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Article ; Online: Increased long-term mortality following new-onset atrial fibrillation in the intensive care unit: A systematic review and meta-analysis.

Garside, Tessa / Bedford, Jonathan P / Vollam, Sarah / Gerry, Stephen / Rajappan, Kim / Watkinson, Peter J

2022 Volume 72, Page(s) 154161

Abstract: Purpose: We performed a systematic review and meta-analysis to investigate the long-term outcomes of patients who develop new-onset atrial fibrillation (NOAF) during an intensive care unit (ICU) admission.: Methods: We searched the MEDLINE and EMBASE ...

Abstract	Purpose: We performed a systematic review and meta-analysis to investigate the long-term outcomes of patients who develop new-onset atrial fibrillation (NOAF) during an intensive care unit (ICU) admission. Methods: We searched the MEDLINE and EMBASE databases from 2000 to 2022. We included studies of adults based in general ICUs that evaluated long-term outcomes (at least 30 days after hospital discharge) of NOAF. We excluded studies involving patients with a history of atrial fibrillation (AF). We performed risk of bias assessment of the included studies based on a modified Newcastle Ottawa score (NOS). We extracted summary data for long-term outcomes. Where the outcome was reported in three or more studies we pooled effect sizes. Results: We screened 2206 studies and included 15 studies reporting data from 561,797 patients. Pooled analysis of 4 studies using a random effects model revealed an association between NOAF acquired in an ICU and 90-day mortality (including ICU and hospital mortality) (RR 1.53, 95% CI 1.12-2.08). We also found an association between NOAF and 1-year mortality from 7 studies (RR 1.79, 95% CI 1.65-1.96), which remained when analysing 1-year mortality in hospital survivors (RR 1.72 (95% CI 1.49-1.98). Conclusions: In patients who develop NOAF in an ICU, both 90-day and 1-year mortality are increased in comparison to those who do not develop NOAF. Current evidence suggests an increased risk of thromboembolic events after hospital discharge in patients who develop NOAF in an ICU.
MeSH term(s)	Adult ; Humans ; Atrial Fibrillation/etiology ; Risk Factors ; Intensive Care Units ; Hospital Mortality ; Patient Discharge
Language	English
Publishing date	2022-10-07
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2022.154161
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Zs.A 2152: Show issues

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Article: The feasibility and acceptability of a physician-led ICU follow-up service: A prospective cohort study.

Stedman, Wade / Donaldson, Lachlan / Garside, Tessa / Green, Sarah / Donoghoe, Stephanie F / Whitfield, Victoria E / Bass, Frances / Delaney, Anthony / Hammond, Naomi

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

2023 Volume 37, Issue 1, Page(s) 3–11

Abstract: Background: Increased recognition of post-intensive care syndrome has led to widespread development of intensive care follow-up services internationally.: Objective: The objective of this study was to determine the feasibility and acceptability of an ...

