Scholars@Duke
Karthik Raghunathan

Karthik Raghunathan

Associate Professor of Anesthesiology
Anesthesiology, VA Anesthesiology Service
karthik.raghunathan@duke.edu
DUMC Box 3094, Durham, NC 27710
D5005 VAMC, Durham, NC 27710
Office hours Available by appointment, call Staff Assistant at 919-286-6938.  

Selected Publications

Association of neighborhood disadvantage with clinical and healthcare utilization outcomes following traumatic brain injury.

Journal Article J Clin Neurosci · January 2026 BACKGROUND: Health disparities in traumatic brain injury (TBI) risk and outcomes have been observed. Neighborhood-level social determinants of health (SDOH), such as built environment and socioeconomic disadvantage, may contribute to these disparities. To ... Full text Link to item Cite

Quality of Recovery in Veterans Following Postoperative Ketamine Infusion Implementation.

Journal Article Pain Manag Nurs · November 18, 2025 Chronic pain is highly prevalent among Veterans and contributes to poor surgical recovery. This pilot quality improvement project evaluated a structured postoperative ketamine infusion program at a Veterans Affairs medical center. Veterans with chronic pai ... Full text Link to item Cite

Influence of Social Support and Personality Traits on Digital Health Technology Adoption Among U.S. Veterans: A Mixed-Methods Study.

Journal Article Mil Med · November 1, 2025 INTRODUCTION: Digital health technologies (DHT), including telemedicine and world wide web-based tools, have transformed healthcare delivery by enhancing patient self-management and clinical monitoring capabilities. Despite widespread adoption in many popu ... Full text Link to item Cite

Patient Race and Preferred Language Influence the Use of Physical Restraints on Nonintubated Intensive Care Unit Patients.

Journal Article Ann Am Thorac Soc · November 2025 Rationale: Physical limb restraints are commonly used in intensive care units (ICUs) to protect patients and staff but are associated with increased morbidity and disparities in care, particularly in intubated patients. Whether disparities in restraint use ... Full text Link to item Cite

Early beta-blocker exposure and association with brain injury biomarkers following moderate to severe traumatic brain injury: A TRACK-TBI study.

Journal Article J Intensive Care Soc · November 2025 BACKGROUND: Beta-blockers have been studied for potential benefits in traumatic brain injury (TBI). This study aimed to investigate the association between early beta-blocker exposure and brain injury biomarkers following moderate-severe TBI. METHODS: We c ... Full text Open Access Link to item Cite

Association of appropriate empiric antimicrobial therapy with acute kidney injury in gram-negative sepsis.

Journal Article J Intensive Care Soc · October 9, 2025 BACKGROUND: Despite advances in sepsis management, the relationship between appropriate empiric antibiotic therapy and acute kidney injury (AKI) in sepsis remains unclear. This study aimed to examine the association of appropriate empiric antimicrobial the ... Full text Link to item Cite

Validity of two subjective skin tone scales and its implications on healthcare model fairness.

Journal Article NPJ Digit Med · October 3, 2025 Skin tone assessments are critical for fairness evaluation in healthcare algorithms (e.g., pulse oximetry) but lack validation. Using prospectively collected facial images from 90 hospitalized adults at the San Francisco VA, three independent annotators ra ... Full text Link to item Cite

Early Vasopressor Utilization in Critically Ill Patients With Acute Traumatic Spinal Cord Injury: A Retrospective Cohort Study.

Journal Article Crit Care Med · October 1, 2025 OBJECTIVES: Evidence regarding vasopressor support for acute spinal cord injury (SCI) is lacking. We report early vasopressor use and hospital outcomes in patients with SCI. DESIGN: Propensity-score standardized mortality ratio-weighted retrospective cohor ... Full text Link to item Cite

Retrospective Analysis of the Association of Preoperative Sex Hormone Therapy With the Development of Postoperative Acute Kidney Injury.

