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1. Point of Care Echocardiography in an Irish Critical Care Unit

Author

D, Kuriakose, R, O’Mahony, R, Rooplalsingh, P, McCanny, and F, Colreavy

Abstract

Aims We sought to evaluate the clinical impact of a 6 month transthoracic echocardiography (TTE) teaching programme in a critical care unit. Methods An observational single centre study. Four critical care doctors, 2 fellows and 2 consultants were trained to use TTE. The study was conducted over 2 six month study periods; period 1 before echocardiography training and period 2 following echocardiography training. Results An increased number of TTE examinations were performed following echocardiography training, 47 TTE studies during period 1 and 144 TTE studies during period 2. The commonest indications for TTE examination were assessment of ventricular function, wall motion abnormalities and cardiac tamponade. The percentage of TTE studies leading to a change in clinical management were similar during both periods, 30% period 1 and 34% period 2. During period 2 the majority of TTE’s leading to management change were performed by critical care doctors who frequently manipulated vasoactive medications and administered fluid therapy. Conclusions A 6 month echocardiography training programme led to an increase number of TTE studies independently performed by critical care doctors with resultant clinical impact in one third of cases.

Published
2018

2. Sildenafil citrate, a selective phosphodiesterase type 5 inhibitor: urologic and cardiovascular implications

Author

Avinash Nehra, K. Chandrasekaran, Bijoy K. Khandheria, and F. Colreavy

Subjects
Male, medicine.medical_specialty, Phosphodiesterase Inhibitors, Sildenafil, Urology, Vasoactive intestinal peptide, Phosphodiesterase 3, Calcitonin gene-related peptide, Piperazines, Sildenafil Citrate, Nitric oxide, Cardiovascular Physiological Phenomena, chemistry.chemical_compound, Erectile Dysfunction, 3',5'-Cyclic-GMP Phosphodiesterases, Internal medicine, medicine, Humans, Sulfones, Cyclic Nucleotide Phosphodiesterases, Type 5, Phosphoric Diester Hydrolases, business.industry, medicine.disease, PDE5 drug design, Endocrinology, Erectile dysfunction, chemistry, Purines, cGMP-specific phosphodiesterase type 5, business
Abstract

Erectile dysfunction (ED) occurs in varying degrees in an estimated 20 to 30 million American men and is associated with adverse effects on quality of life; particularly personal well-being, family and social interrelationships. Research into ED has focused primarily on the physiologic mechanisms of corpus cavernosum smooth muscle relaxation, and penile erection as the end result of smooth muscle relaxation. These processes are mediated by cholinergic, nonadrenergic, noncholinergic (NANC, e.g., nitric oxide), vasoactive intestinal peptide (VIP), and potentially calcitonin gene-related peptide (CGRP) containing nerves. Release of nitric oxide following sexual stimulation from non-adrenergic, non cholinergic nerves and vascular endothelium activates guanylyl cyclase and induces intracellular cGMP synthesis. In turn, cGMP results in lowering intracellular concentrations, inhibits contractility of the penile smooth muscle, and induces an erectile response. Phosphodiesterase type 5 (PDE 5) is the predominant enzyme responsible for cGMP hydrolysis in trabecular smooth muscle. Activation of PDE 5 terminates NO-induced, cGMP-mediated smooth muscle relaxation, and subsequent penile flaccidity. Sildenafil citrate is a potent PDE type 5 reversible and selective inhibitor which blocks cGMP hydrolysis effectively. FDA approval of sildenafil citrate as the first oral agent for ED in males has resulted in significant interest. We discuss the clinical and pharmacologic properties of sildenafil citrate as well as the urologic and cardiac implications.

