About

Joshua Doyle is an Assistant Professor of Sociology at Purdue University within the College of Liberal Arts. He is a sociologist who studies how culture influences decision-making. His current research focuses on social trust as a predictor of cooperative behaviors and support for environmental protections. Doyle employs a mixture of experimental methods and statistical analysis of observational data in his research, contributing to the understanding of social psychology, culture and action, environmental problems, social trust, and cooperation.

Research topics

• Internal medicine
• Medicine
• Cardiology
• Physics
• Materials science
• Pathology
• Radiology
• Composite material
• Engineering
• Optics
• Mathematical analysis
• Mathematics
• Structural engineering
• Geometry

Selected publications

• S154 Patients with new-onset interstitial lung disease (ILD) do not have higher mortality than those with established ILD when admitted to intensive care with severe acute respiratory failure (SARF)

  2025-11-01

  article

  <h3>Introduction</h3> Admission to the intensive care unit (ICU) is deemed unfavourable for most patients with interstitial lung disease (ILD) who develop severe acute respiratory failure (SARF). Owing to the fulminant trajectory of their disease, individuals with new-onset ILD may have a particularly poor prognosis. This study compares ICU and post-discharge outcomes between patients with new-onset ILD and established ILD following admission for SARF. <h3>Methods</h3> Patients with ILD-related SARF and consecutively admitted to the adult ICU between 2009–2023 were included in this retrospective observational cohort study. New-onset ILD was defined as onset of ILD symptoms less than 6 months before ICU admission. Established ILD was thus defined as onset of ILD symptoms more than 6 months before ICU admission. Kaplan-Meier time-to-event analysis was censored at 12 months from ICU admission. <h3>Results</h3> Of 80 patients with ILD-SARF (55% male, median age 51 IQR 43–60), overall ICU mortality was 50%. Connective-Tissue Disease ILD (CTD-ILD), Idiopathic Interstitial Pneumonias (IIPs) and Exposure-Related ILD formed 40%, 28% and 10% of ILD subtypes diagnosed, respectively. 43 patients were transferred from secondary care. 50 were already intubated at admission. During admission, 64 patients received invasive mechanical ventilation (IMV), 23 received extracorporeal membrane oxygenation therapy (ECMO), and 30 received 2 or more immunosuppressive medications. Non-survivors in ICU had higher admission APACHE (p=0.026) and SOFA (p=0.018) scores, older age (OR 1.09, 95% CI 1.01–1.16), lower BMI (OR 0.84, 95% CI 0.72–0.98), and were more likely to receive IMV during admission (p=0.024). ICU mortality amongst new-onset ILD patients (n=33) was comparable to those with established ILD (n=47) (48% vs 51%, p= 0.82). New-onset ILD patients had a longer median length of ICU stay (25 vs 13 days, p=0.128) and time on IMV (29 vs 16 days, p=0.077). 1-year survival was higher in new-onset ILD patients (51% vs 36%, p=0.172). <h3>Conclusion</h3> Half the patients with ILD-associated SARF survived ICU admission at this specialist SARF/ILD centre. New-onset ILD patients had similar ICU survival to established ILD, with possibly better 1-year survival. Further data is being analysed for predicting ICU and post-discharge survival of patients with ILD-SARF treated at a SARF centre.

  PublisherDOI

• An Integrated Experimental-Computational Study of Vocal Fold Vibration in Type I Thyroplasty

  Journal of Biomechanical Engineering · 2024-02-06 · 2 citations

  articleOpen access

  Subject-specific computational modeling of vocal fold (VF) vibration was integrated with an ex vivo animal experiment of type 1 thyroplasty to study the effect of the implant on the vocal fold vibration. In the experiment, a rabbit larynx was used to simulate type 1 thyroplasty, where one side of the vocal fold was medialized with a trans-muscular suture while the other side was medialized with a silastic implant. Vocal fold vibration was then achieved by flowing air through the larynx and was filmed with a high-speed camera. The three-dimensional computational model was built upon the pre-operative scan of the laryngeal anatomy. This subject-specific model was used to simulate the vocal fold medialization and then the fluid-structure interaction (FSI) of the vocal fold. Model validation was done by comparing the vocal fold displacement with postoperative scan (for medialization), and by comparing the vibratory characteristics with the high-speed images (for vibration). These comparisons showed the computational model successfully captured the effect of the implant and thus has the potential for presurgical planning.

