These studies done by a research team under the leadership of Paul E. Wischmeyer MD, EDIC, FASPEN, FCCM; Professor with Tenure of Anesthesiology and Surgery, Duke University School of Medicine; Director of Duke Hospital TPN/Nutrition Service; Associate Vice-Chair of Clinical Research in Anesthesiology.
Dr. Wischmeyer also oversees a large research program that includes a range of lab-and clinical trial based nutrition and exercise studies that have successfully moved into phase 1, 2, and 3 randomized clinical trials in humans. This includes work on the impact of the microbiome and probiotics on outcomes from infectious diseases.
Dr. Wischmeyer has been funded by the National Institutes of Health (NIH) and Government funding, including the:
- National Heart, Lung, and Blood Institute (NHLBI)
- National Institute of General Medical Sciences (NIGMS)
- National Institute of Aging (NIA)
- National Institute of Diabetes and Digestive and Kidney Diseases ()NIDDK
- Department of Defense and Canadian Institutes of Health Research (CIHR)
He also has research funded by non-profit foundations to both himself and the young physician-researchers he mentors, including the
- American Society of Parenteral and Enteral Nutrition (ASPEN)
- Foundation for Anesthesiology Education and Research (FAER)
- International Anesthesia Research Foundation (IARS)
- American Heart Association (AHA)
Dr. Wischmeyer’s background is in critical care, perioperative medicine, and nutrition (including microbiome and probiotic research). The inspiration for Dr. Wischmeyer’s work and his passion to study way’s to address patient’s suffering from illness comes from his own experience as a lifelong patient since age 15, when he was diagnosed with Inflammatory Bowel Disease (Ulcerative Colitis) and hospitalized for nearly a year as a teenager. Since then he has had 23 major surgeries with many ICU stays, leaving him with about half of his intestine remaining and he has had an ostomy for much of his life. As a frequent patient himself, Dr. Wischmeyer has lived and seen the key role of nutrition and exercise in his own recovery and health, and thus has committed his life to studying these safe, simple treatments that can help all patients recover faster and better.
With our ongoing nutrition and exercise research, we are already improving some patient outcomes, but there is still much more work to be done! Our studies aim to improve clinical outcomes and quality of life for all people and patients. Below are our main areas of research:
Microbiome:
Over 100 trillion microbes live in our gut, skin, and other parts of our body, making up the microbiome. Strategies to manipulate the microbiome, such as with probiotics, may improve outcomes for patients with a wide range of illness (including COVID-19), before and after surgery, and when in ICU. Our research seeks to examine the role of probiotic and microbiome interventions on health and to analyze the microbiome through bio-sample collection. This will help us understand the best ways to design rational approaches to be tested in clinical trials with the goal of improving patient outcomes.
Preparing for Cancer Care or Having Surgery is like training for a marathon- and in this case it is the most important race many patients will ever train for- the race of their lives! Just as good nutrition and exercise are essential to training for a marathon, it is equally important for patients to prepare. This is our passion- to perform studies to teach patients everywhere how to be ready!
Nutrition in Surgery:
Every Amerian can expect to undergo 9.2 surgical procedures in their lifetime! Here at Duke we dream of day when all patients having elective surgery will be assessed for nutrition needs and receive key well-studied and simple nutrition interventions before and after surgery that we know reduce risk of infections and other complications. Unfortunately, research shows less then 1% of U.S. patients receive these basic nutrition therapies. You can help change this! We have developed a new scientifically based nutrition program that optimizes protein and key nutrient intake for patients having surgery. This program called the PeriOperative EnhancemenT (POET) Nutrition Program (the first of it’s kind in the US) screens all elective surgery patients and ensures they receive the critical nutrition care that can give them the best chance to recover without complication from their surgeries. We have ongoing clinical trials that are studying the impact of these simple and inexpensive interventions to help make them standard of care. But, nutrition is not backed by the major pharmaceutical company dollars that’s drugs are, so we need your help to continue to build real nutrition science to help patients everywhere.
Nutrition in ICU and Cancer:
Recovering from ICU or preparing for cancer therapy is among the most grueling marathons a human can endure. We all know the challenges cancer causes, however many patients with and without cancer need ICU care at some point. In fact, Every American can expect to average 1.7 intensive care unit (ICU) admissions in their lifetime. We have improved outcomes from sepsis, cancer, and ICU care as data indicates >90% of ICU patients are surviving ICU stay. However, this survival comes at a cost. Cancer and ICU survivors frequently experience significant post-ICU and hospital physical disabilities, including muscle weakness and impairments in physical functioning that can last for years. These same data reveal many ICU “survivors” are not returning home to functional lives post-ICU; but, instead to rehabilitation settings where it is unclear if they ever return to a meaningful quality of life. Recent data shows up to 2 out of 3 ICU survivors (65%) suffer significant functional limitations and impaired quality of life. Thus, it must be asked in modern ICU care- “are we creating survivors…or victims?”. A major contributor to this poor quality of life and weakness in patients is poor nutrition in hospital and after hospital. Data shows patients receive less than half the protein and calories they need in the ICU, often for many weeks and are often literally starving. This often worsens after the hospital stay ends as patients have poor appetites and are not given instructions on how much or what to eat to recover. Our research programs engage in clinical trials to identify and teach patient how to eat to recover and help them get their quality of lives back. You can help!
