curtis, Kate, additional, Romero, Lorena, additional, Ponsford, Jennie, additional, Lannin, Natasha A, additional, O'Brien, Terence J., additional, Cameron, Peter, additional, Cooper, D. James, additional, Rushworth, Nick, additional, and Fitzgerald, Melinda, additional

Published
2023
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22. Prognostication and Withdrawal of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) Working Group

Author

Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, Hawryluk, Gregory, Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, and Hawryluk, Gregory

Abstract

Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the Seattle International severe traumatic Brain Injury Consensus Conference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care. A total of 97.6% of the 42 SIBICC panelists completed the survey. Responses to most questions were highly variable. Overall, panelists reported infrequent use of prognostic calculators, and observed variability in patient prognostication and goals of care decisions. They felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome as well as what chance of achieving that outcome is acceptable. Panelists felt that the public should help to define what constitutes a good outcome and expressed some support for a “nihilism guard.” More than 50% of panelists felt that if it was certain to be permanent, a vegetative state or lower severe disability would justify a withdrawal of care decision, whereas 15% felt that upper severe disability justified such a decision. Whether conceptualizing an ideal or existing prognostic calculator to predict death or an unacceptable outcome, on average a 64-69% chance of a poor outcome was felt to justify treatment withdrawal. These results demonstrate important variability in goals of care decision making and a desire to reduce this variability. Our panel of recognized TBI experts opined on the neurological outcomes and chances of those outcomes that might prompt consideration of care withdrawal; however, imprecision of prognostication and existing prognostication tools is a significant impediment t

Published
2023

24. Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group

Author

Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, Hawryluk, Gregory, Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, and Hawryluk, G

Subjects
withdrawal of care, survey, Neurology (clinical), SIBICC, brain injury, prognosi, nihilism
Abstract

Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the Seattle International severe traumatic Brain Injury Consensus Conference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care. A total of 97.6% of the 42 SIBICC panelists completed the survey. Responses to most questions were highly variable. Overall, panelists reported infrequent use of prognostic calculators, and observed variability in patient prognostication and goals of care decisions. They felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome as well as what chance of achieving that outcome is acceptable. Panelists felt that the public should help to define what constitutes a good outcome and expressed some support for a “nihilism guard.” More than 50% of panelists felt that if it was certain to be permanent, a vegetative state or lower severe disability would justify a withdrawal of care decision, whereas 15% felt that upper severe disability justified such a decision. Whether conceptualizing an ideal or existing prognostic calculator to predict death or an unacceptable outcome, on average a 64-69% chance of a poor outcome was felt to justify treatment withdrawal. These results demonstrate important variability in goals of care decision making and a desire to reduce this variability. Our panel of recognized TBI experts opined on the neurological outcomes and chances of those outcomes that might prompt consideration of care withdrawal; however, imprecision of prognostication and existing prognostication tools is a significant impediment to standardizing the approach to care-limiting decisions.

Published
2023
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27. Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure

Author

Jackson, Alexander I.R., primary, Boney, Oliver, additional, Pearse, Rupert M., additional, Kurz, Andrea, additional, Cooper, D. James, additional, van Klei, Wilton A., additional, Cabrini, Luca, additional, Miller, Timothy E., additional, Moonesinghe, S. Ramani, additional, Myles, Paul S., additional, Grocott, Michael P.W., additional, Myles, Paul, additional, Gan, T.J., additional, Peyton, Phil, additional, Sessler, Dan, additional, Tramèr, Martin, additional, Cyna, Alan, additional, De Oliveira, Gildasio S., additional, Wu, Christopher, additional, Jensen, Mark, additional, Kehlet, Henrik, additional, Botti, Mari, additional, Haller, Guy, additional, Grocott, Mike, additional, Cook, Tim, additional, Fleisher, Lee, additional, Neuman, Mark, additional, Story, David, additional, Gruen, Russell, additional, Bampoe, Sam, additional, Evered, Lis, additional, Scott, David, additional, Silbert, Brendan, additional, van Dijk, Diederik, additional, Kalkman, Cor, additional, Chan, Matthew, additional, Grocott, Hilary, additional, Eckenhoff, Rod, additional, Rasmussen, Lars, additional, Eriksson, Lars, additional, Beattie, Scott, additional, Wijeysundera, Duminda, additional, Landoni, Giovanni, additional, Leslie, Kate, additional, Biccard, Bruce, additional, Howell, Simon, additional, Nagele, Peter, additional, Richards, Toby, additional, Lamy, Andre, additional, Lalu, Manoj, additional, Pearse, Rupert, additional, Mythen, Monty, additional, Canet, Jaume, additional, Moller, Ann, additional, Gin, Tony, additional, Schultz, Marcus, additional, Pelosi, Paolo, additional, Gabreu, Marcelo, additional, Futier, Emmanuel, additional, Creagh-Brown, Ben, additional, Abbot, Tom, additional, Klein, Andy, additional, Corcoran, Tomas, additional, Cooper, D. Jamie, additional, Dieleman, Stefan, additional, Diouf, Elisabeth, additional, McIlroy, David, additional, Bellomo, Rinaldo, additional, Shaw, Andrew, additional, Prowle, John, additional, Karkouti, Keyvan, additional, Billings, Josh, additional, Mazer, David, additional, Jayarajah, Mohindas, additional, Murphy, Michael, additional, Bartoszko, Justyna, additional, Sneyd, Rob, additional, Morris, Steve, additional, George, Ron, additional, Moonesinghe, Ramani, additional, Shulman, Mark, additional, Lane-Fall, Meghan, additional, Nilsson, Ulrica, additional, Stevenson, Nathalie, additional, van Klei, Wilton, additional, Miller, Tim, additional, Jackson, Sandy, additional, Buggy, Donal, additional, Short, Tim, additional, Riedel, Bernhard, additional, Gottumukkala, Vijay, additional, Pace, Nathan, additional, Alkhaffaf, Bilal, additional, and Johnson, Mark, additional

