M. Grocott's research while affiliated with University of Southampton and other places

... A clear structure with terms of reference, a central management team, multidisciplinary groups, a division into smaller teams with experienced leaders, and goal and target setting could facilitate these collaborations [39,48,50,63,64,69,75,79,81]. Problems included poor recruitment of local investigators, especially in LMICs and Africa, dropout of investigators across multiple rounds of the same study, power imbalances between HIC and LMIC authors, a skewed data representation of the identified regions, variations in the local and regional context, and difficulties in achieving consensus [27,30,31,33,35,36,39,40,43,49,63,67,75,80]. ...

... Emerging evidence suggests that myosteatosis is associated with reduced physical fitness when objectively evaluated by CPET in cancer patients undergoing hepatopancreatobiliary surgery. 18 Interestingly, in oesophago-gastric cancer patients undergoing resection, chest wall skeletal muscle mass was associated on CPET with oxygen uptake at anaerobic threshold (VO2 at AT) and at peak exercise (VO2 peak), rather than myosteatosis. 19 The relationship between body composition and CPET in CRC patients remains unclear. ...

... We find that in order to overcome these challenges, bedside open tracheostomies in the ICU should be standardised and meticulously planned with participation of highly experienced surgeons, anaesthetist and scrub team. We followed key recommendations in minimising aerosol generation during open tracheostomy in COVID-19 patients including advancing the endotracheal tube distal to proposed site of tracheal window prior to entry, hyperinflation of endotracheal cuff, withholding ventilation at key points and covering operative site with gauze swabs when ventilation recommences (13). These factors, alongside a short mean procedural time (nine minutes) are likely to have been key contributing factors to minimising risk to healthcare workers involved in the procedure. ...

... In recent years, a comprehensive, international consensus group consisting of multidisciplinary experts has recently made several recommendations as to which outcome measures should be included in perioperative medicine trials. The Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COM-PAC) Group have utilised clinical evidence and expert consensus to determine clinically important outcome measures in areas such as mortality, morbidity, system-specific outcomes and patient centre outcomes [18][19][20][21][22][23][24]. This allows consistency in outcomes research and reduces the risk of heterogeneity errors in trial compassion ( Fig. 1). ...

... Techniques examined include, but are not limited to, intra-operative opioid use, volatile inhalational anaesthesia and propofol total intravenous anaesthesia [TIVA], regional anaesthesia, the systemic use of amide local anaesthetics, dexamethasone and use of dexmedetomidine (a highly selective alpha-2 adrenergic agonist). To facilitate further research, a workgroup has determined Standardised End-Points (StEPs) to standardise measured primary and secondary outcomes in clinical trials of the effect of peri-operative interventions on oncologic outcomes [7]. Here, we review current evidence around a number of anaesthetic-analgesic techniques in relation to long-term cancer outcomes. ...

... Pulmonary complications are a common and lethal sequela of elective surgery, affecting 2-62% of patients depending on the operative approach and casemix. 1 As elective surgery is upscaled to address a growing global backlog from the COVID-19 pandemic, pulmonary events pose a major threat to patient safety. 2,3 Such events were implicated in 37% of postoperative deaths before the pandemic, and as many as 66% of deaths during the pandemic due to additional risks of perioperative SARS-CoV-2 infection. ...

... End-of-life cancer care has become increasingly aggressive over the past decades [1][2][3] with considerable variation among countries as documented in receipt of chemotherapy (from 4.8 to 12.7%) [1], intensive care unit (ICU) care (from 24.3 to 27.4%) [2], and mechanical ventilation (from 5.7 to 6.2%) [3] in the last month of life, resulting in disproportionately escalating health expenditures in many countries [1][2][3][4]. Aggressive end-of-life care leads to greater patient distress [5], worse quality of life [6], poor care quality [7], and value-discordant end-of-life care [8]. Accurate prognostic awareness facilitates cancer patients' ability to make informed end-of-life-care plans that avoid aggressive end-of-life care [9]. ...