The Perioperative and Critical Illness Resilience Lab engages in several areas of research. Our lab operates with a specific vision to restore long-term health for people who experience a critical illness, traumatic injury or complex surgery. Some of our hypotheses are developed by analyzing large data sets. We hope our research can predict who is most vulnerable to a poor outcome so that treatment needs can be adjusted.
Dr. Laudanski launched the Perioperative and Critical Illness Resilience Lab from seminal research conducted by a consortium of scientists funded through a multimillion-dollar glue grant by the National Institute of General Medical Sciences within the National Institutes of Health (NIH). The grant was funded to study the genomic storm that occurs in the body after traumatic injury. The work demonstrated that genomic data could be analyzed rapidly, a speed that improved with the emergence of next-generation genomics.
After receiving a Vision Grant from the Society of Critical Care Medicine, our lab developed animal models of sepsis. We then turned our attention to cardiac surgery as the ultimate model of critical illness. At the same time, we addressed persistent inflammation, which was the first cause of death in our studies. The COVID-19 pandemic provided several opportunities to cross-validate our studies and characterize long COVID-19.
Today, our research focuses on:
- Immune system. We're working to rapidly identify mechanisms that control the expression of DNA as drivers of short-, medium- and long-term performance of the immune system. We have a special interest in favorable, suboptimal and harmful immunostasis after critical illness and complex surgery compared to how the body functioned before illness or surgery.
- Protective mechanisms. Our lab is studying the role of natural protective mechanisms on long-term resilience. We're also studying how a reduction in natural protective mechanisms plays a key role in dampening the inflammatory response.
- Nanotechnology. We're using nanotechnology to understand the performance of the immune system. This approach offers significantly more sophisticated agility and informational value to provide real-time data to healthcare providers than do current technologies.
- Electronic records. Using electronic medical records and digital health signatures as the source of data allows us to better identify genomic predictors of unfavorable clinical outcomes and worsening of health. We're studying ways to predict who will have a suboptimal recovery trajectory and which intervention will be most helpful.
- Implementing treatment. We're studying ways to improve outcomes through meaningful use of medical treatments — implementing our findings from the lab into healthcare. This involves the ecosystem of healthcare providers, patients and insurance stakeholders.
Key research results
Some of our key research results include:
- Demonstrating the immunological genomic storm in the wake of trauma.
- Finding that the expression of several genes involved in metabolism, immune system performance and tissue remodeling remains deeply affected after sepsis, cardiac surgery and COVID-19.
- Discovering that epigenetic mechanisms may be altered up to three months after elective heart surgery, resulting in suboptimal immune system performance.
- Finding that key mechanisms reducing immune system performance are significantly depleted after COVID-19 and cardiac surgery, coinciding with an increase in biomarkers of degeneration and senescence.
- Demonstrating that using telecare or remote critical care to diagnose clinical worsening as early as possible is an effective tool and can be done with the help of advanced practice practitioners, nurses and respiratory therapists.
- Showing that implementing an algorithm based on artificial intelligence reduces harm and increases effectiveness in delivering care.