Published
2001
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3. Posters

Author

T. Török, A. Kardos, L. Rudas, D. Paprika, A. McLuckie, R. J. Beale, D. Bihari, H. Keller, N. Seltzer, A. Weimer, H. Menning, P. Ulrich, U. Staedt, W. Kirschstein, T. Kasai, S. Endo, N. Arakawa, N. Sato, T. Suzuki, S. Taniguchi, K. Inada, K. Hiramori, W. Schmidt, I. Meineke, M. Nottrott, I. Frerichs, S. Müller, G. Hellige, E. De Blasio, A. De Sio, G. Sibilio, A. Papa, D. Golia, V. Grassia, G. Bove, M. Zehelgruber, G. Mundigler, G. Christ, C. Merhaut, U. Klaar, C. Kratochwill, S. Hofmann, P. Siostrzonek, F. Suarez, M. Corrales, R. Rábago, P. Gonzalez-Arenas, R. Morales, J. Sanchez, J. Fraile, M. Rey, J. Martinell, P. -N. Niederst, K. -P. Mellwig, H. K. Schmidt, U. Gleichmann, R. Körfer, S. Di Bartolomeo, M. Bertolissi, G. Nardi, A. De Monte, U. Janssens, J. -G. Ochs, H. G. Klues, P. Hanrath, T. Sajjanhar, S. M. Tibby, M. Hatherill, D. Anderson, I. A. Murdoch, B. Krivec, G. Voga, I. Žuran, R. Skale, R. Parežnik, M. Podbregar, E. Bonnefoy, P. Chevalier, G. Kirkorian, J. Guidolet, A. Marchand, D. Bouchayer, P. Bert Marcaz, P. Touboul, T. Welte, J. Molling, M. S. Jepsen, G. Claus, H. Klein, G. Cinnella, M. Dambrosio, N. Brienza, M. Conte, S. M. Maggiore, A. M. Leone, A. Brienza, N. DiVenere, K. Vandewoude, J. Poelaert, D. Vogelaers, R. Blanca Garcia, W. Buylaert, C. Roosens, F. Colardyn, D. Annane, E. Béllissant, E. Pussard, R. Asmar, F. Lacombe, E. Lanata, O. Madonna, M. Safar, J. F. Giudicelli, J. C. Raphael, Ph. Gajdos, M. Mattys, L. Dumont, J. F. Annaert, C. Mardirosoff, J. Goldstein, T. Verbeet, J. Massaut, N. A. Haas, F. Uhlemann, I. Daehnert, F. Berger, B. Stiller, S. Dittrich, I. Schulze-Neick, P. Eweit, P. E. Lange, C. J. M. Langenherp, H. Pietersen, G. Geskes, A. Wagenmakers, P. Soeters, M. Maggiorini, S. Brimioulle, P. Lejeune, M. Delcroix, F. Vermeulen, J. Stephanazzi, R. Naeije, M. Kunert, H. Stolzenburg, L. Scheuble, K. Emmerich, L. J. Ulbricht, I. Krakau, H. Gülker, M. J. Broch, V. Valentín, B. Murcia, E. Bartual, A. Málaga, L. L. Miralles, F. Valls, C. J. Wallin, B. Sidenö, J. Vaage, L. G. Leksell, H. G. Stuchlinger, D. Seidler, U. Hollenstein, K. Janata, M. Muellner, W. Loeffler, G. Gamper, A. Bur, R. Malzer, A. N. Laggner, M. M. Hirschl, M. Binder, H. Herkner, F. Turani, C. Ceraso, A. Lironcurti, P. Senesi, C. Leonardis, A. F. Sabato, H. G. Pietersen, C. J. M. Langenberg, A. J. M. Wagenmakers, S. de Lange, P. B. Soeters, A. Royira, L. Oussedik, C. Cambray, C. Glmeno, M. Cerda, Ma. A. Sanchez, A. Lesmes, M. Guerrero, E. Vigil, F. Ortega, F. Lucena, E. R. Righini, R. Alvisi, E. Marangoni, G. Gritti, A. Ordóñez, A. Hernández, J. Pérez-Bernal, R. Hinojosa, J. M. Borrego, A. Franco, J. López-Barneo, E. Gutiérrez, J. Cerro, D. Rincón, R. Martin, M. Saussine, C. L. Sany, B. Calvet, D. Raison, J. M. Frapier, C. -J. Wallin, Å. Olsson, R. Nordländer, V. Vasilkov, A. Safronov, V. Marinchev, A. C. Rodrigues, A. Moraes, F. Galas, V. Angelim, C. Medeiros, J. O. Auler, G. Bellotti, F. Pilleggi, M. J. Carmona, E. R. R. Messias, D. Joseph, F. Baigorri, A. Artigas, L. Blanch, F. Wagner, M. Dandel, G. Günther, Y. Weng, M. Loebe, R. Hetzer, F. Colreavy, M. Balea, M. Cahalan, JL. Carpintero, M. C. de la Fuente, M. A. Estecha, J. M. Molina, L. R. del Fresno, D. Daga, R. Toro, A. Poullet, M. V. de la Torre, A. J. Garcia, A. Michalopoulos, K. Rellos, D. Skambas, O. Liakopoulos, and S. Geroulanos

