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Henry Halliday
Henry Halliday
	Halliday at his acceptance of the James Spence Medal
Born	29 November 1945; Belfast
Died	12 November 2022 (aged 76); Belfast
Nationality	British
Education	Queen's University Belfast, Rainbow Babies & Children's Hospital, Cleveland, University of California, San Francisco
Known for	Developing a pulmonary surfactant that enabled very small babies to breath properly
	Scientific career
Fields	Pediatrics, neonatology
Institutions	Royal Jubilee Maternity Hospital, Mater Infirmorum Hospital, Queen's University Belfast

Henry Lewis Halliday (29 November 1945 – 12 November 2022) was a British-Irish paediatrician and neonatologist. In 2021, Halliday was awarded the James Spence Medal for research into neonatology, for coordinating two of the largest neonatal multicentre trials for prevention and treatment of a number of neonatal respiratory illnesses and for a breakthrough in the development of a new lung surfactant^[1]^[2] that brought relief to very small babies suffering from infant respiratory distress syndrome (RDS).

Life

Halliday was one of four siblings, the eldest of four brothers.^[3] His father Louis Halliday was an accountant, while his mother Gladys was a shopkeeper.^[3] Halliday attended school at the Belfast Royal Academy before deciding to study medicine.^[4] He matriculated in 1965 at Queen's University Belfast medical school and graduated in 1970.^[4]

In 1977, Halliday married Marjorie Dalziel who was an intensive care nurse.^[3] The couple had three children, Joy, Gail & Brian Joshua,^[5] all of whom became doctors.^[3]

Career

Halliday decided to pursue a career in paediatrics with a specialism in neonatal medicine.^[3] After his postgraduate training in Belfast, he moved to the United States where he spent three years, first working at the Rainbow Babies & Children's Hospital in Cleveland and later at the Cardiovascular Research Institute, University of California in San Francisco.^[6] In San Francisco, Halliday met the influential John Allen Clements, a specialist in pulmonary surfactant who stimulated his interest in surfactant research and pulmonology.^[6]

Upon returning to Belfast in 1979 he was appointed to the Royal Maternity Hospital as second consultant neonatologist.^[4] At the Royal Maternity, Halliday worked to develop a new neonatal unit and to expand neonatal care across the whole of Northern Ireland. While there, he worked with the paediatrician's Garth McClure and Mark Reid along with the obstetrician, Knox Ritchie.^[3] In 1980, he passed the MD Thesis at Queens University with a paper on the role of left to right shunting through a patent ductus arteriosus.^[7]^[6]

Surfactant development

In 1984, Halliday held a randomised, controlled trial of an artificial surfactant known as the "Belfast surfactant" to test how effective it was on pre-term infants, for the treatment of RDS.^[8] The trial was largely a disappointment as he realised his artificial surfactant wasn't a good substitute for the natural surfactant.^[6]

Halliday's product was a synthetic lung surfactant^[9] called Turfsurf^[10]^[11] and was a mixture of Dipalmitoylphosphatidylcholine and high-density lipoproteins in a ratio of 10:1.^[12] However, the surfactant was never developed into a commercial product as the trial was disappointing.^[12] In the same year, Halliday met Colin J Morley^[9] who had developed a synthetic lung surfactant known as "ALEC" with Alec Bangham.^[13] Morley analysed Halliday's results in a sub-group of infants of 25–29 weeks’ gestation in four trials and showed how that surfactant treated infants had lower death rates than if treated normally. As the control group was insufficiently large, Morley suggested to Halliday that he make contact with the Swedish physician Bengt Robertson who had also developed a surfactant Poractant alfa known under the trade name Curosurf.^[14]^[9] Robertson and his colleague Tore Curstedt had created Curosurf from pig lungs instead of cow lungs.^[9] Halliday spent a month with Robertson at the Karolinska University Hospital in Stockholm in November 1984, when they ran a 27 day pre-clinical trial both In vitro and in rabbit fetus's ventilated with a plethysmograph where Turfsurf was compared to Curosurf.^[9] Curosurf was found to be superior.^[9]^[15]^[16] Halliday witnessed the highly efficacious Corusurf at work when pre-term twins were treated, who were going blue in the face due to a lack of oxygen and almost immediately after treatment, turning a healthy pink.^[9]^[17]