Abstract	Background: Increased recognition of post-intensive care syndrome has led to widespread development of intensive care follow-up services internationally. Objective: The objective of this study was to determine the feasibility and acceptability of an intensive care unit (ICU) follow-up clinic in Australia for patients and their caregivers and to describe satisfaction with this service. Methods: This was a prospective cohort study in a mixed tertiary ICU in Australia. Eligible patients were adults admitted to the ICU for 7 days or more and/or ventilated for 48 h or more, as well as their primary caregiver. Patients and their primary caregivers were invited to attend a follow-up clinic 4-8 weeks after hospital discharge. The clinic appointment was attended by an ICU physician and nurse, with multidisciplinary support. Feasibility and acceptability were defined as the proportion of clinic attendance and frequency of interventions initiated at the clinic. Satisfaction was measured by a 5-point satisfaction survey (very dissatisfied to very satisfied). The burden of ongoing disease was reported via multiple validated instruments. Results: From April 2020-July 2021, 386 patients met the inclusion criteria. Only 146 patients were approached for consent due to site staffing limitations. Eighty-three patients and 32 caregivers consented to attend the clinic. Seventy percent (54/77) of patients attended scheduled appointments and 50% (16/32) of caregivers. For patients, 23 medical referrals were made, 8 patients had medication changes, and 10 patients were offered social work support. Satisfaction surveys were completed by 65% (35/54) of attending patients; 97% (34) patients reported either being 'very satisfied' or 'satisfied' with the service. All responding caregivers (10) were either 'very satisfied' or 'satisfied' with the clinic. Conclusion: There were a large number of patients meeting the inclusion criteria to the ICU follow-up clinic, and clinic attendance was moderate for patients but lower for caregivers. Reported satisfaction with the service was high for both patients and their caregiver.
MeSH term(s)	Adult ; Humans ; Prospective Studies ; Feasibility Studies ; Follow-Up Studies ; Intensive Care Units ; Critical Care
Language	English
Publishing date	2023-12-07
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1159493-7
ISSN	1878-1721 ; 1036-7314
ISSN (online)	1878-1721
ISSN	1036-7314
DOI	10.1016/j.aucc.2023.10.003
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Zs.A 3762: Show issues

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Article ; Online: Case series investigating the cortical silent period after burns using transcranial magnetic stimulation.

Garside, Tessa / Wood, Fiona M / Vallence, Ann-Maree

Burns : journal of the International Society for Burn Injuries

2018 Volume 44, Issue 5, Page(s) 1195–1202

Abstract: Objective: The study aimed to investigate intracortical inhibition following a burn injury, and to establish transcranial magnetic stimulation (TMS) as a useful and sensitive tool to investigate the cortical response to a burn injury.: Methods: ... ...

Abstract	Objective: The study aimed to investigate intracortical inhibition following a burn injury, and to establish transcranial magnetic stimulation (TMS) as a useful and sensitive tool to investigate the cortical response to a burn injury. Methods: Thirteen burn injured patients and 12 uninjured subjects underwent TMS to measure the cortical silent period (cSP), a marker of intracortical inhibition. Results: In burn injury patients, cSP was similar in the burn-injured and less-injured arm (133 and 132ms respectively; p=0.96). cSP was numerically shorter in burns patients than control subjects, however, these differences were not statistically significant (133 vs 148ms, p=0.24). Subgroup analysis revealed cSP was shorter in the burn arm of patients compared to the uninjured control subjects in patients with upper-limb burn (cSP 120ms vs 148ms, p=0.03), those with <10% TBSA (cSP 120ms vs 148ms, p=0.01), those <2 years' post-burn (cSP 110ms vs 148ms, p=0.01), and patients with partial thickness burns (cSP 120ms vs 148ms, p=0.02). Conclusions: These results demonstrate significantly shorter cSP in the burned arm in patients with upper limb burn sustained <2years ago, those with partial thickness burns, those with upper limb burns only, and those with burns of less than 10% TBSA. The results are consistent with the existing literature, which demonstrates a reduction in cSP duration in patients with a range of peripheral nerve injuries. There is a strong suggestion that cortical inhibition is altered following burn injury, and that TMS is a useful and sensitive method for investigating changes in cortical inhibition in burn patients.
MeSH term(s)	Adolescent ; Adult ; Burns/physiopathology ; Case-Control Studies ; Cerebral Cortex/physiopathology ; Electromyography ; Evoked Potentials, Motor ; Female ; Humans ; Male ; Middle Aged ; Motor Cortex/physiopathology ; Neural Inhibition ; Neuronal Plasticity ; Quality of Life ; Time Factors ; Transcranial Magnetic Stimulation ; Trauma Severity Indices ; Young Adult
Language	English
Publishing date	2018-05-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	197308-3
ISSN	1879-1409 ; 0305-4179
ISSN (online)	1879-1409
ISSN	0305-4179
DOI	10.1016/j.burns.2018.04.010
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Zs.A 1250: Show issues

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Article ; Online: Acute assessment of spinal cord injury in New South Wales: A retrospective study of current practice in two spinal cord injury referral centers.

