14 results on '"Eamon P. Raith"'
Search Results
2. Critical care management of adult traumatic brain injury
- Author
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Eamon P. Raith and Ugan Reddy
- Subjects
Anesthesiology and Pain Medicine ,Critical Care and Intensive Care Medicine - Published
- 2023
3. Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016
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Suren Krishnan, C A Frauenfelder, Eamon P. Raith, Andrew A. Udy, and David Pilcher
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Hospital mortality ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,law ,Intensive care ,medicine ,Humans ,Hospital Mortality ,030223 otorhinolaryngology ,Critical Care Outcomes ,Aged ,Retrospective Studies ,Mechanical ventilation ,business.industry ,Head and neck cancer ,Australia ,General Medicine ,Middle Aged ,medicine.disease ,Respiration, Artificial ,Intensive care unit ,Intensive Care Units ,Treatment Outcome ,Otorhinolaryngology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Emergency medicine ,Female ,Observational study ,business ,New Zealand ,Cohort study - Abstract
ObjectiveTo report intensive care unit admission outcomes for head and neck cancer patients.MethodsA retrospective, observational cohort analysis of all Australian and New Zealander head and neck cancer patient intensive care unit admissions from January 2000 to June 2016, including data from 192 intensive care units.ResultsThere were 10 721 head and neck cancer patients, with a median age of 64 years (71.6 per cent male). Of admissions, 76.4 per cent were in public hospitals, 96.9 per cent were post-operative and 43.6 per cent required mechanical ventilation. Annual head and neck cancer admissions increased from 2000 to 2015 (from 348 to 1132 patients), but the overall proportion of intensive care unit admissions remained constant. In-hospital mortality was 2.7 per cent, and intensive care unit mortality was 0.7 per cent. The in-hospital mortality risk decreased three-fold (p < 0.001).ConclusionHead and neck cancer patients had low mortality in the intensive care unit and in hospital. Risk of dying decreased despite more intensive care unit admissions. This is the first large-scale cohort study quantifying intensive care unit utilisation by head and neck cancer patients. It informs future work investigating alternatives to the intensive care unit for these patients.
- Published
- 2021
4. Neuromonitoring
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Eamon P. Raith and Ugan Reddy
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Anesthesiology and Pain Medicine ,Critical Care and Intensive Care Medicine - Published
- 2020
5. Critical care management of adult traumatic brain injury
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Ugan Reddy, Eamon P. Raith, and Francesco Fiorini
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Coma ,medicine.medical_specialty ,business.industry ,Traumatic brain injury ,Critical Care and Intensive Care Medicine ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Medicine ,030212 general & internal medicine ,Cerebral perfusion pressure ,medicine.symptom ,business ,Intensive care medicine ,Brain trauma ,030217 neurology & neurosurgery - Abstract
Severe traumatic brain injury (TBI) is associated with significant morbidity and mortality. The critical care management of TBI requires a coordinated and comprehensive approach to treatment, including strategies to prevent secondary brain injury and maintenance of adequate cerebral perfusion and oxygenation. Management protocols have evolved with international consensus, providing guidelines that assist clinicians in delivering optimal care. Those from the Brain Trauma Foundation are continuously updated to incorporate new trial data ( https://braintrauma.org/coma/guidelines ).
