Division for Anesthesiology and intensive care

Trauma and sepsis are common causes for intensive care admission. These conditions are closely linked and carry high mortality. We are conducting translational studies ranging from epidemiology to in vitro experiments in this field.

Our Research

Trauma is leading cause of death for individuals under the age of 45. We are conducting epidemiological studies on various aspects of trauma including risk factors, outcomes and long-term consequences of this devastating disease. Our group is also studying the serious complications encountered in intensive care of trauma victims such as multiple organ failure and sepsis. These studies also include dynamics of biomarkers induced by severe trauma and sepsis. 

Sepsis is causes more than 5 million deaths annually and remains a major challenge to the medical profession. We are conducting epidemiological studies on risk factors, magnitudes and outcomes of this lethal condition. We are also performing experimental studies on pathophysiological aspects mainly regarding endothelial dysfunction, a major component in the development of septic shock.

Funding:

• European Society of Intensive Care Medicine
• Stockholm County Council
• Carnegie Foundation
• Magnus Bergvall Foundation
• Laerdal Foundation
• Swedish Society of Medicine
• Swedish Cancer and Traffic Injury Society Fund
• LPS Medical Foundation

In this epidemiological project we are investigating differences in ICU care that are attributed to gender and sex including admittance patterns, the level of ICU care, discharge from the ICU and mortality.

David Nelson's research has focused on integrated approaches of interpreting multiple data streams from brain injury patients. His current research focuses on several aspects of brain injury including biomarkers, coagulation, dysautonomic reactions and multimodal monitoring.

The manifold drug, surgical and device treatments in cardiovascular disease and improved diagnostics imposes a need for patient-specific outcome prediction.

Modeling has the potential to bridge the gap between evidence-based medicine proving treatment effects in groups of patients and patient-specific aspects of the disease state necessitating individualization. The current computerized cardiovascular model runs in real-time and allows testing of treatments within minutes and is therefore a realistic clinical tool, although further validation is needed.

Projects

Analysis and optimization of cardiac loading in complex cardiovascular disease and mechanical circulatory support – clinical studies enforced by computerized cardiovascular physiology simulation.

Collaborations

• Professor Dirk Donker MD PhD, Cardiovascular and Respiratory Physiology (CRPH), Science and Technology, University of Twente, The Netherlands.
  Consultant intensivist/cardiologist Utrecht Medical Center, The Netherlands
• Associate Professor Clinical Physiology Marcus Carlsson, Lunds University Hospital, Sweden. Clinical Investigator, National Institute of Health (NIH), Bethesda, Maryland, USA.
• Associate Professor Pediatric Cardiology Petru Liuba, Lunds University Hospital, Sweden
• Associate Professor Pediatric Cardiology Nina Hakacova, Lunds University Hospital, Sweden

Funding

• Swedish Heart Lung Foundation 2019
• Stockholm City Council ALF/SLL 2017-2018
• Swedish Research Council 2013-2015

Our research

We focus on exploring the role of the nitrate-nitrite-NO pathway for the generation of nitric oxide (NO) and other reactive nitrogen intermediates in mammals.

The inorganic anions nitrate (NO³¯) and nitrite (NO²¯) can recycle in vivo to form NO and other bioactive nitrogen oxides. This represents an important alternative source of NO, especially during hypoxia/ischemia when the classical L-arginine/NO synthase pathway may be dysfunctional. A picture is now emerging suggesting important biological functions of the nitrate-nitrite-NO pathway with provocative implications in relation to the diet and cardiovascular homeostasis. In addition, an expanding number of studies suggest a therapeutic potential for nitrate and nitrite in cardiovascular and metabolic diseases.

In a translational approach our research spans from experimental in vitro studies to human clinical trials.

Funding

• Swedish Research Council (VR)
• Swedish Heart and Lung Foundation
• Stockholm County Council (ALF)