Journal Article Anesth Analg · September 23, 2025 BACKGROUND: Postoperative acute kidney injury (AKI) worsens surgical outcomes. Previous studies have observed an age- and sex-dependent effect on postoperative AKI rates. The objective of our study was to determine whether preoperative exposure to male or ... Full text Link to item Cite

Lexical associations can characterize clinical documentation trends related to palliative care and metastatic cancer.

Journal Article Sci Rep · May 18, 2025 Palliative care is known to improve quality of life in advanced cancer. Natural language processing offers insights to how documentation around palliative care in relation to metastatic cancer has changed. We analyzed inpatient clinical notes using unsuper ... Full text Link to item Cite

The effect of culture on the benefits of awake prone positioning for adults with COVID-19 acute respiratory distress syndrome: A systematic review and meta-analysis.

Journal Article Eur J Anaesthesiol Intensive Care · April 2025 BACKGROUND: Randomised controlled trials (RCTs) conducted early during the pandemic showed that awake prone positioning (APP) significantly reduced the risk of intubation among adults with COVID-19 acute respiratory distress syndrome (ARDS), but more recen ... Full text Link to item Cite

Protocol and design of the REPOSE study: a double-blinded, randomised, placebo-controlled trial to evaluate the efficacy of suvorexant to improve postoperative sleep and reduce delirium severity in older patients undergoing non-cardiac surgery.

Journal Article BMJ Open · March 13, 2025 INTRODUCTION: Postoperative delirium occurs in up to 40% of older surgical patients and has been associated with prolonged hospital stays, long-term cognitive impairment and increased 1-year postoperative mortality. Postoperative sleep disturbances may inc ... Full text Link to item Cite

Association of Causative Pathogens With Acute Kidney Injury in Adult Patients With Community-Onset Sepsis.

Journal Article Crit Care Explor · February 1, 2025 IMPORTANCE: The influence of disease-causing pathogen on acute kidney injury (AKI) in septic patients is poorly understood. OBJECTIVES: We examined the association of microbial pathogen with AKI among patients with community-onset sepsis. DESIGN, SETTING, ... Full text Link to item Cite

Disparities in educational attainment and assault mortalities among Asian Americans in the USA, 2009-2021.

Journal Article Inj Prev · December 9, 2024 BACKGROUND: In 2021, a spike in Asian American hate crimes resurged discussion on Asian health disparities. This study describes the association between education and assault among Asian Americans and their subgroups. METHODS: This cross-sectional study us ... Full text Link to item Cite

Perioperative Albumin Among Adults Undergoing Thoracic Surgery in the United States: Utilization, Associations With Clinical Outcomes, and Contribution to Hospital Costs.

Journal Article J Cardiothorac Vasc Anesth · November 2024 OBJECTIVES: To estimate the use of albumin among adults undergoing thoracic surgery in the United States, compare baseline characteristics, clinical and cost outcomes of recipients versus nonrecipients, and determine albumin's contribution to total hospita ... Full text Link to item Cite

Variation in Mentions of Race and Ethnicity in Notes in Intensive Care Units Across a Health Care System.

Journal Article Am J Crit Care · November 1, 2024 BACKGROUND: Social constructs like race can affect how patients are perceived and impact care. This study investigated whether mentions of race in notes for critically ill patients differed according to patients' race. METHODS: This retrospective cohort st ... Full text Link to item Cite

Risk Factors for Increased Opioid Use During Postoperative Intensive Care.

Journal Article Crit Care Explor · November 1, 2024 IMPORTANCE: In the ICU, opioids treat pain and improve ventilator tolerance as part of an analgosedation approach. Identifying predictors of opioid consumption during the ICU course might highlight actionable items to reduce opioid consumption. OBJECTIVES: ... Full text Link to item Cite

Association of Area Deprivation Index With Mortality in Critically Ill Adults With COVID-19.