- Published
- 2020
6. Dysnatremia and 6-Month Functional Outcomes in Critically Ill Patients With Aneurysmal Subarachnoid Hemorrhage: A Prospective Cohort Study
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Anna Campain, Therese Starr, Jan Merthens, Yvonne Robertson, Vishnu Bhardwa, Jeremy Cohen, Mark E. Finnis, Rinaldo Bellomo, Gail Brinkerhoff, Sacha Schweikert, Oliver Flower, Paul J Young, Andrew A. Udy, Matthew Anstey, Anthony Delaney, Deborah Barge, Andrew van der Poll, Anna Hunt, Eamon P. Raith, Lynette Newby, Mandy Tallott, Paul M. Healey, Jasmin Board, Emily Fitzgerald, James Anstey, D. James Cooper, Cassie Lawrence, David Pearson, and Gian Luca Di Tanna
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medicine.medical_specialty ,Subarachnoid hemorrhage ,hypernatremia ,hyponatremia ,RC86-88.9 ,Critically ill ,business.industry ,Confounding ,Medical emergencies. Critical care. Intensive care. First aid ,General Medicine ,Odds ratio ,medicine.disease ,critical care ,Modified Rankin Scale ,Internal medicine ,medicine ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Hypernatremia ,aneurysmal subarachnoid hemorrhage ,Prospective cohort study ,Hyponatremia ,business ,Original Clinical Report - Abstract
Supplemental Digital Content is available in the text., OBJECTIVES: To investigate the association between plasma sodium concentrations and 6-month neurologic outcome in critically ill patients with aneurysmal subarachnoid hemorrhage. DESIGN: Prospective cohort study. SETTING: Eleven ICUs in Australia and New Zealand. PARTICIPANTS: Three-hundred fifty-six aneurysmal subarachnoid hemorrhage patients admitted to ICU between March 2016 and June 2018. The exposure variable was daily measured plasma sodium. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Six-month neurologic outcome as measured by the modified Rankin Scale. A poor outcome was defined as a modified Rankin Scale greater than or equal to 4. The mean age was 57 years (± 12.6 yr), 68% were female, and 32% (n = 113) had a poor outcome. In multivariable analysis, including age, illness severity, and process of care measures as covariates, higher mean sodium concentrations (odds ratio, 1.17; 95% CI, 1.05–1.29), and greater overall variability—as measured by the sd (odds ratio, 1.53; 95% CI, 1.17–1.99)—were associated with a greater likelihood of a poor outcome. Multivariable generalized additive modeling demonstrated, specifically, that a high initial sodium concentration, followed by a gradual decline from day 3 onwards, was also associated with a poor outcome. Finally, greater variability in sodium concentrations was associated with a longer ICU and hospital length of stay: mean ICU length of stay ratio (1.13; 95% CI, 1.07–1.20) and mean hospital length of stay ratio (1.08; 95% CI, 1.01–1.15). CONCLUSIONS: In critically ill aneurysmal subarachnoid hemorrhage patients, higher mean sodium concentrations and greater variability were associated with worse neurologic outcomes at 6 months, despite adjustment for known confounders. Interventional studies would be required to demonstrate a causal relationship.
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- 2021
7. Repurposing a Neurocritical Care Unit for the Management of Severely Ill Patients With COVID-19: A Retrospective Evaluation
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Eamon P, Raith, Astri M V, Luoma, Mark, Earl, Meera, Dalal, Sandra, Fairley, Felicity, Fox, Katharine, Hunt, Charlotte, Willett, and Ugan, Reddy
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Adult ,Male ,Critical Care ,Medication Therapy Management ,COVID-19 ,Middle Aged ,Respiration, Artificial ,United Kingdom ,Intensive Care Units ,Patient Admission ,Treatment Outcome ,Hospital Bed Capacity ,Humans ,Female ,Hospital Mortality ,Nervous System Diseases ,Pandemics ,Referral and Consultation ,Aged ,Retrospective Studies - Abstract
The World Health Organisation declared a coronavirus disease 2019 (COVID-19) pandemic on March 11, 2020. Following activation of the UK pandemic response, our institution began planning for admission of COVID-19 patients to the neurointensive care unit (neuro-ICU) to support the local critical care network which risked being rapidly overwhelmed by the high number of cases. This report will detail our experience of repurposing a neuro-ICU for the management of severely ill patients with COVID-19 while retaining capacity for urgent neurosurgical and neurology admissions.We conducted a retrospective process analysis of the repurposing of a quaternary level neuro-ICU during the early stages of the COVID-19 pandemic in the United Kingdom. We retrieved demographic data, diagnosis, and outcomes from the electronic health care records of all patients admitted to the ICU between March 1, 2020 and April 30, 2020. Processes for increase in surge capacity, reduction in ICU demand, and staff redeployment and rapid training are reported.Over a 10-day period, total ICU capacity was increased by 21.7% (from 23 to 28 beds) while the capacity to provide mechanical ventilation was increased by 77% (from 13 to 23 beds). There were 30 ICU admissions of 29 COVID-19 patients between March 1 and April 30, 2020; median (range) length of ICU stay was 9.9 (1.3 to 32) days, duration of mechanical ventilation 11 (1 to 27) days, and ICU mortality rate 41.4%. There was a 44% reduction in urgent neurosurgical and neurology admissions compared with the same period in 2019.It is possible to repurpose a dedicated neuro-ICU for the management of critically ill non-neurological patients during a pandemic response, while maintaining access for urgent neuroscience referrals.
