2013 DIG Research Projects | “Comparative effectiveness in Perioperative and Critical Care Medicine: Crystalloid Fluid Therapy”
I was born and raised in India. I completed my basic medical education and initial training there, and immigrated to the United States in 1999. As a graduate student at the State University of New York in Albany, I studied epidemiology while interning at the Albany Medical College and the New York State Department of Health. Anesthesiology afforded me an opportunity to pursue my twin passions: applied pathophysiology and pharmacology at the bedside; and clinical epidemiology.
By the summer of 2002, I was accepted into an anesthesiology training program in Philadelphia, where I trained over the next three years. My family and I moved to Springfield, MA, to complete my training within the Tufts University system, as my wife, a neurologist, took up a job in a medically underserved area. My fellowship in critical care medicine served to further my understanding of acute illness and by July 2007, I had begun working as a staff anesthesiologist at the Baystate Medical Center. This academic tertiary community hospital provided me with opportunities to work as an educator, engage in research, and provide care to patients from all over western Massachusetts and eastern New York. After five years at this location, a chance encounter with Andrew Shaw, MD, MBBS, at an anesthesiology conference led to an offer to join the anesthesiology team at Duke.
The promise of collaboration with committed and capable peers at the very highest level was impossible to turn down. A family of five at this point, we moved to Duke in July of 2012. A few months later, I found out that I was a DIG recipient!
My research project aims to answer the following question: “What is the right kind of intravenous crystalloid fluid to use during severe illness and surgery?” Intravenous fluids are used to support circulation when patients are admitted to hospitals for major surgery or during critical illness. Despite nearly universal use, the fundamental question of “what fluid is best in which situation” remains unresolved. There is wide variation across various populations and our study is going to examine the results of using different combinations of fluids. At the population level, since intravenous fluid use is so common, even small differences in important outcomes will have immense consequences.
I decided to work on this question since my epidemiologic training prepared me for the study of patterns of disease across different populations. Also, as an anesthesiologist and intensive care specialist, I use these fluids every day. This was a practical question directly relevant to my patients.
The DREAM Campaign gives investigators the critical support they need to make the leap from an interesting idea to a pilot project early in their careers. Pilot data is pivotal in testing hypotheses and to subsequent, continued support for promising avenues of research. As a testament to this, in Spring of 2013, we were awarded a $206,944 extramural grant from the Baxter Healthcare Corporation Fluids franchise, and in Fall of 2013, we were awarded the $100,00 APSF/ASA Endowed Research Award from the APSF Scientific Evaluation Committee. This could not have happened without the initial funding from the DIG award and Dr. Shaw’s tremendous mentorship.