Southampton Academy of Research

Dr Ahilanandan Dushianthan is an Intensive Care & Respiratory Consultant at University Hospital Southampton (UHS) and holder of a Research Leaders Programme (RLP) fellowship.

His main research interest is acute respiratory distress syndrome (ARDS), a life-threatening condition where injury to the lungs means they cannot provide the body's vital organs with enough oxygen.

Changing priorities during the COVID-19 pandemic

Ahilanandan first came to Southampton in 2010 to do a fellowship and then a PhD in Prof Mike Grocott’s critical care research group.

After this, he completed intensive care training to become both a respiratory and critical care consultant, splitting his time between these two specialities. This left little time for his research.

Yet when the COVID-19 pandemic hit, he switched to working full time in the intensive care unit (ICU), where he was most needed. As this was mostly night shifts, he found he had more time for research.

He led recruitment in Southampton to the national REMAP-CAP study, as well as local studies to investigate severe COVID-19. He also established a live dataset of COVID-19 cases with Prof Tom Wilkinson, Dr Anna Freeman and Dr Hannah Burke.

Even when vaccines were rolled out and the immediate threat of COVID-19 receded, Ahilanandan decided not to return to his respiratory medicine work. Instead, he plans to concentrate on his intensive care work. This includes more time dedicated to research.

“What’s interesting in intensive care is that you are faced, day in day out, with dilemmas that are not evidence-based,” he explains, “so it goes hand in hand with research.”

Targeting lung injury treatments

Ahilanandan applied for the RLP fellowship so that he could dedicate more time to research, with the aim of securing more grants and developing his leadership skills. In the longer term, he hopes to apply for an Associate Professor role, splitting his time between clinical work and research.

“What the RLP does is not only buys you dedicated time,” he says, “but it’s also a recognition that you are part of the research group and offer leadership skills.”

He intends to use the fellowship to develop his research into acute respiratory distress syndrome (ARDS), a life-threatening form of acute lung injury. Despite the fact this condition has been known about for more than 50 years, he says treatment options are still limited.

“Once you are on a ventilator with ARDS,” he explains, “the likelihood of you dying is pretty high, at around 30 percent, and if you are very, very sick it can be up to about 50 percent.”

One of the main challenges with treating ARDS is that different patients can respond very differently to the same treatment. He’s therefore looking to determine who will respond to which medicine, so that treatments can be targeted to patients they are most likely to benefit.

Oxygen and lung injury

The other area Ahilanandan is focussing on is oxygen, which is widely used to treat patients in ICU. While getting enough oxygen is essential for our survival, too much oxygen can damage the lungs.

He wants to find out more about how oxygen drives this process. In particular, he is interested in how giving oxygen affects surfactant, a substance which lines the inside of the lungs and helps prevent them from collapsing.

Treatment to top up the lungs’ surfactant has been successful in premature babies, who’s lungs are often underdeveloped and at risk of collapsing. His research is investigating whether adults with ARDS, including those with severe COVID-19, might also benefit from extra surfactant.