Matthieu Legrand
University of California-San Francisco, CA·Medicine & Clinical Research
Patients in operating rooms and intensive care units can look stable one hour and be in organ failure the next. Both projects here attack that problem in critical care medicine: one tests which of two common blood-pressure drugs better protects the kidneys during surgery, the other looks for early blood signals that mark burn patients heading toward sepsis.
- Fields
Medicine & Clinical Research
Public Health & Epidemiology
Physiology
- Topics
acute kidney injury
perioperative medicine
intraoperative hypotension
- Grants
- 2 known grants, through Aug 2029
What they work on
- Test whether norepinephrine, which constricts vessels and strengthens the heartbeat, prevents postoperative acute kidney injury better than phenylephrine, a pure vasoconstrictor, in adults undergoing major non-cardiac surgery under general anesthesia.
- Run the VEGA-2 comparison as a multicenter pragmatic cluster-randomized, open-label, multiple-crossover trial inside the Multicenter Perioperative Outcomes Group, with participating sites switching first-line vasopressor between periods.
- Test whether the initial host response to severe burn injury predisposes patients to later sepsis, by longitudinally analyzing plasma and clinical outcomes in a prospective cohort of roughly 400 adults with severe burns.
- Define sub-phenotypes of burn patients from biomarkers of immune dysregulation and cardiovascular injury, and link them to sepsis as the primary endpoint and to mortality, ICU length of stay and organ failure.
- Compare proteomic signatures among burn patients with sepsis, burn patients with sterile inflammation, and non-burn critically ill patients with sepsis or septic shock, to identify markers specific to infection.
More about the research
Each uses large patient cohorts rather than animal models, and each is designed to change bedside decisions.
Why it matters
Both projects aim at decisions clinicians make now with weak evidence. A definitive comparison of norepinephrine and phenylephrine could inform perioperative guidelines for tens of millions of surgical patients a year and may reduce postoperative acute kidney injury and its downstream chronic kidney disease and costs. In burn care, blood-based sub-phenotypes and proteomic signatures could let teams spot patients at high risk of sepsis on ICU arrival, recognize sepsis earlier against a background of burn inflammation, and select patients for future preventive trials.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
The choice of vasopressor to prevent postoperative acute kidney injury after major non-cardiac surgery: a multicenter pragmatic cluster cross-over randomized trial (the VEGA-2 trial)
NIH · Sep 2024 – Aug 2029
Identification of sub-phenotypes of severely ill burn patients and risk for secondary sepsis: SEPSISBURN
NIH · Sep 2023 – Jul 2027
Closest labs
Todd Miano
University of Pennsylvania, PA·Medicine & Clinical Research
Test whether kidney injury linked to vancomycin plus piperacillin-tazobactam is a pseudotoxicity, meaning creatinine rises without real tissue damage, in a randomized trial against vancomycin plus cefepime in acutely ill patients with infection.
Andrew Bishara
University of California-San Francisco, CA·Medicine & Clinical Research·Early-career
Implement machine learning models that predict perioperative acute kidney injury in real time during surgery and alert clinicians while kidney-protective treatments can still be given.
Denise Hasson
New York University, NY·Medicine & Clinical Research·Early-career
Characterize baseline nutritional status in 200 high-risk pediatric ICU patients using dietary questionnaires, malnutrition screening, arm circumference, skinfold thickness, grip strength and muscle ultrasound, and test whether these risk subtypes predict acute kidney injury.
The school
University of California-San Francisco: 89 labs on PI Pages, $2.1B a year on research, 164 research doctorates a year.
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