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Article ; Online: Antibody NI006 for Cardiac Transthyretin Amyloid Depletion.

Berrill, Max

2023 Volume 389, Issue 13, Page(s) 1248–1249

Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2309584
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Article ; Online: Evaluation of Oxygenation in 129 Proning Sessions in 34 Mechanically Ventilated COVID-19 Patients.

Berrill, Max

Journal of intensive care medicine

2020 Volume 36, Issue 2, Page(s) 229–232

Abstract: A minority of patients with Severe Acutre Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) disease-2019 (Covid-19) develop pulmonary features consistent with the Acute Respiratory Distress Syndrome (ARDS). Prone positioning (PP) is an intervention with ... ...

Abstract	A minority of patients with Severe Acutre Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) disease-2019 (Covid-19) develop pulmonary features consistent with the Acute Respiratory Distress Syndrome (ARDS). Prone positioning (PP) is an intervention with proven survival benefits in moderate-to-severe and severe ARDS. It is advocated in international guidelines as an intervention in mechanically ventilated Covid-19 patients, despite very few published trials investigating its efficacy in Covid-19. There is an ongoing debate regarding the prevalence of reported mismatches between the severity of hypoxaemia and the preservation of pulmonary compliance in some patients, in the early stages of SARS-CoV-2 infection. This has led some to question its utility within this context. 129 proning sessions were identified in 34 consecutively prone patients admitted to the intensive care unit at a single center in the United Kingdom. Baseline characteristics of patients were consistent with previously published national and international reports and patients were ventilated in general concordance with the ARDSnet ventilation protocol. Paired analysis of the partial pressure of arterial oxygen(PaO
MeSH term(s)	COVID-19/mortality ; COVID-19/therapy ; Female ; Humans ; London ; Male ; Middle Aged ; Oxygen/blood ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Prone Position ; Respiration, Artificial ; Respiratory Distress Syndrome/mortality ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2
Chemical Substances	Oxygen (S88TT14065)
Keywords	covid19
Language	English
Publishing date	2020-09-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	632828-3
ISSN	1525-1489 ; 0885-0666
ISSN (online)	1525-1489
ISSN	0885-0666
DOI	10.1177/0885066620955137
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Article: Evaluation of Oxygenation in 129 Proning Sessions in 34 Mechanically Ventilated COVID-19 Patients

Berrill, Max

J Intensive Care Med

Abstract	A minority of patients with Severe Acutre Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) disease-2019 (Covid-19) develop pulmonary features consistent with the Acute Respiratory Distress Syndrome (ARDS). Prone positioning (PP) is an intervention with proven survival benefits in moderate-to-severe and severe ARDS. It is advocated in international guidelines as an intervention in mechanically ventilated Covid-19 patients, despite very few published trials investigating its efficacy in Covid-19. There is an ongoing debate regarding the prevalence of reported mismatches between the severity of hypoxaemia and the preservation of pulmonary compliance in some patients, in the early stages of SARS-CoV-2 infection. This has led some to question its utility within this context. 129 proning sessions were identified in 34 consecutively prone patients admitted to the intensive care unit at a single center in the United Kingdom. Baseline characteristics of patients were consistent with previously published national and international reports and patients were ventilated in general concordance with the ARDSnet ventilation protocol. Paired analysis of the partial pressure of arterial oxygen(PaO2): fraction of inspired oxygen(FiO2) ratio (PF ratio) (n = 89) and FiO2 (n = 129) was recorded within 3 hours of both the initiation and termination of PP and differences were assessed with the paired Student's t-test and Wilcoxon Signed-Rank test. Proning improved the PF ratio by 43.5 ± 54.9 from 99.8 ± 37.5 to 151.9 ± 58.9 (43.6% increase) [p < 0.0001] and reduced FiO2 by 0.17 ± 0.2 from 0.68 ± 0.2 to 0.51 ± 0.2 (25% decrease) [p < 0.0001]. 82% of proning maneouveres resulted in an improvement in the PF ratio. In summary, PP improved arterial oxygenation and reduced oxygen requirements in most Covid-19 patients in this single- center, retrospective analysis.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #804175
Database	COVID19

