Critical Care Medicine

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Critical Care Medicine:

The Critical Care Medicine physicians provide care for patients in the adult intensive care units of UCSF's Moffitt-Long hospitals. Our patient population is quite diverse, including patients with:

  • Acute respiratory failure
  • ARDS
  • Sepsis
  • Cardiac dysfunction
  • Renal failure
  • Neurologic disorders
  • Transplantation of the kidney, liver, pancreas, heart, lungs, and bone marrow
  • Major surgical procedures, including coronary revascularization and valve replacements, vascular surgery, neurosurgery, neuro-interventional procedures, and major spine repairs

 

Faculty and Staff

Our Faculty & Staff:

  • The Critical Care Medicine Faculty at UCSF Moffitt-Long Hospital belong to the Department of Anesthesia and/or the Department of Medicine
  • All faculty are board certified in their specialty and also have subspecialty certification in critical care medicine
  • Research interests are varied and detailed bibliographies are available upon request

Faculty Members:

Matt Aldrich, MD
Director of Critical Care Medicine

Kristine Breyer, MD
Assistant Clinical Professor

Dan Burkhardt, MD
Associate Professor, Department of Anesthesia and Perioperative Care

Lundy Campbell, MD
Associate Clinical Professor, Department of Anesthesia and Perioperative Care

Lee-lynn Chen, MD
Associate Clinical Professor, Department of Anesthesia and Perioperative Care

Christopher Choukalas, MD
Assistant Clinical Professor, Department of Anesthesia and Perioperative Care

Neal Cohen, MD
Professor, Department of Anesthesia and Perioperative Care
Vice Dean, School of Medicine

Michael Gropper, MD, PHD
Professor and Vice Chair, Department of Anesthesia and Perioperative Care
Professor of Physiology
Director, Critical Care Medicine
Investigator, CVRI

Vanessa Henke, MD
Assistant Clinical Professor

Lindsey Huddleston, MD
Assistant Clinical Professor

Rondall Lane, MD
Associate Clinical Professor

Linda Liu, MD
Professor, Department of Anesthesia and Perioperative Care
Director, Critical Care Medicine Fellowship
Medical Director, Respiratory Care

Dorre Nicholau , MD
Professor, Department of Anesthesia and Perioperative Care
Chair, Physician Well-being Committee, Department of Anesthesia and Perioerative Care

Manny Pardo, MD
Professor, Department of Anesthesia and Perioperative Care
Vice Chair for Education, Department of Anesthesia and Perioperative Care
Sol Shnider Endowed Chair for Anesthesia Education

James Ramsay, MD
Professor of Clinical Anesthesia

Andrew Schober, MD
Assistant Clinical Professor

David Shimabukuro, MDCM
Associate Clinical Professor, Department of Anesthesia and Perioperative Care
Associate Medicine Director, 9 & 13 ICUs

Kristina Sullivan, MD
Associate Clinical Professor, Department of Anesthesia and Perioperative Care
Director, Anesthesia Internship

John Taylor, MD
Associate Clinical Professor, Department of Anesthesia and Perioperative Care
Medical Director, Post Anesthesia Care Unit, UCSF Moffitt-Long Hospital
Medical Director, Anesthesia Workroom, UCSF Moffitt-Long Hospital

Kevin Thornton, MD
Director of the Critical Care Fellowship

John Turnbull, MD
Assistant Clinical Professor, Department of Anesthesia and Perioperative Care

 

Nurse Practitioners

Critical Care Nurse Practitioners

The critical care nurse practitioners (CCNPs) of UCSF are a group of advanced practice nurses who provide expert care in the adult intensive care units at UCSF Health. The CCNPs are an element of the interdisciplinary critical care team that includes attending physicians, physicians in training, pharmacists, registered nurses, rehabilitation therapists, and UCSF students. The CCNPs provide care in all of the adult intensive care units including cardiothoracic, neurologic, neurosurgical, medical, surgical, oncology, and transplant.

