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1,340 results on '"Wasowicz, M"'

1. Representing Built Environments with Digital Tools: Problems with Human Perception

Author

Wąsowicz, M., di Prisco, Marco, Series Editor, Chen, Sheng-Hong, Series Editor, Vayas, Ioannis, Series Editor, Kumar Shukla, Sanjay, Series Editor, Sharma, Anuj, Series Editor, Kumar, Nagesh, Series Editor, Wang, Chien Ming, Series Editor, Zembaty, Zbigniew, editor, Beben, Damian, editor, Perkowski, Zbigniew, editor, Rak, Adam, editor, Bosco, Giovanni, editor, and Solanki, Pranshoo, editor

Published
2021
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2. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., R Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, Bernhard, Li, Michael H-G., Lee, C.H. Angus, Ismail, Hilmy, Cuthbertson, Brian H., Wijeysundera, Duminda N., and Ho, Kwok M.

Published
2021
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3. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Myles, P.S., Abbott, T.E.F., Shulman, M.A., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Wallace, S., Farrington, C., Croal, B.L., Grocott, M.P.W., Granton, J.T., Oh, P., Thompson, B., Levett, D., Hillis, G., Beattie, W.S., Wijeysundera, H.C., Wijeysundera, Duminda N., Beattie, W. Scott, Hillis, Graham S., Abbott, Tom E.F., Shulman, Mark A., Ackland, Gareth L., Mazer, C. David, Myles, Paul S., Pearse, Rupert M., Cuthbertson, Brian H., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., and Lifford, R.

Published
2020
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4. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Myles, P.S., Shulman, M.A., Wallace, S., Farrington, C., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Wijeysundera, D.N., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Croal, B.L., Lum, M., Martin, D., James, S., Filipe, H., Pinto, M., Kynaston, S., Pearse, R.M., Abbott, T.E.F., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Cuthbertson, B.H., Torres, E., Ambosta, A., Melo, M., Mamdani, M., Thorpe, K.E., Grocott, M.P.W., Hillis, G., Wijeysundera, H.C., Bartoszko, J., and Laupacis, A.

Published
2019
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5. Using the 6-minute walk test to predict disability-free survival after major surgery

Author

Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Ismail, H., Riedel, B., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., MacCormick, A., Leslie, K., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Granton, J.T., Day, L., Pazmino-Canizares, J., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Shulman, M.A., Cuthbertson, B.H., Wijeysundera, D.N., Pearse, R.M., Torres, E., Ambosta, A., Farrington, C., and Myles, P.S.

Published
2019
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8. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, DN, Beattie, WS, Hillis, GS, Abbott, TEF, Shulman, MA, Ackland, GL, Mazer, CD, Myles, PS, Pearse, RM, Cuthbertson, BH, Measurement of Exercise Tolerance before Surgery Study Investiga, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, Gutierrez Del Arroyo, A, Raj, A, Lifford, R, International and National Coordinators, Central Project Office Operations Committee, CPET Methods Committee, Outcome Adjudication Committee, and International Steering Committee

Abstract

BACKGROUND: The Duke Activity Status Index (DASI) questionnaire might help incorporate self-reported functional capacity into preoperative risk assessment. Nonetheless, prognostically important thresholds in DASI scores remain unclear. We conducted a nested cohort analysis of the Measurement of Exercise Tolerance before Surgery (METS) study to characterise the association of preoperative DASI scores with postoperative death or complications. METHODS: The analysis included 1546 participants (≥40 yr of age) at an elevated cardiac risk who had inpatient noncardiac surgery. The primary outcome was 30-day death or myocardial injury. The secondary outcomes were 30-day death or myocardial infarction, in-hospital moderate-to-severe complications, and 1 yr death or new disability. Multivariable logistic regression modelling was used to characterise the adjusted association of preoperative DASI scores with outcomes. RESULTS: The DASI score had non-linear associations with outcomes. Self-reported functional capacity better than a DASI score of 34 was associated with reduced odds of 30-day death or myocardial injury (odds ratio: 0.97 per 1 point increase above 34; 95% confidence interval [CI]: 0.96-0.99) and 1 yr death or new disability (odds ratio: 0.96 per 1 point increase above 34; 95% CI: 0.92-0.99). Self-reported functional capacity worse than a DASI score of 34 was associated with increased odds of 30-day death or myocardial infarction (odds ratio: 1.05 per 1 point decrease below 34; 95% CI: 1.00-1.09), and moderate-to-severe complications (odds ratio: 1.03 per 1 point decrease below 34; 95% CI: 1.01-1.05). CONCLUSIONS: A DASI score of 34 represents a threshold for identifying patients at risk for myocardial injury, myocardial infarction, moderate-to-severe complications, and new disability.

Published
2020

12. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, Bernhard, primary, Li, Michael H-G., additional, Lee, C.H. Angus, additional, Ismail, Hilmy, additional, Cuthbertson, Brian H., additional, Wijeysundera, Duminda N., additional, Ho, Kwok M., additional, Wallace, S., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Au, S., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, J.K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Lum, M., additional, Martin, D., additional, S James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, R Lifford, R., additional, Melo, M., additional, Mamdani, M., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2021
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15. Integration of the Duke Activity Status Index into preoperative risk evaluation: a multicentre prospective cohort study

Author

Wijeysundera, Duminda N., primary, Beattie, W. Scott, additional, Hillis, Graham S., additional, Abbott, Tom E.F., additional, Shulman, Mark A., additional, Ackland, Gareth L., additional, Mazer, C. David, additional, Myles, Paul S., additional, Pearse, Rupert M., additional, Cuthbertson, Brian H., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Wijeysundera, D.N., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Stephens, R.C.M., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Thorpe, K.E., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2020
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17. Preparation for a first-in-man lentivirus trial in cystic fibrosis patients

Author

Griesenbach, U, Alton, E, Beekman, J, Boyd, C, Davies, J, Davies, L, Dekkers, J, Gill, D, Hasegawa, M, Higgins, T, Hironaka, T, Inoue, M, Hyde, S, Innes, A, Pringle, I, Pytel, K, Sumner-Jones, S, Tsugumine, S, Wasowicz, M, and Medical Research Council (MRC)