Published
2023
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29. Protocol for a multicentre randomised controlled trial of early and sustained prophylactic hypothermia in the management of traumatic brain injury

Author

Nichol, Alistair, Gantner, Dashiell, Presneill, Jeffrey, Murray, Lynnette, Trapani, Tony, Bernard, Stephen, Cameron, Peter, Capellier, Gilles, Forbes, Andrew, McArthur, Colin, Newby, Lynette, Rashford, Stephen, Rosenfeld, Jeffrey V., Smith, Tony, Stephenson, Michael, Varma, Dinesh, Walker, Tony, Webb, Steve, and Cooper, D. James

Published
2015
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32. High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury:insights from CENTER-TBI and OzENTER-TBI

Author

Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, Maas, Andrew I.R., Wiegers, Eveline J.A., Galimberti, Stefania, Citerio, Giuseppe, Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, Maas, Andrew I.R., Wiegers, Eveline J.A., Galimberti, Stefania, and Citerio, Giuseppe

Abstract

Purpose: The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods: This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO2) and the oxygen inspired fraction (FiO2). We explored the association between high PaO2 and FiO2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO2 and FiO2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results: The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO2 ranged from 93 to 166 mmHg. Exposure to higher PaO2 and FiO2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO2 levels, which remained independently associated with 6-month mortality. Conclusions: In two large prospective multicenter cohorts of critically ill patients with TBI, level

Published
2022

33. High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

Author

Rezoagli, E, Petrosino, M, Rebora, P, Menon, D, Mondello, S, Cooper, D, Maas, A, Wiegers, E, Galimberti, S, Citerio, G, Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, Maas, Andrew I. R., Wiegers, Eveline J. A., Galimberti, Stefania, Citerio, Giuseppe, Rezoagli, E, Petrosino, M, Rebora, P, Menon, D, Mondello, S, Cooper, D, Maas, A, Wiegers, E, Galimberti, S, Citerio, G, Rezoagli, Emanuele, Petrosino, Matteo, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, Maas, Andrew I. R., Wiegers, Eveline J. A., Galimberti, Stefania, and Citerio, Giuseppe

Abstract

Purpose: The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods: This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO2) and the oxygen inspired fraction (FiO2). We explored the association between high PaO2 and FiO2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO2 and FiO2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results: The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO2 ranged from 93 to 166 mmHg. Exposure to higher PaO2 and FiO2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO2 levels, which remained independently associated with 6-month mortality. Conclusions: In two large prospective multicenter cohorts of critically ill patients with TBI, levels of PaO2 and FiO2 varied widely across centers during the first seven days after ICU admission. Exposure to high

Published
2022

38. Medication-related Medical Emergency Team activations: a case review study of frequency and preventability.

Author

Levkovich, Bianca J., Orosz, Judit, Bingham, Gordon, Cooper, D. James, Dooley, Michael, Kirkpatrick, Carl, and Jones, Daryl A.