The CCNP group collaborates with the UCSF School of Nursing and supports the UCSF Surgical and Critical Care Nurse Practitioner Fellowship. The CCNP group is active in various quality improvement, cost reduction, and technology implementation projects. Highlights of these projects can be found in the Links section.

 

Nurse Practitioner Supervisor

Thomas Farley, RN, MS, ACNP-BC
Assistant Clinical Professor of Nursing, UCSF and University of Arizona
MS, University of California, San Francisco
BA, University of Massachusetts, Amherst
Thomas.Farley@ucsf.edu



Staff

Amada Apacible, CCRN, FNP-BC, CCNP
Assistant Clinical Professor, UCSF School of Nursing
MS, University of California, San Francisco
BSN and BA, University of Washington
MariaAmada.Apacible@ucsf.edu

 

Maureen Arriola, ACNP-BC
MSN, University of California, San Francisco
BSN, University of San Francisco
Maureen.Arriola@ucsf.edu



 

Deborah Chege, AGACNP-BC, NP-C

Post Masters - University of Pennsylvania

MSN, Temple University, Philadelphia
BSN, Temple University, Philadelphia
Deborah.Chege@ucsf.edu

 

Karin Clifton, ACNP-BC 
MSN, Columbia University
BSN, Columbia University
BA, University of California at Berkeley
Karin.Clifton@ucsf.edu


 

Rubi Hickson, RN, CCRN, MS, ACNP-BC
MS, University of Connecticut
BSN, Biola University
Rubi.Hickson@ucsf.edu



 

Kenneth Johnson, ACNP-BC
MSN, University of California, San Francisco
BSN, Indiana University
Kenneth.Johnson@ucsf.edu



 

Geoffrey Howland Latham, ACNP-BC
Assistant Clinical Professor UCSF
MSN, University of California, San Francisco
BSN, University of North Carolina, Wilmington



 

Stacy Mills, ACNP-BC
MSN, University of California, San Francisco
BSN, University of San Francisco
Stacy.Mills@ucsf.edu



 

Kate Mylan, RN, MSN, ACNP-AG
ACNP Certificate, University of California, San Francisco
MSN, University of San Francisco
BA, University of Notre Dame
Kathleen.Mylan@ucsf.edu

 

Gil Ponsones, ACNP-BC
MSN, Wayne State University
BSN, Centro Escolar University, Manila, Philippines
Gil.Ponsones@ucsf.edu



 

Mellyn Reading, ACNP-BC
MSN, University of California, San Francisco
BSN, University of California, San Francisco
BA Literature, University of California, Santa Cruz
Mellyn.Reading@ucsf.edu


 

Jennifer Schwarz, MS, ACNP-BC
MS, Columbia University
BS, Columbia University
BA, University of California, Berkeley
Jennifer.Schwarz@ucsf.edu


 

Annette Taube, MSN, AGACNP-BC
MSN, University of Texas Health Science Center at San Antonio
BSN, University of Texas Health Science Center at San Antonio
Annette.Taube@ucsf.edu


 

Matthew White, ACNP-BC
MSN, University of California, San Francisco
BSN, University of Alabama at Birmingham
Matthew.White@ucsf.edu



 

Erika Wilson, RN, MS, ACNP-BC
MS, University of California, San Francisco
BSN, California State University, Long Beach
Erika.Wilson@ucsf.edu




Per Diem Staff

Jeff Capodanno, ACNP-BC
MSN, University of California, San Francisco
BSN, Stony Brook University, SUNY
Jeffrey.Capodanno@ucsf.edu



 

Kristopher Jackson, RN, MSN, AGACNP-BC
PhD [in progress] University of New Mexico, Albuquerque
MSN, Thomas Jefferson University, Philadelphia
BSN, Thomas Jefferson University, Philadelphia
BS, Monmouth University, West Long Branch
Kristopher.Jackson@ucsf.edu

 

Todd Johnson, MS, ACNP-BC, CEN
MS, University of California, San Francisco
BS, University of Massachusetts, Boston
Todd.Johnson2@ucsf.edu




 

