Anthony Christopher Gordon | |
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Nationality | British |
Alma mater | St Bartholomew's Hospital Medical School, University of London |
Scientific career | |
Fields | Critical Care Sepsis |
Institutions | Imperial College London |
Thesis | Genetic polymorphisms of the innate immune system: influence on susceptibility and outcome in severe sepsis and septic shock |
Doctoral advisor | Charles Hinds |
Website | www |
Anthony Gordon MBE FRCA FMedSci is a British clinician scientist and the Chair of Anaesthesia & Critical Care at Imperial College London and works as an intensive care consultant at Imperial College Healthcare NHS Trust. [1]
Educated at Kings College School, Wimbledon, [2] he studied medicine at St Bartholomew's Hospital Medical School, University of London, and was awarded a BSc in Anatomy with Basic Medical Sciences in 1990 and MBBS in 1993. He undertook his doctoral studies with Charles Hinds and was awarded an MD for his thesis exploring genetic polymorphisms in sepsis [3]
He undertook his postgraduate medical training in London with an additional year at Royal North Shore Hospital in Sydney, Australia [4] He was awarded the Intensive Care Society visiting fellowship in 2005 and spent two years in Vancouver at St Paul's Hospital, University of British Columbia [5] and also worked as the director of medical development of a university spin-out company (Sirius Genomics Inc) developing pharmacogenetic tests for use in the ICU. [6]
As an NIHR Research Professor (2016-2022) [7] he leads a multi-disciplinary team investigating the use of ‘omic techniques [8] and artificial intelligence (AI) [9] to improve outcomes in sepsis, with a particular focus on clinical trials and translational studies. He was the Chief Investigator of the VANISH clinical trial evaluating early vasopressin use (in combination with hydrocortisone) [10] and the LeoPARDS trial evaluating levosimendan, [11] both in septic shock.
He is the UK Chief Investigator for the REMAP-CAP clinical trial, [12] which was the first trial to demonstrate that the immune modulating drugs, tocilizumab and sarilumab, saved lives from severe COVID-19. [13] The Prime Minister announced this result from 10 Downing Street [14] and Gordon is the first author of the published paper. [15] This adaptive platform trial has reported on more than a dozen other interventions for severe COVID-19, including hydrocortisone, convalescent plasma, anti-virals, anti-platelet drugs, [16] therapeutic heparin, [17] [18] ACE inhibitors and Angiotensin Receptor Blockers (ARBs), [19] high-dose vitamin C [20] and simvastatin. [21] The trial has now been selected by the NIHR as the national platform trial to find the most effective treatments for people hospitalised with severe flu. [22]
In March 2024 he was appointed as Programme Director of the National Research Collaboration Programme (NRCP). [23] The NRCP is an NIHR / NHS England partnership that commissions high quality evidence for treatments where research can present particular challenges and might otherwise not progress.
His contributions to clinical science have been recognised in appointment as a Fellow of the Academy of Medical Sciences (2022), [24] an Honorary Member of the Intensive Care Society [25] and NIHR Senior Investigator (2023) [26] . He was appointed as a Member of the Order of the British Empire (MBE) in the 2024 Birthday Honours for services to Critical Care Medicine [27] .
Sepsis is a potentially life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs.
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). For those who survive, a decreased quality of life is common.
Procalcitonin (PCT) is a peptide precursor of the hormone calcitonin, the latter being involved with calcium homeostasis. It arises once preprocalcitonin is cleaved by endopeptidase. It was first identified by Leonard J. Deftos and Bernard A. Roos in the 1970s. It is composed of 116 amino acids and is produced by parafollicular cells of the thyroid and by the neuroendocrine cells of the lung and the intestine.
Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. The normal serum range for chloride is 96 to 106 mEq/L, therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. As of now there are no specific symptoms of hyperchloremia; however, it can be influenced by multiple abnormalities that cause a loss of electrolyte-free fluid, loss of hypotonic fluid, or increased administration of sodium chloride. These abnormalities are caused by diarrhea, vomiting, increased sodium chloride intake, renal dysfunction, diuretic use, and diabetes. Hyperchloremia should not be mistaken for hyperchloremic metabolic acidosis as hyperchloremic metabolic acidosis is characterized by two major changes: a decrease in blood pH and bicarbonate levels, as well as an increase in blood chloride levels. Instead those with hyperchloremic metabolic acidosis are usually predisposed to hyperchloremia.
Stress hyperglycemia is a medical term referring to transient elevation of the blood glucose due to the stress of illness. It usually resolves spontaneously, but must be distinguished from various forms of diabetes mellitus.
Hemofiltration, also haemofiltration, is a renal replacement therapy which is used in the intensive care setting. It is usually used to treat acute kidney injury (AKI), but may be of benefit in multiple organ dysfunction syndrome or sepsis. During hemofiltration, a patient's blood is passed through a set of tubing via a machine to a semipermeable membrane where waste products and water are removed by convection. Replacement fluid is added and the blood is returned to the patient.
