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Derivation and validation of a prognostic model for postoperative risk stratification of critically ill patients with faecal peritonitis

Julian Bion 2 Gary H. Mills 1 Anthony C. Gordon 8 Geraldine. M. Clarke 7 Andrew Walden 6 Paula Hutton 5 Paul A. H. Holloway 8 Jean‑Daniel Chiche 10 Frank Stuber 9 Christopher Garrard 5 Charles Hinds 3 On

A complex endeavour: an ethnographic study of the implementation of the Sepsis Six clinical care bundle

Background Implementation of the ‘Sepsis Six’ clinical care bundle within an hour of recognition of sepsis is recommended as an approach to reduce mortality in patients with sepsis, but achieving reliable delivery of the bundle has proved challenging. There remains little understanding of the barriers to reliable implementation of bundle components. We examined frontline clinical ...

Gut instinct

Barriers to the use of selective digestive decontamination include concerns about emergence of resistant organisms, over-estimation of current performance in preventing ventilator-associated pneumonia (VAP), alternative methods of preventing VAP, and misunderstanding of mechanisms of action. A definitive cluster-randomised trial should be undertaken that incorporates practitioner ...

The magnitude and mechanisms of the weekend effect in hospital admissions: A protocol for a mixed methods review incorporating a systematic review and framework synthesis

Background Growing literature has demonstrated that patients admitted to hospital during weekends tend to have less favourable outcomes, including increased mortality, compared with similar patients admitted during weekdays. Major policy interventions such as the 7-day services programme in the UK NHS have been initiated to reduce this weekend effect, although the mechanisms behind ...

Night thoughts

Intensive Care Med Night thoughts Bertrand Guidet Julian Bion - B. Guidet Sorbonne Universite´s, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epide´miologie et de Sante´ Publique, F

Virtual restorative environment therapy as an adjunct to pain control during burn dressing changes: study protocol for a randomised controlled trial

Background The pain of a severe burn injury is often characterised by intense background pain, coupled with severe exacerbations associated with essential procedures such as dressing changes. The experience of pain is affected by patients’ psychological state and can be enhanced by the anxiety, fear and distress caused by environmental and visual inputs. Virtual Reality (VR) ...

Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort

Geraldine M Clarke 2 Andrew Walden 7 Anthony C Gordon 6 Paula Hutton 5 Jean-Daniel Chiche 4 Paul AH Holloway 6 Gary H Mills 0 9 Julian Bion 8 Frank Stber 3 Christopher Garrard 5 Charles Hinds 10 on behalf of

Explaining Matching Michigan: an ethnographic study of a patient safety program

obtained from Berkshire NHS Research Ethics Committee was obtained for this study. Competing interests Julian Bion held the advisory role of senior clinical lead for the Matching Michigan project, conducted

Variants in the Mannose-binding Lectin Gene MBL2 do not Associate With Sepsis Susceptibility or Survival in a Large European Cohort

Background. Sepsis is an increasingly common condition, which continues to be associated with unacceptably high mortality. A large number of association studies have investigated susceptibility to, or mortality from, sepsis for variants in the functionally important immune-related gene MBL2. These studies have largely been underpowered and contradictory. Methods. We genotyped and ...

Integrating sepsis management recommendations into clinical care guidelines for district hospitals in resource-limited settings: the necessity to augment new guidelines with future research

Shevin T Jacob 0 Matthew Lim 2 Patrick Banura 1 Satish Bhagwanjee 6 Julian Bion 5 Allen C Cheng 4 Hillary Cohen 3 Jeremy Farrar Sandy Gove Philip Hopewell Christopher C Moore Cathy Roth T Eoin West

Clinical review: Outreach – a strategy for improving the care of the acutely ill hospitalized patient

We examined the literature relating to the safe care of acutely ill hospitalized patients, and found that there are substantial opportunities for improvement. Recent research suggests substantial benefit may be obtained by systems of outreach care that facilitate better integration, co-ordination, collaboration and continuity of multidisciplinary care. Herein we review the various ...

Erythropoietin mimics the acute phase response in critical illness

Background In a prospective observational study, we examined the temporal relationships between serum erythropoietin (EPO) levels, haemoglobin concentration and the inflammatory response in critically ill patients with and without acute renal failure (ARF). Patients and method Twnety-five critically ill patients, from general and cardiac intensive care units (ICUs) in a university ...

The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis

Objective The Surviving Sepsis Campaign (SSC or “the Campaign”) developed guidelines for management of severe sepsis and septic shock. A performance improvement initiative targeted changing clinical behavior (process improvement) via bundles based on key SSC guideline recommendations on process improvement and patient outcomes. Design and setting A multifaceted intervention to ...

Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008

Objective To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, “Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock,” published in 2004. Design Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and ...