Research

Critical Care Research

Our research focuses on several themes including: Acute Respiratory Distress Syndrome, Neuro-Critical Care, and Long-term Outcomes following Critical Illness. We are actively investigating how to best use novel diagnostic and therapeutic technologies for mechanical ventilation, extra-corporeal life support. Our scientists lead multi-centre studies and also collaborate with research consortia nationally and internationally including the Canadian Critical Care Trials Group

Current Major Research Areas:

  • Acute Kidney Injury and Renal Replacement Therapy
  • ARDS
  • Critical Illness in Pregnancy
  • Diaphragm Function in Critical Illness
  • Ethics and Communication
  • Extracorporeal Life Support
  • ICU Management of Multiorgan Transplant Patients
  • Influenza and Pandemic Planning
  • Long-term Patient and Family Outcomes after Critical Illness
  • Mechanical Ventilation
  • Neurosciences and Neurocritical Care
  • Oncological Critical Care
  • Point-of-Care Ultrasound in Critically Ill Patients
  • Post-ICU Psychological and Neurocognitive Outcomes
  • Pulmonary Hypertension
  • Quality Improvement
  • Sedation, Analgesia, and Delirium in the ICU

Current Ongoing Studies:

  • BALANCE (Site PIs: M. Detsky, E. Wilcox)
  • COGWELL – long-term neurocognitive outcomes (observational) (PI: E. Wilcox)
  • COHO – critical care outcomes of patients with hematologic malignancy and hematopoietic stem cell transplantation (PIs: L. Munshi, S. Mehta)
  • COMPARE – measuring MAP and ICP in neurologically critically ill patients (PI: V. McCredie)
  • CONCEPT – evaluating auto-regulation in TBI patients (Site PI: V. McCredie)
  • DONATE – management peri-organ donation after NDD (Site PI: J. Singh)
  • EPOCH – pilot physiological study of esophageal balloon-guided setting of HFOV (PIs: N. Ferguson, E. Fan)
  • EPVent2 – RCT titrating PEEP using transpulmonary pressure (Site PIs: E. Fan/N. Ferguson)
  • iCORE – multicentre ICU quality and research database (PI: E. Fan)
  • Improving Communication Between Surgery and Critical Care – effectiveness of novel signover and daily communication tool (PIs: L. Munshi, C. Lee, S. Brar, B. Haas)
  • INDEX CTP – dynamic CT as ancillary test for potential NDD donors (PI: J. Singh)
  • MOVE ME – manual bagging or mechanical ventilation during ICU rehabilitation (PIs: G. Ignat, E. Fan)
  • MYOTRAUMA – observational study of diaphragm function with ultrasound (PI: E. Goligher)
  • NeuroETT (PI: N. Ferguson)
  • PiCCO – physiological study of EVLW following lung transplant (PI: L. Munshi, J. Granton, M. Cypel)
  • PREDICT – predictors of apnea and their relationship with time to death following withdrawal of life sustaining therapy in DCD canditates (PIs: L. Munshi, J. Singh)
  • PREVENT (Site PI: S. Mehta)
  • PROSPECT (Site PIs: M. Herridge, S. Mehta, E. Wilcox)
  • SNIFF3 – validity of assessing diaphragm function during sniff maneuver compared with magnetic stimulation of phrenic nerve (PI: E. Goligher)
  • SOLVE ARDS (PIs: L. Del Sorbo, N. Ferguson, E. Fan)
  • STARRT-AKI – Early vs. usual dialysis initiation RCT (Site PIs: M. Herridge, E. Wilcox)
  • STRIVE (PIs: G. Douflé, E. Fan)
  • USEFUL – diagnosis of physiological mechanisms of weaning failure using focused cardiothoracic ultrasound (PI: E. Goligher)

Current Upcoming Studies:

Investigator-Initiated/CCCTG

  • FISH (Site PI: S. Mehta)
  • SiDDICU (Site PIs: N. Ferguson, S. Mehta)

Industry Sponsored

  • CRANE (Site PIs: J. Granton, E. Wilcox)
  • SAGE (Site PIs: J. Singh, E. Wilcox)
  • SCARLET (Site PI: M. Detsky)

