Search

Your search keyword '"Pappachan, John V."' showing total 30 results
Start Over Author "Pappachan, John V."
30 results on '"Pappachan, John V."'

1. Correction: ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children— a systematic review and meta-analysis

Author

Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C. A. T., Marino, Luise V., Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L., Kneyber, Martin C. J., Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F., Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V., Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J., Tekguc, Hakan, Tziouvas, Konstantinos, Parienti, Jean-Jacques, Goyer, Isabelle, and Valla, Frederic V.

Published
2023
Full Text
View/download PDF

2. ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children— a systematic review and meta-analysis

Author

Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C. A. T., Marino, Luise V., Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L., Kneyber, Martin C. J., Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F., Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V., Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J., Tekguc, Hakan, Tziouvas, Konstantinos, Parienti, Jean-Jacques, Goyer, Isabelle, and Valla, Frederic V.

Published
2022
Full Text
View/download PDF

3. Surfactant Phospholipid Kinetics in Ventilated Children after Therapeutic Surfactant Supplementation.

Author

Goss, Victoria M., Dushianthan, Ahilanandan, McCorkell, Jenni, Morton, Katy, Goss, Kevin C. W., Marsh, Michael J., Pappachan, John V., and Postle, Anthony D.

Subjects
CHILD patients, PEDIATRIC intensive care, RADIOLABELING, ARTIFICIAL respiration, STABLE isotopes
Abstract

Acute lung Injury leads to alterations in surfactant lipid composition and metabolism. Although several mechanisms contribute to dysregulated surfactant metabolism, studies investigating in vivo surfactant metabolism are limited. The aim of this study is to characterise surfactant phospholipid composition and flux utilising a stable isotope labelling technique in mechanically ventilated paediatric patients. Paediatric patients (<16 years of age) received 3.6 mg/kg intravenous methyl-D9-choline chloride followed by the endotracheal instillation of 100 mg/kg of exogenous surfactant after 24 h. Bronchioalveolar fluid samples were taken at baseline and 12, 24, 36, 48, 72 and 96 h after methyl-D9-choline infusion. Nine participants (median age of 48 days) were recruited. The primary phosphatidylcholine (PC) composition consisted of PC16:0/16:0 or DPPC (32.0 ± 4.5%). Surfactant supplementation resulted in a 30% increase in DPPC. Methyl-D9 PC enrichment was detected after 12 h and differed significantly between patients, suggesting variability in surfactant synthesis/secretion by the CDP-choline pathway. Peak enrichment was achieved (0.94 ± 0.15% of total PC) at 24 h after methyl-D9-choline infusion. There was a trend towards reduced enrichment with the duration of mechanical ventilation prior to study recruitment; however, this was not statistically significant (p = 0.19). In this study, we demonstrated the fractional molecular composition and turnover of surfactant phospholipids, which was highly variable between patients. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

4. How to follow the guidelines, when the appropriate fluid is missing?

Author

Brossier, David W; https://orcid.org/0000-0002-2059-9888, Goyer, Isabelle, Morice, Claire, Alsohime, Fahad, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Porcheret, Florence, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Valla, Frederic V, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Kneyber, Martin CJ, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Rooze, Shancy, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, et al, Brossier, David W; https://orcid.org/0000-0002-2059-9888, Goyer, Isabelle, Morice, Claire, Alsohime, Fahad, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Porcheret, Florence, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Valla, Frederic V, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Kneyber, Martin CJ, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Rooze, Shancy, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, and et al