Carla Wittenberg MSN, ACNP-BC, RNFA
Assistant Clinical Professor, UCSF School of Nursing
MSN, University of Pennsylvania, Philadelphia
BSN, University of Pennsylvania, Philadelphia
BAEd, University of Arizona, Tucson
Carla.Wittenberg@ucsf.edu

 

Tania Yarema, ACNP-BC
Assistant Clinical Professor, UCSF School of Nursing
MSN, UCSF School of Nursing
BSN, Sault College of Applied Arts, Canada
Tania.Yarema@ucsf.edu

Residents

Resident Rotation

  • Every month residents from the Departments of Anesthesia, Emergency Medicine, Internal Medicine, and Surgery rotate through the ICU.
  • The call schedule is varied, but residents average every 3rd-4th night call.
  • Teaching is provided during morning lectures, daily attending rounds, and throughout the day by the fellows.
  • Objectives are to understand indication and techniques of invasive central monitoring, airway management, patient sedation, and care of patients with multiorgan failure
Medical Students

Medical Students

  • Every month up to two students from UCSF School of Medicine join the ICU team. Students are responsible for following their own patients and receive guidance from the residents, fellows, and attendings.
  • Students do not take overnight call, but are encouraged to stay late 1 day per week in order to learn from the entire ICU experience.
  • Students are expected to be present for the entire month, but are off on the weekends and should check with the attending of the week if time off is needed for interviews.
  • Prior rotations on medicine and surgery are required due to the complexity of the patients in the ICU.

 

 

Fellows

Fellows

Please visit our Critical Care Medicine Fellowship page

Orientation

Welcome to the Critical Care Rotation

Our intention is to have everyone go through a formal orientation on the first Monday of the month.

If you are rotating onto the service on the weekend before the first Monday or if your rotation has you coming onto the ICU in the middle of the month, then we suggest that you download the orientation slides. Hopefully they can help smooth out your transition onto the service.

Download Slides

Please feel free to contact any attending on the ICU service if you have further questions.

Research

Role of Mucus in Acute Asthma:

John Fahy, MD

Follow up to ICU study in 2000 showing that neutrophils and IL-8 were associated with prolonged intubation in ventilated acute asthma

New study examined the pathologic role of mucus in acute asthma, indicating that exuded plasma proteins inhibit mucin degradation in the airways in a protease dependent manner

New data suggests that the presence of neutrophils and neutrophil elastase may be necessary for the clearance of pathologic mucus. 

Biological Studies in Asthma: Molecular Phenotying of Asthma

Prescott Woodruff, MD

New NHLBI Ro1 on molecular phenotyping of asthma, potential clinical implications for acute asthma

Additional NHLBI funding for a spiromics clinical center funded from 2009-2016

Pending funding for a Ro1 on the role of Th2 and smooth muscle remodeling in asthma with possible clinical implications for severe asthmatics admitted to the ICU

ARDS Network Trials

Michael Matthay, MD
Mark Eisner, MD 
Kathleen Liu, MD 
Carolyn Calfee, MD 

ATLA Trial: Aerosolized beta-2 agonist therapy with albuterol did not improve clinical outcomes, even when adjusted for baseline covariates. Routine administration of aerosolized beta-2 agonists cannot be recommended for patients with acute lung injury. Overall mortality was lower (20%) than in prior ARDS Network trials, even though the APACHE III score was higher and a greater percentage of patients were in shock at the time of study entry.

OMEGA Trial: Omega-3 fatty acid and anti-oxidant supplementation twice daily to enteral feeds does not improve outcomes in patients with ALI, and in fact, may worsen outcomes. Routine twice daily supplementation of omega-3 fatty acids and anti-oxidants to enteral feedings cannot be recommended in patients with ALI.

EDEN Trial: ongoing, 310 enrolled 

SAILS Trial: Statin trial, probably will start in October 2009

Lung Water Study

Michael Matthay, MD

Lisa Brown, MD 
Kathleen Liu, MD 

Prospective measure of pulmonary edema in ALI patients with femoral artery catheter via thermodilutaion method through CVP.

