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Article: Benefits of using ultrasound and non-invasive haemodynamic monitoring for critically ill and cardiac surgical patients.

Mullany, D

2013 Volume 41, Issue 6, Page(s) 706–709

MeSH term(s)	Cardiac Surgical Procedures ; Critical Care/methods ; Hemodynamics ; Humans ; Monitoring, Physiologic/methods ; Perioperative Care/methods ; Ultrasonography/methods
Language	English
Publishing date	2013-11-21
Publishing country	United States
Document type	Editorial
ZDB-ID	187524-3
ISSN	1448-0271 ; 0310-057X
ISSN (online)	1448-0271
ISSN	0310-057X
DOI	10.1177/0310057X1304100604
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Article ; Online: Association Between Thromboelastometry Identified Hypercoagulability and Thromboembolic Complications After Arthroplasty: A Prospective Observational Study in Patients With Obesity.

Gurunathan, Usha / Chiang, Lily / Hines, Joel / Pearse, Bronwyn / McKenzie, Scott / Hay, Karen / Mullany, Daniel / Nandurkar, Harshal / Eley, Victoria

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis

2023 Volume 29, Page(s) 10760296231199737

Abstract: The prothrombotic state of obesity can increase the risk of thromboembolism. We aimed to investigate if there was an association between baseline hypercoagulable rotational thromboelastometry (ROTEM) profile and thromboembolic complications in ... ...

Abstract	The prothrombotic state of obesity can increase the risk of thromboembolism. We aimed to investigate if there was an association between baseline hypercoagulable rotational thromboelastometry (ROTEM) profile and thromboembolic complications in arthroplasty patients with obesity. Patients with a body mass index ≥ 25 kg/m
MeSH term(s)	Humans ; Thrombelastography ; Thrombophilia/complications ; Thromboembolism/etiology ; Obesity/complications ; Arthroplasty/adverse effects
Language	English
Publishing date	2023-10-10
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	1237357-6
ISSN	1938-2723 ; 1076-0296
ISSN (online)	1938-2723
ISSN	1076-0296
DOI	10.1177/10760296231199737
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Zs.A 4370: Show issues

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Article: Successful conservative management of an iatrogenic ECMO cannula--related inferior vena cava injury.

Bhaskar, B / Mullany, D / Parmar, D / Ziengenfuss, M / Shekar, K

Anaesthesia and intensive care

2015 Volume 43, Issue 3, Page(s) 418–419

MeSH term(s)	Blood Transfusion/methods ; Catheters/adverse effects ; Extracorporeal Membrane Oxygenation/adverse effects ; Extracorporeal Membrane Oxygenation/instrumentation ; Humans ; Iatrogenic Disease ; Male ; Middle Aged ; Radiography ; Vena Cava, Inferior/diagnostic imaging ; Vena Cava, Inferior/injuries
Language	English
Publishing date	2015-04-21
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	187524-3
ISSN	1448-0271 ; 0310-057X
ISSN (online)	1448-0271
ISSN	0310-057X
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Article: Competencies, learning opportunities, teaching and assessments for training in general intensive care.

O'Connor, Enda / Mullany, Daniel

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

2012 Volume 14, Issue 3, Page(s) 245–247

MeSH term(s)	Clinical Competence ; Critical Care/standards ; Health Care Surveys ; Humans ; Learning
Language	English
Publishing date	2012-09
Publishing country	Australia
Document type	Letter
ZDB-ID	2401976-8
ISSN	1441-2772
ISSN	1441-2772
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Zs.A 6672: Show issues

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Article ; Online: Successful use of pre and post-operative ECMO for pulmonary endarterectomy, mitral valve replacement and myomectomy in a patient with chronic thromboembolic pulmonary hypertension and hypertrophic cardiomyopathy.

Williams, Livia / Kermeen, Fiona / Mullany, Daniel / Thomson, Bruce

Heart, lung & circulation

2015 Volume 24, Issue 10, Page(s) e153–6

Abstract: As a salvage strategy, extracorporeal membrane oxygenation (ECMO) permits the recovery of end-organ perfusion, whilst allowing the surgeon time for patient reassessment and surgical planning. We report upon the first known case in which VA ECMO was ... ...