Subjects
Genetics & Heredity, Technology, Medical And Health Sciences, Science & Technology, Biotechnology & Applied Microbiology, Medicine, Research & Experimental, Research & Experimental Medicine, Biological Sciences, Life Sciences & Biomedicine, Biotechnology
Published
2019
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18. A simplified (modified) Duke Activity Status Index (M-DASI) to characterise functional capacity: A secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) study

Author

Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., Wijeysundera, H.C., Riedel, B., Li, M.H-G, Lee, C.H.A., Ismail, H., Cuthbertson, B.H., Wijeysundera, D.N., Ho, K.M., Wallace, S., Thompson, B., Ellis, M., Borg, B., Kerridge, R.K., Douglas, J., Brannan, J., Pretto, J., Godsall, M.G., Beauchamp, N., Allen, S., Kennedy, A., Wright, E., Malherbe, J., Melville, A., Sivakumar, H., Murmane, A., Kenchington, K., Kirabiyik, Y., Gurunathan, U., Stonell, C., Brunello, K., Steele, K., Tronstad, O., Masel, P., Dent, A., Smith, E., Bodger, A., Abolfathi, M., Sivalingam, P., Hall, A., Painter, T.W., Macklin, S., Elliott, A., Carrera, A.M., Terblanche, N.C.S., Pitt, S., Samuels, J., Wilde, C., Leslie, K., MacCormick, A., Bramley, D., Southcott, A.M., Grant, J., Taylor, H., Bates, S., Towns, M., Tippett, A., Marshall, F., Mazer, C.D., Kunasingam, J., Yagnik, A., Crescini, C., Yagnik, S., McCartney, C.J.L., Choi, S., Somascanthan, P., Flores, K., Au, S., Beattie, W.S., Karkouti, K., Clarke, H.A., Jerath, A., McCluskey, S.A., Wasowicz, M., Day, L., Pazmino-Canizares, J., Oh, P., Belliard, R., Lee, L., Dobson, K., Chan, V., Brull, R., Ami, N., Stanbrook, M., Hagen, K., Campbell, D., Short, T., Van Der Westhuizen, J., Higgie, J.K., Lindsay, H., Jang, R., Wong, C., Mcallister, D., Ali, M., Kumar, J., Waymouth, E., Kim, C., Dimech, J., Lorimer, M., Tai, J., Miller, R., Sara, R., Collingwood, A., Olliff, S., Gabriel, S., Houston, H., Dalley, P., Hurford, S., Hunt, A., Andrews, L., Navarra, L., Jason-Smith, A., Thompson, H., McMillan, N., Back, G., Lum, M., Martin, D., S James, S., Filipe, H., Pinto, M., Kynaston, S., Phull, M., Beilstein, C., Bodger, P., Everingham, K., Hu, Y., Niebrzegowska, E., Corriea, C., Creary, T., Januszewska, M., Ahmad, T., Whalley, J., Haslop, R., McNeil, J., Brown, A., MacDonald, N., Pakats, M., Greaves, K., Jhanji, S., Raobaikady, R., Black, E., Rooms, M., Lawrence, H., Koutra, M., Pirie, K., Gertsman, M., Jack, S., Celinski, M., Levett, D., Edwards, M., Salmon, K., Bolger, C., Loughney, L., Seaward, L., Collins, H., Tyrell, B., Tantony, N., Golder, K., Ackland, G.L., Stephens, R.C.M., Gallego-Paredes, L., Reyes, A., Gutierrez del Arroyo, A., Raj, A., Lifford, R., Melo, M., Mamdani, M., Hillis, G., and Wijeysundera, H.C.

Abstract

Background Accurate assessment of functional capacity, a predictor of postoperative morbidity and mortality, is essential to improving surgical planning and outcomes. We assessed if all 12 items of the Duke Activity Status Index (DASI) were equally important in reflecting exercise capacity. Methods In this secondary cross-sectional analysis of the international, multicentre Measurement of Exercise Tolerance before Surgery (METS) study, we assessed cardiopulmonary exercise testing and DASI data from 1455 participants. Multivariable regression analyses were used to revise the DASI model in predicting an anaerobic threshold (AT) >11 ml kg −1 min −1 and peak oxygen consumption (VO 2 peak) >16 ml kg −1 min −1, cut-points that represent a reduced risk of postoperative complications. Results Five questions were identified to have dominance in predicting AT>11 ml kg −1 min −1 and VO 2 peak>16 ml.kg −1min −1. These items were included in the M-DASI-5Q and retained utility in predicting AT>11 ml.kg −1.min −1 (area under the receiver-operating-characteristic [AUROC]-AT: M-DASI-5Q=0.67 vs original 12-question DASI=0.66) and VO 2 peak (AUROC-VO2 peak: M-DASI-5Q 0.73 vs original 12-question DASI 0.71). Conversely, in a sensitivity analysis we removed one potentially sensitive question related to the ability to have sexual relations, and the ability of the remaining four questions (M-DASI-4Q) to predict an adequate functional threshold remained no worse than the original 12-question DASI model. Adding a dynamic component to the M-DASI-4Q by assessing the chronotropic response to exercise improved its ability to discriminate between those with VO 2 peak>16 ml.kg −1.min −1 and VO 2 peak<16 ml.kg −1.min −1. Conclusions The M-DASI provides a simple screening tool for further preoperative evaluation, including with cardiopulmonary exercise testing, to guide perioperative management.

Published
2020

20. How big a drop in agricultural exports to the United Kingdom after Brexit? Simulations for sensitive products of four Visegrad countries.

Author

Pawlak K, Hagemejer J, Michalek JJ, and Dunin-Wasowicz M

Subjects
Czech Republic, European Union, Poland, United Kingdom, Agriculture
Abstract

After the European Union (EU) was left by the United Kingdom (UK), a free trade area was established between these economies. Although bilateral trade in all goods is tariff-free, regulatory requirements make exports more costly and burdensome. We used a partial equilibrium model to analyze the implications of Brexit for agricultural exports from Visegrad countries (Czechia, Hungary, Poland and Slovakia). We assess trade creation and trade diversion effects resulting from an increase in non-tariff measures and border costs for 4-digit agricultural products identified as sensitive in each of the Visegrad countries. The simulations reveal that exports of sensitive products from Visegrad countries to the UK could decrease by up to 20%. While the macroeconomic importance of this change is not significant, for the producers of the sensitive goods such export losses are substantial., Competing Interests: The authors have declared that no competing interests exist.

