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R. Blaine Easley, MD
Department of Anesthesiology/Critical Care Medicine
Division of Pediatric Anesthesiology and Pediatric Critical Care
The Johns Hopkins School of Medicine
600 North Wolfe Street, Blalock 941
Baltimore, MD 21287
The two areas of Dr. Easley’s research inform each other. His basic science research is focused on developing translational models of lung injury that can help to determine the mechanical and molecular basis of both acute lung injury and ventilator-associated lung injury. His clinical research is involved in better understanding how to care for children who are mechanically ventilated and who may have or may develop lung injury. Using a combination of high-resolution CT imaging and exploratory functional genomics, Dr. Easley and his colleagues (some from the Department of Pulmonary Medicine at Hopkins) quantify regional lung mechanics and correlate changes in regional lung behavior with the molecular responses to injury; this work is supported by grants from the Foundation for Anesthesia Education and Research and the NIH.
Dr. Easley is a co-investigator in an NIH-supported study to evaluate protocolized sedation care of children who are receiving mechanical ventilation (MV). The overall goal of this study is to determine if a care plan implemented by nurses at the bedside can improve outcomes in these children. Studies show that methods used to sedate patients affect the lengths of time that they remain on MV. Moreover, extended durations of MV increase the patient’s risk of lung injury. A protocolized plan is geared toward reducing the patient’s time spent on ventilation and, thereby, reducing injury. This study has two major outcome measures. One is to determine whether empowering nurses to regulate sedation will reduce the amount of sedatives given to patients; the other is to assess whether protocolized sedation will reduce children’s duration of MV.
In an associated area of exploration, Dr. Easley is investigating sleep and pain management in critically ill children who are receiving MV to assess whether strategies for pain management adversely affect their sleep. Studies have shown that adults in the ICU who receive MV have sleep disturbances and that MV is a leading risk factor for sleep disturbances and pain, even after discharge. As similar studies have not been conducted in children, it is not known if they sleep, how well they sleep, or if their levels of pain are adversely effected before and after their discharge from the ICU.. This preliminary study will help investigators to begin to develop metrics to measure the quality and quantity of sleep and develop therapies and pain management strategies to improve sleep, reduce pain, and help children to wean off of ventilation sooner, allowing them to leave the ICU sooner.
A third area of interest for Dr. Easley involves the use of high-resolution CT imaging to describe and quantify pathophysiology in lung injury. Dr. Easley and other investigators at the Lunglab at Johns Hopkins develop and apply these CT imaging techniques in large animal models of lung injury. Using a technique for quantifying regional pulmonary blood flow, Dr. Easley has been able to demonstrate differences in regional lung perfusion that occur with injury and with medical therapy. His research group has developed a hypothesis for why a transpulmonary thermodilution catheter (PiCCO) may not correctly quantify extravascular lung water (EVLW) . They believe that the mechanism pertains to regional blood flow related to inhibition of hypoxic pulmonary vasoconstriction (HPV). In a series of studies using CT blood flow techniques, they were able to demonstrate that an inhibitor of HPV caused a marked increase in EVLW without changing CT-measured fluid content. This significant finding was presented at the 2007 meeting of the American Thoracic Society and at the Vascular Medicine Institute at Johns Hopkins.
The critical care community currently lacks the ability to determine when mechanical ventilation is beginning to harm patients, regardless of whether they are healthy at the outset of therapy or already have lung disease. Through all of his efforts, Dr. Easley is working to develop a way to recognize this dreaded treatment-induced injury and to develop therapies to treat lung injury when it occurs.
- American Academy of Pediatrics
- American Society of Anesthesiology
- American Thoracic Society
- Society of Critical Care Medicine
- Society for Pediatric Anesthesia
- Society for Congenital Cardiac Anesthesia
- American Society of Critical Care Anesthesiologist
- Easley RB, Brady KM, Tobias JD. Dexmedetomidine for the treatment of postanesthesia shivering in children. Pediatr Anesth 17:341–6, 2007.
- Brady KM, Lee JK, Kibler KK, Smielewski P, Czosynka M, Easley RB, Koehler RC, Shaffner DH. Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy. Stroke 38(10):2818–25, 2007.
- Meester R, Easley RB, Brady KM, Chilson K, Tobias JD. Monitored anesthesia care with a combination of ketamine and dexmedetomidine during cardiac catheterization. Am J Ther 15(1):24–30, 2008.
- Easley RB, Tobias JD. Pro: dexmedetomidine should be used for infants and children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 22(1):147–51, 2008.
- Hoag JB, Liu M, Easley RB, Hassoun H, Rabb H, Simon BA. Effects of acid aspiration-induced acute lung injury on kidney function. Am J Physiol Renal Physiol 294(4):F900–8, 2008.
- Fuld MK, Easley RB, Saba O, Chon D, Reinhardt JM, Hoffman EA, Simon BA. CT-measured regional specific volume change reflects regional ventilation in supine sheep. J Appl Physiol 104(4):1177–84, 2007.
Laboratory Members/Key Associates
Kathy K. Kibler, BS Anesthesiology Lab Coordinator
Daniel G. Mulreany, BS Biomedical Engineer/Lab Coordinator
Tim Burman, BS (Hillary) Animal Technician
Clinical Research Coordinator
Beth White, RN
Jason W. Custer, MD
Brett A. Simon, MD, PhD
David Kazcka, MD, PhD
David Hager, MD
- Stauffer Award, Best Scientific Manuscript, Association of University Radiologists (2007)
- Young Investigator (Junior Faculty) Award, Society for Pediatric Anesthesia (2005)
- Outstanding Young Physician Award, Medical Alumni Association, Univ. of Missouri (2004)
- Alpha Omega Alpha Medical Honor Society, Elected to Gamma chapter
- University of Missouri, Columbia (Oct. 1998–present)
- Outstanding Resident in Pediatric Anesthesiology
- Dept. of Anesthesiology/Critical Care Medicine, Johns Hopkins Hospital (2002)
- Robert L. Jackson Outstanding Student in Pediatrics
- Department of Child Health, University of Missouri (1995)
- Rollins Graduate Student Honor Society (first initiate class), Univ. of Missouri (1994)