Curriculum Vitae

Name: John Kinsella

Qualifications: M.B., B.S. , F.R.C.A., M.D.

Present Appointment:

Professor and Head of Section of Anaesthesia, Pain & Critical Care Medicine, University Of Glasgow
Lead Consultant in ICU, Glasgow Royal Infirmary
Consultant in Anaesthesia and Intensive Care, Glasgow Royal Infirmary

Research Topics

Intensive care

Lead Consultant for Intensive Care, Glasgow Royal Infirmary. I lead a team of 6 consultants at GRI and am Chairman of the Critical Care Delivery Group. I provide care for some of the most deprived patients in the UK, with serious co-morbidity. The care provided is firmly based on Evidence Based Medicine. I contribute to the development o the local EBM guidelines and nationally through my role in SIGN. The ICU outcomes are carefully audited and we have low mortality rates compared to national averages. I am a leading expert of the management of the critically ill burned patient.

Management of burns patients

Includes accurate diagnosis, resuscitation and initial management. I have an interest in improving analgesia for burn patients and perioperative management. I have many years of experience anaesthetising patients with major burns. I have also changed the feeding protocols for burns patients in the Royal Infirmary to use more aggressive early enteral feeding.

I introduced fibre-optic intubation for the management of the difficult airway at Glasgow Royal and taught this technique locally and nationally.

I have personally made a number of significant research observations. These include:

• I was the first person to document a relationship between smoke inhalation and asthma. This observation was important for fire victims but this was subsequently found to occur in victims of the September 11th explosions, the reports of which quoted my original work.
• I performed pain studies on burns patients, in which I was the first person to use patient controlled analgesia in this setting and performed studies that documented a very variable but often a very high requirement for opioids. The result of this work is that burns victims now are more likely to receive sufficient analgesia and that the regimens are flexible according to their needs.
• I performed studies that finally refuted previous work that erroneously suggested that it was possible to achieve pre-emptive analgesia in humans. This understanding leads to an avoidance of techniques that may provide inadequate analgesia.
• My studies on non-steroidal analgesia were used in national guidelines.
• My current work on vitamins, as part of a multidisciplinary group, is improving the assessment of nutritional status and the effect of interventions in the critically ill.
• My work on respiratory physiology has improved the measurement of work of breathing, improved the understanding of the effects of oxygen on physiology and calls into question many studies on the effects of drugs that did not allow for the effects of supplemental oxygen. The current studies we are performing on the critically ill will further help the understanding of the effects on acute illness on cardio-respiratory outcomes.
• My work on errors in information in ICU highlighted a low but significant risk of error. This led to a massive investment in information technology in our Unit and the proposed research with the Department of Computing at Aberdeen may further refine this and develop predictive tool to be used in real time. The Study funded by the EU, for which I was the clinical lead in Glasgow, developed the technology which in now the standard across Europe and allows this type of information to be collected.
• In 1999 I set up the Scottish Intensive Care Society multicentre research group which has led to the collaboration of all the ICUs in Scotland in planning and performing research.

Current Research Themes

I currently lead or take part in several research projects all of which are based on the study of the physiological response to critical illness. The overall theme of this research is the effect of acute illness and interventions on cardiovascular and respiratory function and the consequent effect on morbidity and mortality. This is consistent with the research themes in Glasgow University, especially inflammation and cardiovascular disease. The emphasis is on the effects in patients with severe co-morbidities typical of the East End of Glasgow. This research would also be highly relevant to a possible future theme of Glasgow University Medical School in “Acute Medicine”

Cardiorespiratory physiology applied to anaesthesia and intensive care. I am supervising an M.D. student. We are investigating the role of cardiopulmonary exercise testing as a predictor of perioperative complications and also the recovery from physiological effects of ICU and major surgery. This is a follow up of the many studies we have performed in respiratory physiology.

Inflammation and nutrition in critical illness. I am supervising a PhD student. In this project we are instituting new methods of assessing nutritional status and the response to vitamin and micronutrient replacement. I am also part of a collaboration to investigate a novel agent to improve pulmonary compliance and clearance of secretions in ARDS. The company developing this agent has received £1M venture capital funding in June 2007 and research proposal will be developed for 2008.

I am leading a group, in collaboration with Prof Sleeman (Aberdeen University) investigating the changes in physiological parameters in response to treatment to predict subsequent outcomes. This will be the main study in the MD of my current Lecturer.

I am the lead of a proposed European Study into resuscitation and fluid management in pancreatitis. This study was devised in 2007. I am also a co-instigator of a multicentre study, which has just recently been funded investigating fluid and level of care following major surgery. Both these studies follow up to the study of fluid optimisation, and will be facilitated by the structure for multicentre critical care research that I established when I became a Senior Lecturer.

