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Donation allows St. Michael’s Hospital to recruit one of the world’s leading experts in mechanical ventilation

Toronto, November 13, 2013

By Leslie Shepherd

Dr. Laurent Brochard
Dr. Laurent Brochard

A $4-million donation from philanthropists Pat and Barbara Keenan has allowed St. Michael’s Hospital to recruit one of the world’s leading experts in mechanical ventilation, or machine-assisted breathing, for critically ill patients.

The donation funded The Keenan Chair in Critical Care and Respiratory Medicine at St. Michael's Hospital that helped attract Dr. Laurent Brochard, who arrived at St. Michael’s this month from Geneva University Hospital in Switzerland.

“Laurent Brochard is one of the top mechanical ventilation researchers in the world,” said Dr. Arthur Slutsky, vice-president of research at St. Michael’s, who himself is another member of that elite group. “His work has transformed how mechanical ventilation is done. It has changed clinical practices for a fundamental practice that saves lives every day.”

Mechanical ventilators define an intensive care unit. Patients on mechanical ventilators are some of the sickest patients in a hospital and are taken care of in critical care areas such as the ICU, operating room and Emergency Department. They have serious lung conditions arising from infections, such as severe influenza; trauma; or neurological conditions that prevent them from breathing such as a drug overdose or bleeding in the brain.

Despite their life-saving benefits, there are many risks to being on a ventilator, including infection and lung damage, so the goal is to get patients off ventilators as soon as possible. Several of Dr. Brochard’s research studies have led to significant reductions in the time patients spend on ventilators.

Dr. Brochard was the lead researcher in a study that found connecting patients with chronic obstructive pulmonary disease to a ventilator with a mask instead of a tube down the windpipe reduced their mortality rate by two-thirds. This has since become the standard of care for COPD patients on ventilators and has saved tens of thousands of patients around the world. About 4 per cent of Canadians over 35 have COPD and it is the third-leading cause of death in the country.

Dr. Brochard also found that the way physicians use ventilators can determine how beneficial or harmful they are to patients with acute respiratory distress syndrome. ARDS is an often fatal condition that occurs when fluid builds up in the tiny, elastic air sacs in the lungs known as alveoli, reducing the amount of oxygen that reaches the bloodstream. Reducing the volume of each mechanical breath for people with ARDS reduces lung injuries, and he found a way to set the best level of pressure in those difficult conditions.

In another series of studies, Dr. Brochard discovered a new mechanism by which ventilators were triggering an extra breath in some patients, which can be harmful. One of his current areas of interest is new methods of ventilation such as NAVA (neurally adjusted ventilator assist) ventilation, which involves the patient’s own brain signals. The brain stimulates nerves in the diaphragm; this activity is captured, fed to the ventilator and used to help synchronize the patient’s efforts to breathe with the ventilator’s work. NAVA was invented by another scientist at St. Michael’s, Dr. Christer Sinderby.

“Dr. Brochard’s arrival confirms St. Michael’s respiratory diseases, lung injury and mechanical ventilation group as one of the best in the world,” said Dr. Robert Howard, president and CEO of the hospital.

Led by Dr. Slutsky, and augmented by the addition of Dr. Brochard, St. Michael’s “is one of the best places in the world for mechanical ventilation and acute lung injury research, which will improve patient care not just at St. Michael’s, but elsewhere,” Dr. Howard said. “If someone is on a ventilator here, it means they are going to have the best people in the world to help them.”

Dr. Brochard said one of the reasons he moved to Toronto was because of the concentration of expertise in the city, especially at St. Michael’s. “These are people who changed the way we provide critical care to help save lives,” he said.

Having such a team is also a magnet for attracting the best and the brightest from around the world. Researchers from Europe. South America and Asia have already applied to come work with Dr. Brochard.

Dr. Brochard has also taken on a major leadership role as director of the Interdepartmental Division of Critical Care Medicine at the University of Toronto.

In addition to his work as a researcher and a clinician, Dr. Brochard has published 300 papers in peer-reviewed journals, was editor-in-chief of Intensive Care Medicine (the official journal of the European Society for Intensive Care Medicine) from 2001 to 2007, and is currently deputy editor for the American Journal of Respiratory and Critical Care Medicine.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

Media contacts

For more information, or to arrange an interview with Dr. Brochard, contact:

Leslie Shepherd
Manager, Media Strategy
416-864-6094
shepherdl@smh.ca