Subjects
Medical education, business.industry, Medicine, Critical Care and Intensive Care Medicine, business
Published
1996
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4. National scientific medical meeting 1995 abstracts

Author

S. Norris, C. Collins, J. Hegarty, C. O’Farrelly, J. Carton, L. Madrigal, D. P. O’Donoghue, H. Holloway, J. F. Fielding, W. Mullins, S. W. Hone, M. Donnelly, F. Powell, A. W. Blayney, E. A. Cahill, S. F. Daly, M. J. Turner, P. A. Sullivan, M. McLoughlin, M. M. Skelly, H. E. Mulcahy, T. Connell, C. Duggan, M. J. Duffy, A. Troy, K. Sheahan, A. Whelan, C. M. Herra, C. T. Keane, H. Johnson, B. Lee, E. Doherty, T. McDonnell, D. Mulherin, O. FitzGerald, B. Bresnihan, H. M. Hassett, A. Boyce, V. Greig, C. O’Herlihy, P. P. A. Smyth, E. F. Roche, I. McCormack, E. Tempany, M. J. Cullen, D. F. Smith, Y. McBrinn, B. Murray, R. Freaney, D. Keating, M. J. McKenna, J. A. O’Hare, H. Alam, Q. Raza, M. Geoghegan, S. Killalea, M. Hall, J. Feely, L. Kyne, B. O’Hara, M. Cullen, I. M. Rea, J. P. Donnelly, R. W. Stout, P. Lacey, M. J. Donnelly, J. McGrath, T. P. Hennessy, C. V. I. Timon, D. Hyde, H. X. Xia, M. Buckley, C. O’Morain, S. Keating, H. Xia, J. P. McGrath, R. C. Stuart, P. Lawlor, P. J. Byrne, T. N. Walsh, T. P. J. Hennessy, M. Duffy, M. Tubridy, J. Redmond, K. Monahan, R. P. Murphy, D. R. Headon, T. O’Gorman, F. M. O’Reilly, C. Darby, G. M. Murphy, A. Murphy, M. Codd, P. Dervan, D. Lawlor, S. O. Loughlin, N. Flanagan, R. Watson, L. Barnes, C. Kilgallen, E. Sweeney, A. Mynes, D. Mooney, I. Donoghue, O. Browne, J. A. Kirrane, D. McKenna, M. Young, E. O’Toole, S. O’Briain, U. Srinivasan, C. Feighery, N. Leonard, E. Jones, M. A. Moloney, D. G. Weir, M. Lawler, A. O’Neill, H. Gowing, D. Pamphilon, S. R. McCann, G. O’Toole, A. Orren, C. M. Seifer, D. C. Crowley, G. J. Sheehan, T. Deignan, J. Kelly, V. J. Tormey, J. Faul, C. Leonard, C. M. Burke, L. W. Poulter, S. Lynch, G. McEntee, O. Traynor, E. Barry, P. Costello, A. Keavney, R. Willoughby, C. O’Donnell, M. Cahill, A. Earley, P. Eustace, R. Osborne, C. Saidlear, B. Holmes, A. Early, A. P. Moran, A. Neisser, R. J. Polt, H. Bernheimer, M. Kainz, B. Schwerer, L. Gallagher, R. Firth, N. Kennedy, E. McGilloway, N. Tubridy, K. Shields, W. K. Cullen, M. J. Rowan, A. R. Moore, M. Rowan, D. Coakley, B. Lawlor, G. Swanwick, R. Al-Naeemi, R. Murphy, N. M. Codd, M. Goggins, N. P. Kennedy, B. L. Mallon, H. Mulcahy, M. Skelly, D. O. Donoghue, D. McCarthy, A. Saunders, D. J. Veale, J. J. F. Belch, D. Breathnach, E. Murphy, G. Kernohan, K. Gibson, A. G. Wilson, G. W. Duff, N. de