Nicholas Barrett
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View article: Extracorporeal Cardiopulmonary Resuscitation: Reviewing the Evidence and Exploring Its Equitable Implementation in the UK National Health Service
Extracorporeal Cardiopulmonary Resuscitation: Reviewing the Evidence and Exploring Its Equitable Implementation in the UK National Health Service Open
Extracorporeal cardiopulmonary resuscitation offers a potentially revolutionary improvement in the historically poor outcomes for refractory cardiac arrest. Current evidence has only demonstrated efficacy in single high volume centres in E…
View article: Evaluation of Plasma Biomarkers to Understand the Biology and Heterogeneity of Treatment Effect in Lower Tidal Volume Ventilation Facilitated by Extracorporeal CO2 Removal in Acute Hypoxemic Respiratory Failure: A Secondary Analysis of the REST Trial
Evaluation of Plasma Biomarkers to Understand the Biology and Heterogeneity of Treatment Effect in Lower Tidal Volume Ventilation Facilitated by Extracorporeal CO2 Removal in Acute Hypoxemic Respiratory Failure: A Secondary Analysis of the REST Trial Open
OBJECTIVES: In patients with acute hypoxemic respiratory failure (AHRF), the use of lower tidal volume ventilation facilitated by veno-venous extracorporeal C O 2 removal (vv-ECCO 2 R) does not improve clinical outcomes. The primary object…
View article: Mechanical Circulatory Support for Massive Pulmonary Embolism
Mechanical Circulatory Support for Massive Pulmonary Embolism Open
Up to 50% of patients with pulmonary embolism (PE) experience hemodynamic instability and approximately 70% of patients who die of PE experience an accelerated cascade of symptoms within the first hours of onset of symptoms, thus necessita…
View article: Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal
Recent Advances and Future Directions in Extracorporeal Carbon Dioxide Removal Open
Extracorporeal carbon dioxide removal (ECCO2R) is an emerging technique designed to reduce carbon dioxide (CO2) levels in venous blood while enabling lung-protective ventilation or alleviating the work of breathing. Unlike high-flow extrac…
View article: Endosomal sorting protein SNX4 limits synaptic vesicle docking and release
Endosomal sorting protein SNX4 limits synaptic vesicle docking and release Open
Sorting nexin 4 (SNX4) is an evolutionary conserved organizer of membrane recycling. In neurons, SNX4 accumulates in synapses, but how SNX4 affects synapse function remains unknown. We generated a conditional SNX4 knock-out mouse model and…
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: The effects of blood cell salvage on transfusion requirements after decannulation from veno-venous extracorporeal membrane oxygenation: an emulated trial analysis
The effects of blood cell salvage on transfusion requirements after decannulation from veno-venous extracorporeal membrane oxygenation: an emulated trial analysis Open
The use of BCS during VV-ECMO decannulation may be an effective strategy to augment haemoglobin levels and reduce PRBC transfusions.
View article: Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life Support Organization Consensus Guidelines
Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life Support Organization Consensus Guidelines Open
Background Critical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitor…
View article: Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery
Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery Open
IMPORTANCE Supplementing potassium in an effort to maintain high-normal serum concentrations is a widespread strategy used to prevent atrial fibrillation after cardiac surgery (AFACS), but is not evidence-based, carries risks, and is costl…
View article: Endosomal sorting protein SNX4 limits synaptic vesicle docking and release
Endosomal sorting protein SNX4 limits synaptic vesicle docking and release Open
Sorting nexin 4 (SNX4) is an evolutionary conserved organizer of membrane recycling. In neurons, SNX4 accumulates in synapses, but how SNX4 affects synapse function remains unknown. We generated a conditional SNX4 knock-out mouse model and…
View article: The intricate physiology of veno-venous extracorporeal membrane oxygenation: an overview for clinicians
The intricate physiology of veno-venous extracorporeal membrane oxygenation: an overview for clinicians Open
During veno-venous extracorporeal membrane oxygenation (V-V ECMO), blood is drained from the central venous circulation to be oxygenated and decarbonated by an artificial lung. It is then reinfused into the right heart and pulmonary circul…
View article: Left ventricular unloading in patients supported with veno-arterial extra corporeal membrane oxygenation; an international EuroELSO survey
Left ventricular unloading in patients supported with veno-arterial extra corporeal membrane oxygenation; an international EuroELSO survey Open
Introduction Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) improves end-organ perfusion in cardiogenic shock but may increase afterload, which can limit cardiac recovery. Left ventricular (LV) unloading strategies may aid ca…
View article: Extracorporeal Life Support Organization Registry International Report 2022: 100,000 Survivors
Extracorporeal Life Support Organization Registry International Report 2022: 100,000 Survivors Open