Published
2022
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21. Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery

Author

Edwards M, Forbes G, Berdunov V, Mihaylova B, Dias P, Thomson A, Grocott M, Mythen M, Gillies M, Phan T, Evered L, Wijeysundera D, McCluskey S, Hofer C, Abukhudair H, Szczeklik W, Hajjar L, Kahan B, Pearse R, MacDonald N, Abbott T, Martin T, Januszewska M, Niebrzegowska E, Bekele S, Pates K, Haines R, Walker S, Fowler A, Oliveira M, Whalley J, Stephens T, Amaral V, May S, Manou V, Jones T, Dunkley S, Pakats M, Griffiths B, Fernandez M, Jonas M, Bolger C, Collings N, Burnish R, Kelleher M, Dawson H, Lang A, Campbell R, Rea N, Clark S, Blunt M, Rosbergen M, Hodgson R, Wittenberg M, Filipe H, Gleeson Y, Pakou G, Szakmany T, Gunter U, Hodkinson G, Reay M, Gidda R, Allcock C, Cole A, Watts A, Gardner W, Tindall M, Anumakonda V, Agarwal N, Price T, Clark P, Thompson R, Fowler S, Gray K, McGregor A, Smith T, Wilson T, Guha A, Hodgson A, McSkeane A, Barberis L, Mohamed M, Prentice S, Saunders Z, Ratnam V, Pawa N, Sayan A, Thankachen M, Svensson M, Raj A, Ahmad N, Ivermee C, Cashman J, Smee E, Kanapeckaite L, Corcoran P, Fitzgerald E, Peyton P, Buckley A, Baulch S, Claxton G, Harris S, Sidiropolous S, de Almeida J, Simoes C, Galas F, Camara L, Malbouisson L, Soares S, Fernandes C, Joaquim E, Stefani L, Falcao L, Salgado M, Guimaraes G, Gomes M, Lineburger E, Navarro L, Salles L, Azi L, Prado R, Benedetti R, de Godoy E, Bastos F, da Silva R, dos Santos W, Pazmino-Canizares J, Parotto M, Wasowicz M, Beattie S, Meineri M, Clarke H, Ladha K, Jerath A, Ayach N, Poonawala H, Sellers D, Duncan D, Carroll J, Hudson C, van Vlymen J, Jaeger M, Shelley J, Shore D, McQuaide S, Richebe P, Godin N, Gobert Q, Fortier L, Verdonck O, Sato H, Schricker T, Codere-Maruyama T, Lattermann R, Hatzakorzian R, Moore A, Sato T, Funk D, Kowalski S, Girling L, Monterola M, Fidler K, Sander M, Markmann M, Schulte D, Singer R, Koch C, Ruhrmann S, Habig L, Edinger F, Schneck E, Treskatsch S, Ertmer M, Trauzeddel R, Weyland A, Diers A, Grote T, Pabel S, Lipka A, Nannen L, Fleischer A, Wittmann M, Winkler A, Neumann C, Fingerhut M, Ehrentraut H, Guttenthaler V, Heringlake M, Brandt S, Olsson S, Schmidt C, Schemke S, Murat L, Abu Khudair H, Farhoud E, Ghidan A, Al Masri M, Abu Kwiak S, Abdel-Nabi H, Grigoras I, Ristescu I, Jitaru I, Manole M, Rusu D, Gata A, Aldecoa C, Gonzalez A, Alfonso S, Perz L, Feijoo J, Guerra Y, Herrero A, Ripolles-Melchor J, Abad-Motos A, de Pablo E, Martinez-Hurtado E, Abad-Gurumeta A, Salvachua-Fernandez R, Nozal-Mateo B, de Nadal M, Galan P, Visauta E, Peral E, Da Prat I, Suarez S, Peral C, Una-Orejon R, Caldera-Alvarez M, Fernandez-Francos S, Davila A, Ortola C, Gutierrez A, Mugarra A, Romero E, Soro M, Gracia E, Pozo N, Villafane A, Diez A, Sanchez C, Buron F, Blanco R, Duran M, Parada P, Torres M, Rivas M, Brage S, Castro A, Conde M, Pardal C, Ben M, Perez A, Sancho J, Alarcon M, Mariotti S, Marcolino I, Winter A, McGrane T, Craven D, Turnbo T, Mayo G, Campbell D, Klintworth S, Tilley A, Weinstein M, Horan A, Chowdary R, Carlon V, Balasinorwala T, Yang G, and OPTIMISE II Investigators

Published
2019

22. Association of preoperative anaemia with cardiopulmonary exercise capacity and postoperative outcomes in noncardiac surgery: a substudy of the Measurement of Exercise Tolerance before Surgery (METS) Study

