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Article ; Online: Robotic CME in obese patients: advantage of robotic ultrasound scan for vascular dissection.

Maertens, Vicky / Stefan, Samuel / Mykoniatis, Ioannis / Siddiqi, Najaf / David, Gerald / Khan, Jim S

2022 Volume 17, Issue 1, Page(s) 155–161

Abstract: Complete mesocolic excision (CME) in right-sided colon cancers appears to confer oncological benefits compared to conventional colectomy. Identification of the superior mesenteric vein (SMV) remains challenging. We describe the novel use of intra- ... ...

Abstract	Complete mesocolic excision (CME) in right-sided colon cancers appears to confer oncological benefits compared to conventional colectomy. Identification of the superior mesenteric vein (SMV) remains challenging. We describe the novel use of intra-operative robotic ultrasound scan (rUSS) in obese patients (BMI ≥ 29). All consecutive patients having robotic CME for colon cancer between 2014 and 2017 were included in this retrospective cohort study. Data were recorded on an ethics approved prospective database and included patient demographics, clinical and oncological outcomes. Patients were divided into group 1 (BMI ≤ 28) and group 2 (BMI ≥ 29). SMV first approach was employed in all cases and SMV detection was aided using rUSS in group 2. Primary outcome was postoperative morbidity. Secondary outcomes included conversion rate, operative time and length of stay (LOS). 41 (group 1, median 66 years) were compared to 32 patients (group 2, median 63 years). There were no conversions to laparoscopy or laparotomy. Median operative times for group 2 were 30 min longer (186 vs. 216 min, p = 0.05). Overall morbidity was similar (20% vs. 19% in group 1 and 2, p = 0.26). There was no significant difference between the two groups with regard to LOS (median 7 vs. 6 days, p = 0.48), readmissions (2 vs. 5, p = 0.13), R0 resection rate (98% vs. 94%, p = 0.43) and lymph node harvest (median 31 vs. 30, p = 0.28).CME can be technically more challenging than conventional colectomy in obese patients and is associated with longer operative times. The use of rUSS in obese patients can help to identify SMV and allow safer dissection.
MeSH term(s)	Humans ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Robotics ; Colonic Neoplasms/diagnostic imaging ; Colonic Neoplasms/surgery ; Colonic Neoplasms/pathology ; Dissection ; Lymph Node Excision ; Laparoscopy ; Colectomy ; Operative Time ; Treatment Outcome
Language	English
Publishing date	2022-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-022-01398-6
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Article ; Online: Neonatal high-frequency oscillatory ventilation: where are we now?

Hibberd, Jakob / Leontini, Justin / Scott, Thomas / Pillow, J Jane / Miedema, Martijn / Rimensberger, Peter C / Tingay, David Gerald

Archives of disease in childhood. Fetal and neonatal edition

2023

Abstract: High-frequency oscillatory ventilation (HFOV) is an established mode of respiratory support in the neonatal intensive care unit. Large clinical trial data is based on first intention use in preterm infants with acute respiratory distress syndrome. ... ...

Abstract	High-frequency oscillatory ventilation (HFOV) is an established mode of respiratory support in the neonatal intensive care unit. Large clinical trial data is based on first intention use in preterm infants with acute respiratory distress syndrome. Clinical practice has evolved from this narrow population. HFOV is most often reserved for term and preterm infants with severe, and often complex, respiratory failure not responding to conventional modalities of respiratory support. Thus, optimal, and safe, application of HFOV requires the clinician to adapt mean airway pressure, frequency, inspiratory:expiratory ratio and tidal volume to individual patient needs based on pathophysiology, lung volume state and infant size. This narrative review summarises the status of HFOV in neonatal intensive care units today, the lessons that can be learnt from the past, how to apply HFOV in different neonatal populations and conditions and highlights potential new advances. Specifically, we provide guidance on how to apply an open lung approach to mean airway pressure, selecting the correct frequency and use of volume-targeted HFOV.
Language	English
Publishing date	2023-09-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2023-325657
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Article: Isolation of wild yeasts from Olympic National Park and Moniliella megachiliensis ONP131 physiological characterization for beer fermentation

Araujo Piraine, Renan Eugênio / Nickens, David Gerald / Sun, David J. / Leivas Leite, Fábio Pereira / Bochman, Matthew L.

