Glenfield Hospital

About: Glenfield Hospital is a healthcare organization based out in Leicester, United Kingdom. It is known for research contribution in the topics: Population & Extracorporeal membrane oxygenation. The organization has 1382 authors who have published 1812 publications receiving 99238 citations. The organization is also known as: Glenfield General Hospital.

A method for measuring threats and errors in surgery

Abstract: We examined the measurement of non-technical skills for surgical teams using a framework derived from aviation. Twenty four paediatric cardiac surgical and 20 orthopaedic operations were studied by a single observer. Predefined intraoperative failures were recorded, from which it was possible to derive measures of technical errors, threats, and non-technical errors (NTEs). A second non-technical scoring (NTS) method was used which required the observer to give a score from 1 to 4 on the four dimensions of the scale for three stages of each operation. There was a significant positive relationship between NTEs and operative duration in orthopaedic surgery (p < 0.01). In paediatric cardiac surgery, the ranked NTS measures correlated positively with the number of threats (p < 0.005) and with operative duration (p < 0.005). Non-technical skills measures (ranked NTS and NTEs) were also significantly positively correlated (p < 0.01). This suggests that it is possible to evaluate non-technical skills in operating theatre teams, but further work is needed to improve the reliability and accuracy of the measurement methods.

Cytokine Imbalance in Infants Receiving Extracorporeal Membrane Oxygenation for Respiratory Failure

Abstract: Background: It is likely that the imbalance between the pro- and anti-inflammatory cytokines will determine the outcome in infants with severe respiratory failure receiving extracorporeal membrane oxygenation (ECMO). Aims: We determined if there was an imbalance between pro- and anti-inflammatory cytokines in serial bronchoalveolar lavage (BAL) fluid obtained from survivors and non-survivors of ECMO. Methods: We therefore measured the cellular changes and the molar ratios of pro-inflammatory and anti-inflammatory cytokines in serial BAL fluid obtained from survivors and non-survivors of ECMO. Fifteen infants surviving ECMO (median age 1 day, range 1–120) and 7 who did not (28 days, range 1–402) were studied. Results: In the lungs of survivors, the increased proportion of airway neutrophils at presentation decreased with time and was matched by a parallel increase in percent alveolar macrophages as the infants’ condition improved. The pro- and anti-inflammatory pulmonary cytokine ratios were static in the survivors. In the non-survivors, the ratio of tumour necrosis factor-α (TNF-α) against soluble TNF-receptor 1 (sTNF-R1) and soluble TNF receptor 2 (sTNF-R2) was increased at days 2–3 when compared to the survivors, but the molar ratio interleukin-1β (IL-1β)/soluble IL-1 receptor antagonist (sIL-1RA) was largely undetectable due to undetectable IL-1β. Conclusions: These data suggest that the infants who survive ECMO resolve their pulmonary inflammation and that in non-survivors the ratio of TNF-α against its receptor antagonists is increased and is associated with a poor outcome. Furthermore, this group of infants were unable to produce significant concentrations of IL-1β.