Garside, Tessa / Stanford, Ralph / Flower, Oliver / Li, Trent / Dababneh, Edward / Hammond, Naomi / Bass, Frances / Middleton, James / Tang, Jonathan / Ball, Jonathan / Delaney, Anthony

The journal of spinal cord medicine

2023 , Page(s) 1–8

Abstract: Introduction: Interventions provided in the early phases after spinal cord injury (SCI) may improve neurological recovery and provide for best possible functional outcomes. Knowing this relies on early and clear documentation of the level and grade of ... ...

Abstract	Introduction: Interventions provided in the early phases after spinal cord injury (SCI) may improve neurological recovery and provide for best possible functional outcomes. Knowing this relies on early and clear documentation of the level and grade of the spinal cord injury. Guidelines advocate for early documentation of neurological status within 72 h of injury to allow early prognostication and to help guide initial management. It is unclear whether this is current practice in New South Wales (NSW). Methods: Patients with acute SCI who were admitted to two SCI referral centers during 2018-2019 in NSW were included. Data relating to documentation of neurological status, timing of imaging, surgery and transfer to spinal cord injury center were collected and summarized using descriptive statistics. Results: Only 18 percent of patients had an acceptable neurological examination according to the International Standards for Classification of Spinal Cord Injury (ISNCSCI) within 72 h of injury (either not done, or unable to determine the neurological level of injury). At the first neurological examination, the neurological level of injury and grade was unable to be determined in 26.8% of patients and 29.9% of patients respectively. At discharge from acute care and transfer to rehabilitation, the neurological level was undetermined in 28.9% of patients and grade undetermined in 26.8%. ISNCSCI examination was most commonly performed by spinal rehabilitation doctors after patients were discharged from the intensive care unit (ICU). Conclusions: Documentation of neurological level and grade of SCI within 72 h of injury is not being performed in the large majority of this cohort, which may impede evaluation of neurological improvement in response to acute treatment, and hinder prognostication.
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1223949-5
ISSN	2045-7723 ; 1079-0268
ISSN (online)	2045-7723
ISSN	1079-0268
DOI	10.1080/10790268.2023.2247625
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Zs.A 2416: Show issues

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Article: Risk factors for new-onset atrial fibrillation during critical illness: A Delphi study.

Bedford, Jonathan P / Garside, Tessa / Darbyshire, Julie L / Betts, Timothy R / Young, J Duncan / Watkinson, Peter J

Journal of the Intensive Care Society

2021 Volume 23, Issue 4, Page(s) 414–424

Abstract: Background: New-onset atrial fibrillation (NOAF) is common during critical illness and is associated with poor outcomes. Many risk factors for NOAF during critical illness have been identified, overlapping with risk factors for atrial fibrillation in ... ...

Abstract	Background: New-onset atrial fibrillation (NOAF) is common during critical illness and is associated with poor outcomes. Many risk factors for NOAF during critical illness have been identified, overlapping with risk factors for atrial fibrillation in patients in community settings. To develop interventions to prevent NOAF during critical illness, modifiable risk factors must be identified. These have not been studied in detail and it is not clear which variables warrant further study. Methods: We undertook an international three-round Delphi process using an expert panel to identify important predictors of NOAF risk during critical illness. Results: Of 22 experts invited, 12 agreed to participate. Participants were located in Europe, North America and South America and shared 110 publications on the subject of atrial fibrillation. All 12 completed the three Delphi rounds. Potentially modifiable risk factors identified include 15 intervention-related variables. Conclusions: We present the results of the first Delphi process to identify important predictors of NOAF risk during critical illness. These results support further research into modifiable risk factors including optimal plasma electrolyte concentrations, rates of change of these electrolytes, fluid balance, choice of vasoactive medications and the use of preventative medications in high-risk patients. We also hope our findings will aid the development of predictive models for NOAF.
Language	English
Publishing date	2021-06-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2701626-2
ISSN	1751-1437 ; 1751-1437
ISSN (online)	1751-1437
ISSN	1751-1437
DOI	10.1177/17511437211022132
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Article ; Online: Balanced Crystalloids versus Saline in Critically Ill Adults - A Systematic Review with Meta-Analysis.

