Scholars@Duke
Hercilia Mayumi Homi

Hercilia Mayumi Homi

Assistant Professor of Anesthesiology
Anesthesiology, Pediatrics
homi0001@mc.duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2301 Erwin Road, 2905 Duke Children Hospital, Durham, NC 27710

Selected Publications

Safety of antifibrinolytics in 6583 pediatric patients having craniosynostosis surgery: A decade of data reported from the multicenter Pediatric Craniofacial Collaborative Group.

Journal Article Paediatr Anaesth · December 2022 BACKGROUND: Antifibrinolytics such as tranexamic acid and epsilon-aminocaproic acid are effective at reducing blood loss and transfusion in pediatric patients having craniofacial surgery. The Pediatric Craniofacial Collaborative Group has previously report ... Full text Link to item Cite

The Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference Methodology.

Journal Article Paediatr Anaesth · February 2021 OBJECTIVE: This article describes the methodology used for the Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference. DESIGN: This is a novel Consensus Conference of national experts in Pediatric Craniofacial Surgery and Anesthesia, who wi ... Full text Link to item Cite

Machine Learning Applied to Registry Data: Development of a Patient-Specific Prediction Model for Blood Transfusion Requirements During Craniofacial Surgery Using the Pediatric Craniofacial Perioperative Registry Dataset.

Journal Article Anesth Analg · January 2021 BACKGROUND: Craniosynostosis is the premature fusion of ≥1 cranial sutures and often requires surgical intervention. Surgery may involve extensive osteotomies, which can lead to substantial blood loss. Currently, there are no consensus recommendations for ... Full text Link to item Cite

The effect of intraoperative methadone during pediatric cardiac surgery on postoperative opioid requirements.

Journal Article Paediatr Anaesth · July 2020 BACKGROUND: Pain control in pediatric patients undergoing cardiac surgery presents a unique challenge. Postoperatively, many of these patients require long-term opioid infusions and sedation leading to need for prolonged weaning from opioids and longer hos ... Full text Link to item Cite

Predictors of transfusion outcomes in pediatric complex cranial vault reconstruction: a multicentre observational study from the Pediatric Craniofacial Collaborative Group.

Journal Article Can J Anaesth · May 2019 PURPOSE: Pediatric patients undergoing complex cranial vault reconstruction (CCVR) are at risk of significant perioperative blood loss requiring blood product transfusion. Minimizing allogeneic blood product transfusion is an important goal because of the ... Full text Link to item Cite

Double-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin Undergoing Congenital Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · February 2019 OBJECTIVES: To determine whether precardiopulmonary bypass (CPB) normalization of antithrombin levels in infants to 100% improves heparin sensitivity and anticoagulation during CPB and has beneficial effects into the postoperative period. DESIGN: Randomize ... Full text Link to item Cite

Natural history of nonimmune-mediated thrombocytopenia and acute kidney injury in pediatric open-heart surgery.

Journal Article Paediatr Anaesth · March 2017 OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pedia ... Full text Link to item Cite

Reduction in blood transfusion in a cohort of infants having cardiac surgery with cardiopulmonary bypass after instituting a goal-directed transfusion policy.

Journal Article Perfusion · October 2016 BACKGROUND: Current trends in pediatric cardiac surgery and anesthesiology include goal-directed allogeneic blood transfusion, but few studies address the transfusion of platelets and cryoprecipitate. We report a quality improvement initiative to reduce th ... Full text Link to item Cite

Cardiopulmonary Bypass Strategy for a Cyanotic Child With Hemoglobin SC Disease.

Journal Article Ann Thorac Surg · June 2016 Hemoglobin SC (HbSC) disease is a hemoglobinopathy that may produce sickling under conditions of hypoxemia, dehydration, and acidosis. We present a case of HbSC disease and tricuspid atresia, type IB. We describe management by cardiopulmonary bypass CPB us ... Full text Link to item Cite

A change in anticoagulation monitoring improves safety, reduces transfusion, and reduces costs in infants on cardiopulmonary bypass.

Journal Article Paediatr Anaesth · June 2015 BACKGROUND: An immature coagulation system coupled with the hypothermia and hemodilution associated with cardiopulmonary bypass (CPB) in infants makes the activated clotting time (ACT) an ineffective monitor for anticoagulation in this population. The Medt ... Full text Link to item Cite

Exacerbation of systemic inflammation and increased cerebral infarct volume with cardiopulmonary bypass after focal cerebral ischemia in the rat.

Journal Article J Thorac Cardiovasc Surg · September 2010 OBJECTIVE: Stroke remains a significant contributor to morbidity and mortality after cardiac surgery. Cardiopulmonary bypass is known to induce a significant inflammatory response, which could adversely influence outcomes. We hypothesized that cardiopulmon ... Full text Link to item Cite

Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass.

Journal Article Anesth Analg · July 2010 BACKGROUND: Aprotinin, a nonspecific serine protease inhibitor, has been used to decrease bleeding and reduce the systemic inflammatory response after cardiopulmonary bypass (CPB). Studies have variably linked aprotinin administration with both improved as ... Full text Open Access Link to item Cite

Longitudinal assessment of neurocognitive function in rats after cardiopulmonary bypass: evidence for long-term deficits.