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Article ; Online: Evaluation of Oxygenation in 129 Proning Sessions in 34 Mechanically Ventilated COVID-19 Patients

Berrill, Max

Journal of Intensive Care Medicine

2020 , Page(s) 88506662095513

Abstract	A minority of patients with Severe Acutre Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) disease-2019 (Covid-19) develop pulmonary features consistent with the Acute Respiratory Distress Syndrome (ARDS). Prone positioning (PP) is an intervention with proven survival benefits in moderate-to-severe and severe ARDS. It is advocated in international guidelines as an intervention in mechanically ventilated Covid-19 patients, despite very few published trials investigating its efficacy in Covid-19. There is an ongoing debate regarding the prevalence of reported mismatches between the severity of hypoxaemia and the preservation of pulmonary compliance in some patients, in the early stages of SARS-CoV-2 infection. This has led some to question its utility within this context. 129 proning sessions were identified in 34 consecutively prone patients admitted to the intensive care unit at a single center in the United Kingdom. Baseline characteristics of patients were consistent with previously published national and international reports and patients were ventilated in general concordance with the ARDSnet ventilation protocol. Paired analysis of the partial pressure of arterial oxygen(PaO 2 ): fraction of inspired oxygen(FiO 2 ) ratio (PF ratio) (n = 89) and FiO 2 (n = 129) was recorded within 3 hours of both the initiation and termination of PP and differences were assessed with the paired Student’s t-test and Wilcoxon Signed-Rank test. Proning improved the PF ratio by 43.5 ± 54.9 from 99.8 ± 37.5 to 151.9 ± 58.9 (43.6% increase) [ p < 0.0001] and reduced FiO 2 by 0.17 ± 0.2 from 0.68 ± 0.2 to 0.51 ± 0.2 (25% decrease) [ p < 0.0001]. 82% of proning maneouveres resulted in an improvement in the PF ratio. In summary, PP improved arterial oxygenation and reduced oxygen requirements in most Covid-19 patients in this single- center, retrospective analysis.
Keywords	Critical Care and Intensive Care Medicine ; covid19
Language	English
Publisher	SAGE Publications
Publishing country	us
Document type	Article ; Online
ZDB-ID	632828-3
ISSN	1525-1489 ; 0885-0666
ISSN (online)	1525-1489
ISSN	0885-0666
DOI	10.1177/0885066620955137
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Right Ventricular Dysfunction Predicts Outcome in Acute Heart Failure.

Berrill, Max / Ashcroft, Eshan / Fluck, David / John, Isaac / Beeton, Ian / Sharma, Pankaj / Baltabaeva, Aigul

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 911053

Abstract: Aim: The severity of cardiac impairment in acute heart failure (AHF) predicts outcome, but challenges remain to identify prognostically important non-invasive parameters of cardiac function. Left ventricular ejection fraction (LVEF) is relevant, but ... ...

Abstract	Aim: The severity of cardiac impairment in acute heart failure (AHF) predicts outcome, but challenges remain to identify prognostically important non-invasive parameters of cardiac function. Left ventricular ejection fraction (LVEF) is relevant, but only in those with reduced LV systolic function. We aimed to assess the standard and advanced parameters of left and right ventricular (RV) function from echocardiography in predicting long-term outcomes in AHF. Methods: A total of 418 consecutive AHF patients presenting over 12 months were prospectively recruited and underwent bedside echocardiography within 24 h of recruitment. We retrospectively assessed 8 RV and 5 LV echo parameters of the cardiac systolic function to predict 2-year mortality, using both guideline-directed and study-specific cutoffs, based on the maximum Youden indices Results: A total of 7/8 parameters of RV systolic function were predictive of 2-year outcome, with study cutoffs like international guidelines. A cutoff of < -1.8 s Conclusion: With cutoffs broadly like the ESC guidelines, we identified RV dysfunction to be associated with adverse prognosis, whereas LVEF could not identify patients at risk.
Language	English
Publishing date	2022-05-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.911053
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Article: Tricuspid Regurgitation in Acute Heart Failure: Predicting Outcome Using Novel Quantitative Echocardiography Techniques.

