Nicholas Hart
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View article: Symptomatic improvement in patients with excessive dynamic airway collapse (EDAC) following initiation of positive airway pressure therapy
Symptomatic improvement in patients with excessive dynamic airway collapse (EDAC) following initiation of positive airway pressure therapy Open
Excessive dynamic airway collapse (EDAC) is characterized by abnormal airway collapse during expiration, leading to symptoms such as breathlessness, cough, and reduced quality of life. Treatment options remain limited, and evidence-based g…
View article: Neurologic and Psychological Outcomes 2 Years After Multisystem Inflammatory Syndrome in Children
Neurologic and Psychological Outcomes 2 Years After Multisystem Inflammatory Syndrome in Children Open
Importance Neurologic and psychological sequelae are observed 1 year after hospitalization for multisystem inflammatory syndrome in children (MIS-C), but whether these concerns persist is not known. Objective To examine the trajectory of n…
View article: Codeveloping a Novel Intervention for People With Post‐COVID Condition: The Balance‐ACT Study
Codeveloping a Novel Intervention for People With Post‐COVID Condition: The Balance‐ACT Study Open
Introduction Some people experience persistent symptoms, such as fatigue, brain fog and breathlessness, long after the onset of COVID‐19 infection. This is known as the post‐COVID syndrome (PCS). We developed a unique and holistic psycho‐p…
View article: Improving physical function with physiotherapy assistants following intensive care unit admission (EMPRESS): A randomised controlled feasibility study
Improving physical function with physiotherapy assistants following intensive care unit admission (EMPRESS): A randomised controlled feasibility study Open
Introduction: Early rehabilitation of critically ill patients is challenging due to limited staff resources. This study assessed the feasibility of delivering a randomised controlled trial of physiotherapy assistants delivering early proto…
View article: Implementation of a Quality Improvement Tool “Recover25” to Guide the Care of Patients Experiencing Prolonged Critical Illness: A Mixed-Method Feasibility Study
Implementation of a Quality Improvement Tool “Recover25” to Guide the Care of Patients Experiencing Prolonged Critical Illness: A Mixed-Method Feasibility Study Open
OBJECTIVES: Few quality improvement (QI) tools are specifically designed to manage the care of patients experiencing prolonged critical illness. This risks omissions in care. To determine the implementation feasibility and clinician accept…
View article: Core Outcome Set for Studies Investigating Secretion Clearance Interventions Used in the Community by Patients With Neuromuscular Disease
Core Outcome Set for Studies Investigating Secretion Clearance Interventions Used in the Community by Patients With Neuromuscular Disease Open
Background: Several treatments are used in the community to improve secretion clearance for patients with neuromuscular disease (NMD). However, the optimal intervention remains unclear with further research required. We aimed to dev…
View article: Foetal cortical expansion is associated with neurodevelopmental outcome at 2-years in congenital heart disease: a longitudinal follow-up study
Foetal cortical expansion is associated with neurodevelopmental outcome at 2-years in congenital heart disease: a longitudinal follow-up study Open
View article: Outcomes and measures in studies of techniques to promote secretion clearance in individuals with neuromuscular conditions: a scoping review
Outcomes and measures in studies of techniques to promote secretion clearance in individuals with neuromuscular conditions: a scoping review Open
Background Techniques to support secretion clearance for individuals with neuromuscular conditions and respiratory muscle weakness include mechanical insufflation–exsufflation and chest wall vibrations. Assessing the comparative efficacy o…
View article: Mechanical insufflation-exsufflation use in neuromuscular disease: a single centre cohort study
Mechanical insufflation-exsufflation use in neuromuscular disease: a single centre cohort study Open
Introduction Mechanical insufflation-exsufflation (MIE) is a commonly used therapy to augment secretion clearance in individuals with neuromuscular disease. There are no clear evidence-based guidelines on the settings that should be used i…
View article: Lower Airway and Oral Microbiome Dysbiosis in Patients with Long COVID Post-Hospitalisation: A UK Multicentre, Prospective Cohort Study
Lower Airway and Oral Microbiome Dysbiosis in Patients with Long COVID Post-Hospitalisation: A UK Multicentre, Prospective Cohort Study Open
View article: Home high-flow therapy during recovery from severe chronic obstructive pulmonary disease (COPD) exacerbation: a mixed-methods feasibility randomised control trial
Home high-flow therapy during recovery from severe chronic obstructive pulmonary disease (COPD) exacerbation: a mixed-methods feasibility randomised control trial Open
Introduction Patients recovering from severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a 30-day readmission rate of 20%. This study evaluated the feasibility of conducting a randomised controlled trial to e…
View article: Physiological Assessment of ECCO <sub>2</sub> R on the Work of Breathing in Exacerbations of COPD
Physiological Assessment of ECCO <sub>2</sub> R on the Work of Breathing in Exacerbations of COPD Open
Clinicaltrials.gov; NCT02086084; registered 1 December 2015; https://clinicaltrials.gov/study/NCT02086084?cond=copd&term=ecco2r&rank=4.
View article: Effect of nostril occlusion and mouth sealing in the measurement of sniff nasal inspiratory pressure
Effect of nostril occlusion and mouth sealing in the measurement of sniff nasal inspiratory pressure Open
Sniff nasal inspiratory pressure (SNIP) is used to assess respiratory muscle strength in neuromuscular diseases like amyotrophic lateral sclerosis (ALS). The effect of contralateral nostril occlusion and mouth sealing on SNIP measurement a…
View article: Prolonged weaning from mechanical ventilation: who, what, when and how?
