Publications by authors named "Bentley Fulcher"
Objective: Extracorporeal membrane oxygenation (ECMO) is a high-risk procedure with significant morbidity and mortality and there is an uncertain volume-outcome relationship, especially regarding long-term functional outcomes. The aim of this study was to examine the association between ECMO centre volume and long-term death and disability outcomes.
Design Setting And Participants: This is a registry-embedded observational cohort study.
Article Synopsis
- The study explored the effects of conservative versus liberal oxygen strategies on patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) in the ICU, aiming to find a balance between avoiding hyperoxia and preventing hypoxia.
- A total of 300 patients were randomly assigned to either conservative (target SaO 92-96%) or liberal oxygen (target SaO 97-100%), but both groups showed similar outcomes in ICU-free days and mortality rates at days 28 and 60.
- The conservative group had significantly more major protocol deviations compared to the liberal group, but overall, the two oxygen strategies did not differ in their impact on patient recovery in the ICU.
Article Synopsis
- ECMO (extracorporeal membrane oxygenation) is a life-supporting procedure for critically ill patients with severe cardiac or respiratory failure, but its long-term effects on survival and disability are still unclear.
- A study conducted in Australia involved 391 patients who underwent ECMO, assessing their outcomes related to death or moderate-to-severe disability 6 months post-treatment.
- Results showed that 66% of patients experienced death or disability, with higher rates in those who received extracorporeal cardiopulmonary resuscitation (eCPR) compared to veno-venous ECMO (VV-ECMO), indicating the need for careful consideration of treatment methods.
Unlabelled: Although the criteria for initiation of venovenous extracorporeal membrane oxygenation (VV ECMO) are well defined, the criteria and timing for VV ECMO decannulation are less certain. The aim of this study was to describe the ventilation and physiologic factors at the time of VV ECMO decannulation and to determine if these factors have association with mechanical ventilation or ICU length of stay after ECMO decannulation.
Design: Multicenter, prospective cohort study.
The outcomes of survivors of critical illness due to coronavirus disease (COVID-19) compared with non-COVID-19 are yet to be established. We aimed to investigate new disability at 6 months in mechanically ventilated patients admitted to Australian ICUs with COVID-19 compared with non-COVID-19. We included critically ill patients with COVID-19 and non-COVID-19 from two prospective observational studies.
View Article and Find Full Text PDFBackground: The use of extracorporeal membrane oxygenation (ECMO) is increasing in the management of critical care patients. ECMO service delivery requires an organisation-supported approach to ensure appropriate resources to deliver training, equipment, capacity, staffing, and the required model of care for quality care delivery. The aim of this nested substudy was to explore challenges specific to nursing staff in ECMO services in Australian intensive care units.
View Article and Find Full Text PDFBackground: There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months.
Methods: In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome.
Objectives: A core set of outcomes have been identified and published, which are essential to include in all clinical research evaluating the use of extracorporeal membrane oxygenation in critically ill patients, particularly regarding safety and adverse events. The purpose of this international modified Delphi study was to determine which measurement tools and the timing of measurement should be selected for the core outcome set for research evaluating patients receiving extracorporeal membrane oxygenation.
Design: This was a two-round international, multidisciplinary web-based, modified Delphi study.