Food microbiology. 2022 June, v. 104

2022

Abstract: Thousands of yeasts have the potential for industrial application, though many were initially considered contaminants in the beer industry. However, these organisms are currently considered important components in beers because they contribute new ... ...

Abstract	Thousands of yeasts have the potential for industrial application, though many were initially considered contaminants in the beer industry. However, these organisms are currently considered important components in beers because they contribute new flavors. Non-Saccharomyces wild yeasts can be important tools in the development of new products, and the objective of this work was to obtain and characterize novel yeast isolates for their ability to produce beer. Wild yeasts were isolated from environmental samples from Olympic National Park and analyzed for their ability to ferment malt extract medium and beer wort. Six different strains were isolated, of which Moniliella megachiliensis ONP131 displayed the highest levels of attenuation during fermentations. We found that M. megachiliensis could be propagated in common yeast media, tolerated incubation temperatures of 37 °C and a pH of 2.5, and was able to grow in media containing maltose as the sole carbon source. Yeast cultivation was considerably impacted (p < 0.05) by lactic acid, ethanol, and high concentrations of maltose, but ONP131 was tolerant to high salinity and hop acid concentrations. This is one of the first physiological characterizations of M. megachiliensis, which has potential for the production of beer and other fermented beverages.
Keywords	Moniliella megachiliensis ; beers ; brewing industry ; carbon ; ethanol ; fermentation ; food microbiology ; industrial applications ; lactic acid ; malt extract ; maltose ; national parks ; pH ; salt tolerance ; yeasts
Language	English
Dates of publication	2022-06
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	50892-5
ISSN	1095-9998 ; 0740-0020
ISSN (online)	1095-9998
ISSN	0740-0020
DOI	10.1016/j.fm.2021.103974
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Article ; Online: Lung volume distribution in preterm infants on non-invasive high-frequency ventilation.

Gaertner, Vincent D / Waldmann, Andreas D / Davis, Peter G / Bassler, Dirk / Springer, Laila / Thomson, Jessica / Tingay, David Gerald / Rüegger, Christoph Martin

Archives of disease in childhood. Fetal and neonatal edition

2022 Volume 107, Issue 5, Page(s) 551–557

Abstract: Introduction: Non-invasive high-frequency oscillatory ventilation (nHFOV) is an extension of nasal continuous positive airway pressure (nCPAP) support in neonates. We aimed to compare global and regional distribution of lung volumes during nHFOV versus ... ...

Abstract	Introduction: Non-invasive high-frequency oscillatory ventilation (nHFOV) is an extension of nasal continuous positive airway pressure (nCPAP) support in neonates. We aimed to compare global and regional distribution of lung volumes during nHFOV versus nCPAP. Methods: In 30 preterm infants enrolled in a randomised crossover trial comparing nHFOV with nCPAP, electrical impedance tomography data were recorded in prone position. For each mode of respiratory support, four episodes of artefact-free tidal ventilation, each comprising 30 consecutive breaths, were extracted. Tidal volumes (V Main results: Overall, 228 recordings were analysed. Relative V Conclusion: Although regional ventilation was similar between nHFOV and nCPAP, end-expiratory lung volume was higher and aeration homogeneity was slightly improved during nHFOV. The aeration difference was greatest in non-gravity dependent regions, possibly due to the oscillatory pressure waveform. The clinical importance of these findings is still unclear.
MeSH term(s)	Continuous Positive Airway Pressure/methods ; High-Frequency Ventilation/methods ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intermittent Positive-Pressure Ventilation/methods ; Noninvasive Ventilation/methods ; Tidal Volume
Language	English
Publishing date	2022-01-31
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2021-322990
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Article ; Online: Lung volume changes during apnoeas in preterm infants.

