Critical Care

Critical care wardCritical care involves the care of the sickest patients in the hospital. Critically ill patients have usually been through a significant insult to their body (such as trauma, infection, burn) and have developed organ failure and require life-support. Critical Care is the largest theme bringing together clinicians and scientists from diverse backgrounds and includes collaborative research from hospitals throughout north-west London. Investigations range from evaluating biological mechanisms of organ failure through to the development of innovative technologies which allow the short-term and long-term support and recovery of organs. 

Many people are exposed to the environment of an Intensive care unit (ICU) either personally or through a family member. It is often a life-changing event and our work aims to reduce this impact facilitating post-ICU recovery.

Research themes:

Citation

BibTex format

@article{Palazzo:2014:10.4103/2321-3868.126090,
author = {Palazzo, S and James-Veldsman, E and Wall, C and Hayes, M and Vizcaychipi, M},
doi = {10.4103/2321-3868.126090},
journal = {Burns and Trauma},
pages = {29--35},
title = {Ventilation strategies in burn intensive care: A retrospective observational study},
url = {http://dx.doi.org/10.4103/2321-3868.126090},
volume = {2},
year = {2014}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Consensus regarding optimal burns intensive care (BICU) patient management is lacking. This study aimed to assess whether ventilation strategies, cardiovascular support and sedation in BICU patients have changed over time, and whether this affects outcome. A retrospective observational study comparing two 12-patient BICU cohorts (2005/06 and 2010/11) was undertaken. Demographic and admission characteristics, ventilation parameters, sedation, fluid resuscitation, cardiovascular support and outcome (length of stay, mortality) data were collected from patient notes. Data was analysed using T-tests, Fisher's exact and Mann-Whitney U tests. In our study cohort groups were equivalent in demographic and admission parameters. There were equal ventilator-free days in the two cohorts 10 ± 12.7 vs. 13.3 ± 12.2 ventilator free days; P = 0.447). The 2005/06 cohort were mechanically ventilated more often than in 2010/11 cohort (568 ventilator days/1000 patient BICU days vs. 206 ventilator days/1000 patient BICU days; P = 0.001). The 2005/06 cohort were ventilated less commonly in tracheostomy group/endotracheal tube spontaneous (17.8% vs. 26%; P = 0.001) and volume-controlled modes (34.4% vs. 40.8%; P = 0.001). Patients in 2010/11 cohort were more heavily sedated (P = 0.001) with more long-acting sedative drug use (P = 0.001) than the 2005/06 cohort, fluid administration was equivalent. Patient outcome did not vary. Inhalational injury patients were ventilated in volume-controlled (44.5% vs. 28.1%; P = 0.001) and pressure-controlled modes (18.2% vs. 9.5%; P = 0.001) more frequently than those without. Outcome did not vary. This study showed there has been shift away from mechanical ventilation, with increased use of tracheostomy/tracheal tube airway spontaneous ventilation. Inhalation injury patients require more ventilatory support though patient outcomes do not differ. Prospective trials are required to establish which strategies confer benefit
AU  - Palazzo,S
AU  - James-Veldsman,E
AU  - Wall,C
AU  - Hayes,M
AU  - Vizcaychipi,M
DO  - 10.4103/2321-3868.126090
EP  - 35
PY  - 2014///
SP  - 29
TI  - Ventilation strategies in burn intensive care: A retrospective observational study
T2  - Burns and Trauma
UR  - http://dx.doi.org/10.4103/2321-3868.126090
VL  - 2
ER  -
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