Prolonged weaning from mechanical ventilation: who, what, when and how? Open
Weaning from invasive mechanical ventilation is an important part of the management of respiratory failure patients. Patients can be classified into those who wean on the first attempt (simple weaning), those who require up to three attemp…
View article: Long COVID demographic and secondary care referral characteristics in primary care: analysis of anonymised primary care data from a multiethnic, deprived urban area in the UK
Long COVID demographic and secondary care referral characteristics in primary care: analysis of anonymised primary care data from a multiethnic, deprived urban area in the UK Open
Once the nature and number of patients with Long COVID was more fully understood, UK secondary care developed services to investigate, treat and support these patients. We aimed to identify evidence for demographic health inequalities base…
View article: Codesign of a Quality Improvement Tool for Adults With Prolonged Critical Illness: A Modified Delphi Consensus Study
Codesign of a Quality Improvement Tool for Adults With Prolonged Critical Illness: A Modified Delphi Consensus Study Open
OBJECTIVES: Increasing numbers of patients experience a prolonged stay in intensive care. Yet existing quality improvement (QI) tools used to improve safety and standardize care are not designed for their specific needs. This may result in…
View article: PRACTICE: Development of a Core Outcome Set for Trials of Physical Rehabilitation in Critical Illness
PRACTICE: Development of a Core Outcome Set for Trials of Physical Rehabilitation in Critical Illness Open
Rationale: Findings from individual trials of physical rehabilitation interventions in critically ill adults have limited potential for meta-analysis and informing clinical decision-making because of the heterogeneity in selection a…
View article: 1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study
1-year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study Open
Background In patients with coronavirus disease 2019 (COVID-19) requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid ad…
View article: Application of information from external data to correct for collider bias in a Covid-19 hospitalised cohort
Application of information from external data to correct for collider bias in a Covid-19 hospitalised cohort Open
View article: A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS)
A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS) Open
OBJECTIVES: Critically ill adults requiring artificial airways experience profound communication deficits. Studies of interventions supporting communication report disparate outcomes, creating subsequent challenges in the interpretation of…
View article: Two-year prospective cohort of intensive care survivors enrolled on a digitally enabled recovery pathway focussed on individualised recovery goal attainment
Two-year prospective cohort of intensive care survivors enrolled on a digitally enabled recovery pathway focussed on individualised recovery goal attainment Open
This study found multiple ongoing functional deficits, challenges achieving recovery goals, and limited improvements in self-reported outcomes, with moderate healthcare costs after hospital discharge indicate substantial ongoing rehabilita…
View article: Exploring the Experiences of Living With the Post‐COVID Syndrome: A Qualitative Study
Exploring the Experiences of Living With the Post‐COVID Syndrome: A Qualitative Study Open
Introduction Many people experience persistent symptoms for more than 12 weeks following SARS‐CoV‐2 infection, which is known as post‐COVID‐19 condition (PCS) or Long COVID (LC). PCS can impair people's quality of life and daily functionin…
View article: Response
Response Open
View article: A history of home mechanical ventilation: The past, present and future
A history of home mechanical ventilation: The past, present and future Open
This state-of-the-art review provides an overview of the history of home mechanical ventilation (HMV), including early descriptions of mechanical ventilation from ancient and Renaissance perspectives and the mass development of ventilators…
View article: Post-acute COVID-19 neuropsychiatric symptoms are not associated with ongoing nervous system injury
Post-acute COVID-19 neuropsychiatric symptoms are not associated with ongoing nervous system injury Open
A proportion of patients infected with severe acute respiratory syndrome coronavirus 2 experience a range of neuropsychiatric symptoms months after infection, including cognitive deficits, depression and anxiety. The mechanisms underpinnin…
View article: Cohort Profile: Post-Hospitalisation COVID-19 (PHOSP-COVID) study
Cohort Profile: Post-Hospitalisation COVID-19 (PHOSP-COVID) study Open
The Post-Hospitalisation COVID-19 (PHOSP-COVID) study is a national UK multicentre cohort study of patients who were hospitalized for COVID-19 and subsequently discharged.PHOSP-COVID was established to investigate the medium- and long-term…
View article: One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study
One year health outcomes associated with systemic corticosteroids for COVID-19: a longitudinal cohort study Open
Background In patients with COVID-19 requiring supplemental oxygen, dexamethasone reduces acute severity and improves survival, but longer-term effects are unknown. We hypothesised that systemic corticosteroid administration during acute C…
View article: The metabolic effects of intermittent versus continuous feeding in critically ill patients
The metabolic effects of intermittent versus continuous feeding in critically ill patients Open
View article: P101 Neural respiratory drive among COPD patients with mild or moderate airflow limitation in primary care: reproducibility, reliability and association with other biomarkers
P101 Neural respiratory drive among COPD patients with mild or moderate airflow limitation in primary care: reproducibility, reliability and association with other biomarkers Open
Introduction and Objectives Neural respiratory drive (NRD) is central control of breathing maintained through the respiratory muscles, particularly diaphragm and intercostals. NRD can be measured by surface electromyography (EMG) of the se…
View article: International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients
International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients Open
Background: There are limited data reporting diagnostic practices, compared to clinical guidelines, for patients with chronic respiratory failure requiring home mechanical ventilation (HMV). There are no data detailing the current use of d…