Brittney Williams, MD, 2019 FAER MRTG Awardee, conducting research focused on the Role of TLR7 in Platelet Activation and Dysfunction in Sepsis.
Brittney Williams, MD, 2019 FAER MRTG Awardee, conducting research focused on the Role of TLR7 in Platelet Activation and Dysfunction in Sepsis.
Vijay Krishnamoorthy, MD, MPH, PhD, Assistant Professor, Anesthesiology and Population Health Sciences, and Co-Director, Critical Care and Perioperative Population Health Research (CAPER Unit), Department of Anesthesiology, Duke University, Durham, North Carolina.
Vijay Krishnamoorthy, MD, MPH, PhD, Assistant Professor, Anesthesiology and Population Health Sciences, and Co-Director, Critical Care and Perioperative Population Health Research (CAPER Unit), Department of Anesthesiology, Duke University, Durham, North Carolina.
As the COVID-19 pandemic has unfolded globally, a greater focus has been placed on the care of critically ill patients around the world. While critical care medicine has always held an important place in the management of medical and surgical patients worldwide, the recognition and role of the specialty during the current pandemic has been clear. For example, critical care clinicians have been deeply involved in decisions regarding best therapeutics, optimal management of supportive therapies (i.e., mechanical ventilation and renal replacement), and patient triage in the setting of resource constraints (Br J Anaesth 2020;125:e248-51). With this increased focus on the field of critical care medicine, it has become apparent that significant research is necessary to advance patient care above and beyond COVID-19 and to fill research gaps existing in both pragmatic and specialized areas throughout our subspecialty. Given these critical research needs, the Foundation for Anesthesia Education and Research (FAER) continues to support investigators in critical care medicine to advance science and improve patients' lives on a global scale.
To achieve these important research priorities and improve outcomes for critically ill patients worldwide, FAER has supported cutting-edge research, education, and training in the field of critical care medicine. This support has spanned several topics in critical care, including resuscitation, sepsis, and injury, and a variety of research approaches, including basic science, translational research, and population health. This work has led to further research funding and ultimately advances in patient care that clinicians apply at the bedside every day.
Building upon research support from my FAER Mentored Research Training Grant (MRTG), our team is addressing clinical research questions in the care of patients with severe traumatic brain injury (TBI). While severe TBI causes significant primary anatomic injury to the brain, its impact on non-neurologic organ dysfunction is being increasingly recognized (J Neurosurg 2019;131:1931-7; J Neurotrauma 2020;37:770-81), but gaps in knowledge exist. Particularly, the underlying mechanisms of myocardial injury and multi-organ dysfunction, and their impact on secondary brain injuries and functional outcomes, represent a significant gap in the literature. Understanding these fundamental relationships (and the variation in acute care management of non-neurologic organ systems following severe TBI) can lead to therapies addressing non-neurologic organ dysfunction and may represent a novel paradigm for improving clinical outcomes following severe TBI. Through support from the National Institutes of Health, our team is working to address these important questions, but this would not be possible without the critical initial support for this line of research from my FAER MRTG.
In addition to research support, career development support through the FAER MRTG has resulted in significant expansion of my methodologic toolkit in epidemiology and population health sciences, and this has allowed collaborations with investigators on important topics in perioperative and critical care population health. In light of the current expansion of the role of anesthesiologists beyond the operating room and the increased focus on health care utilization and costs, the advancement of perioperative and critical care population health research is a priority. Given the increased availability of large and multicenter databases, increasing methodologic rigor has been identified as a key priority in perioperative and critical care observational research (Br J Anaesth June 2020). To address these important areas, I have had the opportunity to co-direct Duke Anesthesiology's Critical Care and Perioperative Population Health Research (CAPER) Unit. The mission of CAPER is to “improve patients' lives, by advancing critical care and perioperative medicine through rigorous population health research and education.” Our unit's work has led to local, national, and international collaborations and has increased knowledge in a variety of cross-cutting subject matter areas, including observational research methods, injury, opioid utilization, nutrition, and resuscitation. The support of FAER in my career development has been critical in advancing CAPER's mission and population health research in our field.
While the anesthesiology community has worked hard to address many research gaps in the care of critically ill patients over the past several decades, significant work remains. I cannot emphasize how much FAER's support has helped me in my research career, both in terms of critical support of research and career development, and this has led to further research funding and advancement of perioperative and critical care research. I am very pleased to see that FAER continues to support investigators in critical care medicine for tackling complex topics, ultimately leading to improved lives for our patients worldwide.
