Dr. Sten Rubertsson, Professor of Anesthesia and Intensive Care Medicine at the University of Uppsala in Sweden, is one of our distinguished Critical Care Medicine alumni. After returning to Sweden, he has mentored a large number of postdoctoral trainees in research. Most recently, Dr. Joahnna Nordmark completed her extensive research on hypothermia treatment after cardiac arrest (CA) with cardiopulmonary resuscitation (CPR) and return of spontaneous circulation (ROSC). Her official defense with Dr. Kochanek as the opponent took place on March 28, 2009. Dr. Nordmark's investigations included animal studies on pigs and humans after CA with ROSC after CPR. Moderate hypothermia was initiated with IV infusion of 4 degree C saline solution which proved safe and effective. Four patients had monitoring of intracranial pressure (ICP) which showed an increase after CA w ROSC but rarely above 20 mm Hg, as well as microdialysis, demonstrating signs of cerebral energy failure (increased lactate/pyruvate ratio) and excitotoxicity (increased glutamate). No negative effects on the cardiovascular system were observed from the use of hypothermia and there were no indications of cerebral disturbances during rewarming.
In Sweden as in other European countries, postdoctoral research of this magnitude takes approximately five years for completion, leading to a thesis which is usually published as a supplement to one of the leading journals. For approval, the thesis must be officially defended with an appointed opponent having documented expertise in the studied field. The opponent criticizes the thesis, directing multiple questions to the respondent, defending his or her investigations. After deemed successful by a team of prominent local faculty members, the respondent is promoted to a higher academic degree beyond the medical school MD degree. Additional qualifications including a scientific lecture, may lead to appointment as "Docent" at the university, which corresponds to the level of an associate professor in the US.