FLCCC Contributions to the Field of Medicine
Members of the FLCCC Alliance came together in early 2020, when the SARS-CoV-2 virus began to sweep through the world, to study and create effective treatments for the disease known as COVID-19. The treatments created were the MATH+ Hospital Treatment Protocol, and the I-MASK+ Prophylaxis and Early Outpatient Treatment Protocol. They have also made several other significant contributions to the field of medicine. Below are contributions made by FLCCC’s five core critical care physicians. The FLCCC Physicians section contains CVs and bibliographies of the FLCCC Alliance physicians.
Dr. Meduri is the father of noninvasive ventilation, as he first investigated and reported its applications in all forms of acute respiratory failure. Dr. Meduri collaborated with Italian investigators (Drs. M. Antonelli and M. Confalonieri) in several landmark randomized trials providing efficacy and safety evidence. The worldwide implementation of noninvasive ventilation – based on the protocol developed by Dr. Meduri – is recognized as a significant contribution to reducing morbidity and mortality in critical care medicine. In patients with severe COVID-19, noninvasive ventilation has played an essential role in decreasing the need for endotracheal intubation.
Dr. Meduri was the first to describe the concepts of both the dysregulated systemic and pulmonary inflammation in ARDS and the cellular mechanisms responsible for regulation. His identification of the glucocorticoid receptor as the critical regulator for restoring health in critical illness has provided the rationale for prolonged glucocorticoid treatment in multiple critical illness states.
Over the past thirty years, Dr. Meduri has been the leading worldwide investigator and developer in the use of prolonged glucocorticoid treatment in acute respiratory distress syndrome (ARDS) and severe pneumonia, as principal investigator in translational research and multiple landmark randomized trials. To date, prolonged glucocorticoid administration is the only treatment intervention that has reduced mortality in ARDS and in COVID-19. Dr. Meduri’s work has been referenced in 25,000 peer-reviewed publications.
Pierre Kory is the former Chief of the Critical Care Service and Medical Director of the Trauma and Life Support Center at the University of Wisconsin. He is considered one of the world pioneers in the use of ultrasound by physicians in the diagnosis and treatment of critically ill patients. He helped develop and run the first national courses in Critical Care Ultrasonography in the U.S., and served as a Director of these courses with the American College of Chest Physicians for several years. He is also the senior editor of the most popular textbook in the field titled “Point of Care Ultrasound,” now in its 2nd edition and that has been translated into 7 languages worldwide. He has led over 100 courses nationally and internationally, teaching physicians this now-standard skill in his specialty.
Dr. Kory was also one of the U.S. pioneers in the research, development, and teaching of performing therapeutic hypothermia to treat post-cardiac arrest patients. In 2005, his hospital was the first in New York City to begin regularly treating patients with therapeutic hypothermia. He then served as an expert panel member for New York City’s Project Hypothermia, a collaborative project between the Fire Department of New York and Emergency Medical Services. This project created cooling protocols within a network of 44 regional hospitals – along with a triage and transport system that directed patients to centers of excellence in hypothermia treatment – of which his hospital was one of the first.
Known as a Master Educator, Dr. Kory has won numerous departmental and divisional teaching awards in every hospital he has worked. He has delivered hundreds of courses and invited lectures throughout his career.
In collaboration with Dr. Paul Marik, Dr. Kory pioneered the research and treatment of septic shock patients with high doses of intravenous ascorbic acid. His work was the first to identify the critical relationship between the time of initiation of therapy and survival in septic shock patients – an aspect of the therapy that led to understanding all the failed randomized controlled trials that employed delayed therapy.
Dr. Kory has led ICU’s in multiple COVID-19 hotspots throughout the pandemic. Having led his old ICU in New York City during their initial surge in May for 5 straight weeks, he then travelled to other COVID-19 hotspots to run COVID ICU’s in Greenville, South Carolina and Milwaukee, WI during their surges. He has co-authored 5 influential papers on COVID-19, with the most impactful being a paper that was the first to support the diagnosis of early COVID-19 respiratory disease as an organizing pneumonia, thus explaining the critical response of the disease to corticosteroids.
Dr. Marik has special knowledge and training in a diverse set of medical fields, with specific training in Internal Medicine, Critical Care, Neurocritical Care, Pharmacology, Anesthesia, Nutrition, and Tropical Medicine and Hygiene. Dr. Marik is currently a tenured Professor of Medicine and Chief of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia. Dr. Marik has written over 500 peer-reviewed journal articles, 80 book chapters and authored four critical care books. He has been cited over 43,000 times in peer-reviewed publications and has an H-index of 77. He has delivered over 350 lectures at international conferences and visiting professorships. He has received numerous teaching awards, including the National Teacher of the Year award by the American College of Physicians in 2017.
He is the 2nd most published critical care physician in the world ever, and is a world renowned expert in the management of sepsis – his contributions to the understanding and management of the hemodynamic, fluid, nutritional, and supportive care practices in sepsis have transformed the care of patients throughout the world. He also led the Society of Critical Care Medicine task force on corticosteroids in sepsis. He has already co-authored 10 papers on many therapeutic aspects of COVID-19.
Dr, Varon has contributed more than 830 peer-reviewed journal articles, 10 full textbooks, and 15 dozen book chapters to medical literature. He currently serves as Editor-in-Chief for Critical Care and Shock and Current Respiratory Medicine Reviews. Dr. Varon has won many prestigious awards and is considered one of the top physicians in the United States. Dr. Varon is also known for his groundbreaking contributions to Critical Care Medicine in the fields of cardiopulmonary resuscitation and therapeutic hypothermia. He has developed and studied technology for selective brain cooling. With Dr. Carlos Ayus, he co-described the hyponatremia associated with extreme exercise syndrome also known as the “Varon-Ayus syndrome.” With Mr. James Boston, he co-described the healthcare provider anxiety syndrome also known as “Boston-Varon syndrome.” Along with Professor Luc Montagnier (Nobel Prize Winner for Medicine in 2008), Dr. Varon created the Medical Prevention and Research Institute in Houston, Texas, which conducts work on basic sciences projects. Dr. Varon has appeared in numerous national and international television and radio programs showing his techniques and care of patients. During the past 11 months of the COVID pandemic, Dr. Varon has become a world leader for his work on COVID19 and his co-development of the MATH+ protocol to care for these patients. For this he has won multiple awards, including a proclamation by the Mayor of the City of Houston as “Dr. Joseph Varon Day”.
Dr. Iglesias is board-certified in Internal Medicine, Nephrology, Critical Care, and is a specialist in Hypertension of the American Society of Hypertension. He currently is an Associate Professor of Medicine at the University of Medicine and Dentistry of the N.J. School of Osteopathic Medicine, and Associate Professor of Medicine at Hackensack Meridian School of Medicine. He is the medical director of the John J. DePalma Renal Institute of Central Jersey, one of the largest dialysis centers in New Jersey. His interests are all aspects of clinical and critical care nephrology, care of the renal transplant patient, hypertension, critical care, and septic shock medicine. He is involved in active clinical research in many areas of critical illness including septic shock, congestive heart failure, and acute kidney injury. His randomized controlled trial published in the major medical journal Chest was the first to demonstrate markedly reduced requirements for vasopressor therapy in septic shock patients treated with intravenous ascorbic acid. He has worked tirelessly at bedsides in ICUs of multiple hospitals in New Jersey throughout the pandemic. His rapidly accumulated clinical insights and expertise helped develop the MATH+ hospital treatment protocol for COVID-19.