The sequential organ failure assessment score, previously known as the sepsis-related organ failure assessment score, is used to track a person's status during the stay in an intensive care unit (ICU) to determine the extent of a person's organ function or rate of failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
Dalteparin is a low molecular weight heparin. It is marketed as Fragmin. Like other low molecular weight heparins, dalteparin is used for prophylaxis or treatment of deep vein thrombosis and pulmonary embolism to reduce the risk of a stroke or heart attack. Dalteparin acts by potentiating the activity of antithrombin III, inhibiting formation of both Factor Xa and thrombin. It is normally administered by self-injection.
David Lawrence Sackett was an American-Canadian physician and a pioneer in evidence-based medicine. He is known as one of the fathers of Evidence-Based Medicine. He founded the first department of clinical epidemiology in Canada at McMaster University, and the Oxford Centre for Evidence-Based Medicine. He is well known for his textbooks Clinical Epidemiology and Evidence-Based Medicine.
Hydroxyethyl starch (HES/HAES), sold under the brand name Voluven among others, is a nonionic starch derivative, used as a volume expander in intravenous therapy. The use of HES on critically ill patients is associated with an increased risk of death and kidney problems.
Early goal-directed therapy was introduced by Emanuel P. Rivers in The New England Journal of Medicine in 2001 and is a technique used in critical care medicine involving intensive monitoring and aggressive management of perioperative hemodynamics in patients with a high risk of morbidity and mortality. In cardiac surgery, goal-directed therapy has proved effective when commenced after surgery. The combination of GDT and Point-of-Care Testing has demonstrated a marked decrease in mortality for patients undergoing congenital heart surgery. Furthermore, a reduction in morbidity and mortality has been associated with GDT techniques when used in conjunction with an electronic medical record.
The National Institute for Health and Care Research (NIHR) is the British government's major funder of clinical, public health, social care and translational research. With a budget of over £1.2 billion in 2020–21, its mission is to "improve the health and wealth of the nation through research". The NIHR was established in 2006 under the government's Best Research for Best Health strategy, and is funded by the Department of Health and Social Care. As a research funder and research partner of the NHS, public health and social care, the NIHR complements the work of the Medical Research Council. NIHR focuses on translational research, clinical research and applied health and social care research.
The Society of Intensive Care Medicine (SICM) is the representative body for Intensive Care Medicine (ICM) professionals in Singapore.
Paul Ellis Marik is an American physician and former professor of medicine who until his resignation in January 2022 served as chair of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia, and was also a critical care doctor at Sentara Norfolk General Hospital. His research interests include sepsis and tissue oxygenation. In August 2023 the American Board of Internal Medicine informed Marik his certification was to be revoked for spreading misinformation.
Vasodilatory shock, vasogenic shock, or vasoplegic shock is a medical emergency belonging to shock along with cardiogenic shock, septic shock, allergen-induced shock and hypovolemic shock. When the blood vessels suddenly relax, it results in vasodilation. In vasodilatory shock, the blood vessels are too relaxed leading to extreme vasodilation and blood pressure drops and blood flow becomes very low. Without enough blood pressure, blood and oxygen will not be pushed to reach the body's organs. If vasodilatory shock lasts more than a few minutes, the lack of oxygen starts to damage the body's organs. Vasodilatory shock like other types of shock should be treated quickly, otherwise it can cause permanent organ damage or death as a result of multiple organ dysfunction.
Intravenous Ascorbic Acid or PAA, pharmacologic ascorbic acid, is a process that delivers soluble ascorbic acid directly into the bloodstream. It is not approved for use to treat any medical condition.
Drug repositioning is the repurposing of an approved drug for the treatment of a different disease or medical condition than that for which it was originally developed. This is one line of scientific research which is being pursued to develop safe and effective COVID-19 treatments. Other research directions include the development of a COVID-19 vaccine and convalescent plasma transfusion.
The treatment and management of COVID-19 combines both supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support as needed, and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; however, for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important. Some people may experience persistent symptoms or disability after recovery from the infection, known as long COVID, but there is still limited information on the best management and rehabilitation for this condition.
The Randomised Evaluation of COVID-19 Therapy is a large-enrollment clinical trial of possible treatments for people in the United Kingdom admitted to hospital with severe COVID-19 infection. The trial was later expanded to Indonesia, Nepal and Vietnam. The trial has tested ten interventions on adults: eight repurposed drugs, one newly developed drug and convalescent plasma.
The International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) is an international research initiative based in Oxford, England. It is hosted at the Nuffield Department of Medicine within the University of Oxford and led by the Epidemic diseases Research Group Oxford (ERGO). ISARIC is funded by the Bill & Melinda Gates Foundation, Foreign, Commonwealth and Development Office, and Wellcome Trust.
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