Journal Article Am J Crit Care · November 1, 2024 BACKGROUND: Various social determinants of health have been established as significant risk factors for COVID-19 transmission, prevalence, incidence, and mortality. Area deprivation index (ADI, a composite score made up of educational, housing, and poverty ... Full text Link to item Cite

Hospital Outcomes in Patients Who Developed Acute Respiratory Distress Syndrome After Community-Acquired Pneumonia.

Journal Article J Intensive Care Med · October 2024 Purpose: To identify risk factors for and outcomes in acute respiratory distress syndrome (ARDS) in patients hospitalized with community-acquired pneumonia (CAP). Methods: This is a retrospective study using the Premier Healthcare Database between 2016 and ... Full text Link to item Cite

ICU outcomes following a Central Line Associated Blood Stream Infections (CLABSI) reduction quality improvement project.

Journal Article Curr Med Res Opin · October 2024 BACKGROUND: Central Line Associated Blood Stream Infections (CLABSI) are significant complications for hospitalized patients. Several different approaches have been used to reduce CLABSI. OBJECTIVE: This study aimed to (1) describe a systematic approach us ... Full text Link to item Cite

Early Beta-Blocker Utilization in Critically Ill Patients With Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article J Intensive Care Med · September 2024 BACKGROUND: There is limited evidence that beta-blockers may provide benefit for patients with moderate-severe traumatic brain injury (TBI) during the acute injury period. Larger studies on utilization patterns and impact on outcomes in clinical practice a ... Full text Link to item Cite

Trends in the Utilization of Multiorgan Support Among Adults Undergoing High-risk Cardiac Surgery in the United States.

Journal Article J Cardiothorac Vasc Anesth · September 2024 OBJECTIVES: To examine trends in the prevalence of multiorgan dysfunction (MODS), utilization of multi-organ support (MOS), and mortality among patients undergoing cardiac surgery with MODS who received MOS in the United States. DESIGN: Retrospective cohor ... Full text Link to item Cite

Maternal outcomes by mode of delivery among pregnant patients with eclampsia: a retrospective cohort study.

Journal Article American journal of obstetrics & gynecology MFM · September 2024 Full text Cite

Association of Early Dexmedetomidine Utilization With Clinical Outcomes After Moderate-Severe Traumatic Brain Injury: A Retrospective Cohort Study.

Journal Article Anesth Analg · August 1, 2024 BACKGROUND: Traumatic brain injury (TBI) is an expensive and common public health problem. Management of TBI oftentimes includes sedation to facilitate mechanical ventilation (MV) for airway protection. Dexmedetomidine has emerged as a potential candidate ... Full text Link to item Cite

Association of early dexmedetomidine exposure with brain injury biomarker levels following moderate - Severe traumatic brain injury: A TRACK-TBI study.

Journal Article J Clin Neurosci · August 2024 BACKGROUND: Traumatic brain injury (TBI) triggers autonomic dysfunction and inflammatory response that can result in secondary brain injuries. Dexmedetomidine is an alpha-2 agonist that may modulate autonomic function and inflammation and has been increasi ... Full text Link to item Cite

Use of Early Ketamine Sedation and Association With Clinical and Cost Outcomes Among Mechanically Ventilated Patients With COVID-19: A Retrospective Cohort Study.

Journal Article Crit Care Explor · July 1, 2024 OBJECTIVES: To describe the utilization of early ketamine use among patients mechanically ventilated for COVID-19, and examine associations with in-hospital mortality and other clinical outcomes. DESIGN: Retrospective cohort study. SETTING: Six hundred ten ... Full text Link to item Cite

Measuring Implicit Bias in ICU Notes Using Word-Embedding Neural Network Models.

Journal Article Chest · June 2024 BACKGROUND: Language in nonmedical data sets is known to transmit human-like biases when used in natural language processing (NLP) algorithms that can reinforce disparities. It is unclear if NLP algorithms of medical notes could lead to similar transmissio ... Full text Link to item Cite

Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension.