Hammond, Naomi E / Zampieri, Fernando G / Di Tanna, Gian Luca / Garside, Tessa / Adigbli, Derick / Cavalcanti, Alexandre B / Machado, Flavia R / Micallef, Sharon / Myburgh, John / Ramanan, Mahesh / Rice, Todd W / Semler, Matthew W / Young, Paul J / Venkatesh, Balasubramanian / Finfer, Simon / Delaney, Anthony

NEJM evidence

2022 Volume 1, Issue 2, Page(s) EVIDoa2100010

Abstract: Balanced Crystalloids and Saline in Critical IllnessThis article presents a frequentist (showing no significant difference) and Bayesian (in which the posterior probability that balanced crystalloids reduced mortality was 89.5%) systematic review of ... ...

Abstract	Balanced Crystalloids and Saline in Critical IllnessThis article presents a frequentist (showing no significant difference) and Bayesian (in which the posterior probability that balanced crystalloids reduced mortality was 89.5%) systematic review of randomized clinical trials comparing balanced crystalloids with saline in critically ill adults with the primary outcome of 90-day mortality.
Language	English
Publishing date	2022-01-18
Publishing country	United States
Document type	Journal Article
ISSN	2766-5526
ISSN (online)	2766-5526
DOI	10.1056/EVIDoa2100010
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Article ; Online: Association Between Selective Decontamination of the Digestive Tract and In-Hospital Mortality in Intensive Care Unit Patients Receiving Mechanical Ventilation: A Systematic Review and Meta-analysis.

Hammond, Naomi E / Myburgh, John / Seppelt, Ian / Garside, Tessa / Vlok, Ruan / Mahendran, Sajeev / Adigbli, Derick / Finfer, Simon / Gao, Ya / Goodman, Fiona / Guyatt, Gordon / Santos, Joseph Alvin / Venkatesh, Balasubramanian / Yao, Liang / Di Tanna, Gian Luca / Delaney, Anthony

JAMA

2022 Volume 328, Issue 19, Page(s) 1922–1934

Abstract: Importance: The effectiveness of selective decontamination of the digestive tract (SDD) in critically ill adults receiving mechanical ventilation is uncertain.: Objective: To determine whether SDD is associated with reduced risk of death in adults ... ...