Vries, L. B. A. van de Putte, J. Donoghue, F. O’Kelly, Z. Johnson, T. Maher, A. Moran, C. Keane, D. O’Neill, N. Horgan, J. M. Barragry, D. M. Campbell, M. Behan, P. R. O’Connell, V. S. Donnelly, D. Crowley, M. Geary, P. Boylan, M. Fanagan, K. Hickey, T. Teoh, M. Doyle, R. Harrison, D. Lyons, Y. Shenouda, M. Coughlan, P. McKenna, P. Lenehan, M. Foley, P. Kelehan, P. Ravichandran, M. Kelly, A. Conroy, C. Fitzpatrick, D. Egan, C. L. Regan, B. V. McAdam, P. McParland, G. A. FitzGerald, D. J. Fitzgerald, S. C. Sharma, K. Foran, C. Barry-Kinsella, R. F. Harrison, F. J. Gillespie, P. O’Mahony, M. Boyle, M. J. White, F. Donohoe, Y. Birrane, M. Naughton, R. B. Fitzsimons, M. Piracha, S. McConkey, E. Griffin, E. Hayes, T. Clarke, N. Parfrey, K. Butler, A. J. Malone, P. J. Kearney, P. F. Duggan, A. Lane, R. Keville, M. Turner, S. Barry, D. Sloan, S. Gallagher, M. Darby, P. Galligan, J. Stack, N. Walsh, M. O’Sullivan, M. Fitzgerald, D. Meagher, S. Browne, C. Larkin, P. Casey, E. O’Callaghan, S. Rooney, E. Walsh, M. Morris, T. Burke, M. Roe, C. Maher, M. Wrigley, M. Gill, M. Burgess, E. Corcoran, D. Walsh, B. Gilmer, C. B. Hayes, L. Thornton, J. Fogarty, R. Lyons, M. O’Connor, V. Delaney, K. Buckley, D. Lillis, V. Delany, C. Hayes, P. Dack, D. Igoe, H. J. O’Neill, P. Kelly, D. McKeown, L. Clancy, G. Varghese, S. Hennessy, J. J. Gilmartin, K. Birthistle, D. Carrington, H. Maguire, P. Atkinson, C. Foley-Nolan, M. Lynch, B. Cryan, D. Whyte, C. Conlon, V. Kucinskas, U. Usinskiene, I. Sakalyte, E. Dawson, K. Molloy, N. Goulden, J. Doyle, E. Lawlor, M. G. Harrington, N. El-Nageh, M. -L. Nolan, J. O’Riordan, G. Judge, G. Crotty, T. Finch, M. Borton, T. Barnes, O. Gilligan, G. Lee, R. Limmer, M. Madden, C. Bergin, A. O’Leary, F. Mulcahy, F. Wallis, M. Glennon, M. Cormican, U. NiRiain, M. Heiginbothom, F. Gannon, T. Smith, C. O’Sullivan, R. Hone, D. A. Caugant, C. A. P. Fijen, E. J. Van Schalkwyk, G. J. Coetzee, U. Ni Riain, M. G. Cormican, L. Park, J. Flynn, V. Regazzoli, M. Hayes, G. Nicholson, P. Higgins, N. Flynn, G. Corbett-Feeney, D. J. Conway, N. J. O’Higgins, S. Rajendiran, J. Byrne, E. Kilfeather, P. Dingle, M. Hunter, S. K. Al-Ghazal, P. Stanley, J. Palmer, A. Hong, P. Saxby, D. Sheehan, I. Regan, J. O’Mullane, M. Ni