Author

Bartoszko, J., primary, Thorpe, K.E., additional, Laupacis, A., additional, Wijeysundera, D.N., additional, Myles, P.S., additional, Shulman, M.A., additional, Wallace, S., additional, Farrington, C., additional, Thompson, B., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Kirabiyik, Y., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T.W., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, Leslie, K., additional, MacCormick, A., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, Mazer, C.D., additional, Kunasingam, J., additional, Yagnik, A., additional, Crescini, C., additional, Yagnik, S., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Oh, P., additional, Belliard, R., additional, Lee, L., additional, Dobson, K., additional, Chan, V., additional, Brull, R., additional, Ami, N., additional, Stanbrook, M., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Croal, B.L., additional, Lum, M., additional, Martin, D., additional, James, S., additional, Filipe, H., additional, Pinto, M., additional, Kynaston, S., additional, Pearse, R.M., additional, Abbott, T.E.F., additional, Phull, M., additional, Beilstein, C., additional, Bodger, P., additional, Everingham, K., additional, Hu, Y., additional, Niebrzegowska, E., additional, Corriea, C., additional, Creary, T., additional, Januszewska, M., additional, Ahmad, T., additional, Whalley, J., additional, Haslop, R., additional, McNeil, J., additional, Brown, A., additional, MacDonald, N., additional, Pakats, M., additional, Greaves, K., additional, Jhanji, S., additional, Raobaikady, R., additional, Black, E., additional, Rooms, M., additional, Lawrence, H., additional, Koutra, M., additional, Pirie, K., additional, Gertsman, M., additional, Jack, S., additional, Celinski, M., additional, Levett, D., additional, Edwards, M., additional, Salmon, K., additional, Bolger, C., additional, Loughney, L., additional, Seaward, L., additional, Collins, H., additional, Tyrell, B., additional, Tantony, N., additional, Golder, K., additional, Ackland, G.L., additional, Gallego-Paredes, L., additional, Reyes, A., additional, Gutierrez del Arroyo, A., additional, Raj, A., additional, Lifford, R., additional, Cuthbertson, B.H., additional, Torres, E., additional, Ambosta, A., additional, Melo, M., additional, Mamdani, M., additional, Grocott, M.P.W., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2019
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25. Heart rate recovery and morbidity after noncardiac surgery: Planned secondary analysis of two prospective, multi-centre, blinded observational studies

Author

Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, Montague, L, Bianchi, C, Ackland, GL, Abbott, TEF, Minto, G, Clark, M, Owen, T, Prabhu, P, May, SM, Reynolds, JA, Cuthbertson, BH, Wijesundera, D, Pearse, RM, Myles, PS, Shulman, MA, Wallace, S, Farrington, C, Thompson, B, Ellis, M, Borg, B, Kerridge, RK, Douglas, J, Brannan, J, Pretto, J, Godsall, MG, Beauchamp, N, Allen, S, Kennedy, A, Wright, E, Malherbe, J, Ismail, H, Riedel, B, Melville, A, Sivakumar, H, Murmane, A, Kenchington, K, Kirabiyik, Y, Gurunathan, U, Stonell, C, Brunello, K, Steele, K, Tronstad, O, Masel, P, Dent, A, Smith, E, Bodger, A, Abolfathi, M, Sivalingam, P, Hall, A, Painter, TW, Macklin, S, Elliott, A, Carrera, AM, Terblanche, NCS, Pitt, S, Samuels, J, Wilde, C, Leslie, K, MacCormick, A, Bramley, D, Southcott, AM, Grant, J, Taylor, H, Bates, S, Towns, M, Tippett, A, Marshall, F, Mazer, CD, Kunasingam, J, Yagnik, A, Crescini, C, Yagnik, S, McCartney, CJL, Choi, S, Somascanthan, P, Flores, K, Wijeysundera, DN, Beattie, WS, Karkouti, K, Clarke, HA, Jerath, A, McCluskey, SA, Wasowicz, M, Granton, JT, Day, L, Pazmino-Canizares, J, Oh, P, Belliard, R, Lee, L, Dobson, K, Chan, V, Brull, R, Ami, N, Stanbrook, M, Hagen, K, Campbell, D, Short, T, Van Der Westhuizen, J, Higgie, K, Lindsay, H, Jang, R, Wong, C, Mcallister, D, Ali, M, Kumar, J, Waymouth, E, Kim, C, Dimech, J, Lorimer, M, Tai, J, Miller, R, Sara, R, Collingwood, A, Olliff, S, Gabriel, S, Houston, H, Dalley, P, Hurford, S, Hunt, A, Andrews, L, Navarra, L, Jason-Smith, A, Thompson, H, McMillan, N, Back, G, Croal, BL, Lum, M, Martin, D, James, S, Filipe, H, Pinto, M, Kynaston, S, Phull, M, Beilstein, C, Bodger, P, Everingham, K, Hu, Y, Niebrzegowska, E, Corriea, C, Creary, T, Januszewska, M, Ahmad, T, Whalley, J, Haslop, R, McNeil, J, Brown, A, MacDonald, N, Pakats, M, Greaves, K, Jhanji, S, Raobaikady, R, Black, E, Rooms, M, Lawrence, H, Koutra, M, Pirie, K, Gertsman, M, Jack, S, Celinski, M, Levett, D, Edwards, M, Salmon, K, Bolger, C, Loughney, L, Seaward, L, Collins, H, Tyrell, B, Tantony, N, Golder, K, Stephens, RCM, Gallego-Paredes, L, Reyes, A, del Arroyo, AG, Raj, A, Lifford, R, King, A, Pollak, C, Williams, C, Patrick, A, West, C, Vickers, E, Green, R, Jones, A, Otto, J, Lach, A, Whittle, J, Paredes, LG, Toner, A, Williams, A, Pradhu, P, Hull, D, and Montague, L

Abstract

BACKGROUND: Impaired cardiac vagal function, quantified preoperatively as slower heart rate recovery (HRR) after exercise, is independently associated with perioperative myocardial injury. Parasympathetic (vagal) dysfunction may also promote (extra-cardiac) multi-organ dysfunction, although perioperative data are lacking. Assuming that cardiac vagal activity, and therefore heart rate recovery response, is a marker of brainstem parasympathetic dysfunction, we hypothesized that impaired HRR would be associated with a higher incidence of morbidity after noncardiac surgery. METHODS: In two prospective, blinded, observational cohort studies, we established the definition of impaired vagal function in terms of the HRR threshold that is associated with perioperative myocardial injury (HRR ≤ 12 beats min-1 (bpm), 60 seconds after cessation of cardiopulmonary exercise testing. The primary outcome of this secondary analysis was all-cause morbidity three and five days after surgery, defined using the Post-Operative Morbidity Survey. Secondary outcomes of this analysis were type of morbidity and time to become morbidity-free. Logistic regression and Cox regression tested for the association between HRR and morbidity. Results are presented as odds/hazard ratios [OR or HR; (95% confidence intervals). RESULTS: 882/1941 (45.4%) patients had HRR≤12bpm. All-cause morbidity within 5 days of surgery was more common in 585/822 (71.2%) patients with HRR≤12bpm, compared to 718/1119 (64.2%) patients with HRR>12bpm (OR:1.38 (1.14-1.67); p = 0.001). HRR≤12bpm was associated with more frequent episodes of pulmonary (OR:1.31 (1.05-1.62);p = 0.02)), infective (OR:1.38 (1.10-1.72); p = 0.006), renal (OR:1.91 (1.30-2.79); p = 0.02)), cardiovascular (OR:1.39 (1.15-1.69); p<0.001)), neurological (OR:1.73 (1.11-2.70); p = 0.02)) and pain morbidity (OR:1.38 (1.14-1.68); p = 0.001) within 5 days of surgery. CONCLUSIONS: Multi-organ dysfunction is more common in surgical patients with cardiac vagal dys

