Stephen Heard, M.D.

Academic Role: Professor and Chair
Faculty Appointment(s) and Affiliations:

School of Medicine
   Anesthesiology
   Surgery
Graduate School of Biomedical Sciences
   Clinical and Population Health Research
  

Photo: Stephen O. Heard, M.D.I attend in both the operating room and surgical intensive care units, however, my clinical and research interests center on critical care medicine. I enjoy the challenge of caring for the critically-ill patient and receive great satisfaction in seeing a patient for whom I have cared survive such an illness. The surgical intensive care units at UMass Memorial Medical Center provide care for a diverse patient population: cardiothoracic, vascular, trauma, neurosurgical, transplant, urologic, orthopedic, burns and general surgery. In some of these units, “medical” patients are also cared for by the ICU team. This is an exciting time for critical care medicine - both in general and at UMass Memorial. A plethora of prospective, randomized studies pertaining to the care of the critically-ill patient has been conducted and has enabled us to improve the care and outcome of these patients. Furthermore, coordinated care is very important in the treatment of these patients. At UMass Memorial, the administrative structure of critical care was changed. The silo approach to the patient has been abandoned and provision of care is much more coordinated and spans across many departments and divisions. In addition, telemedicine in the form of the eICU allows behind the scenes backup monitoring of all patients. The changes have resulted in documented and gratifying improvements in patient outcomes.

My research interests include strategies to prevent catheter-related bloodstream infections (CRBSI), sepsis and septic shock, the acute respiratory distress syndrome (ARDS), and monitoring. Over the past several years, UMass Memorial has been a part of a number clinical trials evaluating the effectiveness of catheters impregnated with antibiotics to prevent CRBSI, passive immunotherapy with anti-endotoxin or anti-tumor necrosis factor-a antibodies in patients with sepsis, and alveolar lavage with surfactant in the treatment of patients with ARDS. The department also has an active and vibrant basic science and clinical research effort in noninvasive monitoring headed by Dr. Babs Soller with whom I collaborate.

I believe active involvement in organized medicine is very important. I am a member of the American Society of Anesthesiologists, the American Society of Critical Care Anesthesiologists, the Massachusetts Society of Anesthesiologists, the Society of Critical Care Medicine, and the American College of Chest Physicians. I have either held leadership positions or served on committees in all of these organizations. In addition, I have lobbied for our specialty at both the state and federal levels. My goal is to help and encourage more physicians to become involved in state and national specialty societies.

Lastly, the number of patients waiting for an organ far exceeds the number or organs that are donated. UMass Memorial Medical Center is a member of an initiative sponsored by the Health Resources and Services Administration (HRSA) of the federal government to increase organ donation. UMass Memorial has been a leader in New England in providing organs following either brain death or cardiac death.

Selected Publications

O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S.  Summary of recommendations:  guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52:1087-99.

Walz JM, Avelar RL, Longtine KJ, Carter KL, Mermel LA, Heard SO.  Anti-infective external coating of central venous catheters:  a randomized, noninferiority trial comparing 5-fluorouracil with chlorhexidine/silver sulfadiazine in preventing catheter colonization.  Crit Care Med 2010; 38:2095-102.

Watson NC, Heard SO.  The use of lactate as a biomarker.  J Intensive Care Med 2010; 25:301-2.

Jones N, Cocchiarella A, Faris K, Heard SO.  Pancreatitis associated with Strongyloides stercoralis infection in a patient chronically treated with corticosteroids.  J Intensive Care Med 2010; 25:172-4.

Matheos T, Walz JM, Adams JP, Johnson K, Longtine K, Longtine J, O'Neill M, Heard SO. Comparison of the duration of antimicrobial activity of 2 different antimicrobial central venous catheters.  Infect Control Hosp Epidemiol 2010; 31:295-7.

Walz JM, Memtsoudis SG, Heard SO.  Analytic reviews: prevention of central venous catheter bloodstream infections.  J Intensive Care Med 2010; 25:131-8.

Walz JM, Faris K, Heard SO.  Who let the bugs in?  Crit Care Med 2008; 36:2689-90.

Soller BR, Ryan KL, Rickards CA, Cooke WH, Yang Y, Soyemi OO, Crookes BA, Heard SO, Convertino VA.  Oxygen saturation determined from deep muscle, not thenar tissue, is an early indicator of central hypovolemia in humans.  Crit Care Med 2008; 36:176-82.

Soller BR, Yang Y, Soyemi OO, Ryan KL, Rickards CA, Walz, JM, Heard SO, Convertino VA. Noninvasively determined muscle oxygen saturation is an early indicator of central hypovolemia in humans. J Appl Physiol 2008; 104:475-81.

Corwin HL, Gettinger A, Fabian TC, May A, Pearl RG, Heard SO, et al. Efficacy and safety of epoetin alfa in critically ill patients. New Engl J Med 2007; 357:965-976.

Bernat JL, D’Alessandro AM, Port FK, Bleck TP, Heard SO, et al. Report of national conference on donation after cardiac death. Am J Transplant 2006; 6:281-291.