Gaertner, Vincent D / Waldmann, Andreas D / Davis, Peter G / Bassler, Dirk / Springer, Laila / Tingay, David Gerald / Rüegger, Christoph Martin

Archives of disease in childhood. Fetal and neonatal edition

2022 Volume 108, Issue 2, Page(s) 170–175

Abstract: Objective: Mechanisms of non-invasive high-frequency oscillatory ventilation (nHFOV) in preterm infants are unclear. We aimed to compare lung volume changes during apnoeas in preterm infants on nHFOV and nasal continuous positive airway pressure (nCPAP). ...

Abstract	Objective: Mechanisms of non-invasive high-frequency oscillatory ventilation (nHFOV) in preterm infants are unclear. We aimed to compare lung volume changes during apnoeas in preterm infants on nHFOV and nasal continuous positive airway pressure (nCPAP). Methods: Analysis of electrical impedance tomography (EIT) data from a randomised crossover trial comparing nHFOV with nCPAP in preterm infants at 26-34 weeks postmenstrual age. EIT data were screened by two reviewers to identify apnoeas ≥10 s. End-expiratory lung impedance (EELI) and tidal volumes (V Results: In 30 preterm infants, 213 apnoeas were identified. During apnoeas, oscillatory volumes were detectable during nHFOV. EELI decreased significantly during apnoeas (∆EELI nCPAP: -8.0 (-11.9 to -4.1) AU/kg, p<0.001; ∆EELI nHFOV: -3.4 (-6.5 to -0.3), p=0.03) but recovered over the first five breaths after apnoeas. Compared with before apnoeas, V Conclusion: Apnoeas were characterised by a significant decrease in EELI which was regained over the first breaths after apnoeas, partly mediated by a larger V Trial registration number: ACTRN12616001516471.
MeSH term(s)	Humans ; Infant ; Infant, Newborn ; Apnea ; Continuous Positive Airway Pressure/methods ; Infant, Premature ; Intermittent Positive-Pressure Ventilation/methods ; Respiratory Distress Syndrome, Newborn ; Tidal Volume ; Cross-Over Studies
Language	English
Publishing date	2022-08-29
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2022-324282
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Article ; Online: Robotic Complete Mesocolic Excision (CME) is a safe and feasible option for right colonic cancers: short and midterm results from a single-centre experience.

Siddiqi, Najaf / Stefan, Samuel / Jootun, Ravish / Mykoniatis, Ioannis / Flashman, Karen / Beable, Richard / David, Gerald / Khan, Jim

Surgical endoscopy

2021 Volume 35, Issue 12, Page(s) 6873–6881

Abstract: Background: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven ... ...

Abstract	Background: Complete mesocolic excision (CME) for right colon cancers has traditionally been an open procedure. Surgical adoption of minimal access CME remains limited due to the technical challenges, training gaps and lack of level-1 data for proven benefits. Currently there is limited published data regarding the clinical results with the use of robotic CME surgery. Aim To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. Aim: To report our experience, results and techniques, highlighting a clinical and oncological results and midterm oncological outcomes for robotic CME. Methods: All patients undergoing standardised robotic CME technique with SMV first approach between January 2015 and September 2019 were included in this retrospective review of a prospectively collected database. Patient demographics, operative data and clinical and oncological outcomes were recorded. Results: Seventy-seven robotic CME resections for right colonic cancers were performed over a 4-year period. Median operative time was 180 (128-454) min and perioperative blood loss was 10 (10-50) ml. There were 25 patients who had previous abdominal surgery. Median postoperative hospital stay was 5 (3-18) days. There was no conversion to open surgery in this series. Median lymph node count was 30 (10-60). Three (4%) patients had R1 resection. There was one (1%) local recurrence in stage III disease and 4(5%) distal recurrence in stage II and stage III. There was no 30- or 90-day mortality. Three-year disease-free survival was 100%, 91.7% and 92% for stages I, II and III, respectively. Overall survival was 94%. Conclusions: Robotic CME is feasible, effective and safe. Good oncological results and improved survival are seen in this cohort of patients with a standardised approach to robotic CME.
MeSH term(s)	Colectomy ; Colonic Neoplasms/surgery ; Humans ; Laparoscopy ; Lymph Node Excision ; Mesocolon/surgery ; Retrospective Studies ; Robotic Surgical Procedures ; Treatment Outcome
Language	English
Publishing date	2021-01-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-020-08194-z
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Article ; Online: Isolation of wild yeasts from Olympic National Park and Moniliella megachiliensis ONP131 physiological characterization for beer fermentation.

