Lawrence Lewis Lab
My work in traumatic brain injury (TBI) has evolved over the past decade and a half from biomechanical models of TBI, and the use of accelerometers to determine g forces, and the study of methods to attenuate these forces; to the diagnosis of mild to moderate TBI using serum biomarkers. Our work has spanned sports from cycling to soccer to football.
Our current work, which is funded by the Department of Defense, looks at the use of certain novel biomarkers to help to diagnose brain injury. We hope this work will lead to sensitive and specific marker of neuronal injury which can be performed on a variety of platforms for civilians and military personnel alike.
Besides our clinical studies in TBI, I have also had a longstanding interest in asthma and anaphylaxis. Although TBI and asthma/anaphylaxis may seem quite disparate, I have found considerable common ground regarding the application of clinical research principles to our emergency department population. Regarding our asthma trials, our group has studied the efficacy of various therapeutic modalities from intravenous leukotriene inhibitors, to novel beta agonists, to vagal stimulation in the treatment of acute exacerbations of asthma. Last year our group, along with others, were the first to demonstrate the feasibility of vagal nerve stimulation in subjects with acute asthma exacerbation, and presented pilot data showing significant improvement in FEV1.
||Utrasound image during device insertion. CA = carotid artery;
IJ = internal jugular vein; SA = introducer/sheath assembly; T = trachea.
Although the association between beta agonists and elevated serum lactate concentration had been described previously, our group was the first to quantify the effect of inhaled beta agonists on serum lactate concentration in patients with an acute exacerbation of asthma.
Finally, our research team has also helped perform a number of important clinical studies in the past couple of years. The ATTRACT trial (Acute venous Thrombosis: Thrombus Removal with Adjunctive Catheter-directed Thrombolysis) is the largest RCT to date to compare the use of pharmamechanical catheter-directed thrombolysis to usual care (anticoagulation) for the prevention of post-thrombotic syndrome in patients with proximal DVT.
We were also a leading site for the first clinical trial to evaluate the efficacy of ecallantide (a plasma kallikrein inhibitor) in the treatment of angiotensin converting enzyme inhibitor-induced angioedema; the most common cause of angioedema seen in US emergency departments.
Lawrence Lewis, MD
Professor, Division of Emergency Medicine
Washington University School of Medicine
660 South Euclid Avenue
Campus Box 8072
St. Louis, MO 63110