Heard SO, Munson EL, Doern GV. Exposure of bacteria to antimicrobial impregnated central venous catheters does not directly lead to the emergence of antimicrobial resistance. Chest 2004; 126:1628-1635.

Soller BR, Idwasi PO, Balaguer J, Levin S, Simsir SA, Vander Salm TJ, Collette H, Heard SO. Noninvasive, NIRS-Measured Muscle pH and PO2 Indicate Tissue Perfusion for Cardiac Surgical Patients on Cardiopulmonary Bypass. Critical Care Medicine 2003; 31:2324-2331.

Soller BR, Kahn T, Favreau J, His C, Puyana JC, Heard SO. Investigation of muscle pH as an indication of liver pH and injury from hemorrhagic shock. J Surg Res 2003; 114:195-201.

Dickson EW, Doern GV, Trevino L, Mazzoni M, Heard SO. Prevention of descending pneumonia in rats with perflubron-delivered tobramycin. Acad Emerg Med 2003; 10:1019-1023.

Smyrnios NA, Irwin RS, Connolly AE, Wilson MM, Curley FJ, French CL, Heard SO. Effects of a multifaceted, multidisciplinary, hospital-wide quality improvement program on weaning from mechanical ventilation. Crit Care Med 2002; 30(6):1224-1230.

Soller BR, Cingo N, Puyana JC, Khan T, Hsi C, Kim H, Favreau J, Heard SO. Simultaneous measurement of hepatic tissue pH, venous oxygen saturation and hemoglobin by near infrared spectroscopy. Shock 2001; 15:106-111.

Talke P, Chen R, Thomas B, Aggarwall A, Gottlieb A, Thorborg P, Heard S. Hemodynamic and adrenergic effects of dexmedetomidine after vascular surgery. Anesth Analg 2000; 90:834-839.

Abraham E, Baughman R, Fletcher E, Heard S, et al. Liposomal prostaglandin E1 (TLC C-53) in adult respiratory distress syndrome (ARDS): A controlled, randomized, double-blind, multi-center clinical trial. Crit Care Med 1999; 27:1478-1485.

Heard SO, Longtine K, Toth I, Puyana JC, Potenza B, Smyrnios N. The influence of liposomal-encapsulated prostaglandin E1 on hydrogen peroxide concentrations in the exhaled breath of patients with the acute respiratory distress syndrome ARDS. Anesth Analg 1999; 89:353-357.

Darouiche RO, Raad II, Heard SO, et al. Comparative clinical efficacy of antimicrobial-impregnated central venous catheters. New Engl J Med 1999; 340:1-8.

Wiswell TE, Smith RM, Katz LB, Mastroianni L, Wong DY, Willms D, Heard S, et al. Bronchopulmonary segmental lavage with Surfaxin” (KL4-Surfactant) for acute respiratory distress syndrome. Am J Respir Crit Care Med 1999; 160:1188-1195.

Heard SO, Fink MP, Gamelli RL, et al. Prophylactic administration of recombinant human granulocyte colony-stimulating factor (Filgrastim) decreases the incidence of nosocomial blood-stream infections in patients with acute traumatic brain injury or cerebral hemorrhage. Crit Care Med 1998; 26:748-754.

Heard SO, Wagle M, Vijayakumar E, et al. The influence of triple-lumen central venous catheters coated with chlorhexidine and silver sulfadiazine on the incidence of catheter-related bacteremia: a randomized, controlled clinical trial. Arch Intern Med 1998: 158;81-87.

Heard SO, Toth IE, Perkins MW, Leonard JL. The role of protein kinase C in lipopolysaccharide-induced myocardial depression in guinea pigs. Shock 1994; 1:419-424.

Gluck E, Heard SO, Patel C, Mohr J, Calkins J. Use of ultra-high frequency ventilation in patients with ARDS. Chest 1993; 103:1413-1420.

Heard SO, Thomas WT, Ferrari D, Hanna D, Wong PD, Liland A, Willock MM. Analgesic effect of intraarticular bupivacaine or morphine after arthroscopic knee surgery: a randomized, prospective, double-blind study. Anesth Analg 1992; 74:822-826.

Heard SO, Helsmoortel CM, Kent JC, Shahnarian A, Fink MP. Gastric tonometry in healthy volunteers: effect of ranitidine on calculated intramural pH. Crit Care Med 1991; 19:271-274.

 

 

Academic Background

M.D. University of Texas, Houston, TX, 1978

 

 

Postdoctoral Training

Newton-Wellesley Hospital, Newton, MA, Residency in Internal Medicine, 1978-1981
University of Florida, Gainesville, FL, Residency in Anesthesiology, 1981-83
University of Florida, Gainesville, FL, Fellowship in Critical Care Medicine, 1983-84

 

 

Office: S2-755
Phone: 508-856-3266
Fax: 508-856-3921
EMail: Stephen.Heard@umassmed.edu