SELECTED PUBLICATIONS

  1. Alali AS, McCredie V, Mainprize TG, Gomez D, Nathens AB. Structure, process and culture of intensive care units treating patients with severe traumatic brain injury: survey of centers participating in the American College of Surgeons Trauma Quality Improvement Program. J Neurotrauma 2017, in press.
  2. Burry L, Scales D, Williamson D, Foster J, Mehta S, Guenette M, Fan E, Detsky M, Azad A, Bernard F, Rose L. Feasibility of melantonin for prevention of delirium in critically ill patients: a protocol for a multicentre, randomised, placebo-controlled study. BMJ Open 2017;30:e015420.
  3. Mehta S, Burns KE, Machado FR, Fox-Robichaud AE, Cook DJ, Calfee CS, Ware LB, Burnham EL, Kissoon N, Marshall JC, Mancebo J, Finfer S, Hartog C, Reinhart K, Maitland K, Stapleton RD, Kwizera A, Amin P, Abroug F, Smith O, Laake JH, Shrestha GS, Herridge MS. Gender parity in critical care medicine. Am J Respir Crit Care Med 2017, in press.
  4. Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, Cooper A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011 Apr 7;364(14):1293-304.
  5. Batt J, dos Santos CC, Cameron JI, Herridge MS. Intensive care unit-acquired weakness: clinical phenotypes and molecular mechanisms. Am J Respir Crit Care Med. 2013 Feb 1;187(3):238-46.
  6. Herridge MS and Cameron JI. Disability after Critical Illness. N Engl J Med 2013; 369:1367- 136.
  7. Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand LE, Austin, P, Zhou Q, Matte A, Walter F, Lamontagne F, Granton JT, Arabi Y, Arroliga A, Stewart TE, Slutsky AS, Meade MO, for the OSCILLATE Trial Investigators and the Canadian Critical Care Trials Group. Early high- frequency oscillation for patients with acute respiratory distress syndrome: A randomized controlled trial. New Engl J Med 2013; 368:795-805
  8. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS, for the ARDS Definition Task Force. Acute respiratory distress syndrome: The Berlin definition. JAMA 2012;307:2526-2533.
  9. Fan E, Laupacis A, Pronovost PJ, Guyatt GH, Needham DM. Users’ guide to the medical literature: how to use an article on quality improvement. JAMA 2010; 304:2287-2295.
  10. Pipeling MR, Fan E. Therapies for refractory hypoxemia in acute respiratory distress syndrome. JAMA 2010; 304:2521-2527.
  11. Downar J. Kritek PA. Family presence during resuscitation. New Engl J Med. 2013 Mar;368(11):1060-2.
  12. Singh JM, MacDonald RD, Bronskill SE, Schull MJ. Incidence and predictors of critical events during urgent air-medical transport. Can Med Assoc J. 2009 Oct 27;181(9):579-84.
  13. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA; Canadian Critical Care Trials Group H1N1 Collaborative. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA. 2009;302:1872-9
  14. Peñuelas O, Frutos-Vivar F, Fernandez C, Anzueto A, Epstein SK, Apezteguía C, González M, Nin N, Raymondos K, Tomicic V, Desmery P, Arabi Y, Jibaja M, Matamis D, Pelosi P, Ferguson ND, Esteban A, for the Ventila Group. Characteristics and Outcomes of Ventilated Patients According to Time to Liberation from Mechanical Ventilation. Am J Respir Crit Care Med 2011; 184:430-437.
  15. Sud S, Sud M, Friedrich JO, Meade MO, Ferguson ND, Wunsch H, Adhikari NK. High frequency oscillation in acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. BMJ 2010 340:c2327
  16. Ranieri VM, Thompson BT, Barie PS, Dhainaut JF, Douglas IS, Finfer S, Gardlund B, Marshall JC, Rhodes A, Artigas A, Payen D, Tenhunen J, Al-Khalidi HR, Thompson V, Janes J, Macias WL, Vangerow B, Williams MD, for the PROWESS-SHOCK Study Group. Drotrecogin Alfa (Activated) in Adults with Septic Shock. New Engl J Med 366:2055-64.
