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Dr Peter Smielewski

University Position
Senior Research Associate

Interests

In an established environment of Clinical Neuroscience Dept large quantities of data can be captured from bed-side monitors. Using that data, continuous assessment of changing cerebrovascular haemodynamics and oxygenation is possible but requires sophisticated signal analysis. My primary research involves development of ICM+ software which encapsulates 20 years of our experience in brain monitoring gained in multiple neurosurgical and intensive care centres. It collects data from bedside monitors and produces on-line trends of parameters defined using highly configurable signal processing formulae. Using a variety of statistical charts complex information coming off the bedside monitors can be summarized in a concise fashion and presented to medical staff in a simple way that alerts them to the development of various pathological processes. The software is now installed in a number of academic centres around the world providing basis for multi-centre collaborations in brain monitoring.

Key Publications

Diffusion limited oxygen delivery following head injury.

DOI: http://doi.org/10.1097/01.ccm.0000127777.16609.08
Journal: Crit Care Med
E-pub date: 1 Jun 2004
Authors: DK Menon, JP Coles, AK Gupta, TD Fryer, P Smielewski, DA Chatfield, F Aigbirhio, JN Skepper, PS Minhas, PJ Hutchinson, TA Carpenter, JC Clark, JD Pickard

Incidence and mechanisms of cerebral ischemia in early clinical head injury.

DOI: http://doi.org/10.1097/01.WCB.0000103022.98348.24
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Feb 2004
Authors: JP Coles, TD Fryer, P Smielewski, DA Chatfield, LA Steiner, AJ Johnston, SPMJ Downey, GB Williams, F Aigbirhio, PJ Hutchinson, K Rice, TA Carpenter, JC Clark, JD Pickard, DK Menon

Limbic hypometabolism in Alzheimer’s disease and mild cognitive impairment.

DOI: http://doi.org/10.1002/ana.10669
Journal: Ann Neurol
E-pub date: 1 Sep 2003
Authors: PJ Nestor, TD Fryer, P Smielewski, JR Hodges

Publications

Comparison of 15oxygen positron emission tomography and near-infrared spectroscopy for measurement of cerebral physiology

DOI: http://doi.org/10.1186/cc14525
Journal: Critical care (London, England)
E-pub date: 1 Jan 2015
Authors: J Simpson, N Sudhan, H Hare, J Donnelly, X Liu, F Aigbirhio, T Fryer, G Stocks-Gee, P Smielewski, D Bulte, J Coles

Critical thresholds for cerebrovascular reactivity after traumatic brain injury.

DOI: http://doi.org/10.1007/s12028-011-9630-8
Journal: Neurocrit Care
E-pub date: 1 Apr 2012
Authors: E Sorrentino, J Diedler, M Kasprowicz, KP Budohoski, C Haubrich, P Smielewski, JG Outtrim, A Manktelow, PJ Hutchinson, JD Pickard, DK Menon, M Czosnyka

Early derangements in oxygen and glucose metabolism following head injury: the ischemic penumbra and pathophysiological heterogeneity.

DOI: http://doi.org/10.1007/s12028-008-9119-2
Journal: Neurocrit Care
E-pub date: 1 Aug 2008
Authors: MG Abate, M Trivedi, TD Fryer, P Smielewski, DA Chatfield, GB Williams, F Aigbirhio, TA Carpenter, JD Pickard, DK Menon, JP Coles

Effect of hyperoxia on regional oxygenation and metabolism after severe traumatic brain injury: preliminary findings.

DOI: http://doi.org/10.1097/01.CCM.0000292014.60835.15
Journal: Crit Care Med
E-pub date: 1 Jan 2008
Authors: J Nortje, JP Coles, I Timofeev, TD Fryer, FI Aigbirhio, P Smielewski, JG Outtrim, DA Chatfield, JD Pickard, PJ Hutchinson, AK Gupta, DK Menon

Hyperventilation following head injury: effect on ischemic burden and cerebral oxidative metabolism.

DOI: http://doi.org/10.1097/01.CCM.0000254066.37187.88
Journal: Crit Care Med
E-pub date: 1 Feb 2007
Authors: JP Coles, TD Fryer, MR Coleman, P Smielewski, AK Gupta, PS Minhas, F Aigbirhio, DA Chatfield, GB Williams, S Boniface, TA Carpenter, JC Clark, JD Pickard, DK Menon

Intersubject variability and reproducibility of 15O PET studies.

DOI: http://doi.org/10.1038/sj.jcbfm.9600179
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Jan 2006
Authors: JP Coles, TD Fryer, PG Bradley, J Nortje, P Smielewski, K Rice, JC Clark, JD Pickard, DK Menon

Sources of variability in oxygen-15 PET studies in acute brain injury – impact on sample size estimation

DOI: http://doi.org/10.1038/sj.jcbfm.9591524.0675
Journal: Journal of Cerebral Blood Flow & Metabolism
E-pub date: 31 Aug 2005
Authors: JP Coles, TD Fryer, PG Bradley, J Nortje, P Smielewski, K Rice, JC Clark, JD Pickard, DK Menon

Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury.

DOI: http://doi.org/10.1093/brain/awh536
Journal: Brain
E-pub date: 31 Aug 2005
Authors: AS Cunningham, R Salvador, JP Coles, DA Chatfield, PG Bradley, AJ Johnston, LA Steiner, TD Fryer, FI Aigbirhio, P Smielewski, GB Williams, TA Carpenter, JH Gillard, JD Pickard, DK Menon

Effect of cerebral perfusion pressure augmentation on regional oxygenation and metabolism after head injury.

