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1. Epidemiology of perioperative RV dysfunction: risk factors, incidence, and clinical implications

Author: Ben Shelley, Rhiannon McAreavey, and Philip McCall
Subjects: Right ventricle, Perioperative medicine, Postoperative complications, Cardiovascular complications, Surgery, RD1-811
Abstract: Abstract In this edition of the journal, the Perioperative Quality Initiative (POQI) present three manuscripts describing the physiology, assessment, and management of right ventricular dysfunction (RVD) as pertains to the perioperative setting. This narrative review seeks to provide context for these manuscripts, discussing the epidemiology of perioperative RVD focussing on definition, risk factors, and clinical implications. Throughout the perioperative period, there are many potential risk factors/insults predisposing to perioperative RVD including pre-existing RVD, fluid overload, myocardial ischaemia, pulmonary embolism, lung injury, mechanical ventilation, hypoxia and hypercarbia, lung resection, medullary reaming and cement implantation, cardiac surgery, cardiopulmonary bypass, heart and lung transplantation, and left ventricular assist device implantation. There has however been little systematic attempt to quantify the incidence of perioperative RVD. What limited data exists has assessed perioperative RVD using echocardiography, cardiovascular magnetic resonance, and pulmonary artery catheterisation but is beset by challenges resulting from the inconsistencies in RVD definitions. Alongside differences in patient and surgical risk profile, this leads to wide variation in the incidence estimate. Data concerning the clinical implications of perioperative RVD is even more scarce, though there is evidence to suggest RVD is associated with atrial arrhythmias and prolonged length of critical care stay following thoracic surgery, increased need for inotropic support in revision orthopaedic surgery, and increased critical care requirement and mortality following cardiac surgery. Acute manifestations of RVD result from low cardiac output or systemic venous congestion, which are non-specific to the diagnosis of RVD. As such, RVD is easily overlooked, and the relative contribution of RV dysfunction to postoperative morbidity is likely to be underestimated. We applaud the POQI group for highlighting this important condition. There is undoubtedly a need for further study of the RV in the perioperative period in addition to solutions for perioperative risk prediction and management strategies. There is much to understand, study, and trial in this area, but importantly for our patients, we are increasingly recognising the importance of these uncertainties.
Published: 2024
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2. Reproducibility of heart rate recovery measures across differing modalities and intensities of submaximal exercise in healthy volunteers: A healthy volunteer study

Author: Haroon Minhas, Christopher Morton, Martin Shaw, and Ben Shelley
Subjects: Heart rate recovery, Reproducibility, Submaximal exercise testing, Cycle ergometry, Shuttle walk test, Step test, Anesthesiology, RD78.3-87.3
Abstract: Abstract Purpose Submaximal exercise tests (SET) are an easier to conduct and less physically demanding alternative to cardiopulmonary exercise testing for assessment of pre-operative fitness. Assessment of heart rate recovery (HRR) following SETs offers an easily obtained marker of vagal reactivation and sympathetic withdrawal and therefore provides an indication of an individual’s fitness. This study sought to assess the reproducibility of HRR across different workloads and modalities of SET. Methods Thirty-four healthy volunteers were recruited to undergo two SETs at 40% and 60% of their predicted maximal workload. A second group of thirty-one healthy volunteers were recruited to undergo three SETs of differing modalities; Cycle ergometry, Step and Shuttle Walk tests. HRR was quantified using the conventional indices HRR1 and HRR2 (calculated as heart rate (HR) on exercise cessation minus HR at 1 and 2 min of rest) and a novel area under the HRR vs. time curve (HRRAUC) method. Reproducibility of results was assessed using intra-class correlation coefficient (ICC) and limits of agreements. Results The results showed that HRR1 and HRR2 were poorly reproducible across differing workloads and exercise modalities (ICC 0.52 for all comparisons). Conclusions These results suggest that HRRAUC may be a superior way of quantifying HRR following SETs, adding objectivity to SET results. Quantifying HRRAUC could prove to have useful clinical applications for pre-operative risk assessment, assessing fitness to undergo treatment and monitoring disease progression.
Published: 2024
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3. Study protocol for a randomised controlled trial to investigate the effectiveness of thoracic epidural and paravertebral blockade in reducing chronic post-thoracotomy pain: 2 (TOPIC 2)

Author: Ben Shelley, Andreas Goebel, Stephen Grant, Louise Jackson, Hugh Jarrett, Marcus Jepson, Amy Kerr, Nandor Marczin, Rajnikant Mehta, Teresa Melody, Lee Middleton, Babu Naidu, Lajos Szentgyorgyi, Sarah Tearne, Ben Watkins, Matthew Wilson, Andrew Worrall, Joyce Yeung, and Fang Gao Smith
Subjects: Thoracotomy, Thoracic surgery, Paravertebral block, Thoracic epidural blockade, Anaesthesia, Chronic pain, Medicine (General), R5-920
Abstract: Abstract Background Thoracotomy is considered one of the most painful surgical procedures and can cause debilitating chronic post-surgical pain lasting months or years postoperatively. Aggressive management of acute pain resulting from thoracotomy may reduce the likelihood of developing chronic pain. This trial compares the two most commonly used modes of acute analgesia provision at the time of thoracotomy (thoracic epidural blockade (TEB) and paravertebral blockade (PVB)) in terms of their clinical and cost-effectiveness in preventing chronic post-thoracotomy pain. Methods TOPIC 2 is a multi-centre, open-label, parallel group, superiority, randomised controlled trial, with an internal pilot investigating the use of TEB and PVB in 1026 adult (≥ 18 years old) patients undergoing thoracotomy in up to 20 thoracic centres throughout the UK. Patients (N = 1026) will be randomised in a 1:1 ratio to receive either TEB or PVB. During the first year, the trial will include an integrated QuinteT (Qualitative Research Integrated into Trials) Recruitment Intervention (QRI) with the aim of optimising recruitment and informed consent. The primary outcome is the incidence of chronic post-surgical pain at 6 months post-randomisation defined as ‘worst chest pain over the last week’ equating to a visual analogue score greater than or equal to 40 mm indicating at least a moderate level of pain. Secondary outcomes include acute pain, complications of regional analgesia and surgery, health-related quality of life, mortality and a health economic analysis. Discussion Both TEB and PVB have been demonstrated to be effective in the prevention of acute pain following thoracotomy and nationally practice is divided. Identification of which mode of analgesia is both clinically and cost-effective in preventing chronic post-thoracotomy pain could ameliorate the debilitating effects of chronic pain, improving health-related quality of life, facilitating return to work and caring responsibilities and resulting in a cost saving to the NHS. Trial registration NCT03677856 [ClinicalTrials.gov] registered September 19, 2018. https://clinicaltrials.gov/ct2/show/NCT03677856 . First patient recruited 8 January 2019.
Published: 2023
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4. Feasibility of 2-dimensional speckle tracking echocardiography strain analysis of the right ventricle with trans-thoracic echocardiography in intensive care: a literature review and meta-analysis

Author: James McErlane, Ben Shelley, and Philip McCall
Subjects: Right ventricle, Echocardiography, Speckle tracking, Feasibility, Intensive care, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Objectives To identify variables that affect the feasibility of 2-dimensional right ventricular speckle tracking echocardiography (RV-STE) in the intensive care unit. Background Trans-thoracic echocardiography (TTE) of the right ventricle is challenging. RV-STE is a novel echocardiography method thought to measure global RV function more fully than conventional TTE parameters. The feasibility of RV-STE in ICU populations has not been well described, and variables influencing RV-STE in ICU have not been investigated. This study aimed to address this. Methods A literature review using Ovid MEDLINE(R) was undertaken. We performed meta-analysis with subgroup analysis of; RV-STE type (RV free-wall [RVFWLS] versus RV global longitudinal strain [RVGLS]), study design (prospective versus retrospective), coronavirus disease-19 (COVID-19) study or not, and strain software used. This was followed by meta-regression of proportion of invasive mechanical ventilation (IMV), with and without COVID-19 studies as a co-variate. Results Eleven relevant studies from the literature search were identified, reporting an overall feasibility of RV-STE of 83.3% (95%CI 74.6–89.4%). Prospective study design was associated with higher feasibility compared with retrospective studies (p = 0.02). There were no statistical differences on univariate analysis between RVFWLS versus RVGLS, COVID-19 study or not, or strain software used. Meta-regression with COVID-19 study as a covariate demonstrated that higher proportions of IMV were significantly associated with worse feasibility (p = 0.04), as were COVID-19 studies (p
Published: 2023
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5. Right ventricular free wall longitudinal strain is independently associated with mortality in mechanically ventilated patients with COVID-19

Author: James McErlane, Philip McCall, Jennifer Willder, Colin Berry, Ben Shelley, and the COVID-RV investigators
Subjects: Right ventricle, Speckle tracking echocardiography, Coronavirus disease 2019, Mechanical ventilation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Right ventricular (RV) dysfunction has been commonly reported in patients with Coronavirus disease 2019 (COVID-19), and is associated with mortality in mixed cohorts of patients requiring and not requiring invasive mechanical ventilation (IMV). Using RV-speckle tracking echocardiography (STE) strain analysis, we aimed to identify the prevalence of RV dysfunction (diagnosed by abnormal RV-STE) in patients with COVID-19 that are exclusively undergoing IMV, and assess association between RV dysfunction and 30 day mortality. We performed a prospective multicentre study across 10 ICUs in Scotland from 2/9/20 to 22/3/21. One-hundred-and-four echocardiography scans were obtained from adult patients at a single timepoint between 48 h after intubation, and day 14 of intensive care unit admission. We analysed RV-STE using RV free-wall longitudinal strain (RVFWLS), with an abnormal cutoff of > −20%. We performed survival analysis using Kaplan–Meier, log rank, and multivariate cox-regression (prespecified covariates were age, gender, ethnicity, severity of illness, and time since intubation). Results Ninety-four/one-hundred-and-four (90.4%) scans had images adequate for RVFWLS. Mean RVFWLS was −23.0% (5.2), 27/94 (28.7%) of patients had abnormal RVFWLS. Univariate analysis with Kaplan–Meier plot and log-rank demonstrated that patients with abnormal RVFWLS have a significant association with 30-day mortality (p = 0.047). Multivariate cox-regression demonstrated that abnormal RVFWLS is independently associated with 30-day mortality (Hazard-Ratio 2.22 [1.14–4.39], p = 0.020). Conclusions Abnormal RVFWLS (> −20%) is independently associated with 30-day mortality in patients with COVID-19 undergoing IMV. Strategies to prevent RV dysfunction, and treatment when identified by RVFWLS, may be of therapeutic benefit to these patients. Trial Registration: Retrospectively registered 21st Feb 2021. ClinicalTrials.gov Identifier: NCT04764032.
Published: 2022
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6. Outcome following unplanned critical care admission after lung resectionCentral MessagePerspective

