Richard R. Riker MD

Department of Medicine
Division Pulmonary and Critical Care Medicine
Director Critical Care Research
Maine Medical Center
(207) 662-4174 Office
(207) 662-6326 Fax
rikerr@mmc.org

Biosketch

Richard R. Riker, MD earned his medical degree at the University of Vermont, completed residencies in emergency medicine and internal medicine at Northwestern University in Chicago , and his fellowship in pulmonary and critical care medicine at Maine Medical Center.  In the Department of Medicine since 1992, Dr. Riker has been honored for teaching excellence from the Departments of Medicine and Family Practice and has received a best research presentation award from the Society of Critical Care Medicine.  Dr. Riker co-authored the 2002 clinical practice guidelines for sedation and analgesia in the ICU from the Society of Critical Care Medicine and is a reviewer for Critical Care Medicine, Chest, Clinical Intensive Care, and the Journal of Intensive Care Medicine.

Research Interests

The research program in the Special Care Unit at Maine Medical Center has focused on three areas of interest:  Sepsis, Adult Respiratory Distress Syndrome, and the issues of patient comfort in the ICU including sedation, agitation, and delirium.  Maine Medical Center has been involved in cutting edge trials of new Sepsis therapies for the last 13 years including monoclonal antibody therapy  directed at endotoxin (E5 and HA-1A) as well several anti-TNF antibodies and receptor antagonists.  More recently, studies of anticoagulant therapy (tissue factor pathway inhibitor and the now FDA-approved drotrecognin alfa activated or Xigris) and additional efforts directed at binding endotoxin are ongoing.  ARDS research has been conducted here since the mid 1980s with surfactant replacement trials, studies of novel modes of ventilatory support including high-frequency oscillation and partial liquid ventilation, and drug specific interventions such as neutrophil elastase and phospholipase A2 inhibitors.  Efforts to improve patient comfort in the ICU with better monitoring and treatment of sedation, analgesia, and delirium have been the focus of most of our center-specific studies.  We have worked closely with colleagues from around the world to better define specific conditions, developed and validated several monitoring tools, and pioneered use of new medications and novel applications of existing therapies.

Selected Publications

Riker RR, Fraser GL, Richen P. Movement disorders associated with withdrawal from high-dose intravenous haloperidol therapy in delirious ICU patients. Chest 1997; 111:1778-1781.

Avent KM, Riker RR, et.al. Metabolism of haloperidol to pyridinium species in patients receiving high doses intravenously: is HPTP an intermediate? Life Sciences 1997; 24:2383-2390.

Riker RR, Picard JT,GL Fraser. Prospective evaluation of the sedation-agitation scale in adult ICU patients. Crit Care Med 1999; 27:1325-1329.

Simmons LE, Riker RR, Fraser GL, Prato BS. Assessing sedation in ventilated ICU patients with the bispectral index and the sedation-agitation scale. Crit Care Med 1999; 27:1499-1504.

Fraser GL, Riker RR, Prato BS, Wilkins ML. The frequency and cost of patient-initiated device removal in the ICU. Pharmacotherapy 2001;21:1-6.

Riker RR, Fraser GL, Simmons LE, Wilkins ML.  Validating the Sedation-Agitation Scale with the Bispectral Index and Visual Analog Scale in Adult ICU Patients after Cardiac Surgery.  Intensive Care Med 2001; 27:853-858.

Schenarts CL, Burton JH, Riker RR. Adrenocortical dysfunction following etomidate induction in emergency department patients. Acad Emerg Med 2001; 8:1-7

Parker MG, Fraser GL, Watson DM, Riker RR. Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy. Intensive Care Med 2002: 28:81-84

Jacobi J, Fraser GL, Coursin DB, Riker RR, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002; 30:119-141.

Riker RR, Fraser GL, Wilkins ML. Comparing the bispectral index and suppression ratio with burst suppression of the electroencephalogram during pentobarbital infusions in adult intensive care patients. Pharmacotherapy 2003; 23:1087-93.