Faculty of Medicine
 

Technology Application Unit
Intensive Care Unit, Mount Sinai Hospital, University of Toronto
 
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University of Toronto
 

 

 

    Thomas E. Stewart

 

Mount Sinai Hospital Suite 427

600 University Ave

Toronto ON

M5G 1X5

 

E-mail: tom.stewart@utoronto.ca

 

Professor of Medicine and Anaesthesia

Chief Clinical Officer and Physician-in-Chief, Mount Sinai Hospital, Toronto

Type of Research: Clinical Topics in Critical Care, Mechanical Ventilation, Lung Protective Ventilation Strategies, High Frequency Oscillation, Technology Applications in Critical Care.

Current Research Funding: Canadian Institute of Health Research, Physicians Services Incorporated, Ontario Thoracic Society, Change Foundation, and several private industries.

Description of Research Program: My research has largely revolved around the conduct of large scale clinical trials in mechanical ventilation. Historically this involved the evaluation of a pressure and volume limited ventilation strategy. Currently it involves a lung open ventilation strategy that is also pressure and volume limited. In addition I am coordinating a multi-center trial looking at the safety and efficacy of HFOV with a more aggressive lung open approach. In conjunction with our team, in our unit we are interested in many applications of mechanical ventilation, currently this includes extubation protocols, sedation protocols, recruitment maneuvers, physiologic monitoring and frequency tolerance during HFOV. Recently under the auspices of our newly created Technology Application Unit (www.medtau.org) we have gained an interest in the evaluation of new technologies and their role in clinical medicine with a focus on critical care. Finally, in conjunction with our simulator program (see human simulation program at www.medtau.org) we have gained an interest in using simulation to facilitate critical care teaching and the training of advanced techniques.

 

Recent Publications:

Byrick RF, Mullen JB, Murphy P, Kay JC, Stewart TE, Edelist G.  Inhaled nitric oxide does not alter pulmonary or cardiac effects of fat embolism in dogs after cemented arthroplasty.  Can J Anaesth 1999 Jun; 46(6): 605-12.

Ferguson ND, Stewart TE, Etchells EE.  Review of Cochrane injuries group albumin reviewers.  Human albumin administration in critically ill patients:systematic review of randomised controlled trials. Intensive Care Medicine 1999; 25 (3): 323-325.

Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E, The Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group.  A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care.  N Engl J Med 1999; 340: 409-17. (Site Principal Investigator).

Stewart TE, Zhang H.  Nitric oxide in sepsis.  Respiratory Care 1999; 44 (3): 308-313.

Cooper AB, Ferguson ND, Hanly PJ, Meade MO, Kachura JR, Granton JT, Slutsky AS, Stewart TE.  Long Term Follow-up of Survivors of Acute Lung Injury:  Lack of Effect of A Ventilation Strategy to Prevent Barotrauma. Critical Care Medicine 1999; 27:2616-21.

Ferguson ND, Stewart TE, Etchells EE.  Human albumin administration in critically ill patients (letter to editor).  Intensive Care Medicine 1999;25:9, B1033.

Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ.  Sleep in critically ill patients requiring mechanical ventilation. Chest 2000;117(3):809-818.

Dancey DR, Hayes J, Gomez M, Schouten BD, Fish J, Peters W, Slutsky AS,  Stewart TE. ARDS in patients with thermal injury. Intensive Care Medicine 2000 (25):1231-1236.

Meade MO, Cook R, Guyatt G, Groll R, Kachura J, Cook D, Bedard M, Slutsky AS,  Stewart TE.  Interobserver Variation in Interpreting Chest Radiographs for the Diagnosis of Acute Respiratory Distress Syndrome. Am J of Respir and Crit Care Med 2000; 161:85-90.

Dos Santos CC, McGeer A, Stewart TE.  “Anti-microbial or antiseptic impregnated central venous catheters: update on a “central” debate”. Intensive Care Med 2000;26:246-249.

Lee WL, Detsky AS, Stewart TE.  Lung-protective mechanical ventilation strategies in ARDS.  Intensive Care Medicine 2000;26:1151-1155.

Mehta S, Lapinsky SE, Hallett DC, Merker D, Groll RJ, Cooper AB, MacDonald RJ, Stewart TE.  Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome. Critical Care Medicine 2001;29(7):1360-1369.

Lapinsky SE, Weshler J, Mehta S, Varkul M, Hallett D, Stewart TE.  Handheld computers in critical care.  Critical Care 2001; 5(4):227-231.

Meade MO, Guyatt GH, Cook RJ, Groll RJ, Kachura J, Wigg M, Cook DJ, Slutsky AS, Stewart TE.  Agreement between alternative classifications of acute respiratory distress syndrome. Am. J. Respir. Crit. Care Med. 2001;163: 490-493.

Hebert PC, Yetisir E, Martin C, Blajchman MA, Wells G, Marshal J, Tweeddale M, Pagliarello G, Schweitzer I, The Transfusion Requirements in Critical Care Investigators for the Canadian Critical Care Trials Group.  Is a low transfusion threshold safe in critically ill patients with cardiovascular diseases?  Critical Care Medicine 2001 29(2): 227-234. (Site Principal Investigator).

Singer PA, Barker G, Bowman KW, Harrison C, Kernerman P, Kopelow J, Lazar N, Weijer C, Workman S; for the University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force.  Hospital policy on appropriate use of life-sustaining treatment.  Critical Care Medicine 2001;29:187-191. (Site Principal Investigator).

Varkul MD, Stewart TE, Lapinsky SE, Ferguson ND, Mehta S.  Successful use of combined high frequency oscillatory ventilation, inhaled nitric oxide, and prone positioning in the acute respiratory distress syndrome. Anesthesiology 2001; 95:707-709.

Needham DM, Detsky AS, Stewart TE.  “Recent evidence for choice of fluids in patients with severe infection”.  Intensive Care Medicine (2001) 27(3): 609-612.

Mehta S, Lapinsky S, Hallett D, Merker D, Groll RJ, Cooper AB, MacDonald RJ, Stewart TE.  “Prospective trial of high-frequency oscillation in adults with acute respiratory distress syndrome”.  Crit Care Med (2001) 29 (7): 1360-1369.

Chahine-Malus N, Stewart TE, Lapinsky SE, Marras T, Dancey D, Leung R, Mehta S.  “Utility of routine chest radiographs in a medical-surgical intensive care unit: A quality assurance survey”.  Critical Care 2001, 5:271-275.

Hartlieb M, Stewart TE.  “ARDS: New approaches in ventilatory management”.  J Respir Dis.  In press.

Stewart TE.  “Use of HFOV in adults with acute respiratory distress syndrome”.  Canadian J of Anaesthesia.  In press.

Lapinsky SE, Weshler J, Mehta S, Varkul M, Hallett D, Stewart TE.  “Handheld computers in critical care”.  Critical Care.  In press.