Author: Ben Shelley, MBChB, DipPaed, FRCA, FFICM, MD, Philip McCall, MBChB, FRCA, MD, Adam Glass, MB, BCh, BAO, FRCA, Izabella Orzechowska, MSc, and Andrew Klein, MBBS, FRCA
Subjects: critical care, lung resection, thoracic surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract: Objective(s): Patients undergoing lung resection are at risk of perioperative complications, many of which necessitate unplanned critical care unit admission in the postoperative period. We sought to characterize this population, providing an up-to-date estimate of the incidence of unplanned critical care admission, and to assess critical care and hospital stay, resource use, mortality, and outcomes. Methods: A multicenter retrospective cohort study of patients undergoing lung resection in participating UK hospitals over 2 years. A comprehensive dataset was recorded for each critical care admission (defined as the need for intubation and mechanical ventilation and/or renal replacement therapy), in addition to a simplified dataset in all patients undergoing lung resection during the study period. Multivariable regression analysis was used to identify factors independently associated with critical care outcome. Results: A total of 11,208 patients underwent lung resection in 16 collaborating centers during the study period, and 253 patients (2.3%) required unplanned critical care admission with a median duration of stay of 13 (4-28) days. The predominant indication for admission was respiratory failure (68.1%), with 77.8% of patients admitted during the first 7 days following surgery. Eighty-seven (34.4%) died in critical care. On multivariable regression, only the diagnosis of right ventricular dysfunction and the need for both mechanical ventilation and renal-replacement therapy were independently associated with critical care survival; this model, however, had poor predictive value. Conclusions: Although resource-intensive and subject to prolonged stay, following unplanned admission to critical care after lung resection outcomes are good for many patients; 65.6% of patients survived to hospital discharge, and 62.7% were discharged to their own home.
Published: 2022
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7. Comment on Propofol and survival: an updated meta-analysis of randomized clinical trials

Author: Adam Glass, Philip McCall, and Ben Shelley
Subjects: Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published: 2023
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8. The utility of transthoracic echocardiographic measures of right ventricular systolic function in a lung resection cohort

Author: Philip McCall, Alvin Soosay, John Kinsella, Piotr Sonecki, and Ben Shelley
Subjects: right ventricle, speckle tracked strain, cardiovascular magnetic resonance imaging, lung resection, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Right ventricular (RV) dysfunction occurs following lung resection and is associated with post-operative complications and long-term functional morbidity. Accurate peri-operative assessment of RV function would have utility in this population. The difficulties of transthoracic echocardiographic (TTE) assessment of RV function may be compounded following lung resection surgery, and no parameters have been validated in this patient group. This study compares conventional TTE methods for assessing RV systolic function to a reference method in a lung resection population. Right ventricular index of myocardial performance (RIMP), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE) and S′ wave velocity at the tricuspid annulus (S′), along with speckle tracked global and free wall longitudinal strain (RV-GPLS and RV-FWPLS respectively) are compared with RV ejection fraction obtained by cardiovascular magnetic resonance (RVEFCMR). Twenty-seven patients undergoing lung resection underwent contemporaneous CMR and TTE imaging; pre-operatively, on post-operative day two and at 2 months. Ability of each of the parameters to predict RV dysfunction (RVEFCMR 0.05). TAPSE performed marginally better with an AUROCC of 0.65 (P = 0.04). RV-GPLS and RV-FWPLS demonstrated good predictive ability with AUROCC’s of 0.74 and 0.76 respectively (P < 0.01 for both). This study demonstrates that the conventional TTE parameters of RV systolic function are inadequate following lung resection. Longitudinal strain performs better and offers some ability to determine poor RV function in this challenging population.
Published: 2019
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9. Anesthesia for thoracic surgery: A survey of middle eastern practice

Author: Abdelazeem Eldawlatly, Ahmed Turkistani, Ben Shelley, Mohamed El-Tahan, Alistair Macfie, John Kinsella, and Thoracic-anaesthesia Group Collaborators
Subjects: Middle east, survey, thoracic anesthesia, Anesthesiology, RD78.3-87.3
Abstract: Purpose: The main objective of this survey is to describe the current practice of thoracic anesthesia in the Middle Eastern (ME) region. Methods: A prospective online survey. An invitation to participate was e-mailed to all members of the ME thoracic-anaesthesia group. A total of 58 members participated in the survey from 19 institutions in the Middle East. Questions concerned ventilation strategies during one-lung ventilation (OLV), anesthesia regimen, mode of postoperative analgesia, use of lung isolation techniques, and use of i.v. fluids. Results: Volume-controlled ventilation was favored over pressure-controlled ventilation (62% vs 38% of respondents, P
Published: 2012
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10. Perioperative cardiovascular pathophysiology in patients undergoing lung resection surgery: a narrative review

Author: Ben Shelley, Adam Glass, Thomas Keast, James McErlane, Cara Hughes, Brian Lafferty, Nandor Marczin, and Philip McCall
Subjects: Postoperative Complications, Anesthesiology and Pain Medicine, Ventricular Dysfunction, Right, Hemodynamics, Humans, Thoracic Surgical Procedures, Lung
Abstract: Although thoracic surgery is understood to confer a high risk of postoperative respiratory complications, the substantial haemodynamic challenges posed are less well appreciated. This review highlights the influence of cardiovascular comorbidity on outcome, reviews the complex pathophysiological changes inherent in one-lung ventilation and lung resection, and examines their influence on cardiovascular complications and postoperative functional limitation. There is now good evidence for the presence of right ventricular dysfunction postoperatively, a finding that persists to at least 3 months. This dysfunction results from increased right ventricular afterload occurring both intraoperatively and persisting postoperatively. Although many patients adapt well, those with reduced right ventricular contractile reserve and reduced pulmonary vascular flow reserve might struggle. Postoperative right ventricular dysfunction has been implicated in the aetiology of postoperative atrial fibrillation and perioperative myocardial injury, both common cardiovascular complications which are increasingly being appreciated to have impact long into the postoperative period. In response to the physiological demands of critical illness or exercise, contractile reserve, flow reserve, or both can be overwhelmed resulting in acute decompensation or impaired long-term functional capacity. Aiding adaptation to the unique perioperative physiology seen in patients undergoing thoracic surgery could provide a novel therapeutic avenue to prevent cardiovascular complications and improve long-term functional capacity after surgery.
Published: 2023
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11. The Effect of an Accelerated Renal Replacement Therapy Initiation Is Not Modified by Baseline Risk