Subjects
ANTIHYPERTENSIVE agents, BLOOD pressure, RAPID response teams, CONFIDENCE intervals, ACADEMIC medical centers, SCIENTIFIC observation, MEDICATION error prevention, DISEASE incidence, MANN Whitney U Test, MEDICAL care use, ADRENERGIC beta blockers, CRITICAL care medicine, RESEARCH funding, TACHYCARDIA, TOXICITY testing, CHI-squared test, HEART beat, ADVERSE health care events, PATIENT care, DATA analysis software, ODDS ratio, EMERGENCY medicine, PATIENT safety, LONGITUDINAL method
Abstract

Objectives Despite recognition of clinical deterioration and medication-related harm as patient safety risks, the frequency of medication-related Rapid Response System activations is undefined. We aimed to estimate the incidence and preventability of medication-related Medical Emergency Team (MET) activations and describe the associated adverse medication events. Methods A case review study of consecutive MET activations at two acute, academic teaching hospitals in Melbourne, Australia with mature Rapid Response Systems was conducted. All MET activations during a 3-week study period were assessed for a medication cause including identification of the contributing adverse medication event and its preventability, using validated tools and recognised classification systems. Results There were 9439 admissions and 628 MET activations during the study period. Of these, 146 (23.2%) MET activations were medication related: an incidence of 15.5 medication-related MET activation per 1000 admissions. Medication-related MET activations occurred a median of 46.6 hours earlier (IQR 22-165) in an admission than non-medication-related activations (p=0.001). Furthermore, this group also had more repeat MET activations during their admission (p=0.021, OR=1.68, 95% CI 1.09 to 2.59). A total of 92 of 146 (63%) medication- related MET activations were potentially preventable. Tachycardia due to omission of beta-blocking agents (10.9%, n=10 of 92) and hypotension due to cumulative toxicity (9.8%, n=9 of 92) or inappropriate use (10.9%, n=10 of 92) of antihypertensives were the most common adverse medication events leading to potentially preventable medication-related MET activations. Conclusions Medications contributed to almost a quarter of MET activations, often early in a patient's admission. One in seven MET activations were due to potentially preventable adverse medication events. The most common of these were omission of beta-blockers and clinically inappropriate antihypertensive use. Strategies to prevent these events would increase patient safety and reduce burden on the MET. [ABSTRACT FROM AUTHOR]

Published
2023
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42. People in intensive care with COVID ‐19: demographic and clinical features during the first, second, and third pandemic waves in Australia

Author

Begum, Husna, primary, Neto, Ary S, additional, Alliegro, Patricia, additional, Broadley, Tessa, additional, Trapani, Tony, additional, Campbell, Lewis T, additional, Cheng, Allen C, additional, Cheung, Winston, additional, Cooper, D James, additional, Erickson, Simon J, additional, French, Craig J, additional, Litton, Edward, additional, McAllister, Richard, additional, Nichol, Alistair, additional, Palermo, Annamaria, additional, Plummer, Mark P, additional, Rotherham, Hannah, additional, Ramanan, Mahesh, additional, Reddi, Benjamin, additional, Reynolds, Claire, additional, Webb, Steven AR, additional, Udy, Andrew A, additional, and Burrell, Aidan, additional

Published
2022
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43. Comparison of 6-Month Outcomes of Survivors of COVID-19 versus Non–COVID-19 Critical Illness

Author

Hodgson, Carol L., primary, Higgins, Alisa M., additional, Bailey, Michael J., additional, Mather, Anne M., additional, Beach, Lisa, additional, Bellomo, Rinaldo, additional, Bissett, Bernie, additional, Boden, Ianthe J., additional, Bradley, Scott, additional, Burrell, Aidan, additional, Cooper, D. James, additional, Fulcher, Bentley J., additional, Haines, Kimberley J., additional, Hodgson, Isabelle T., additional, Hopkins, Jack, additional, Jones, Alice Y. M., additional, Lane, Stuart, additional, Lawrence, Drew, additional, van der Lee, Lisa, additional, Liacos, Jennifer, additional, Linke, Natalie J., additional, Gomes, Lonni Marques, additional, Nickels, Marc, additional, Ntoumenopoulos, George, additional, Myles, Paul S., additional, Patman, Shane, additional, Paton, Michelle, additional, Pound, Gemma, additional, Rai, Sumeet, additional, Rix, Alana, additional, Rollinson, Thomas C., additional, Tipping, Claire J., additional, Thomas, Peter, additional, Trapani, Tony, additional, Udy, Andrew A., additional, Whitehead, Christina, additional, Anderson, Shannah, additional, Neto, Ary Serpa, additional, Young, Meredith, additional, Board, Jasmin, additional, McCracken, Phoebe, additional, Martin, Emma-Leah, additional, Burgess, Nicola, additional, Hearn, Kirsty, additional, Brewster, David, additional, Waanders, Alyssa, additional, Simpson, Shannon, additional, de Silva, Yasmin, additional, Barrett, Jonathon, additional, Hanlon, Gabrielle, additional, Lang, Jenna, additional, Burleigh, Sarah, additional, Killer, Elisha, additional, Wang, Michael, additional, O’Connor, Lauren, additional, Thomas, Lauren, additional, Dennis, Lucy, additional, Caruana, Joanna, additional, Al-Bassam, Wisam, additional, Shealy, Morag, additional, Chapman, Marianne, additional, O’Connor, Stephanie, additional, Sheehan, Janne, additional, Alexander, Emily, additional, Sukkar, Amanda, additional, Davis, Liesl, additional, Bass, Francis, additional, Hammond, Naomi, additional, O’Connor, Anne, additional, Yarad, Elizabeth, additional, Totaro, Richard, additional, Buhr, Heidi, additional, Reddy, Nazmeen, additional, Chaseling, Wendy, additional, Ip, Kelvin, additional, Tronstad, Oystein, additional, Mahoney, Alison, additional, Fanning, Cadi, additional, Esterman, Hariette, additional, Kozary, Alexia, additional, and Scott, Bronte, additional