Chaoimh, M. Leahy, J. J. Heffron, M. Lehane, C. Keohane, N. O’Leary, M. Sheehan, E. Renny-Walsh, M. J. Whelton, C. T. Doyle, J. Webster, N. Benjamin, S. FitzGerald, J. S. Chadha, M. G. FitzGerald, G. R. FitzGerald, L. Hemeryck, P. McGettigan, J. Golden, N. Arthur, S. Y. Wen, P. Deegan, T. Cooke, G. I. Adebayo, P. Gaffney, M. Sinnot, D. O’Riordan, T. Hayes, C. M. O’Connor, M. X. FitzGerald, C. Costello, G. Finlay, J. Hayes, C. O’Connor, K. McMahon, S. Hone, J. Robertson, R. Coakley, S. O’Neill, M. Walsh, J. McCarthy, D. Lannon, A. E. Wood, R. Sharkey, E. Mulloy, M. Long, I. Kilgallen, V. Tormey, S. Horne, T. Feeney, Ó. Ó Muiré, M. J. Griffin, D. Hughes, A. Knaggs, D. Magee, C. McCrory, B. March, D. Phelan, M. White, J. Fabry, D. Buggy, C. Cooney, E. Aziz, D. O’Keefe, A. J. McShane, J. Boylan, E. Tobin, C. Motherway, F. Colreavy, N. Denish, R. Dwyer, A. Bergin, K. O’Brien, R. MacSullivan, K. D. Carson, W. P. Blunnie, D. C. Moriarty, B. Kinirons, B. Lyons, N. Cregg, W. Casey, K. P. Moore, S. A. Colbert, C. Ecoffey, D. O’Gorman, J. Fitzgerald, P. Diamond, M. B. Codd, D. D. Sugrue, J. Kellett, M. Tighe, C. J. McKenna, J. Galvin, H. A. McCann, A. Scallon, A. Fraser, M. Norton, G. Tomkin, I. Graham, A. Byrne, M. Maher, N. Moran, D. Fitzgerald, D. O’Callaghan, D. Coyle, A. G. Nugent, C. McGurk, G. D. Johnston, A. Nugent, B. Silke, N. Murphy, L. Jennings, D. Pratico, C. Doyle, T. Hennessy, H. McCann, D. Sugrue, S. Donnelly, A. Hennessy, C. Hartigan, D. MacDonald, S. Blake, D. McDonald, D. Dominque, S. R. McMechan, G. MacKenzie, J. Allen, G. T. Wright, G. J. Dempsey, M. Crawley, J. Anderson, A. A. J. Adgey, M. T. Harbinson, N. P. S. Campbell, C. M. Wilson, P. K. Ellis, E. M. McIlrath, A. McShane, T. V. Keaveny, K. Rabenstein, F. Scheller, D. Pfeiffer, C. Urban, I. Moser, G. Jobst, A. Manz, S. Verpoorte, F. Dempsey, D. Diamond, M. Smyth, E. Dempsey, V. Hamilton, J. Twomey, R. Crowley, L. Fenelon, F. Walsh, J. McCann, P. McDonagh, E. McGovern, D. Luke, K. Crowley, D. Mannion, D. Murphy, K. Clarkson, E. Carton, I. Leonard, D. O’Toole, M. Staunton, M. Griffin, D. Owens, P. Collins, A. Johnson, G. H. Tomkin, N. A. Herity, J. D. Allen, R. O’Moore, G. M. Crotty, M. DeArce, K. Nikookam, P. Keenan, D. Cregan, N. O’Meara, S. Forman, D. A. Cusack, and B. Farrell