The success of the 27-day experiment spurred Halliday and Robertson to create the first international clinical trial for Corusurf.^[9] They selected a randomised group of preterm infants of around 10 hours old who were suffering from severe RDS who were given a single dose of Corosurf at 200 mg/kg. A control group was created that were subject to mechanical ventilation. Corosurf was found to reduce pulmonary air leaks and neonatal mortality in preterm infants.^[18] Halliday created further international clinical trials that led from single dose treatments that reduced mortality in the early 1980s from 50% to about 10% with multiple doses in the 1990s.^[9] In 1992, Halliday published the results of a large Randomized European Multicentre trial that he coordinated and led that concluded that treatment with multiple doses of Curosurf surfactant is more effective than single-dose treatment in severe neonatal respiratory distress syndrome that further reduced pneumothorax death.^[19]

Use of postnatal steroids

Halliday's other area of interest was in the use of postnatal steroids (inhaled and systemic) to prevent chronic lung disease.^[4] In 2000, Halliday coordinated a large multicentre, randomized clinical trial of early corticosteroid treatment, known as OSSECT to compare whether there was any difference in early (<3 days) with late (>15 days) steroid therapy and dexamethasone with inhaled budesonide treatment in preterm infants at risk of developing chronic lung disease. The study found no difference.^[20] He also conducted research on the pathogenesis of CLD and inflammation, as well as iron metabolism in the foetus and neonate and long term follow-up of survivors of CLD.^[4]

Publishing

In 2004, Halliday along with his colleague, the German paediatrician Christian P. Speer co-founded the journal "Biology of the Neonate" now known as Neonatology.^[21]

Societies

In 1992 he was appointed Honorary Professor in the Department of Child Health at Queen's University.^[4] In 1997 he appointed President of the European Society for Paediatric Research.^[4] In 2006 Halliday was appointed to the position of president of the European Association of Perinatal Medicine.^[22]

Awards and honours

In 2010 Halliday was awarded the Maternité Prize from the European Society of Perinatal Medicine for his advocacy in international medical politics that led to structural reform.^[23] In 2021, Halliday was awarded the James Spence Medal by the British Paediatric Association for outstanding contributions to paediatric knowledge,^[24] Halliday was the first Northern Ireland physician to be awarded the medal.^[2]

Bibliography

Halliday, Henry L. (2005). "History of Surfactant from 1980". Neonatology. 87 (4): 317–322. doi:10.1159/000084879. PMID 15985754.
Halliday, Henry L.; McClure, Garth; Reid, Mark; Bell, Angela; Tubman, Richard (1998). Handbook of neonatal intensive care (4th ed.). London: W.B. Saunders. ISBN 9780702017728.
HAPO Study Cooperative Research Group (1 February 2009). "Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: Associations With Neonatal Anthropometrics". Diabetes. 58 (2). American Diabetes Association: 453–459. doi:10.2337/db08-1112. PMC 2628620. PMID 19011170.