In addition, the development of a Scottish Managed Clinical Network for Burns (which I also took a significant role) will be an opportunity to develop major studies. I lead the data collection and audit group in this network.

In collaboration with an NHS consultant colleague I am undertaking a series of studies on ethics in ICU. This interest has developed from the many ethical challenges that present in managing critical illness and in conducting research in this environment.

Recent Grants and Awards

Chief Scientists Office £225,000 2007 Co-investigator Aberdeen/Glasgow Study
Pragmatic RCT
NHS and Private Hospitals, £300,000; (via Glasgow University) 2002-2007
Several research fellows (Dr R Black, Dr T Quasim, Dr A Hay, Dr P Glen, Dr G Becker) employed for 1 year each part time by these hospitals for clinical work and the rest of the time allocated for research. Overall funding transferred to Glasgow University
Royal College of Anaesthetists £500 2004 (with Hay D)
Cytomegalovirus in Critical Illness
Chief Scientists Office £26,285 2004-2006 (with Evans TJ)
The Influence of a Dominant Toll-like Receptor 5 Stop Codon Polymorphism on the Development of Infection in Critically Ill Patients
Chief Scientists Office £ 14,500 2003-2005 (with Harten J, McMillan D)
Fluid optimisation
Chief Scientists Office £85,000 and further £20,000 2000 (with Johnson M)
Respiratory physiology in ICU.
European Society of Anaesthesia (ESA) €15,000 2001 (with Harten J)
Preoptimisation
European Union €1,000,000 2000 (multicentre Glasgow/Madrid/Toledo)
Computing in ITU, approx £100,000 to GRI
GRI Endowments £24,700 1998-2001 (with McMillan D)
ITU albumin research

Publications

2007
Kinsella J, Booth MG.   End of Life Decisions in Intensive Care.   Journal of the National Institute of Public Health 2007 Vol.56(3): pp
Litchfield K, Harten JM, Anderson KJ, Kinsella J, McGrady EM.   The Effect of Oxygen on Cardiac Function in Healthy Full-term Women.   Anaesthesia 2007. 62(9): 931-935.
Johnson MK, Birch M, Carter R, Kinsella J, Stevenson RD.   Measurement of Physiological Recovery from Exacerbation of Chronic Obstructive Pulmonary disease using Within-breath Forced Oscillometry.   Thorax 2007. 62(4): 299-306. PMID: 17105778

2007 In submission
Vasilaki AT, McMillan DC, Kinsella J, O'Reilly D, Duncan A, Talwar D.   Assessment of B-complex vitamin concentrations in patients with critical illness: Plasma, red cell or white cell?   Clin Chem 2007 - completed to submit Aug 07
Jack ES, Shaw M, Harten JM, Anderson K, Kinsella J.   Cardiovascular changes after achieving constant effect site propofol concentration.   Anaesthesia 2007 - completed to submit Aug 07
Quasim T, McMillan D, Talwar D, O'Reilly D, Kinsella J.   Serum B2-microglobulin, Urinary Albumin, Urine Albumin clearance /B2 Microglobulin Clearance Ratio and Mortality in the Critically-ill surgical patient.   J Clin Path 2007 - redrafting
Johnson M, Carter R, Higgins M, Kinsella J, Stevenson R.   Evaluation of two methods for measuring respiratory elastance in spontaneously breathing subjects.   European Respiratory Journal 2007 - in submission Aug 07
Harten J, Anderson K, Berry C, Rankin A, Kinsella J.   Cardiovascular effects of normobaric hyperoxia in patients with a permanent pacemaker.   Cardiovascular Research 2007
Harten J, Crozier J, McCreath B, Hay A, McMillan D, McArdle C, Kinsella J.   Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery; a randomised controlled pilot study.
Vasilaki AT, McMillan DC, Kinsella J, O'Reilly D, Duncan A, Talwar D.   Assessment of B-complex vitamin concentrations in patients with critical illness: Plasma, red cell or white cell? Clin Chem 2007 - completed to submit Aug 07
Jack ES, Shaw M, Harten JM, Anderson K, Kinsella J.   Cardiovascular changes after achieving constant effect site propofol concentration.   Anaesthesia 2007 - completed to submit Aug 07
Quasim T, McMillan D, Talwar D, O'Reilly D, Kinsella J.   Serum B2-microglobulin, Urinary Albumin, Urine Albumin clearance / B2 Microglobulin Clearance Ratio and Mortality in the Critically-ill surgical patient.   J Clin Path 2007 - redrafting
Johnson M, Carter R, Higgins M, Kinsella J, Stevenson R.   Evaluation of two methods for measuring respiratory elastance in spontaneously breathing subjects.   European Respiratory Journal - 2007 - redrafting
Johnson M, Carter R, Kinsella J, Stevenson RD.   Longitudinal predictors of survival in interstitial lung disease.   European Respiratory Journal - in submission Aug 07
Harten J, Anderson K, Berry C, Rankin A, Kinsella J.   Cardiovascular effects of normobaric hyperoxia in patients with a permanent pacemaker.   Cardiovascular Research 2007
Harten J, Crozier J, McCreath B, Hay A, McMillan D, McArdle C, Kinsella J.   Effect of intraoperative fluid optimisation on renal function in patients undergoing emergency abdominal surgery; a randomised controlled pilot study.   British Journal of Anaesthesia - being re-submitted
Smith S, Harten J, Jack E, Carter R, Kinsella J.   Preoxygenation in healthy volunteers: A randomised cross-over study comparing supine and 45° seated position   British Journal of Anaesthesia - being re-submitted