Author: Federico Angriman, Bruno L. Ferreyro, Natalia Angeloni, Bruno R. da Costa, Ron Wald, Sean M. Bagshaw, Neill K.J. Adhikari, Rinaldo Bellomo, Didier Dreyfuss, Bin Du, Martin P. Gallagher, Stéphane Gaudry, François Lamontagne, Michael Joannidis, Kathleen D. Liu, Daniel F. McAuley, Shay P. McGuinness, Alistair D. Nichol, Marlies Ostermann, Paul M. Palevsky, Haibo Qiu, Ville Pettilä, Antoine G. Schneider, Orla M. Smith, Suvi T. Vaara, Matthew Weir, Glenn M. Eastwood, Leah Peck, Helen Young, Peter Kruger, Gordon Laurie, Emma Saylor, Jason Meyer, Ellen Venz, Krista Wetzig, Craig French, Forbes McGain, John Mulder, Gerard Fennessy, Sathyajith Koottayi, Samantha Bates, Miriam Towns, Rebecca Morgan, Anna Tippett, Andrew Udy, Chris Mason, Elisa Licari, Dashiell Gantner, Jason McClure, Alistair Nichol, Phoebe McCracken, Jasmin Board, Emma Martin, Shirley Vallance, Meredith Young, Chelsey Vladic, Steve McGloughlin, David Gattas, Heidi Buhr, Jennifer Coles, Debra Hutch, James Wun, Louise Cole, Christina Whitehead, Julie Lowrey, Kristy Masters, Rebecca Gresham, Victoria Campbell, David Gutierrez, Jane Brailsford, Loretta Forbes, Lauren Murray, Teena Maguire, Martina NiChonghaile, Neil Orford, Allison Bone, Tania Elderkin, Tania Salerno, Tim Chimunda, Jason Fletcher, Emma Broadfield, Sanjay Porwal, Cameron Knott, Catherine Boschert, Julie Smith, Angus Richardson, Dianne Hill, Graeme Duke, Peter Oziemski, Santiago Cegarra, Peter Chan, Deborah Welsh, Stephanie Hunter, Owen Roodenburg, John Dyett, Nicos Kokotsis, Max Moser, Yang Yang, Laven Padayachee, Joseph Vetro, Himangsu Gangopadhyay, Melissa Kaufman, Angaj Ghosh, Simone Said, Alpesh Patel, Shailesh Bihari, Elisha Matheson, Xia Jin, Tapaswi Shrestha, Kate Schwartz, Rosalba Cross, Winston Cheung, Helen Wong, Mark Kol, Asim Shah, Amanda Y. Wang, Zoltan Endre, Celia Bradford, Pierre Janin, Simon Finfer, Naomi Diel, Jonathan Gatward, Naomi Hammond, Anthony Delaney, Frances Bass, Elizabeth Yarad, Hergen Buscher, Claire Reynolds, Nerilee Baker, Romuald Bellmann, Andreas Peer, Julia Hasslacher, Paul Koglberger, Sebastian Klein, Klemens Zotter, Anna Brandtner, Armin Finkenstedt, Adelheid Ditlbacher, Frank Hartig, Dietmar Fries, Mirjam Bachler, Bettina Schenk, Martin Wagner, Philipp Eller, Thomas Staudinger, Esther Tiller, Peter Schellongowski, Andja Bojic, Eric A. Hoste, Stephanie Bracke, Luc De Crop, Daisy Vermeiren, Fernando Thome, Bianca Chiella, Lucia Fendt, Veronica Antunes, Frédérick D'Aragon, Charles St-Arnaud, Michael Mayette, Élaine Carbonnaeu, Joannie Marchand, Marie-Hélène Masse, Marilène Ladouceur, Alexis F. Turgeon, François Lauzier, David Bellemare, Charles Langis Francoeur, Guillaume LeBlanc, Gabrielle Guilbault, Stéphanie Grenier, Eve Cloutier, Annick Boivin, Charles Delisle-Thibault, Panagiota Giannakouros, Olivier Costerousse, Jean-François Cailhier, François-Martin Carrier, Ali Ghamraoui, Martine Lebrasseur, Fatna Benettaib, Maya Salamé, Dounia Boumahni, Ying Tung Sia, Jean-François Naud, Isabelle Roy, Henry T. Stelfox, Stacey Ruddell, Braden J. Manns, Shelley Duggan, Dominic Carney, Jennifer Barchard, Richard P. Whitlock, Emilie Belley-Cote, Nevena Savija, Alexandra Sabev, Troy Campbell, Thais Creary, Kelson Devereaux, Shira Brodutch, Claudio Rigatto, Bojan Paunovic, Owen Mooney, Anna Glybina, Oksana Harasemiw, Michelle Di Nella, John Harmon, Navdeep Mehta, Louis Lakatos, Nicole Haslam, Francois Lellouche, Mathieu Simon, Ying Tung, Patricia Lizotte, Pierre-Alexandre Bourchard, Bram Rochwerg, Tim Karachi, Tina Millen, John Muscedere, David Maslove, J. Gordon Boyd, Stephanie Sibley, John Drover, Miranda Hunt, Ilinca Georgescu, Randy Wax, Ilan Lenga, Kavita Sridhar, Andrew Steele, Kelly Fusco, Taneera Ghate, Michael Tolibas, Holly Robinson, Matthew A. Weir, Ravi Taneja, Ian M. Ball, Amit Garg, Eileen Campbell, Athena Ovsenek, Sean van Diepen, Nadia Baig, Sheldon Magder, Han Yao, Ahsan Alam, Josie Campisi, Erika MacIntyre, Ella Rokosh, Kimberly Scherr, Stephen Lapinsky, Sangeeta Mehta, Sumesh Shah, Daniel J. Niven, Michael Russell, Kym Jim, Gillian Brown, Kerry Oxtoby, Adam Hall, Luc Benoit, Colleen Sokolowski, Bhanu Prasad, Jag Rao, Shelley Giebel, Demetrios J. Kutsogiannis, Patricia Thompson, Tayne Thompson, Robert Cirone, Kanthi Kavikondala, Mark Soth, France Clarke, Alyson Takaoka, David Mazer, Karen Burns, Jan Friedrich, David Klein, Gyan Sandhu, Marlene Santos, Imrana Khalid, Jennifer Hodder, Peter Dodek, Najib Ayas, Victoria Alcuaz, Gabriel Suen, Oleksa Rewa, Gurmeet Singh, Sean Norris, Neil Gibson, Castro Arias, Aysha Shami, Celine Pelletier, Alireza Zahirieh, Andre Amaral, Nicole Marinoff, Navjot Kaur, Adic Perez, Jane Wang, Gregory Haljan, Christopher Condin, Lauralyn McIntyre, Brigette Gomes, Rebecca Porteous, Irene Watpool, Swapnil Hiremath, Edward Clark, Margaret S. Herridge, Felicity Backhouse, M. Elizabeth Wilcox, Karolina Walczak, Vincent Ki, Asheer Sharman, Martin Romano, R.T. Noel Gibney, Adam S. Romanovsky, Lorena McCoshen, Gordon Wood, Daniel Ovakim, Fiona Auld, Gayle Carney, Meili Duan, Xiaojun Ji, Dongchen Guo, Zhili Qi, Jin Lin, Meng Zhang, Lei Dong, Jingfeng Liu, Pei Liu, Deyuan Zhi, Guoqiang Bai, Yu Qiu, Ziqi Yang, Jing Bai, Zhuang Liu, Haizhou Zhuang, Haiman Wang, Jian Li, Mengya Zhao, Xiao Zhou, Xianqing Shi, Baning Ye, Manli Liu, Jing Wu, Yongjian Fu, Dali Long, Yu Pan, Jinlong Wang, Huaxian Mei, Songsong Zhang, Mingxiang Wen, Enyu Yang, Sijie Mu, Jianquan Li, Tingting Hu, Bingyu Qin, Min Li, Cunzhen Wang, Xin Dong, Kaiwu Wang, Haibo Wang, Jianxu Yang, Chuanyao Wang, Dongxin Wang, Nan Li, Zhui Yu, Song Xu, Lan Yao, Guo Hou, Zhou Liu, Liping Lu, Yingtao Lian, Chunting Wang, Jichen Zhang, Ruiqi Ding, Guoqing Qi, Qizhi Wang, Peng Wang, Zhaoli Meng, Man Chen, Xiaobo Hu, Xiandi He, Shibing Zhao, Lele Hang, Rui Li, Suhui Qin, Kun Lu, Shijuan Dun, Cheng Liu, Qi Zhou, Zhenzhen Chen, Jing Mei, Minwei Zhang, Hao Xu, Jincan Lin, Qindong Shi, Lijuan Fu, Qinjing Zeng, Hongye Ma, Jinqi Yan, Lan Gao, Hongjuan Liu, Lei Zhang, Hao Li, Xiaona He, Jingqun Fan, Litao Guo, Yu Liu, Xue Wang, Jingjing Sun, Zhongmin Liu, Juan Yang, Lili Ding, Lulu Sheng, Xingang Liu, Jie Yan, Quihui Wang, Yifeng Wang, Dan Zhao, Shuangping Zhao, Chenghuan Hu, Jing Li, Fuxing Deng, Haibo Qui, Yi Yang, Min Mo, Chun Pan, Changde Wu, Yingzi Huang, Lili Huang, Airan Liu, Anna-Maija Korhonen, Sanna Törnblom, Sari Sutinen, Leena Pettilä, Jonna Heinonen, Eliria Lappi, Taria Suhonen, Sari Karlsson, Sanna Hoppu, Ville Jalkanen, Anne Kuitunen, Markus Levoranta, Jaakko Långsjö, Sanna Ristimäki, Kaisa Malila, Anna Wootten, Simo Varila, Mikko J Järvisalo, Outi Inkinen, Satu Kentala, Keijo Leivo, Paivi Haltia, Jean-Damien Ricard, Jonathan Messika, Abirami Tiagarajah, Malo Emery, Aline Dechanet, Coralie Gernez, Damien Roux, Laurent Martin-Lefevre, Maud Fiancette, Isabelle Vinatier, Jean Claude Lacherade, Gwenhaël Colin, Christine Lebert, Marie-Ange Azais, Aihem Yehia, Caroline Pouplet, Matthieu Henry- Lagarrigue, Amélie Seguin, Laura Crosby, Julien Maizel, Dimitri Titeca-Beauport, Alain Combes, Ania Nieszkowska, Paul Masi, Alexandre Demoule, Julien Mayaux, Martin Dres, Elise Morawiec, Maxens Decalvele, Suela Demiri, Morgane Faure, Clémence Marios, Maxime Mallet, Marie Amélie Ordon, Laura Morizot, Marie Cantien, François Pousset, Florent Poirson, Yves Cohen, Laurent Argaud, Martin Cour, Laurent Bitker, Marie Simon, Romain Hernu, Thomas Baudry, Sylvie De La Salle, Adrien Robine, Nicholas Sedillot, Xavier Tchenio, Camille Bouisse, Sylvie Roux, Fabienne Tamion, Steven Grangé, Dorothée Carpentier, Guillaume Chevrel, Luis Ensenyat-Martin, Sophie Marque, Jean-Pierre Quenot, Pascal Andreu, Auguste Dargent, Audrey Large, Nicolas Chudeau, Mickael Landais, Benoit Derrien, Jean Christophe Callahan, Christophe Guitton, Charlène Le Moal, Alain Robert, Karim Asehnoune, Raphaël Cinotti, Nicolas Grillot, Dominique Demeure, Christophe Vinsonneau, Imen Rahmani, Mehdi Marzouk, Thibault Dekeyser, Caroline Sejourne, Mélanie Verlay, Fabienne Thevenin, Lucie Delecolle, Didier Thevenin, Bertrand Souweine, Elisabeth Coupez, Mireille Adda, Jean-Pierre Eraldi, Antoine Marchalot, Nicolas De Prost, Armand Mekontso Dessap, Keyvan Razazi, Ferhat Meziani, Julie Boisrame-Helms, Raphael Clere-Jehl, Xavier Delabranche, Christine Kummerlen, Hamid Merdji, Alexandra Monnier, Yannick Rabouel, Hassene Rahmani, Hayat Allam, Samir Chenaf, Vincenta Franja, Bertrand Pons, Michel Carles, Frédéric Martino, Régine Richard, Benjamin Zuber, Guillaume Lacave, Karim Lakhal, Bertrand Rozec, Hoa Dang Van, Éric Boulet, Fouad Fadel, Cedric Cleophax, Nicolas Dufour, Caroline Grant, Marie Thuong, Jean Reignier, Emmanuel Canet, Laurent Nicolet, Thierry Boulain, Mai-Anh Nay, Dalila Benzekri, François Barbier, Anne Bretagnol, Toufik Kamel, Armelle Mathonnet, Grégoire Muller, Marie Skarzynski, Julie Rossi, Amandine Pradet, Sandra Dos Santos, Aurore Guery, Lucie Muller, Luis Felix, Julien Bohé, Guillaume Thiéry, Nadia Aissaoui, Damien Vimpere, Morgane Commeureuc, Jean-Luc Diehl, Emmanuel Guerot, Orfeas Liangos, Monika Wittig, Alexander Zarbock, Mira Küllmar, Thomas van Waegeningh, Nadine Rosenow, Kathy Brickell, Peter Doran, Patrick T. Murray, Giovanni Landoni, Rosalba Lembo, Alberto Zangrillo, Giacomo Monti, Margherita Tozzi, Matteo Marzaroli, Gaetano Lombardi, Gianluca Paternoster, Michelangelo Vitiello, Shay McGuinness, Rachael Parke, Magdalena Butler, Eileen Gilder, Keri-Anne Cowdrey, Samantha Wallace, Jane Hallion, Melissa Woolett, Philippa Neal, Karina Duffy, Stephanie Long, Colin McArthur, Catherine Simmonds, Yan Chen, Rachael McConnochie, Lynette Newby, David Knight, Seton Henderson, Jan Mehrtens, Stacey Morgan, Anna Morris, Kymbalee Vander Hayden, Tara Burke, Matthew Bailey, Ross Freebairn, Lesley Chadwick, Penelope Park, Christine Rolls, Liz Thomas, Ulrike Buehner, Erin Williams, Jonathan Albrett, Simon Kirkham, Carolyn Jackson, Troy Browne, Jennifer Goodson, David Jackson, James Houghton, Owen Callender, Vicki Higson, Owen Keet, Clive Dominy, Paul Young, Anna Hunt, Harriet Judd, Cassie Lawrence, Shaanti Olatunji, Yvonne Robertson, Charlotte Latimer-Bell, Deborah Hendry, Agnes Mckay-Vucago, Nina Beehre, Eden Lesona, Leanlove Navarra, Chelsea Robinson, Ryan Jang, Andrea Junge, Bridget Lambert, Michel Thibault, Philippe Eckert, Sébastien Kissling, Erietta Polychronopoulos, Elettra Poli, Marco Altarelli, Madeleine Schnorf, Samia Abed Mallaird, Claudia Heidegger, Aurelie Perret, Philippe Montillier, Frederic Sangla, Seigenthaller Neils, Aude De Watteville, Mandeep-Kaur Phull, Aparna George, Nauman Hussain, Tatiana Pogreban, Steve Lobaz, Alison Daniels, Mishell Cunningham, Deborah Kerr, Alice Nicholson, Pradeep Shanmugasundaram, Judith Abrams, Katarina Manso, Geraldine Hambrook, Elizabeth McKerrow, Juvy Salva, Stephen Foulkes, Matthew Wise, Matt Morgan, Jenny Brooks, Jade Cole, Tracy Michelle Davies, Helen Hill, Emma Thomas, Marcela Vizcaychipi, Behrad Baharlo, Jaime Carungcong, Patricia Costa, Laura Martins, Ritoo Kapoor, Tracy Hazelton, Angela Moon, Janine Musselwhite, Ben Shelley, Philip McCall, Gill Arbane, Aneta Bociek, Martina Marotti, Rosario Lim, Sara Campos, Neus Grau Novellas, Armando Cennamo, Andrew Slack, Duncan Wyncoll, Luigi Camporota, Simon Sparkes, Rosalinde Tilley, Austin Rattray, Gayle Moreland, Jane Duffy, Elizabeth McGonigal, Philip Hopkins, Clare Finney, John Smith, Harriet Noble, Hayley Watson, Claire-Louise Harris, Emma Clarey, Eleanor Corcoran, James Beck, Clare Howcroft, Nora Youngs, Elizabeth Wilby, Bethan Ogg, Adam Wolverson, Sandra Lee, Susie Butler, Maryanne Okubanjo, Julia Hindle, Ingeborg Welters, Karen Williams, Emily Johnson, Julie Patrick-Heselton, David Shaw, Victoria Waugh, Richard Stewart, Esther Mwaura, Lynn Wren, Louise Mew, Sara-Beth Sutherland, Jane Adderley, Jim Ruddy, Margaret Harkins, Callum Kaye, Teresa Scott, Wendy Mitchell, Felicity Anderson, Fiona Willox, Vijay Jagannathan, Michele Clark, Sarah Purv, Andrew Sharman, Megan Meredith, Lucy Ryan, Louise Conner, Cecilia Peters, Dan Harvey, Ashraf Roshdy, Amy Collins, Malcolm Sim, Steven Henderson, Nigel Chee, Sally Pitts, Katie Bowman, Maria Dilawershah, Luke Vamplew, Elizabeth Howe, Paula Rogers, Clara Hernandez, Clara Prendergast, Jane Benton, Alex Rosenberg, Lui G. Forni, Alice Grant, Paula Carvelli, Ajay Raithatha, Sarah Bird, Max Richardson, Matthew Needham, Claire Hirst, Jonathan Ball, Susannah Leaver, Luisa Howlett, Carlos Castro Delgado, Sarah Farnell-Ward, Helen Farrah, Geraldine Gray, Gipsy Joseph, Francesca Robinson, Ascanio Tridente, Clare Harrop, Karen Shuker, Derek McLaughlan, Judith Ramsey, Sharon Meehan, Bernd Oliver Rose, Rosie Reece-Anthony, Babita Gurung, Tony Whitehouse, Catherine Snelson, Tonny Veenith, Andy Johnston, Lauren Cooper, Ron Carrera, Karen Ellis, Emma Fellows, Samanth Harkett, Colin Bergin, Elaine Spruce, Liesl Despy, Stephanie Goundry, Natalie Dooley, Tracy Mason, Amy Clark, Gemma Dignam, Geraldine Ward, Ben Attwood, Penny Parsons, Sophie Mason, Michael Margarson, Jenny Lord, Philip McGlone, Luke E. Hodgson, Indra Chadbourn, Raquel Gomez, Jordi Margalef, Rinus Pretorius, Alexandra Hamshere, Joseph Carter, Hazel Cahill, Lia Grainger, Kate Howard, Greg Forshaw, Zoe Guy, Kianoush B. Kashani, Robert C. Albright, Amy Amsbaugh, Anita Stoltenberg, Alexander S. Niven, Matthew Lynch, AnnMarie O'Mara, Syed Naeem, Sairah Sharif, Joyce McKenney Goulart, Ashita Tolwani, Claretha Lyas, Laura Latta, Azra Bihorac, Haleh Hashemighouchani, Philip Efron, Matthew Ruppert, Julie Cupka, Sean Kiley, Joshua Carson, Peggy White, George Omalay, Sherry Brown, Laura Velez, Alina Marceron, Javier A. Neyra, Juan Carlos Aycinena, Madona Elias, Victor M. Ortiz-Soriano, Caroline Hauschild, and Robert Dorfman
Subjects: Renal Replacement Therapy, Pulmonary and Respiratory Medicine, Critical Illness, Medicine and Health Sciences, Humans, Acute Kidney Injury
Published: 2022
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12. Feasibility of right ventricular free wall longitudinal strain assessment of contractile reserve in patients undergoing lung resection

