Vimal Grover

Vimal Grover
The Royal Marsden NHS Foundation Trust · Anaesthetic Department

MB ChB (Hons) BSc (Hons) MRCP FRCA MD (res)

About

24
Publications
1,526
Reads
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177
Citations
Citations since 2016
4 Research Items
165 Citations
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Publications

Publications (24)
Article
Full-text available
Introduction Immune checkpoint inhibitors (ICIs) are increasingly a standard of care for many cancers; these agents can result in immune-related adverse events (irAEs) including fever, which is common but can rarely be associated with systemic immune activation (SIA or acquired HLH). Methods All consecutive patients receiving ICIs in the Drug Deve...
Poster
Background There are fewer adverse events with immune checkpoint inhibitors (ICPI) than with chemotherapy, however, some patients receiving ICPI may require intensive care treatment in case of severe immune-related adverse events (IRAE’s), which should be immediately recognized to permit an appropriate treatment. We present data of patients admitte...
Article
Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, ob...
Article
With a chronic shortage of doctors in intensive care, alternative roles are being explored. One of these is the role of the Advanced Critical Care Practitioner. The Advanced Critical Care Practitioner Curriculum was developed by the Faculty of Intensive Care Medicine and is used to provide a structured programme of training. The Advanced Critical C...
Article
Full-text available
Antibiotic use in intensive care units (ICUs) can promote antimicrobial resistance. Outbreaks of multi-resistant bacteria significantly affect patient outcomes and delivery of care. Antibiotic stewardship programmes (ASPs), combining root-cause analyses and multi-faceted prevention strategies, are necessary, often at significant cost and time. Whic...
Article
Benzodiazepines increase vulnerability to infection through α1 subunit dependent Υ-amino-butyric-type-A (GABAA) signalling. Immune cell expression of GABAA receptors and the effect of diazepam on influenza infection was investigated. In patients with pneumonia, α1 GABAA subunits were expressed on alveolar macrophages and blood monocytes. In mice, i...
Article
Full-text available
Background and objectives: The bronchoscopic microsample (BMS) probe allows direct epithelial lining fluid (ELF) level measurement without saline lavage. We investigated whether cytokine levels in ELF from a BMS differed from those obtained by bronchoalveolar lavage (BAL) in stable and acute lung disease. Methods: In a single-centre, prospective...
Article
Full-text available
Introduction Ventilator-associated pneumonia (VAP) increases mortality in critical illness. However, clinical diagnostic uncertainty persists. We hypothesised that measuring cell-surface and soluble inflammatory markers, incorporating Triggering Receptor Expressed by Myeloid cells (TREM)-1, would improve diagnostic accuracy. Methods A single centr...
Article
Full-text available
Ventilator associated pneumonia (VAP) is a common nosocomial infection in the ICU. Diagnosis based on best available criteria remains difficult. Current and novel biomarkers have the potential to speed up and improve the accuracy of its diagnosis. This review highlights the markers that have gained the most attention to date and aims to discuss the...
Article
Full-text available
A 12-bed ICU experienced an outbreak of multiresistant Acinetobacter baumannii (MRA) from October 2009 to May 2010. A multifaceted strategy involving segregation, enhanced infection control procedures, and microbiological surveillance was implemented. We evaluated its impact on antibiotic stewardship.
Article
Full-text available
The use of bronchoalveolar lavage (BAL) to investigate inflammatory lung disease in the critically ill may not be tolerated in hypoxic patients. Furthermore, soluble protein analysis of BAL fluid suffers from inaccuracies related to saline dilution. The bronchoscopic microsample (BMS) probe allows absolute cytokine levels in epithelial lining fluid...
Article
This commentary aims to provide Anaesthetists and Intensivists with an understanding of the viral hepatitides and their impact on clinical practice. This will include the modes and risks of transmission, clinical features and new options for disease treatment. Peri-operative management, safe clinical practice and needlestick injury will also be dis...
Article
Full-text available
Introduction Biomarkers have been investigated in order to speed up diagnosis of VAP, a common condition in ICU patients. TREM-1 is a protein involved in amplification of immune responses to bacterial and fungal infection and exists as soluble and surface forms.1 2 The diagnostic value of soluble TREM-1 in broncho-alveolar lavage fluid (BALF) in VA...
Article
Here, we provide an overview of viral hepatitis, the risks of transmission and new developments in the treatment of infected individuals. Acute hepatitis is a potentially fatal disease and, when not fatal, can lead to a chronic viral carrier status with the attendant risks of cirrhosis and hepatocellular carcinoma. Liver transplantation is often th...

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Project (1)
Project
To determine and incorporate into clinical practice the most accurate biomarkers for rapid diagnostics of lung infection