Abstract

Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care. Recently paediatric societies have produced evidence-based practice guidelines that recommend the use of balanced isotonic fluid when prescribing IV-MFT in both acute and critical paediatric care. Unfortunately, the applicability of these guidelines could be called into question when a ready-to-use glucose-containing balanced isotonic fluid is not available. The main objective of this study was to describe the availability of glucose-containing balanced isotonic fluids in European and Middle Eastern paediatric acute and critical care settings. This work is an ancillary study of the survey dedicated to IV-MFT practices in the paediatric acute and critical care settings in Europe and Middle East, a cross-sectional electronic 27-item survey, emailed in April–May 2021 to paediatric critical care physicians across 34 European and Middle East countries. The survey was developed by an expert multi-professional panel within the European Society of Peadiatric and Neonatal Intensive Care (ESPNIC). Balanced isotonic fluid with glucose 5% was available for only 32/153 (21%) responders. Balanced isotonic fluid with glucose 5% was consistently available in the UK (90%) but not available in France, Greece, The Netherlands and Turkey. Conclusion: Ready-to-use isotonic balanced IV solutions containing glucose in sufficient amount exist but are inconsistently available throughout Europe. National and European Medication Safety Incentives should guarantee the availability of the most appropriate and safest IV-MFT solution for all children. What is Known:• Intravenous maintenance fluid therapy (IV-MFT) is probably the most prescribed drug in paediatric hospital care.• Balanced isotonic fluid is recommended when prescribing IV-MFT in both acute and critical paediatric care. What is New:• Balanced isotonic fluid with glucose 5% is available for less than 25% of the prescrib

Published
2024

6. Correction: ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children— a systematic review and meta-analysis

Author

Brossier, David W; https://orcid.org/0000-0002-2059-9888, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Briant, Anais R, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Rooze, Shancy, Verbruggen, Sascha C A T; https://orcid.org/0000-0003-4866-9865, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Kneyber, Martin C J; https://orcid.org/0000-0002-6008-3376, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Morice, Claire, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Porcheret, Florence, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, et al, Brossier, David W; https://orcid.org/0000-0002-2059-9888, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Briant, Anais R, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Rooze, Shancy, Verbruggen, Sascha C A T; https://orcid.org/0000-0003-4866-9865, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Kneyber, Martin C J; https://orcid.org/0000-0002-6008-3376, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Morice, Claire, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Porcheret, Florence, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, and et al

Published
2023

7. ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis

Author

Brossier, David W, Tume, Lyvonne N, Briant, Anais R, Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C A T, Marino, Luise V, Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L, Kneyber, Martin C J, Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V, Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J, Tekguc, Hakan, Tziouvas, Konstantinos, et al, and University of Zurich

Subjects
10036 Medical Clinic, 610 Medicine & health, 2706 Critical Care and Intensive Care Medicine
Published
2022
Full Text
View/download PDF

8. A scoping review: urinary markers of metabolic maturation in preterm infants and future interventions to improve growth

Author

Marino, Luise V, Paulson, Simone, Ashton, James J, Weeks, Charlotte, Young, Aneurin, Pappachan, John V, Swann, Jonathan, Johnson, Mark J, and Beattie, Robert Mark

Abstract

Background: growth failure in infants born preterm is a significant issue, increasing the risk of poorer neurodevelopmental outcomes and metabolic syndrome later in life. During the first 1000 days of life biological systems mature rapidly involving developmental programming, cellular senescence, and metabolic maturation, regulating normal growth and development. However, little is known about metabolic maturation in infants born preterm and the relationship with growth. Objective: to examine the available evidence on urinary markers of metabolic maturation and their relationship with growth in infants born preterm. Eligibility criteria: Studies including in this scoping review using qualitative or quantitative methods to describe urinary markers of metabolic maturation and the relationship with growth in infants born preterm. Results: after a screening process 15 titles were included in this review, from 1998-2021 drawing from China (n = 1), Italy (n = 3), Germany (n = 3), Greece (n = 1), Japan (n = 2), Norway (n = 1), Portugal (n = 1), Spain (n = 2) and USA (n = 1). The included studies examined urinary metabolites in 1131 infants. A content analysis identified 4 overarching themes relating to; (i) metabolic maturation relative to gestational age, (ii) metabolic signature and changes in urinary metabolites over time, (iii) nutrition and (iv) growth. Conclusion: the results of this scoping review suggest there are considerable gaps in our knowledge relating to factors associated with metabolic instability, what constitutes normal maturation of preterm infants, and how the development of reference phenome age z scores for metabolites of interest could improve nutritional and growth outcomes.

