Critical Care Medicine
Critical Care Medicine:
The Critical Care Medicine physicians provide care for patients in the adult intensive care units of UCSF's Moffitt-Long and Mission Bay 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
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 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
Manny Pardo, MD
Professor, Department of Anesthesia and Perioperative Care
Vice Chair for Education, Department of Anesthesia and Perioperative Care
Andrew Schober, MD
Assistant Clinical Professor
David Shimabukuro, MDCM
Associate Clinical Professor, Department of Anesthesia and Perioperative Care
Associate Medicine Director, 9 & 13 ICUs
Associate Clinical Professor, Department of Anesthesia and Perioperative Care
Director, Anesthesia Residency Program
Kevin Thornton, MD
Director of the Critical Care Fellowship
John Turnbull, MD
Assistant Clinical Professor, Department of Anesthesia and Perioperative Care
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 |
House 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 [email protected] |
 Maureen Arriola, ACNP-BC MSN, University of California, San Francisco BSN, University of San Francisco [email protected] |
 Deborah Chege, NP-C MSN, Temple University, Philadelphia BSN, Temple University, Philadelphia [email protected] |
 Karin Clifton, ACNP- BC MSN, Columbia University BSN, Columbia University BA, University of California at Berkeley [email protected] |
 Archie Garino, MSN, AGACNP-BC MSN, The University of Texas Health Science Center at San Antonio BSN, Texas Tech University Health Sciences Center [email protected] |
 Erin Gasser, MS, AG-ACNP-BC, CCRN MS, UCSF School of Nursing BSN, University of Michigan BS, University of Michigan [email protected] |
 Rubi A. Hickson, RN, CCRN, MS, ACNP-BC MS, University of Connecticut BSN, Biola University [email protected] |
 Kenneth Johnson, ACNP-BC MSN, University of California, San Francisco BSN, Indiana University [email protected] |
Kristina Kordesch, ACNP-AG MSN, Columbia University, New York BSN, Columbia University, New York BS, University of California, Davis [email protected] |
 Geoffrey Howland Latham, ACNP-BC Assistant Clinical Professor UCSF MSN, University of California, San Francisco BSN, University of North Carolina, Wilmington [email protected] |
 Stacy Mills, ACNP-BC MSN, University of California, San Francisco BSN, University of San Francisco [email protected] |
 Gil Ponsones, ACNP-BC MSN, Wayne State University BSN, Centro Escolar University, Manila, Philippines [email protected] |
 Jennifer Schwarz, MS, ACNP-BC MS, Columbia University BS, Columbia University BA, University of California, Berkeley |
Brianna Sparrow, AG-ACNP-BC MSN, University of California, San Francisco BSN, Azusa Pacific University [email protected] |
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 [email protected] |
 Matthew White, ACNP-BC MSN, University of California, San Francisco BSN, University of Alabama at Birmingham [email protected] |
 Erika Wilson, RN, MS, ACNP-BC MS, University of California, San Francisco BSN, California State University, Long Beach [email protected] |
Per Diem
 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 |
 Todd Johnson, MS, ACNP-BC, CEN MS, University of California, San Francisco BS, University of Massachusetts, Boston [email protected] |
 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 [email protected] |
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
- 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
Please visit our Critical Care Medicine Fellowship page
Welcome to the Critical Care Rotation
Our intention is to have everyone go through a formal orientation on the first Monday of the month.
Please feel free to contact any attending on the ICU service if you have further questions.
Role of Mucus in Acute Asthma:
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
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
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
Director, Anesthesia Critical Care Fellowship
Executive Director, Critical Care Medicine
Director, Medicine Critical Care Fellowship
Fellowship Coordinator
Anesthesia Critical Care Fellowship
[email protected]
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