David Antcliffe is a Clinical Senior Lecturer at Imperial College and an Honorary Consultant in Critical Care at Charing Cross Hospital.
He obtained his degree in medicine in 2003 from University College London and pursued post-graduate training in Acute and Intensive Care Medicine across London. Between 2011 and 2015 he completed a PhD at Imperial College using metabolic profiling to aid in the diagnosis of pneumonia in patients requiring critical care funded by the Imperial College BRC and the Intensive Care Foundation.
After obtaining a dual CCT in Acute and Intensive Care Medicine in 2016 he returned to Imperial College to continue pursuing his academic interests in phenotyping critical illness.
His current research interests involve using a range of profiling techniques, including metabonomic, transcriptomic and inflammatory profiling, to identify sub-phenotypes in sepsis that could predict a patient's responsiveness to specific therapeutic strategies and lead to a personalised approach to sepsis care. This approach has lead to the finding that stratifying patients with septic shock based on the way in which their genes are expressed (sepsis response signature (SRS) transcriptomic endotypes) identified groups who respond differently to corticosteroids in this condition. Ongoing work aims to translate this finding to the bedside to use point of care tests to identify patients who are most likely to benefit from these interventions.
Corticosteroid Response and Gene Expression in Septic Shock (CRESS)
(Winner of the Intensive Care Society Research Prioritisation Exercise, 2019)
In this project, I aim to translate findings from transcriptomic studies identifying a link between gene expression patterns and outcomes following corticosteroid use for septic shock to the bedside. The ultimate goal is to deliver a large scale, personalised medicine trial in septic shock where gene expression profiles would be used to guide treatment decisions.
Phenotyping the Patient's Journey
Metabolic Phenotyping or Molecular Phenomics uses metabonomic methods to examine 'metabolic fingerprints' of diseases and the way they change in response to treatment. In this, Imperial College BRC supported, project I am using these methods to track the metabolic trajectories of patients with septic shock with the intention of tracking responses to treatments and development of new organ dysfunction. Samples collected from two large, Imperial College run, septic shock randomised controlled trials (VANISH and LeoPARDS) are being used to define and validate metabolic trajectories in this condition and will become one of the largest metabolic data sets in sepsis.
Study Evaluating Acute Dysfunction in balance and postural control after critical illness (StEADy)
Including the Activate- (Muscle activation during early mobility strategies in health) pilot study
In collaboration with the Musculoskeletal laboratory, this project aims to establish patterns of trunk and peripheral muscle activity during recovery from critical illness. We aim to understand changes that occur to the control of balance and posture in response to critical illness. Improving our knowledge in this area may change the way that post critical illness rehabilitation is provided.
Management of severe acute respiratory failure during the COVID-19 pandemic A National Service Evaluation (COVID-ICU)
This collaborative observational cohort study intends to characterise the ICU management of Covid-19 induced Severe Acute Respiratory Failure.
It will document the management of critically ill COVID-19 patients and compare it to current best practice. and will characterize the trajectory of subjects with COVID19-ARDS in terms of respiratory physiology and responsiveness to adjunctive ARDS therapies/manoeuvres.
et al., The end is just the beginning: involvement of bereaved next of kin in qualitative research, Bmj Supportive & Palliative Care, ISSN:2045-4368
et al., 2021, Natural history, trajectory, and management of mechanically ventilated COVID-19 patients in the United Kingdom, Intensive Care Medicine, Vol:47, ISSN:0342-4642, Pages:549-565
Antcliffe DB, Gordon AC, 2019, Why Understanding Sepsis Endotypes Is Important for Steroid Trials in Septic Shock, Critical Care Medicine, Vol:47, ISSN:0090-3493, Pages:1782-1784
et al., 2019, Levosimendan in septic shock in patients with biochemical evidence of cardiac dysfunction: a subgroup analysis of the LeoPARDS randomised trial, Intensive Care Medicine, Vol:45, ISSN:0342-4642, Pages:1392-1400
et al., 2019, Transcriptomic signatures in sepsis and a differential response to steroids: from the VANISH randomized trial, American Journal of Respiratory and Critical Care Medicine, Vol:199, ISSN:1073-449X, Pages:980-986
et al., 2018, Profiling inflammatory markers in patients with pneumonia on intensive care, Scientific Reports, Vol:8, ISSN:2045-2322
et al., 2017, Metabolic profiling in patients with pneumonia on intensive care, Ebiomedicine, Vol:18, ISSN:2352-3964, Pages:244-253
Gordon AC, Antcliffe D, 2016, Metabonomics and intensive care, Critical Care, Vol:20, ISSN:1364-8535
et al., 2018, Analysis of lipoproteins in septic shock, European Society of Intensive Care Medicine Congress, SpringerOpen, ISSN:2197-425X
Antcliffe D, Al-Beidh F, Gordon A, 2018, Metabolic profiles in sepsis evolve over time, European Society of Intensive Care Medicine Congress, SpringerOpen, ISSN:2197-425X
et al., 2018, Multivariate analysis of cytokines in septic shock predicts outcome, European Society of Intensive Care Medicine Congress, SpringerOpen, ISSN:2197-425X