2006
Harten J, Hay A, McMillan D, McArdle C, O'Reilly D St J, Kinsella J.   Postoperative serum urea concentration is associated with 30-day mortality in patients undergoing emergency abdominal surgery.   Annals of Clinical Biochemistry 2006: 43; 295-299. PMID 16824280
Kinsella J, Anderson K, Harten J.   Cardiovascular changes after induction of anaesthesia.   Anaesthesia. 200;61(1): 66-7. PMID: 16409348
Anderson K, Gambhir S, Glavin R, Kinsella J.   The use of an anaesthetic simulator to assess single use laryngoscopy equipment.   International Journal for Quality in Heath Care 2006; 18: 17-22. PMID 16287900

2005
Anderson K, Harten J, Booth M, Kinsella J.   The cardiovascular effects of inspired oxygen fraction in anaesthetised patients.   European Journal of Anaesthesia   2005: 22: 420-425.
Walsh TS, McClelland DB, Lee RJ, Garrioch M, Maciver CR, McArdle F, Crofts SL, Mellor I, Kinsella J et al.   Prevalence of ischaemic heart disease at admission to intensive care and its influence on red cell transfusion thresholds: Multicentre Scottish study.   British Journal of Anaesthesia. 2005: 94: 445-452
Booth M, Lind A, Read E, Kinsella J.   Public perception of emergency research.   European Journal of Anaesthesiology. 2005; Vol. 22(12) 933-937. PMID 16318665
Quasim T, McMillan D, Talwar D, Vasalaki A, O'Reilly D, Kinsella J. The relationship between plasma and red cell B-vitamin concentrations in critically ill patients.    Clinical Nutrition 2005: 24; 956-960. PMID 16054730
Johnson M, Birch M, Carter R, Kinsella J, R Stevenson.   Use of reactance to estimate transpulmonary resistance. Evaluation of two methods for measuring respiratory elastance in spontaneously breathing subjects.   European Respiratory Journal 2005. 25; 1061-1069.
Harten J, Anderson K, Kinsella J, Higgins M.   Normobaric hyperoxia reduces cardiac index in patients after coronary artery bypass surgery.   Journal of Cardiothoracic Vascular Surgery 2005;19: 173-175.
Harten J, McCreath B, McMillan D, McArdle C, Kinsella J.   The Effect of Gendere on Postoperative mortality following emergency abdominal surgery.   Gender Medicine 2005; 2: 35-40.

2004
Booth M, Docherty P, Fairgreave R, Kinsella J.   Relatives knowledge of decision making in ICU.   Journal of Medical Ethics 2004: 30: 459-462
Walsh TS, Garrioch M, Maciver C, Lee RJ, MacKirdy F, McClelland DB, Kinsella J, Wallis C.   Audit of Transfusion in Intensive Care in Scotland Study Group. Red cell requirements for intensive care units adhering to evidence-based transfusion guidelines.   Transfusion 2004: 44(10):1405-1411.
Booth M, Woolrich L, Kinsella J.   Audit of family witnessed resuscitation in UK emergency departments.   Eurpean Journal of Anaesthesia 2004; 21: 725-728
Quasim T, McMillan DC, Wallace AM, and Kinsella J.   The relationship between leptin concentrations, the systemic inflammatory response and illness severity in surgical patients admitted to ITU.   Clinical Nutrition 2004, 23, 233-238.
Kinsella J.   M.D. Thesis. Clinical Studies in Acute Pain.   University of Glasgow 2004.
Black R, Woolman P, Kinsella J.   Variation in the transcription of laboratory data in an intensive care unit.   Anaesthesia 2004. 59: 767-769.
Harten J, Kinsella J.   Perioperative Optimisation.   Scottish Medical Journal 2004 49(1): 6-9. (editorial)