The Extracorporeal Life Support Organization (ELSO) maintains the world’s largest extracorporeal membrane oxygenation (ECMO) registry by volume, center participation, and international scope. This 2022 ELSO Registry Report describes the pr…
View article: The Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal Compared With Conventional Lung Protective Ventilation on Cardiac Function
The Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal Compared With Conventional Lung Protective Ventilation on Cardiac Function Open
OBJECTIVES: Lower tidal volume ventilation (targeting 3 mL/kg predicted body weight, PBW) facilitated by extracorporeal carbon dioxide removal (ECCO 2 R) has been investigated as a potential therapy for acute hypoxemic respiratory failure …
View article: Routine Metagenomics Service for ICU Patients with Respiratory Infection
Routine Metagenomics Service for ICU Patients with Respiratory Infection Open
Rationale: Respiratory metagenomics (RMg) needs evaluation in a pilot service setting to determine utility and inform implementation into routine clinical practice. Objectives: Feasibility, performance, and clinical impacts on antimicrobia…
View article: Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study
Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study Open
We present a series of core competencies, training requirements and ongoing governance protocols to guide safe ECPR implementation. These findings can be used to develop training syllabus and guide minimum standards for competency as the g…
View article: Routine respiratory metagenomics service for intensive care unit patients
Routine respiratory metagenomics service for intensive care unit patients Open
Background Respiratory metagenomics (RMg) needs evaluation in a pilot service setting to determine utility and inform implementation into clinical practice. Methods Feasibility, performance and clinical impacts on antimicrobial prescribing…
View article: AB093. SOH23ABS_233. The management of respiratory failure with level 2 strategies including the airway pressure release ventilation-time controlled adaptive ventilation mode in a regional intensive care unit—a case series
AB093. SOH23ABS_233. The management of respiratory failure with level 2 strategies including the airway pressure release ventilation-time controlled adaptive ventilation mode in a regional intensive care unit—a case series Open
AB093. SOH23ABS_233. The management of respiratory failure with level 2 strategies including the airway pressure release ventilation-time controlled adaptive ventilation mode in a regional intensive care unit—a case series
View article: AB092. SOH23ABS_229. Polytrauma in the intensive care unit
AB092. SOH23ABS_229. Polytrauma in the intensive care unit Open
Background: Recently, the Irish Minister for Health designated the Mater Hospital in Dublin and Cork University Hospital as the two major centres for the provision of trauma care in the state. These trauma centres will provide all major re…
View article: Relationship between D-dimers and dead-space on disease severity and mortality in COVID-19 acute respiratory distress syndrome: A retrospective observational cohort study
Relationship between D-dimers and dead-space on disease severity and mortality in COVID-19 acute respiratory distress syndrome: A retrospective observational cohort study Open
We report no association between dead space and inflammatory markers in mechanically ventilated patients with C-ARDS. Our results support theories suggesting that multiple mechanisms, in addition to immunothrombosis, play a role in the pat…
View article: “Bridging the Gap” international ECLS training and simulation - evaluation of the 10th educational corner on EuroELSO congress 2022 in London, United Kingdom
“Bridging the Gap” international ECLS training and simulation - evaluation of the 10th educational corner on EuroELSO congress 2022 in London, United Kingdom Open
Introduction: Simulation training offers an authentic team-based learning opportunity without risk to real patients. The Educational Corner at the annual congress of the European Branch of Extracorporeal Life Support Organisation (EuroELSO…
View article: Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How?
Unloading the Left Ventricle in Venoarterial ECMO: In Whom, When, and How? Open
Venoarterial extracorporeal membrane oxygenation provides cardiorespiratory support to patients in cardiogenic shock. This comes at the cost of increased left ventricle (LV) afterload that can be partly ascribed to retrograde aortic flow, …
View article: Extracorporeal Carbon Dioxide Removal With the Hemolung in Patients With Acute Respiratory Failure: A Multicenter Retrospective Cohort Study*
Extracorporeal Carbon Dioxide Removal With the Hemolung in Patients With Acute Respiratory Failure: A Multicenter Retrospective Cohort Study* Open
Objectives: Extracorporeal carbon dioxide removal (ECCO 2 R) devices are effective in reducing hypercapnia and mechanical ventilation support but have not been shown to reduce mortality. This may be due to case selection, device performanc…
View article: Steroid exposure and outcome in COVID-19 pneumonia
Steroid exposure and outcome in COVID-19 pneumonia Open
Corticosteroid exposure increased with the severity of COVID-19 pneumonia. Pulsed dose steroids were used more frequently in patients receiving greater respiratory support. Future studies should address patient selection and outcomes assoc…