Published
2019

26. Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial: study protocol for a multicentre international trial of cardiac output-guided fluid therapy with low-dose inotrope infusion compared with usual care in patients undergoing major elective gastrointestinal surgery

Author

Edwards, MR, Forbes, G, MacDonald, N, Berdunov, V, Mihaylova, B, Dias, P, Thomson, A, Grocott, MPW, Mythen, MG, Gillies, MA, Sander, M, Phan, TD, Evered, L, Wijeysundera, DN, McCluskey, SA, Aldecoa, C, Ripolles-Melchor, J, Hofer, CK, Abukhudair, H, Szczeklik, W, Grigoras, I, Hajjar, LA, Kahan, BC, Pearse, RM, Abbott, T, Martin, T, Januszewska, M, Niebrzegowska, E, Bekele, S, Pates, K, Haines, R, Walker, S, Fowler, A, Oliveira, M, Whalley, J, Stephens, T, Amaral, VDS, May, S, Manou, V, Jones, T, Dunkley, S, Pakats, M-L, Griffiths, B, Fernandez, M, Edwards, M, Jonas, M, Bolger, C, Collings, N, Burnish, R, Kelleher, M, Dawson, H, Lang, A, Campbell, R, Rea, N, Clark, S, Blunt, M, Rosbergen, M, Hodgson, R, Wittenberg, M, Filipe, H, Gleeson, Y, Pakou, G, Szakmany, T, Gunter, U, Hodkinson, G, Reay, M, Gidda, R, Allcock, C, Cole, A, Watts, A, Gardner, W, Tindall, M, Anumakonda, V, Agarwal, N, Price, T, Clark, P, Thompson, R, Fowler, S, Gray, K, McGregor, A, Smith, T, Wilson, T, Guha, A, Hodgson, A, McSkeane, A, Barberis, L, Mohamed, M, Prentice, S, Saunders, Z, Ratnam, V, Pawa, N, Sayan, A, Thankachen, M, Svensson, M-L, Raj, A, Ahmad, N, Ivermee, C, Cashman, J, Smee, E, Kanapeckaite, L, Tuong, P, Corcoran, P, Fitzgerald, E, Peyton, P, Buckley, A, Baulch, S, Claxton, G, Harris, S, Sidiropolous, S, de Almeida, JP, Simoes, C, Galas, FRBG, Camara, L, Malbouisson, LMS, Soares, SD, Fernandes, CR, Joaquim, EHG, Stefani, LC, Falcao, LF, Salgado, M, Guimaraes, GN, Gomes, MDA, Lineburger, E, Navarro, L, Salles, LC, Azi, LMTDA, Prado, RG, Benedetti, RH, de Godoy, EP, Bastos, FA, da Silva, RJC, dos Santos, WF, McCluskey, S, Wijeysundera, D, Pazmino-Canizares, J, Parotto, M, Wasowicz, M, Beattie, S, Meineri, M, Clarke, H, Ladha, K, Jerath, A, Ayach, N, Poonawala, H, Sellers, D, Duncan, D, Carroll, J, Hudson, C, van Vlymen, J, Jaeger, M, Shelley, J, Shore, DD, McQuaide, S, Richebe, P, Godin, N, Gobert, Q, Fortier, LP, Verdonck, O, Sato, H, Schricker, T, Codere-Maruyama, T, Lattermann, R, Hatzakorzian, R, Moore, A, Sato, T, Funk, D, Kowalski, S, Girling, L, Monterola, M, Fidler, K, Markmann, M, Schulte, D, Singer, R, Koch, C, Ruhrmann, S, Habig, L, Edinger, F, Schneck, E, Treskatsch, S, Ertmer, M, Trauzeddel, R-F, Weyland, A, Diers, A, Grote, T, Pabel, S, Lipka, A, Nannen, L, Fleischer, A, Wittmann, M, Winkler, A, Neumann, C, Fingerhut, M-L, Ehrentraut, H, Guttenthaler, V, Heringlake, M, Brandt, S, Olsson, S, Schmidt, C, Schemke, S, Murat, L, Abu Khudair, H, Farhoud, E, Ghidan, A, Al Masri, M, Abu Kwiak, S, Abdel-Nabi, H, Ristescu, I, Jitaru, I, Manole, M, Rusu, D, Gata, A, Gonzalez, AP, Alfonso, SM, Perz, LV, Feijoo, JR, Guerra, Y, Herrero, A, Abad-Motos, A, de Pablo, EL, Martinez-Hurtado, E, Abad-Gurumeta, A, Salvachua-Fernandez, R, Nozal-Mateo, B, de Nadal, M, Galan, P, Visauta, EC, Peral, EC, Da