Imperial College London

DrDavidInwald

Faculty of MedicineFaculty of Medicine Centre

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3312 1625d.inwald

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

80 results found

Brick T, Agbeko RS, Davies P, Davis PJ, Deep A, Fortune P-M, Inwald DP, Jones A, Levin R, Morris KP, Pappachan J, Ray S, Tibby SM, Tume LN, Peters MJet al., 2017, Attitudes towards fever amongst UK paediatric intensive care staff, EUROPEAN JOURNAL OF PEDIATRICS, Vol: 176, Pages: 423-427, ISSN: 0340-6199

JOURNAL ARTICLE

Marlais M, Lyttle MD, Inwald D, 2017, Ten concerns about blood pressure measurement and targets in paediatric sepsis, INTENSIVE CARE MEDICINE, Vol: 43, Pages: 433-435, ISSN: 0342-4642

JOURNAL ARTICLE

Marlais M, Lyttle MD, Inwald D, 2017, Ten concerns about blood pressure measurement and targets in paediatric sepsis (vol 43, pg 433, 2017), INTENSIVE CARE MEDICINE, Vol: 43, Pages: 472-472, ISSN: 0342-4642

JOURNAL ARTICLE

O'Brien S, Nadel S, Almossawi O, Inwald DPet al., 2017, The Impact of Chronic Health Conditions on Length of Stay and Mortality in a General PICU, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 18, Pages: 1-7, ISSN: 1529-7535

JOURNAL ARTICLE

O'Hara CB, Canter RR, Mouncey PR, Carter A, Jones N, Nadel S, Peters MJ, Lyttle MD, Harrison DA, Rowan KM, Inwald D, Woolfall Ket al., 2017, A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock., Arch Dis Child

OBJECTIVE: The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. DESIGN: Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. PARTICIPANTS: Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child's hospital admission (range: 1-41). RESULTS: All parents said they would have provided consent for the use of their child's data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child's death, but supported a personalised postal 'opt-out' approach to consent. CONCLUSIONS: Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents' views informed the development of the pilot trial protocol and site staff training. TRIAL REGISTRATION NUMBER: ISRCTN15244462-results.

JOURNAL ARTICLE

Potes C, Conroy B, Xu-Wilson M, Newth C, Inwald D, Frassica Jet al., 2017, A clinical prediction model to identify patients at high risk of hemodynamic instability in the pediatric intensive care unit, CRITICAL CARE, Vol: 21, ISSN: 1466-609X

JOURNAL ARTICLE

Ray S, Rogers L, Noren DP, Dhar R, Nadel S, Peters MJ, Inwald DPet al., 2017, Risk of over-diagnosis of hypotension in children: a comparative analysis of over 50,000 blood pressure measurements, INTENSIVE CARE MEDICINE, Vol: 43, Pages: 1540-1541, ISSN: 0342-4642

JOURNAL ARTICLE

Ray S, Rogers L, Noren DP, Dhar R, Nadel S, Peters MJ, Inwald DPet al., 2017, Erratum to: Risk of over-diagnosis of hypotension in children: a comparative analysis of over 50,000 blood pressure measurements., Intensive Care Med

JOURNAL ARTICLE

Soo AKS, Inwald DP, 2017, Pulmonary hemorrhage as a complication of Respiratory Syncyntial Virus (RSV) bronchiolitis, PEDIATRIC PULMONOLOGY, Vol: 52, Pages: E32-E36, ISSN: 8755-6863

JOURNAL ARTICLE

Herberg JA, Kaforou M, Wright VJ, Shailes H, Eleftherohorinou H, Hoggart CJ, Cebey-Lopez M, Carter MJ, Janes VA, Gormley S, Shimizu C, Tremoulet AH, Barendregt AM, Salas A, Kanegaye J, Pollard AJ, Faust SN, Patel S, Kuijpers T, Martinon-Torres F, Burns JC, Coin LJM, Levin Met al., 2016, Diagnostic Test Accuracy of a 2-Transcript Host RNA Signature for Discriminating Bacterial vs Viral Infection in Febrile Children, JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, Vol: 316, Pages: 835-845, ISSN: 0098-7484

JOURNAL ARTICLE

Inwald D, Jolowicz K, 2016, Tony Inwald Obituary, BMJ-BRITISH MEDICAL JOURNAL, Vol: 355, ISSN: 1756-1833

JOURNAL ARTICLE

Karam O, Demaret P, Duhamel A, Shefler A, Spinella PC, Stanworth SJ, Tucci M, Leteurtre S, PlasmaTV investigatorset al., 2016, Performance of the PEdiatric Logistic Organ Dysfunction-2 score in critically ill children requiring plasma transfusions., Ann Intensive Care, Vol: 6, ISSN: 2110-5820

BACKGROUND: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions. METHODS: This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer-Lemeshow test). RESULTS: Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71-0.81) and the Hosmer-Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1. CONCLUSIONS: In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.

