Marcos F. Vidal Melo, M.D.

he recipient of the 2007 ASA Presidential Scholar Award is Marcos F. Vidal Melo, M.D., an Assistant Professor of Anesthesia in the Department of Anesthesia and Critical Care, Massachusetts General Hospital/Harvard Medical School, Boston. Dr. Vidal Melo received a B.Sc. in Civil Engineering and M.Sc. in Biomedical Engineering from the Federal University of Rio de Janeiro, Brazil, an M.D. from the Fluminense Federal University in Brazil, and a doctorate in Experimental Surgery at the University of Heidelberg, Germany. He commenced a clinical anesthesiology residency at Southwestern Medical Center, Dallas, Texas, and then his interest in acute respiratory distress syndrome research motivated him to complete his residency and a cardiac anesthesia fellowship in the Department of Anesthesia and Critical Care at Massachusetts General Hospital.

Dr. Vidal Melo has focused his research efforts on the advancement of positron emission tomography (PET)-based techniques to study ventilation, perfusion and inflammation in the lung and has applied these techniques to patients and to animal models of lung disease.

Highlights of his contributions on functional lung imaging and pulmonary pathophysiology include: 1) in collaboration with J.G. Venegas, M.D., the design of a unique PET method to accurately quantify and visualize in vivo and noninvasively alveolar ventilation-perfusion () distributions in animals and humans; 2) studying hypoxemia during severe bronchoconstriction with R. S. Harris, M.D., the demonstration that a significant portion of the mismatch derived from regions of the lung smaller than secondary pulmonary lobules (2.2 cm³), although chest radiographs misleadingly showed large regions of lung collapse and reduced ventilation. He also indicated that mismatch following pharmacologically triggered bronchoconstriction was correlated with the degree of pre-existing heterogeneity, suggesting that uniformity of ventilation was a desired therapeutic target; 3) on pulmonary embolism (PE), the identification and quantification of in vivo adaptive changes of pulmonary ventilation after a PE resulting in shifting of regional ventilation from embolized to nonembolized areas; and 4) investigating lung injury due to surfactant depletion, the finding of a significant impairment in the distribution of regional alveolar volume to perfusion superimposed on the dysfunction caused by pulmonary edema, and the demonstration that the impairment could be altered by mechanical ventilation and posture to optimize gas exchange.

More recently, with collaborators Tilo Winkler, Ph.D., Guido Musch, M.D., and Tobias Schroeder, M.D., Dr. Vidal Melo is establishing the ability of PET techniques to detect and quantify regional neutrophil infiltration during smoke inhalation and ventilator-induced lung injury (VILI), the importance of pre-existing heterogeneity to regional inflammation following smoke inhalation, and the significance of heterogeneous lung expansion on the magnitude and distribution of inflammation during mechanical ventilation. Dr. Vidal Melo has recently been funded by the National Heart, Lung, and Blood Institute (NHLBI) to continue his studies on regional lung inflammation and dysfunction during VILI.

As our Director of Research in Cardiac Anesthesia, Dr. Vidal Melo has led a number of investigator-initiated and industry-sponsored clinical studies at Massachusetts General Hospital. This has given our residents and fellows the opportunity to participate in clinical investigation and has attracted physicians from other countries to their group. Dr. Vidal Melo is respected and esteemed by our staff as a skillful clinician and co-worker. Residents and fellows consider him an excellent teacher and frequently comment upon his ability to fuse basic scientific knowledge with daily clinical practice, bringing intellectual depth to the teaching and practice of anesthesiology.

In summary, Marcos F. Vidal Melo typifies the innovative clinician-scientist that we seek to develop in our educational programs and attract to our medical specialty. He is an important leader of an emerging and important field of research and is poised to improve our care of the respiratory failure patient by giving us a better understanding of the dysfunction of the injured lung. He is a most deserving recipient of the 2007 ASA Presidential Scholar Award.

Warren M. Zapol, M.D., is Anesthetist-in-Chief, Department of Anesthesiology, Massachusetts General Hospital and Reginald Jenney Professor of Anesthesia, Harvard Medical School, Boston, Massachusetts.