2003
Harten JM. Anderson KJ. Angerson WJ. Booth MG. Kinsella J.   The effect of normobaric hyperoxia on cardiac index in healthy awake volunteers.   Anaesthesia 2003. 58(9): 885-8.
Quasim T, McMillan DC, Talwar D, Sattar N, O'Reilly DStJ, Kinsella J.   Lower concentrations of caretinoids in the critically ill patient are related to a systemic inflammatory response and increased lipid peroxidation.   Clinical Nutrition 2003. 22(5): 459-62.
Talwar D, Quasim T, McMillan DC, Kinsella J, Williamson C, O'Reilly DS.   Pyridoxal Phosphate Decreases in Plasma but not Erythrocytes during Systemic Inflammatory Response.   Clinical Chemistry. 2003. 49(3): 515-518.
Talwar D, Quasim T, McMillan DC, Kinsella J, Williamson C, O'Reilly DS.   Optimisation of a sensitive high performance liquid chromatography assay for pyridoxal 5-phosphate in human plasma and erythrocytes using pre-column semicarbazole derivatisation .   Journal of Chromatography B 2003. 792(2): 333-43.

2002 AND PRIOR
MacGregor G, Smith AJ, Thakker B, Kinsella J.   Yoghurt Biotherapy; Contraindicated in immunosuppressed patients.   Postgraduate Medical Journal 2002. 78(920): 366-7.
Quasim T, McMillan DC, Kinsella J.   Negative fluid balance as a predictor of mortality.   Chest   2001. 120(4); 1424-5.
Gallagher G, Rae CP, Watson S, Kinsella J.   Target-controlled alfentanil analgesia for dressing change following extensive reconstructive surgery for trauma.   Journal of Pain & Symptom Management 2001; 21(1): 1-2.
Gallagher G, Rae C, Kenny G, Kinsella J.   The use of a target controlled infusion of alfentanil to provide analgesia for burn dressing changes - a dose finding study.   Anaesthesia 2000; 55: 1159-1163.
Rae R, Kinsella J, Daniel M, Booth M.   The palm print as predictor of difficult intubation.   Acta Anaesthesiol Scand. 2001 Sep;45(8):1053. PMID: 11576065
Rae CP, Gallagher G, Watson S, Kinsella J.   An audit of patient perception compared with medical and nursing staff estimation of pain during burn dressing changes.   European Journal of Anaesthesiology 2000; 17: 43-45.
Oliver MF.   Effect of Mivazerol on Perioperative Cardiac Complications during Non-cardiac Surgery in Patients with Coronary Heart Disease - The European Mivazerol Trial (EMIT).   Anesthesiology 1999. 91(4):951-61. PMID: 10519497 (part of mulicentre group on behalf of whom published)
Rae CP, Mansfield MD, Dryden C, Kinsella J.   Analgesic effect of adenosine on ischaemic pain in human volunteers.   British Journal of Anaesthesia 1999; 82: 427-428.
Williams L, Fletcher GC, Kinsella J.   A simple in vitro method for evaluating the efficiency of ultrasonic nebulisers when used to deliver drugs to intubated, ventilated patients and the effect of nebuliser and ventilator settings on the uptake of fluid from the nebuliser chamber.   European Journal of Anaesthesiology 1999; 16: 479-484.
Booth MG, Quasim I, Kinsella J.   In-flight Medical Emergencies: Response of Anaesthetists who were passengers on commercial flights.   European Journal of Anaesthesiology 1999; 16: 840-842.
Millar AY, Mansfield MD, Kinsella J.   Influence of timing of morphine administration on postoperative pain and analgesic consumption.   British Journal of Anaesthesia 1998; 81: 373-376.
Mansfield M, Russell D, Kenny GC, Kinsella J.   An investigation of the effect of ondansetron on time to induction of anaesthesia with thiopentone and propofol.   European Journal of Anaesthesiology 1997; 14: 24-28.
Mansfield MD, James KS, Kinsella J.   Influence of dose and timing of administration of morphine on postoperative pain and analgesic requirements.   British Journal of Anaesthesia 1996; 76: 358-361.
Mansfield MD, Kinsella J.   Use of invasive cardiovascular monitoring in patients with burns greater than 30 per cent body surface area: A survey of 251 centres.   Burns 1996; 22: 549-551.
Mansfield MD, Firth F, Glynn C, Kinsella J.   A comparison of ibuprofen arginine with morphine sulphate for pain relief after orthopaedic surgery.   European Journal of Anaesthesiology 1996; 13: 492-497.
Mansfield MD, Russell D, Kenny GNC, Kinsella J.   Effect of ondansetron on anaesthetic induction times with thiopentone and propofol.   European Journal of Anaesthesiology 1996; 13: 205-206.
Inglis A, Hinnie J, Kinsella J.   A metabolic complication of severe burns.   Burns 1995; 21: 212-214.
Davidson JAH, Kinsella J, Imrie CW.   Mumps virus infection.   British Journal of Intensive Care 1994: 4(6), 196-198.
Kinsella J, Moffat AC, Patrick JA, Prentice JW, McArdle CS, Kenny GNC.   Ketorolac trometamol for postoperative analgesia after orthopaedic surgery.   British Journal of Anaesthesia 1992; 69: 19-22.
Kinsella J, Carter R, Reid WH, Campbell D, Clark CJ.   Increased airways reactivity after smoke inhalation.   Lancet 1991; 337: 595-597.
Riyami BS, Kinsella J, Pollok J, et al.   Alveolar macrophage chemotaxis in fire victims with smoke inhalation and burns injury.   European Journal of Clinical Investigation 1991; 21: 485-489.
Riyami BS, Tree R, Kinsella J, et al.   Changes in alveolar macrophage, monocyte, and neutrophil cell profiles after smoke inhalation injury.   Journal of Clinical Pathology 1990; 43-45.
Kinsella J, Glavin R, Reid WH.   Patient-controlled analgesia for burn patients: A preliminary report.   Burns 1988; 14(6): 500-503.