Journal Article Anesth Analg · May 1, 2024 BACKGROUND: Patients with pulmonary hypertension have a high risk of maternal morbidity and mortality. It is unknown if a trial of labor carries a lower risk of morbidity in these patients compared to a planned cesarean delivery. The objective of this stud ... Full text Link to item Cite

Reduce intraoperative albumin utilisation in cardiac surgical patients: a quality improvement initiative.

Journal Article BMJ Open Qual · April 24, 2024 BACKGROUND: Albumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes. The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoper ... Full text Link to item Cite

Association of Early Dexmedetomidine Utilization With Clinical and Functional Outcomes Following Moderate-Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · April 1, 2024 OBJECTIVE: To examine early sedation patterns, as well as the association of dexmedetomidine exposure, with clinical and functional outcomes among mechanically ventilated patients with moderate-severe traumatic brain injury (msTBI). DESIGN: Retrospective c ... Full text Open Access Link to item Cite

Pain trajectories after bilateral orthotopic lung transplantation surgery performed via a clamshell incision.

Journal Article Clin Transplant · February 2024 INTRODUCTION: The nature, intensity, and progression of acute pain after bilateral orthotopic lung transplantation (BOLT) performed via a clamshell incision has not been well investigated. We aimed to describe acute pain after clamshell incisions using pai ... Full text Link to item Cite

Malnutrition and Adverse Outcomes After Surgery for Head and Neck Cancer.

Journal Article JAMA Otolaryngol Head Neck Surg · January 1, 2024 IMPORTANCE: Patients with head and neck cancer (HNC) have an increased risk of malnutrition, partly due to disease location and treatment sequelae. Although malnutrition is associated with adverse outcomes, there is little data on the extent of outcomes an ... Full text Open Access Link to item Cite

Timely Albumin Infusion May Improve Resource Utilization in Patients with Cirrhosis and Spontaneous Bacterial Peritonitis.

Journal Article Biomed Res Int · 2024 Spontaneous bacterial peritonitis is a life-threatening complication of cirrhosis that can increase healthcare utilization. The impact of albumin administration timing on hospital resource utilization and its optimal timing is unclear, despite its efficacy ... Full text Link to item Cite

Propensity score methods in observational research: brief review and guide for authors.

Journal Article Br J Anaesth · November 2023 Causal inference in observational research requires a careful approach to adjustment for confounding. One such approach is the use of propensity score analyses. In this editorial, we focus on the role of propensity score-based methods in estimating causal ... Full text Link to item Cite

Early enteral nutrition is associated with improved outcomes in critically ill mechanically ventilated medical and surgical patients.

Journal Article Clin Nutr ESPEN · October 2023 BACKGROUND AND AIMS: Data suggest that guidelines for enteral nutrition (EN) initiation are not closely followed in clinical practice. In addition, critically ill mechanically ventilated (MV) patients have varying metabolic needs, which often increase and ... Full text Link to item Cite

Change to Mixed-Lipid Emulsion From Soybean Oil-Based Lipid Emulsion in Pediatric Patients.

Journal Article JAMA Netw Open · September 5, 2023 IMPORTANCE: Critically ill pediatric patients often require parenteral nutrition (PN) in the intensive care unit (ICU). Literature suggests mixed lipid emulsions (LE) with soybean oil reduction strategies may improve outcomes. OBJECTIVE: To examine the ass ... Full text Open Access Link to item Cite

State Firearm Laws and Rate of Assault-Related Firearm Death.

Journal Article J Am Coll Surg · September 1, 2023 BACKGROUND: Studying firearm-related mortality is important to reduce preventable firearm death in the US. This study aims to determine the relationship between firearm laws and assault death with firearms. STUDY DESIGN: This ecologic study used public dat ... Full text Link to item Cite

Epidemiology, Resistance Profiles, and Outcomes of Bloodstream Infections in Community-Onset Sepsis in the United States.

