Research Group Schefold

Acute and Intensive Care: innovative approaches to apparent challenges

Main Areas of Work

  • Immunological and metabolic or neuromuscular changes in critical disease (including diagnostic testing, and development and testing of innovative therapeutic measures)
  • Daily problems in intensive care medicine that are of great clinical importance
  • Acute nephrology and cardiorenal medicine
  • Development of biomarkers

Brief description

The group applies translational research to address important everyday problems in acute or intensive care. We are particularly interested in studying how the patient’s response («host response») affects critical disease.

The translational section of our group (research group on «Immunosuppression in Critical Illness», Head Dr. T. Spinetti) concentrates on important elements of the reaction of the immune system to critical disease. We are particularly interested in the metabolic and immunological interfaces, as well as the interface between innate and acquired immunity. Our preliminary studies have shown that many critically ill patients pass through a phase of marked immunosuppression («injury-associated immunosuppression»). If this immune suppressive phase is protracted, this is associated with an impaired immune response, more secondary infections and a poor clinical outcome.

Our clinical studies have already shown that innovative personalised therapies can be used to treat this «immune organ failure» caused by critical disease – for example, by employing immune stimulation or extracorporeal therapies. We are convinced that the future of intensive care medicine lies in these individualized therapies and that these can lead to considerable improvements in the clinical course of these patients.

Next to translational research, our clinically orientated section of the group is led by Dr. P. Zürcher and concentrates on critical-illness induced neuromuscular changes. This includes acquired difficulties in swallowing (dysphagia) – and in particular also research on the «Bernese Dysphagia Algorithm», which was recently proposed. Now that we have shown the clinical relevance and investigated risk factors for acquired dysphagia, we are concentrating on developing interventional therapeutic approaches to improve the clinical outcomes of affected critically ill patients.

Associated staff

Dr. Thibaud Spinetti, PhD
Head of the group «Immunosuppression in critical illness»

Dr. med. Patrick Zürcher
.

Dr. Michel Moser, PhD

Dr. med. Jan Waskowski
.

Dr. sc. nat. Anna Neodo

Dr. phil. nat. Fiona Augsburger, PhD

  • Our projects are regularly supported by doctoral and master students in medicine.

Current projects

  • Innosuisse project to develop an innovative therapy for extracorporeal dialysis and immunomodulation (Innovation Project – Life Sciences 43113-1)
  • «RECREATE», Project for intraoperative immunomodulation using cytokine adsorption in heart surgery, Collaboration Department of Cardiovascular Surgery)
  • «PHINEST», Pharyngeal electrical stimulation for the treatment of dysphagia after extubation: multicenter randomized clinical study
  • «HOT-ICU», Handling oxygenation targets in the ICU, multinational randomized clinical study
  • «IMPACT/HOPE», Innosuisse innovation project to develop non-invasive devices for measuring blood pressure (Collaboration)
  • «NAChO», Prospective observational study with extensive omics diagnostic testing for nutrients in critical disease

Important publications

Collaborations

Inselspital, Bern University Hospital

  • Department of Nephrology and Hypertension (Prof. D. Uehlinger, MD, Prof. U. Huynh-Do, MD, Prof. D. Fuster, MD)
  • Department of Anesthesiology and Pain Medicine (M. Lüdi, MD)
  • Department of Infectious Diseases (C. Hirzel, MD)
  • Department of Cardiovascular Surgery (Prof. L. Engelberger, MD, F. Gisler, MD)
  • Departments of Neurology and Neurosurgery (Prof. W. Z'Graggen, MD, Head of Neurointensive Care)

International Collaborations

  • Innovative Clinical Trials Group, University Medical Center Göttingen (Prof. S. von Haehling, MD)
  • Charité, Universitätsmedizin Berlin (Prof. W. Doehner, MD)
  • Medical University of Graz (Prof. K. Amrein, MD)
  • Collaboration for Research in Intensive Care (CRIC), Copenhagen (Prof. M. H. Moller, MD, Prof. B. Rasmussen, MD,Prof. A. Perner, MD)
  • European Group on Immunology of Sepsis, EGIS (Founding Member)
  • Jena University Hospital, Center for Clinical Studies (Prof. F. Brunkhorst, MD)