Prat, IC, Suarez, SG, Peral, C, Una-Orejon, R, Caldera-Alvarez, MV, Fernandez-Francos, S, Davila, AS, Ortola, CF, Gutierrez, A, Mugarra, A, Romero, E, Soro, M, Gracia, E, Pozo, N, Villafane, AP, Diez, AF, Sanchez, CGM, Buron, FD, Blanco, RP, Duran, MV, Parada, PD, Torres, MB, Rivas, MC, Brage, SM, Castro, AMG, Conde, MJP, Pardal, CB, Ben, MRT, Perez, A, Sancho, JM, Alarcon, MM, Hofer, C, Mariotti, S, Marcolino, I, Winter, A, McGrane, T, Craven, D, Turnbo, T, Mayo, G, Campbell, D, Klintworth, S, Tilley, A, Weinstein, M, Horan, A, Chowdary, R, Carlon, VA, Balasinorwala, T, Yang, G, Edwards, MR, Forbes, G, MacDonald, N, Berdunov, V, Mihaylova, B, Dias, P, Thomson, A, Grocott, MPW, Mythen, MG, Gillies, MA, Sander, M, Phan, TD, Evered, L, Wijeysundera, DN, McCluskey, SA, Aldecoa, C, Ripolles-Melchor, J, Hofer, CK, Abukhudair, H, Szczeklik, W, Grigoras, I, Hajjar, LA, Kahan, BC, Pearse, RM, Abbott, T, Martin, T, Januszewska, M, Niebrzegowska, E, Bekele, S, Pates, K, Haines, R, Walker, S, Fowler, A, Oliveira, M, Whalley, J, Stephens, T, Amaral, VDS, May, S, Manou, V, Jones, T, Dunkley, S, Pakats, M-L, Griffiths, B, Fernandez, M, Edwards, M, Jonas, M, Bolger, C, Collings, N, Burnish, R, Kelleher, M, Dawson, H, Lang, A, Campbell, R, Rea, N, Clark, S, Blunt, M, Rosbergen, M, Hodgson, R, Wittenberg, M, Filipe, H, Gleeson, Y, Pakou, G, Szakmany, T, Gunter, U, Hodkinson, G, Reay, M, Gidda, R, Allcock, C, Cole, A, Watts, A, Gardner, W, Tindall, M, Anumakonda, V, Agarwal, N, Price, T, Clark, P, Thompson, R, Fowler, S, Gray, K, McGregor, A, Smith, T, Wilson, T, Guha, A, Hodgson, A, McSkeane, A, Barberis, L, Mohamed, M, Prentice, S, Saunders, Z, Ratnam, V, Pawa, N, Sayan, A, Thankachen, M, Svensson, M-L, Raj, A, Ahmad, N, Ivermee, C, Cashman, J, Smee, E, Kanapeckaite, L, Tuong, P, Corcoran, P, Fitzgerald, E, Peyton, P, Buckley, A, Baulch, S, Claxton, G, Harris, S, Sidiropolous, S, de Almeida, JP, Simoes, C, Galas, FRBG, Camara, L, Malbouisson, LMS, Soares, SD, Fernandes, CR, Joaquim, EHG, Stefani, LC, Falcao, LF, Salgado, M, Guimaraes, GN, Gomes, MDA, Lineburger, E, Navarro, L, Salles, LC, Azi, LMTDA, Prado, RG, Benedetti, RH, de Godoy, EP, Bastos, FA, da Silva, RJC, dos Santos, WF, McCluskey, S, Wijeysundera, D, Pazmino-Canizares, J, Parotto, M, Wasowicz, M, Beattie, S, Meineri, M, Clarke, H, Ladha, K, Jerath, A, Ayach, N, Poonawala, H, Sellers, D, Duncan, D, Carroll, J, Hudson, C, van Vlymen, J, Jaeger, M, Shelley, J, Shore, DD, McQuaide, S, Richebe, P, Godin, N, Gobert, Q, Fortier, LP, Verdonck, O, Sato, H, Schricker, T, Codere-Maruyama, T, Lattermann, R, Hatzakorzian, R, Moore, A, Sato, T, Funk, D, Kowalski, S, Girling, L, Monterola, M, Fidler, K, Markmann, M, Schulte, D, Singer, R, Koch, C, Ruhrmann, S, Habig, L, Edinger, F, Schneck, E, Treskatsch, S, Ertmer, M, Trauzeddel, R-F, Weyland, A, Diers, A, Grote, T, Pabel, S, Lipka, A, Nannen, L, Fleischer, A, Wittmann, M, Winkler, A, Neumann, C, Fingerhut, M-L, Ehrentraut, H, Guttenthaler, V, Heringlake, M, Brandt, S, Olsson, S, Schmidt, C, Schemke, S, Murat, L, Abu Khudair, H, Farhoud, E, Ghidan, A, Al Masri, M, Abu Kwiak, S, Abdel-Nabi, H, Ristescu, I, Jitaru, I, Manole, M, Rusu, D, Gata, A, Gonzalez, AP, Alfonso, SM, Perz, LV, Feijoo, JR, Guerra, Y, Herrero, A, Abad-Motos, A, de Pablo, EL, Martinez-Hurtado, E, Abad-Gurumeta, A, Salvachua-Fernandez, R, Nozal-Mateo, B, de Nadal, M, Galan, P, Visauta, EC, Peral, EC, Da Prat, IC, Suarez, SG, Peral, C, Una-Orejon, R, Caldera-Alvarez, MV, Fernandez-Francos, S, Davila, AS, Ortola, CF, Gutierrez, A, Mugarra, A, Romero, E, Soro, M, Gracia, E, Pozo, N, Villafane, AP, Diez, AF, Sanchez, CGM, Buron, FD, Blanco, RP, Duran, MV, Parada, PD, Torres, MB, Rivas, MC, Brage, SM, Castro, AMG, Conde, MJP, Pardal, CB, Ben, MRT, Perez, A, Sancho, JM, Alarcon, MM, Hofer, C, Mariotti, S, Marcolino, I, Winter, A, McGrane, T, Craven, D, Turnbo, T, Mayo, G, Campbell, D, Klintworth, S, Tilley, A, Weinstein, M, Horan, A, Chowdary, R, Carlon, VA, Balasinorwala, T, and Yang, G