Author: James McErlane, Adam Glass, Alvin Soosay, Philip McCall, and Ben Shelley
Subjects: Anesthesiology and Pain Medicine
Published: 2023
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13. Thoracic anaesthetic research: 90 years of sustained progress

Author: Ben Shelley, Marc Licker, and Peter Slinger
Subjects: Anesthesiology and Pain Medicine
Abstract: Over the 90 years since the first description of one-lung ventilation, the practice of thoracic surgery and anaesthesia continues to develop. Minimally invasive surgical techniques are increasingly being used to minimise the surgical insult and facilitate improved outcomes. Challenging these outcomes, however, are parallel changes in patient characteristics with more older and sicker patients undergoing surgery. Thoracic anaesthesia as a speciality continues to respond to these challenges with evolution of practice and strong academic performance.
Published: 2022

14. Corrigendum to ‘Impaired systemic oxygen extraction long after mild COVID-19: potential perioperative implications’ (Br J Anaesth 2022; 128: e246–9)

Author: Paul M. Heerdt, Ben Shelley, and Inderjit Singh
Subjects: Anesthesiology and Pain Medicine
Published: 2022
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15. Do we have the 'power' to 'drive' down the incidence of pulmonary complications after thoracic surgery

Author: Ben Shelley and Nandor Marczin
Subjects: Positive-Pressure Respiration, Anesthesiology and Pain Medicine, Postoperative Complications, Incidence, Tidal Volume, Humans, Thoracic Surgery, Thoracic Surgical Procedures, Respiration, Artificial, One-Lung Ventilation
Abstract: The concept, mechanisms, and physical and physiological determinants of ventilator-induced lung injury, as well as the influence of lung-protective ventilation strategies, are novel paradigms of modern intensive care and perioperative medicine. Driving pressure and mechanical power have emerged as meaningful and modifiable targets with specific relevance to thoracic anaesthesia and one-lung ventilation. The relationship between these factors and postoperative pulmonary complications remains complex because of the methodological design and outcome selection. Larger observational studies are required to better understand the characteristics of driving pressure and power in current practice of thoracic anaesthesia in order to design future trials in high-risk thoracic populations at risk of acute lung injury.
Published: 2022