Invited Reviews in Peer Reviewed Journals
Black RG, Kinsella J.   Anaesthetic management for burn patients.   British Journal of Anaesthesia. CPD Reviews. 2001; 1(6); 1-4.
Gallagher G, Rae CP, Kinsella J.   Treatment of pain in severe burns.   New Ethical Journal 2001; 4: 57-64.
Kinsella J, Harten J.   Effect of perioperative fluid therapy on outcome following major surgery.   Royal College of Anaesthetists Bulletin 2001; 8: 362-365.
Gallagher G, Rae CP, Kinsella J.   Treatment of pain in severe burns.   American Journal of Clinical Dermatology 2000; 1(6): 329-335. PMID: 11702609
Kinsella J.   Smoke inhalation injury. Diagnosis and management.   British Journal of Intensive Care 1993. 3(1) 8-14.
Kinsella J.   The travelling fellowship ICS 1992.   Care of the Critically Ill 1993; 9(4): 176-177.
Kinsella J, Booth MG.   Pain relief in burns.   Burns 1991; 17(5): 391-395. (winner of prize)
Kinsella J, Findlay J.   Carbon monoxide poisoning.   Care of the Critically Ill. 1991; 7: 182-184.
Kinsella J.   Smoke inhalation.   Burns 1988; 14(4): 269-279. (winner of prize)

Books and Book Chapters
Davis PD, Kinsella J.   ed Basic Physics and Measurement in Anaesthesia 6th Edition   2008 Butterworth Heinmann
Kinsella J.   Pancreatitis in Intensive Care. Update in Pancreatitis  2007 ed C Johnson
Kinsella J, Rae C.   Burn Pain.   Clinical Pain Management 2nd Edition: Acute Pain ed MacIntyre P and Rowbotham D. Arnold 2007
Kinsella J, Rae C.   Burn Pain.   Clinical Pain Management: Acute Pain ed MacIntyre P and Rowbotham D. Arnold 2002
Kinsella J, Quasim T.   Acute Pancreatitis.   Core Cases in Critical Care ed Ridley S. GMM 2002. 131-139
Kinsella J, Rae CP.   Smoke inhalation and airway injury.   In: Burns. Bailliere 1997; 385-406
Kinsella J.   Editor of Burns.   Bailliere, London 1997
Kinsella J, Rae CP.   Burn pain.   Burns. Kinsella J. ed. Bailliere 1997; 459-471
Kinsella J.   Preface. In: Ballieres   Clinical Anaesthesiology. Kinsella J. ed. Balliere 1997; 9-9.
Millar AY, Kinsella J.   Modern management of the severely burned patient.   International Handbook of Intensive Care 1996; 109-114.
Kinsella J.   Training in Intensive Care.   Group of Anaesthetists in Training Year Book 1995; 38-39.