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Critical Care

The foci of Dr. Anthony Pietropaoli’s critical care research program include:

  1. The clinical measurement of microcirculatory dysfunction and its relationships with vital organ dysfunction, morbidity, and mortality in sepsis.
  2. The relationships between red blood cell and neutrophil dysfunction in promoting microcirculatory dysfunction in sepsis.

Sepsis is defined as a dysregulated host response to infection. It accounts for up to half of the deaths in U.S. hospitals, and the incidence has been progressively rising over the past 20 years.

Microcirculatory dysfunction is a critically important feature of the dysregulated host response of sepsis, driving the vital organ failure that is in turn responsible for sepsis morbidity and mortality. We are interested in studying clinically practical methods for microcirculatory function measurement to more rapidly and accurately diagnose sepsis, to assess prognosis, and to gauge the effectiveness of novel therapeutic intervention.

Microcirculatory dysfunction in sepsisDysfunction of blood cells, including erythrocytes and neutrophils, is another critical feature of the dysregulated host response of sepsis. Dysfunctional erythrocytes and neutrophils cause microvascular occlusion, impaired vasoreactivity, vascular leak, and coagulation activation, thus contributing to microcirculatory dysfunction in sepsis. We are interested in measuring this cellular dysfunction, and exploring relationships between blood cell dysfunction, microcirculatory dysfunction, and clinical outcomes in sepsis patients.