16. Pulmonary artery wave reflection and right ventricular function after lung resection

Author: Adam Glass, Philip McCall, Alex Arthur, Kenneth Mangion, and Ben Shelley
Subjects: Anesthesiology and Pain Medicine
Abstract: Lung resection has been shown to impair right ventricular function. Although conventional measures of afterload do not change, surgical ligation of a pulmonary artery branch, as occurs during lobectomy, can create a unilateral proximal reflection site, increasing wave reflection (pulsatile component of afterload) and diverting blood flow through the contralateral pulmonary artery. We present a cardiovascular magnetic resonance imaging (MRI) observational cohort study of changes in wave reflection and right ventricular function after lung resection.Twenty-seven patients scheduled for open lobectomy for suspected lung cancer underwent cardiovascular MRI preoperatively, on postoperative Day 2, and at 2 months. Wave reflection was assessed in the left and right pulmonary arteries (operative and non-operative, as appropriate) by wave intensity analysis and calculation of wave reflection index. Pulmonary artery blood flow distribution was calculated as percentage of total blood flow travelling in the non-operative pulmonary artery. Right ventricular function was assessed by ejection fraction and strain analysis.Operative pulmonary artery wave reflection increased from 4.3 (2.1-8.8) % preoperatively to 9.5 (4.9-14.9) % on postoperative Day 2 and 8.0 (2.3-11.7) % at 2 months (P0.001) with an associated redistribution of blood flow towards the nonoperative pulmonary artery (r0.523; P0.010). On postoperative Day 2, impaired right ventricular ejection fraction was associated with increased operative pulmonary artery wave reflection (r=-0.480; P=0.028) and pulmonary artery blood flow redistribution (r=-0.545; P=0.011). At 2 months, impaired right ventricular ejection fraction and right ventricular strain were associated with pulmonary artery blood flow redistribution (r=-0.634, P=0.002; r=0.540, P=0.017).Pulsatile afterload increased after lung resection. The unilateral increase in operative pulmonary artery wave reflection resulted in redistribution of blood flow through the nonoperative pulmonary artery and was associated with right ventricular dysfunction.NCT01892800.
Published: 2022

17. Book Review

Author: Edward Greenwood and Ben Shelley
Subjects: Anesthesiology and Pain Medicine
Published: 2023
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18. Right ventricular dysfunction in patients with <scp>COVID</scp> ‐19 pneumonitis: replies

Author: Ben Shelley and Philip McCall
Subjects: Anesthesiology and Pain Medicine, SARS-CoV-2, Ventricular Dysfunction, Right, Ventricular Function, Right, COVID-19, Humans, Pneumonia
Published: 2022
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19. Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Author: Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J, Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J,Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Schultz, Marcus, J, Servillo, G, Vargas, M, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Graduate School, AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, AII - Inflammatory diseases, ACS - Heart failure & arrhythmias, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, APH - Global Health, ACS - Diabetes & metabolism, ACS - Microcirculation, Marcus, J (LAS VEGAS study investigator, the PROVE Network and the Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Beretta, L, and Landoni, G
Subjects: Adult, Male, medicine.medical_specialty, Intra operative, health care facilities, manpower, and services, [SDV]Life Sciences [q-bio], Critical Illness, Las Vegas Study, Article, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, Tidal Volume, medicine, Humans, General anaesthesia, Lung, Tidal volume, Female, Respiration, Artificial, Sex Characteristics, Las vegas, business.industry, Respiration, respiratory failure, sex, respiratory system, Sex difference, respiratory tract diseases, Anesthesiology and Pain Medicine, 030228 respiratory system, Relative risk, Artificial, Cohort, Breathing, Observational study, business, intra-operative tidal volume, circulatory and respiratory physiology
Abstract: BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as V(T) of 8 ml kg(−1) or less predicted bodyweight (PBW). A V(T) was deemed ‘default’ if the set V(T) was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V(T) was often set, both in women and men; mode V(T) was 500 ml. Median [IQR] V(T) was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(−1) PBW, P*** < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P*** < 0.001]. In the mediation analysis, patients’ height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V(T). CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V(T) than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223
Published: 2021
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20. The utility of transthoracic echocardiographic measures of right ventricular systolic function in a lung resection cohort

Author: P. McCall, Ben Shelley, Alvin Soosay, John Kinsella, and Piotr Sonecki
Subjects: lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, cardiovascular magnetic resonance imaging, Population, Systolic function, right ventricle, 030204 cardiovascular system & hematology, Free wall, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, education, speckle tracked strain, Advanced and Specialized Nursing, education.field_of_study, Ejection fraction, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Research, Magnetic resonance imaging, lcsh:RC666-701, lung resection, Cohort, Rv function, Cardiology, Lung resection, business
Abstract: Right ventricular (RV) dysfunction occurs following lung resection and is associated with post-operative complications and long-term functional morbidity. Accurate peri-operative assessment of RV function would have utility in this population. The difficulties of transthoracic echocardiographic (TTE) assessment of RV function may be compounded following lung resection surgery, and no parameters have been validated in this patient group. This study compares conventional TTE methods for assessing RV systolic function to a reference method in a lung resection population. Right ventricular index of myocardial performance (RIMP), fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE) and S′ wave velocity at the tricuspid annulus (S′), along with speckle tracked global and free wall longitudinal strain (RV-GPLS and RV-FWPLS respectively) are compared with RV ejection fraction obtained by cardiovascular magnetic resonance (RVEFCMR). Twenty-seven patients undergoing lung resection underwent contemporaneous CMR and TTE imaging; pre-operatively, on post-operative day two and at 2 months. Ability of each of the parameters to predict RV dysfunction (RVEFCMR P > 0.05). TAPSE performed marginally better with an AUROCC of 0.65 (P = 0.04). RV-GPLS and RV-FWPLS demonstrated good predictive ability with AUROCC’s of 0.74 and 0.76 respectively (P
Published: 2019
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21. Right Ventricular Dysfunction in Ventilated Patients with COVID-19 (COVID-RV)

Author: Philip McCall, Bethany Stanley, Claudia-Martina Messow, John Allan, Alex Puxty, Lisa Gemmell, Colin Berry, Ben Shelley, Dominic Strachan, and Jennifer Mary Willder
Subjects: Mechanical ventilation, ARDS, medicine.medical_specialty, biology, business.industry, medicine.drug_class, medicine.medical_treatment, medicine.disease, Troponin, Plateau pressure, Intensive care, Internal medicine, medicine, biology.protein, Natriuretic peptide, Breathing, Cardiology, business, Cohort study
Abstract: PurposeCOVID-19 is associated with cardiovascular complications, with right ventricular dysfunction (RVD) commonly reported. The combination of acute respiratory distress syndrome (ARDS), injurious invasive ventilation, micro/macro thrombi and the potential for direct myocardial injury create conditions where RVD is likely to occur. No study has prospectively explored the prevalence of RVD, and its association with mortality, in a cohort requiring mechanical ventilation.MethodsProspective, multi-centre, trans-thoracic echocardiographic, cohort study of ventilated patients with COVID-19 in Scottish intensive care units. RVD was defined as the presence of severe RV dilatation and interventricular septal flattening. To explore role of myocardial injury, high sensitivity troponin and N-terminal pro B-type natriuretic peptide (NT-proBNP) were measured in all patients.ResultsOne hundred and twenty-one patients were recruited to COVID-RV, 118 underwent imaging and it was possible to determine the primary outcome in 112. RVD was present in seven (6.2% [95%CI; 2.5%, 12.5%]) patients. Thirty-day mortality was 85.7% in those with RVD, compared to 44.8% in those without (p=0.051). Patients with RVD were more likely to have; pulmonary thromboembolism (pabnormal troponin (p=0.048). Abnormal NT-proBNP (OR 4.77 [1.22, 21.32], p=0.03) and abnormal Troponin (16.54 [4.98, 67.12], pConclusionCOVID-RV demonstrates a prevalence of RVD in ventilated patients with COVID-19 of 6.2% and is associated with a mortality of 85.7%. Association is observed between RVD and each of the aetiological domains of; ARDS, ventilation, micro/macro thrombi and myocardial injury.
Published: 2021
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22. Thoracic Anesthesia during the 2019 Novel Coronavirus Infection Pandemic: 2021 Updated Recommendations for Airway Management by the EACTAIC Thoracic Subspecialty Committee

Author: Radu Stoica, Maria-Jose Jiménez, Mohamed R. El Tahan, Ben Shelley, Edmond Cohen, Steffen Rex, Balazs Paloczi, Manuel Granell Gil, Federico Piccioni, Guido Di Gregorio, Nandor Marczin, Waheedullah Karzai, Marc-Joseph Licker, Gianluca Paternoster, Carmen Unzueta, Chirojit Mukherjee, Mert Şentürk, Ahmed Salaheldin Morsy, Fabio Guarracino, Massimiliano Sorbello, Davud Yapici, Johan Bence MBChB, J.M.J. Mourisse, Laszlo L Szegedi, Vojislava Neskovic, Paolo Pelosi, Patrick Wouters, Izumi Kawagoe, Caroline Vanpeteghem, Tamás Végh, A. Brunelli, Ricard Navarro-Ripoll, and Mojca Drnvsek-Globoikar
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Care, medicine.medical_treatment, coronavirus, Thoracic anesthesia, Subspecialty, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Special Article, Anesthesiology, Intensive care, Pandemic, medicine, Humans, Anesthesia, Lung cancer, Pandemics, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Infectious period, Anesthesiology and Pain Medicine, lung separation, personal protective equipment, Airway management, Cardiology and Cardiovascular Medicine, business
Abstract: Contains fulltext : 244115.pdf (Publisher’s version ) (Closed access) The novel coronavirus pandemic has radically changed the landscape of normal surgical practice. Lifesaving cancer surgery, however, remains a clinical priority, and there is an increasing need to fully define the optimal oncologic management of patients with varying stages of lung cancer, allowing prioritization of which thoracic procedures should be performed in the current era. Healthcare providers and managers should not ignore the risk of a bimodal peak of mortality in patients with lung cancer; an imminent spike due to mortality from acute coronavirus disease 2019 (COVID-19) infection, and a secondary peak reflecting an excess of cancer-related mortality among patients whose treatments were deemed less urgent, delayed, or cancelled. The European Association of Cardiothoracic Anaesthesiology and Intensive Care Thoracic Anesthesia Subspecialty group has considered these challenges and developed an updated set of expert recommendations concerning the infectious period, timing of surgery, vaccination, preoperative screening and evaluation, airway management, and ventilation of thoracic surgical patients during the COVID-19 pandemic.
Published: 2021

