AAGBI/Anaesthesia Small Research Grant
The successful applicants for the AAGBI/Anaesthesia Small Research Grant were:
Principal Applicant
Dr Vimal Grover
Clinical Fellow in Intensive Care Medicine & Anaesthetics SpR (Imperial School), Chelsea and Westminster Hospital, London
Title
The use of soluble and surface trem-1 (triggering receptor expressed on myeloid cells) as a marker of ventilator associated pneumonia (vap) in intensive care.
Amount
£14,080
Abstract
Ventilator associated pneumonia (VAP) causes significant morbidity in Intensive Car Patients. We hypothesise that measuring multiple biomarkers of bacterial inflammation (surface and soluble Triggering Receptor Expressed on Myeloid Cells-1 (TREM-1), IL-1, IL-6, IL-8, CD11b, L-selection) in both lung and peripheral blood will allow a faster and more accurate diagnosis of VAP. Preliminary data obtained from ventilated ICU patients suggest that differential expression of both surface and soluble TREM-1 in paired blood and bronchoalveloar lavage fluid (BALF) samples show promise in diagnosing VAP.
Final Report from Dr V Grover (284 KB)
Principal Applicant
Dr Jonathan Thompson
Senior Lecturer & Honorary Consultant in Anaesthesia & Critical Care, Division of Anaesthesia, Critical Care & Pain Management, Leicester Royal Infirmary, Leicester
Title
What is the role of nociceptin in sepsis?
Amount
£13,800
Abstract
There is increasing evidence that the endogenous nociceptin system is involved in cardiovascular regulation and immune modulation. Preliminary data from our group suggest that the nociceptin system may also be involved in sepsis. The aims of this study are:
Primary:
To quantify the mRNA expression of the nociceptin receptor NOP and its endogenous peptide N/OFQ by neutrophil polymorphs in critically ill patients diagnosed with sepsis
Secondary:
To investigate the associations between neutrophil NOP, N/OFQ mRNA and:
- Plasma N/OFQ peptide concentrations
- Sepsis severity and clinical outcomes
- Blood-borne markers of systemic inflammation severity (TNF-!, IL-6, IL-18, CRP, procalcitonin)
Final Report
An article on the results of this study can be found on the PLOS website.
Principal Applicant
Dr S V Mallet
Consultant Anaesthetist, Royal Free Hospital, London
Title
In-vitro investigation comparing I.N.R. and whole blood thromboelastic changes seen in patients following major hepatectomy.
Amount
£14,697
Abstract
The regulation of blood coagulation is dependent on a delicately balanced interplay of platelets, pro & anti coagulant proteins. Traditionally the international normalised ratio (INR) and other conventional coagulation tests (CCTs) have been used as a measure of coagulability and as a guide to the administration of blood products.
Recent work by Tripodi1, Thachil2 and Caldwell3 have demonstrated that INR may be a poor indicator of bleeding risk in patients with liver dysfunction. Whole blood viscoelastic tests such as ROTEM®; (Rotational Thromboelastometry) have been thought to better represent in vivo conditions and therefore the complexities of coagulation.
We aim to compare the viscoelastic test ROTEM®; with CCTs during and following liver resection. In addition we will measure factor levels of pro and anticoagulant proteins and thrombin generation profiles. Improved understanding of coagulation characteristics in this cohort of patients may result in more appropriate use of blood products.
Published abstracts:
Krazanicki DA, Miltsios KG, Broomhead R, Riddell A, Mallett SV. PT-INR may only yield part of the picture post liver resection. EJA 2011;28: S48;86.
Sugavanam A, Schofiels S, Krzanicki D, Riddel A, Mallett SV. Prothrombin time & International normalised ratio (PT/INR) are not indicative of the global haemostatic profile following major hepatectomy. Hepatology 2012.