Published
2022

10. ESPNIC clinical practice guidelines:intravenous maintenance fluid therapy in acute and critically ill children— a systematic review and meta-analysis

Author

Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C.A.T., Marino, Luise V., Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L., Kneyber, Martin C.J., Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F., Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V., Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J., Tekguc, Hakan, Tziouvas, Konstantinos, Parienti, Jean Jacques, Goyer, Isabelle, Valla, Frederic V., Brossier, David W., Tume, Lyvonne N., Briant, Anais R., Jotterand Chaparro, Corinne, Moullet, Clémence, Rooze, Shancy, Verbruggen, Sascha C.A.T., Marino, Luise V., Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula, Joram, Nyandat L., Kneyber, Martin C.J., Kühlwein, Eva, Lopez, Jorge, López-Herce, Jesus, Mayberry, Huw F., Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria, Morice, Claire, Pappachan, John V., Porcheret, Florence, Reis Boto, Leonor, Schlapbach, Luregn J., Tekguc, Hakan, Tziouvas, Konstantinos, Parienti, Jean Jacques, Goyer, Isabelle, and Valla, Frederic V.

Abstract

Purpose: Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. Methods: A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. Results: 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. “Strong consensus” was reached for 11/16 (69%) and “consensus” for 5/16 (31%) of the recommendations. Conclusions: Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance.

Published
2022

11. ESPNIC clinical practice guidelines: intravenous maintenance fluid therapy in acute and critically ill children- a systematic review and meta-analysis

Author

Brossier, David W; https://orcid.org/0000-0002-2059-9888, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Briant, Anais R, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Rooze, Shancy, Verbruggen, Sascha C A T; https://orcid.org/0000-0003-4866-9865, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Kneyber, Martin C J; https://orcid.org/0000-0002-6008-3376, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Morice, Claire, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Porcheret, Florence, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, et al, Brossier, David W; https://orcid.org/0000-0002-2059-9888, Tume, Lyvonne N; https://orcid.org/0000-0002-2547-8209, Briant, Anais R, Jotterand Chaparro, Corinne; https://orcid.org/0000-0002-1538-7127, Moullet, Clémence; https://orcid.org/0000-0003-1056-9869, Rooze, Shancy, Verbruggen, Sascha C A T; https://orcid.org/0000-0003-4866-9865, Marino, Luise V; https://orcid.org/0000-0002-1257-121X, Alsohime, Fahad, Beldjilali, Sophie, Chiusolo, Fabrizio; https://orcid.org/0000-0003-0265-609X, Costa, Leonardo, Didier, Capucine, Ilia, Stavroula; https://orcid.org/0000-0002-0936-368X, Joram, Nyandat L; https://orcid.org/0000-0003-4107-3241, Kneyber, Martin C J; https://orcid.org/0000-0002-6008-3376, Kühlwein, Eva, Lopez, Jorge; https://orcid.org/0000-0002-9942-6399, López-Herce, Jesus; https://orcid.org/0000-0001-6105-9178, Mayberry, Huw F; https://orcid.org/0000-0002-3769-2595, Mehmeti, Fortesa, Mierzewska-Schmidt, Magdalena, Miñambres Rodríguez, Maria; https://orcid.org/0000-0001-7955-5612, Morice, Claire, Pappachan, John V; https://orcid.org/0000-0002-3559-0595, Porcheret, Florence, Reis Boto, Leonor; https://orcid.org/0000-0001-6144-1617, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Tekguc, Hakan; https://orcid.org/0000-0001-6424-6761, Tziouvas, Konstantinos; https://orcid.org/0000-0002-6863-7708, and et al

