The Division of Pulmonary, Critical Care, and Sleep Medicine conducts research in clinical critical care, critical care physiology, cardiac arrest, post-resuscitation care, and observational and interventional studies in patient with critical illness related to 2019 coronavirus disease (COVID-19). We also create simulations designed to improve critical care outcomes.

Critical Care Clinical Research

David A. Kaufman, MD, is principal investigator of several of NYU Langone’s ongoing critical care research projects. He has a number of specific interests:

• understanding 2019 coronavirus disease (COVID-19)–related critical illness
• understanding lung mechanics in patients with respiratory failure to improve patient comfort and outcomes in those requiring mechanical ventilation
• identifying patients at high risk for developing acute respiratory distress syndrome, with the goal of implementing strategies to decrease its incidence and severity
• improving shock resuscitation through a better understanding of the use of intravenous fluids

Recent Publications

Hope AA … Gong MN. The association between prehospital vulnerability, ARDS development, and mortality among at-tisk adults. Results from the LIPS-A clinical trial. Ann Am Thorac Soc. 2019. DOI.

Gopalratnam K … Kaufman DA. Less is more in the ICU: Resuscitation, oxygenation and routine tests. Semin Respir Crit Care Med. 2016. DOI.

Kor DJ … Gong MN; for the US Critical Illness and Injury Trials Group: Lung Injury Prevention with Aspirin Study Group (USCIITG: LIPS-A). Effect of aspirin on development of ARDS in at-risk patients presenting to the emergency department: The LIPS-A randomized clinical trial. JAMA. 2016. DOI.

Lakshminarayana PH … Kaufman DA. Can transcutaneous CO2 tension be used to calculate ventilatory dead space? A pilot study. Crit Care Res Pract. 2016. DOI.

Critical Care Physiology Clinical Studies, Humanization Studies, and Ethics

Jan Bakker, MD, PhD, principal investigator, has numerous research interests in critical care medicine and cardiopulmonary physiology, the hemodynamics of sepsis, hemodynamic effects of mechanical support of the circulation, ethics and humanization studies

Dr. Bakker has a number of active research projects:

• COVID-19 and diastolic shock index, blood volume, ferritin levels, lactate levels, and cause of death among other topics
• peripheral circulation as an endpoint of resuscitation in septic shock patients
• effect of mechanical support of the circulation on the microcirculation in patients with circulatory failure
• effect of early standardized fluid resuscitation in patients with severe sepsis on peripheral perfusion and lactate levels
• early use of a vasopressor with limited fluid resuscitation in septic shock patients
• cardiac dysfunction in septic shock and the effect of raising blood pressure on cardiac function parameters
• reluctance to admit patients with hematological malignancies to the intensive care unit (ICU)
• post-intensive care syndrome (PICS) in ICU patients and family members in Latin America
• effect of the social and economic context of the patient and family on PICS in Latin America
• organizational and economic consequences of ICU waste
• end-of-life care in critically ill

Recent Publications

Bakker J, Postelnicu R, and Mukherjee V. Lactate: Where are we now? Crit Care Clin. 2020. DOI.

Trogrlic Z … Ista E. Improved guideline adherence and reduced brain dysfunction after a multicenter multifaceted implementation of ICU delirium guidelines in 3,930 patients. Crit Care Med. 2019. DOI.

van den Akker JPC … den Uil CA. Risk indicators for acute kidney injury in cardiogenic shock. J Crit Care. 2019. DOI.

Verkerk BS … Bakker J. Opioid and benzodiazepine requirements in obese adult patients receiving extracorporeal membrane oxygenation. Ann Pharmacother. 2019. DOI.

Wernly B, Bakker J, and Jung C. Venous blood lactate concentrations in patients with shock: Interesting but not really helpful. J Crit Care. 2019. DOI.

Hernandez G … Bakker J; the ANDROMEDA-SHOCK study investigators. Early goal-directed therapy using a physiological holistic view: The ANDROMEDA-SHOCK—a randomized controlled trial. Ann Intensive Care. 2018. DOI.

Cardiopulmonary Resuscitation Research Program

Led by Sam Parnia, MD, PhD, at the Parnia Lab, the mission of the Cardiopulmonary Resuscitation Research Program is to improve the survival and functional outcome of people experiencing cardiac arrest and post-cardiac arrest syndrome. This is a complex cascade of biological events that follows the restoration of the heartbeat and circulation and contributes to organ injury, including persistent disorders of consciousness. Our approach involves identifying and encouraging ever-improving methods to prevent premature death and decreasing associated disabilities from cardiac arrest.

The work of this program includes an international, multicenter cardiac arrest study that is being conducted by an interdisciplinary team. Our areas of research interest include the following:

• trials to evaluate treatments for COVID-19
• methods to measure and improve brain resuscitation during CPR
• models to predict cardiac arrest survival and neurological outcome
• neuroimaging of brain injury after CPR
• neuroprotective strategies after CPR
• biomarkers of organ injury after CPR
• quality of life in cardiac arrest survivors
• mechanisms underlying various states of consciousness during and after resuscitation
• qualitative studies of the experience of death

This is the first research program in New York City dedicated to saving the lives and brains of people with cardiac arrest and shedding light on what happens when we die.

Critical Care Simulation

Simulation, an important tool in the training and education of practicing physicians, allows trainee physicians to learn new procedures and clinical teams to practice the management of critically ill patients without risk of patient harm.

The simulation research team, led by Brian S. Kaufman, MD, takes on a third-year fellow each year to develop a research project involving ways in which simulation can improve critical care patient outcomes. The team includes Kevin J. Felner, MD, and Anthony Andriotis, MD.

Recent Publications

Mitchell O … Madeira C: Development and evaluation of a cognitive add booklet for use in rapid response scenarios. Simul Healthc. 2019. DOI.

Zachary BM … Felner KJ. The utility of high-fidelity simulation for training critical care fellows in the management of extracorporeal membrane oxygenation emergencies: A randomized controlled trial. Crit Care Med. 2017. DOI.

Greenstein YY … Kaufman B. Goal-directed transthoracic echocardiography during advanced cardiac life support: A pilot study using simulation to assess ability. Simul Healthc. 2015. DOI.