  PublisherOA PDFDOI

• A Comparison of Long-Term Outcomes in Patients Managed With Venovenous Extracorporeal Membrane Oxygenation in the First and Second Waves of the COVID-19 Pandemic in the United Kingdom

  Critical Care Medicine · 2023-04-05 · 4 citations

  articleOpen access

  OBJECTIVES: Early studies of venovenous extracorporeal membrane oxygenation (ECMO) in COVID-19 have revealed similar outcomes to historical cohorts. Changes in the disease and treatments have led to differences in the patients supported on venovenous ECMO in the first and second waves. We aimed to compare these two groups in both the acute and follow-up phase. DESIGN: Retrospective single-center cohort study comparing mortality at censoring date (November 30, 2021) and decannulation, patient characteristics, complications and lung function and quality of life (QOL-by European Quality of Life 5 Dimensions 3 Level Version) at first follow-up in patients supported on venovenous ECMO between wave 1 and wave 2 of the COVID-19 pandemic. SETTING: Critical care department of a severe acute respiratory failure service. PATIENTS: Patients supported on ECMO for COVID-19 between wave 1 (March 17, 2020, to August 31, 2020) and wave 2 (January 9, 2020, to May 25, 2021). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One hundred twenty-three patients were included in our analysis. Survival at censoring date (χ 2 , 6.35; p = 0.012) and decannulation (90.4% vs 70.0%; p < 0.001) was significantly lower in the second wave, while duration of ECMO run was longer (12.0 d [18.0-30.0 d] vs 29.5 d [15.5-58.3 d]; p = 0.005). Wave 2 patients had longer application of noninvasive ventilation (NIV) prior to ECMO and a higher frequency of barotrauma. Patient age and NIV use were independently associated with increased mortality (odds ratio 1.07 [1.01-1.14]; p = 0.025 and 3.37 [1.12-12.60]; p = 0.043, respectively). QOL and lung function apart from transfer coefficient of carbon monoxide corrected for hemoglobin was similar at follow-up across the waves. CONCLUSIONS: Most patients with COVID-19 supported on ECMO in both waves survived in the short and longer term. At follow-up patients had similar lung function and QOL across the two waves. This suggests that ECMO has an ongoing role in the management of a carefully selected group of patients with COVID-19.

  PublisherOA PDFDOI

• Continuous renal replacement therapy in patients receiving extracorporeal membrane oxygenation therapy

  Journal of the Intensive Care Society · 2022-01-10 · 11 citations

  articleOpen accessSenior author

  Methods of continuous renal replacement therapy (CRRT) in extracorporeal membrane oxygenation (ECMO) patients include dedicated central venous cannula (CVC) (vCRRT), in-series with filter connected to ECMO circuit (eCRRT) or in-line with haemodiafilter incorporated within ECMO circuit. We assessed the efficacy and safety of eCRRT versus vCRRT in 20 ECMO-CRRT patients. Average filter lifespan was 42 vs 28 hours and filter runs completing 72hours were 40% vs 13.8% (eCRRT vs vCRRT, respectively). One incidence of ECMO circuit air embolus occurred (vCRRT). eCRRT achieved adequate filtration and increased filter lifespan, and has become our default for ECMO-CRRT if a pre-existing dialysis CVC is not present.

  PublisherOA PDFDOI

• A comparison of long term outcomes in patients managed with VV-ECMO in the first and second waves of the COVID-19 pandemic in the UK

  Research Square · 2022-04-11

  preprintOpen access

  Abstract Background Early studies of veno-venous extracorporeal membrane oxygenation (VV-ECMO) in COVID-19 have revealed similar outcomes to historical cohorts. Changes in the disease and treatments has led to differences in the patients supported on VV-ECMO in the 1 st and 2 nd waves. We aimed to compare these two groups in both the acute and follow-up phase. Methods In this retrospective study, we identified the differences between patients supported on ECMO for COVID-19 between wave 1 (17/03/2020-31/08/2020) and wave 2 (01/09/2020-25/05/2021). We examined mortality at censoring date (30/11/2021) and decannulation, patient characteristics, complications and lung function and quality of life (QOL – by EQ5D3L) at first follow-up. Findings One-hundred and twenty-three patients were included in our analysis. Survival at censoring date [Chi-sqaured 6.35, p=0.012] and decannulation [90.4% vs 70.0%, p&lt;0.001], was significantly lower in the 2 nd wave, whilst duration of ECMO run was longer [12.0(18.0-30.0) days vs. 29.5(15.5-58.3)] days (p=0.005)). Wave 2 patients had longer application of non-invasive ventilation (NIV) prior to ECMO and a higher incidence of barotrauma. Patient age and NIV use were independently associated with increased mortality [OR 1.07(1.01-1.14), p=0.025 and 3.37(1.12–12.60), p=0.043 respectively]. QOL and lung function, apart from KCOc was similar at follow up across the waves. Conclusion Most patients with COVID-19 supported on ECMO in both waves survived in the short and longer term. At follow-up patients had similar lung function and QOL across the 2 waves. This suggests that ECMO has an ongoing role in the management of a carefully selected group of patients with COVID-19. Trial Registration Research Ethics Committee (20/EM/0204)

