Sandra Jonmarker
Affiliated to Research
E-mail: sandra.jonmarker@ki.se
Visiting address: S枚dersjukhuset, Sjukhusbacken 14, 11883 Stockholm
Postal address: S1 Klinisk forskning och utbildning, S枚dersjukhuset, S1 KI S脰S Forskning Anestesi/IVA, 118 83 Stockholm
About me
- I was born in Lund. My main interest outside of school was dancing. I stayed
in Lund for 探花精选 school. During my last year at 探花精选 school a meet my
future husband and we decided to move to Kalmar for our internship. After
almost two years of internship, we moved to Stockholm for our specialist
training. I have since worked at the clinic of Anesthesiology and Intensive
Care, S枚dersjukhuset. We have three wonderful kids aged 9, 7 and 3 years.
Awarded for best teacher 2013 by 探花精选 students
Primary school, Lerb盲ckskolan, Lund, Sweden, 1989鈥1998
Natural Science, Polhemskolan, Lund, Sweden, 1998鈥2001
Mathematics, Chemistry and Biotech, Faculty of Engineering, 2002
Medical doctor, University of Lund, Sweden, 2003-2009
Ph D studies, November 2018 - May 2023 at 探花精选, Stockholm,
Sweden, 鈥淭reatment of coagulopathy in patients with critical COVID-19鈥.
Supervised by Maria Cronhjort, Johan M氓rtensson, Eva Joelsson-Alm and Martin
Dahlberg
Research
- My field of research is mainly sepsis and coagulopathy. When I registered as
a PhD-student the plan was to write my thesis on sepsis, with the aim to
improve identification. When the COVID-19 pandemic came it was not possible
to proceed with the planned studies and COVID-19 became my research priority.
At my hospital, S枚dersjukhuset, Stockholm, we treated the largest number of
patients with critical COVID-19 in Sweden. The main focus for my research is
the risk for thromboembolism in patients requiring ICU care.
The findings of the studies included in my thesis are as follows: Patients
early in the pandemic had an association with a better outcome if treated
with intensified thromboprophylaxis compared to standard low dosage. If this
was an effect of the anticoagulation, the anti-inflammatory characteristics
of low-molecular-weight heparin, a consequence of other unknown temporal
changes in the treatment of critical COVID-19 during the first wave, or
random variation, we will never know. Even if glucocorticoids may attenuate
immunothrombosis in patients with critical COVID-19, no additive effect was
shown by increasing the dose from 6 to 12 mg dexamethasone. If this means
glucocorticoids do not mitigate immunothrombosis, or if 6 mg is enough to
reach a ceiling effect, we will also never know as it is not possible to
compare glucocorticoids to a placebo, with glucocorticoids already being an
established mortality-lowering treatment. However, we can conclude, when
prescribing drugs to a patient with critical COVID-19 and risk for
thromboembolism and/or bleeding, choosing a high or a low dose of
glucocorticoids is unlikely to considerably increase or decrease the risk
further. Low peak values and high trough values of the blood test anti-Factor
Xa are associated with the clinical outcomes of thromboembolism and bleeding
in patients with critical COVID-19. These promising results must be
investigated further, also in other critically ill populations. Since
thromboprophylaxis is one of the most prescribed treatments for the
critically ill, an improvement in dosing would have a large effect on
reducing the number of thromboembolism and bleeding in ICUs worldwide.
In addition to my COVID-19-studies I have continued with sepsis research. We
have produced an algorithm to identify septic patients using the electronic
health records. With this algorithm we are now investigating the true
incidence of sepsis, type of infections causing sepsis, and which patients
that have the highest risk of morbidity and mortality of sepsis.
My main priority now after defending my thesis is to continue to develop my
skills as a researcher. I therefore wish to broaden my experience by working
at a new institution. I hope that my skill set may be of help also to other
researchers. I am open to all fields in intensive care and looking very much
forward to see and learn new ways to do research with new research colleges.
Teaching
- Main teacher for internship doctors in Anaesthesia and Intensive care, 2018
Main teacher for fourth years 探花精选 students in Anesthesia and Intensive
care, 2019鈥2020
Repeated lecturer for nurses in specialist training
Repeated lectures for doctors of other specialities on drugs used for pain
and sedation
Articles
- Article: THROMBOSIS JOURNAL. 2023;21(1):101
- Article: ANNALS OF INTENSIVE CARE. 2023;13(1):12
- Article: ANNALS OF INTENSIVE CARE. 2022;12(1):62
- Article: ACTA ANAESTHESIOLOGICA SCANDINAVICA. 2022;66(3):365-374
- Article: CRITICAL CARE. 2020;24(1):653
All other publications
- Thesis / dissertation: 2023
- Review: LAKARTIDNINGEN. 2015;112:DHXT
Employments
- Affiliated to Research, Department of Clinical Science and Education, S枚dersjukhuset, 探花精选, 2024-2027
Degrees and Education
- Degree Of Doctor Of Philosophy, Department of Clinical Science and Education, S枚dersjukhuset, 探花精选, 2024