Biography

Areas of specialism

Critical care medicine; Respiratory medicine; Perioperative medicine

My qualifications

2011
PhD
Imperial College
1999
Bachelor Medicine (BM)
University of Southampton

Research

Research interests

Research projects

Supervision

Postgraduate research supervision

My publications

Publications

Creagh-Brown B, De Silva A, Pubudu A, Ferrando-Vivas P, Harrison DA (2016) Relationship Between Peak Lactate and Patient Outcome Following High-Risk Gastrointestinal Surgery: Influence of the Nature of Their Surgery: Elective Versus Emergency, Critical Care Medicine 44 (5) pp. 918-925 Lippincott, Williams & Wilkins
Objectives: The association between hyperlactatemia and adverse outcome in patients admitted to ICUs following gastrointestinal surgery has not been reported. To explore the hypothesis that in a large cohort of gastrointestinal surgical patients, the peak serum lactate (in the first 24 hr) observed in patients admitted to ICU following surgery is associated with unadjusted and severity-adjusted acute hospital mortality and that the strength of association is greater in patients admitted following ?emergency? surgery than in patients admitted following ?elective? surgery.

Design: A retrospective cohort study of all patients who had gastrointestinal surgery and were admitted directly to the ICU between 2008 and 2012.

Setting: Two hundred forty-nine hospitals in the United Kingdom.

Patients: One hundred twenty-one thousand nine hundred ninety patients.

Interventions: None.

Measurements and Main Results: Peak blood lactate in the first 24 hours of admission to critical care, acute hospital mortality, length of stay, and other variables routinely collected within the U.K. Intensive Care National Audit and Research Centre Case Mix Programme database. Elevated blood lactate was associated with increased risk of death and prolonged duration of stay, and the relationship was maintained once adjusted for confounding variables. The positive association between mortality and levels of blood lactate continued down into the ?normal range,? without evidence of a plateau. There was no difference in the extent to which hyperlactatemia was related to mortality between patients admitted following elective and emergency surgery.

Conclusions: These findings have implications for our understanding of the role of lactate in critically ill patients.

Davidson AC, Banham S, Elliott M, Kennedy D, Gelder C, Glossop A, Church AC, Creagh-Brown B, Dodd JW, Felton T, Foex B, Mansfield L, McDonnell L, Parker R, Patterson CM, Sovani M, Thomas L (2016) BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults, THORAX 71 pp. 1-35 BMJ PUBLISHING GROUP
Vandevala T, Pavey L, Chelidoni O, Chang N, Creagh-Brown B, Cox AC (2017) Psychological rumination and recovery from work in Intensive Care Professionals: Associations with stress, burnout, depression, and health, Journal of Intensive Care 5 (16) BioMed Central
Background The work demands of critical care can be a major cause of stress in intensive care unit (ICU) professionals and lead to poor health outcomes. In the process of recovery from work, psychological rumination is considered to be an important mediating variable in the relationship between work demands and health outcomes. This study aimed to extend our knowledge of the process by which ICU stressors and differing rumination styles are associated with burnout, depression and risk of psychiatric morbidity among ICU professionals. Methods Ninety-six healthcare professionals (58 doctors and 38 nurses) who work in ICUs in the UK completed a questionnaire on ICU-related stressors, burnout, work-related rumination, depression and risk of psychiatric morbidity. Results Significant associations between ICU stressors, affective rumination, burnout, depression and risk of psychiatric morbidity were found. Longer working hours were also related to increased ICU stressors. Affective rumination (but not problem-solving pondering or distraction detachment) mediated the relationship between ICU stressors, burnout, depression and risk of psychiatric morbidity, such that increased ICU stressors, and greater affective rumination, were associated with greater burnout, depression and risk of psychiatric morbidity. No moderating effects were observed. Conclusions Longer working hours were associated with increased ICU stressors, and increased ICU stressors conferred greater burnout, depression and risk of psychiatric morbidity via increased affective rumination. The importance of screening healthcare practitioners within intensive care for depression, burnout and psychiatric morbidity has been highlighted. Future research should evaluate psychological interventions which target rumination style and could be made available to those at highest risk. The efficacy and cost effectiveness of delivering these interventions should also be considered.
Rayner L, Mcgovern Andrew Peter, Creagh-Brown Ben, Woodmansey C, de Lusignan Simon (2018) Type 2 Diabetes And Asthma: Systematic Review, Current Diabetes Reviews 14 Bentham Science Publishers
Background and Objective: Obesity is an important contributor to the risk of both asthma and Type 2 Diabetes (T2DM). However, it has been suggested that T2DM and asthma are also independently associated. The aim of this systematic review was to synthesize the evidence for an independent relationship between T2DM and asthma. Methods: MEDLINE and EMBASE were searched for studies reporting the relationship between asthma and T2DM in adults. Given a potential bidirectional relationship, articles relating to T2DM as a risk factor for asthma, and asthma as a risk factor for T2DM were examined separately. Results: Eight studies were identified for inclusion in the review (n=2,934,399 participants). Four studies examined incident diabetes in those with asthma. The pooled (random effects model) adjusted hazard ratio for incident T2DM in asthma was 1.37 (95%CI 1.12-1.69; p