Abstract	As a salvage strategy, extracorporeal membrane oxygenation (ECMO) permits the recovery of end-organ perfusion, whilst allowing the surgeon time for patient reassessment and surgical planning. We report upon the first known case in which VA ECMO was instituted as peri-operative supportive therapy for a young patient, in-extremis, with surgically correctable Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and Hypertrophic Cardiomyopathy (HOCM).
MeSH term(s)	Adult ; Cardiomyopathy, Hypertrophic/complications ; Cardiomyopathy, Hypertrophic/surgery ; Chronic Disease ; Endarterectomy ; Extracorporeal Membrane Oxygenation ; Humans ; Hypertension, Pulmonary/complications ; Hypertension, Pulmonary/surgery ; Male ; Mitral Valve Insufficiency/complications ; Mitral Valve Insufficiency/surgery ; Papillary Muscles/surgery ; Perioperative Care ; Pulmonary Artery/surgery ; Renal Insufficiency/complications ; Thromboembolism/complications
Language	English
Publishing date	2015-10
Publishing country	Australia
Document type	Case Reports ; Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2015.04.174
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Article: Improved hospital mortality with a low MET dose: the importance of a modified early warning score and communication tool.

Mullany, D V / Ziegenfuss, M / Goleby, M A / Ward, H E

Anaesthesia and intensive care

2016 Volume 44, Issue 6, Page(s) 734–741

Abstract: Rapid response systems have been mandated for the recognition and management of the deteriorating patient. Increasing medical emergency team (MET) dose may be associated with improved outcomes. Large numbers of MET calls may divert resources from the ... ...

Abstract	Rapid response systems have been mandated for the recognition and management of the deteriorating patient. Increasing medical emergency team (MET) dose may be associated with improved outcomes. Large numbers of MET calls may divert resources from the program providing the service unless additional personnel are provided. To describe the implementation and outcomes of a multifaceted rapid response system (RRS) in a teaching hospital, we conducted an observational study. The RRS consisted of the introduction of a MET together with 1) redesign of the ward observation chart with the vital sign variables colour-coded to identify variation from normal; 2) mandated minimum frequency of vital sign measurement; 3) three formal levels of escalation based on the degree of physiological instability as measured by a modified early warning score (MEWS); 4) COMPASS© education and e-learning package with a two-hour face-to-face small group tutorial; 5) practise in escalation and communication using the ISBAR (Identify, Situation, Background, Assessment, Response/Recommendation) communication tool. The primary outcome measures were all-cause hospital mortality rate and hospital standardised mortality ratio (HSMR) compared to peer hospitals calculated by the Health Round Table. There were 161,153 separations and 1,994 hospital deaths from July 2008 to December 2012. The MET call rate was 11.3 per 1000 separations in 2012. There was a decline in all-cause hospital mortality from 13.8 to 11 deaths/1000 separations. The HSMR decreased from 95.7 in 2008 to 66 in the second half of 2012 (below the three standard deviation control limit). A low MET dose may be associated with improved hospital mortality when combined with a MEWS and an intervention to improve communication.
MeSH term(s)	Communication ; Hospital Mortality ; Hospital Rapid Response Team ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Middle Aged ; Vital Signs
Language	English
Publishing date	2016-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	187524-3
ISSN	1448-0271 ; 0310-057X
ISSN (online)	1448-0271
ISSN	0310-057X
DOI	10.1177/0310057X1604400616
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Article ; Online: The rapidly evolving use of extracorporeal life support (ECLS) in adults.

Mullany, Dan / Shekar, Kiran / Platts, David / Fraser, John

Heart, lung & circulation

2014 Volume 23, Issue 11, Page(s) 1091–1092

MeSH term(s)	Adult ; Extracorporeal Circulation/instrumentation ; Extracorporeal Circulation/methods ; Extracorporeal Circulation/trends ; Female ; Humans ; Male
Language	English
Publishing date	2014-11
Publishing country	Australia
Document type	Letter
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2014.04.009
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Article ; Online: Use of rFVIIa for critical bleeding in cardiac surgery: dose variation and patient outcomes.