Published
2022
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44. Additional file 1 of Comparison of 6-month outcomes of sepsis versus non-sepsis critically ill patients receiving mechanical ventilation

Author

Hodgson, Carol L., Higgins, Alisa M., Bailey, Michael, Barrett, Jonathon, Bellomo, Rinaldo, Cooper, D. James, Gabbe, Belinda J., Iwashyna, Theodore, Linke, Natalie, Myles, Paul S., Paton, Michelle, Philpot, Steve, Shulman, Mark, Young, Meredith, and Serpa Neto, Ary

Abstract

Additional file 1. The electronic supplement includes additional information about the study including methods and results, participating sites, missing data, adjusted and unadjusted analyses, the flowchart of included participants, trajectory of long-term outcomes and incidence of disability.

Published
2022
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45. High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI

Author

Petrosino, Matteo, Rezoagli, Emanuele, Rebora, Paola, Menon, David K., Mondello, Stefania, Cooper, D. James, Maas, Andrew I. R., Wiegers, Eveline J. A., Stefania, Galimberti, Citerio, Giuseppe, Nada, Andelic, Andreassen, Lasse, Vik, Anne, Anke, Audny Gabriele Wagner, Frisvold, Shirin, Skandsen, Toril, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Rezoagli, E, Petrosino, M, Rebora, P, Menon, D, Mondello, S, Cooper, D, Maas, A, Wiegers, E, Galimberti, S, Citerio, G, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, „Springer Nature' grupė, CENTER-TBI, OzENTER-TBI Participants Investigators, Public Health, Neurology, Neurosurgery, Pediatric Surgery, Mattern, Julia, McMahon, Catherine, Menon, David, Menovsky, Tomas, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Ackerlund, Cecilia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Ples, Horia, Pomposo, Inigo, Posti, Jussi P., Amrein, Krisztina, Puybasset, Louis, Rădoi, Andreea, Raj, Rahul, Rhodes, Jonathan, Richter, Sophie, Roe, Cecilie, Roise, Olav, Rosenfeld, Jeffrey, Andelic, Nada, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandrød, Oddrun, Schirmer-Mikalsen, Kari, Schou, Rico Frederik, Andreassen, Lasse, Sewalt, Charlie, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Anke, Audny, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Audibert, Gérard, Vámos, Zoltán, Steen, Gregory, Jeroen, T. J. M. van Dijck, Essen, Thomas A., Wijk, Roel, Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Volovici, Victor, Azouvi, Philippe, Vulekovic, Peter, Wiegers, Eveline, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Ziverte, Agate, Zoerle, Tommaso, Cooper, Jamie, Azzolini, Maria Luisa, Gantner, Dashiell, Gruen, Russel, Murray, Lynette, Rosenfeld, Jeffrey V., Varma, Dinesh, MacIsaac, Christopher, Jordan, Andrea, Bartels, Ronald, Beer, Ronny, Bellander, Bo-Michael, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Beqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Brorsson, Camilla, Buki, Andras, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Ezer, Erzsébet, Fabricius, Martin, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Galanaud, Damien, Ghuysen, Alexandre, Giga, Lelde, Golubović, Jagoš, Gomez, Pedro A., Gravesteijn, Benjamin, Grossi, Francesca, Gupta, Deepak, Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Huijben, Jilske, Hutchinson, Peter J., Jankowski, Stefan, Johnson, Faye, Karan, Mladen, Kolias, Angelos G., Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Laureys, Steven, Lejeune, Aurelie, Lecky, Fiona, Ledoux, Didier, Lightfoot, Roger, Lingsma, Hester, Maas, Andrew I. R., Manara, Alex, Maréchal, Hugues, Martino, Costanza, Citerio, Giuseppe [0000-0002-5374-3161], Apollo - University of Cambridge Repository, Ročka, Saulius, and Tamošuitis, Tomas

