Mar 28, 2017

Emergency Medicine: Heart and Stroke Foundation Clinician-Scientist, Dr. Steve Lin

Emergency Medicine
Steven-Lin.jpg

Steven-Lin.jpg
Congratulations to Steve Lin (Emergency physician, Trauma Team Leader and scientist, St. Michael’s Hospital), the recipient of the Heart and Stroke Foundation of Canada (HSFC) 2017/18 Ontario Clinician-Scientist Award (Phase I). These awards were established to build cardiovascular and cerebrovascular (CCVD) health research capacity in Ontario by providing salary support to highly qualified individuals to protect professional time for research that will prevent disease, improve health outcomes, and reduce the burden of illness and disability.

Over the next four years, Steve, along with one  of his mentors, St. Michael’s cardiologist Paul Dorian, and Ryerson physicist, Vladislav Toronov, will be developing and validating the use of a novel near-infrared spectroscopy (NIRS) device to monitor and optimize cerebral oxygenation and aerobic metabolism during cardiac arrest resuscitation.

Why is this Important?

Over 40,000 Canadians suffer out-of-hospital cardiac arrests each year. Despite advances in medical treatment, overall survival rates remain low. Approximately two-thirds of patients die from neurological injuries during their intensive care admission, which are due to prolonged ischemia and subsequent reperfusion injury. Currently, there is no accepted approach to monitor or measure cerebral perfusion and oxygenation during cardiac arrest resuscitation. As such, there is a need for real-time monitoring of cerebral perfusion and oxygenation that can allow for goal-directed therapy to reduce the incidence of post-cardiac arrest brain injury and brain death.

Importance of Mentorship

Steve crystalized his passion for research and becoming a clinician-scientist after spending three summers during his undergraduate studies with St. Michael’s nephrologist Philip Marsden and his lab as a summer research student, exploring the genetic regulation of nitric oxide production and its role in cardiovascular disease. Throughout his tenure, he not only earned two co-author publications, but several research awards, including from HSF Student Research Scholarship. Upon entering EM residency in 2007, Steve developed an interest in clinical research, particularly in resuscitation science and joined Laurie Morrison and Steven Brooks at Rescu, where he  made important contributions to the Strategies for Post Arrest Resuscitation Care (SPARC) Network Trial of 37 hospitals, including developing and testing a web-based data collection interface, which still serves as the largest post-resuscitation registry in the world. He also concurrently completed his master's in Clinical Epidemiology examining the associations between the processes of care related to targeted temperature management on patient survival and neurological outcome after out-of-hospital cardiac arrest, which was supported by Physicians' Services Incorporated (PSI) Resident Research Grant (as principal investigator) and earned him the American Heart Association Young Investigators Award and the Canadian Association of Emergency Physicians Top New Investigator Award. He subsequently published this work in critical care medicine.

Rescu Leadership

It is important to note, that without the right mentorship, leadership and infrastructure, salary awards, such as Steve’s would not be possible. We are fortunate to have Canada’s largest clinical research resuscitation program housed within St. Michael’s – Rescu focuses on the evaluation and implementation of prehospital, time-sensitive interventions in acute emergencies. At the helm of Rescu is Laurie Morrison, the Robert & Dorothy Pitts Research Chair in Acute Care & Emergency Medicine, professor and clinician-scientist in the Division of Emergency Medicine, Department of Medicine at U of T, and Li Ka Shing Knowledge Institute at SMH. Laurie’s expertise in clinical trials management, as well as her proven collaborative research nature in a range of in- and out-of-hospital funded projects (as PI and as a co-investigator), has made her a sought after mentor and world leader in resuscitation science, who has been recognized through countless of awards. We in the ED at SMH and across the division are fortunate to count her as a colleague, supporter and mentor.