Patrick Murphy

Background:

Originally from Eastern Canada, Patrick completed his medical degree at Queen’s University. He is currently a PGY-4 in General Surgery at Western University.  During his 3^rd year of residency he completed his Masters of Science in Surgery at Western University and a Masters of Public Health from Johns Hopkins University. His research focus lies in Trauma, Acute Care Surgery and Critically Ill (ICU) patients. Within these domains he is interested in quality of healthcare delivery and the use of large datasets to characterize variability within health systems and indicators of high-quality surgical and non-surgical care. Additionally, during his residency Patrick has completed two randomized control trials on the use of negative pressure wound therapy on primarily closed surgical incisions to prevent surgical site infections.

Patrick is planning to complete a fellowship in Trauma, Acute Care Surgery and Surgical Critical Care.

Research Summary:

Patrick’s thesis was a combination of a prospective observational study on the incidence of intra-abdominal hypertension in a mixed medical-surgical ICU and a basic science study in rats on novel therapeutics for abdominal compartment syndrome.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are increasingly recognized clinical entities in the critically ill patient. IAH is the sustained or repeated pathological elevation of intra-abdominal pressure (IAP) to ?12mmHg and persistent increases can severely impact end-organ function in critically ill patients. The incidence of IAH has not been previously well characterized using standard measurement techniques and definitions. Our study consisted of nearly 300 consecutive patients and demonstrated an incidence of 45%. Further, IAH was an independent predictor of ICU mortality (OR 2.95) even when controlling from other variables in a regression analysis.

Abdominal compartment syndrome (ACS) results in significant organ dysfunction and is associated with considerable mortality (80%) even with decompressive laparotomy. Carbon monoxide (CO) and hydrogen sulphide (H2S)-releasing molecules (CORM-3 and GYY4137, respectively) have been shown to be potent anti-oxidant and anti-inflammatory agents at the tissue and systemic level. We induced 2 ours of ACS in 19 rats and prior to decompression gave the animals either CORM-3, GYY4137 or a non-active vehicle. We used a sham control with animals who did not undergo ACS. We demonstrated that the organ dysfunction associated with ACS is severe and we demonstrated the effect of both CO and H2S, on tempering the ACS-associated metabolic and organ derangement. CORM-3 demonstrated a greater effect than GYY4137, and was able to restore most of the measured parameters to levels comparable to sham.

This work has been submitted to the Journal of Trauma and Acute Care Surgery and the Journal of Surgical Research

Selected Publications:

Murphy PB, Vogt KN, Mele TS, Hameed SM, Ball CG, Parry NG and WORC-ACS. Timely surgical care for acute biliary disease: An indication of quality. Annals of Surgery. 264(6):913-914, 2016

Murphy PB, Paskar D, Racz J, Parry NG, Leslie K, Mele T. Implementation of an acute care surgery service facilitates modern clinical practice guidelines for gallstone pancreatitis to be met – A retrospective study. Journal Amer Coll Surg. 221(5):975-981, 2015

Murphy, PB. Intra-abdominal Hypertension and Abdominal Compartment Syndrome (2016). Electronic Thesis and Dissertation Repository. 3786. http://ir.lib.uwo.ca/etd/3786