Journal Article Crit Care Med · September 1, 2023 OBJECTIVES: To describe frequency of positive blood cultures, patterns of pathogens' characteristics and their resistance profile in patients with blood cultures drawn due to a presumed diagnosis of community-onset sepsis, and to examine the association be ... Full text Link to item Cite

Association of Early Beta-Blocker Exposure and Functional Outcomes in Critically Ill Patients With Moderate to Severe Traumatic Brain Injury: A Transforming Clinical Research and Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Explor · September 2023 OBJECTIVES: We aimed to 1) describe patterns of beta-blocker utilization among critically ill patients following moderate-severe traumatic brain injury (TBI) and 2) examine the association of early beta-blocker exposure with functional and clinical outcome ... Full text Open Access Link to item Cite

Opioid-Sparing Multimodal Analgesia Use After Cesarean Delivery Under General Anesthesia: A Retrospective Cohort Study in 729 US Hospitals.

Journal Article Anesth Analg · August 1, 2023 BACKGROUND: Optimizing analgesia after cesarean delivery is essential to quality of patient recovery. The American Society of Anesthesiologists and the Society for Obstetric Anesthesia and Perinatology recommend multimodal analgesia (MMA). However, little ... Full text Link to item Cite

Utilization and Outcomes of Extracorporeal Membrane Oxygenation Following Traumatic Brain Injury in the United States.

Journal Article J Intensive Care Med · May 2023 Objectives: Describe contemporary ECMO utilization patterns among patients with traumatic brain injury (TBI) and examine clinical outcomes among TBI patients requiring ECMO. Design: Retrospective cohort study. Setting: Premier Healthcare Database (PHD) bet ... Full text Link to item Cite

Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study.

Journal Article Anesth Analg · April 1, 2023 BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute ... Full text Link to item Cite

Resident involvement in cataract surgery at the Veterans Health Administration: complications, case complexity, and the role of experience.

Journal Article J Cataract Refract Surg · March 1, 2023 PURPOSE: To characterize intraoperative complications, case complexity, and changes in complication rates with surgical experience for cataract surgeries involving residents at the Veterans Health Administration (VHA). SETTING: All VHA facilities where cat ... Full text Link to item Cite

Postoperative Acute Kidney Injury by Age and Sex: A Retrospective Cohort Association Study.

Journal Article Anesthesiology · February 1, 2023 BACKGROUND: Acute kidney injury (AKI) after noncardiac surgery is common and has substantial health impact. Preclinical and clinical studies examining the influence of sex on AKI have yielded conflicting results, although they typically do not account for ... Full text Link to item Cite

Erratum: Early Albumin Infusion Is Associated With Greater Survival to Discharge Among Patients With Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury Among Patients With Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury (Critical Care Explorations (2022) 4 (e0793) DOI: 10.1097/CCE.0000000000000793)

Journal Article Critical Care Explorations · January 18, 2023 In an article in the December 2022 compendium of the Journal, the title should have been: Early Albumin Infusion Is Associated With Greater Survival to Discharge Among Patients With Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury. ... Full text Cite

Association of Appropriate Empirical Antimicrobial Therapy With In-Hospital Mortality in Patients With Bloodstream Infections in the US.

Journal Article JAMA Netw Open · January 3, 2023 IMPORTANCE: Bloodstream infections (BSIs) are a major public health problem associated with high morbidity. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy. OBJECTIVE: To estimate the ass ... Full text Link to item Cite

Restrictive Firearm Laws and Firearm-Related Suicide.

Journal Article J Am Coll Surg · January 1, 2023 BACKGROUND: There were 23,854 suicides by firearms in 2017 in the US, accounting for 60% of all gun deaths. Studying firearm-related mortalities is vital for reducing preventable gun deaths. This study aims to determine the association between state-level ... Full text Link to item Cite

Mutual information: Measuring nonlinear dependence in longitudinal epidemiological data.