23. Letter to the editor: A call for pragmatic bedside assessment of RV function in COVID-19

Author: Ben Shelley, Jennifer Mary Willder, P. McCall, and James McErlane
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, business.industry, Ventricular Dysfunction, Right, COVID-19, Anesthesiology and Pain Medicine, Internal medicine, Rv function, Ventricular Function, Right, medicine, Cardiology, Humans, Cardiology and Cardiovascular Medicine, business, Letter to the Editor
Published: 2021

24. Dexamethasone in Hospitalized Patients with Covid-19

Author: Susara Blunden, Alexander Mentzer, Tom Dymond, Nazima Pathan, Sabrina Helena Rossi, Calum Robertson, Robert Heyderman, Stacy Todd, Richard Haynes, Ahmad Abu-Arafeh, William Ricketts, Davinder Dosanjh, Simon Drysdale, Danyal Jajbhay, Grant D. Stewart, Andrew Ustianowski, Jane Blazeby, Ashton Barnett-Vanes, Nicholas Kametas, Elizabeth Bancroft, Ankur Gupta-Wright, Hanif Esmail, Gerard McKnight, Catherine Harwood, Anthony De soyza, Tuck-Kay Loke, Mili Estee Torok, Wei Shen Lim, Vishal Dey, Brendan Payne, Charles Christoph Roehr, Dominic Crocombe, Imogen Skene, Ran Wang, Martin Landray, Anna Bibby, Jamie Brannigan, Søren Kudsk-Iversen, Kathryn Puxty, Katrina Cathie, Maheshi Nirmala Ramasamy, Alan Montgomery, Louis Grandjean, Xin Hui Chan, Ben Gibbison, Dinesh Saralaya, Omer Elneima, Natalie Blencowe, Eleanor Mishra, Henry HL Wu, Roy Soiza, Patrick Lillie, Christian Alexander Linares, Simon Tso, Benjamin Caplin, Sarah Burge, Sakib Rokadiya, Manish Patel, Jamie Cooper, Lee Hoggett, Gareth Jones, Matt Morgan, Alex Horsley, Saul Faust, Martin Llewelyn, Alex Scott, Kim Hinshaw, Arvind Nune, Effrossyni Gkrania-Klotsas, Elizabeth Whittaker, Shaman Jhanji, Chetan Parmar, Chris Imray, Kathryn Rowan, Christopher Green, Mark Peters, Eoin O'Sullivan, Pallav Shah, Paul Dark, Luke Hodgson, Ryan Malcolm Hum, Varun Sarodaya, Chris Brightling, Pilar Rivera Ortega, Jonathan Emberson, Lucy Chappell, Ben Shelley, Richard Adams, Joseph Barker, John Kenneth Baillie, Manu Vatish, Jaki, Thomas [0000-0002-1096-188X], Apollo - University of Cambridge Repository, University of St Andrews. School of Medicine, National Institute for Health Research, and UK Research and Innovation
Subjects: deksametazon, Male, medicine.medical_treatment, Anti-Infective Agents/therapeutic use, Administration, Oral, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Rate ratio, Dexamethasone, law.invention, 0302 clinical medicine, Randomized controlled trial, Anti-Infective Agents, RA0421, law, RA0421 Public health. Hygiene. Preventive Medicine, Odds Ratio, 030212 general & internal medicine, 11 Medical and Health Sciences, Aged, 80 and over, Respiratory Distress Syndrome, Covid19, 3rd-DAS, General Medicine, Covid-19 -- drug therapy, Multicenter Study, Hospitalization, Randomized Controlled Trial, Injections, Intravenous, Original Article, Steroids, Drug Therapy, Combination, Female, covid-19 -- terapija z zdravili, medicine.drug, Dexamethasone/administration & dosage, RM, medicine.medical_specialty, Randomization, dexamethasone, Lung injury, COVID-19/drug therapy, 03 medical and health sciences, SDG 3 - Good Health and Well-being, General & Internal Medicine, Internal medicine, Journal Article, udc:616.9, medicine, Humans, Comparative Study, Glucocorticoids, Aged, Mechanical ventilation, SARS-CoV-2, business.industry, Oxygen Inhalation Therapy, Glucocorticoids/administration & dosage, COVID-19, Odds ratio, NIS, Length of Stay, Respiration, Artificial, United Kingdom, RM Therapeutics. Pharmacology, COVID-19 Drug Treatment, RECOVERY Collaborative Group, Respiratory failure, business, Anaesthesia Pain and Critical Care
Abstract: Supported by a grant (MC_PC_19056) to the University of Oxford from the Medical Research Council of United Kingdom Research and Innovation and the National Institute for Health Research (NIHR); and by core funding provided by NIHR Oxford Biomedical Research Centre, Wellcome, the Bill and Melinda Gates Foundation, the Department for International Development, Health Data Research UK, the Medical Research Council Population Health Research Unit, the NIHR Health Protection Unit in Emerging and Zoonotic Infections, and NIHR Clinical Trials Unit Support Funding. Dr. Lim is supported by core funding provided by NIHR Nottingham Biomedical Research Centre, Dr. Felton by the NIHR Manchester Biomedical Research Centre, and Dr. Jaki by a grant (MC_UU_0002/14) from the UK Medical Research Council and by an NIHR Senior Research Fellowship (NIHR-SRF-2015-08-001). BACKGROUND: Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. METHODS: In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the final results of this assessment. RESULTS: A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P
Published: 2021
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25. Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19

Author: Susara Blunden, Alexander Mentzer, Tom Dymond, Robert Heyderman, Stacy Todd, Richard Haynes, Ahmad Abu-Arafeh, William Ricketts, Simon Drysdale, Danyal Jajbhay, Grant D. Stewart, Andrew Ustianowski, Jane Blazeby, Ashton Barnett-Vanes, Nicholas Kametas, Elizabeth Bancroft, Ankur Gupta-Wright, Hanif Esmail, Gerard McKnight, Catherine Harwood, Joe Fawke, Vivien Price, Tuck-Kay Loke, Kieran Nunn, Mili Estee Torok, Wei Shen Lim, Vishal Dey, Brendan Payne, Alexander Stockdale, Charles Christoph Roehr, Dominic Crocombe, Imogen Skene, Martin Landray, Anna Bibby, Jamie Brannigan, Padmasayee Papineni, Søren Kudsk-Iversen, Kathryn Puxty, Katrina Cathie, Maheshi Nirmala Ramasamy, Alan Montgomery, Louis Grandjean, Xin Hui Chan, Ben Gibbison, Cielito Caneja, Dinesh Saralaya, Omer Elneima, Charles Reynard, Natalie Blencowe, Eleanor Mishra, Henry HL Wu, Roy Soiza, Patrick Lillie, Paul Pfeffer, Christian Alexander Linares, Simon Tso, Benjamin Caplin, Sarah Burge, Sakib Rokadiya, Brunskill Nigel, Joel Tarning, Manish Patel, Jamie Cooper, Lee Hoggett, Nazima Pathan, Alex Horsley, Saul Faust, Martin Llewelyn, Alex Scott, Kim Hinshaw, Giorgio Calisti, Effrossyni Gkrania-Klotsas, Shaman Jhanji, Ben Burton, Anna Daunt, Chetan Parmar, Chris Imray, Christopher Green, Jonathan Underwood, Mark Peters, James A Watson, Eoin O'Sullivan, Pallav Shah, Paul Dark, Luke Hodgson, Ryan Malcolm Hum, Varun Sarodaya, Pilar Rivera Ortega, Jonathan Emberson, Ben Shelley, Richard Adams, Joseph Barker, John Kenneth Baillie, Manu Vatish, Tony Whitehouse, University of St Andrews. School of Medicine, Group, RECOVERY Collaborative, Jaki, Thomas [0000-0002-1096-188X], and Apollo - University of Cambridge Repository
Subjects: Male, medicine.medical_treatment, 030204 cardiovascular system & hematology, Rate ratio, law.invention, Pneumonia, viral/drug therapy, chloroquine, 0302 clinical medicine, Randomized controlled trial, law, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, klorokin, 030212 general & internal medicine, Treatment Failure, Middle aged, Coronavirus infections/drug therapy, Aged, 80 and over, Incidence (epidemiology), General Medicine, 3rd-DAS, Middle Aged, hidroksiklorokin, Antiviral Agents/adverse effects, Covid-19 -- drug therapy, Hospitalization, Doxycycline, Hydroxychloroquine/adverse effects, Original Article, Female, Coronavirus Infections, covid-19 -- terapija z zdravili, medicine.drug, Hydroxychloroquine, medicine.medical_specialty, RM, hydroxychloroquine, Pneumonia, Viral, Antiviral Agents, 03 medical and health sciences, Betacoronavirus, SDG 3 - Good Health and Well-being, Internal medicine, udc:616.9, medicine, Humans, Pandemics, Aged, Mechanical ventilation, business.industry, SARS-CoV-2, COVID-19, NIS, Interim analysis, Respiration, Artificial, Confidence interval, RM Therapeutics. Pharmacology, COVID-19 Drug Treatment, Treatment failure, Relative risk, Respiration, artificial, business
Abstract: Supported by a grant (MC_PC_19056) to the University of Oxford from UK Research and Innovation and the NIHR and by core funding provided by NIHR Oxford Biomedical Research Centre, Wellcome, the Bill and Melinda Gates Foundation, the Department for International Development, Health Data Research UK, the Medical Research Council Population Health Research Unit, the NIHR Health Protection Unit in Emerging and Zoonotic Infections, and NIHR Clinical Trials Unit Support Funding. BACKGROUND: Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials. METHODS: In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality. RESULTS: The enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P = 0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine. CONCLUSIONS: Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. Publisher PDF
Published: 2020
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26. Don't Forget the Right Ventricle

Author: Brian Lafferty, Philip McCall, and Ben Shelley
Subjects: medicine.medical_specialty, Heart Injury, Thoracic Surgical Procedure, business.industry, Incidence (epidemiology), MEDLINE, Surgery, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Ventricle, Cardiothoracic surgery, medicine, Cardiology and Cardiovascular Medicine, business
Published: 2020
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27. Management of the airway and lung isolation for thoracic surgery during the COVID‐19 pandemic: a reply

