Rhode Island Hospital in Providence, Rhode Island, the largest academic medical center in the state, is the only Level 1 trauma hospital in the area, serving all of Rhode Island, Southeastern Massachusetts and Eas­tern Connecticut, 1.5 million.

Nationally recognized for its superior critical care services, Rhode Island Hospital’s critical care staff members take a multidisciplinary approach to patient care, with a physician, critical care nurses and respiratory therapists caring for each patient.

Rhode Island Hospital has four me­dical critical care units and six surgical critical care units with a total of 134 critical care beds. Critical care units include: Coronary critical care unit (10 beds); medical intensive care unit (18 beds); cardiothoracic intensive care unit (8 beds); surgical intensive care unit (8 beds); trauma intensive care unit (11 beds); intensive neurocritical care unit (12 beds); respiratory intermediate care unit (19 beds); intermediate coronary care unit (24 beds); intermediate cardiothoracic care unit (8 beds); and the intermediate surgical Rhode Island Hospital physicians treat more than 120 critical care patients each month, many of whom are transferred from other hospitals, ma­king Rhode Island Hospital one of the busiest hospitals in New England for acute care. Rhode Island Hospital recently opened Rhode Island ExpressCare, in partnership with its sister hospital, The Miriam Hospital, to facilitate the transfer of patients to these institutions from hospitals around the region. Additionally, the two partners recently launched an ambulance ser­vice, LifePACT (Pediatric and Adult Critical Care Transport), allowing our physicians to provide the highest qua­lity care for our critically ill patients en route to the hospital.    

In addition to its critical care units, Rhode Island Hospital has the only program in the state to provide care for burn patients, including surgery, manual therapy, splinting and measu­rement of customized garments. It is estimated that there are 2.4 million burns each year in the United States, 1 million of which result in substantial disability. In 2003, a fire at the Station Nightclub in Rhode Island resulted in 100 deaths and 200 injuries. Rhode Island Hospital physicians treated 200 patients in three hours immediately following the fire, many of which required significant care over the course of the next several months or years.

An important part of Rhode Island Hospital’s critical care mission is to bring contemporary treatments to patients. As such, eligible patients are offered the opportunity to participate in clinical research trials. Rhode Island Hospital has enjoyed a 20-year partnership with The Warren Alpert Medical School of Brown University, enabling us to attract some of the best and brightest minds in the world to Providence. The hospital provides an environment that encourages teamwork, collaboration and research, enabling our clinical staff to develop cutting-edge techniques and treatment to improve the care and quality of life for patients.  

One area of focus for research is the incidence and treatment of sepsis, particularly in the older population. A great deal of this research is conduc­ted by Mitchell M. Levy, MD, interim director of pulmonary, critical care and sleep medicine division at Rhode Island Hospital and a professor of medicine at The Warren Alpert Me­dical School of Brown University.

Additional research is conducted by Steven P. LaRosa, MD, director of the Ocean State Clinical Coordinating Center, a member of the division of infectious diseases at Rhode Island Hospital and an assistant professor of medicine at Brown Medical School and myself. Dr. Levy is also president of the Society of Critical Care Me­dicine and is co-chair of the Survi­ving Sepsis Campaign Management Guide­lines Committee.

Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria. Also known as systemic inflammatory response syndrome (SIRS), sepsis can lead to death and typically affects patients 65 or older. In fact, that age group accounts for 60 percent of patients who develop severe sepsis in the United States and the incidence is steadily increasing. Older patients are often difficult to diagnose. Although advanced age appears to be a factor in a high risk of death due to severe sepsis, recent evidence also suggests that many older patients respond well to interventions that are begun promptly.

At Rhode Island Hospital, we treat approximately 150 patients per year for severe sepsis, 80 percent of which were admitted through the emergency department. Our group is currently studying anti-cytokine therapies, Toll-like receptor 4 blocking agents, anticoagulants and a number of other supportive care strategies in the management of severe sepsis.

Rhode Island Hospital was founded in 1863 and is the largest teaching hospital of  The Warren Alpert Me­dical School of Brown University. Many of its physicians are recognized as leaders in their respective fields of cancer, cardiology, diabetes, emergency medicine and trauma, neuroscience, orthopedics, pediatrics, radiation oncology and surgery. Rhode Island Hospital, which has 719 beds and more than 34,000 annual discharges, receives nearly million each year in external research funding. It is home to Hasbro Children’s Hospital, the state’s only facility dedicated to pediatric care, which is ranked among the top 30 children’s hospitals in the country by Parents magazine.

Steven M. Opal, MD   
steven_opal@brown.edu
Steven M. Opal, MD, is a member of the division of infectious diseases at Rhode Island Hospital and a professor of medicine at The Warren Alpert Medical School of Brown University. He has served as the principal investigator for numerous worldwide, multi-center trials of adjuvant agents for severe sepsis, and has served on numerous data safety monitoring boards. Opal is a member of several professional societies including the Society of Critical Care Medicine, the International Cytokine Society, the Infectious Diseases Society of America and the International Endotoxin and Innate Immunity Society, and is on the steering committee of the International Sepsis Forum.