From Bench to Bedside

🧠 Pioneering Translational Research

From Pathophysiology to Clinical Trial in Ventilator-Associated Pneumonia (VAP)

📜 Background

Translating discoveries from the laboratory to clinical trials is rare and challenging, especially in critical care. During Otavio’s research fellowship in 2011, supported by ALAT-SEPAR (Latin American & Spanish Pulmonary Societies), he joined a leading translational research group, led by Prof. Antoni Torres, at Hospital Clínic-IDIBAPS (Barcelona), investigating the role of gravity in the pathophysiology of VAP.

This work integrated medicine, engineering, and physics, challenging a longstanding critical care dogma: that patients should remain semi-recumbent to prevent VAP.

🔬 My Contribution

• Bench Experiments: First-author work on in vitro studies using artificial saliva to model secretion dynamics in endotracheal tubes under gravitational influence.
• Animal Models: Contributed to large-scale porcine models to experiment different scenarios of VAP prevention and severe VAP treatment.
• Clinical Translation: Designed and the led analyses for the GRAVITY-VAP Trial, a randomized multicenter clinical trial testing these hypotheses in humans.

The trial was presented in the Clinical Trials Session at LIVES 2017 (Vienna), an acknowledgment reserved for impactful research in intensive care medicine.

🌍 Impact

• Bridged bench-to-bedside science across multiple disciplines
• Published in Intensive Care Medicine
• Highly cited and generated ongoing debates on positioning strategies in ICUs
• Challenged established practice, influencing VAP prevention discussions worldwide

📚 Selected References

Li Bassi G*, Panigada M*, Ranzani OT, et al. (2017). Randomized, multicenter trial of lateral Trendelenburg versus semirecumbent body position for the prevention of ventilator-associated pneumonia. Intensive Care Med, 43(11):1572–1584. https://doi.org/10.1007/s00134-017-4858-1

Li Bassi G*, Ranzani OT*, Marti JD, et al. (2013). An in vitro study to assess determinant features associated with fluid sealing in the design of endotracheal tube cuffs and exerted tracheal pressures. Crit Care Med, 41(2):518–526. https://doi.org/10.1097/CCM.0b013e31826a4804

Li Bassi G, Marti JD, ..,Ranzani OT, …, et al. (2014). Gravity predominates over ventilatory pattern in the prevention of ventilator-associated pneumonia. Crit Care Med, 42(9):e620–e627. https://doi.org/10.1097/CCM.0000000000000487