Abstract	Importance: The effectiveness of selective decontamination of the digestive tract (SDD) in critically ill adults receiving mechanical ventilation is uncertain. Objective: To determine whether SDD is associated with reduced risk of death in adults receiving mechanical ventilation in intensive care units (ICUs) compared with standard care. Data sources: The primary search was conducted using MEDLINE, EMBASE, and CENTRAL databases until September 2022. Study selection: Randomized clinical trials including adults receiving mechanical ventilation in the ICU comparing SDD vs standard care or placebo. Data extraction and synthesis: Data extraction and risk of bias assessments were performed in duplicate. The primary analysis was conducted using a bayesian framework. Main outcomes and measures: The primary outcome was hospital mortality. Subgroups included SDD with an intravenous agent compared with SDD without an intravenous agent. There were 8 secondary outcomes including the incidence of ventilator-associated pneumonia, ICU-acquired bacteremia, and the incidence of positive cultures of antimicrobial-resistant organisms. Results: There were 32 randomized clinical trials including 24 389 participants in the analysis. The median age of participants in the included studies was 54 years (IQR, 44-60), and the median proportion of female trial participants was 33% (IQR, 25%-38%). Data from 30 trials including 24 034 participants contributed to the primary outcome. The pooled estimated risk ratio (RR) for mortality for SDD compared with standard care was 0.91 (95% credible interval [CrI], 0.82-0.99; I2 = 33.9%; moderate certainty) with a 99.3% posterior probability that SDD reduced hospital mortality. The beneficial association of SDD was evident in trials with an intravenous agent (RR, 0.84 [95% CrI, 0.74-0.94]), but not in trials without an intravenous agent (RR, 1.01 [95% CrI, 0.91-1.11]) (P value for the interaction between subgroups = .02). SDD was associated with reduced risk of ventilator-associated pneumonia (RR, 0.44 [95% CrI, 0.36-0.54]) and ICU-acquired bacteremia (RR, 0.68 [95% CrI, 0.57-0.81]). Available data regarding the incidence of positive cultures of antimicrobial-resistant organisms were not amenable to pooling and were of very low certainty. Conclusions and relevance: Among adults in the ICU treated with mechanical ventilation, the use of SDD compared with standard care or placebo was associated with lower hospital mortality. Evidence regarding the effect of SDD on antimicrobial resistance was of very low certainty.
MeSH term(s)	Humans ; Anti-Infective Agents/administration & dosage ; Anti-Infective Agents/therapeutic use ; Bacteremia/mortality ; Bacteremia/prevention & control ; Bayes Theorem ; Gastrointestinal Tract/drug effects ; Gastrointestinal Tract/microbiology ; Hospital Mortality ; Intensive Care Units ; Pneumonia, Ventilator-Associated/mortality ; Pneumonia, Ventilator-Associated/prevention & control ; Respiration, Artificial/adverse effects ; Respiration, Artificial/mortality ; Critical Illness/mortality ; Critical Illness/therapy ; Drug Resistance, Microbial/drug effects ; Infection Control/methods
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2022-11-01
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2022.19709
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Article ; Online: High-intensity Aerobic Exercise Blocks the Facilitation of iTBS-induced Plasticity in the Human Motor Cortex.

Smith, Ashleigh E / Goldsworthy, Mitchell R / Wood, Fiona M / Olds, Timothy S / Garside, Tessa / Ridding, Michael C

Neuroscience

2017 Volume 373, Page(s) 1–6

Abstract: Acute exercise studies using transcranial magnetic stimulation (TMS) can provide important insights into the mechanisms underpinning the positive relationship between regular engagement in physical activity and cortical neuroplasticity. Emerging evidence ...

Abstract	Acute exercise studies using transcranial magnetic stimulation (TMS) can provide important insights into the mechanisms underpinning the positive relationship between regular engagement in physical activity and cortical neuroplasticity. Emerging evidence indicates that a single session of aerobic exercise can promote the response to an experimentally induced suppressive neuroplasticity paradigm; however, little is known about the neuroplasticity response to facilitatory paradigms, including intermittent theta burst stimulation (iTBS). To more fully characterize the effects of exercise on brain plasticity we investigated if a single 30 min bout of high-intensity cycling (80% predicted heart rate reserve) modulated the response to an iTBS paradigm compared to rest. In 18 participants (9 females; 25.5 ± 5.0 years, range: 18-35 years) iTBS was applied using standard repetitive transcranial magnetic stimulation techniques immediately following exercise or 30 min of rest. Motor evoked potentials (MEPs) were recorded from the right first dorsal interosseous muscle at baseline, after the exercise/rest period but before iTBS, and at 5 time points following iTBS (0, 5, 10, 20 and 30 min). Contrary to our hypothesis, MEPs were suppressed following iTBS after a single 30 min bout of lower limb aerobic exercise compared to rest. These results indicate that acute aerobic exercise may not always enhance the response to an experimentally induced neuroplasticity paradigm. Further investigation of the factors that influence the relationship between exercise and neuroplasticity is warranted.
MeSH term(s)	Adolescent ; Adult ; Evoked Potentials, Motor/physiology ; Exercise/physiology ; Female ; Humans ; Male ; Motor Cortex/physiology ; Muscle, Skeletal/physiology ; Neuronal Plasticity/physiology ; Rest ; Time Factors ; Transcranial Magnetic Stimulation/methods ; Young Adult
Language	English
Publishing date	2017-12-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	196739-3
ISSN	1873-7544 ; 0306-4522
ISSN (online)	1873-7544
ISSN	0306-4522
DOI	10.1016/j.neuroscience.2017.12.034
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Article ; Online: The influence of a single bout of aerobic exercise on short-interval intracortical excitability.