Willis, C / Bird, R / Mullany, D / Cameron, P / Phillips, L

Vox sanguinis

2010 Volume 98, Issue 4, Page(s) 531–537

Abstract: Background and objectives: Recombinant activated factor VIIa (rFVIIa) is increasingly being used in non-haemophiliac patients for the treatment of severe bleeding refractory to standard interventions. Optimal dosing regimens remain debated in cardiac ... ...

Abstract	Background and objectives: Recombinant activated factor VIIa (rFVIIa) is increasingly being used in non-haemophiliac patients for the treatment of severe bleeding refractory to standard interventions. Optimal dosing regimens remain debated in cardiac surgery. Therefore, this study investigated the use of different rFVIIa dosing practices on response to bleeding and patient outcomes in cardiac surgery patients using data from the Haemostasis Registry. Methods: Data were extracted from the Haemostasis Registry that records cases of off-licence rFVIIa use in participating institutions. Univariate analyses compared patients receiving < or =40 microg/kg, 41-60 microg/kg, 61-80 microg/kg, 81-100 microg/kg and >100 microg/kg of rFVIIa on key parameters. Logistic regression models investigated the relationship between independent variables and 28-day mortality. Results: Complete data was available on 804 cardiac surgery patients who received rFVIIa. Of these, 42 (5.2%) were treated with doses < or =40 microg/kg, while the dose group containing the most patients was 81-100 microg/kg (368, 45.77%). Results demonstrated no significant differences in the rate of thromboembolic adverse events, response to bleeding or 28-day mortality. Conclusions: These findings raise the important question of whether lower doses of rFVIIa may be as effective as higher doses in the treatment of severe bleeding in cardiac surgery patients.
MeSH term(s)	Aged ; Cardiac Surgical Procedures/adverse effects ; Factor VIIa/administration & dosage ; Female ; Hemorrhage/drug therapy ; Hemorrhage/etiology ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage/drug therapy ; Postoperative Hemorrhage/etiology ; Recombinant Proteins/administration & dosage ; Treatment Outcome
Chemical Substances	Recombinant Proteins ; recombinant FVIIa (AC71R787OV) ; Factor VIIa (EC 3.4.21.21)
Language	English
Publishing date	2010-05
Publishing country	England
Document type	Journal Article
ZDB-ID	80313-3
ISSN	1423-0410 ; 0042-9007
ISSN (online)	1423-0410
ISSN	0042-9007
DOI	10.1111/j.1423-0410.2009.01276.x
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Article ; Online: Comparison of outcome in Jehovah's Witness patients in cardiac surgery: an Australian experience.

Bhaskar, B / Jack, R K / Mullany, D / Fraser, J

Heart, lung & circulation

2010 Volume 19, Issue 11, Page(s) 655–659

Abstract: Introduction: Despite the advances in modern medicine, cardiac surgery remains associated with significant amounts of blood transfusion and is responsible for nearly 20% of all transfusions in Australasia. Progressive advances in perfusion technology ... ...