  PublisherOA PDFDOI

• A Comparison of Outcomes for Patients with ARDS Secondary to COVID-19 Infection and Viral Pneumonia Treated with Extracorporeal Membrane Oxygenation

  2021-05-01

  articleSenior author

  RationaleThe role of venous-venous extracorporeal membrane oxygenation (ECMO) in the management of acute respiratory distress syndrome (ARDS) due to COVID-19 infection remains uncertain. This observational study aimed to compare the outcomes of a cohort of COVID-19 patients and a cohort of patients with viral ARDS of different aetiology commenced on ECMO at a single tertiary centre. MethodsAll COVID-19 positive patients admitted to the Royal Brompton Hospital, one of five ECMO referral centres in the UK, between 17th March and 30th May 2020 for ECMO treatment were identified for inclusion (N=52). A cohort of consecutive patients admitted for ECMO support with a primary diagnosis of viral ARDS during the two years preceding the coronavirus pandemic were identified for comparison (N=53). Baseline patient characteristics, patient outcomes, complications and ECMO parameters were collated and analysed. This study was registered with the Integrated Research Application System (Project ID: 285452) and ethical approval was granted by the Research Ethics Council (reference 20/EM/0204). ResultsNo significant difference was found in 30-day mortality (11.5 vs. 11.3%, P=0.972), 60-day mortality (15.4 vs. 22.6%, P=0.347), the proportion of patients who survived to ECMO decannulation (90.4 vs. 83.0%, P=0.267) and the proportion of patients who survived to discharge from ICU (83.1 vs. 71.7%, P=0.148). Similarly, the incidence of peri-ECMO complications were comparable between the two cohorts except for pulmonary embolus which was markedly more common in the COVID-19 cohort (57.7 vs. 24.5%, P=<0.001). A longer average length of ECMO run (22.5 vs. 15.3 days, P=0.015) and stay in ICU (40.2 vs. 33.4 days, P=0.089) was observed in the COVID-19 cohort although this difference was not statistically significant. Increased ECMO dependence, as measured by sweep gas and circuit flow rates required to maintain adequate gas exchange, was observed in the COVID-19 cohort. ConclusionsThese results demonstrate comparable short-term outcomes for patients with COVID-19 and viral ARDS due to other causes treated with venous-venous ECMO. Increased ECMO dependence and length of ECMO run in this series are likely to reflect a trend towards accepting patients with more severe isolated respiratory failure during the COVID-19 pandemic. This data supports the equitable use of ECMO for advanced respiratory support for viral pneumonia of any cause.

  PublisherDOI

• Six Month Mortality in Patients with COVID-19 and Non-COVID-19 Viral Pneumonitis Managed with Veno-Venous Extracorporeal Membrane Oxygenation

  ASAIO Journal · 2021 · 25 citations

  • Medicine
  • Internal medicine

  A significant proportion of patients with COVID-19 develop acute respiratory distress syndrome (ARDS) with high risk of death. The efficacy of veno-venous extracorporeal membrane oxygenation (VV-ECMO) for COVID-19 on longer-term outcomes, unlike in other viral pneumonias, is unknown. In this study, we aimed to compare the 6 month mortality of patients receiving VV-ECMO support for COVID-19 with a historical viral ARDS cohort. Fifty-three consecutive patients with COVID-19 ARDS admitted for VV-ECMO to the Royal Brompton Hospital between March 17, 2020 and May 30, 2020 were identified. Mortality, patient characteristics, complications, and ECMO parameters were then compared to a historical cohort of patients with non-COVID-19 viral pneumonia. At 6 months survival was significantly higher in the COVID-19 than in the non-COVID-19 viral pneumonia cohort (84.9% vs. 66.0%, p = 0.040). Patients with COVID-19 had an increased Murray score (3.50 vs. 3.25, p = 0.005), a decreased burden of organ dysfunction (sequential organ failure score score [8.76 vs. 10.42, p = 0.004]), an increased incidence of pulmonary embolism (69.8% vs. 24.5%, p < 0.001) and in those who survived to decannulation longer ECMO runs (19 vs. 11 days, p = 0.001). Our results suggest that survival in patients supported with EMCO for COVID-19 are at least as good as those treated for non-COVID-19 viral ARDS.