Araujo Piraine, Renan Eugênio / Nickens, David Gerald / Sun, David J / Leivas Leite, Fábio Pereira / Bochman, Matthew L

Food microbiology

2021 Volume 104, Page(s) 103974

Abstract	Thousands of yeasts have the potential for industrial application, though many were initially considered contaminants in the beer industry. However, these organisms are currently considered important components in beers because they contribute new flavors. Non-Saccharomyces wild yeasts can be important tools in the development of new products, and the objective of this work was to obtain and characterize novel yeast isolates for their ability to produce beer. Wild yeasts were isolated from environmental samples from Olympic National Park and analyzed for their ability to ferment malt extract medium and beer wort. Six different strains were isolated, of which Moniliella megachiliensis ONP131 displayed the highest levels of attenuation during fermentations. We found that M. megachiliensis could be propagated in common yeast media, tolerated incubation temperatures of 37 °C and a pH of 2.5, and was able to grow in media containing maltose as the sole carbon source. Yeast cultivation was considerably impacted (p < 0.05) by lactic acid, ethanol, and high concentrations of maltose, but ONP131 was tolerant to high salinity and hop acid concentrations. This is one of the first physiological characterizations of M. megachiliensis, which has potential for the production of beer and other fermented beverages.
MeSH term(s)	Basidiomycota ; Beer/analysis ; Fermentation ; Parks, Recreational ; Saccharomyces cerevisiae
Language	English
Publishing date	2021-12-28
Publishing country	England
Document type	Journal Article
ZDB-ID	50892-5
ISSN	1095-9998 ; 0740-0020
ISSN (online)	1095-9998
ISSN	0740-0020
DOI	10.1016/j.fm.2021.103974
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Article ; Online: Factors that impact second attempt success for neonatal intubation following first attempt failure: a report from the National Emergency Airway Registry for Neonates.

Archives of disease in childhood. Fetal and neonatal edition

2024

Abstract: Objective: To determine the factors associated with second attempt success and the risk of adverse events following a failed first attempt at neonatal tracheal intubation.: Design: Retrospective analysis of prospectively collected data on intubations ...

Abstract	Objective: To determine the factors associated with second attempt success and the risk of adverse events following a failed first attempt at neonatal tracheal intubation. Design: Retrospective analysis of prospectively collected data on intubations performed in the neonatal intensive care unit (NICU) and delivery room from the National Emergency Airway Registry for Neonates (NEAR4NEOS). Setting: Eighteen academic NICUs in NEAR4NEOS. Patients: Neonates requiring two or more attempts at intubation between October 2014 and December 2021. Main outcome measures: The primary outcome was successful intubation on the second attempt, with severe tracheal intubation-associated events (TIAEs) or severe desaturation (≥20% decline in oxygen saturation) being secondary outcomes. Multivariate regression examined the associations between these outcomes and patient characteristics and changes in intubation practice. Results: 5805 of 13 126 (44%) encounters required two or more intubation attempts, with 3156 (54%) successful on the second attempt. Second attempt success was more likely with changes in any of the following: intubator (OR 1.80, 95% CI 1.56 to 2.07), stylet use (OR 1.65, 95% CI 1.36 to 2.01) or endotracheal tube (ETT) size (OR 2.11, 95% CI 1.74 to 2.56). Changes in stylet use were associated with a reduced chance of severe desaturation (OR 0.74, 95% CI 0.61 to 0.90), but changes in intubator, laryngoscope type or ETT size were not; no changes in intubator or equipment were associated with severe TIAEs. Conclusions: Successful neonatal intubation on a second attempt was more likely with a change in intubator, stylet use or ETT size.
Language	English
Publishing date	2024-02-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2023-326501
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Article ; Online: End tidal carbon dioxide is as reliable as transcutaneous monitoring in ventilated postsurgical neonates.

