Nick Fletcher

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The difference between mean systemic filling (Pmsf) and central venous pressure (CVP) is the venous return gradient (dVR). The aim of this study is to assess the significance of the Pmsf analogue (Pmsa) and the dVR during a fluid challenge. We performed a prospective observational study in postsurgical patients. Patients were monitored with a central venous(More)
These experiments assessed whether reported increases in food consumption and food-reinforced instrumental performance in undeprived rats by the 5-HT1A agonist 8-hydroxy-2(di-n-propylamino)tetralin (8-OH-DPAT) are due to an increment in the incentive value of foods. Against this hypothesis, we found that when undeprived rats were trained to lever press for(More)
Myocardial dysfunction may contribute to the haemodynamic instability which accompanies sepsis, and may result in circulatory failure. There is no association between systolic dysfunction (SD) and mortality in septic patients and there is conflicting evidence regarding the effects of diastolic dysfunction (DD) on mortality in septic patients. We conducted a(More)
There has been a recent explosion of education and training in echocardiography in the specialties of anesthesiology and critical care. These devices, by their impact on clinical management, are changing the way surgery is performed and critical care is delivered. A number of international bodies have made recommendations for training and developed(More)
OBJECTIVES The clinical outcomes of patients discharged after prolonged postoperative intensive care unit (ICU) stay following cardiac surgery are unclear. The aim of this study was to assess survival and functional status in patients whose ICU stay exceeded 5 or 10 days in a tertiary cardiac surgical unit. METHODS Patients undergoing adult cardiac(More)
OBJECTIVE This study aims to describe the pharmacodynamics of a fluid challenge over a 10-minute period in postoperative patients. DESIGN Prospective observational study. SETTING General and cardiothoracic ICU, tertiary hospital. PATIENTS Twenty-six postoperative patients. INTERVENTION Two hundred and fifty-milliliter fluid challenge performed over(More)
OBJECTIVE To investigate the safety of a novel, miniaturized, monoplane transesophageal echocardiography probe (mTEE) and its potential as a hemodynamic monitoring tool. DESIGN This was a retrospective analysis of the clinical evaluation of a disposable mTEE in ventilated patients with severe cardiogenic shock requiring hemodynamic support. mTEE(More)
Tremor is an important cause of disability and poor quality of life amongst multiple sclerosis (MS) patients. We assessed the outcomes of ventral intermediate (VIM) nucleus deep brain stimulation for the treatment of multiple sclerosis (MS)–associated tremor at a single centre in a prospective fashion. Sixteen patients (9 female, 7 male) with a mean age of(More)
Transient stop-flow arm arterial–venous equilibrium pressure (Pmsf-arm) is a validated technique for measuring the mean systemic filling pressure (Pmsf). Pmsf is a functional measure of the effective intravascular volume status. This study aims to assess the precision of the Pmsf-arm measurement. Pmsf-arm was measured by inflating a pneumatic tourniquet(More)