Subjects
medicine.medical_specialty, business.industry, Family medicine, medicine, MEDLINE, General Medicine, business
Published
1995
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5. Oculodento-osseous dysplasia: review of anaesthetic problems

Author

F. Colreavy, J. Dunphy, and S. Colbert

Subjects
Anaesthetic management, medicine.medical_specialty, Anesthesiology and Pain Medicine, Dysplasia, business.industry, Pediatrics, Perinatology and Child Health, Dual mode, medicine, medicine.disease, business, Difficult intubation, Surgery
Abstract

Summary Oculodento-osseous dysplasia (ODOD) is a rare congenital condition characterized by ocular, nasal, dental, digital and skeletal stigmata. A dual mode of inheritance has led to two distinct clinical forms of the syndrome. The more severe form is distinguished by neurological involvement. These patients will present for multiple general anaesthetics during childhood. A new case of this syndrome is reported and the anaesthetic management described. The principal anaesthetic implication of ODOD is the possibility of difficult intubation due to the combination of bony, dental and nasal anomalies. The neurological and ocular anomalies are also discussed in relation to anaesthesia.

Published
1994
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6. Poster Discussions

Author

P. Pelosi, M. Croci, D. Chiumello, A. Pedoto, L. Gattinoni, S. Nunes, P. Valta, J. Takala, R. Fretschner, T. Winkler, Th. P. Laubscher, J. X. Brunner, M. Imhoff, J. H. Lehner, D. Löhlein, G. Foti, ME. Sparacino, M. Cereda, L. De Marchi, N. Patroniti, D. Weismann, A. Pesenti, A. De Salve, L. Zappa, D. Stefania, R. Zavaglio, A. Sordi, H. Reissmann, O. Katzenstein, A. Prause, B. Fuellekrug, W. Pothmann, K. Crowley, M. Geoghegan, F. Colreavy, D. McMahon, M. Doyle, G. Conti, M. Rocco, S. Tarquini, L. Ruscio, M. Gionfrida, A. Lappa, M. Antonelli, T. Kubota, and K. Murata

Subjects
Critical Care and Intensive Care Medicine
Published
1996
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8. Royay academy of medicine in Ireland section of biological sciences

Author

W. P. Blunnie, I. Pratt, Anthony G. Molloy, Ciaran Bolger, C. M. Wilson, P. B. Deasy, M. M. Brady, R. G. Luckwill, N. W. Chestnutt, F. R. Comerford, Mark G. Davies, M. S. O'mahony, A. Y. Yasear, William F. M. Wallace, R. S. J. Clarke, M. Garrett, B. Donne, M. Neligan, J. Ehrenfeld, J. P. Jamison, J. F. Andrews, D. F. Murphy, A. C. B. Hooper, E. M. Thompson, L. Drudy, M. Houlden, J. Manning, Elinor Arbuthnott, H. Hourihan, Caroline G. Bullock, Roger Anwyl, John Bannigan, M. G. O’Regan, M. K. Hammad, R. E. Moore, Brian J. Harvey, R. Hill, D. Tynan, Brian E. Leonard, L. Daly, F. P. Robinson, J. F. Jackson, I. M. Bali, Declan Mulkeen, John W. Dundee, W. Holmes, K. M.P. Carroll, K. Horgan, B. L. Sheppard, P. G. Loughran, L. Wai-Ling, John Bonnar, F. Colreavy, R. J. T. Carlisle, S. C. Sharma, P. L. Chambers, J. Sheehan, D. C. Moriarty, C. J. Dockeray, A. Ireland, N. J. Halliday, A. K. Keenan, A. J. McShane, P. Elliott, C. Power, Michael J. Rowan, Clare O'Connor, J. L. Waddington, S. Hanley, D. Gilroy, B. W. Otridge, K. W. Harper, Muiris X. Fitzgerald, J. M. Moohan, A. J. Humphreys, and G. O’Dowd

Subjects
business.industry, Thursday, Section (typography), Library science, Medicine, General Medicine, business, Biological sciences
Published
1985
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11. Point of Care Echocardiography in an Irish Critical Care Unit

Author

Kuriakose D, O’Mahony R, Rooplalsingh R, McCanny P, and Colreavy F

Abstract

Aims We sought to evaluate the clinical impact of a 6 month transthoracic echocardiography (TTE) teaching programme in a critical care unit. Methods An observational single centre study. Four critical care doctors, 2 fellows and 2 consultants were trained to use TTE. The study was conducted over 2 six month study periods; period 1 before echocardiography training and period 2 following echocardiography training. Results An increased number of TTE examinations were performed following echocardiography training, 47 TTE studies during period 1 and 144 TTE studies during period 2. The commonest indications for TTE examination were assessment of ventricular function, wall motion abnormalities and cardiac tamponade. The percentage of TTE studies leading to a change in clinical management were similar during both periods, 30% period 1 and 34% period 2. During period 2 the majority of TTE’s leading to management change were performed by critical care doctors who frequently manipulated vasoactive medications and administered fluid therapy. Conclusions A 6 month echocardiography training programme led to an increase number of TTE studies independently performed by critical care doctors with resultant clinical impact in one third of cases., Competing Interests: The authors have no conflict of interest in relation to the subject matter in this manuscript.

