Anthony Pietropaoli, MD
Vice Chief, Division of Pulmonary & Critical Care Medicine
Medical Director, Medical Intensive Care Service, Strong Memorial Hospital
Associate Director, Adult Critical Care, Strong Memorial Hospital
Medical Director, Department of Respiratory Care, Strong Memorial Hospital
Medical Director, Pulmonary Rehabilitation Program, University of Rochester Medical Center
The University of Rochester Medical Center combines a very broad array of renowned experts, laboratories, and research programs with an approachability, collaborative spirit, and friendliness that is hard to find in other major university medical centers. This easily permits our fellows to link up with research programs that align with their goals and interests.
Our fellowship provides a unique opportunity for fellows to immerse themselves in a scholarly project. The value of this dedicated time for research cannot be under-estimated. My hope and expectation is that our fellows seize this opportunity and use it to its maximal potential to gain unique experiences, insights, and productivity offered by this feature of our program.
I am interested in team-based translational research, especially mechanisms of microvascular dysfunction in sepsis syndrome / ARDS / critical illness. In particular, a dysregulated host response leading to:
- Endothelial dysfunction relating to a deficiency of bioavailable nitric oxide
- Maladaptive neutrophils that accumulate in the lungs and other vital organs, promoting ARDS, systemic vascular leak, and shock.
- Dysfunctional erythrocytes that fail to transduce hypoxic systemic vasodilation, are less deformable so occlude microcirculatory vessels, and are more fragile so release cell-free heme into the circulation causing vasoconstriction, oxidative stress, and further immune dysregulation.
- The role of microvascular dysfunction in degrading the blood-brain barrier, thereby producing sepsis-associated encephalopathy and prolonged cognitive dysfunction.
I'm also interested in epidemiological research examining novel risk factors for poor outcomes or disparate management of critically ill patients, including demographics, comorbidities, and other baseline characteristics.
Surprise fact: I was going to be a general internist—never intended to do a pulmonary/ ccm fellowship. Toward the end of my chief residency I developed Pneumococcal pneumonia, septic shock, ARDS. I was intubated, PEEP was ramped up to 20, pressors, paralysis, pneumothorax, AKI, coagulopathy, delirium, 11 days on mechanical ventilation, post-intensive care syndrome…the whole thing. I changed my mind about my career after that.
“Life is what happens to you while you are busy making other plans”—John Lennon, and others