Hypothalamic-pituitary-adrenal (HPA) axis function and dysfunction

The cause of major complications after surgery and the root cause of many critical illnesses are inflammation - like the inflammation that occurs after a sprained ankle. Instead of occurring in a small area, as in a sprained ankle – it occurs across the whole body (Systemic Inflammatory Response – SIRS) leading to failure of the body’s organs. The steroid hormone cortisol protects the body from excessive inflammation after heart surgery.

Dr Gibbison leads and participates in a wide range of bench-to-bedside work to understand how cortisol is controlled after major surgery and in critical illness. This encompasses mechanistic studies regarding adrenal control in cell culture, experimental medicine studies in patients and through to evidence synthesis with meta-analyses used in guideline synthesis. (A video explaining this work can be found here). With partners from Imperial College and Designworks Ltd, he is developing a blood free, continuous cortisol monitor. Work in this stream is funded by the NIHR, The British Heart Foundation, The BBSRC, The EPSRC and the David Telling Trust.

Neurological Dysfunction

Neurological dysfunction after cardiac surgery and in critical illness is common. For most of those affected, symptoms will be mild such as short-term confusion or memory problems. Although rare, symptoms of brain injury can be more serious such as a stroke and it has been suggested that brain injury may also trigger dementia. Dr Gibbison leads studies which aim to prevent and manage all types of central neurological dysfunction. This includes preventing and managing delirium, as well as preventing strokes after cardiac surgery (CO-TWO Trial). Work in this stream is funded by the NIHR and The David Telling Trust.

Other work

Dr Gibbison leads (e.g. The GAP Study) and participates in (e.g. Prompt2, Prehab-UK) multiple NIHR funded clinical trials / studies that aim to improve outcomes across the peri-operative and critical care pathways. He collaborates with mathematicians and statisticians to answer diverse questions in these pathways (including the place of machine learning in the ICU and optimal ways to manage cardiovascular waiting lists in the NHS).

Other Academic Posts

• Lead Year 3 MBChB Peri-operative and Critical Care (PCC)                                                     
• Lead Year 5 MBChB Acute and Critical Care Assistantship                                      
• Fitness to Practise Case Investigator                                                                                               
• Lead for Clinical Academic Appraisal

External Posts

Associate Editor, Anaesthesia