Berrill, Max / Ashcroft, Eshan / Fluck, David / John, Isaac / Beeton, Ian / Sharma, Pankaj / Baltabaeva, Aigul

Diagnostics (Basel, Switzerland)

2022 Volume 13, Issue 1

Abstract: Background: The prognostic impact of tricuspid regurgitation (TR) in acute heart failure (AHF) remains uncertain. Methods: We retrospectively assessed 418 consecutive AHF patients who underwent comprehensive echocardiographic assessment within 24 h of ... ...

Abstract	Background: The prognostic impact of tricuspid regurgitation (TR) in acute heart failure (AHF) remains uncertain. Methods: We retrospectively assessed 418 consecutive AHF patients who underwent comprehensive echocardiographic assessment within 24 h of study recruitment. TR was quantitatively assessed with 3 guideline-directed measures: regurgitant volumes (RgVol), effective regurgitant orifice area (ERO) and vena contracta (VC) diameter. Disproportionate TR was assessed by the ratio of the VC diameter to the tricuspid annulus diameter (VC/TA) ≥ 0.24. Results: The prevalence of significant (i.e., >mild) TR differed when various standard assessment parameters were applied to quantification: RgVol 50.3% (173/344), ERO 75.6% (260/344) and VC diameter 94.6% (335/354). None were able to delineate those at excess risk of all-cause 2-year mortality using guideline-directed cut-offs of mild, moderate and severe TR. Using a cut-off of VC/TA ≥ 0.24, we identified that 36.9% (130/352) had “disproportionate” TR. Disproportionate TR was associated with an excess risk of mortality at 2 years compared to proportionate TR; HR 1.48 (95% CI 1.06−2.06 [p = 0.02]) which was not significant on multivariate assessment (p = 0.94). Conclusions: TR was not associated with outcome in AHF using guideline measures. A new assessment of “Disproportionate” TR carries a higher risk than proportionate TR but was not related to outcome based on multivariate analysis. Further research is needed to quantify TR more effectively to identify cut-offs for future guidelines and disproportionate TR may be an important part of Heart Failure 2.0.
Language	English
Publishing date	2022-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13010109
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Article ; Online: Tricuspid Regurgitation in Acute Heart Failure

Max Berrill / Eshan Ashcroft / David Fluck / Isaac John / Ian Beeton / Pankaj Sharma / Aigul Baltabaeva

Diagnostics, Vol 13, Iss 1, p

Predicting Outcome Using Novel Quantitative Echocardiography Techniques

2022 Volume 109

Abstract	Background: The prognostic impact of tricuspid regurgitation (TR) in acute heart failure (AHF) remains uncertain. Methods: We retrospectively assessed 418 consecutive AHF patients who underwent comprehensive echocardiographic assessment within 24 h of study recruitment. TR was quantitatively assessed with 3 guideline-directed measures: regurgitant volumes (RgVol), effective regurgitant orifice area (ERO) and vena contracta (VC) diameter. Disproportionate TR was assessed by the ratio of the VC diameter to the tricuspid annulus diameter (VC/TA) ≥ 0.24. Results: The prevalence of significant (i.e., >mild) TR differed when various standard assessment parameters were applied to quantification: RgVol 50.3% (173/344), ERO 75.6% (260/344) and VC diameter 94.6% (335/354). None were able to delineate those at excess risk of all-cause 2-year mortality using guideline-directed cut-offs of mild, moderate and severe TR. Using a cut-off of VC/TA ≥ 0.24, we identified that 36.9% (130/352) had “disproportionate” TR. Disproportionate TR was associated with an excess risk of mortality at 2 years compared to proportionate TR; HR 1.48 (95% CI 1.06–2.06 [ p = 0.02]) which was not significant on multivariate assessment ( p = 0.94). Conclusions: TR was not associated with outcome in AHF using guideline measures. A new assessment of “Disproportionate” TR carries a higher risk than proportionate TR but was not related to outcome based on multivariate analysis. Further research is needed to quantify TR more effectively to identify cut-offs for future guidelines and disproportionate TR may be an important part of Heart Failure 2.0.
Keywords	acute heart failure ; tricuspid regurgitation ; disproportionate TR ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Chest radiograph characteristics in COVID-19 infection and their association with survival.