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- 2020
8. Idiopathic systemic capillary leak syndrome presenting as septic shock: A case report
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Joshua F. Ihle, Anna Kalff, Jennifer Jamieson, Eamon P. Raith, and Julian J. Bosco
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Adult ,Male ,Pulmonary and Respiratory Medicine ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,law.invention ,Angiopathy ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Humans ,Systemic capillary leak syndrome ,030212 general & internal medicine ,business.industry ,Septic shock ,Immunoglobulins, Intravenous ,medicine.disease ,Shock, Septic ,Intensive care unit ,Intensive Care Units ,Distributive shock ,Anesthesia ,Shock (circulatory) ,Fluid Therapy ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Capillary Leak Syndrome - Abstract
Background Idiopathic capillary leak syndrome (Clarkson's Disease) is a rare angiopathy with a heterogenous phenotype that may present as distributive shock refractory to resuscitative management. Objective We report a case of idiopathic systemic capillary leak syndrome presenting as septic shock. Methods Structured case report and review of the literature. Results A 27-year old man admitted to our institution with coryzal symptoms rapidly deteriorated with presumed sepsis, leading to intensive care unit admission. Following further deterioration, Idiopathic systemic capillary leak syndrome was considered and intravenous immunoglobulin administered, resulting in rapid improvement in the patient's clinical status. Conclusions Idiopathic systemic capillary leak syndrome is a rare and potentially life-threatening angiopathy that may present as, and should be considered in, refractory distributive shock. Administration of intravenous immunglobulin resulted in rapid recovery in this patient, and has been associated with positive outcomes in previous cases.
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- 2018
9. Erratum to 'Six-month mortality and functional outcomes in aneurysmal sub-arachnoid haemorrhage patients admitted to intensive care units in Australia and New Zealand: A prospective cohort study' [J. Clin. Neurosci. 80 (2020) 92–99]
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Anna Hunt, Jan Mehrtens, Paul J Young, Eamon P. Raith, Sacha Schweikert, Paul M. Healey, Andrew van der Poll, Anthony Delaney, James Anstey, Matthew Anstey, Yvonne Robertson, Cassie Lawrence, Emily Fitzgerald, Jasmin Board, Gail Brinkerhoff, Therese Starr, Vishnu Bhardwa, Deborah Barge, Jeremy Cohen, Rinaldo Bellomo, Andrew A. Udy, Mark E. Finnis, David A. Cooper, Oliver Flower, Lynette Newby, Mandy Tallott, and David Pearson
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Pediatrics ,medicine.medical_specialty ,Neurology ,business.industry ,Physiology (medical) ,Intensive care ,MEDLINE ,Medicine ,Surgery ,Neurology (clinical) ,General Medicine ,Prospective cohort study ,business - Published
- 2020
10. Severe meningococcal serogroup W sepsis presenting as myocarditis: A case report and review of literature
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Eloise Williams, Eamon P. Raith, Myat Aung, and Aidan Jc Burrell
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Pediatrics ,medicine.medical_specialty ,Myocarditis ,medicine.diagnostic_test ,business.industry ,medicine.drug_class ,Incidence (epidemiology) ,Neisseria meningitidis ,030231 tropical medicine ,Antibiotics ,Magnetic resonance imaging ,Case Reports ,Critical Care and Intensive Care Medicine ,Critical Care Nursing ,medicine.disease ,medicine.disease_cause ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Cardiac magnetic resonance imaging ,medicine ,030212 general & internal medicine ,Complication ,business - Abstract
The global incidence of invasive meningococcal disease due to serogroup W (MenW) has risen over the last decade. The following case emphasises the atypical features of MenW meningococcaemia, which included myocarditis, a rare but important complication. It also highlights the potential novel role that cardiac magnetic resonance imaging can provide in the diagnosis of MenW myocarditis. Complications of these infections can be avoided with early recognition and susceptibility testing to prevent the use of inappropriate antibiotics and treatment failure.
