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Prof Mike Grocott


Director, NIHR Southampton Biomedical Research Centre; Theme Lead, Perioperative and Critical Care theme; Professor of Anaesthesia and Critical Care Medicine

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Mike Grocott is Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, director of the Southampton NIHR Biomedical Research Centre (2022-27) and an NIHR Senior Investigator (reappointed 2022). He was previously NIHR CRN national specialty lead for Anaesthesia Perioperative Medicine and Pain (2015-2020).

Mike is vice-chair of the board of the UK national multidisciplinary Centre for Perioperative Care (CPOC) and was previously elected vice-president of the Royal College of Anaesthetists (2019-20). He serves as joint editor-in-chief of Perioperative Medicine and chair of the UK National Institute of Academic Anaesthesia (2018-2024).

Landmark publications:

10 Most Significant Publications:

1. Grocott MPW and Martin DS, Levett DZH, McMorrow R, Windsor J, Montgomery H, Caudwell Xtreme Everest Research Group. Arterial blood gases and oxygen content in climbers on Mount Everest. New England Journal of Medicine 2009;360;140-149

2. Wijeysundera DN, Pearse RM, Shulman MA, Abbott TEF, Torres E, Ambosta A, Croal BL, Granton JT, Thorpe KE, Grocott MPW, Farrington C, Myles PS, Cuthbertson BH; METS study investigators. Assessment of functional capacity before major non-cardiac surgery: an international, prospective cohort study. Lancet 2018 Jun 30;391(10140):2631-2640

3. Horscroft JA, Kotwica AO, Laner V, West JA, Hennis PJ, Levett DZH, Howard DJ, Fernandez BO, Burgess SL, Ament Z, Gilbert-Kawai ET, Vercueil A, Landis BD, Mitchell K, Mythen MG, Branco C, Johnson RS, Feelisch M, Montgomery HE, Griffin JL, Grocott MPW, Gnaiger E, Martin DS, Murray AJ. Metabolic basis to Sherpa altitude adaptation. Proceedings of the National Academy of Science, USA 2017;114(24):6382-6387

4. Imray CHE, Grocott MPW, Wilson MH, Hughes A, Auerbach PS. Extreme, expedition, and wilderness medicine. Lancet  2015;386(10012):2520-2525

5. Pearse RM, Harrison DA, MacDonald N, Gillies MA, Blunt M, Ackland G, Grocott MPW, Ahern A, Griggs K, Scott R, Hinds C, Rowan K for the OPTIMISE study group. Effect of a peri-operative, cardiac output-guided, hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: A randomized clinical trial and updated systematic review.  Journal of the American Medical Association2014;311(21):2181-90

6. Wilson M, Davagnanam I, Holland G, Dattani RS, Hirani SP, Kolfschoten N, Strycharczuk L, Green C, Thornton JS, Wright W, Bradwell AR, Edsell M, Kitchen ND, Cameron J Holloway CJ, Clarke K, Grocott MP, Montgomery HM and Imray C on behalf of the Caudwell Xtreme Everest Group and the the Birmingham Medical research Expeditionary Society. The Cerebral Venous System and Anatomical Predisposition to High Altitude Headache. Annals of Neurology 2013;73(3):381-9

7. Low EV, Avery AJ, Gupta V, Schedlbauer A, Grocott MP. Identifying the lowest effective dose of acetazolamide for the prophylaxis of acute mountain sickness at altitude: a systematic review and meta-analysis. BMJ 2012;345:e6779

8. Pearse RM, Holt P, Grocott MP. Managing perioperative risk in patients undergoing elective non-cardiac surgery. BMJ  2011;343:b5759

9.  Grocott MPW. Improving outcomes after surgery. BMJ 2009;339:b5173

10. Martin DS, Grocott MP. Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia Critical Care Medicine 2013;41(2):423-32

Major grants (CI/CoCI):

NIHR Efficacy and Mechanism Evaluation - £359,638 (2022-2024) NIHR151287: Oxidative stress, redox status and surfactant metabolism in mechanically ventilated patients requiring different supplementary oxygen strategies.

NIHR Southampton Biomedical Research Centre - £25,232,032 (2022-2027) director, lead applicant and Perioperative and Critical Care theme lead.

NIHR Senior Investigator (renewal) - £80,000 (2022-26), £360,000 (2018-22).

Bill and Melinda Gates Foundation - £1,250,449 (2020-23) A clinical trial of nebulized surfactant for the treatment of severe COVID-19 in adults: COVSurf

NHS England Sustainability and Transformation Partnership - £2,389,876 (2017-2020) -  Cancer Transformation Bid: WESFIT - Factorial design randomized controlled trial evaluating a physical and psychological prehabilitation to patients undergoing elective major intra-cavity cancer surgery

National Institute of Academic Anaesthesia - £240,000 (2011-2015) Royal College of Anaesthetists British Oxygen Chair for the “Fit 4 Surgery” program

Impact example:

Prehabilitation: supporting surgical patients physically and emotionally

Major surgery is like running a marathon. Training for surgery to improve physical fitness is called ‘Prehabilitation.’

Prehabilitation also involves improving mental health and diet. It helps patients cope with the stress of surgery. Our world leading prehabilitation research shows that prehabilitation improves wellbeing, speeds up recovery and reduces problems after surgery. It may even shrink tumours.

We were the first to show that chemotherapy reduces fitness. We linked this to poor outomes after surgery. Then we showed that supervised high-intensity exercise reversed the effects of chemotherapy. The exercise was safe, doable and valued by patients. It also improved fitness and quality of life after surgery.

To develop better care, we explored the causes of these effects. We showed that Chemoradiotherapy (CRT) damages mitochondria in muscles which are the cells’ powerhouses. Exercise reversed some of these effects and improved muscle mass. Finally we were also the first to show that high intensity exercise during CRT may increase tumour shrinkage.

Our regional WesFit trial took prehabilitation into the community. We were funded by the NHS organisation that transforms cancer care. We trained personal trainers to supervise patients exercising in local gymns. The programme was safe, patients were keen to take part and 87% completed the course.

When COVID-19 hit cancer care was disrupted. We responded by adapting our programme to support patients remotely by video call or telephone. We trained personal trainers to deliver exercise, emotional and dietary support in the Safefit programme.

We have advanced prehabilitation through national and international roles including:

  • Leading the NIHR/RCOA/MacMillan guidance for prehabilitation in patients with cancer

  • Winning the 2020 Cancer initiative of the year for WesFit

  • Co-founding the International Prehabilitation Society

  • Chairing Prehabilitation World Congress

  • Contributing to the Royal College of Surgeons/Anaesthetists guidance recommending prehabilitation for all patients before surgery.

Our future work aims to:

  • Understand better how exercise works in prehabilitation, particularly how it may shrink tumours.

  • Develop new personalised prehabilitation packages based on a patient’s needs.

  • Explore whether prehabilitation works before immunotherapy (a different type of cancer treatment).

  • Develop a regional prehabilitation service for patients on palliative care pathways.

Through this, we will improve wellbeing and survival for patients facing the toughest test of their lives.

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