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Article: Out-of-hospital cardiac arrest: stay and play or scoop and run (to an ECMO centre).

Fisher, Caleb M

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine

2023 Volume 24, Issue 1, Page(s) 5–6

Language	English
Publishing date	2023-10-18
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	2401976-8
ISSN	1441-2772
ISSN	1441-2772
DOI	10.51893/2022.1.E
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Zs.A 6672: Show issues

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Article ; Online: Further Exploration of MARS.

Warrillow, Stephen / Fisher, Caleb

Critical care medicine

2022 Volume 50, Issue 2, Page(s) 346–348

Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000005202
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Article ; Online: Ceremonial purification: which rite is right in liver failure?

Fisher, Caleb / Warrillow, Stephen / Bellomo, Rinaldo

Intensive care medicine

2022 Volume 49, Issue 3, Page(s) 366

MeSH term(s)	Humans ; Liver Failure/therapy
Language	English
Publishing date	2022-11-09
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-022-06923-7
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Zs.A 1089: Show issues

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Article ; Online: Ammonia Clearance with Different Continuous Renal Replacement Therapy Techniques in Patients with Liver Failure.

Fisher, Caleb / Baldwin, Ian / Fealy, Nigel / Naorungroj, Thummaporn / Bellomo, Rinaldo

Blood purification

2022 Volume 51, Issue 10, Page(s) 840–846

Abstract: Introduction: Continuous renal replacement therapy (CRRT) can be used to treat hyperammonaemia. However, no study has assessed the effect of different CRRT techniques on ammonia clearance.: Methods: We compared 3 different CRRT techniques in adult ... ...

Abstract	Introduction: Continuous renal replacement therapy (CRRT) can be used to treat hyperammonaemia. However, no study has assessed the effect of different CRRT techniques on ammonia clearance. Methods: We compared 3 different CRRT techniques in adult patients with hyperammonaemia, liver failure, and acute kidney injury. We protocolized CRRT to progressively deliver continuous veno-venous haemofiltration (CVVH), haemodialysis (CVVHD) or haemodiafiltration (CVVHDF). Ammonia was simultaneously sampled from the patient's arterial blood and effluent fluid for each technique. We applied accepted equations to calculate clearance. Results: We studied 12 patients with a median age of 47 years (interquartile range [IQR] 25-79). Acute liver failure was present in 4 (25%) and acute-on-chronic liver failure in 8 (75%). There was no significant difference in median ammonia clearance between CRRT technique; CVVH: 27 (IQR 23-32) mL/min versus CVVHD: 21 (IQR 17-28) mL/min versus CVVHDF: 20 (IQR 14-28) mL/min, p = 0.32. Moreover, for all techniques, ammonia clearance was significantly less than urea and creatinine clearance; urea 50 (47-54) mL/min versus creatinine 42 (IQR 38-46) mL/min versus ammonia 25 (IQR 18-29) mL/min, p = 0.0001. Conclusion: We found no significant difference in ammonia clearance according to CRRT technique and demonstrated that ammonia clearance is significantly less than urea or creatinine clearance.
MeSH term(s)	Acute Kidney Injury/therapy ; Adult ; Ammonia ; Continuous Renal Replacement Therapy ; Creatinine ; Humans ; Hyperammonemia/therapy ; Liver Failure/therapy ; Middle Aged ; Renal Replacement Therapy/methods ; Urea
Chemical Substances	Ammonia (7664-41-7) ; Urea (8W8T17847W) ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2022-01-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000521312
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Article ; Online: The Impact of Early Positive Studies on the Evolution of Extracorporeal Albumin Dialysis Literature: A Bibliometric Analysis.

Chaba, Anis / Warrillow, Stephen / Fisher, Caleb / Maeda, Akinori / Spano, Sofia / Bellomo, Rinaldo

Blood purification

2023 Volume 53, Issue 4, Page(s) 279–287

Abstract: Introduction: Liver failure is a life-threatening condition characterized by the accumulation of metabolic toxins. Extracorporeal albumin dialysis (ECAD) has been promoted as a possible therapy.: Methods: We employed bibliometric analysis to ... ...