Abstract

PURPOSE Intravenous maintenance fluid therapy (IV-MFT) prescribing in acute and critically ill children is very variable among pediatric health care professionals. In order to provide up to date IV-MFT guidelines, the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) undertook a systematic review to answer the following five main questions about IV-MFT: (i) the indications for use (ii) the role of isotonic fluid (iii) the role of balanced solutions (iv) IV fluid composition (calcium, magnesium, potassium, glucose and micronutrients) and v) and the optimal amount of fluid. METHODS A multidisciplinary expert group within ESPNIC conducted this systematic review using the Scottish Intercollegiate Guidelines Network (SIGN) grading method. Five databases were searched for studies that answered these questions, in acute and critically children (from 37 weeks gestational age to 18 years), published until November 2020. The quality of evidence and risk of bias were assessed, and meta-analyses were undertaken when appropriate. A series of recommendations was derived and voted on by the expert group to achieve consensus through two voting rounds. RESULTS 56 papers met the inclusion criteria, and 16 recommendations were produced. Outcome reporting was inconsistent among studies. Recommendations generated were based on a heterogeneous level of evidence, but consensus within the expert group was high. "Strong consensus" was reached for 11/16 (69%) and "consensus" for 5/16 (31%) of the recommendations. CONCLUSIONS Key recommendations are to use isotonic balanced solutions providing glucose to restrict IV-MFT infusion volumes in most hospitalized children and to regularly monitor plasma electrolyte levels, serum glucose and fluid balance.

Published
2022

18. Where Should Critically Ill Adolescents Receive Care? A Qualitative Interview-Based Study of Perspectives of Staff Working in Adult and Pediatric Intensive Care Units.

Author

Wood, Dora, Geoghegan, Sophie, Ramnarayan, Padmanabhan, Davis, Peter J., Tume, Lyvonne, Pappachan, John V., Goodwin, Sarah, and Wray, Jo

Subjects
CRITICALLY ill, ADOLESCENT health, PEDIATRIC intensive care, QUALITATIVE research
Abstract

Purpose: In the United Kingdom, critically ill adolescents are treated in either adult or pediatric intensive care units (AICUs or PICUs). This study explores staff perspectives on where and how best to care for this distinct group. Materials and Methods: Semistructured interviews were conducted with 12 members of staff (3 medical, 6 nursing, and 3 allied health professionals) working in 4 ICUs; 2 general hospital AICUs and 2 tertiary centre--based PICUs in England. Interviews were audio-recorded, transcribed, and analyzed using framework analysis. Findings: One overarching theme was identified, reflecting staff understanding of the term "adolescent," and this was linked to 2 further themes, each of which had several subthemes. "Needs of the critically ill adolescent" included medical needs, dignity and privacy, issues around consent, and the impact of intensive care admission. "Implications for staff" included managing parental presence and lack of familiarity, and emotional impact, of dealing with this patient group. Some of these factors are currently better accommodated in adult settings. Conclusions: Decision-making about the place of care should take into account the individual circumstances of the patient (e.g., nature of their medical condition and previous experiences, maturity, family preference) and not be based only on age at admission. We should work across disciplines to ensure we can discover, and consistently deliver, best practice to meet the needs of critically ill adolescents. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

24. Influenza aerosols in UK hospitals during the influenza H1N1 (2009–10) pandemic: air sampling in the vicinity of patients undergoing WHO-defined aerosol generating procedures

Author

Thompson, Katy-Anne, primary, Pappachan, John V, additional, Bennett, Allan M, additional, Mittal, Himanshu, additional, Macken, Susan, additional, Dove, Brian K, additional, Nguyen-Van-Tam, Jonathan S, additional, Copley, Vicky R, additional, O'Brien, Sarah, additional, Hoffman, Peter, additional, Parks, Simon, additional, Bentley, Andrew, additional, Isalska, Barbara, additional, and Thomson, Gail, additional

Published
2012
Full Text
View/download PDF

25. Monitoring The Kinetics Of Pulmonary Surfactant Phospholipids In Children Intubated On Paediatric Intensive Care

Author

Goss, Victoria M., primary, Koster, Grielof, additional, Taylor, Jenni, additional, Stearn, Katy, additional, Rees, Sara, additional, Mitchell, Rosemary, additional, Townsend, John P., additional, Goss, Kevin C.W., additional, Marsh, Michael J., additional, Macintosh, Iain, additional, Pappachan, John V., additional, and Postle, Anthony D., additional

Published
2012
Full Text
View/download PDF

26. Dynamic Lipidomic Mass Spectrometry Of Endotracheal Secretions And Plasma From Preterm Infants Mechanically Ventilated On The Neonatal Intensive Care Unit

