Imperial College London

DrIanMaconochie

Faculty of MedicineSchool of Public Health

Professor of Practice (Paediatric Emergency Medicine)
 
 
 
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Contact

 

+44 (0)20 3312 3729i.maconochie

 
 
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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

240 results found

Soar J, Donnino MW, Maconochie I, Aickin R, Atkins DL, Andersen LW, Berg KM, Bingham R, Boettiger BW, Callaway CW, Couper K, Couto TB, de Caen AR, Deakin CD, Drennan IR, Guerguerian A-M, Lavonas EJ, Meaney PA, Nadkarni VM, Neumar RW, Ng K-C, Nicholson TC, Nuthall GA, Ohshimo S, O'Neil BJ, Ong GY-K, Paiva EF, Parr MJ, Reis AG, Reynolds JC, Ristagno G, Sandroni C, Schexnayder SM, Scholefield BR, Shimizu N, Tijssen JA, Van de Voorde P, Wang T-L, Welsford M, Hazinski MF, Nolan JP, Morley PTet al., 2018, 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, RESUSCITATION, Vol: 133, Pages: 194-206, ISSN: 0300-9572

Journal article

de Caen A, Maconochie I, 2018, EtCO2 measurement during pediatric cardiac arrest: Does the Emperor have no clothes?, Resuscitation, Vol: 133, Pages: A1-A2, ISSN: 0300-9572

Journal article

Ahmad F, Prabhu R, Liao J, Soe S, Jones MD, Miller J, Berthelson P, Enge D, Copeland KM, Shaabeth S, Johnston R, Maconochie I, Theobald PSet al., 2018, Biomechanical properties and microstructure of neonatal porcine ventricles, Journal of the Mechanical Behavior of Biomedical Materials, Vol: 88, Pages: 18-28, ISSN: 1751-6161

Neonatal heart disorders represent a major clinical challenge, with congenital heart disease alone affecting 36,000 new-borns annually within the European Union. Surgical intervention to restore normal function includes the implantation of synthetic and biological materials; however, a lack of experimental data describing the mechanical behaviour of neonatal cardiac tissue is likely to contribute to the relatively poor short- and long-term outcome of these implants. This study focused on characterising the mechanical behaviour of neonatal cardiac tissue using a porcine model, to enhance the understanding of how this differs to the equivalent mature tissue. The biomechanical properties of neonatal porcine cardiac tissue were characterised by uniaxial tensile, biaxial tensile, and simple shear loading modes, using samples collected from the anterior and posterior walls of the right and left ventricles. Histological images were prepared using Masson’s trichrome staining, to enable assessment of the microstructure and correlation with tissue behaviour. The mechanical tests demonstrated that the neonatal cardiac tissue is non–linear, anisotropic, viscoelastic and heterogeneous. Our data provide a baseline describing the biomechanical behaviour of immature porcine cardiac tissue. Comparison with published data also indicated that the neonatal porcine cardiac tissue exhibits one-half the stiffness of mature porcine tissue in uniaxial extension testing, one-third in biaxial extension testing, and one-fourth stiffness in simple shear testing; hence, it provides an indication as to the relative change in characteristics associated with tissue maturation. These data may prove valuable to researchers investigating neonatal cardiac mechanics.

Journal article

Lillitos PJ, Lyttle MD, Roland D, Powell CVE, Sandell J, Rowland AG, Chapman SM, Maconochie IKet al., 2018, Defining significant childhood illness and injury in the Emergency Department: a consensus of UK and Ireland expert opinion, Emergency Medicine Journal, Vol: 35, Pages: 685-690, ISSN: 1472-0205