Journal Article PLoS One · 2023 Given a large clinical database of longitudinal patient information including many covariates, it is computationally prohibitive to consider all types of interdependence between patient variables of interest. This challenge motivates the use of mutual info ... Full text Link to item Cite

Timely Albumin Improves Survival in Patients With Cirrhosis on Diuretic Therapy Who Develop Acute Kidney Injury: Real-World Evidence in the United States

Journal Article Gastro Hep Advances · January 1, 2023 Background and Aims: Patients admitted with decompensated cirrhosis who develop acute kidney injury (AKI) tend to experience poor outcomes, even if provided with increased organ support such as renal replacement therapies. We assessed the association of al ... Full text Cite

Early Albumin Infusion Is Associated with Greater Survival to Discharge among Patients with Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury among Patients with Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury

Journal Article Critical Care Explorations · December 12, 2022 Importance: Adults hospitalized with sepsis/septic shock commonly develop acute kidney injury (AKI) which imposes a significant burden on the healthcare system. The administration of early human albumin in this patient population may yield more efficient h ... Full text Cite

Racial and Ethnic Differences in the Prevalence of Do-Not-Resuscitate Orders among Older Adults with Severe Traumatic Brain Injury.

Journal Article J Intensive Care Med · December 2022 BACKGROUND: Older adults suffering from traumatic brain injury (TBI) are subject to higher injury burden and mortality. Do Not Resuscitate (DNR) orders are used to provide care aligned with patient wishes, but they may not be equitably distributed across r ... Full text Open Access Link to item Cite

Failure to Rescue After Severe Acute Kidney Injury in Patients Undergoing Non-Cardiac Surgery.

Journal Article J Surg Res · November 2022 INTRODUCTION: Many deaths after surgery can be attributed to "failure to rescue," which may be a better surgical quality indicator than the occurrence of a postoperative complication. Acute kidney injury (AKI) is one such postoperative complication associa ... Full text Link to item Cite

Racial Differences in Firearms Used and Autopsies Following Gun Deaths Exist.

Journal Article J Surg Res · November 2022 INTRODUCTION: Disparities in gun violence across race are well documented. Studying these disparities is essential to reduce preventable gun deaths. This study evaluates the relationship between sociodemographic factors and firearms used in gun deaths. MAT ... Full text Link to item Cite

Hospital change to mixed lipid emulsion from soybean oil-based lipid emulsion for parenteral nutrition in hospitalized and critically ill adults improves outcomes: a pre-post-comparative study.

Journal Article Crit Care · October 18, 2022 INTRODUCTION: Early data suggest use of a mixed lipid emulsion (LE) with a soybean oil reduction strategy in parenteral nutrition (PN) may improve clinical outcomes. Duke University Hospital made a full switch to a Soybean oil/MCT/Olive/Fish Oil lipid (4-O ... Full text Open Access Link to item Cite

Pain Trajectories After Valve Surgeries Performed via Midline Sternotomy Versus Mini-Thoracotomy.

Journal Article J Cardiothorac Vasc Anesth · September 2022 OBJECTIVES: Controlling moderate-to-severe pain remains a major challenge after cardiothoracic surgery. Several outcomes have been compared extensively after valve surgery performed via midline sternotomy versus mini-thoracotomy, but postoperative pain (PO ... Full text Link to item Cite

Risk Factors and Neurological Outcomes Associated With Circulatory Shock After Moderate-Severe Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article Neurosurgery · September 1, 2022 BACKGROUND: Extracranial multisystem organ failure is a common sequela of severe traumatic brain injury (TBI). Risk factors for developing circulatory shock and long-term functional outcomes of this patient subset are poorly understood. OBJECTIVE: To ident ... Full text Open Access Link to item Cite

Cerebral Oximetry During Adult Cardiac Surgery Is Associated With Improved Postoperative Outcomes.

