Intensive Care Monitoring Healthcare Scientist,
NHS Greater Glasgow & Clyde
BrainIT Group Coordinator
Dr Ian Piper is a Principal Health Care Scientist in the Department of Clinical Physics and Bioengineering at NHS Greater Glasgow & Clyde responsible for intensive care monitoring services. His undergraduate training is in Physiology and Electronics with postgraduate training in Clinical Neuroscience. Dr Piper's principal research focus is on the development and validation of clinical monitoring methods useful in the study and treatment of patients with traumatic brain injury. He is co-founder and coordinator of the BrainIT Group (www.brainit.org), a European, multi-centre collaborative network for research into the development of new monitoring and management technology for tracking and improving patient care.
- Mail: Department of Clinical Physics, Southern General Hospital 1345 Govan Road Glasgow, G51 4TF
- Phone: +44 (0) 141 201 2595
Current and Recent Projects
Improving Decision Support for Treating Arterial Hypotension in Adult Patients During their Management in Intensive Care
- Prof. Chris Williams, School of Informatics, University of Edinburgh
- Prof. John Kinsella, Department of Anaesthesia, Pain & Critical Care, University of Glasgow
- Prof. Peter Andrews, University of Edinburgh
- Mr Rob Donald, C3 Global Ltd
- Philips Medical
- BrainIT Group Collaborators
- Automatically and continually monitoring at least four in-vivo patient parameters (eg: ECG, arterial blood pressure, Oxygen saturation and core temperature), together with open interfaces providing input of key demographic data (age, gender etc.) and periodic data (clinical pathology results etc.) related to the patient.
- Outputting a continuous Hypotension Prediction Index (HPi) which will be updated on a minute by minute basis upon any change detected in the patient parameter input set.
- 2013-2015 - Chief Scientist's Office - Improving Decision Support for Treating Arterial Hypotension in Adult Patients During their Management in Intensive Care. (Co-PI). (£223,000)
- 2008-2011 - CORDIS (EU) Seventh Framework ICT Programme (PI) - Advanced Arterial Hypotension Adverse Event prediction through a Novel Bayesian Neural Network (£1,197,116)
- 2002-2006 - CORDIS (EU) Fifth Framework Quality of Life Programme (PI) - BRAIN-IT2 - Brain Monitoring with Information Technology. Research and Infrastructure Support. (£1,185,012)
Maintaining blood pressure in critically ill patients is a key management goal and yet it is the physiological parameter most prone to error. Studies indicate as much as a third of hypotension (low blood pressure) is missed due to presence of artifact. This project is to develop and validate advanced statistical methods for detection, removal and cleaning of artifact from blood pressure (BP) data. Without these methods any audit or trial of BP therapy will not be accurate. This proposal will develop these methods to interpret data from traumatic brain injury (TBI) and sub-arachnoid haemorrhage (SAH) patients and evaluate them in the neuro-intensive care unit at the Southern General Hospital, Glasgow. The proposal brings together experts in anaesthesia and intensive care with the expertise of Prof Williams' group at Edinburgh in advanced methods (including Factorial Switching Linear Dynamical Systems-FSLDS) for physiological condition monitoring (initially developed in the neonatal ICU).
Advanced Arterial Hypotension Adverse Event prediction through a Novel Bayesian Neural Network
The main scientific objective of the project was the determination of the weighted association between multiple patient parameters and subsequent arterial hypotension. The association will then be used to define a Bayesian neural network, which will be trained against the BrainIT dataset, before undertaking a clinical trial to demonstrate the Avert-IT project concept. The main technological objective was the development of an IT-based decision support system ("HypoPredict") appropriate for deployment within intensive and high dependency care units. The system will be capable of:
- Chris Hawthorne and Ian Piper. Monitoring Intracranial Pressure in Patients with Traumatic Brain Injury. Frontiers in Neuroscience. Review Article. 2014 (IN PRESS).
- Sinnott, R.O., and Piper, I,(2009) E-infrastructures fostering multi-centre collaborative research into the intensive care management of patients with brain injury. In: Cannataro, M.(ed.) Handbook of Research on Computational Grid Technologies for Life Sciences, Biomedicine and Healthcare. IGI Global, Hershey, PA, pp. 494-512. ISBN 9781605663746
- Daley M, Piper I. Monitoring of Intracranial Pressure: (Chapter) In: Encyclopedia of Medical Devices and Instrumentation. Wiley 2007.