  17. The NICE-SUGAR Study Investigators. Hypoglycemia and Risk of Death in Critically Ill Patients. New Engl J Med. 2012; 367:1108-1118.
  18. Mehta S, Burry L, Cook DJ, Fergusson D, Steinberg M, Granton JT, Herridge MS, Ferguson ND, Devlin J, Tanois M, Dodek P, Fowler RA, Burns K, Jacka M, Olafson K, Skrobik Y, Hebert P, Sabri E, Meade MO for the SLEAP Investigators and Canadian Critical Care Trials Group. Daily Sedation Interruption in Mechanically Ventilated Critically Ill Patients Cared for with a Sedation Protocol: A Randomized Trial. JAMA. Nov 21;308(19):1985-92.
  19. Ferguson ND, Scales DC, Pinto R, Wilcox ME, Cook DJ, Guyatt GH, Schünemann HJ, Marshall JC, Herridge MS, Meade MO; for the Canadian Critical Care Trials Group. Integrating Mortality and Morbidity Outcomes: Using Quality-Adjusted Life Years in Critical Care Trials. Am J Respir Crit Care Med. 2012 Nov 30.
  20. Bienvenu OJ, Colantuoni, Mendez-Tellez PA, Dinglas VD, Shanholtz C, Husain N, Dennison CR, Herridge MS, Pronovost PJ, Needham DM. Depressive Symptoms and Impaired Physical Function after Acute Lung Injury: A 2-Year Longitudinal Study. Am J Respir Crit Care Med 2012; 185: 517-524.
  21. Keenan SP, Sinuff T, Burns K, Muscedere J, Kutsogiannis J, Mehta S, Dodek P, Cook DJ, Ayas N, Adhikari N, Hand L, Scales D, Pagnotta R, Lazosky L, Rocker G, Dial S, Laupland K, Sanders K, for The Canadian Critical Care Trials Group (CCCTG) and Canadian Critical Care Society (CCCS) Noninvasive Ventilation Guidelines Group. Clinical practice guidelines for noninvasive positive pressure ventilation (NPPV) and noninvasive continuous positive airway pressure (nCPAP) in the acute care setting. Can Med Assoc J 2011; 22;183(3):E195- 214. Epub February 14, 2011.
  22. Dalteparin versus Unfractionated Heparin in Critically Ill Patients. The PROTECT Investigators for the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group. N Engl J Med 2011; 364:1305-1315.
  23. Ferguson ND, Cook DJ, Guyatt GH, Mehta S, Hand LE, Austin, P, Zhou Q, Matte A, Walter F, Lamontagne F, Granton JT, Arabi Y, Arroliga A, Stewart TE, Slutsky AS, Meade MO, for the OSCILLATE Trial Investigators and the Canadian Critical Care Trials Group. Early high- frequency oscillation for patients with acute respiratory distress syndrome: A randomized controlled trial. NEJM 2013; 368:795-805
  24. Mehta S, Burry L, Cook D, Fergusson D, Steinberg M, Granton J, Herridge M, Ferguson N, Devlin J, Tanios M, Dodek P, Fowler R, Burns K, Jacka M, Olafson K, Skrobik Y, Hebert P, Sabri E, Meade M, for the SLEAP Investigators and the Canadian Critical Care Trials Group. Daily sedation interruption in mechanically ventilated critically ill patients cared for with a sedation protocol: A randomized controlled trial. JAMA 2012; 308(19):1985-1992
  25. Lapinsky SE. Critical illness as a result of influenza A/H1N1 infection in pregnancy. BMJ. 2010;340:c1235.
  26. Kumar A, Zarychanski R, Pinto R, Cook DJ, Marshall J, Lacroix J, Stelfox T, Bagshaw S, Choong K, Lamontagne F, Turgeon AF, Lapinsky S, Ahern SP, Smith O, Siddiqui F, Jouvet P, Khwaja K, McIntyre L, Menon K, Hutchison J, Hornstein D, Joffe A, Lauzier F, Singh J, Karachi T, Wiebe K, Olafson K, Ramsey C, Sharma S, Dodek P, Meade M, Hall R, Fowler RA; Canadian Critical Care Trials Group H1N1 Collaborative. Critically ill patients with 2009 influenza A(H1N1) infection in Canada. JAMA. 2009;302:1872-9
  27. Domínguez-Cherit G, Lapinsky SE, Macias AE, Pinto R, Espinosa-Perez L, de la Torre A, Poblano-Morales M, Baltazar-Torres JA, Bautista E, Martinez A, Martinez MA, Rivero E, Valdez R, Ruiz-Palacios G, Hernández M, Stewart TE, Fowler RA. Critically Ill patients with 2009 influenza A(H1N1) in Mexico. JAMA. 2009;302:1880-7

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