Colman, Jordan / Zamfir, Georgiana / Sheehan, Frances / Berrill, Max / Saikia, Sujoy / Saltissi, Felicity

European journal of radiology open

2021 Volume 8, Page(s) 100360

Abstract: Purpose: This study aims to systematically grade CXRs of COVID-19 patients to find associations between CXR (chest radiographs) characteristics and clinical outcomes.: Methods: A retrospective review and grading of CXRs in 161 COVID-19 positive ... ...

Abstract	Purpose: This study aims to systematically grade CXRs of COVID-19 patients to find associations between CXR (chest radiographs) characteristics and clinical outcomes. Methods: A retrospective review and grading of CXRs in 161 COVID-19 positive patients was caried out in this single centre study. CXR changes primarily constituted that of presence or absence of ground glass opacification (GGO) or consolidation and their distribution across both lung fields. We used two grading systems normal/ mild/ moderate/ severe grading and a numeric 0-8 grading system. We defined mild severity as up to 25 % lung involvement, moderate as 25-62.5 % and severe as 62.5-100% lung involvement. Results: Peripheral GGO in lower +/- mid zones of the lungs is the most common finding. Mid zone and perihilar GGO is associated with increased mortality. We additionally show that CXRs have a higher severity score in the non-survivor group and a CXR graded as severe has a relative risk ratio for mortality of 3.28. Finally, we describe the change in CXR severity with length of symptoms, finding 42.3 % of CXR were normal in the first 2 days of symptoms and 0% at 13 days. Conclusion: Using a systematic approach to reviewing and grading CXRs in Covid-19 positive patients we clearly demonstrate that grading, location of airspace abnormalities and rate of CXR changes are related to clinical outcome.
Language	English
Publishing date	2021-06-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2810314-2
ISSN	2352-0477
ISSN	2352-0477
DOI	10.1016/j.ejro.2021.100360
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Article: Right ventricular ejection fraction as predictor of outcome in acute heart failure using RV ellipsoid model: A retrospective analysis of a prospective cross-sectional study.

Ashcroft, Eshan / Lazariashvili, Otar / Belsey, Jonathan / Berrill, Max / Sharma, Pankaj / Baltabaeva, Aigul

JRSM cardiovascular disease

2021 Volume 10, Page(s) 20480040211002775

Abstract: Objectives: The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. ...

Abstract	Objectives: The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. However, these fail to reflect global RV volumes due to reliability on one acoustic window. It is therefore attractive to calculate RV volumes and ejection fraction (RVEF/E) using an ellipsoid geometric model which has been validated against MRI in healthy adults but not in the HF patients. Design: This is a retrospective analysis of a prospective cross-sectional study enrolling 418 consecutive patients with symptoms of HF according to a predefined study protocol. All patients underwent echocardiographic assessment of RV function using Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV fractional area change (RVFAC) and RVEF/E. Setting: Single centre study with multiple locations for acute in-patients including high dependency units. Participants: Patients with acute or exacerbation of chronic HF older than 18 y.o. Main outcome measures: Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality. Results: RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements. Conclusions: In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.
Language	English
Publishing date	2021-03-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2663207-X
ISSN	2048-0040
ISSN	2048-0040
DOI	10.1177/20480040211002775
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Article ; Online: The antiviral properties of vitamin C.

Colunga Biancatelli, Ruben Manuel Luciano / Berrill, Max / Marik, Paul E

Expert review of anti-infective therapy

2019 Volume 18, Issue 2, Page(s) 99–101

MeSH term(s)	Animals ; Antiviral Agents/administration & dosage ; Antiviral Agents/pharmacology ; Ascorbic Acid/administration & dosage ; Ascorbic Acid/pharmacology ; Humans ; Virus Diseases/drug therapy ; Virus Diseases/virology ; Vitamins/administration & dosage ; Vitamins/pharmacology
Chemical Substances	Antiviral Agents ; Vitamins ; Ascorbic Acid (PQ6CK8PD0R)
Language	English
Publishing date	2019-12-23
Publishing country	England
Document type	Editorial
ZDB-ID	2181279-2
ISSN	1744-8336 ; 1478-7210
ISSN (online)	1744-8336
ISSN	1478-7210
DOI	10.1080/14787210.2020.1706483
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