JOURNAL ARTICLE

Martinon-Torres F, Png E, Khor CC, Davila S, Wright VJ, Sim KS, Vega A, Fachal L, Inwald D, Nadel S, Carrol ED, Martinon-Torres N, Marcos Alonso S, Carracedo A, Morteruel E, Lopez-Bayon J, Concha Torre A, Calvo Monge C, Gonzalez de Aguilar PA, Esteban Torne E, del Carmen Martinez-Padilla M, Maria Martinon-Sanchez J, Levin M, Hibberd ML, Salas Aet al., 2016, Natural resistance to Meningococcal Disease related to CFH loci: Meta-analysis of genome-wide association studies, SCIENTIFIC REPORTS, Vol: 6, ISSN: 2045-2322

JOURNAL ARTICLE

Ray S, Cvetkovic M, Brierley J, Lutman DH, Pathan N, Ramnarayan P, Inwald DP, Peters MJet al., 2016, SHOCK INDEX VALUES AND TRENDS IN PEDIATRIC SEPSIS: PREDICTORS OR THERAPEUTIC TARGETS? A RETROSPECTIVE OBSERVATIONAL STUDY, SHOCK, Vol: 46, Pages: 279-286, ISSN: 1073-2322

JOURNAL ARTICLE

Ray S, Cvetkovic M, Lutman DH, Pathan N, Ramnarayan P, Inwald DP, Peters MJet al., 2016, Real-life use of vasopressors and inotropes in cardiogenic shock-observation is necessarily 'theory-laden', CRITICAL CARE, Vol: 20, ISSN: 1466-609X

JOURNAL ARTICLE

Wilson C, Sambandamoorthy G, Holloway P, Ramnarayan P, Inwald DPet al., 2016, Admission Plasma Troponin I Is Associated With Mortality in Pediatric Intensive Care, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 17, Pages: 831-836, ISSN: 1529-7535

JOURNAL ARTICLE

Amores-Hernandez I, Besser RE, Dattani MT, Inwald DPet al., 2015, A 12-year-old child with fever, headache, shock, and coma., Lancet, Vol: 385, Pages: 576-576, ISSN: 1474-547X

JOURNAL ARTICLE

Correia GDS, Ng KW, Wijeyesekera A, Gala-Peralta S, Williams R, MacCarthy-Morrogh S, Jimenez B, Inwald D, Macrae D, Frost G, Holmes E, Pathan Net al., 2015, Metabolic Profiling of Children Undergoing Surgery for Congenital Heart Disease, CRITICAL CARE MEDICINE, Vol: 43, Pages: 1467-1476, ISSN: 0090-3493

JOURNAL ARTICLE

Cvetkovic M, Lutman D, Ramnarayan P, Pathan N, Inwald DP, Peters MJet al., 2015, Timing of Death in Children Referred for Intensive Care With Severe Sepsis: Implications for Interventional Studies, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 16, Pages: 410-417, ISSN: 1529-7535

JOURNAL ARTICLE

Inwald DP, Butt W, Tasker RC, 2015, Fluid resuscitation of shock in children: what, whence and whither?, INTENSIVE CARE MEDICINE, Vol: 41, Pages: 1457-1459, ISSN: 0342-4642

JOURNAL ARTICLE

Inwald DP, Sinitsky L, Walls D, Nadel Set al., 2015, Fluid Overload in General PICU Reply, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 16, Pages: 685-686, ISSN: 1529-7535

JOURNAL ARTICLE

Karam O, Demaret P, Shefler A, Leteurtre S, Spinella PC, Stanworth SJ, Tucci M, Canadian Critical Care Trials Group CCCTG, Pediatric Acute Lung Injury and Sepsis Investigators PALISI, BloodNet, PlasmaTV Investigatorset al., 2015, Indications and Effects of Plasma Transfusions in Critically Ill Children., Am J Respir Crit Care Med, Vol: 191, Pages: 1395-1402

