Dr Stephen Macdonald

Stephen Macdonald

Email: stephen.macdonald@health.wa.gov.au

Stephen Macdonald undertook specialist training in Emergency Medicine in Western Australia. He obtained his Fellowship of the Australasian College for Emergency Medicine (ACEM) in 2010. He was appointed as a clinical academic at the University of Western Australia and is based at Royal Perth Hospital where he divides his time between clinical and research work in the Emergency Department.

The main themes of Dr Macdonald's research are the pathogenesis of septic shock and clinical investigations into the role of intravenous fluid in sepsis resuscitation. He has been recognised with a prestigious international award from the Global Sepsis Alliance for his sepsis research and advocacy work. 

Dr Macdonald is a reviewer for several international journals and grant-awarding bodies, is a section editor for the journal of Emergency Medicine Australia, and is a member of the ACEM Scientific Committee.


1992 BSc (Hons) in Pharmacology, University of Edinburgh, UK
1994 MB ChB, University of Edinburgh, UK
2002 MRCGP (Distinction), Royal College of General Practitioners, UK
2004 Diploma in Child Health, University of Western Australia, Australia
2010 FACEM - Fellow of Australasian College for Emergency Medicine
2014 FRCP (Edin) - Royal College of Physicians of Edinburgh
2018 PhD - University of Western Australia

Grants Awarded

Macdonald S, Shapiro N. Investigating the role of the endothelium in sepsis. UWA Research Collaboration Award 2018-18

Hillis G, Alcock R, Spiro J, Fatovich D, Macdonald S, Schulz C, Briffa T, Geelhoed E. The Royal Perth Hospital evidence based accelerated chest pain pathway (RAPID) study. WA Health Translation Project 2018-2018

Macdonald S, Bosio E. Role if Resistin in endothelial cell activation in human sepsis. Royal Perth Hospital Medical Research Foundation 2017-2018

Keijzers G, Macdonald SPJ, Kinnear F, Taylor D McD, Arendts G, Fatovich DM, Brown SGA, Asha S, Vlad I, McCutcheon D. Restricted Fluid Resuscitation in Sepsis associated Hypotension (REFRESH) trial. Queensland Emergency Medicine Foundation, 2016-17

Macdonald SPJ, Stone SF, Brown SGA. Biomarkers to predict organ failure in early sepsis. Australasian College of Emergency Foundation New Investigator Award, 2014-15

Macdonald SPJ, Chu K, Brown AFT, Brown SGA, Fatovitch DA, Arendts GA, Keijzers G, Kinnear F, Cullen L, Greenslade J, Lukin W, Williams J. Establishment of an Emergency Medicine Research Collaboration. University of Queensland / University of Western Australia Bilateral Research Collaboration Award, 2013-15

Selected Publications in the last 5 years

Smart L, Fatovich DM, Bosio E, Macdonald SPJ, Neil C, Arendts G. Glycocalyx biomarker syndecan-1 is a stronger predictor of respiratory failure in patients with sepsis due to pneumonia compared to endocan. J Crit Care 2018 [NCBI PubMed Entry]

Francis A, Arendts G, Macdonald SPJ, Bosio E, Nagree Y, Mitenko H, Fatovich DM, Brown SGA. Serum mast cell tryptase measurements: sensitivity and specificity for a diagnosis of anaphylaxis in emergency department patients with shock and hypoxaemia, Emerg Med Australas 2018; 30:366-374 [NCBI PubMed Entry]

Self WH, Semler MW, Brown SM, Yealy DM, Rice TW, deBoisblanc BP, Janz DR, Ginde AA, Miller CD, Macdonald SPJ, Bellomo R, Douglas MD, Shapiro NI. Liberal versus restrictive intravenous fluid therapy for early septic shock: rationale for a randomised trial. Ann Emerg Med 2018 [NCBI PubMed Entry]

Macdonald SPJ, Kinnear F, Arendts G, Ho K-M, Brown SGA, Fatovich DM. Near infrared spectroscopy to predict organ failure and outcome in sepsis: the Assessing Risk in Sepsis using tissue oxygen saturations (ARISTOS) study. Eur J Emerg Med 2018 [NCBI PubMed Entry]

Macdonald SPJ, Williams JM, Shetty A, Bellomo R, Finfer S, Shapiro N, Keijzers G. Sepsis in the emergency department - part 1: definitions and outcomes. Emerg Med Australas 2017;29:619-625 [NCBI PubMed Entry]

Shetty A, Macdonald SPJ, Williams J, van Bockxmeer J, de Groot B, Thompson K, Lander H, Finfer S, Iredell J. Lactate ≥2mmol/L plus quick SOFA (LqSOFA) improves utility of qSOFA alone in Emergency Department patients presenting with suspected sepsis. Emerg Med Australas 2017;29:626-34 [NCBI PubMed Entry}

Macdonald SPJ, Taylor DMcD, Keijzers G, Arendts G, Fatovich DM, Kinnear FB, Brown SGA, Bellomo R, Burrows S, Fraser JF, Litton E, Ascencio-Lane J, Anstey M, McCutcheon D, Smart L, Vlad I, Winearls J, Wibrow B. Restricted Fluid Resuscitation in Sepsis-associated Hypotension (REFRESH); study protocol for a pilot randomised controlled trial. Trials 2017;18:399 [NCBI PubMed Entry]