Journal Article J Cardiothorac Vasc Anesth · April 2010 OBJECTIVE(S): Neurologic and neurocognitive dysfunction after cardiopulmonary bypass (CPB) have been shown in both clinical and experimental settings. Although short-term outcome has been evaluated in rats, the assessment of neurocognitive dysfunction with ... Full text Link to item Cite

Cerebral ischemia/stroke and small ubiquitin-like modifier (SUMO) conjugation--a new target for therapeutic intervention?

Journal Article J Neurochem · August 2008 Transient cerebral ischemia/stroke activates various post-translational protein modifications such as phosphorylation and ubiquitin conjugation that are believed to play a major role in the pathological process triggered by an interruption of blood supply ... Full text Link to item Cite

Suitability of the lumbar test dose for the thoracic epidural space.

Journal Article J Cardiothorac Vasc Anesth · October 2006 Full text Link to item Cite

Xenon and the inflammatory response to cardiopulmonary bypass in the rat.

Journal Article J Cardiothorac Vasc Anesth · August 2005 OBJECTIVE: The purpose of this study was to investigate the effect of xenon on the inflammatory response to cardiopulmonary bypass. DESIGN: Prospective, randomized experimental study. SETTING: University research laboratory. PARTICIPANTS: Sprague-Dawley ra ... Full text Link to item Cite

Cognitive dysfunction after cardiac surgery: revisiting etiology.

Journal Article Semin Cardiothorac Vasc Anesth · June 2005 Cognitive dysfunction remains a frequent complication of cardiac surgery. Despite many years of research, few preventive strategies and no definitive therapeutic options exist for the management of this troublesome clinical problem. This shortcoming may be ... Full text Link to item Cite

The influence of xenon, nitrous oxide and nitrogen on gas bubble expansion during cardiopulmonary bypass.

Journal Article Eur J Anaesthesiol · May 2005 BACKGROUND AND OBJECTIVE: Xenon may have favourable applications in the setting of cardiac surgery. Its advantages include a desirable haemodynamic profile as well as potential cardiac and neuroprotective properties. However, its low solubility may lead to ... Full text Link to item Cite

Cardiopulmonary bypass reduces the minimum alveolar concentration for isoflurane.

Journal Article J Cardiothorac Vasc Anesth · October 2004 OBJECTIVE: The purpose of this investigation was to determine the influence of cardiopulmonary bypass (CPB) on the minimum alveolar concentration (MAC) of isoflurane in a rat model of CPB. DESIGN: Prospective. SETTING: University research laboratory. PARTI ... Full text Link to item Cite

Hemodilution during cardiopulmonary bypass increases cerebral infarct volume after middle cerebral artery occlusion in rats.

Journal Article Anesth Analg · October 2004 Although the optimal hematocrit during cardiopulmonary bypass (CPB) is not defined, excessive hemodilution may lead to organ ischemia via a reduction in oxygen-carrying capacity uncompensated by autoregulatory and/or rheologic increases in organ blood flow ... Full text Link to item Cite

"Other" neurologic complications after cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · September 2004 Compared to the neurologic morbidity of stroke and cognitive dysfunction, "other" neurologic complications involving injuries to the brachial plexus, phrenic nerve, cranial nerves, other peripheral nerves, as well as the visual pathways, have been dispropo ... Full text Link to item Cite

Intraischemic nitrous oxide alters neither neurologic nor histologic outcome: a comparison with dizocilpine.

Journal Article Anesth Analg · September 2004 N-Methyl-D-aspartate receptor antagonism contributes to the anesthetic action of nitrous oxide (N(2)O). We examined the effects of the N-methyl-D-aspartate antagonists N(2)O and dizocilpine on outcome from filament occlusion of the middle cerebral artery ( ... Full text Link to item Cite

A no-laminectomy spinal cord compression injury model in mice.

Journal Article J Neurotrauma · May 2004 The purpose of this study was to develop a minimally invasive recovery model of spinal cord injury in the C57Bl/6J mouse. Without laminectomy, the epidural space was exposed by disruption of the T10-T11 interspinous ligament. Perpendicular to the rostral-c ... Full text Link to item Cite

Severe hypotension is not essential for isoflurane neuroprotection against forebrain ischemia in mice.

Journal Article Anesthesiology · November 2003 BACKGROUND: Volatile anesthetics provide protection in experimental models of global cerebral ischemia. To date, all models evaluated have included profound systemic arterial hypotension as a component of the ischemic insult. This study was designed to det ... Full text Link to item Cite

The neuroprotective effect of xenon administration during transient middle cerebral artery occlusion in mice.

Journal Article Anesthesiology · October 2003 BACKGROUND: Xenon has been shown to be neuroprotective in several models of in vitro and in vivo neuronal injury. However, its putative neuroprotective properties have not been evaluated in focal cerebral ischemia. The purpose of this study was to determin ... Full text Link to item Cite

Changes in superoxide dismutase and catalase activities of rat brain regions during early global transient ischemia/reperfusion.

Journal Article Neurosci Lett · November 15, 2002 It has been widely recognized that the hippocampus and striatum are clearly more susceptible to oxidative stress than the remaining brain regions. However, the mechanism involved is not known. The activities of the antioxidant enzymes CuZn-superoxide dismu ... Full text Link to item Cite