Published
2018

12. Advances in critical care management of patients undergoing cardiac surgery.

Author

Aneman A, Brechot N, Brodie D, Colreavy F, Fraser J, Gomersall C, McCanny P, Moller-Sorensen PH, Takala J, Valchanov K, and Vallely M

Subjects
Acute Kidney Injury, Blood Coagulation, Humans, Treatment Outcome, Cardiac Surgical Procedures, Critical Care trends
Abstract

Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management. This narrative review describes standard care, recent advances, and future areas of research in the critical care management of patients undergoing cardiac surgery.

Published
2018
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13. Echocardiographic approach to cardiac tamponade in critically ill patients.

Author

McCanny P and Colreavy F

Subjects
Cardiology methods, Comorbidity, Hemodynamics, Humans, Pericardiocentesis, Respiration, Respiration, Artificial, Ultrasonography, Doppler, Cardiac Tamponade diagnostic imaging, Critical Illness, Echocardiography methods, Pericardial Effusion diagnostic imaging
Abstract

Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. Diagnostic sensitivity of transthoracic echocardiography is dependent on image quality, and in some cases a transoesophageal approach may be required to confirm the diagnosis. Knowledge of the pathophysiology and echocardiographic features of cardiac tamponade are essential for the practicing Intensivist. This review presents an approach to the recognition, diagnosis, and treatment of cardiac tamponade in critically ill patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Published
2017
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14. Successful weaning from mechanical ventilation using phrenic nerve stimulation.

Author

Stanley E, Broderick J, Synnott K, McCarthy J, Smith E, Reid V, Colreavy F, and Carton E

Subjects
Electric Stimulation Therapy instrumentation, Electrodes, Implanted, Humans, Male, Middle Aged, Spinal Cord Injuries diagnosis, Spinal Cord Injuries physiopathology, Time Factors, Treatment Outcome, Diaphragm innervation, Electric Stimulation Therapy methods, Phrenic Nerve physiopathology, Respiration, Artificial, Spinal Cord Injuries therapy, Ventilator Weaning methods
Published
2014
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15. A preoperative headache.

Author

Bolster F, Crosbie I, Ryan J, Colreavy F, and Carty F

Subjects
Adult, Anesthesia, Epidural methods, Colectomy, Colitis, Ulcerative surgery, Female, Humans, Intraoperative Complications, Pneumocephalus etiology, Post-Dural Puncture Headache etiology, Tomography, X-Ray Computed, Anesthesia, Epidural adverse effects, Post-Dural Puncture Headache diagnostic imaging, Preoperative Period
Published
2013
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16. Potential organ donor audit in Ireland.

Author

Hegarty M, O'Neill W, Colreavy F, Dwyer R, Cunningham P, and Hanlon M

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Brain Death, Child, Child, Preschool, Cross-Sectional Studies, Family, Female, Humans, Ireland, Male, Middle Aged, Surveys and Questionnaires, Third-Party Consent statistics & numerical data, Young Adult, Medical Audit, Tissue Donors statistics & numerical data, Tissue and Organ Procurement statistics & numerical data
Abstract

As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1/9/07-31/8/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information/education campaigns.

Published
2010

17. Sildenafil citrate, a selective phosphodiesterase type 5 inhibitor: urologic and cardiovascular implications.

Author

Nehra A, Colreavy F, Khandheria BK, and Chandrasekaran K

Subjects
3',5'-Cyclic-GMP Phosphodiesterases, Cardiovascular Physiological Phenomena drug effects, Cyclic Nucleotide Phosphodiesterases, Type 5, Erectile Dysfunction drug therapy, Humans, Male, Phosphodiesterase Inhibitors therapeutic use, Phosphoric Diester Hydrolases, Piperazines therapeutic use, Purines, Sildenafil Citrate, Sulfones, Phosphodiesterase Inhibitors pharmacology, Piperazines pharmacology
Abstract