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- 2018
11. Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit
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Rinaldo Bellomo, Michael Bailey, Eamon P. Raith, Andrew A. Udy, Christopher MacIsaac, Steven McGloughlin, and David Pilcher
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Adult ,Male ,medicine.medical_specialty ,Organ Dysfunction Scores ,law.invention ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,Intensive care ,medicine ,Pneumonia, Bacterial ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Intensive care medicine ,Retrospective Studies ,Receiver operating characteristic ,business.industry ,Bacterial pneumonia ,Australia ,030208 emergency & critical care medicine ,Retrospective cohort study ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Prognosis ,Intensive care unit ,Systemic Inflammatory Response Syndrome ,Systemic inflammatory response syndrome ,Intensive Care Units ,ROC Curve ,Area Under Curve ,SOFA score ,Female ,business ,New Zealand - Abstract
The Sepsis-3 Criteria emphasized the value of a change of 2 or more points in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, introduced quick SOFA (qSOFA), and removed the systemic inflammatory response syndrome (SIRS) criteria from the sepsis definition.Externally validate and assess the discriminatory capacities of an increase in SOFA score by 2 or more points, 2 or more SIRS criteria, or a qSOFA score of 2 or more points for outcomes among patients who are critically ill with suspected infection.Retrospective cohort analysis of 184 875 patients with an infection-related primary admission diagnosis in 182 Australian and New Zealand intensive care units (ICUs) from 2000 through 2015.SOFA, qSOFA, and SIRS criteria applied to data collected within 24 hours of ICU admission.The primary outcome was in-hospital mortality. In-hospital mortality or ICU length of stay (LOS) of 3 days or more was a composite secondary outcome. Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC). Adjusted analyses were performed using a model of baseline risk determined using variables independent of the scoring systems.Among 184 875 patients (mean age, 62.9 years [SD, 17.4]; women, 82 540 [44.6%]; most common diagnosis bacterial pneumonia, 32 634 [17.7%]), a total of 34 578 patients (18.7%) died in the hospital, and 102 976 patients (55.7%) died or experienced an ICU LOS of 3 days or more. SOFA score increased by 2 or more points in 90.1%; 86.7% manifested 2 or more SIRS criteria, and 54.4% had a qSOFA score of 2 or more points. SOFA demonstrated significantly greater discrimination for in-hospital mortality (crude AUROC, 0.753 [99% CI, 0.750-0.757]) than SIRS criteria (crude AUROC, 0.589 [99% CI, 0.585-0.593]) or qSOFA (crude AUROC, 0.607 [99% CI, 0.603-0.611]). Incremental improvements were 0.164 (99% CI, 0.159-0.169) for SOFA vs SIRS criteria and 0.146 (99% CI, 0.142-0.151) for SOFA vs qSOFA (P.001). SOFA (AUROC, 0.736 [99% CI, 0.733-0.739]) outperformed the other scores for the secondary end point (SIRS criteria: AUROC, 0.609 [99% CI, 0.606-0.612]; qSOFA: AUROC, 0.606 [99% CI, 0.602-0.609]). Incremental improvements were 0.127 (99% CI, 0.123-0.131) for SOFA vs SIRS criteria and 0.131 (99% CI, 0.127-0.134) for SOFA vs qSOFA (P.001). Findings were consistent for both outcomes in multiple sensitivity analyses.Among adults with suspected infection admitted to an ICU, an increase in SOFA score of 2 or more had greater prognostic accuracy for in-hospital mortality than SIRS criteria or the qSOFA score. These findings suggest that SIRS criteria and qSOFA may have limited utility for predicting mortality in an ICU setting.
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- 2017
12. Grade V Subarachnoid Haemorrhage: A Single Centre Analysis of Patient Characteristics, Outcomes and Health Care Costs
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Matthew J Maiden, Benjamin Reddi, Susan Hooper, Michael Hecklemann, Marianne J. Chapman, Minny Ojha, Mark E. Finnis, and Eamon P. Raith
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medicine.medical_specialty ,Single centre ,business.industry ,Health care ,Emergency medicine ,Medicine ,Patient characteristics ,Subarachnoid haemorrhage ,Emergency Nursing ,Critical Care Nursing ,business - Published
- 2019
13. Novel supports for Junior Medical Officers during out-of-hours work
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Owen Roodenburg and Eamon P. Raith
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050210 logistics & transportation ,Medical education ,Medical staff ,Critical Care ,business.industry ,05 social sciences ,MEDLINE ,Workload ,Work Schedule Tolerance ,03 medical and health sciences ,0302 clinical medicine ,Out of hours ,Work (electrical) ,0502 economics and business ,Medical Staff, Hospital ,Internal Medicine ,Humans ,Medicine ,030212 general & internal medicine ,business - Published
- 2017
14. Heart: Cardiac Myxoma
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Eamon P. Raith
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Cancer Research ,business.industry ,Mesenchyme ,Left atrium ,Myxoma ,Connective tissue ,Hematology ,Anatomy ,medicine.disease ,medicine.anatomical_structure ,Oncology ,Stroma ,cardiovascular system ,Genetics ,medicine ,Fossa ovalis ,cardiovascular diseases ,business ,Interatrial septum - Abstract
Note A Cardiac myxoma is a benign gelatinous growth composed of primitive connective tissue cells and stroma resembling mesenchyme that is usually pedunculated and usually arises from the interatrial septum, near the fossa ovalis. The majority (75%) arise within the left atrium. They may be distinguished from thrombi by their endothelial lining and the presence of endothelium-lined crevices and clefts on their surface.
- Published
- 2011
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