The field of critical care toxicology is vital for the effective diagnosis and management of patients critically ill due to poisoning. Expertise in this area is crucial for healthcare professionals facing complex and often life-threatening situations. In 2017, and continuing today, a cadre of dedicated toxicologists has been at the forefront of advancing this specialty. This article highlights the contributions of several key figures who exemplify the expertise necessary for optimal patient outcomes in critical care toxicology.
Jeffrey Brent, M.D., Ph.D., a Distinguished Clinical Professor at the University of Colorado School of Medicine and Colorado School of Public Health, embodies a career dedicated to advancing medical toxicology. His extensive research, evidenced by nearly 300 publications, including original research and reviews, has significantly contributed to the body of knowledge in the field. As Principal Investigator and Director of the Toxicology Investigators Consortium (ToxIC), a nationally recognized research group, Dr. Brent leads collaborative efforts to improve our understanding and management of toxicological emergencies. His past presidency of the American Academy of Clinical Toxicology (AACT) and board membership in the American College of Medical Toxicology (ACMT) underscore his leadership and influence within the specialty. His numerous accolades, including the Louis Roche award and the Ellenhorn Award, further recognize his exceptional contributions to clinical toxicology and patient care. Dr. Brent’s long-standing commitment to research and clinical practice makes him a pivotal figure in critical care toxicology diagnosis and management.
Dr. Burkhart, serving as the Lead Medical Officer for the Medical Informatics Team at the FDA, brings a unique perspective to critical care toxicology, bridging clinical practice with regulatory science. His training at the Rocky Mountain Poison Center, a leading center for toxicology expertise, provided him with a strong foundation in managing poisoned patients. His emergency medicine background further enhances his ability to handle acute and critical cases. As a Past-President of the American College of Medical Toxicology and Clinical Professor of Emergency Medicine at Penn State University College of Medicine, Dr. Burkhart remains actively involved in clinical practice and education. His work at the FDA, combined with his clinical experience, positions him to influence the broader landscape of drug safety and toxicology management, impacting critical care toxicology on a national level.
Paul Dargan, MD, a Consultant Physician and Clinical Toxicologist and Clinical Director at Guy’s and St Thomas’ NHS Foundation Trust in London, and a Reader in Toxicology at King’s College London, represents international leadership in critical care toxicology. His research program, focusing on recreational drug toxicity, self-poisoning, and heavy metal toxicity, addresses some of the most pressing challenges in modern toxicology. With over 210 peer-reviewed publications, Dr. Dargan’s scholarly contributions are extensive and impactful. His roles on the UK Advisory Council on the Misuse of Drugs (ACMD) and the Scientific Committee of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), along with his advisory role to the FDA and WHO, highlight his global influence in shaping policy and practice in toxicology. Dr. Dargan’s expertise is particularly vital in the critical care setting, where rapid diagnosis and management of complex poisonings are paramount.
Dr. Hatten, an Assistant Professor of Emergency Medicine at the University of Colorado School of Medicine and Medical Toxicologist at the Rocky Mountain Poison and Drug Center, is an emerging leader in critical care toxicology. His active practice and academic involvement in the Medical Toxicology Fellowship and Emergency Medicine Residency at the University of Colorado demonstrate his commitment to training the next generation of toxicologists. His Master of Public Health degree complements his clinical expertise, providing a broader perspective on public health aspects of toxicology. Dr. Hatten’s work at a major poison center and his academic roles position him to significantly contribute to the ongoing advancement of critical care toxicology diagnosis and management protocols.
Bruno Megarbane, Professor of critical care medicine at Paris-Diderot University and head of the Medical and Toxicological Intensive Care Unit at Lariboisière Hospital in Paris, brings a European perspective to the forefront of critical care toxicology. His clinical research focusing on prognostic factors and improved management of severe poisonings, particularly cardiotoxicant poisonings, is directly relevant to enhancing patient outcomes in critical care settings. His experimental research into the mechanisms of psychotropic drug toxicity further deepens the understanding of complex poisoning scenarios. As President-elect of the European Association of Poison Centres and Clinical Toxicologists (EAPCCT), and an active member of key intensive care and toxicology societies, Professor Megarbane plays a crucial role in shaping international standards and practices in critical care toxicology.
Dr. Palmer, a partner at Toxicology Associates in Denver, CO, brings a strong foundation in chemistry and pharmacology to the practice of clinical toxicology. His background in organic-medicinal chemistry and pharmacology of opioids, coupled with his clinical toxicology fellowship at the Rocky Mountain Poison and Drug Center, provides a unique blend of expertise. His previous work with the Office of the Medical Investigator adds another dimension to his experience, particularly in forensic toxicology aspects that can be relevant in certain critical care cases. As president-elect of the American Academy of Clinical Toxicology, Dr. Palmer continues to be a prominent figure in the field, influencing the standards and direction of clinical and critical care toxicology.
Julian White AM, MD, a consultant clinical toxinologist and Director of the Toxinology Department at Women’s & Children’s Hospital in Adelaide, Australia, offers a global perspective on critical care toxicology, particularly in the realm of envenomation. With over 40 years of experience and thousands of envenomed patients treated, Dr. White is a world-renowned expert in this niche but critical area of toxicology. His extensive publications and leadership roles in the International Society on Toxinology (IST) underscore his significant contributions to the field. His recognition with Membership of the Order of Australia (AM) further acknowledges his exceptional impact on clinical toxinology. Dr. White’s expertise is invaluable in regions where envenomation is a significant cause of critical illness, highlighting the global relevance of critical care toxicology.
In conclusion, the experts highlighted here represent a fraction of the dedicated professionals advancing critical care toxicology diagnosis and management. Their collective expertise, spanning clinical practice, research, education, and policy, is essential for continued progress in this demanding and vital medical specialty. In 2017 and beyond, their contributions have been, and will continue to be, instrumental in improving the care of critically ill patients suffering from the effects of poisoning worldwide.