Author

Goss, Kevin C.W., primary, Goss, Victoria M., additional, Townsend, Jon P., additional, Gunda, Ranjit, additional, Rhodes-Kitson, Jane, additional, Koster, Grielof, additional, Hall, Mike, additional, Thwaites, Richard, additional, Pappachan, John V., additional, Clark, Howard W., additional, and Postle, Anthony D., additional

Published
2012
Full Text
View/download PDF

27. The Accuracy of Noninvasive Peripheral Pulse Oximetry After Palliative Cardiac Surgery in Patients With Cyanotic Congenital Heart Disease

Author

Scrimgeour, Gemma E., Griksaitis, Michael J., Pappachan, John V., and Baldock, Andrew J.

Abstract

Background: Children with cyanotic congenital heart disease (CCHD) live with oxyhemoglobin saturations that are typically expressed as percentages in the range of 70s and 80s. Peripheral pulse oximetry (measurement of SpO2) performs poorly in this range and yet is widely used to inform clinical decisions in these patients. The reference standard is co-oximetry of arterial samples (SaO2).Methods: In this study, 515 paired measurements of SpO2and SaO2were taken from 19 children who had undergone palliative cardiac surgery.Results: SpO2(Masimo SET LNCS Neo pulse oximeter) overestimated oxyhemoglobin saturation in 82% of measurements (mean 4.6% ± 6.6%). There was a strong negative correlation between mean bias and SaO2(r= −.96, P= .002, 95% confidence interval: −0.99 to −0.68).Conclusion: The results raise a concern that critical hypoxemia may go undetected and untreated if pulse oximetry is relied upon as the primary means of assessing oxyhemoglobin saturation in children with CCHD. Strong preference must be given to co-oximetry of arterial samples.

Published
2017
Full Text
View/download PDF

28. Accuracy of the Masimo SET®LNCS neo peripheral pulse oximeter in cyanotic congenital heart disease

Author

Griksaitis, Michael J., Scrimgeour, Gemma E., Pappachan, John V., and Baldock, Andrew J.

Abstract

AbstractIntroductionNon-invasive peripheral pulse oximeters are routinely used to measure oxyhaemoglobin saturation (SpO2) in cyanotic congenital heart disease. These probes are calibrated in healthy adult volunteers between arterial saturations of ~75 and 100%, using the gold standard of co-oximetry on arterial blood samples. There are little data to attest their accuracy in cyanotic congenital heart disease.AimsWe aimed to assess the accuracy of a commonly used probe in children with cyanotic congenital heart disease.MethodsChildren with cyanotic congenital heart disease admitted to the Paediatric Intensive Care Unit with an arterial line in situ were included to our study. Prospective simultaneous recordings of SpO2, measured by the Masimo SET®LNCS Neo peripheral probe, and co-oximeter saturations (SaO2) measured by arterial blood gas analysis were recorded.ResultsA total of 527 paired measurements of SpO2and SaO2(using an ABL800 FLEX analyser) in 25 children were obtained. The mean bias of the pulse oximeter for all SaO2readings was +4.7±13.8%. The wide standard deviation indicates poor precision. This mean bias increased to +7.0±13.7% at SaO2recordings <75%. The accuracy root mean square of the recordings was 3.30% across all saturation levels, and this increased to 4.98% at SaO2<75%.ConclusionsThe performance of the Masimo SET®LNCS Neo pulse oximeter is poor when arterial oxyhaemoglobin saturations are below 75%. It tends to overestimate saturations in children with cyanotic congenital heart disease. This may have serious implications for clinical decisions.

Published
2016
Full Text
View/download PDF

29. Influenza Aerosols in UK Hospitals during the H1N1 (2009) Pandemic – The Risk of Aerosol Generation during Medical Procedures.