Subjects
Original, GFAP, NCT02210221, FiO, Oxygen Inhalation Therapy, FiO(2), PaO2, Critical Care and Intensive Care Medicine, Oxygen, GOSE, PaO, NCT, Traumatic brain injury, Brain Injuries, Brain Injuries, Traumatic, traumatic brain injury, mortality, Humans, Prospective Studies, Human medicine, Mortality, FiO2
Abstract

Funder: European Commission 7th Framework program, Funder: Australian Health and Medical Research Council, Funder: Università degli Studi di Milano - Bicocca, Purpose: The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods: This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO2) and the oxygen inspired fraction (FiO2). We explored the association between high PaO2 and FiO2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO2 and FiO2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results: The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO2 ranged from 93 to 166 mmHg. Exposure to higher PaO2 and FiO2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO2 and FiO2 levels, which remained independently associated with 6-month mortality. Conclusions: In two large prospective multicenter cohorts of critically ill patients with TBI, levels of PaO2 and FiO2 varied widely across centers during the first seven days after ICU admission. Exposure to high arterial blood oxygen or high supplemental oxygen was independently associated with 6-month mortality in the CENTER-TBI cohort, and the severity of brain injury did not modulate this relationship. Due to the limited sample size, the findings were not wholly validated in the external OzENTER-TBI cohort. We cannot exclude the possibility that the worse outcomes associated with higher PaO2 were due to use of higher FiO2 in patients with more severe injury or physiological compromise. Further, these findings may not apply to patients in whom FiO2 and PaO2 are titrated to brain tissue oxygen monitoring (PbtO2) levels. However, at minimum, these findings support the need for caution with oxygen therapy in TBI, particularly since titration of supplemental oxygen is immediately applicable at the bedside.

Published
2022
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48. Impact of fluid balance on outcome of adult patients treated with extracorporeal membrane oxygenation

Author

Schmidt, Matthieu, Bailey, Michael, Kelly, Joshua, Hodgson, Carol, Cooper, D. James, Scheinkestel, Carlos, and Pellegrino, Vincent

Subjects
Mortality -- United Kingdom -- Australia, Cardiac patients -- Patient outcomes -- Care and treatment, Health care industry
Abstract

Purpose To assess the relationship between early daily fluid balance (FB) and 90-day outcome in adult patients treated with extracorporeal membrane oxygenation (ECMO). Design Retrospective observational study. Setting Tertiary referral centre for ECMO. Patients 115 patients treated with ECMO for refractory heart failure and 57 patients treated with ECMO for refractory respiratory failure. Methods We analysed the association between early daily FB versus hospital and 90-day mortality using multivariable logistic regression model, Cox proportional-hazards model and propensity score. Results We obtained detailed demographic, clinical, and biochemical data, daily FB, and continuous renal replacement days. Fifty-seven per cent of patients had acute kidney injury (AKI) at ECMO initiation, and 60 % (n = 103) of patients received continuous renal replacement therapy (CRRT) during ECMO course, beginning at a median of 1 (0-3.5) days after ECMO initiation. Overall 90-day mortality was 24 %. Survivors exhibited lower daily FB from day 3 to day 5. After adjustments, Acute Physiology and Chronic Health Evaluation (APACHE) III, CRRT during the first 3 days, major bleeding event at day 1 and positive FB on day 3 were independent predictors of 90-day mortality. Positive FB at ECMO day 3 remained an independent predictor of hospital and 90-day mortality, regardless of the statistical model used or the inclusion of a propensity score to have positive FB. Conclusions Positive FB at ECMO day 3 is an independent predictor of 90-day mortality. Further interventional studies aimed at testing the value of strategy of tight control of FB during the early ECMO period are now warranted., Author(s): Matthieu Schmidt [sup.1] [sup.2], Michael Bailey [sup.1] [sup.3], Joshua Kelly [sup.1], Carol Hodgson [sup.1] [sup.3], D. James Cooper [sup.1] [sup.3], Carlos Scheinkestel [sup.3], Vincent Pellegrino [sup.1] [sup.3], Rinaldo Bellomo [...]

Published
2014
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