0000000000333538

AUTHOR

Christine Ryan

showing 6 related works from this author

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre…

2021

BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of…

Pulmonary and Respiratory Medicinemedicine.medical_treatmentPopulationNO03 medical and health sciences0302 clinical medicineCPAPAbdomenSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealmedicineHumansIntubation030212 general & internal medicineContinuous positive airway pressureAdverse effecteducationeducation.field_of_studyContinuous Positive Airway Pressurebusiness.industryrespiratory complications; continuous positive airway pressure; major abdominal surgeryPneumoniaMiddle Agedmedicine.diseaserespiratory tract diseasesIntratrachealPneumoniaTreatment Outcome030228 respiratory systemRespiratory failureAnesthesiaVomitingmedicine.symptomRespiratory InsufficiencyIntubationbusinessAbdominal surgery
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Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute resp…

2022

Contains fulltext : 252214.pdf (Publisher’s version ) (Open Access) BACKGROUND: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. METHODS: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to defi…

MaleSociodemographic FactorsRespiration Artificial/methodsARDS ; mechanical ventilationSeverity of Illness IndexNOSettore MED/41 - ANESTESIOLOGIA80 and overTidal VolumeHumansHospital MortalityProspective Studiesddc:610Developing CountriesAgedHospital Mortality/trendsAged 80 and overDeveloped Countries/statistics & numerical dataDeveloping Countries/statistics & numerical dataRespirationDeveloped CountriesArticlesGeneral Medicineacute respiratory distress syndromeLength of StayMiddle AgedRespiration ArtificialIntensive Care UnitsObservational Studies as Topiclnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]Length of Stay/statistics & numerical dataArtificialIntensive Care Units/statistics & numerical dataIncomeFemaleARDS
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Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

2022

PURPOSE: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. METHODS: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' ( 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). RESULTS: The…

AdultSecondary peritonitiCritical IllnessPeritonitisCritical Care and Intensive Care MedicineAnti-Bacterial AgentsAntimicrobial therapyIntensive Care UnitsSecondary peritonitisIntra-abdominal infectionAnti-Infective AgentsRisk FactorsSource controlSepsisMedicine and Health SciencesHumansIntraabdominal InfectionsMortalityRetrospective StudiesAntimicrobial therapy; Intra-abdominal infection; Mortality; Secondary peritonitis; Source controlIntensive Care Medicine
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The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)

2017

Purpose: Very old critical ill patients are a rapid expanding group in the ICU. Indications for admission, triage criteria and level of care are frequently discussed for such patients. However, most relevant outcome studies in this group frequently find an increased mortality and a reduced quality of life in survivors. The main objective was to study the impact of frailty compared with other variables with regards to short-term outcome in the very old ICU population. Methods: A transnational prospective cohort study from October 2016 to May 2017 with 30 days follow-up was set up by the European Society of Intensive Care Medicine. In total 311 ICUs from 21 European countries participated. Th…

MaleTime FactorsOutcome AssessmentFrail Elderly/statistics & numerical data[SDV]Life Sciences [q-bio]HSJ UCIPassiveCritical Care and Intensive Care MedicineFrailty/classification/diagnosis/mortality/therapySeverity of Illness IndexSeverity of illneElderly0302 clinical medicineQuality of lifeElderly; Frailty; ICU; Mortality; Octogenarians; Severity of illness; Aged 80 and over; Critical Illness; Europe; Euthanasia Passive; Female; Frail Elderly; Frailty; Geriatric Assessment; Humans; Intensive Care Units; Length of Stay; Male; Outcome Assessment Health Care; Proportional Hazards Models; Prospective Studies; Quality of Life; Severity of Illness Index; Time Factors; Hospital MortalityOutcome Assessment Health Care80 and overProspective StudiesHospital Mortality030212 general & internal medicineProspective cohort studyAged 80 and overeducation.field_of_studyddc:617FrailtyMortality rate[SDV] Life Sciences [q-bio]EuropeIntensive Care UnitsLength of Stay/statistics & numerical dataCohortIntensive Care Units/statistics & numerical dataCritical IllneFemaleSOFA scoreHumanmedicine.medical_specialtyOctogenariansTime FactorCritical IllnessFrail ElderlyIntensive Care UnitPopulationINTENSIVE-CARESeverity of illnessEurope/epidemiologyOutcome Assessment (Health Care)03 medical and health sciencesOctogenarianIntensive careSeverity of illnessJournal ArticlemedicineHumansCOHORTMortalityOctogenarinansIntensive care medicineeducationGeriatric AssessmentAgedProportional Hazards ModelsOLDEREuthanasiabusiness.industry030208 emergency & critical care medicineLength of StayEuthanasia PassiveHealth CareProspective StudieCritical Illness/mortalityUNITICUEmergency medicineProportional Hazards ModelQuality of LifebusinessIntensive Care Medicine
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Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensiv…

2016

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were rece…

MalePediatricsARDSmedicine.medical_treatmentlaw.inventionPositive-Pressure Respiration0302 clinical medicinelawRisk FactorsPrevalenceventilator–induced lung injuryProspective StudiesHospital MortalityProspective cohort studyTidal volumeeducation.field_of_studyRespiratory Distress SyndromeAcute respiratory distress syndrometidal volumeARDS critically ill ventilationMiddle AgedIntensive care unitIntensive Care UnitsCritical IllneFemaleHumanPulmonary and Respiratory Medicinemedicine.medical_specialtyCritical IllnessPopulationIntensive Care UnitLung injurymechanical ventilationNO03 medical and health sciencesIntensive caremedicineAcute respiratory distress syndrome mechanical ventilation ventilator–induced lung injury tidal volume positive end–expiratory pressureHumansMED/41 - ANESTESIOLOGIAeducationAgedMechanical ventilationbusiness.industryRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseaseRespiration ArtificialMechanical ventilation Acute respiratory failure Acute respiratory distress syndromeProspective Studie030228 respiratory systemEmergency medicinepositive end–expiratory pressurebusiness
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Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units

2021

Severe intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. I…

Drug Resistancemedicine.disease_causeSeverity of Illness Indexlaw.invention0302 clinical medicineENTEROBACTERIACEAElawDrug Resistance Multiple BacterialMedicine and Health SciencesPharmacology (medical)Cross InfectionbiologyBacterialAntimicrobialIntensive care unitAnti-Bacterial AgentsCommunity-Acquired InfectionsEuropeIntensive Care UnitsAnti-Bacterial Agents; Community-Acquired Infections; Critical Illness; Cross Infection; Europe; Humans; Intensive Care Units; Intraabdominal Infections; Microbial Sensitivity Tests; Peritonitis; Sepsis; Severity of Illness Index; Drug Resistance Multiple BacterialESCHERICHIA-COLI030220 oncology & carcinogenesisKLEBSIELLA-PNEUMONIAEBLOOD-STREAM INFECTIONSPYELONEPHRITISMultiplemedicine.medical_specialtyCritical IllnessMicrobial Sensitivity TestsPeritonitisEnterococcus faecalisNO03 medical and health sciencesIntra‑abdominal InfectionsAntibiotic resistanceFOODSepsisIntensive careInternal medicinemedicineHumansFLUOROQUINOLONE RESISTANCEPseudomonas aeruginosabusiness.industrySeptic shockMORTALITYbiology.organism_classificationmedicine.diseaseRISK-FACTORSIntraabdominal Infectionsbusiness030217 neurology & neurosurgeryEnterococcus faecium
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