Author

Thompson, Katy-Anne, Pappachan, John V., Bennett, Allan M., Mittal, Himanshu, Macken, Susan, Dove, Brian K., Nguyen-Van-Tam, Jonathan S., Copley, Vicky R., O’Brien, Sarah, Hoffman, Peter, Parks, Simon, Bentley, Andrew, Isalska, Barbara, and Thomson, Gail

Subjects
*H1N1 influenza, *HOSPITAL care, *PANDEMICS, *RESPIRATORY infections, *NOSOCOMIAL infections, *MEDICAL personnel
Abstract

Background: Nosocomial infection of health-care workers (HCWs) during outbreaks of respiratory infections (e.g. Influenza A H1N1 (2009)) is a significant concern for public health policy makers. World Health Organization (WHO)-defined ‘aerosol generating procedures’ (AGPs) are thought to increase the risk of aerosol transmission to HCWs, but there are presently insufficient data to quantify risk accurately or establish a hierarchy of risk-prone procedures. Methodology/Principal Findings: This study measured the amount of H1N1 (2009) RNA in aerosols in the vicinity of H1N1 positive patients undergoing AGPs to help quantify the potential risk of transmission to HCWs. There were 99 sampling occasions (windows) producing a total of 198 May stages for analysis in the size ranges 0.86–7.3 µm. Considering stages 2 (4–7.3 µm) and 3 (0.86–4 µm) as comprising one sample, viral RNA was detected in 14 (14.1%) air samples from 10 (25.6%) patients. Twenty three air samples were collected while potential AGPs were being performed of which 6 (26.1%) contained viral RNA; in contrast, 76 May samples were collected when no WHO 2009 defined AGP was being performed of which 8 (10.5%) contained viral RNA (unadjusted OR = 2.84 (95% CI 1.11–7.24) adjusted OR = 4.31 (0.83–22.5)). Conclusions/Significance: With our small sample size we found that AGPs do not significantly increase the probability of sampling an H1N1 (2009) positive aerosol (OR (95% CI) = 4.31 (0.83–22.5). Although the probability of detecting positive H1N1 (2009) positive aerosols when performing various AGPs on intensive care patients above the baseline rate (i.e. in the absence of AGPs) did not reach significance, there was a trend towards hierarchy of AGPs, placing bronchoscopy and respiratory and airway suctioning above baseline (background) values. Further, larger studies are required but these preliminary findings may be of benefit to infection control teams. [ABSTRACT FROM AUTHOR]

Published
2013
Full Text
View/download PDF

30. A scoping review: urinary markers of metabolic maturation in infants with CHD and the relationship to growth.

Author

Marino LV, Paulson S, Ashton JJ, Weeks C, Young A, Pappachan JVP, Swann JR, Johnson MJ, and Beattie RM

Subjects
Infant, Humans, Nutritional Status, Cardiac Surgical Procedures
Abstract

Background: Growth failure in infants born with CHD is a persistent problem, even in those provided with adequate nutrition., Objective: To summarise the published data describing the change in urinary metabolites during metabolic maturation in infants with CHD and identify pathways amenable to therapeutic intervention., Design: Scoping review., Eligibility Criteria: Studies using qualitative or quantitative methods to describe urinary metabolites pre- and post-cardiac surgery and the relationship with growth in infants with CHD., Sources of Evidence: NICE Healthcare Databases website was used as a tool for multiple searches., Results: 347 records were identified, of which 37 were duplicates. Following the removal of duplicate records, 310 record abstracts and titles were screened for inclusion. The full texts of eight articles were reviewed for eligibility, of which only two related to infants with CHD. The studies included in the scoping review described urinary metabolites in 42 infants. A content analysis identified two overarching themes of metabolic variation predictive of neurodevelopmental abnormalities associated with anaerobic metabolism and metabolic signature associated with the impact on gut microbiota, inflammation, energy, and lipid digestion., Conclusion: The results of this scoping review suggest that there are considerable gaps in our knowledge relating to metabolic maturation of infants with CHD, especially with respect to growth. Surgery is a key early life feature for CHD infants and has an impact on the developing biochemical phenotype with implications for metabolic pathways involved in immunomodulation, energy, gut microbial, and lipid metabolism. These early life fingerprints may predict those individuals at risk for neurodevelopmental abnormalities.

Published
2023
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results