Harvard Catalyst Profiles

Harvard T.H. Chan School of Public Health	MPH	2017	Clinical Effectiveness
University College London	MD	2001	Medicine

The Shaefi lab research program is focused on translational and clinical research surrounding the protective effects of different admixtures of oxygen administered perioperatively, as well as prevention and treatment of Perioperative Neurocognitive Disorders following cardiac surgery. His laboratory and clinical focus include the following areas of interest

Preclinical Effects of Protective Hypoxia in Sepsis and Critical Illness Models
The Shaefi lab is investigating whether hypoxia could be beneficial and perhaps even necessary for attenuation of the inflammatory response in various disease states. Murine models of sepsis, trauma, subsequent critical illness and cardiac arrest are currently being utilized. A study of the effects of differing concentrations of oxygen and use of other gasotransmitters in a porcine cardiopulmonary bypass model is also underway.

Clinical Trials Regarding Titration of Oxygen and Use of Low Dose Carbon Monoxide
Dr. Shaefi has completed a randomized clinical trial examining the effect of different intraoperative oxygen concentrations and the effect on postoperative neurocognition in cardiac surgery. Additionally, Dr. Shaefi is involved in a clinical study in which he is assessing clinical outcome and changes in inflammatory signatures with administration of conservative vs conventional oxygen levels delivered to patients in the ICU. Furthermore, he is embarking upon work associated with the administration low-dose carbon monoxide. Carbon monoxide exerts its effects in part by binding to the same hemoproteins as oxygen, largely in the mitochondria. There is significant preclinical data that has been amassed regarding the anti-inflammatory, anti-apoptotic and antimicrobial effects of carbon monoxide. The lab is performing exploratory studies in healthy human volunteers with carbon monoxide exposure as a prelude to larger clinical trials in various surgical and critical illness settings. The demonstration of salutary effects of carbon monoxide in the perioperative space has far reaching and significant implications for the care of our patients.

Biomarker Discovery of Delirium in Cardiac Surgery
Dr. Shaefi has a long-standing interest in post-cardiac surgical delirium. His laboratory is examining proteomic signatures of patients exhibiting delirium after cardiac surgery. This proteomic analysis, together with advanced bioinformatics, has led to the potential identification of various candidate biomarker proteins of delirium after cardiac surgery. Ongoing prospective work will further examine and validate these biomarkers and assess the potential of regulating upstream and downstream signaling of pathways that involve these proteins.