- Piper IR. Intracranial Pressure and Elastance: (Chapter) In Severe Closed Head Injury. ed: Reilly P. 1997. Pathophysiology and Management of Severe Closed Head Injury. Chapman and Hall, 1997 (First Edition), 2nd Edition 2005
- Citerio G, Piper IR. Monitoring of Intracranial Pressure and Cerebral Compliance: (Chapter) In Yearbook of Intensive Care and Emergency Medicine. ed: Vincent JL. Springer, 2002.
- Miller JD, Piper IR, Statham PFX: ICP Monitoring Indications and Techniques Chapter 31: In: Narayan R J, Wilberger J E, Povlishock JT. Neurotrauma. 1st Edition. McGraw Hill: New York, 1996, pp 429-425. Neurotrauma, 1996 (Chapter).
- Miller JD, Piper IR, Jones PA: Pathophysiology of Head Injury Chapter 5: In: Narayan R J, Wilberger J E, Povlishock JT. Neurotrauma. 1st Edition. McGraw Hill: New York, 1996, pp 61-71. Neurotrauma, 1996 (Chapter).
- Miller JD, Piper IR, Jones PA. Integrated multi-modality monitoring in the neurosurgical intensive care unit. Neurosurgical Intensive Care, Neurosurgery Clinics of North America October 1994, 661-670, 1994 (Chapter)
- Miller JD, Piper IR. Monitoring patients following severe head injury. In Zerebroprotektive Massnahmen bei der Energiekrise des Hirns. Eds. H. Wassmann & D Moskopp. 1993 (Chapter)
- Miller JD, Piper IR: Raised intracranial pressure and its effect on brain function. Chapter 23. In: Crockard HA, Hayward R, Hoff JT. Neurosurgery. The scientific basis of clinical practice. 2nd Edition. Blackwell Scientific: Oxford, 1992, pp 373-390. 1992 (Chapter)
- Piper IR: Waveform Analysis of Intracranial Pressure and Craniospinal Compliance: Clinical and Experimental Studies. 1990 (Ph.D. Thesis)
- Depreitere B, Güiza F, Van den Berghe G, Schuhmann MU, Maier G, Piper I, Meyfroidt G. Pressure autoregulation monitoring and cerebral perfusion pressure target recommendation in patients with severe traumatic brain injury based on minute-by-minute monitoring data. J Neurosurg. 2014 Jun;120(6):1451-7.
- Ragauskas A, Bartusis L, Piper I, Zakelis R, Matijosaitis V, Petrikonis K, Rastenyte D. Improved diagnostic value of a TCD-based non-invasive ICP measurement method compared with the sonographic ONSD method for detecting elevated intracranial pressure. Neurol Res. 2014 Jul;36(7):607-14.
- Tosetti P, Hicks RR, Theriault E, Phillips A, Koroshetz W, Draghia-Akli R; Workshop Participants (including Ian Piper). Toward an international initiative for traumatic brain injury research. J Neurotrauma. 2013 Jul 15;30(14):1211-22.
- Fabian Güiza, Bart Depreitere, Ian Piper , Greet Van den Berghe, Geert Meyfroidt. Novel Methods to Predict Increased Intracranial Pressure During Intensive Care and Long-Term Neurological Outcome After Traumatic Brain Injury: Development and Validation in a Multicenter Dataset. Crit Care Med. 2013 Feb;41(2):554-64.
- Ragauskas A, Matijosaitis V, Zakelis R, Petrikonis K, Rastenyte D, Piper I, Daubaris G. Clinical assessment of noninvasive intracranial pressure absolute value measurement method. Neurology. 2012 78(21):1684-91.
- Shaw M, Piper I, Daley M. Autoregulatory model comparison and optimisation methodology. Acta Neurochir Suppl. 2012;114:135-9.
- Donald R, Howells T, Piper I, Chambers I, Citerio G, Enblad P, Gregson B, Kiening K, Mattern J, Nilsson P, Ragauskas A, Sahuquillo J, Sinnott R, Stell A. Early warning of EUSIG-defined hypotensive events using a Bayesian Artificial Neural Network. Acta Neurochir Suppl. 2012;114:39-44.
