Thursday, February 28, 2019
Funded PhD Project (European/UK Students Only)
Apnoea is the cessation of ventilation and it is common after induction of anesthesia. It may cause hypoxemia (low oxygen levels in the blood) and hypercapnia (accumulation of carbon dioxide in the blood). This effect is exaggerated in obese subjects, as a result of the reduction of functional residual capacity and greater metabolic oxygen consumption.
Apnoeic oxygenation (i.e. mass inflow of oxygen via an open airway occurring during apnoea) can prevent hypoxemia, and may have a role in slowing the development of hypercapnia. Numerous techniques in the administration of apnoeic oxygenation have been described. Optiflow (Fisher & Paykel Healthcare, Auckland, New Zealand) is a recently developed oxygen therapy device that delivers high-flow, humidified oxygen via nasal cannulae. It has been shown that such therapy can increase the safe apnoea time, delaying hypoxaemia and slowing the rate of rise in the arterial carbon dioxide levels.
Data on such therapy in obese, apnoeic subjects are noisy and heterogeneous, and the issue of how to optimally manage such subjects remains unresolved.
Computational modelling offers a novel and powerful approach to research in anaesthesia, critical care and medical crises. In contrast to trials on animal models and humans, in-silico models of individualised patients and pathologies are amendable to detailed validation, assuring reproducibility and translation into human application. Our simulation suite, the Interdisciplinary Collaboration in Systems Medicine (ICSM), is a set of integrated, high-fidelity cardiopulmonary models, offering an excellent opportunity to investigate apnoea in obesity. The ICSM suite has already been extensively validated against different patient data and ventilation strategies, such as apnoea, COPD, ARDS.1-5
The main objectives of this PhD Studentship are:
1. Further develop and validate our high-fidelity, pathophysiological, computational models, with particular reference to apnoea, apnoeic oxygenation, obesity and high-flow upper airway oxygenation;
2. Apply the physiological models to investigating the prolongation of apnoea –improving the high-risk period of anaesthetic induction, and optimising gas exchange;
3. Explore optimal rescue strategies using the Optiflow in-silico obese subjects.
During this project, the PhD student will present their results at leading international conferences in the fields of anaesthesia, critical care and bioengineering, and will publish papers in high-impact, peer-reviewed journals. The project will have immediate clinical relevance, and it is expected that the student will form useful networks and collaborations to support their future research career. The PhD student will be in regular contact with the funder, Fisher & Paykel Healthcare, allowing them to build skills in working with industry.
Studentship to commence April 2019
Meet the team:
The Project will be based at University of Nottingham within the Anaesthesia and Critical Care group – Division of Clinical Neuroscience, School of Medicine.
Prof. Jonathan Hardman, the principal supervisor, is the Professor and Head of Anaesthesia and Critical Care group and he is a leading authority in modelling clinical biological systems. He has published more than 200 papers and has supervised 17 doctoral students. Dr Marianna Laviola, the co-supervisor, is a research fellow under Prof Hardman’s supervision, and she will be the primary day-to-day contact of the student. She is currently working on developing of the ICSM simulator to investigate apnoea during severe hypoxemia and new ventilation strategies in critical illness. Prof Declan Bates, Professor of Bioengineering at University of Warwick and the group’s principal collaborator in modelling complex, medical systems, will co-supervise the student remotely.
The University of Nottingham (UoN) has been ranked 8th in the UK for research power (REF 2014), confirming Nottingham’s place in the top tier of the world’s elite higher education Institutions. The UoN offers facilities that will improve the learning and the living experience of the student, from provisions for childcare and restaurants to numerous computer rooms, 13 libraries, 3 sport facilities and 1 NHS health service. The School of Medicine, offering a multidisciplinary research environment, will provide extensive (free) post-graduate courses, helping the PhD student to improve the skills required for this highly interdisciplinary project and for their future career development, across the four domains of the Vitae Researcher Development Framework. The Division of Clinical Neuroscience put emphasis on research through the Neuroclinical Science Research Day, a biannual event aimed to showcase the research of PhD students and research staff.
Duration: 3 years, full-time
Funder: Fisher & Paykel Healthcare (Auckland, New Zealand)
Eligibility: Candidates should hold, or realistically expect to obtain, at least an Upper Second-Class Honours degree or equivalent. This post is open to UK and EU citizens who have a strong academic background in bioengineering, control engineering, computer science, computational modelling (or similar), with some knowledge of biomedical science.
Funding: The funder has provided funds covering home/EU tuition fees for the three-year duration of the studentship, associated project costs, and an annual tax-free stipend (£14,777).
For more information: View Website
For informal questions: [email protected] [email protected]
1. Hardman JG, Bedforth NM, Ahmed AB, Mahajan RP, Aitkenhead AR: A physiology simulator: validation of its respiratory components and its ability to predict the patient's response to changes in mechanical ventilation. Br J Anaesth 1998; 81: 327-332
2. Das A, Gao Z, Menon PP, Hardman JG, Bates DG: A systems engineering approach to validation of a pulmonary physiology simulator for clinical applications. J R Soc Interface 2011; 8: 44-55
3. Laviola M, Das A, Chikhani M, Bates DG, Hardman JG: Computer simulation clarifies mechanisms of carbon dioxide clearance during apnoea. Br J Anaesth In Press
4. Wang W, Das A, Ali T, Cole O, Chikhani M, Haque M, Hardman JG, Bates DG: Can computer simulators accurately represent the pathophysiology of individual COPD patients. Intensive Care Med Exp 2014; 2: 23
5. Das A, Haque M, Chikhani M, Cole O, Wang W, Hardman JG, Bates DG: Hemodynamic effects of lung recruitment maneuvers in acute respiratory distress syndrome. BMC Pulmonary Medicine 2017; 17: 34