Research Development

Staff Publications

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Find out what your colleagues have been writing. This section features articles published by staff working for St Helens and Knowsley Teaching Hospitals and Halton, Knowsley and St Helens community staff.

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All publications by 'Mahambrey T'



Mersey and West Lancashire Teaching Hospitals NHS Trust – St Helens & Knowsley Staff

Metformin-associated lactic acidosis

Abstract A 58-year-old female with known type 2 diabetes mellitus continued to take her usual medications, including metformin, an ACE inhibitor and a non-steroidal anti-inflammatory drug, while suffering from diarrhoea and vomiting. On presentation to the emergency department, she was found to have a profound lactic acidosis, cardiovascular instability and acute..

Published: 08/07/2021
Authors: Fadden E, Longley C, Mahambrey T

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059 Encouraging standardisation of documentation in anaesthetics using the intensive care framework of central lines

The Faculty of Intensive Care Medicine (ICM) produced a series of World Health Organization (WHO) style checklists, the Local Safety Standards for Invasive Procedures (LocSSIPs), based on a framework from NHS England's Safety Domain to ensure safe practice of invasive procedures and prevent a never event [1, 2]. In Whiston Hospital, the..

Published: 01/05/2020
Authors: Mahambrey T

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Reintubation following planned extubation

​ Introduction Studies indicate reintubation rates following planned extubation to be between 10-20% in the general ICU population. There is evidence that extubation failure and reintubation can worsen outcome, with studies suggesting ICU mortality rates of between 25-50% in these patients. Objectives To establish how our failed extubation rate and subsequent..

Published: 19/07/2016
Authors: Whitmore D, Mahambrey T

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Validation of a classification system

​ OBJECTIVE Trials in critical care have previously used unvalidated systems to classify cause of death. We aimed to provide initial validation of a method to classify cause of death in intensive care unit patients. DESIGN, SETTING AND PARTICIPANTS One hundred case scenarios of patients who died in an ICU were..

Published: 19/07/2016
Authors: McCairn AJ, Mahambrey T

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Lung protective ventilation

​ INTRODUCTION In 2013 Futier et al. published work showing that a lung protective ventilation strategy with low tidal volumes for patients undergoing elective major abdominal surgery was associated with improved clinical outcome and reduced healthcare utilisation. It is established within intensive care that protective ventilation strategies are best practice, however until..

Published: 19/07/2016
Authors: Angus W, Glennon K, Mahambrey T, Miller T

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Successful implementation of a medical emergency team

​ Introduction A medical emergency team (MET) was introduced in our institution in January 2012 to provide timely response to the needs of acutely ill inpatients and cardiac arrest calls. The MET assesses the patient and prescribes a management plan for the responsible team to follow; promptly stabilising and transferring patients to..

Published: 19/07/2016
Authors: Elmore J, Mahambrey T, Tridente A, Varia R

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Medical Emergency Team

​ Abstract In January 2011 a multidisciplinary hospital-wide medical emergency team (MET) was introduced at Whiston Hospital replacing the previous cardiac arrest team. The primary aim of this new rapid-response service was to improve early identification and management of deteriorating patients, with a reduction in unplanned intensive care (ICU) admissions, cardiac arrest..

Published: 19/07/2016
Authors: Elmore J, Mahambrey T

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The Critical Care Management of the Burn Patient

​ Abstract Between 4 and 22% of burn patients presenting to the emergency department are admitted to critical care. Burn injury is characterised by a hypermetabolic response with physiologic, catabolic and immune effects. Burn care has seen renewed interest in colloid resuscitation, a change in transfusion practice and the development of anti-catabolic therapies...

Published: 19/07/2016
Authors: Mahambrey T, Shokrollahi K

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Critical Care

​ Abstract Inadequate resuscitation of major haemorrhage is an important cause of avoidable death in severely injured patients. Early recognition of blood loss, control of bleeding and restoration of circulating volume are critical to the management of trauma shock, and transfusion of blood components is a key intervention. Vital signs may..

Published: 19/07/2016
Authors: Bonney S, Mahambrey T, Nee PA

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St Helens Community Staff

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Knowsley Community Staff

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Halton Community Staff

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North West Boroughs Community Health Staff

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