Author: Ben Shelley, M. Thornton, D. Reid, and M. Steven
Subjects: 2019-20 coronavirus outbreak, medicine.medical_specialty, Lung, Coronavirus disease 2019 (COVID-19), Isolation (health care), SARS-CoV-2, business.industry, Pneumonia, Viral, COVID-19, Thoracic Surgery, One-Lung Ventilation, Surgery, Betacoronavirus, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Cardiothoracic surgery, Correspondence, Pandemic, medicine, Humans, Coronavirus Infections, Airway, business, Pandemics
Published: 2020
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28. Thoracic Anesthesia of Patients With Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the European Association of Cardiothoracic Anaesthesiology Thoracic Subspecialty Committee

Author: J.M.J. Mourisse, Ricard Navarro, Steffen Rex, Nandor Marczin, W. Karzai, Ahmed Salaheldeen, Gianluca Paternoster, Ben Shelley, Chirojit Mukherjee, Federico Piccioni, Vojislava Neskovic, Edmond Cohen, Tamás Végh, Mohamed R. El Tahan, Carmen Unzueta, Paolo Pelosi, Patrick Wouters, Caroline Vanpeteghem, Laszlo L Szegedi, Marc Licker, Mert Şentürk, Izumi Kawagoe, Massimiliano Sorbello, Fabio Guarracino, Johan Bence, Davud Yapici, Manuel Granell Gil, Jiménez Mj, Guido Di Gregorio, Mojca Drnovsek Globokar, Radu Stoica, and Balazs Paloczi
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Advisory Committees, coronavirus, Subspecialty, medicine.disease_cause, Cardiac Procedures, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Betacoronavirus, Anesthesiology, Pandemic, medicine, Humans, Anesthesia, Viral, Airway Management, Pandemics, Coronavirus, thoracic anesthesia, business.industry, COVID-19, Pneumonia, lung separation, personal protective equipment, Anesthesia, Cardiac Procedures, Coronavirus Infections, Europe, Pneumonia, Viral, Practice Guidelines as Topic, Anesthesiology and Pain Medicine, Cardiothoracic surgery, Infected patient, Airway management, Cardiology and Cardiovascular Medicine, business
Abstract: Contains fulltext : 225360.pdf (Publisher’s version ) (Closed access) The novel coronavirus has caused a pandemic around the world. Management of patients with suspected or confirmed coronavirus infection who have to undergo thoracic surgery will be a challenge for the anesthesiologists. The thoracic subspecialty committee of European Association of Cardiothoracic Anaesthesiology (EACTA) has conducted a survey of opinion in order to create recommendations for the anesthetic approach to these challenging patients. It should be emphasized that both the management of the infected patient with COVID-19 and the self-protection of the anesthesia team constitute a complicated challenge. The text focuses therefore on both important topics.
Published: 2020

29. Abstracts from the BJA Research Forum

Author: Azeem Alam, M. Charlton, L. Gardner, Jeanne Moriarty, R. J. Anthony, H. Galley, A. Glass, Donald H. Burke, D. Fiszer, L. Jolly, C. Schofield, T. Elajnef, S. Woods, Lingzhi Wu, Helen Laycock, Jane Quinlan, Ben Shelley, A. Koelewyn, S. Maslekar, Sarah Ciechanowicz, I. Umar, John Kinsella, C. Pocknall, Tim G. Hales, T. Dale Maclaine, P. McCall, R. Russell, Hailin Zhao, Catherine E. Warnaby, C. Schultz-Swarthfigure, R. Docking, Mark Wilson, Simon J. Howell, Marie-Anne Shaw, Emer Guinan, Helen F. Galley, N. Beale, Mel McKendrick, A. Chandra, Xiaochun Liao, S. Bowrey, T. Tafili, D. Roiz de Sa, P. Sonecki, C. Hebbes, Fiona Wilson, L. Buck, Daqing Ma, John F. Thompson, Jiang Cui, M. Columb, Michael C. Lee, P. Halford, Mateo Obregón, Masao Takata, Jonathan Moran, P. Raju, C. Daly, A. Windle, Paul McCormick, J. Marinkovic, George Corner, Z. Milan, G. Devoy, D. Fido, D.E. Kean, Carsten Bantel, S. J. Howell, Philip M. Hopkins, Marcela P. Vizcaychipi, N. Flint, Daniel T. Baptista-Hon, Alan Kirk, Z. Huang, B. McCormick, Juliette Hussey, M. Shaw, Graeme McLeod, S. Ong, and O. Kciuk
Subjects: 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, business.industry, Library science, Medicine, 030204 cardiovascular system & hematology, business
Published: 2016
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30. Relative kinetics of B-type natriuretic peptide and N-terminal pro B-type natriuretic peptide after lung resection

Author: Emma Murphy, A. Glass, Ben Shelley, and Philip McCall
Subjects: medicine.medical_specialty, Anesthesiology and Pain Medicine, Endocrinology, business.industry, medicine.drug_class, Internal medicine, Kinetics, medicine, Natriuretic peptide, N terminal pro b type natriuretic peptide, Lung resection, business
Published: 2019
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31. Abstracts of the Spring Anaesthetic Research Society Meeting (ARS)

Author: N. Goodfellow, A Arthur, A. Koh, J. McKenna, P. Phillips, B. A. McGrath, M. Al-Hashimi, P. Shiels, B. Horley, R. Thomas, D. Atkinson, Andrew Archbold, C. Y. Wang, L. Jolly, M. Bown, G. Davies, John Kinsella, M. Sanders, C. Small, M. Hards, C. Doherty, S. Ruane, K. Zealley, Philip McCall, Wadhah Mahbuba, R. Neal, B. Casadei, Andrew Wragg, A. Harada, G. Calo, H. Zhao, S. Munirama, M. Pullman, M. Wyatt, M. Babar, J. Andrzejowski, T. D. Abbott, P.J. Bickford Smith, R. Baker, Daqing Ma, L. Dorn, M. Hua Zhang, Cordula M. Stover, J. P. Thompson, C. Allen, Alan Kirk, Ben Shelley, A. Guleria, B. Shelley, James A. Russell, R.M. Pearse, R. Jayaram, W. Manning, M. Bird, Remo Guerrini, David G. Lambert, J. Cooke, A. Wilkes, L. Bowes, R. De Silva, Gareth L. Ackland, J. Riddell, C. Thomas, Alistair Macfie, Joyce Yeung, A. Ravalia, J. O'Doherty, H. Curley, C. Hirst, S. Harwell, Iain A. Bruce, George Corner, J. McDonald, Graeme McLeod, Helen F. Galley, J. Patel, N. Bateman, A. Verissimo, D. Celnik, R. Perkins, W. Wiles, S. Allen, S. Thomas, G. Wang, Rana Sayeed, D. McGuinness, Philip J. Devereaux, Tara Quasim, E. Whetton, and I. Neville
Subjects: medicine.medical_specialty, Creatinine, business.industry, medicine.medical_treatment, Intensive care unit, Telomere, law.invention, Surgery, Cardiac surgery, chemistry.chemical_compound, Anesthesiology and Pain Medicine, chemistry, Ageing, law, Internal medicine, medicine, Biomarker (medicine), Rifle, Renal replacement therapy, business
Abstract: Biological age is a better measure of functional capacity than chronological age.1 One of the measures of biological age is telomere length. Telomeres are nucleoprotein complexes that protect chromosome ends from damage. The DNA component of telomeres progressively shortens as biological age increases and thus acts as a read out for ‘miles on the biological clock’. 2 Telomere length progressively shortens as biological age increases. Within health care, ageing is almost exclusively described in terms of chronological age. Recent studies explored using biological age to stratify patients and predict outcomes.3 This project acts as a pilot study to investigate whether biological age is related to intensive care unit (ICU) outcomes and whether ICU patients age biologically at an accelerated rate. This project used blood samples from a previous study where patients underwent cardiac surgery and were admitted to the ICU. Blood samples were obtained before surgery and on days 1, 2, and 3 after surgery. The database contained the following physiological parameters: haemoglobin, urea, creatinine, RIFLE score, length of ICU stay, and whether renal replacement therapy was required. Information on co-morbidities and medication was also provided. DNA was isolated using a Maxwell machine and telomere length determined via quantitative PCR. One hundred and fifty-five blood samples from 46 patients underwent analysis. Telomere length did not differ significantly over the 4 days (P=0.662). No relationship was found between telomere length and any physiological parameter, co-morbidity, or medication. There was a trend towards significance with RIFLE score at day 3 increasing as telomere length decreased, although this was not statistically significant (P=0.09). No relationship between telomere length and the available physiological parameters, comorbidities, or medication was found. Telomere length did not vary during ICU stay. This study was limited by its small sample size. Future studies would benefit from a larger sample size; in addition, blood samples could also be obtained at 6 months after discharge to allow gradual alterations in biological age to be determined. Recent studies give evidence that telomere length is a weak biomarker of ageing,3 and that more meaningful data might be obtained using superior markers, such as CDKN2A expression or expression levels of non-coding RNAs.3
Published: 2015
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32. Endothelial glycocalyx layer shedding following lung resection

Author: John Kinsella, Ben Shelley, Phillip J McCall, A Arthur, Alan Kirk, and Lisa Jolly
Subjects: Male, ARDS, Pathology, medicine.medical_specialty, Lung Neoplasms, Clinical Biochemistry, Acute Lung Injury, Pilot Projects, 030204 cardiovascular system & hematology, Lung injury, Glycocalyx, Syndecan 1, Pathogenesis, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Forced Expiratory Volume, Drug Discovery, Medicine, Humans, Postoperative Period, Lung cancer, Aged, business.industry, Biochemistry (medical), Oxygenation, Perioperative, Middle Aged, medicine.disease, carbohydrates (lipids), Oxygen, Female, Endothelium, Vascular, Syndecan-1, Lung resection, Blood Gas Analysis, business, Biomarkers, Heparan Sulfate Proteoglycans
Abstract: Aim: We investigated if the serum biomarkers of endothelial glycocalyx layer (EGL) disruption, heparan sulfate proteoglycan (HSPG) and syndecan-1 (SDC1) were elevated following lung resection surgery. Methods: Plasma samples were collected from 16 patients undergoing lobectomy for primary lung cancer. HSPG and SDC1 were measured at five perioperative timepoints. Postoperative oxygenation was recorded. Results: Post-hoc pair wise comparisons showed SDC1 concentration was significantly elevated on postoperative day 2, p < 0.001. There was no relationship found between HSPG or SDC1 levels and postoperative oxygenation. Conclusion: Our pilot study is the first to provide evidence of EGL disruption following lung resection surgery. We hypothesize that EGL disruption is involved in the pathogenesis of post-lung resection acute lung injury. Abstract presentation: This work was presented in a part at the Anaesthetic Research Society Spring Meeting, Royal College of Anaesthetists, London, UK, 22 April 2015.
Published: 2016