Abstract

INTRODUCTION: Postoperative morbidity and mortality in older patients with comorbidities undergoing gastrointestinal surgery are a major burden on healthcare systems. Infections after surgery are common in such patients, prolonging hospitalisation and reducing postoperative short-term and long-term survival. Optimal management of perioperative intravenous fluids and inotropic drugs may reduce infection rates and improve outcomes from surgery. Previous small trials of cardiac-output-guided haemodynamic therapy algorithms suggested a modest reduction in postoperative morbidity. A large definitive trial is needed to confirm or refute this and inform widespread clinical practice. METHODS: The Optimisation of Perioperative Cardiovascular Management to Improve Surgical Outcome II (OPTIMISE II) trial is a multicentre, international, parallel group, open, randomised controlled trial. 2502 high-risk patients undergoing major elective gastrointestinal surgery will be randomly allocated in a 1:1 ratio using minimisation to minimally invasive cardiac output monitoring to guide protocolised administration of intravenous fluid combined with low-dose inotrope infusion, or usual care. The trial intervention will be carried out during and for 4 hours after surgery. The primary outcome is postoperative infection of Clavien-Dindo grade II or higher within 30 days of randomisation. Participants and those delivering the intervention will not be blinded to treatment allocation; however, outcome assessors will be blinded when feasible. Participant recruitment started in January 2017 and is scheduled to last 3 years, within 50 hospitals worldwide. ETHICS/DISSEMINATION: The OPTIMISE II trial has been approved by the UK National Research Ethics Service and has been approved by responsible ethics committees in all participating countries. The findings will be disseminated through publication in a widely accessible peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: ISRCTN39653756.

Published
2019

27. Using the 6-minute walk test to predict disability-free survival after major surgery

Author

Shulman, M.A., primary, Cuthbertson, B.H., additional, Wijeysundera, D.N., additional, Pearse, R.M., additional, Thompson, B., additional, Torres, E., additional, Ambosta, A., additional, Wallace, S., additional, Farrington, C., additional, Myles, P.S., additional, Ellis, M., additional, Borg, B., additional, Kerridge, R.K., additional, Douglas, J., additional, Brannan, J., additional, Pretto, J., additional, Godsall, M.G., additional, Beauchamp, N., additional, Allen, S., additional, Kennedy, A., additional, Wright, E., additional, Malherbe, J., additional, Ismail, H., additional, Riedel, B., additional, Melville, A., additional, Sivakumar, H., additional, Murmane, A., additional, Kenchington, K., additional, Gurunathan, U., additional, Stonell, C., additional, Brunello, K., additional, Steele, K., additional, Tronstad, O., additional, Masel, P., additional, Dent, A., additional, Smith, E., additional, Bodger, A., additional, Abolfathi, M., additional, Sivalingam, P., additional, Hall, A., additional, Painter, T., additional, Macklin, S., additional, Elliott, A., additional, Carrera, A.M., additional, Terblanche, N.C.S., additional, Pitt, S., additional, Samuels, J., additional, Wilde, C., additional, MacCormick, A., additional, Leslie, K., additional, Bramley, D., additional, Southcott, A.M., additional, Grant, J., additional, Taylor, H., additional, Bates, S., additional, Towns, M., additional, Tippett, A., additional, Marshall, F., additional, McCartney, C.J.L., additional, Choi, S., additional, Somascanthan, P., additional, Flores, K., additional, Beattie, W.S., additional, Karkouti, K., additional, Clarke, H.A., additional, Jerath, A., additional, McCluskey, S.A., additional, Wasowicz, M., additional, Granton, J.T., additional, Day, L., additional, Pazmino-Canizares, J., additional, Hagen, K., additional, Campbell, D., additional, Short, T., additional, Van Der Westhuizen, J., additional, Higgie, K., additional, Lindsay, H., additional, Jang, R., additional, Wong, C., additional, Mcallister, D., additional, Ali, M., additional, Kumar, J., additional, Waymouth, E., additional, Kim, C., additional, Dimech, J., additional, Lorimer, M., additional, Tai, J., additional, Miller, R., additional, Sara, R., additional, Collingwood, A., additional, Olliff, S., additional, Gabriel, S., additional, Houston, H., additional, Dalley, P., additional, Hurford, S., additional, Hunt, A., additional, Andrews, L., additional, Navarra, L., additional, Jason-Smith, A., additional, Thompson, H., additional, McMillan, N., additional, Back, G., additional, Melo, M., additional, Mamdani, M., additional, Hillis, G., additional, and Wijeysundera, H.C., additional

Published
2019
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30. Intraoperative and Early Postoperative Management of Heart Transplantation: Anesthetic Implications.

Author

Neethling E, Moreno Garijo J, Mangalam TK, Badiwala MV, Billia P, Wasowicz M, Van Rensburg A, and Slinger P

Subjects
Humans, Postoperative Complications diagnosis, Postoperative Complications therapy, Tissue Donors, Anesthetics, Heart Failure diagnosis, Heart Failure therapy, Heart Transplantation
Abstract

The gold standard treatment for end-stage heart failure, with 50% mortality within 5 years of diagnosis, is considered heart transplantation. Despite the improvements in immunosuppression, the period of highest mortality risk in the heart transplantation population is during the first year post-transplantation, with primary graft dysfunction being the leading cause of mortality. After adequate preoperative assessment of the recipient, including patients on mechanical support, the intraoperative care of heart transplantation patients requires extensive monitoring followed by proficient management of anesthesia induction and maintenance, ventilation, and fluid therapy. The focus on weaning from cardiopulmonary bypass should be on preventing right ventricular failure and high pulmonary vascular resistances, with protocolized blood conservation strategies and transfusion protocols. The early postoperative care of a heart transplantation patient is focused on the post-cardiopulmonary bypass and transplantation status, with particular attention to the presence of primary graft dysfunction, right ventricular performance, pulmonary pressures, and vasoplegia. The aim is early extubation, inotropic and chronotropic support weaning, and chest tube removal to facilitate discharge of the patient from the intensive care unit. The increased complexity of heart transplantation recipients, including the incremental use of pre- transplantation mechanical circulatory support and extended criteria donor hearts, requires extensive and sophisticated preparation of the cardiac anesthesiologist. This article aims to provide an overview of the intraoperative and early postoperative anesthesia management of heart transplantation patients., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2020
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32. Personalized Ventilation to Multiple Patients Using a Single Ventilator: Description and Proof of Concept.

