The Department of Critical Care Medicine’s research enterprise comprises some of the best known and most productive researchers in acute care medicine. Our faculty continues to provide innovation and leadership across the spectrum of critical care, from basic science to clinical trials and outcomes research. Our research activities are grouped into six primary domains: sepsis, resuscitation, computational biology, brain injury, organ dysfunction and support, and health services research. Our research enterprise comprises two research centers: the Safar Center for Resuscitation Research, and the Clinical Research, Investigation, and Systems Modeling of Acute illness (CRISMA) Center as well as several smaller groups and individual researchers. Our Multidisciplinary Acute Care Clinical Research Organization (MACRO) also performs industry-funded clinical trials and supports many NIH trials.
Beginning with some of the earliest and still most widely quoted epidemiologic research in sepsis, our researchers are pursuing the basic mechanisms of this disease as well as the best ways to treat it. Using multicenter studies, we have investigated the genetic and inflammatory profiles of thousands of patients and are studying processes of care from resuscitation to renal and respiratory support to novel therapies including drugs and devices. We also study basic cellular responses to sepsis including cell function and differentiation. Our collaborations extend from early care in the emergency department to development of sophisticated devices that can manipulate the immune response.
Our researchers are leading the field in outcomes research in acute illness both in adults and children. We study longitudinal cohorts of patients exposed to critical illness and are experts in long term follow-up, use of large datasets, and in performing cost-effectiveness analysis. Together with our data managers and statisticians, we serve as coordinating center for multiple federally funded and industry-sponsored clinical trials. We also study recovery from critical illness including lung injury, kidney injury, and brain injury. Finally, we are doing important work in the area of patient safety.
Beginning with the seminal and ground breaking work of the late Peter Safer, brain injury, both ischemic and traumatic, has been a centerpiece of research within our department. Hypoxic-ischemic encephalopathy remains an incurable disease, and our researchers are studying both the causes of neuronal injury and life-saving treatments including gender specific approaches. Similar work is underway in traumatic brain injury and includes investigation into the mechanisms of cellular energy failure and the effect of novel therapies such as adenosine and other neuroprotective agents. Finally, we are seeking to discover ways to improve recovery after to brain injury and to reduce caregiver burden.
An important theme in our multidisciplinary department is resuscitation. Several of our investigators are studying resuscitation in various shock states including sepsis, cardiac arrest, trauma and hemorrhage, and organ donation. Furthermore, we have led the field in areas such as functional hemodynamic monitoring, medical emergency teams, and even suspended animation. Our funding for this research has come from diverse sourcing including the National Institutes of Heath, Hearth Resources and Services Administration, Defense Advanced Research Projects Agency, Department of Defense, US Army and Navy, American Heart Association, Laerdal foundation, Robert Wood Johnson Foundation, and numerous industry partners.
Our scientists are applying some of the most advanced techniques in systems modeling to problems in the field of critical care. We are using sophisticated computer simulations to unravel the mysteries of clinical problems from sepsis and hemorrhagic shock to mechanical ventilation and acute lung injury. Furthermore, we have exciting research programs using complexity analysis of patient vital sign monitoring aimed at developing early warning systems to detect clinical deteriorations in hospitalized patients. Finally, we are using our world-class WISER Simulation Center to study how best to train the next generation of intensivists and how to keep the current generation at the top of their game.
As critical illness and injury results in a diverse spectrum of organ dysfunction, so too are the research interests of our faculty. We have active research programs in brain, lung, heart, kidney, liver, and gastrointestinal dysfunction along with injury consequent to critical illness. Moreover, several of our investigators study the interplay between organ systems in health and disease such as heart-lung and kidney-lung interaction. Since critical care is supportive care, we have some of the world’s leading experts on the use of respiratory and renal support. We are even studying emotional support in the wake of critical illness.
In addition, these broad research themes, many investigators in the department continue active programs in various areas of critical care medicine, using funding from both government and industry sponsors. Successful research, in the areas identified above, have resulted in a number of collaborative alliances within the department and across the University; detailed descriptions can be found in the CRISMA and Safar Center areas, and listed under each Individual investigator.
The Department is committed to helping junior faculty members interested in research compete successfully for extramural funding. Senior research faculty members act as mentors. The Department has a formal internal grant review process, which involves peer review of the scientific section and assistance from our pre-award grants administrator with preparation of budgets. This program has been successful in helping our young investigators, as well as our more experienced researchers, to write quality applications with a high probability of funding.