Background Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist.Objectives To establish standardised significant illness endpoints for use in determining the performance accuracy of PEWS and safety systems in emergency departments (ED), using a consensus of expert opinion in the UK and Ireland.Design Between July 2017 and February 2018, three online Delphi rounds established a consensus on ‘significant’ clinical conditions, derived from a list of common childhood illness/injury ED presentations. Conditions warranting acute hospital admission in the opinion of the respondent were defined as ‘significant’, using a 5-point Likert scale. The consensus was a priori ≥80% (positive or negative). 258 clinical conditions were tested.Participants and settings Eligible participants were consultants in acute or EM paediatrics, or adult EM, accessed via 53 PERUKI (Paediatric Emergency Research in the UK and Ireland)’s research collaborative sites, and 27 GAPRUKI (General and Adolescent Paediatric Research in the UK and Ireland)’s sites, 17 of which overlap with PERUKI.Main outcome measures To create a list of conditions regarded as ‘significant’with ≥80% expert consensus.Results 43 (68%) of 63 PERUKI and GAPRUKI sites responded; 295 experts were invited to participate. Participants in rounds 1, 2 and 3 were 223 (76%), 177 (60%) and 148 (50%), respectively; 154 conditions reached positive consensus as ‘significant’; 1 condition reached a negative consensus (uncomplicated Henoch-Schönlein purpura); and 37 conditions achieved non-consensus.Conclusions A list of significant childhood conditions has been created using UK and Irish expert consensus, for research purposes, for the first time. Th

Journal article

Vassallo J, Nutbeam T, Rickard AC, Lyttle MD, Scholefield B, Maconochie IK, Smith JEet al., 2018, Paediatric traumatic cardiac arrest: the development of an algorithm to guide recognition, management and decisions to terminate resuscitation, EMERGENCY MEDICINE JOURNAL, Vol: 35, Pages: 669-674, ISSN: 1472-0205

Journal article

Booth A, Moylan A, Hodgson J, Wright K, Langworthy K, Shimizu N, Maconochie Iet al., 2018, Resuscitation registers: How many active registers are there and how many collect data on paediatric cardiac arrests?, RESUSCITATION, Vol: 129, Pages: 70-75, ISSN: 0300-9572

Journal article

Rickard AC, Vassallo J, Nutbeam T, Lyttle MD, Maconochie IK, Enki DG, Smith JEet al., 2018, Paediatric traumatic cardiac arrest: a Delphi study to establish consensus on definition and management, EMERGENCY MEDICINE JOURNAL, Vol: 35, Pages: 434-439, ISSN: 1472-0205

Journal article

Kleinman ME, Perkins GD, Bhanji F, Billi JE, Bray JE, Callaway CW, de Caen A, Finn JC, Hazinski MF, Lim SH, Maconochie I, Morley P, Nadkarni V, Neumar RW, Nikolaou N, Nolan JP, Reis A, Sierra AF, Singletary EM, Soar J, Stanton D, Travers A, Welsford M, Zideman Det al., 2018, ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement, RESUSCITATION, Vol: 127, Pages: 132-146, ISSN: 0300-9572

Journal article

Kleinman ME, Perkins GD, Bhanji F, Billi JE, Bray JE, Callaway CW, de Caen A, Finn JC, Hazinski MF, Lim SH, Maconochie I, Nadkarni V, Neumar RW, Nikolaou N, Nolan JP, Reis A, Sierra AF, Singletary EM, Soar J, Stanton D, Travers A, Welsford M, Zideman Det al., 2018, ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care A Consensus Statement, CIRCULATION, Vol: 137, Pages: E802-E819, ISSN: 0009-7322

Journal article

Perkins GD, Olasveengen TM, Maconochie I, Soar J, Wyllie J, Greif R, Lockey A, Semeraro F, Van de Voorde P, Lott C, Monsieurs KG, Nolan JPet al., 2018, European Resuscitation Council Guidelines for Resuscitation: 2017 update, RESUSCITATION, Vol: 123, Pages: 43-50, ISSN: 0300-9572

Journal article

Chong S-L, Ong GY-K, Chin WYW, Chua JM, Nair P, Ong ASZ, Ng KC, Maconochie Iet al., 2018, A retrospective review of vital signs and clinical outcomes of febrile infants younger than 3 months old presenting to the emergency department., PLoS ONE, Vol: 13, ISSN: 1932-6203