DOI: http://doi.org/10.1097/01.ccm.0000149837.09225.bd
Journal: Crit Care Med
E-pub date: 1 Jan 2005
Authors: AJ Johnston, LA Steiner, JP Coles, DA Chatfield, TD Fryer, P Smielewski, PJ Hutchinson, MT O'Connell, PG Al-Rawi, FI Aigbirihio, JC Clark, JD Pickard, AK Gupta, DK Menon

Imaging of cerebral blood flow and metabolism in brain injury in the ICU.

DOI: http://doi.org/10.1007/3-211-32318-X_94
Journal: Acta Neurochirurgica, Supplementum
E-pub date: 1 Jan 2005
Authors: JD Pickard, PJ Hutchinson, JP Coles, LA Steiner, AJ Johnston, TD Fryer, MR Coleman, P Smielewski, DA Chatfield, F Aigbirhio, GB Williams, K Rice, JC Clark, CH Salmond, BJ Sahakian, PG Bradley, TA Carpenter, R Salvador, A Pena, JH Gillard, AS Cunningham, S Piechnik, M Czosnyka, DK Menon

Does the acute diffusion-weighted imaging lesion represent penumbra as well as core? A combined quantitative PET/MRI voxel-based study.

DOI: http://doi.org/10.1097/01.WCB.0000141557.32867.6B
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Nov 2004
Authors: JV Guadagno, EA Warburton, FI Aigbirhio, P Smielewski, TD Fryer, S Harding, CJ Price, JH Gillard, TA Carpenter, J-C Baron

Does induced hypertension reduce cerebral ischaemia within the traumatized human brain?

DOI: http://doi.org/10.1093/brain/awh268
Journal: Brain
E-pub date: 1 Nov 2004
Authors: JP Coles, LA Steiner, AJ Johnston, TD Fryer, MR Coleman, P Smieleweski, DA Chatfield, F Aigbirhio, GB Williams, S Boniface, K Rice, JC Clark, JD Pickard, DK Menon

Changes in cerebral blood flow during cerebrospinal fluid pressure manipulation in patients with normal pressure hydrocephalus: a methodological study.

DOI: http://doi.org/10.1097/00004647-200405000-00012
Journal: J Cereb Blood Flow Metab
E-pub date: 1 May 2004
Authors: BK Owler, A Pena, S Momjian, Z Czosnyka, M Czosnyka, NG Harris, P Smielewski, T Fryer, T Donvan, A Carpenter, JD Pickard

Defining ischemic burden after traumatic brain injury using 15O PET imaging of cerebral physiology.

DOI: http://doi.org/10.1097/01.WCB.0000100045.07481.DE
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Feb 2004
Authors: JP Coles, TD Fryer, P Smielewski, K Rice, JC Clark, JD Pickard, DK Menon

Normal pressure hydrocephalus and cerebral blood flow: a PET study of baseline values.

DOI: http://doi.org/10.1097/01.WCB.0000093326.88757.49
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Jan 2004
Authors: BK Owler, S Momjian, Z Czosnyka, M Czosnyka, A Péna, NG Harris, P Smielewski, T Fryer, T Donovan, J Coles, A Carpenter, JD Pickard

Responses of posttraumatic pericontusional cerebral blood flow and blood volume to an increase in cerebral perfusion pressure.

DOI: http://doi.org/10.1097/01.WCB.0000090861.67713.10
Journal: J Cereb Blood Flow Metab
E-pub date: 1 Nov 2003
Authors: LA Steiner, JP Coles, AJ Johnston, M Czosnyka, TD Fryer, P Smielewski, DA Chatfield, R Salvador, FI Aigbirhio, JC Clark, DK Menon, JD Pickard

Assessment of cerebrovascular autoregulation in head-injured patients: a validation study.

DOI: http://doi.org/10.1161/01.STR.0000089014.59668.04
Journal: Stroke
E-pub date: 1 Oct 2003
Authors: LA Steiner, JP Coles, AJ Johnston, DA Chatfield, P Smielewski, TD Fryer, FI Aigbirhio, JC Clark, JD Pickard, DK Menon, M Czosnyka

Cerebrovascular pressure reactivity is related to global cerebral oxygen metabolism after head injury.

DOI: http://doi.org/10.1136/jnnp.74.6.765
Journal: J Neurol Neurosurg Psychiatry
E-pub date: 1 Jun 2003
Authors: LA Steiner, JP Coles, M Czosnyka, PS Minhas, TD Fryer, FI Aigbirhio, JC Clark, P Smielewski, DA Chatfield, T Donovan, JD Pickard, DK Menon

Integrated image analysis solutions for PET datasets in damaged brain.

DOI: http://doi.org/10.1023/a:1026293611455
Journal: J Clin Monit Comput
E-pub date: 1 Dec 2002
Authors: P Smielewski, JP Coles, TD Fryer, PS Minhas, DK Menon, JD Pickard

Effect of hyperventilation on cerebral blood flow in traumatic head injury: clinical relevance and monitoring correlates.

DOI: http://doi.org/10.1097/00003246-200209000-00002
Journal: Crit Care Med
E-pub date: 1 Sep 2002
Authors: JP Coles, PS Minhas, TD Fryer, P Smielewski, F Aigbirihio, T Donovan, SPMJ Downey, G Williams, D Chatfield, JC Matthews, AK Gupta, TA Carpenter, JC Clark, JD Pickard, DK Menon