Abstract	Introduction: Despite the advances in modern medicine, cardiac surgery remains associated with significant amounts of blood transfusion and is responsible for nearly 20% of all transfusions in Australasia. Progressive advances in perfusion technology and perioperative supportive management have made it possible for members of the Jehovah's Witnesses (JW) religious group to undergo open cardiac operations with remarkable safety. This study systematically compares the operative mortality and early clinical outcome after cardiac surgery in JWs. Methods and materials: Data was obtained from the cardiac surgery and intensive care unit databases from January 2002 to December 2005. A total of 5353 patients who underwent cardiac surgical procedures including coronary artery bypass grafting with cardiopulmonary bypass (n=4041) and valvular heart surgery (n=2287) were assessed in this study. Of the 5353 patients 49 patients refused blood and blood products because of their religious beliefs. Models were constructed to determine the association between JWs and non-JWs and three outcomes: (1) operative mortality, (2) postoperative variables and (3) length of stay in intensive care unit. Propensity scores were computed from these models and used to match JWs with non-JWs. Results: There were minimal differences in the baseline patient demographic characteristics between the two groups. Haemoglobin and haematocrit levels were higher in JWs both before (13.7g/dL vs 12.8g/dL; P=0.01, and 40.0% vs 39.2%; P=0.08) and after (10.8g/dL vs 9.9g/dL; P=.003, and 34.0% vs 30.9%; P=.001) surgery. Jehovah's Witnesses experienced significantly less bleeding, almost half compared to the control group, with P<0.001. No differences were found in the adjusted and unadjusted operative mortality or intensive care unit and postoperative length of stay between the two groups. Conclusion: This study concurs with the international published data that outcomes for JW patients who undergo cardiac surgery are similar to those who receive transfusion. Every appropriate opportunity to reduce the use of allogeneic blood products.
MeSH term(s)	Aged ; Analysis of Variance ; Australia ; Blood Transfusion ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/mortality ; Critical Care/utilization ; Female ; Humans ; Jehovah's Witnesses ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications ; Regression Analysis ; Religion and Medicine ; Retrospective Studies ; Treatment Outcome ; Treatment Refusal
Language	English
Publishing date	2010-11
Publishing country	Australia
Document type	Comparative Study ; Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2010.07.010
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Article ; Online: The use of tracheostomy speaking valves in mechanically ventilated patients results in improved communication and does not prolong ventilation time in cardiothoracic intensive care unit patients.

Sutt, Anna-Liisa / Cornwell, Petrea / Mullany, Daniel / Kinneally, Toni / Fraser, John F

Journal of critical care

2015 Volume 30, Issue 3, Page(s) 491–494

Abstract: Purpose: The aim of this study was to assess the effect of the introduction of in-line tracheostomy speaking valves (SVs) on duration of mechanical ventilation and time to verbal communication in patients requiring tracheostomy for prolonged mechanical ... ...

Abstract	Purpose: The aim of this study was to assess the effect of the introduction of in-line tracheostomy speaking valves (SVs) on duration of mechanical ventilation and time to verbal communication in patients requiring tracheostomy for prolonged mechanical ventilation in a predominantly cardiothoracic intensive care unit (ICU). Materials and methods: We performed a retrospective preobservational-postobservational study using data from the ICU clinical information system and medical record. Extracted data included demographics, diagnoses and disease severity, mechanical ventilation requirements, and details on verbal communication and oral intake. Results: Data were collected on 129 patients. Mean age was 59 ± 16 years, with 75% male. Demographics, case mix, and median time from intubation to tracheostomy (6 days preimplementation-postimplementation) were unchanged between timepoints. A significant decrease in time from tracheostomy to establishing verbal communication was observed (18 days preimplementation and 9 days postimplementation, P <.05). There was no difference in length of mechanical ventilation (20 days preimplementation-post) or time to decannulation (14 days preimplementation-postimplementation). No adverse events were documented in relation to the introduction of in-line SVs. Conclusions: In-line SVs were successfully implemented in mechanically ventilated tracheostomized patient population. This resulted in earlier verbal communication, no detrimental effect on ventilator weaning times, and no change in decannulation times. Purpose: The purpose of the study was to compare tracheostomy outcomes in mechanically ventilated patients in a cardiothoracic ICU preintroduction and postintroduction of in-line SVs. It was hypothesized that in-line SVs would improve communication and swallowing specific outcomes with no increase in average time to decannulation or the number of adverse events.
MeSH term(s)	Aged ; Communication ; Coronary Care Units ; Critical Care ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Respiration ; Respiration, Artificial/methods ; Retrospective Studies ; Speech ; Time Factors ; Tracheostomy/methods ; Ventilator Weaning
Language	English
Publishing date	2015-06
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2014.12.017
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