Author

Han JS, Mashari A, Singh D, Dianti J, Goligher E, Long M, Ng W, Wasowicz M, Preiss D, Vesely A, Kacmarek R, Keshavjee S, Brochard L, Fisher JA, and Slutsky AS

Abstract

Objectives: To design and test a ventilator circuit that can be used for ventilation of two or more patients with a single ventilator, while allowing individualization of tidal volume, fractional concentration of oxygen, and positive end-expiratory pressure to each patient, irrespective of the other patient's respiratory system mechanics., Design: Description and proof of concept studies., Settings: Respiratory therapy laboratory., Subjects: Ventilation of mechanical test lungs., Interventions: Following a previously advocated design, we used components readily available in our hospital to assemble two "bag-in-a-box" breathing circuits. Each patient circuit consisted of a flexible bag in a rigid container connected via one-way valve to a test lung, along with an inline positive end-expiratory pressure valve, connected to the ventilator's expiratory limb. Compressed gas fills the bags during "patient" exhalation. During inspiration, gas from the ventilator, in pressure control mode, enters the containers and displaces gas from the bags to the test lungs. We varied tidal volume, "respiratory system" compliance, and positive end-expiratory pressure in one lung and observed the effect on the tidal volume of the other., Measurements and Main Results: We were able to obtain different tidal volume, dynamic driving pressure, and positive end-expiratory pressure in the two lungs under widely different compliances in both lungs. Complete obstruction, or disconnection at the circuit connection to one test lung, had minimal effect (< 5% on average) on the ventilation to the co-ventilated lung., Conclusions: A secondary circuit "bag-in-the-box" system enables individualized ventilation of two lungs overcoming many of the concerns of ventilating more than one patient with a single ventilator., Competing Interests: Dr. Mashari is a Senior Scientific Advisor (pro bono) for Glia, nonprofit company making regulatory-approved open-source medical devices. Dr. Goligher has received personal fees and research equipment and from Getinge. Dr. Kacmarek is a consultant for Medtronic on Airway Care and a consultant for Orange Med on mechanical ventilators; he received a research grant from Orange Medical for ventilator comparison. Dr. Slutsky is a consultant for Baxter and Xenios. The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)

Published
2020
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33. Current Evidence and Future Directions of Tranexamic Acid Use, Efficacy, and Dosing for Major Surgical Procedures.

Author

Taam J, Yang QJ, Pang KS, Karanicolas P, Choi S, Wasowicz M, and Jerath A

Subjects
Blood Loss, Surgical, Blood Transfusion, Cardiopulmonary Bypass, Humans, Antifibrinolytic Agents, Cardiac Surgical Procedures adverse effects, Tranexamic Acid
Abstract

Tranexamic acid reduces blood loss and transfusion requirements with no significant thrombotic adverse effects. Postoperative seizures have been seen in cardiac surgical patients in association with patient (advanced age, underlying neurologic disease, chronic kidney disease); surgical (open cardiac procedures, long bypass times); and drug (high tranexamic acid dose) risk factors. Tranexamic acid dosing regimens should be decreased in patients with chronic kidney dysfunction secondary to reduced clearance and drug accumulation. Optimal dosing for cardiac surgical patients has been recommended. Additional research is required to determine dosing regimens in major noncardiac surgery and plasma concentration levels associated with inducing seizures., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Published
2020
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36. To the Editor.

Author

Jerath A, Yang QJ, Wasowicz M, and Pang KS

Subjects
Heart, Humans, Tranexamic Acid, Cardiac Surgical Procedures, Kidney Diseases
Published
2019
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48. Safety and Efficacy of Volatile Anesthetic Agents Compared With Standard Intravenous Midazolam/Propofol Sedation in Ventilated Critical Care Patients: A Meta-analysis and Systematic Review of Prospective Trials.

Author

Jerath A, Panckhurst J, Parotto M, Lightfoot N, Wasowicz M, Ferguson ND, Steel A, and Beattie WS

Subjects
Anesthetics, Inhalation administration & dosage, Anesthetics, Inhalation adverse effects, Anesthetics, Intravenous administration & dosage, Anesthetics, Intravenous adverse effects, Clinical Trials as Topic methods, Humans, Hypnotics and Sedatives adverse effects, Midazolam adverse effects, Nausea chemically induced, Propofol adverse effects, Prospective Studies, Respiration, Artificial adverse effects, Treatment Outcome, Volatilization, Critical Care methods, Hypnotics and Sedatives administration & dosage, Midazolam administration & dosage, Propofol administration & dosage, Respiration, Artificial methods
Abstract

Background: Inhalation agents are being used in place of intravenous agents to provide sedation in some intensive care units. We performed a systematic review and meta-analysis of prospective randomized controlled trials, which compared the use of volatile agents versus intravenous midazolam or propofol in critical care units., Methods: A search was conducted using MEDLINE (1946-2015), EMBASE (1947-2015), Web of Science index (1900-2015), and Cochrane Central Register of Controlled Trials. Eligible studies included randomized controlled trials comparing inhaled volatile (desflurane, sevoflurane, and isoflurane) sedation to intravenous midazolam or propofol. Primary outcome assessed the effect of volatile-based sedation on extubation times (time between discontinuing sedation and tracheal extubation). Secondary outcomes included time to obey verbal commands, proportion of time spent in target sedation, nausea and vomiting, mortality, length of intensive care unit, and length of hospital stay. Heterogeneity was assessed using the I statistic. Outcomes were assessed using a random or fixed-effects model depending on heterogeneity., Results: Eight trials with 523 patients comparing all volatile agents with intravenous midazolam or propofol showed a reduction in extubation times using volatile agents (difference in means, -52.7 minutes; 95% confidence interval [CI], -75.1 to -30.3; P < .00001). Reductions in extubation time were greater when comparing volatiles with midazolam (difference in means, -292.2 minutes; 95% CI, -384.4 to -200.1; P < .00001) than propofol (difference in means, -29.1 minutes; 95% CI, -46.7 to -11.4; P = .001). There was no significant difference in time to obey verbal commands, proportion of time spent in target sedation, adverse events, death, or length of hospital stay., Conclusions: Volatile-based sedation demonstrates a reduction in time to extubation, with no increase in short-term adverse outcomes. Marked study heterogeneity was present, and the results show marked positive publication bias. However, a reduction in extubation time was still evident after statistical correction of publication bias. Larger clinical trials are needed to further evaluate the role of these agents as sedatives for critically ill patients.

Published
2017
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