Smart L, Macdonald SPJ, Burrows S, Bosio E, Arendts G, Fatovich DM. Endothelial glycocalyx biomarkers increase in patients with infection during Emergency Department treatment. J Crit Care 2017;42:304-309 [NCBI PubMed Entry]

Macdonald SPJ, Bosio E, Neil C, Arendts G, Burrows S, Smart L, Brown SGA, Fatovich DM. Resistin and NGAL are associated with inflammatory response, endothelial activation and clinical outcomes in sepsis. Inflamm Res 2017;66:611-619 [NCBI PubMed Entry]

Francis A, Bosio E, Stone SF, Fatovich DM, Arendts G, Nagree Y, Macdonald SPJ, Mitenko H, Rajee M, Burrows S, Brown SGA. Neutrophil activation during acute human anaphylaxis: analysis of MPO and sCD62L. Clin Exp Allergy 2017;47:361-370 [NCBI PubMed Entry}

Idrees M, Macdonald SPJ, Kodali, K. Sepsis Early Alert Tool: early recognition and timely management in the Emergency Department. Emerg Med Australas 2016, Published online 5 May doi: 10.1111/1742-6723.12581 [NCBI PubMed Entry]

Taylor D McD, Fatovich DM, Finucci, DP, Furyk, J, Jin S, Keijzers G, Macdonald SPJ, Mitenko HMA, Richardson, JR, Ting JYS, Thom ON, Ugoni AM, Hughes JA, Bost N, Ward ML, Gibbs CR, Macdonald E, Chalkley DR. Best-practice pain management in the emergency department; A cluster-randomised, controlled intervention trial. Emerg Med Australas 2015;27:549-557 [NCBI PubMed Entry]

Macdonald SPJ, Brown SGA. Near-infrared spectroscopy in the assessment of suspected sepsis in the emergency department Emerg Med J 2015; 32:404-408. [NCBI PubMed Entry]

Barrett OSH, Macdonald SPJ, Playford DA. Near-infrared spectroscopy based microcirculatory assessment in acute atrial fibrillation. Anaesth Intensive Care 2015; 48:105-110. http://www.ncbi.nlm.nih.gov/pubmed/25579297

Macdonald SPJ, Arendts G, Fatovich DM, Brown SGA. Comparison of PIRO, SOFA and MEDS scores for predicting mortality in ED patients with severe sepsis and septic shock. Acad Emerg Med 2014; 21:1257-1263. http://www.ncbi.nlm.nih.gov/pubmed/25377403

Macdonald SPJ, Stone SF, Neil CL, van Eeden PV, Fatovich DM, Arendts GA, Brown SGA Sustained elevation of Resistin, NGAL and IL-8 are associated with severe sepsis/septic shock in the Emergency Department. PLoSONE 2014; 9(10):e110678 http://www.ncbi.nlm.nih.gov/pubmed/25343379

Isbister GK, Page CB, Buckley NA, Fatovich DM, Pascu O, Macdonald SPJ, Calver LA, Brown SGA. Randomised controlled trial of intravenous antivenoms versus placebo for latrodectism: the second redback antivenoms evaluation (RAVE-II) study. Ann Emerg Med 2014; 64:620-628.e2. http://www.ncbi.nlm.nih.gov/pubmed/24999282

Brown SGA, Ball EL, Macdonald SPJ, Wright C, Taylor DM. Spontaneous pneumothorax: a multicentre retrospective analysis of emergency treatment, complications and outcomes. Intern Med J 2014; 44:450-457. http://www.ncbi.nlm.nih.gov/pubmed/24612237

Macdonald SPJ, Nagree Y, Fatovich DM, Brown SGA Modified TIMI risk score cannot be used to identify low risk chest pain in the Emergency Department: a multicentre validation study Emerg Med J 2014; 31:281-285. [NCBI PubMed Entry]

Huddle N, Arendts G, Macdonald SPJ, Fatovich DM, Brown SGA. Is comorbid status the best predictor of one-year mortality in patients with severe sepsis and sepsis with shock? Anaesth Intensive Care 2013; 41:482-489. [NCBI PubMed Entry]

Macdonald SPJ, Brown SGA. Near-infrared spectroscopy in the assessment of suspected sepsis in the emergency department (Review) Emerg Med J Published Online First: 23 October 2013 doi 10.1136/emermed-2013-202956. [NCBI PubMed Entry]

Macdonald SPJ, Nagree Y, Fatovich DM, Phillips M, Brown SGA. Serial multiple biomarkers in the assessment of suspected acute coronary syndrome: Multiple Infarct Markers in Chest pain (MIMIC) study. Emergency Medicine Journal 2013; 30:149-154. [NCBI PubMed Entry]

Chung K, Playford D, Macdonald SPJ. Improving stress testing compliance following chest pain presentations to the Emergency Department. Emergency Medicine Australasia 2012; 24:518-524. [NCBI PubMed Entry]

Macdonald SPJ, Arendts G, Nagree Y, Xu X-F. Neutrophil gelatinase-associated lipocalin (NGAL) predicts renal injury in acute decompensated cardiac failure; a prospective observational study. BMC Cardiovascular Disorders 2012; 12:8. [NCBI PubMed Entry]

Macdonald SPJ, Nagree Y, Fatovich DM, Flavell HL, Loutsky F. Comparison of two clinical scoring systems for emergency department risk stratification of suspected acute coronary syndrome. Emergency Medicine Australasia 2011; 23:717-725. [NCBI PubMed Entry]

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