Abstract	Introduction: Liver failure is a life-threatening condition characterized by the accumulation of metabolic toxins. Extracorporeal albumin dialysis (ECAD) has been promoted as a possible therapy. Methods: We employed bibliometric analysis to scrutinize the conceptual, intellectual, and social structure of the ECAD literature including its co-citation network and thematic analysis to explore its evolution and organization. Results: We identified 784 documents with a mean of 30.25 citations per document in a corpus of 15,191 references. The average citation rate peaked in 1998 at 280.75 citations/year before a second 2013 peak of 54.81 citations/year and then progressively decreased to its nadir in 2022 (1.48 yearly citations). We identified four primary co-citation clusters, with the most impactful publications being small "positive" manuscripts by Mitzner et al. (2000) and Heemann et al. (2002) (Cluster 1). This first cluster had several relational citations with clusters 2 and 3, but almost no citation link with cluster 4 represented by Bañares et al. (2013), Saliba et al. (2013), and Larsen et al. (2016), with their three negative randomized controlled trials. Finally, the thematic map revealed a shift in focus over time, with inflammation and ammonia as recent emergent themes. Conclusions: This bibliometric analysis provided a transparent and reproducible longitudinal assessment of ECAD literature and demonstrated how positive studies with low levels of evidence can dominate a research field and overshadow negative findings from higher quality studies. These insights hold significant implications for future research and clinical practice within this domain.
MeSH term(s)	Humans ; Renal Dialysis ; Bibliometrics ; Albumins ; Liver Failure
Chemical Substances	Albumins
Language	English
Publishing date	2023-10-31
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	605548-5
ISSN	1421-9735 ; 0253-5068
ISSN (online)	1421-9735
ISSN	0253-5068
DOI	10.1159/000534915
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Article ; Online: Correction and Control of Hyperammonemia in Acute Liver Failure: The Impact of Continuous Renal Replacement Timing, Intensity, and Duration.

Warrillow, Stephen / Fisher, Caleb / Bellomo, Rinaldo

Critical care medicine

2020 Volume 48, Issue 2, Page(s) 218–224

Abstract: Objectives: Hyperammonemia is a key contributing factor for cerebral edema in acute liver failure. Continuous renal replacement therapy may help reduce ammonia levels. However, the optimal timing, mode, intensity, and duration of continuous renal ... ...

Abstract	Objectives: Hyperammonemia is a key contributing factor for cerebral edema in acute liver failure. Continuous renal replacement therapy may help reduce ammonia levels. However, the optimal timing, mode, intensity, and duration of continuous renal replacement therapy in this setting are unknown. We aimed to study continuous renal replacement therapy use in acute liver failure patients and to assess its impact on hyperammonemia. Design: Retrospective observational study. Setting: ICU within a specialized liver transplant hospital. Patients: Fifty-four patients with acute liver failure. Interventions: Data were obtained from medical records and analyzed for patient characteristics, continuous renal replacement therapy use, ammonia dynamics, and outcomes. Main results: Forty-five patients (83%) had high grade encephalopathy. Median time to continuous renal replacement therapy commencement was 4 hours (interquartile range, 2-4.5) with 35 (78%) treated with continuous venovenous hemodiafiltration and 10 (22%) with continuous venovenous hemofiltration. Median hourly effluent flow rate was 43 mL/kg (interquartile range, 37-62). The median ammonia concentration decreased every day during treatment from 151 µmol/L (interquartile range, 110-204) to 107 µmol/L (interquartile range, 84-133) on day 2, 75 µmol/L (interquartile range, 63-95) on day 3, and 52 µmol/L (interquartile range, 42-70) (p < 0.0001) on day 5. The number of patients with an ammonia level greater than 150 µmol/L decreased on the same days from 26, to nine, then two, and finally none. Reductions in ammonia levels correlated best with the cumulative duration of therapy hours (p = 0.03), rather than hourly treatment intensity. Conclusions: Continuous renal replacement therapy is associated with reduced ammonia concentrations in acute liver failure patients. This effect is related to greater cumulative dose. These findings suggest that continuous renal replacement therapy initiated early and continued or longer may represent a useful approach to hyperammonemia control in acute liver failure patients.
MeSH term(s)	APACHE ; Adult ; Age Factors ; Ammonia/metabolism ; Body Weight ; Continuous Renal Replacement Therapy/methods ; Female ; Humans ; Hyperammonemia/etiology ; Hyperammonemia/physiopathology ; Hyperammonemia/therapy ; Intensive Care Units ; Liver Failure, Acute/complications ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Time Factors
Chemical Substances	Ammonia (7664-41-7)
Language	English
Publishing date	2020-01-14
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000004153
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Article ; Online: Early and prolonged continuous hypertonic saline infusion in patients with acute liver failure.