Exercise:
We developed a range of personalized exercise programs to improve physical function in patients before surgery, before cancer care and after ICU (including after COVID-19). These include our Preoperative Exercise & Nutrition To Improve Perioperative Outcomes (PREvENT) study which evaluates patients with the same exercise testing Olympic athletes use to train. This testing creates a personalized High Intensity Interval Training program (HIIT) (heart rate goals during short periods of intense anaerobic exercise, with less intense recovery periods in between) for our patients in the weeks before surgery to “train for marathon of surgery” or after ICU to allow actual recovery to occur. As we all know, just asking someone to “go home and exercise some” is often not easy or effective for most of us. We provide scientifically-guided personalized programs for patients of all ages and abilities. Our goal is to use these programs, and combine them with scientifically based nutrition to improve physical function in patients preparing for surgery, cancer care, or recovering from ICU or hospitalization. Some of our patients come back and train near the hospital with our trainers using their personalized programs. However, this is often not practical. So, in another study that we have teamed up with Dr. Tony Sung in the Duke Cancer center to perform we are now allowing patients to train at home. The study is called novel Remotely Monitored, Mobile-health-supported High Intensity Interval Training program (REMM-HIIT) to improve physical function in cancer and post-ICU patients (including patients recovering from COVID-19). Patients are provided Apple watches and Iphones during the study to help track their physical activity. Only the first HIIT session takes place in-person; all subsequent sessions take place in the patient’s home with remote monitoring and support. Our goal is to use REMM-HIIT to improve physical function in our patients prior to cancer care and after ICU with the hope that this will lead to improved outcomes in all patients.
How you can help
Our Nutrition and Exercise studies have the potential to greatly improve the lives of people going through illness, surgery, and recovering from ICU (including COVID-19). However, they do take a lot of resources and effort.
We have received funding for much of this work from the NIH and non-profit foundations. However, more funds are needed to support the development of new ideas or essential research infrastructure.
If you are interested in donating money towards our Nutrition and Exercise research efforts, we would greatly appreciate it.
Links to video on Dr. Wischmeyer’s Story on his Experience with Illness, Recovery and Research:
https://www.youtube.com/watch?v=zcA0piTXwoY&t=48s
All videos on his research at his Youtube Page: https://www.youtube.com/channel/UClysqOIhj7xmgw4IQu3lrmA/videos?view_as=subscriber
Links to Dr. Wischmeyer’s Professional and Research Profiles and Social Media Sites:
Duke Faculty Profile |Researchgate | LinkedIn | Twitter |
Over 100 trillion microbes live in our gut, skin, and other parts of our body, making up the microbiome. Strategies to manipulate the microbiome, such as with probiotics, may improve outcomes for patients with a wide range of illness (including COVID-19), before and after surgery, and when in ICU. Our research seeks to examine the role of probiotic and microbiome interventions on health and to analyze the microbiome through bio-sample collection. This will help us understand the best ways to design rational approaches to be tested in clinical trials with the goal of improving patient outcomes.
Exercise:
We developed a range of personalized exercise programs to improve physical function in patients before surgery, before cancer care and after ICU (including after COVID-19). These include our Preoperative Exercise & Nutrition To Improve Perioperative Outcomes (PREvENT) study which evaluates patients with the same exercise testing Olympic athletes use to train. This testing creates a personalized High Intensity Interval Training program (HIIT) (heart rate goals during short periods of intense anaerobic exercise, with less intense recovery periods in between) for our patients in the weeks before surgery to “train for marathon of surgery” or after ICU to allow actual recovery to occur. As we all know, just asking someone to “go home and exercise some” is often not easy or effective for most of us. We provide scientifically-guided personalized programs for patients of all ages and abilities. Our goal is to use these programs, and combine them with scientifically based nutrition to improve physical function in patients preparing for surgery, cancer care, or recovering from ICU or hospitalization. Some of our patients come back and train near the hospital with our trainers using their personalized programs. However, this is often not practical. So, in another study that we have teamed up with Dr. Tony Sung in the Duke Cancer center to perform we are now allowing patients to train at home. The study is called novel Remotely Monitored, Mobile-health-supported High Intensity Interval Training program (REMM-HIIT) to improve physical function in cancer and post-ICU patients (including patients recovering from COVID-19). Patients are provided Apple watches and Iphones during the study to help track their physical activity. Only the first HIIT session takes place in-person; all subsequent sessions take place in the patient’s home with remote monitoring and support. Our goal is to use REMM-HIIT to improve physical function in our patients prior to cancer care and after ICU with the hope that this will lead to improved outcomes in all patients.
