Dr Peter Smielewski
University of Cambridge
Dr Peter Smielewski is a senior research associate at the Brain Physics Lab, Department of Clinical Neurosciences, University of Cambrige, UK. He specializes in intensive care unit monitoring, data integration and analysis.
He graduated from Warsaw University of Technology, with a Master degree in Electrical Engineering, and subsequently received his PhD at the Division of Neurosurgery, University of Cambridge, UK, where he developed computer-aided methods of non-invasive assessment of cerebral blood flow regulation. He is the main author of a physiological monitoring data collection and real-time analysis software ICM+, by now licensed by Cambridge University to over 140 clinical research centres worldwide, and which incorporates all the methods of assessment of various aspects of cranio-spinal dynamics that he and his colleagues have been developing over the last 25 years.
His current focus includes methodologies for continuous assessment of cerebral autoregulation and cerebrovascular properties and their role in individualised management of traumatic brain injury patients. He is a co-applicant of CENTER-TBI, a large European brain trauma data collection project, and a leader of its ICU High Resolution physiological data acquisition part. He currently has 279 PubMed entries and H-index of 69, with over 14000 citations to date.
Listening to the injured brain
New advances in Transcranial Doppler ultrasound have now made it possible to obtain continuous measurements of cerebral blood flow waveforms over prolonged periods of time, measured in hours (or possibly days) rather than minutes. This opens new possibilities for application of TCD to pathologies like acute traumatic brain injury, where single, daily measurements are not sufficient to keep up with their highly dynamic character. When TCD cerebral blood flow velocity measurement is combined with measurement of arterial blood pressure waveform a purpose designed software can extract many parameters helping to track the status of cerebral autoregulation and other cerebrovascular properties like critical closing pressure (arterial pressure at which cerebral flow ceases) and critical closing margins (a ‘safety cushion’ for blood pressure). These in turn, when examined, for example, against intracranial pressure may help to inform selection of individual targets for TBI in ICU, thus aiding in personalised medicine approach.
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