OBJECTIVES: Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. We aim to describe a large population of febrile infants less than 3 months old presenting to a pediatric emergency department (ED) and to assess the performance of current heart rate guidelines in the prediction of serious infections (SI). MATERIALS AND METHODS: We performed a retrospective review of febrile infants younger than 3 months old, between March 2015 and Feb 2016, in a large tertiary pediatric ED. We documented the primary outcome of SI for each infant, as well as the clinical findings, vital signs, and Severity Index Score (SIS). We assessed the performance of the Paediatric Canadian Triage and Acuity Scale (PaedCTAS), Advanced Pediatric Life Support (APLS) guidelines and Fleming normal reference values, using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operating characteristics curve (AUC). RESULTS: 1057 infants were analyzed, with 326 (30.6%) infants diagnosed with SI. High temperature, tachycardia, and low SIS score were significantly associated with SI. Item analysis showed that the SIS performance was driven by the presence of mottling (p = 0.003) and high temperature (p<0.001). The APLS guideline had the highest sensitivity (66.0%, 95% CI 60.5-71.1%), NPV (73.3%, 95% CI 69.7-76.5%) and AUC (0.538), while the PaedCTAS (2 standard deviation from normal) had the highest specificity (98.5%, 95% CI 97.3-99.3%) and PPV (55.2%, 95% CI 32.7-71.0%). CONCLUSIONS: Current guidelines on infantile heart rates have a variable performance. In our study, the APLS heart rate guidelines performed with the highest sensitivity, but no individual guideline predicted for SIs satisfactorily.

Journal article

Maconochie I, de Caen A, 2018, When should ADULT CPR be delivered to children?, RESUSCITATION, Vol: 122, Pages: A4-A5, ISSN: 0300-9572

Journal article

Appelbaum N, Clarke J, Maconochie I, Darzi Aet al., 2017, A model for habitus-adjusted paediatric weight estimation by age and data concerning the validation of this method on a large dataset of English children., Data in Brief, Vol: 16, Pages: 771-774, ISSN: 2352-3409

It is often not possible to weigh children upon arrival at an emergency room before commencing the provision of emergency care. Because drugs for children are prescribed on the basis of age and body weight, estimations of weight are necessitated. Age-based equations have been one of the most commonly used weight estimation strategies historically. Due to the variability of weight for age in children, and variations in body habitus, these methods are inaccurate by design (Young and Korotzer, 2016) [1].

Journal article

Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castren M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian A-M, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Lofgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng K-C, Nadkarni VM, Nishiyama C, Nuthall G, Ong GY-K, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JPet al., 2017, 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, CIRCULATION, Vol: 136, Pages: E424-E440, ISSN: 0009-7322

Journal article

Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham RM, Brooks SC, Castren M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian A-M, Hatanaka T, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Lofgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng K-C, Nadkarni VM, Nishiyama C, Nuthall G, Ong GY-K, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra AF, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers A, Vaillancourt C, Van de Voorde P, Hazinski MF, Nolan JPet al., 2017, 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Summary, RESUSCITATION, Vol: 121, Pages: 201-214, ISSN: 0300-9572

Journal article

Perkins GD, Neumar R, Monsieurs KG, Lim SH, Castren M, Nolan JP, Nadkarni V, Montgomery B, Steen P, Cummins R, Chamberlain D, Aickin R, De Caen A, Wang T-L, Stanton D, Escalante R, Callaway CW, Soar J, Olasveengen T, Maconochie I, Wyckoff M, Greif R, Singletary EM, O'Connor R, Iwami T, Morrison L, Morley P, Lang E, Bossaert Let al., 2017, The International Liaison Committee on Resuscitation-Review of the last 25 years and vision for the future, RESUSCITATION, Vol: 121, Pages: 104-116, ISSN: 0300-9572

Journal article

Appelbaum N, Clarke J, Maconochie I, Darzi Aet al., 2017, Paediatric weight estimation by age in the digital era: optimising a necessary evil., Resuscitation, Vol: 122, Pages: 29-35, ISSN: 0300-9572

BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool. 1,070,743 children from the 2015/2016 UK National Child Measurement Program dataset, aged between 4 and 5 and 11 and 12 years, had age-based weight estimates made by all five methods. RESULTS: Primary outcomes were the percentage of weight estimations within 10%, 20%, and those greater than 20% discrepant from actual weight for each method. Our theoretical, gender-dependent, habitus-adjusted method performed better than all other methods across all error thresholds. The overall number of estimations within 10% was 70.4%, and within 20% was 95.45%. The mean percentage error was -1% compared to actual weight. CONCLUSION: The use of a digital tool incorporating a subjective assessment of body habitus, gender assignment, and the ability to estimate weight based on age-in-months might be able optimise the process of paediatric weight estimation by age, making this practice as safe and accurate as possible for the occasions when weight estimation by age is chosen over length-based methods.