Journal Article J Cardiothorac Vasc Anesth · September 2022 OBJECTIVE: To examine the association/effect of intraoperative cerebral oximetry (CeOx) on major organ morbidity and mortality (MOMM) after adult cardiac surgery. DESIGN: A retrospective, multicenter cohort study. SETTING: Patients treated at any hospital ... Full text Link to item Cite

No Association of Early Postoperative Heart Rate With Outcomes After Coronary Artery Bypass Grafting.

Journal Article Am J Crit Care · September 1, 2022 BACKGROUND: Elevated perioperative heart rate potentially causes perioperative myocardial injury because of imbalance in oxygen supply and demand. However, large multicenter studies evaluating early postoperative heart rate and major adverse cardiac and ce ... Full text Link to item Cite

Underutilization of Acetaminophen in Older Adult Trauma Patients.

Journal Article Am Surg · August 2022 INTRODUCTION: Older adults are more vulnerable to opioid-associated morbidity. The purpose of this study was to determine the frequency and timing of acetaminophen and opioid use in the postoperative period. METHODS: Older adult trauma patients (≥65 years) ... Full text Link to item Cite

Association Between Gabapentinoids and Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2022 OBJECTIVE: Perioperative gabapentinoids in general surgery have been associated with an increased risk of postoperative pulmonary complications (PPCs), while resulting in equivocal pain relief. This study's aim was to examine the utilization of gabapentino ... Full text Link to item Cite

Micronutrient deficiencies in critically ill patients receiving continuous renal replacement therapy.

Journal Article Clin Nutr ESPEN · August 2022 BACKGROUND & AIMS: Continuous renal replacement therapy (CRRT) is essential to the management of acute kidney injury (AKI) in critical illness. Unfortunately, large quantities of micronutrients are shown to be lost in CRRT effluent. Current literature desc ... Full text Link to item Cite

Trends in Assault Mortalities Among Asian Americans, 2009-2018.

Journal Article J Surg Res · July 2022 INTRODUCTION: As of yet, few studies have described the prevalence or rates of assault mortalities involving Asian victims on a national level. This study aimed to describe yearly trends and regional differences in assault mortalities among Asians. METHODS ... Full text Link to item Cite

Mechanical thrombectomy for perioperative ischemic stroke following elective inpatient surgery in the United States.

Journal Article J Clin Neurosci · July 2022 Perioperative ischemic stroke significantly increases morbidity and mortality in patients undergoing elective surgery. Mechanical thrombectomy can improve ischemic stroke outcomes, but frequency and trend of its utilization for treatment of perioperative i ... Full text Open Access Link to item Cite

Role of Early Enteral Nutrition in Mechanically Ventilated COVID-19 Patients.

Journal Article Crit Care Explor · April 2022 UNLABELLED: Current guidance recommends initiation of early enteral nutrition (early EN) within 24-36 hours of ICU admission in critically ill COVID-19 patients. Despite this recommendation, there is quite limited evidence describing the effect of early EN ... Full text Link to item Cite

Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity.

Journal Article Anesth Analg · January 1, 2022 BACKGROUND: Both postoperative acute kidney injury (AKI) and preoperative chronic kidney disease (CKD) are associated with significantly worse outcomes following surgery. The relationship of both of these conditions with each other and with CKD progression ... Full text Link to item Cite

Review of Perioperative Music Medicine: Mechanisms of Pain and Stress Reduction Around Surgery.

Journal Article Front Med (Lausanne) · 2022 Clinical-experimental considerations and an approach to understanding the autonomic basis of improved surgical outcomes using Perioperative Music Medicine (PMM) are reviewed. Combined surgical, psycho-physiological, and experimental perspectives on Music M ... Full text Link to item Cite

Analgesia After Cesarean Delivery in the United States 2008-2018: A Retrospective Cohort Study.