RATIONALE: Plasma transfusions are frequently prescribed for critically ill children, although their indications lack a strong evidence base. Plasma transfusions are largely driven by physician conceptions of need, and these are poorly documented in pediatric intensive care patients. OBJECTIVES: To identify patient characteristics and to characterize indications leading to plasma transfusions in critically ill children, and to assess the effect of plasma transfusions on coagulation tests. METHODS: Point-prevalence study in 101 pediatric intensive care units in 21 countries, on 6 predefined weeks. All critically ill children admitted to a participating unit were included if they received at least one plasma transfusion. MEASUREMENTS AND MAIN RESULTS: During the 6 study weeks, 13,192 children were eligible. Among these, 443 (3.4%) received at least one plasma transfusion and were included. The primary indications for plasma transfusion were critical bleeding in 22.3%, minor bleeding in 21.2%, planned surgery or procedure in 11.7%, and high risk of postoperative bleeding in 10.6%. No bleeding or planned procedures were reported in 34.1%. Before plasma transfusion, the median international normalized ratio (INR) and activated partial thromboplastin time (aPTT) values were 1.5 and 48, respectively. After plasma transfusion, the median INR and aPTT changes were -0.2 and -5, respectively. Plasma transfusion significantly improved INR only in patients with a baseline INR greater than 2.5. CONCLUSIONS: One-third of transfused patients were not bleeding and had no planned procedure. In addition, in most patients, coagulation tests are not sensitive to increases in coagulation factors resulting from plasma transfusion. Studies assessing appropriate plasma transfusion strategies are urgently needed.

JOURNAL ARTICLE

Sinitsky L, Walls D, Nadel S, Inwald DPet al., 2015, Fluid Overload at 48 Hours Is Associated With Respiratory Morbidity but Not Mortality in a General PICU: Retrospective Cohort Study, PEDIATRIC CRITICAL CARE MEDICINE, Vol: 16, Pages: 205-209, ISSN: 1529-7535

JOURNAL ARTICLE

Inwald DP, Arul GS, Montgomery M, Henning J, McNicholas J, Bree Set al., 2014, Management of children in the deployed intensive care unit at Camp Bastion, Afghanistan, JOURNAL OF THE ROYAL ARMY MEDICAL CORPS, Vol: 160, Pages: 236-240, ISSN: 0035-8665

JOURNAL ARTICLE

Macrae D, Grieve R, Allen E, Sadique Z, Betts H, Morris K, Pappachan VJ, Parslow R, Tasker RC, Baines P, Broadhead M, Duthie ML, Fortune P-M, Inwald D, McMaster P, Peters MJ, Schindler M, Guerriero C, Piercy D, Slavik Z, Snowdon C, Van Dyck L, Elbourne Det al., 2014, A clinical and economic evaluation of Control of Hyperglycaemia in Paediatric intensive care (CHiP): a randomised controlled trial, HEALTH TECHNOLOGY ASSESSMENT, Vol: 18, Pages: 1-+, ISSN: 1366-5278

JOURNAL ARTICLE

Macrae D, Grieve R, Allen E, Sadique Z, Morris K, Pappachan J, Parslow R, Tasker RC, Elbourne Det al., 2014, A Randomized Trial of Hyperglycemic Control in Pediatric Intensive Care, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 370, Pages: 107-118, ISSN: 0028-4793

JOURNAL ARTICLE

McLean JRL, Inwald DP, 2014, The utility of stroke volume variability as a predictor of fluid responsiveness in critically ill children: a pilot study, INTENSIVE CARE MEDICINE, Vol: 40, Pages: 288-289, ISSN: 0342-4642

JOURNAL ARTICLE

Montero-Martin M, Inwald DP, Carrol ED, Martinon-Torres Fet al., 2014, Prognostic markers of meningococcal disease in children: recent advances and future challenges, EXPERT REVIEW OF ANTI-INFECTIVE THERAPY, Vol: 12, Pages: 1357-1369, ISSN: 1478-7210

JOURNAL ARTICLE

Warrick C, Patel P, Hyer W, Neale G, Sevdalis N, Inwald Det al., 2014, Diagnostic error in children presenting with acute medical illness to a community hospital, INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, Vol: 26, Pages: 538-546, ISSN: 1353-4505

JOURNAL ARTICLE

Couto-Alves A, Wright VJ, Perumal K, Binder A, Carrol ED, Emonts M, de Groot R, Hazelzet J, Kuijpers T, Nadel S, Zenz W, Ramnarayan P, Levin M, Coin L, Inwald DPet al., 2013, A new scoring system derived from base excess and platelet count at presentation predicts mortality in paediatric meningococcal sepsis, CRITICAL CARE, Vol: 17, ISSN: 1466-609X

JOURNAL ARTICLE

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