Journal article

Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI, Perkins GD, Soar J, Truhlar A, Wyllie J, Zideman DAet al., 2017, Executive Summary. Section 1 of the European Resuscitation Council Guidelines for Resuscitation 2015 (vol 19, pg 54, 2015), NOTFALL & RETTUNGSMEDIZIN, Vol: 20, Pages: 538-539, ISSN: 1434-6222

Journal article

Maconochie IK, 2017, Highlights from this issue, Emergency Medicine Journal, Vol: 34, ISSN: 1472-0205

Journal article

Bressan S, Lyphout C, Yordanov Y, Da Dalt L, Maconochie Iet al., 2017, Management of pediatric head injury: a survey of EuSEM pediatric emergency section, EUROPEAN JOURNAL OF EMERGENCY MEDICINE, Vol: 24, Pages: 308-309, ISSN: 0969-9546

Journal article

Lopez-Herce J, Rodriguez Nunez A, Maconochie I, Van de Voorde P, Biarent D, Eich C, Bingham R, Rajka T, Zideman D, Carrillo A, de Lucas N, Calvo C, Manrique Iet al., 2017, Current international recommendations for pediatric cardiopulmonary resuscitation: the European guidelines, EMERGENCIAS, Vol: 29, Pages: 266-281, ISSN: 1137-6821

Journal article

Deakin CD, England S, Diffey D, Maconochie Iet al., 2017, Can ambulance telephone triage using NHS Pathways accurately identify paediatric cardiac arrest?, RESUSCITATION, Vol: 116, Pages: 109-112, ISSN: 0300-9572

Journal article

Robinson C, Wolters A, Steventon A, Hargreaves D, Pope R, Maconochie Iet al., 2017, Predictors of emergency department attendance following NHS 111 calls for children and young people: analysis of linked data., Clin Med (Lond), Vol: 17, Pages: s13-s13

Journal article

Lillitos PJ, Maconochiet IK, 2017, Paediatric early warning systems (PEWS and Trigger systems) for the hospitalised child: time to focus on the evidence, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 102, Pages: 479-480, ISSN: 0003-9888

Journal article

Cleugh FM, Maconochie IK, 2017, Management of the multiply injured child, PAEDIATRICS & CHILD HEALTH, Vol: 27, Pages: 209-214, ISSN: 1205-7088

Journal article

Donoghue K, Rose H, Boniface S, Deluca P, Coulton S, Alam MF, Gilvarry E, Kaner E, Lynch E, Maconochie I, McArdle P, McGovern R, Newbury-Birch D, Patton R, Phillips CJ, Phillips T, Russell I, Strang J, Drummond Cet al., 2017, Alcohol Consumption, Early-Onset Drinking, and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England, JOURNAL OF ADOLESCENT HEALTH, Vol: 60, Pages: 438-446, ISSN: 1054-139X

Journal article

Maconochie I, 2016, Highlights from this issue, Emergency medicine journal : EMJ, Vol: 33

Journal article

Nijman R, Jorgensen R, Maconochie I, 2016, MANAGEMENT OF CHILDREN WITH FEVER FULFILLING CRITERIA FOR PAEDIATRIC SEPSIS: PROSPECTIVE STUDY IN PAEDIATRIC EMERGENCY CARE, EUROPEAN JOURNAL OF PEDIATRICS, Vol: 175, Pages: 1494-1494, ISSN: 0340-6199

Journal article

Sandell JM, Maconochie IK, 2016, Paediatric early warning systems (PEWS) in the ED, EMERGENCY MEDICINE JOURNAL, Vol: 33, Pages: 754-755, ISSN: 1472-0205

Journal article

Nijman R, Jorgensen R, Oostenbrink R, Maconochie Iet al., 2016, THE ROLE OFANTIPYRETICS IN LOWERING HEART RATE AND RESPIRATORY RATE IN FEBRILE CHILDREN AT RISK OF SERIOUS BACTERIAL INFECTIONS IN THE EMERGENCY DEPARTMENT, EUROPEAN JOURNAL OF PEDIATRICS, Vol: 175, Pages: 1431-1432, ISSN: 0340-6199

Journal article

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