Intensive Care Medicine

Our work

The centre is involved in the following research areas:

Pathology of critical illness

• Mitochondrial dysfunction in critical illness.
• Association between autonomic and immune dysfunction and relationship to postoperative complications.
• Mechanisms of acute renal injury (P2X7 receptor activation).
• Nitrite reductase activity in sepsis and hypoxaemia.

Novel monitoring and diagnostics

• Tissue PO2 monitoring as a marker of local oxygen supply adequacy in shock states
• NADH redox state as a marker of the adequacy of tissue perfusion
• Novel haemodynamic monitoring parameters using linked oesophageal Doppler ultrasound and blood pressure monitoring
• Novel biomarkers for early detection of sepsis and infection
• Development of a critical illness stress index.

Novel interventions

• Long-acting sulphide donor therapy for ischaemia-reperfusion injury
• Beta-blocker therapy in severe sepsis
• Activators of mitochondrial biogenesis to enhance recovery from critical illness
• CD73 therapy for acute lung injury
• Patient-individualized targeted mobilization.

Our people

The Critical Care Trials team is the clinical research arm of the Bloomsbury Institute of Intensive Care Medicine. The team includes the clinical lead, Dr David Brealey, and 5.3 whole-time equivalent research nurses. We aim to attract and deliver a wide portfolio of studies that are pertinent not just to Critical Care but the whole Emergency Pathway. As such, we frequently work outside the physical walls of Critical Care, recruiting patients across the hospital from the Emergency Department to Day Case Chemotherapy.

Students

• Miranda Melis  
• Muska Miller (nee Khpal)
• Naveed Saleem
• Giacomo Stanzani
• Robert Tidswell

Publications

1. Rudiger A, Dyson A, Singer M, et al (2013) Early functional and transcriptomic changes in the myocardium predict outcome in a long-term rat model of sepsis. Clin Sci; 124:391-401.
2. Ackland GL, Kazymov V, Singer M, et al (2013) Peripheral neural detection of danger-associated and pathogen-associated molecular patterns. Crit Care Med; 41:e85-92. 
3. Zolfaghari PS, Dyson A, Singer M, et al. (2013) The metabolic phenotype of rodent sepsis: cause for concern? Intensive Care Med Experimental.
4. Morelli M, Donati A, Singer M, et al. (2013) Microvascular effects of heart rate control with esmolol in patients with septic shock. Crit Care Med;41:2162-2168.
5. Marty FM, Man CY,  Brealey D, et al. (2013) Safety and Pharmacokinetics of Intravenous Zanamivir Treatment in Hospitalized Adults With Influenza: An Open-label, Multicenter, Single-Arm, Phase II Study. J Infect Dis. 
6.  Sachdev M, Brealey D, Singer M, et al. (2013) Changes in dental plaque following hospitalisation in a critical care unit: an observational study. Crit Care; 17:R189.
7.  Dyson A, Simon F,  Singer M, et al. (2012) Bladder tissue oxygen tension monitoring in pigs subjected to a range of cardiorespiratory and pharmacologic challenges. Intensive Care Med; 38:1868-76.
8. Atlas G, Brealey D, Singer M, et al. (2012) Additional hemodynamic measurements with an oesophagal Doppler monitor: a preliminary report of compliance, force, kinetic energy, and afterload in the clinical setting. J Clin Monit Comput; 26:473-82.
9. Adlakha A, Pavlou M, Singer M, et al. (2011) Survival of HIV-infected patients admitted to the intensive care unit in the era of highly active antiretroviral therapy. Int J STD AIDS; 22:498-504.
10. Ackland GL, Dyson A, Singer M, et al. (2010) Low molecular weight polyethylene glycol improves survival in experimental sepsis. Crit Care Med; 38:629-36.
11. Ackland GL, Dyson A, Singer M, et al. (2010) Cardioprotection, attenuated systemic inflammation, and survival benefit of 1-adrenoceptor blockade in severe sepsis in rats. Crit Care Med; 38:388-94.

Facilities

Mervyn Singer Lab is advanced in vivo monitoring of cardio-respiratory function, organ perfusion, tissue oxygenation, and metabolic monitoring Models of sepsis, haemorrhage (-reperfusion), haemodilution and both whole-body or organ-specific hypoxaemia(-reoxygenation).

• Vascular cannulation
• Mechanical ventilation
• Echocardiography
• Metabolic cart
• Laser Doppler and Doppler flow monitoring
• Tissue PO2 monitoring
• Blood gas analyses
• Ex vivo/in vitro respirometry
• HPLC
• Standard lab techniques (Westerns, PCR.)

Related Programmes 

Our members contribute to the MBBS, iBSc, BSc and master’s degrees within the Division of Medicine. We provide BSc and MSc/MRes research project supervision. We also have an established track record in providing high-quality training to PhD students interested in basic, translational, and clinical research in the areas of lung cancer and airway stem cells.

Prizes

• 2013 | UK Intensive Care Society Young Investigator Award (W Khaliq)
• 2013 | UK Intensive Care Society Young Investigator Award (N Arulkumaran)
• 2012 | MRC Centenary Award (Dr N Ekbal)
• 2010 | UK Intensive Care Society Young Investigator Award (N Ekbal)
• 2010 | European Society of Intensive Care Basic Science Award (J Morel)
• 2009 | UK Intensive Care Society Young Investigator Award (S Barnes)
• 2007 | European Society of Intensive Care Basic Science Award (J Carre)
• 2007 | European Society of Intensive Care Intelligent Monitoring Award (A Dyson)
• 2007 | UK Intensive Care Society Research Award (A Dyson)