Emmett Whitaker, M.D., FAAP, associate professor of anesthesiology, neurological sciences, and pediatrics, received a substantial R35 MIRA grant from NIGMS for his study “Vascular Determinants of Anesthesia-Induced Hypotension at the Extremes of Age.” This five-year project—the department’s first NIH grant—addresses intraoperative hypotension in neonates, infants, and older adults under anesthesia.
Emmett Whitaker, M.D., FAAP, associate professor of anesthesiology, neurological sciences, and pediatrics
Emmett Whitaker, M.D., FAAP, associate professor of anesthesiology, neurological sciences, and pediatrics at the Larner College of Medicine, has been granted a prestigious R35 MIRA award by the National Institute of General Medical Sciences (NIGMS) in recognition of his groundbreaking research on “Vascular Determinants of Anesthesia-Induced Hypotension at the Extremes of Age.” With an impressive grant of $1.95 million, equivalent to an R01, this funding will propel his investigations over the upcoming five years, focusing on understanding and mitigating intraoperative hypotension—an issue of critical concern among neonates, infants, and older adults undergoing anesthesia.
The unique feature of R35 grants lies in their provision of funding that isn’t confined to specific projects, affording researchers the flexibility to delve into emerging scientific ideas. Known as the Maximizing Investigators’ Research Award program (MIRA) within NIGMS, the R35 grant format has been in existence since 2015.
Whitaker’s research is poised to offer invaluable insights to medical professionals and anesthesiologists, empowering them to identify early intervention opportunities and determine the most efficacious approaches to enhance organ perfusion, transcending the sole emphasis on elevating blood pressure. Within the populations of neonates, infants, and geriatric patients, occurrences of intraoperative hypotension and compromised organ perfusion exceed the norm. While the precise mechanisms responsible for this distinction remain elusive, the pivotal role played by extreme age demographics is strongly inferred. The vascular systems of these diverse groups share several common attributes that may contribute to hypotension.
Whitaker and his dedicated team plan to synergize intact animal models with in vitro methods. This comprehensive approach enables scientists to study blood vessels both under typical conditions and in specific scenarios, facilitating a clear distinction between adjusted cases and controls. Notably, Whitaker emphasized that the factors contributing to this issue can exhibit considerable variability,
He elaborates, “Blood pressure interpretation can be intricate—it’s not an exact science. Optimal blood pressure may coexist with inadequate organ perfusion. Our focus is on comprehending and defining organ perfusion-based hypotension by monitoring blood flow in vital organs, such as the brain, kidneys, and gut. Subsequent induction of hypotension in test subjects enables us, as anesthesiologists, to ascertain the decline in organ blood flow. This knowledge equips us to intervene effectively, before irreversible organ damage occurs.”
Whitaker’s research seeks to evaluate the outcomes of potential interventions, assessing their impact on the target populations. Certain pressure agents, such as norepinephrine, may exhibit superior efficacy in treating anesthesia-induced hypotension compared to alternatives. Furthermore, the team aspires to uncover enhanced strategies for addressing organ perfusion beyond conventional blood pressure-centric treatments.
This research holds exceptional significance for the Larner College of Medicine, constituting a pivotal milestone—this is the first NIH grant awarded to the Department of Anesthesiology. “My colleagues in the department played a pivotal role,” emphasized Whitaker. “Their unwavering support was instrumental in not only laying the groundwork for this award but also in empowering me to achieve it.” This accomplishment highlights Whitaker’s expertise while also underscoring the institution’s dedication to advancing medical understanding and elevating patient care within the realm of anesthesiology.
“The folks at the Vermont Center for Cardiovascular and Brain Health (VCCBH), particularly Drs. Mary Cushman, Marilyn J. Cipolla, and Mark Nelson, played an integral role in securing this esteemed grant opportunity,” reflected Whitaker. “The VCCBH provides an immensely supportive environment. Grants of this caliber serve as crucial mechanisms for enhancing patient care and attracting diverse scientists, clinicians, and students keen on pioneering work in an environment that nurtures their pursuits.” Mary Cushman, M.D., along with Mark Nelson, Ph.D., are co-directors of the VCCBH and Marilyn Cipolla, Ph.D., is a professor of Neurological Sciences.