Michel, Claire / Warming, Scott / Neto, Ary Serpa / Abeygunawardana, Vihangi / Fisher, Caleb / Kishore, Kartik / Warrillow, Stephen / Bellomo, Rinaldo

Journal of critical care

2023 Volume 76, Page(s) 154289

Abstract: Purpose: To study patient characteristics, physiological changes, and outcomes associated with prolonged continuous hypertonic saline (HTS) infusion in acute liver failure (ALF).: Materials and methods: Retrospective observational cohort study of ... ...

Abstract	Purpose: To study patient characteristics, physiological changes, and outcomes associated with prolonged continuous hypertonic saline (HTS) infusion in acute liver failure (ALF). Materials and methods: Retrospective observational cohort study of adult patients with ALF. We collected clinical, biochemical, and physiological data six hourly for the first week, daily until day 30 or hospital discharge, and weekly, when documented, until day 180. Results: Of 127 patients, 85 received continuous HTS. Compared with non-HTS patients they were more likely to receive continuous renal replacement therapy (CRRT) (p < 0.001) and mechanical ventilation (p < 0.001). Median HTS duration was 150 (Interquartile range (IQR): 84-168) hours, delivering a median 2244 (IQR: 979-4610) mmol sodium load. Median peak sodium concentration was 149 mmol/L vs 138 mmol/L in non-HTS patients (p < 0.001). The median rate of sodium increase with infusion was 0.1 mmol/L/h and median rate of decrease during weaning was 0.1 mmol/L every 6 h. Median lowest pH value was 7.29 vs. 7.35 in non-HTS patients. Survival of HTS patients was 72.9% overall and 72.2% without transplantation. Conclusions: In ALF patients, the prolonged administration of HTS infusion was not associated with severe hypernatremia or rapid shifts in serum sodium upon commencement, delivery, or weaning.
MeSH term(s)	Adult ; Humans ; Retrospective Studies ; Treatment Outcome ; Saline Solution, Hypertonic/therapeutic use ; Sodium ; Liver Failure, Acute/therapy
Chemical Substances	Saline Solution, Hypertonic ; Sodium (9NEZ333N27)
Language	English
Publishing date	2023-03-16
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2023.154289
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Article ; Online: Medical students as interpreters in health care situations: "… it's a grey area".

Ryan, Anna Therese / Fisher, Caleb / Chiavaroli, Neville

The Medical journal of Australia

2019 Volume 211, Issue 4, Page(s) 170–174

Abstract: Objective: To examine the extent to which medical students in Australia are acting as interpreters in medical settings, and their perceptions of this activity.: Design, setting, participants: Anonymous online survey of final year students in the ... ...

Abstract	Objective: To examine the extent to which medical students in Australia are acting as interpreters in medical settings, and their perceptions of this activity. Design, setting, participants: Anonymous online survey of final year students in the graduate medical program of the University of Melbourne, undertaken in 2014. Main outcome measures: Numbers of students who had acted or who had been asked to act as ad hoc interpreters in health care situations during their clinical rotations and outside the medical education context. Results: 146 of 319 final year medical students completed the survey (46% response). 106 students (73%) reported they could speak at least one language in addition to English; none had formal interpreting qualifications, but 40 (36%) had been asked to interpret during clinical rotations, and 36 (34%) had done so. The students described a diverse range of experiences, including complex interactions regarding informed consent and the breaking of bad news. Conclusion: Medical students frequently acted as interpreters during their clinical training. Most did not feel appropriately qualified to interpret in clinical situations, and some felt pressured to do so, but many found the experience positive. Our study highlights the lack of clear guidelines regarding medical student interpreters in Australian health care settings.
MeSH term(s)	Australia ; Communication Barriers ; Humans ; Language ; Physician-Patient Relations ; Students, Medical ; Surveys and Questionnaires ; Translating
Language	English
Publishing date	2019-06-12
Publishing country	Australia
Document type	Journal Article
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/mja2.50235
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Article ; Online: Improved Thyreostatic Drug Detection in Animal Tissues Using Liquid Chromatography-High-Field Asymmetric Waveform Ion Mobility Spectrometry-Mass Spectrometry.