Smith, Ashleigh E / Goldsworthy, Mitchell R / Garside, Tessa / Wood, Fiona M / Ridding, Michael C

Experimental brain research

2014 Volume 232, Issue 6, Page(s) 1875–1882

Abstract: Regular physical activity can have positive effects on brain function and plasticity. Indeed, there is some limited evidence that even a single bout of exercise may promote plasticity within the cortex. However, the mechanisms by which exercise acutely ... ...

Abstract	Regular physical activity can have positive effects on brain function and plasticity. Indeed, there is some limited evidence that even a single bout of exercise may promote plasticity within the cortex. However, the mechanisms by which exercise acutely promotes plasticity are not clear. To further explore the effects of acute exercise on cortical function, we examined whether a single bout of exercise was associated with changes in cortical excitability and inhibition. Using standard techniques, cortical stimulus-response curves [90% resting motor threshold (RMT)-150% RMT] were investigated in nine subjects (four females, 31.1 ± 11.7 years) and short-interval intracortical inhibition (SICI) [interstimulus interval 2 ms and 3 ms, conditioning intensities of 80% active motor threshold (AMT) and 90% AMT] in 13 subjects (six females, 28.4 ± 5.1 years) before and at 0 and 15 min following 30 min of ergometer cycling at low-moderate or moderate-high intensity. There were no changes in cortical excitability following exercise but less SICI at both 0 and 15 min post-exercise (F [2, 24] = 7.7, P = 0.003). These findings show that a short period of exercise can transiently reduce SICI. Such a change in inhibition after exercise may contribute to the development of a cortical environment that would be more optimal for plasticity and may partially explain previous findings of enhanced neuroplasticity following low-intensity exercise.
MeSH term(s)	Adult ; Analysis of Variance ; Electromyography ; Evoked Potentials, Motor/physiology ; Exercise/physiology ; Female ; Humans ; Male ; Middle Aged ; Motor Cortex/physiology ; Neural Inhibition ; Surveys and Questionnaires ; Time Factors ; Transcranial Magnetic Stimulation/methods ; Young Adult
Language	English
Publishing date	2014-02-26
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1201-4
ISSN	1432-1106 ; 0014-4819
ISSN (online)	1432-1106
ISSN	0014-4819
DOI	10.1007/s00221-014-3879-z
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Article: Survey of critical care practice in Australian and New Zealand burn referral centres.

Holley, Anthony D / Reade, Michael C / Lipman, Jeffrey / Delaney, Anthony / Udy, Andrew / Lee, Richard / Litton, Edward / Cheung, Winston / Turner, Andrew / Garside, Tessa / Macken, Lewis / Reddi, Benjamin / Kol, Mark / Kazemi, Alex / Shah, Asim / Townsend, Shane / Cohen, Jeremy

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

2019 Volume 21, Issue 4, Page(s) 303–304

MeSH term(s)	Australia ; Burns/therapy ; Critical Care/methods ; Health Care Surveys ; Humans ; New Zealand ; Practice Patterns, Physicians' ; Referral and Consultation ; Surveys and Questionnaires
Language	English
Publishing date	2019-11-25
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2401976-8
ISSN	1441-2772
ISSN	1441-2772
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