References

^ "Professor Henry Halliday". Royal College of Paediatrics and Child Health. 21 July 2021. Retrieved 7 December 2022.
^ ^a ^b "Professor Emeritus Henry Halliday is first in NI to be awarded prestigious James Spence Medal". All news. Queens University Belfast. 21 July 2021. Retrieved 7 December 2022.
^ ^a ^b ^c ^d ^e ^f "Professor Henry Halliday, paediatrician who vastly improved the survival prospects of very premature babies – obituary". The Telegraph. 24 November 2022. Retrieved 7 December 2022.
^ ^a ^b ^c ^d ^e ^f ^g Sweet, David (23 November 2022). "Obituary: Professor Henry Halliday". British Association of Perinatal Medicine. London. Retrieved 7 December 2022.
^ "Prof Henry Lewis HALLIDAY". Funeral Times. Belfast. Retrieved 13 December 2022.
^ ^a ^b ^c ^d Speer, Christian P.; Curstedt, Tore; Saugstad, Ola D. (22 December 2022). "Henry L. Halliday (1945–2022)". Neonatology. 120 (1): 1–2. doi:10.1159/000528598. PMID 36549281.
^ Halliday, H.L. "Assessment of left-to-right shunt in neonatal patient ductus arteriosus". E-Thesis. British Library. Retrieved 10 February 2023.
^ Halliday, Henry L.; Reid, Mark McC.; Meban, Cowan; Mcclure, Garth; Lappin, Terence R.J.; Thomas, Paul S. (March 1984). "Controlled Trial of Artificial Surfactant to Prevent Respiratory Distress Syndrome". The Lancet. 323 (8375): 476–478. doi:10.1016/s0140-6736(84)92849-6. PMID 6142208. S2CID 9022480.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Halliday, Henry L (April 2017). "The fascinating story of surfactant: Fascinating story of surfactant". Journal of Paediatrics and Child Health. 53 (4): 327–332. doi:10.1111/jpc.13500. PMID 28271629. S2CID 30967601.
^ Levene, Malcolm (28 July 2021). Suffer the Little Children?: A Personal History of Newborn Medicine. Troubador Publishing Ltd. p. 309. ISBN 978-1-80046-646-3.
^ "Henry Lewis Halliday – 2022". In Memoriam. The Woodlands, Texas: American Pediatric Society. Retrieved 13 December 2022.
^ ^a ^b Ainsworth, Sean B.; Milligan, David W. A. (December 2002). "Surfactant Therapy for Respiratory Distress Syndrome in Premature Neonates: A Comparative Review". American Journal of Respiratory Medicine. 1 (6): 417–433. doi:10.1007/BF03257169. PMID 14720029. S2CID 7756898.
^ Morley, C.J.; Miller, N.; Bangham, A.D.; Davis, J.A. (January 1981). "Dry Artificial Lung Surfactant and ITS Effect on Very Premature Babies". The Lancet. 317 (8211): 64–68. doi:10.1016/s0140-6736(81)90002-7. PMID 6109119. S2CID 30829649.
^ Heijbel, Matts; Betteridge, Neil (9 June 2016). "Tore Curstedt's Curosurf helped millions of preterm babies". Karolinska Institutet. News from Karolinska Institutet. Retrieved 12 February 2023.
^ Curstedt, Tore; Halliday, Henry L.; Speer, Christian P. (2015). "A Unique Story in Neonatal Research: The Development of a Porcine Surfactant". Neonatology. 107 (4): 321–329. doi:10.1159/000381117. PMID 26044099.
^ Halliday, H; Robertson, B; Nilsson, R; Rigaut, JP; Grossmann, G (October 1987). "Automated image analysis of alveolar expansion patterns in immature newborn rabbits treated with natural or artificial surfactant". British Journal of Experimental Pathology. 68 (5): 727–32. PMC 2013175. PMID 3689674.
^ Noack, G.; Berggren, P.; Curstedt, T.; Grossmann, G.; Herin, P.; Mortensson, W.; Nilsson, R.; Robertson, B. (September 1987). "Severe Neonatal Respiratory Distress Syndrome Treated with the Isolated Phospholipid Fraction of Natural Surfactant". Acta Paediatrica. 76 (5): 697–705. doi:10.1111/j.1651-2227.1987.tb10552.x. PMID 3661171.
^ "Surfactant replacement therapy for severe neonatal respiratory distress syndrome: an international randomized clinical trial. Collaborative European Multicenter Study Group". Pediatrics. 82 (5): 683–91. November 1988. doi:10.1542/peds.82.5.683. PMID 2903480.
^ Speer, Christian P.; Robertson, Bengt; Curstedt, Tore; Halliday, Henry L.; Compagnone, Daniele; Gefeller, Olaf; Harms, Karsten; Herting, Egbert; McClure, Garth; Reid, Marc; Tubman, Richard; Herin, Peter; Noack, Gerd; Kok, Joke; Koppe, Janna; van Sonderen, Loekie; Laufkötter, Edgar; Köhler, Wolfgang; Boenisch, Herbert; Albrecht, Klaus; Hanssler, Ludwig; Haim, Michaela; Oetomo, Sidarto B.; Okken, Albert; Altfeld, Peter C.; Groneck, Peter; Kachel, Walter; Relier, Jean-Pierre; Walti, Herve (1 January 1992). "Randomized European Multicenter Trial of Surfactant Replacement Therapy for Severe Neonatal Respiratory Distress Syndrome: Single Versus Multiple Doses of Curosurf". Pediatrics. 89 (1): 13–20. doi:10.1542/peds.89.1.13. PMID 1727997.
^ Halliday, HL; Patterson, CC; Halahakoon, CW; European Multicenter Steroid Study, Group (February 2001). "A multicenter, randomized open study of early corticosteroid treatment (OSECT) in preterm infants with respiratory illness: comparison of early and late treatment and of dexamethasone and inhaled budesonide". Pediatrics. 107 (2): 232–40. doi:10.1542/peds.107.2.232. PMID 11158452. {{cite journal}}: |first4= has generic name (help)
^ "Neonatology News". Karger. Basel: S. Karger AG.
^ "Previous EAPM presidents". About Us - Previous EAPM presidents. European Association of Perinatal Medicine. Retrieved 16 March 2023.
^ "Erich Saling Maternity Prize". EAPM. European Association of Perinatal Medicine. 2015. Retrieved 12 March 2023.
^ McConville, Marie Louise (17 November 2022). "Tributes to prominent neonatologist who conducted pioneering research". The Irish News Ltd. The Irish News. Retrieved 1 February 2023.