Erectile dysfunction (ED) occurs in varying degrees in an estimated 20 to 30 million American men and is associated with adverse effects on quality of life; particularly personal well-being, family and social interrelationships. Research into ED has focused primarily on the physiologic mechanisms of corpus cavernosum smooth muscle relaxation, and penile erection as the end result of smooth muscle relaxation. These processes are mediated by cholinergic, nonadrenergic, noncholinergic (NANC, e.g., nitric oxide), vasoactive intestinal peptide (VIP), and potentially calcitonin gene-related peptide (CGRP) containing nerves. Release of nitric oxide following sexual stimulation from non-adrenergic, non cholinergic nerves and vascular endothelium activates guanylyl cyclase and induces intracellular cGMP synthesis. In turn, cGMP results in lowering intracellular concentrations, inhibits contractility of the penile smooth muscle, and induces an erectile response. Phosphodiesterase type 5 (PDE 5) is the predominant enzyme responsible for cGMP hydrolysis in trabecular smooth muscle. Activation of PDE 5 terminates NO-induced, cGMP-mediated smooth muscle relaxation, and subsequent penile flaccidity. Sildenafil citrate is a potent PDE type 5 reversible and selective inhibitor which blocks cGMP hydrolysis effectively. FDA approval of sildenafil citrate as the first oral agent for ED in males has resulted in significant interest. We discuss the clinical and pharmacologic properties of sildenafil citrate as well as the urologic and cardiac implications.

Published
2001
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18. Echocardiography in Intensive Care: The Basics. Part II.

Author

Donovan KD and Colreavy F

Abstract

Objective: To review the current status of echocardiography in critically ill patients with special reference to the advantages and disadvantages of the transthoracic and transoesophageal approaches., Data Sources: A review of articles published in peer reviewed journals from 1976-1999 and identified through a MEDLINE search on echocardiography., Summary of Review: Echocardiography is a rapidly evolving field which is relatively new to intensivists. Both transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) are extremely useful in managing critically ill patients. In intensive care practice echocardiograpy is used to evaluate clinical syndromes such as unexplained hypotension, search for source of sepsis or source of emboli, as well as haemodynamic assessment and monitoring. TOE although somewhat invasive, provides superb images which often assist in both diagnosis and improved treatment., Conclusions: Echocardiography often provides useful information in critically ill patients. Intensivists should familiarise themselves with this new technology and if possible become skilled practitioners of this exciting technique. The care of critically ill patients will benefit from its widespread use.

Published
1999

19. Improvement in endothelial function by angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus.

Author

O'Driscoll G, Green D, Maiorana A, Stanton K, Colreavy F, and Taylor R

Subjects
Acetylcholine, Aged, Angiotensin-Converting Enzyme Inhibitors adverse effects, Blood Flow Velocity drug effects, Blood Flow Velocity physiology, Diabetes Mellitus, Type 2 physiopathology, Diabetic Angiopathies drug therapy, Diabetic Angiopathies physiopathology, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Enalapril adverse effects, Endothelium, Vascular physiopathology, Forearm blood supply, Humans, Middle Aged, Nitroprusside, omega-N-Methylarginine, Angiotensin-Converting Enzyme Inhibitors administration & dosage, Diabetes Mellitus, Type 2 drug therapy, Enalapril administration & dosage, Endothelium, Vascular drug effects
Abstract

Objectives: The aim of this study was to assess the effect of angiotensin-converting enzyme (ACE) inhibition with enalapril on forearm endothelial function in subjects with type II diabetes mellitus., Background: Endothelial function is depressed in the presence of conventional risk factors for atherosclerosis, and various therapies, such as lipid-lowering therapy in hypercholesterolemia, can improve endothelial-mediated vasodilation. ACE inhibition has improved such function in several conditions including type I diabetes, but there is no evidence for a beneficial effect in type II diabetes., Methods: The influence of enalapril (10 mg twice daily for 4 weeks) on endothelium-dependent and -independent vasodilator function was determined in 10 type II diabetic subjects using a double-blinded placebo-controlled crossover protocol. Forearm blood flow was measured using strain-gage plethysmography and graded intrabrachial infusion of acetylcholine (ACh), N(G)-monomethyl-L-arginine (LNMMA) and sodium nitroprusside (SNP)., Results: Enalapril increased the response to the endothelium-dependent vasodilator, ACh (p < 0.02) and the vasoconstrictor response to the nitric oxide (NO) synthase inhibitor, LNMMA (p < 0.002). No difference was evident in the response to SNP., Conclusions: In type II diabetic subjects without evidence of vascular disease, the ACE inhibitor enalapril improved stimulated and basal NO-dependent endothelial function. The study extends the spectrum of beneficial effects demonstrated to result from ACE inhibition in diabetes.

Published
1999
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