Purves, Randy W / Souster, Kim / West, Michelle / Huda, Azhar M / Fisher, Caleb M E / Belford, Michael W / Shurmer, Bryn O

Journal of agricultural and food chemistry

2022 Volume 70, Issue 16, Page(s) 4785–4791

Abstract: Thyreostatic drugs (thyreostats) interfere with thyroid function and have been used illegally in animals slaughtered for food. Thyreostat use leads to poorer quality meat, and the drug residues can cause adverse effects in humans. These drugs, with the ... ...

Abstract	Thyreostatic drugs (thyreostats) interfere with thyroid function and have been used illegally in animals slaughtered for food. Thyreostat use leads to poorer quality meat, and the drug residues can cause adverse effects in humans. These drugs, with the exception of thiouracil, do not occur naturally and require sensitive methodologies for their detection in animal tissues. Because thyreostats are low-molecular-weight polar analytes, liquid chromatography-mass spectrometry (LC-MS) is typically used for detection and, in particular, triple quadrupole mass spectrometry with selective reaction monitoring (i.e., LC-SRM). However, LC-SRM thyreostat methods suffer from chemical background noise and endogenous interferences arising from the complex tissue matrix. An improved high-field asymmetric waveform ion mobility spectrometry interface (FAIMS Pro), which separates ions based on differential ion mobility, was combined with LC-SRM to minimize these interferences. Using the same samples and conditions, LC-FAIMS-SRM showed improvements in the signal-to-noise ratio (S/N) of up to 50 times compared with our validated LC-SRM method. In addition, wider linear ranges, including substantial improvements in the lower limit of quantification (approximately an order of magnitude for tapazole and methylthiouracil), were observed with LC-FAIMS-SRM.
MeSH term(s)	Animals ; Chromatography, Liquid ; Drug Residues ; Ion Mobility Spectrometry/methods ; Ions/chemistry ; Tandem Mass Spectrometry/methods
Chemical Substances	Ions
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	241619-0
ISSN	1520-5118 ; 0021-8561
ISSN (online)	1520-5118
ISSN	0021-8561
DOI	10.1021/acs.jafc.1c06937
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Article: Improved Thyreostatic Drug Detection in Animal Tissues Using Liquid Chromatography–High-Field Asymmetric Waveform Ion Mobility Spectrometry–Mass Spectrometry

Purves, Randy W. / Souster, Kim / West, Michelle / Huda, Azhar M. / Fisher, Caleb M. E. / Belford, Michael W. / Shurmer, Bryn O.

Journal of agricultural and food chemistry. 2022 Jan. 21, v. 70, no. 16

2022

Abstract	Thyreostatic drugs (thyreostats) interfere with thyroid function and have been used illegally in animals slaughtered for food. Thyreostat use leads to poorer quality meat, and the drug residues can cause adverse effects in humans. These drugs, with the exception of thiouracil, do not occur naturally and require sensitive methodologies for their detection in animal tissues. Because thyreostats are low-molecular-weight polar analytes, liquid chromatography–mass spectrometry (LC–MS) is typically used for detection and, in particular, triple quadrupole mass spectrometry with selective reaction monitoring (i.e., LC–SRM). However, LC–SRM thyreostat methods suffer from chemical background noise and endogenous interferences arising from the complex tissue matrix. An improved high-field asymmetric waveform ion mobility spectrometry interface (FAIMS Pro), which separates ions based on differential ion mobility, was combined with LC–SRM to minimize these interferences. Using the same samples and conditions, LC–FAIMS–SRM showed improvements in the signal-to-noise ratio (S/N) of up to 50 times compared with our validated LC–SRM method. In addition, wider linear ranges, including substantial improvements in the lower limit of quantification (approximately an order of magnitude for tapazole and methylthiouracil), were observed with LC–FAIMS–SRM.
Keywords	chemical species ; food chemistry ; liquid chromatography ; mass spectrometry ; meat ; methimazole ; methylthiouracil ; signal-to-noise ratio ; thiouracil ; thyroid function
Language	English
Dates of publication	2022-0121
Size	p. 4785-4791.
Publishing place	American Chemical Society
Document type	Article
ZDB-ID	241619-0
ISSN	1520-5118 ; 0021-8561
ISSN (online)	1520-5118
ISSN	0021-8561
DOI	10.1021/acs.jafc.1c06937
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