Intensive Care Medicine

The Bloomsbury Intensive Care Medicine Institute offers an internationally renowned critical care research programme and a very active experimental and clinical research portfolio. Our outputs range from new drugs and devices to novel insights into the pathophysiology underlying critical illness.

Learning for the next pandemic: the Wuhan experience of managing critically ill people

Prof. Mervyn Singer and colleagues explore the Wuhan response to managing critically ill patients in a novel disease pandemic, and lessons learnt for future pandemics.

Breathing aid co-developed by Mercedes HPP helping COVID-19 patients

Low-cost breathing aids developed by Mercedes High Performance Powertrains, University College London and University College London Hospital have been shipped to hospitals around the world in a life-saving partnership.

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.

Prof Mervyn Singer

Dr Geoff Bellingan

Dr David Brealey

Dr Alex Dyson

Dr Anna Kleyman

Dr Pietro Arina

Dr Nishkantha Arulkumaran

Dr Joseph Harris

Dr Adarsh Kulkarni

Dr Charles McFadyen

Dr Francis Ryckaert

Dr Timothy Snow

Students

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

Publications

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.
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.
Zolfaghari PS, Dyson A, Singer M, et al. (2013) The metabolic phenotype of rodent sepsis: cause for concern? Intensive Care Med Experimental.
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.
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.
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.

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.
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.
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.
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.
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.

Funding and Partnerships

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.