Also collecting dead space, lung compliance and blood samples for biomarker measurements.

TRALI SCCOR studies

Michael Gropper, MD, PhD
Mark Looney, MD 
Kathleen Liu, MD 
Michael Matthay, MD 
David Shimabukuro, MD 

Prospective studies establishing the incidence of TRALI here at UCSF and the Mayo Clinic. Will complete in the fall, 2009.

Also mouse studies by Dr. Looney implicate a novel role for platelets in the pathogenesis of TRALI and ALI.

NHLBI application pending by Drs. Looney and Liu to do a phase II trials of average age versus fresh blood in cardiac surgery patients. 

Role of Cigarette Smoke Exposure in ALI

Carolyn Calfee, MD
Jean Hsieh, MD 
Michael Matthay, MD 

Determined which biologic samples that can be used to monitor active and passive smoke exposure: blood and urine seem best.

Prospective cohort of nearly 300 severe trauma victims at SFGH being analyzed now.

Prospective cohort of patients at risk of ALI at Vanderbilt University to be analyzed in the near future. 

ER ICU Cohort

Carolyn Calfee, MD
Kathleen Liu, MD 

Identify patients admitted to the ICUs from the ER.

Several end points, both clinical and biologic.

Note our recent Chest 2009 article on identifying patients with ALI in the ER before intubation (Levitt et al). 

ALI Genetics Study

Anil Sapru, MD
Kathleen Liu, MD 
Carolyn Calfee, MD 
Michael Matthay, MD 

Interesting results so far with candidate gene approach on FACTT data, implicating coagulation genes in the severity of ALI.

More studies in process on candidate genes as well as a NIH GO application to do Genome Wide Association Study in ALI with other institutions.

Major prospective pediatric study in process at UCSF and Oakland Childrens Hospital. 

BOLD Trial

Michael Matthay, MD 
Lorraine Ware, MD 

First prospective randomized trial of brain dead patients attempting to modify organ function prior to transplantation.

Focus is on lung function. Hypothesis is that aerosolized beta-2 agonists will improve donor oxygenation.

Enrollment at 45 hospitals in Northern California with California Transplant Donor Network, nearly 50% completed. 

Acute Kidney Injury Study

Kathleen Liu, MD 

Prospective study of patients at risk of acute kidney injury or with early acute kidney injury to identify clinical and biologic markers that predict outcomes.

Cohort of patients collected: n=130.

Measurements and data analysis being carried out now. 

Mesenchymal Stem Cells for Acute Lung Injury

Jae Woo Lee, MD 
Michael Matthay, MD 

Perfused human lung studies indicate that treatment with human mesenchymal stem cells can reverse acute pulmonary edema and acute lung injury after endotoxin induced lung injury.

We submitted a Challenge application with the University of Pittsburgh to carry out a phase I clinical trial.

Innate Immune Pathways in Sepsis-induced Endothelial Dysfunction, Coagulopathy, and Vascular Leak

Judith Hellman, MD 

Study effects of toll-like receptor 2 (TLR2), a host innate immune receptor for microbial lipoproteins on endothelial cell activation in vitro.

Test effects of TLR2 activation on endothelial cell function, including permeability and modulation of coagulation in vitro.

Evaluate role of TLR2 in sepsis-induced coagulopathy and in vascular leak in vivo. 

Contact Information

Contact Information

Linda Liu, M.D.
Director, Anesthesia Critical Care Fellowship
liul@anesthesia.ucsf.edu

Michael Gropper, Ph.D., M.D.
Director, Critical Care Medicine
gropperm@anesthesia.ucsf.edu

Michael Matthay, M.D.
Director, Medicine Critical Care Fellowship
matthaym@anesthesia.ucsf.edu

Fellowship Coordinator
Anesthesia Critical Care Fellowship
fellowships@anesthesia.ucsf.edu

Department of Anesthesia and Perioperative Care
505 Parnassus Ave
Room M917, Box 0624
San Francisco, California 94143
Phone: 415-353-1116
Fax: 415-353-1990