Ewan Goligher, MD, PhD

Senior Scientist, Toronto General Hospital Research Institute (TGHRI)

https://orcid.org/0000-0002-0990-6701
Keywords: acute respiratory distress syndrome (ARDS), mechanical ventilation, respiratory muscle function

Dr. Goligher is an Associate Professor in the Interdepartmental Division of Critical Care Medicine at the University of Toronto and a Clinician Scientist at the University Health Network. After studying biochemistry and medicine at the University of British Columbia, he training in internal medicine and critical care medicine at the University of Toronto. He subsequently earned a doctoral degree in physiology from the University of Toronto, focusing on mechanisms of diaphragmatic dysfunction during mechanical ventilation. His research program is focused on characterizing the mechanisms and impact of injury in the lung and diaphragm during mechanical ventilation, and on employing innovative clinical trial designs to test lung and diaphragm-protective ventilation strategies.

My laboratory studies the mechanisms and impact of lung and diaphragm injury during mechanical ventilation. We are specifically focused on optimizing patient-ventilator interaction to accelerate recovery and improve long-term outcome in acute respiratory failure. We employ techniques in translational science, physiology, imaging, clinical epidemiology, and Bayesian statistics to characterize the link between mechanical ventilation and outcome in acute respiratory failure. Our mission is to improve outcomes for patients around the world through innovative approaches to ventilatory support.

Dr. Goligher is currently working on the following studies:

 

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Associated Program(s)

STIMULUS: A randomized clinical trial of diaphragm pacing in patients on life support for breathing failure

Study Status: Completed
Study Purpose: This study assessed the use of gentle electrical pulses to temporarily stimulate the diaphragm muscle to contract in patients on a breathing machine. The gentle electrical pulses were delivered through a special catheter.
Background: Mechanical ventilation (the 'breathing machine') and sedation are common life-saving methods used to help patients with breathing problems, especially those with lung failure. However, these treatments suppress the patient’s natural breathing rhythm and stop the diaphragm (the main breathing muscle) from contracting. When the diaphragm stops contracting, several problems may rapidly develop. These include diaphragm muscle weakness, poor blood circulation, lung deflation and lung injury. These problems can slow down a patient’s recovery and prolong their need to stay on the “breathing machine”. This also increases their risk of death or long-term disability.
Study Methods: For our study, we equipped 19 patients on mechanical ventilation with a special catheter. The catheter had  electrodes that connected directly to the phrenic nerve. Through this catheter, gentle electrical pulses were delivered to the phrenic nerve, to cause the diaphragm muscle to contract in sync with the ventilator.
Key Findings: This was a first in-human trial of this strategy. The diaphragm was successfully stimulated and all patients were kept artificially breathing for as long as they were on the ventilator. Overall, the study procedure was considered safe. The ability to temporarily stimulate the phrenic nerve to keep the diaphragm contracting is a promising strategy. It has the potential to reduce the negative effects of mechanical ventilation on the diaphragm, lungs, and circulation. Studying this for the first time in humans, will lead to future research to test the benefit of this strategy for survival, recovery, and quality of life.
Health Conditions: Lungs & Breathing conditions

 

For a list of Dr. Goligher's publications, please visit PubMed, Scopus or ORCID.

Senior Scientist, Toronto General Hospital Research Institute (TGHRI)

Associate Professor, Department of Medicine, University of Toronto