Tingay, David Gerald / Mun, Kwok Sean / Perkins, Elizabeth Jean

Archives of disease in childhood. Fetal and neonatal edition

2013 Volume 98, Issue 2, Page(s) F161–4

Abstract: Objectives: To compare the agreement, precision and repeatability of end tidal carbon dioxide (EtCO2 ) and transcutaneous carbon dioxide (TcCO2 ) with partial pressure of arterial CO(2) ( PaCO2) in postoperative neonates.: Patients: Fifty ... ...

Abstract	Objectives: To compare the agreement, precision and repeatability of end tidal carbon dioxide (EtCO2 ) and transcutaneous carbon dioxide (TcCO2 ) with partial pressure of arterial CO(2) ( PaCO2) in postoperative neonates. Patients: Fifty mechanically ventilated neonates without lung disease, and with no contraindications for either TcCO2 or EtCO2 monitoring. Interventions: Paired TcCO2 and EtCO2 values were recorded with three consecutive measurements within the first 48 h of surgery. Main outcome measures: EtCO2, TcCO2 and PaCO2 triplets were compared using Bland-Altman plots. Results: One hundred thirty-two triplet measures of CO(2) were recorded with mean PaCO2 43.5 (7.3) mm Hg, EtCO2 38.8 (6.4) mm Hg and 43.8 (8.8) mm Hg (p<0.0001 for EtCO2 against PaCO2; paired t test). The PaCO2 - EtCO2 bias±2SD was 4.1±9.0 mm Hg and -0.8±13.0 mm Hg for PaCO2 - TcCO2. 56.1% of EtCO2, and 60.6% of TcCO2 values were within ±5 mm Hg of paired PaCO2. Conclusions: In postoperative neonates, EtCO2 and TcCO2 demonstrated a clinically acceptable agreement with PaCO2.
MeSH term(s)	Blood Gas Monitoring, Transcutaneous/methods ; Capnography/methods ; Carbon Dioxide/analysis ; Carbon Dioxide/blood ; Feasibility Studies ; Humans ; Infant Care/methods ; Infant, Newborn ; Monitoring, Physiologic/methods ; Partial Pressure ; Postoperative Care/methods ; Reproducibility of Results ; Respiration, Artificial ; Tidal Volume
Chemical Substances	Carbon Dioxide (142M471B3J)
Language	English
Publishing date	2013-03
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/fetalneonatal-2011-301606
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Article ; Online: Volume guaranteed? Accuracy of a volume-targeted ventilation mode in infants.

Farrell, Olivia / Perkins, Elizabeth J / Black, Don / Miedema, Martijn / Paul, Joel Don / Pereira-Fantini, Prue M / Tingay, David Gerald

Archives of disease in childhood. Fetal and neonatal edition

2017

Abstract: Objectives: Volume-targeted ventilation (VTV) is widely used and may reduce lung injury, but this assumes the clinically set tidal volume (V: Design: Continuous inflations were recorded for 24 hours in 100 infants, mean (SD) 34 (4) weeks gestation ... ...

Abstract	Objectives: Volume-targeted ventilation (VTV) is widely used and may reduce lung injury, but this assumes the clinically set tidal volume (V Design: Continuous inflations were recorded for 24 hours in 100 infants, mean (SD) 34 (4) weeks gestation and 2483 (985) g birth weight, receiving synchronised mechanical ventilation (SLE5000, SLE, UK) with or without VTV and either the manufacturer's V4 (n=50) or newer V5 (n=50) VTV algorithm. The V Results: A total of 7 497 137 inflations were analysed. With VTV enabled (77 infants), the V Conclusion: VTV was accurate and reliable even with moderate leak and PaCO
Language	English
Publishing date	2017-06-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/archdischild-2017-312640
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