Section Chief, Adult Critical Care AnesthesiaDepartments / Divisions
Durham, NC 27710
General anesthesiology; adult intensive care
I am performing clinical research in three separate but inter-related areas:
Sedation: I am interested in measurements of depth of sedation as well as evaluation of sedative agents and agent related outcomes in critically ill adults. I assisted in protocol development and now am the PI for a multi-center, Phase II, prospective, randomized, open label study of a novel sedative agent. The drug, phos-propofol (Aquavan®), is the pro-drug of propofol, a commonly used sedative agent in the ICU. We are investigating the efficacy and pharmacokinetic profile of Aquavan in post-operative patients requiring mechanical ventilation in the ICU. We will continue enrolling patients into the first quarter of 2006.
We have submitted a follow up paper to our healthy volunteer dexmedetomidine pharmacodynamics and pharmacokinetics papers that examines the inter- rater and intra-rater reliability of two sedation scoring systems in subjects receiving dexmedetomidine and remifentanil infusions.
Delirium: Delirium is a medically and financially significant complication occurring in as many as 80% of sedated, ventilated ICU patients. I am PI for two IRB approved studies: “Incidence and risk factors for delirium in the ICU” and “Molecular basis of post-operative delirium in the elderly”. With these studies, done in collaboration with the laboratory of Dr. Madan Kwatra, we hope to better define the risk factors and biochemical mechanisms of delirium. These studies are supported by funds awarded by NIH and the Department of Anesthesiology.
We will be presenting initial results at the First International Symposium on Delirium in the Elderly, to be held in Charleston, SC, in April 2006.
Sleep: I am designing a series of clinical trials to investigate the role that sleep plays in the development of delirium in the ICU. We will investigate the prevalence of sleep deprivation in surgical ICU patients, its influence on the subsequent development of delirium, and pharmacologic interventions designed to restore sleep in ICU patients and what role such interventions may have in the prophylaxis and treatment of delirium.
Others: In addition, I am pursuing projects in high frequency oscillatory ventilation in thoracic trauma patients with pulmonary contusions (paper in press) and the management of gram-positive pneumonia in intubated surgical ICU patients (co-PI, sponsored by Pfizer).
This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.
Young, CC; Prielipp, RC. Benzodiazepines in the intensive care unit. Critical Care Clinics. 2001;17:843-862. (2001) Abstract