Dr Nick Hart (Clinical Research Lead)
Dr Manu Shankar-Hari (Integrated Academic Training Lead)
Intensive Care Medicine and Lane Fox Respiratory Service, as part of the Division of Acute Medicine, have established a research strategy that has been mapped onto the Trust’s clinical strategy for Intensive Care Medicine. This infrastructure will provide a first class clinical and research environment for the training and development of translational science intensive care medicine clinical-academics with the post based at Guy’s & St Thomas’ NHS Foundation Trust. Trainees rotate between clinical posts within the critical care units. In addition, there are specialist fellowship posts in acute severe respiratory failure, echocardiography, weaning failure, rehabilitation and chronic respiratory failure, which cut across the NHS England specialist commissioned Acute Respiratory Failure and Complex Home Ventilation. There are opportunities to develop clinical research interests on the St Thomas’ site, and basic science research interests on the Guy’s site, which are linked with King’s College London (KCL) academic units.
The main research programmes and corresponding PIs are summarised below:
Acute Kidney injury and Critical Care Nephrology (PI: Dr Marlies Ostermann, Professor Anthony Dorling, Professor Graham Lord) The programme ranges from basic science laboratory research exploring the pathophysiology of acute kidney injury to biomarker studies and clinical trials.
Severe acute respiratory failure, Advanced physiological monitoring and functional imaging (PIs: Dr Luigi Camporota, Dr Nicholas Barrett and Prof Richard Beale). The Critical Care at Guy’s and St Thomas’ is one of only five UK severe respiratory failure centres, with an active clinical research programme in advanced respiratory monitoring, cardio-respiratory physiological modelling and imaging to individualise and optimise the provision of mechanical ventilation and extracorporeal respiratory support (ECMO and ECCO2R). We use innovative bioengineering and physiological modelling techniques to study ECMO outcome and response to novel ventilator techniques.
Skeletal muscle wasting, weakness and rehabilitation (PIs: Prof Nicholas Hart and Prof Stephen Harridge). Part of a world leading clinical research team working with the King’s College London Division of Basic & Biomedical Sciences.
Critical illness data Science and Quality Improvement (PIs: Dr Marius Terblanche and Dr Andrew Jones; Prof Charles Wolfe). Access to local, national and international critical care data resources provide the platform for the critical illness data science and Quality Improvement programme.
Sepsis immunology (Dr Manu Shankar-Hari; Dr Chad Swanson; Prof Graham Lord). This translational research focuses on the adaptive immune system changes in sepsis and in sepsis survivors to inform ways to improve outcomes.
Enrichment of sepsis and ARDS sub-phenotypes for clinical trials; Critical illness Epidemiology, Health Services Research; and Longer-term outcomes from critical illness (Dr Manu Shankar-Hari). Within ARDS and sepsis cohorts, there are between and within patient differences in pathobiology, treatment effects of interventions and outcomes, which results in indeterminate (statistically negative) randomized clinical trials (RCTs). Critical illness survivors have increased risk of longer-term death and other adverse outcomes. This research programme uses fundamental epidemiological principles of biomarker research and clustering by clinical/biological characteristics.
The department has the infrastructure to support Academic Clinical Lecturers (ACL) and Academic Clinical fellows (ACL). The research and clinical programme will be tailored to suit the training needs of the ACL and ACFs.
Academic Clinical Fellows (ACFs) have a structured programme with 3 blocks: (a) 6 months block spent in research (b) 6 months in clinical and (c) the final 3 months in research. The ACFs are expected to spend the final three-month block writing grant applications and/or publications. The ACFs will be supported to generate PhD funding applications.
ACFs and ACLs will be expected to contribute significantly towards the weekly departmental postgraduate education seminars, and case review sessions. They will also be supported to attend regional training days and training opportunities within the GSTT-BRC. Both ACLs and ACFs will be allocated a clinical supervisor and an educational supervisor with whom they are expected to have regular meetings.
Pilot feasibility and multicentre clinical trials are performed in Critical Care and Lane Fox and the established CLRN funded research personnel and space infrastructure, combined with access to a large numbers of diverse patient groups across the division, ensures high recruitment activity to a broad range of studies that would provide excellent training.