Critical Care – About our CAG

About the Critical Care CAG

The vision of the CAG is to establish a collaboration with a national and international reputation for high quality clinical research and teaching, and ensuring that our patients benefit from this environment.  We want to build on the current reputation of RSCH, through SPACeR, being a good place for industry and other sponsors to come with large internationally important trials, extending this to ASPH over time. We also intend to increase the number of (joint) grant applications for NIHR etc. from CAG members going forward. We recognise the ambitions of the NHS locally, through the AHSN and new LCRN, to increase the number of Chief and Principal Investigators in Surrey, and work with colleagues across the region to achieve this. We aim to develop high quality teaching and learning programmes (including post graduate research degrees) in this exciting specialty over time.

Our Aims

  • A collaboration with national and international reputation for high quality clinical research and teaching
  • Build the number of joint grant applications to the NIHR and other awarding funding bodies
  • To increase the number of PI’s and CI’s in Surrey as we build the success of our CAG

Our Work


  • Microhepflow: Pilot study of microvascular monitoring during liver resection surgery

Background and study aims 
During liver resection surgery the medical team will manipulate the circulation (blood pressure etc) in order to minimise blood loss. Routine clinical monitoring during liver resection surgery includes heart rate, blood pressure and measures of cardiac output. Microcirculatory monitoring is an investigation technique that measures flow through the smallest blood vessels (capillaries) and this information might be an important determinant of complications. In the future microcirculatory monitoring could guide therapy. This study will look at the microcirculation before, during and after liver resection surgery to see if it provides clinically relevant information.

Who can participate? 
Patients undergoing elective liver resection surgery.

What does the study involve?
Taking part in this study will not affect your care in any way. It is simply gathering further information which may eventually help us tailor our practice better for individual patients. Before your operation we will place a very small camera-type device under your tongue to collect information on blood flow in the small blood vessels in the tongue. We will repeat these measurements after you have been put to sleep but before the operation has started, during surgery when the liver is first exposed, at the time they have finished removing part of the liver, when you first arrive at intensive care, and later on in intensive care after you have received some fluids through a drip. We will also place this device on your liver during the surgery to measure the blood flow in the small vessels in the liver when it is first exposed and again after part of the liver has been removed. During surgery the camera will be covered in a sterile plastic sheath to ensure there is no risk of introducing infection. This will be the same method we would use to prevent infection when introducing instruments for keyhole surgery. During some of these measurements you will be awake and the sensation would be similar to a thermometer being placed under the tongue. This will not be there continuously but for a period of minutes to gain readings of the blood flow. You will be unaware of measurements taken during the surgery as you will be anaesthetised (asleep).

What are the possible benefits and risks of participating? 
There will be no direct benefit or risk to you personally in this study. We will collect information enabling us to better understand blood flow in the small blood vessels (capillaries) of patients undergoing liver resection and whether this relates to patient outcomes. The information gained from this study could provide the basis for future studies looking at different treatments for patients based on the blood flow in their small blood vessels, which may improve patient care. The camera-type device used may be slightly uncomfortable when placed under the tongue, similar to a thermometer being placed under the tongue. It will not be painful and you can choose to withdraw from the study at any point. All your care relating to the surgery will be carried out identically whether you participate in the study or not.

Where is the study run from? 
Royal Surrey County Hospital (UK).

When is the study starting and how long is it expected to run for?
From December 2014 to December 2015.

Who is funding the study? 
Surrey Health Partners and Surrey Peri-operative Anaesthetic Critical care colaboraive Research group (SPACeR) (UK).

Who is the main contact?
Dr Ben Creagh-Brown

  • MAMAs– Muscle wAsting in Major Abdominal Surgery



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