- The brain monitoring with Information Technology (BrainIT) collaborative network: EC feasibility study results and future direction. Piper I, Chambers I, Citerio G, Enblad P, Gregson B, Howells T, Kiening K, Mattern J, Nilsson P, Ragauskas A, Sahuquillo J, Donald R, Sinnott R, Stell A; BrainIT Group. Acta Neurochir (Wien). 2010 Nov;152(11):1859-71.
- Federating distributed clinical data for the prediction of adverse hypotensive events. Anthony Stell, Richard Sinnott, Jipu Jiang, Rob Donald, Iain Chambers, Per Enblad, Barbara Gregson, Tim Howells, Karl Kiening, Pelle Nilsson,Giuseppe Citerio, Arminas Ragauskas, Juan Sahuquillo and Ian Piper. Phil. Trans. R. Soc. A 2009 367, 2679-2690
- Shaw M, Piper I. Pilot application of fractal characterisation and its response to change on physiological wave forms. Acta Neurochir Suppl (2008) 102: 229–233
- Piper I on Behalf of BrainIT Group. Not if but when; no longer why but how. Critical Care. 2007;11
- Mitchell P, Gregson B, Piper I, Ceterio G, Mendelow AD, Chambers IR. Blood pressure in head injured patients J Neurol Neurosurg Psychiatry 2007;78 399-402
- Howells T, Elf K, Jones P, Ronne-Engstrom E, Piper I, Nillson P, Andrews P, Enblad P. Pressure reactivity as a guide in the treatment of cerebral perfusion pressure in patients with brain trauma. J Neurosurg 102:311-317, 2005
- Daley M, Leffler CW, Jackson S, Piper I. Use of the resistance area product derived from Doppler MCA velocity to estimate the range of active cerebrovascular regulation. Acta Neurochirurgica Vol 81, 155-157,2002.
- Mascia L, Andrews P, Souter M, Merrick M, Piper IR. Cerebral blood flow and metabolism in severe brain injury: the role of pressure autoregulation during cerebral perfusion pressure management.Intensive Care Med. 2000 Feb;26(2):202-5.
- Mascia L, Piper IR, Andrews P, Souter M, Web D. The role of endothelin-1 in pressure autoregulation of cerebral blood flow in rats. Intensive Care Med. 1999 Nov;25(11):1282-6.
- Raabe A. , Cosnyka M, Piper I. Monitoring of intracranial compliance: correction for a change in body position. Acta Neurochir (Wien) 1999; 14(1): 31-36.
- Piper I.R., Garrioch M.A., Souter M.J., Andrews P.J.D ., Thomson D1., HND. Effects of Diaspirin Crosslinked Haemoglobin on Post-traumatic Cerebral Perfusion Pressure and Blood Flow in a Rodent Model of Diffuse Brain Injury British Journal of Intensive Care 1998; 80: 639-643.
- Jones PA, Andrews PJD, Midgley S, Anderson SI, Piper IR, Tocher JL, Housley AM, Corrie JA, Slattery J, Dearden NM, Miller JD. Measuring the Burden of Secondary Insults in Head Injured Patients During Intensive Care. J Neurosurg. Anaesth.6(1) 4-14, 1994.
- Corrie J, Piper IR, Housley A, Tocher J L, Jones P A, Anderson S I, Midgley S, Dearden N M, Miller JD: Microcomputer Based Data Recording Improves Identification of Secondary Insults During Acute Management of Head Injured Patients. Br. J. Intensive Care. 3: (June) 225-233, 1993.
- Piper IR, Chan KH, Whittle IR, Miller JD: An experimental study of cerebrovascular resistance, pressure transmission and craniospinal compliance. Neurosurgery 32:805-816, 1993
- Piper IR, Lawson A, Dearden NM, Miller JD: A microcomputer based research data collection system in head injury intensive care. British Journal of Intensive Care, 1 (2), 73-78, 1991
- Piper IR, Miller JD, Dearden NM, Leggate JRS, Robertson I: Systems analysis of cerebrovascular pressure transmission: an observational study in head injured patients. J Neurosurg 73, 871-880, 1990