  PublisherDOI

• Safe ECMO reconfiguration from veno-venous to veno-veno-venous to support hypoxic patients with severe COVID 19, a single centre cohort

  Perfusion · 2021-01-01

  article

  Objective: Veno-venous ECMO is a well-established support technique for patients with respiratory failure-induced hypoxia allowing for pulmonary recovery and implementation of lung-protective ventilatory settings. However, in severe respiratory failure cases, ECMO may be unable to provide full support, and patients remain hypoxic. In this case series, we describe the reconfiguration of VV ECMO to veno-veno-venous (VV-V) ECMO, a more complex hybrid cannulation strategy, where a third cannula is inserted to improve venous drainage to provide more ECMO blood flow and therefore increase systemic oxygenation in patients receiving ECMO for severe COVID-19. Methods: Data from patients who received circuit reconfiguration from VV ECMO to VV-V ECMO at the Royal Brompton Hospital during the COVID-19 pandemic between March 2020 - February 2021 was collected from the ICU's Clinical Information System (ICCA, Philips Healthcare) and analysed. Endpoints included PaO2, ECMO blood flow, arterial saturation and any complications relating to the reconfiguration. Results: 15 patients (9/15 male) with an average BMI of 39.0 ± 10.7 received circuit configuration bedside with no complications. An increase in ECMO blood flow (average 0.54 ± 0.76 LPM), PaO2 (average 4.96 ± 4.23 kPa) and arterial saturation (7 ± 6%) were demonstrated over the cohort of patients. 10/15 patients survived their ECMO run, 2 patients died on ECMO and 3 patients are still receiving ECMO at the time of writing. Conclusions: ECMO reconfiguration to a VV-V cannulation strategy is a safe procedure to increase ECMO blood flow and therefore, arterial oxygenation and saturation in hypoxic patients with severe COVID-19.

  Publisher

• Veno-venous extracorporeal membrane oxygenation for the acute respiratory distress syndrome: a bridge too far?

  Acta cardiologica. Supplementum · 2021-01-04 · 3 citations

  articleOpen access

  Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) provides a bridge to recovery in patients with acute respiratory failure due to the acute respiratory distress syndrome (ARDS). Survival in ARDS has improved over 15 years, and VV-ECMO may rescue even the most severe of these patients. Predictors of survival on ICU are based upon the principles of reversibility of the inciting aetiology, and premorbid 'reserve' - an imprecise term encompassing comorbidities and frailty. ECMO can support failing organs for prolonged periods, thus sometimes masking trajectories of decline, or unmasking irretrievable intrinsic conditions at a later time point in the critical illness. Clinicians are confronted with new on-treatment dilemmas: how long should we continue this high level of care? Will the patient's limited respiratory reserve manage off ECMO? Or are we hastening their demise? How long is it justifiable to keep someone on ECMO, if the predicted survival off is ultimately poor, but they are in a stable state whilst supported? The palliative withdrawal from ECMO is unchartered territory that requires further study. We describe two representative cases and discuss the wide ethical issues surrounding the initiation and withdrawal of ECMO.

  PublisherOA PDFDOI

• Impact of Thrombosis and Bleeding in Patients with Severe COVID-19 versus Other Viral Pneumonias in the Context of Extracorporeal Membrane Oxygenation

  Seminars in Thrombosis and Hemostasis · 2021-08-13 · 10 citations

  reviewOpen access

  Extracorporeal membrane oxygenation (ECMO) could be life saving for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced severe respiratory failure not responding to optimal conventional management, including mechanical ventilation and proning.[1] However, thrombosis and/or bleeding may be major complications of patients supported with ECMO.[2]

  PublisherOA PDFDOI

Frequent coauthors

• Lui G. Forni

  Royal Surrey NHS Foundation Trust

  17 shared

• Stéphane Ledot

  11 shared

• Stephen A. Rizzi

  Langley Research Center

  11 shared

• Haoxiang Luo

  Vanderbilt University

  10 shared

• Brijesh Patel

  Imperial College London

  10 shared

• Deepa J. Arachchillage

  Imperial College London

  10 shared

• Suveer Singh

  Chelsea and Westminster Hospital

  10 shared

• Benjamin Garfield

  Imperial College London

  9 shared