33. Anesthesia for Thoracic Surgery: A Survey of UK Practice

Author: Ben Shelley, John Kinsella, and Alistair Macfie
Subjects: Anesthesia, Epidural, medicine.medical_specialty, Volume control, Positive-Pressure Respiration, Thoracic epidural, Interquartile range, Monitoring, Intraoperative, medicine, Humans, Anesthesia, Paravertebral Block, Tidal volume, Pain, Postoperative, business.industry, Analgesia, Patient-Controlled, Nerve Block, Thoracic Surgical Procedures, Respiration, Artificial, Drug Utilization, United Kingdom, Analgesics, Opioid, Anesthesiology and Pain Medicine, Cardiothoracic surgery, Current practice, Health Care Surveys, Anesthetics, Inhalation, Anesthetic, Anesthesia, Inhalation, Cardiology and Cardiovascular Medicine, business, Ireland, medicine.drug
Abstract: Objective The authors sought to provide a snapshot of contemporary thoracic anesthetic practice in the United Kingdom and Ireland. Design An online survey. Setting United Kingdom. Participants An invitation to participate was e-mailed to all members of the Association of Cardiothoracic Anaesthetists. Intervention None. Measurements and Main Results A total of 132 responses were received; 2 were excluded because they did not originate from the United Kingdom. Values are number (percent). Anesthetic Technique The majority of respondents (109, 85%) maintain anesthesia with a volatile anesthetic agent, with a lesser proportion (20, 15%) reporting use of a total intravenous anesthetic technique. The majority of respondents (78, 61%) favor pressure control ventilation over volume control (50, 39%); just under half (57, 45%) report the routine use of positive end-expiratory pressure (median = 5 cmH 2 O [interquartile range (IQR), 4-5]). Fifty-two (40%) respondents report ventilating to a target tidal volume (median = 6 mL/kg [IQR, 5-7]). Most (114, 89%) respondents routinely ventilate with an F I O 2 less than 1.0. Thoracic epidural blockade (TEB) is favored by nearly two thirds of respondents (80, 62%) compared with paravertebral block (39, 30%) and other analgesic techniques (10, 8%). Anesthesiologists favoring TEB are significantly less likely to prescribe systemic opioids (17, 21% v 39, 100% [ p v 0, 0% [ p = 0.003] and 28, 35% v 4, 11% [ p =0.013], respectively). Most respondents (127, 98%) report a double-lumen tube as their first choice. Many (82, 64%) report “rarely” using bronchial blockers. Conclusions The authors hope this survey both provides interest and serves as a useful resource reflecting the current practice of thoracic anesthesia.
Published: 2011
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34. Magnetic resonance imaging safety of Epilong Soft epidural catheters

Author: P. McCall, Ben Shelley, and M. Steven
Subjects: Anesthesia, Epidural, medicine.medical_specialty, Epidural catheter, Anesthesiology and Pain Medicine, Catheters, Indwelling, medicine.diagnostic_test, business.industry, Medicine, Humans, Magnetic resonance imaging, Radiology, business, Magnetic Resonance Imaging
Published: 2014

35. Interoperator and intraoperator variability of whole blood coagulation assays: a comparison of thromboelastography and rotational thromboelastometry

Author: Mark Steven, I. Quasim, Lynne Anderson, Stephen F. Moise, Andrew Sinclair, Stefan Schraag, and Ben Shelley
Subjects: Adult, Male, medicine.medical_specialty, Coefficient of variation, Fibrinogen, Blood product, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, Blood Coagulation, Whole blood, Observer Variation, medicine.diagnostic_test, business.industry, Reproducibility of Results, Thromboelastography, Cardiac surgery, Thrombelastography, Thromboelastometry, Anesthesiology and Pain Medicine, Anesthesia, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: Near-patient viscoelastic tests have proved useful in decreasing blood and blood product use in cardiac surgery. Two different analyzers are available, TEG and ROTEM. Many different individuals operate these devices, which raises concern that this factor may significantly affect results. The present study sought to objectively assess variability in results between operators.Prospective study.Regional cardiac center.Adult patients undergoing elective cardiac surgery.Thirty-six mL of blood were taken from each of 21 patients. TEG kaolin and functional fibrinogen (FF) analyses and the equivalent ROTEM INTEM S and FIBTEM S analyses were performed. Six operators performed one of each test per patient to assess interoperator variability. One further operator performed 6 of each test per patient to assess intraoperator variability.All routine measurement parameters were noted and the coefficient of variation (CV) calculated, analyzing comparable parameters. All inter-operator CVs were significantly lower for ROTEM analyses compared with TEG. CV for INTEM S CT/ kaolin r time was 4.7 versus 16.3 and MCF/MA was 2.6 versus 4.3 (p0.01). Similarly, FIBTEM S MCF/ FF MA was 8.3 versus 12.2. All intraoperator CVs were significantly lower for ROTEM analyses compared with TEG (p0.01). CV for INTEM S CT/kaolin r time was 3.1 versus 9.8 and MCF/ MA was 1.6 versus 4. Similarly, FIBTEM S MCF/ MA was 6.9 versus 12.1.This series of results suggested ROTEM analyses are more reproducible than TEG and, consequently, that ROTEM may be better suited for use in a multiuser environment.
Published: 2014

36. Postoperative medications

Author: Ben Shelley
Published: 2014
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37. The thoracic patient

Author: Ben Shelley and Alistair Macfie
Published: 2014
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38. Total intravenous anaesthesia

Author: Nick Sutcliffe and Ben Shelley
Subjects: Surgical stimulation, business.industry, Dosing regimen, Adequate anaesthesia, Critical Care and Intensive Care Medicine, Target controlled infusion, Anesthesiology and Pain Medicine, Anesthesia, Target drug, Infusion pump, Medicine, Total intravenous anaesthesia, business, Propofol, medicine.drug
Abstract: Driven by better understanding of the pharmacokinetic principles involved and improvements in infusion pump technology, total intravenous anaesthesia (TIVA) has become more popular and has many potential advantages. Safe and effective use of TIVA requires the practitioner to have a sound understanding of the pharmacokinetics involved and the pharmacokinetic behaviour of many drugs can be described by a three-compartment model. Mathematical modelling can be used to calculate the blood and theoretical effect-site concentrations of anaesthetic drugs for a given dosing regimen. Following consideration of the three-compartment model, manual regimes were developed to permit TIVA, but such regimes were insufficiently flexible to provide adequate anaesthesia for all patients in all circumstances. Target controlled infusion (TCI) systems are computerized infusion systems capable of delivering variable infusion regimes based on a complex mathematical solution to the pharmacokinetic models. Such systems allow the anaesthetist to achieve and maintain any desired target drug concentration appropriate to an individual patient and level of surgical stimulation. TCI systems have facilitated the increased use of TIVA over the past decade such that this technique has become ‘mainstream' throughout much of the world.
Published: 2010
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39. Low-serum 25-hydroxyvitamin D reflects severity of illness in critically ill patients

Author: John Kinsella, Ben Shelley, Tara Quasim, Dinesh Talwar, and Donald C. McMillan
Subjects: Male, medicine.medical_specialty, Critical Care, business.industry, Critically ill, Critical Illness, Critical Care and Intensive Care Medicine, Vitamin D Deficiency, Article, Emergency medicine, Severity of illness, medicine, Humans, Female, Serum 25 hydroxyvitamin d, Vitamin D, Intensive care medicine, business
Published: 2012

40. Incidence, Impact and Mechanisms of Perioperative Right VEntricular Dysfunction (IMPRoVE) (IMPRoVE)

Author: University of Glasgow, NHS Greater Glasgow and Clyde, Royal London Hospital, and Dr Ben Shelley, Honorary Professor/Consultant in Cardiothoracic Anaesthesia and Intensive Care
Published: 2023

41. Validation of Heart Rate Recovery as a Peri-operative Risk Measure (VERVE)

Author: NHS National Waiting Times Centre Board, NHS Greater Glasgow and Clyde, NHS Ayrshire and Arran, NHS Lanarkshire, and Dr Ben Shelley, Honorary Clinical Associate Professor/Consultant in Cardiothoracic Anaesthesia and Intensive Care
Published: 2022

42. Right Ventricular Dysfunction in Ventilated Patients With COVID-19 (COVID-RV)

Author: Golden Jubilee National Hospital, Robertson Centre for Biostatistics, and Dr Ben Shelley, Honorary Clinical Associate Professor
Published: 2021

43. Absent Visitors: The Wider Implications of COVID-19 on Non-COVID Cardiothoracic ICU Patients, Relatives and Staff (VINCI)

Author: Golden Jubilee National Hospital and Dr Ben Shelley, Chief Investigator
Published: 2020

44. bnP for pRediction of Outcome FollowIng Lung rEsection Surgery (PROFILES)

Author: Dr Ben Shelley, Chief Investigator
Published: 2019

45. Right Ventricular Inflammation After Lung Resection

Author: Dr Ben Shelley, Consultant Cardio-thoracic Anaesthesia and Critical Care
Published: 2018

46. Right Side of Heart Function After Lung Surgery

Author: Golden Jubilee National Hospital and Dr Ben Shelley, Clinical Research Fellow
Published: 2016

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