Acute Lung Injury / Acute Respiratory Distress Syndrome and Sepsis

Dr. Michelle Gong is a pulmonary and critical care physician and molecular and genetic epidemiologist from the Harvard School of Public Health.  Her research interests focuses on outcomes in critical care medicine and the genetic and molecular epidemiology of complex pulmonary diseases and critical illnesses such as sepsis and acute lung injury/acute respiratory distress syndrome (ALI/ARDS).  Dr. Gong has been recognized with the NIH Health Disparity Scholar Award and the Mentored Patient-Oriented Research Career Development Award for her research and has been a principal investigator or co-investigator on NIH-funded studies on critical care research and the genetic susceptibility to organ failures.  Dr. Gong’s current research investigations in the field of sepsis and ALI/ARDS include:

• Clinical and molecular predictors for the development of ALI/ARDS and for poor outcomes in sepsis or ALI/ARDS
• Genetic susceptibility to the development of or poor outcomes in ALI/ARDS
• Role of diabetes and insulin therapy in the prevention of ALI/ARDS
• Intensive insulin therapy in sepsis in the medical intensive care unit
• Genetic susceptibility to chronic renal failure after kidney transplants

Palliative Care

Dr. Judith Nelson, a national expert in palliative medicine and intensive care, has been engaged in a program of research to understand and improve the experience of critical illness for patients and their families. Her work includes:

• a recent study of distressing symptoms in cancer patients receiving intensive care
• a national survey of physician and nurse ICU directors about barriers to better end-of-life care and possible remedies for deficiencies in current care models
• an ongoing investigation of the symptom burden of chronic critical illness in patients requiring prolonged mechanical ventilation
• a study of the communication needs of patients and families deciding about treatment for chronic critical illness
• the development of quality indicators for end-of-life care in intensive care units

Immune Response in Chronic Critical Illness

A spectrum of infirmities plague the chronic phase of critical illness, defined as persistent ventilatory insufficiency after twoweeks of ICU care. Dr. Thomas Kalb has shown that the immune response is blunted in patients surviving critical illness. He is now embarking on a clinical based investigation to further characterize this impairment and to determine its clinical significance. Correlation between in vitro lymphocyte response to antigen and meaningful clinical outcome measures such as weaning success, infection rate, and mortality is being tested.

Sepsis

Dr. Kalb is also co-investigator in a phase III trial of recombinant Tissue Factor Pathway Inhibitor in severe sepsis, sponsored by Chiron Corporation. This multi-center, double blind, placebo-controlled randomized study is designed to evaluate the mortality benefit of an agent that has shown tremendous promise for significant impact pre-clinically and in phase I and II trials.