Journal Article Anesth Analg · December 1, 2021 BACKGROUND: Optimizing analgesia after cesarean delivery is a priority and requires balancing adequate pain relief with the risk of analgesics-associated adverse effects. Current recommendations are for use of a multimodal, opioid-sparing analgesic regimen ... Full text Link to item Cite

Racial and Ethnic Differences in Health Care Utilization Following Severe Acute Brain Injury in the United States.

Conference J Intensive Care Med · November 2021 OBJECTIVE: To examine racial and ethnic differences in the utilization of 3 interventions (tracheostomy placement, gastrostomy tube placement, and hospice utilization) among patients with severe acute brain injury (SABI). DESIGN: Retrospective cohort study ... Full text Link to item Cite

Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury.

Journal Article Neurocrit Care · October 2021 BACKGROUND/OBJECTIVE: Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly ... Full text Open Access Link to item Cite

Association of Early Multiple Organ Dysfunction With Clinical and Functional Outcomes Over the Year Following Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study.

Journal Article Crit Care Med · October 1, 2021 OBJECTIVES: Traumatic brain injury is a leading cause of death and disability in the United States. While the impact of early multiple organ dysfunction syndrome has been studied in many critical care paradigms, the clinical impact of early multiple organ ... Full text Link to item Cite

Acute Care Resource Use After Elective Surgery in the United States: Implications During the COVID-19 Pandemic.

Journal Article Am J Crit Care · July 1, 2021 BACKGROUND: The COVID-19 pandemic created pressure to delay inpatient elective surgery to increase US health care capacity. This study examined the extent to which common inpatient elective operations consume acute care resources. METHODS: This cross-secti ... Full text Link to item Cite

Changes in analgesic strategies for lobectomy from 2009 to 2018.

Journal Article JTCVS Open · June 2021 OBJECTIVE: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. METHODS: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic ... Full text Open Access Link to item Cite

Association of gabapentinoid utilization with postoperative pulmonary complications in gynecologic surgery: a retrospective cohort study.

Journal Article Curr Med Res Opin · May 2021 OBJECTIVE: To investigate gabapentinoid utilization and association with postoperative pulmonary complications after gynecologic surgery. METHODS: After Institutional Review Board approval, we performed this retrospective cohort study using the Premier Hea ... Full text Link to item Cite

Trends in Comorbidities and Complications Using ICD-9 and ICD-10 in Total Hip and Knee Arthroplasties.

Journal Article J Bone Joint Surg Am · April 21, 2021 BACKGROUND: The transition to the new ICD-10 (International Classification of Diseases, Tenth Revision) coding system in the U.S. poses challenges to the ability to consistently and accurately measure trends in comorbidities and complications. We examined ... Full text Link to item Cite

Echocardiogram Utilization Patterns and Association With Mortality Following Severe Traumatic Brain Injury.

Journal Article Anesth Analg · April 1, 2021 BACKGROUND: Severe traumatic brain injury (TBI) can result in left ventricular dysfunction, which can lead to hypotension and secondary brain injuries. Although echocardiography is often used to examine cardiovascular function in multiple clinical settings ... Full text Open Access Link to item Cite

Acceptability and Feasibility of Perioperative Music Listening: A Rapid Qualitative Inquiry Approach.

Journal Article J Music Ther · March 16, 2021 Perioperative music decreases pain, anxiety, and analgesia requirements while increasing patient satisfaction. We investigated the acceptability of perioperative music at a women's and children's hospital in Singapore, seeking to uncover barriers and facil ... Full text Link to item Cite

Postoperative Utilization of Oral Nutrition Supplements in Surgical Patients in US Hospitals.

Journal Article JPEN J Parenter Enteral Nutr · March 2021 BACKGROUND: Postoperative nutrition delivery is essential to surgical recovery; unfortunately, postoperative dietary intake is often poor. Recent surgical guidelines recommend use of oral nutritional supplements (ONS) to improve nutrition delivery. Our aim ... Full text Link to item Cite

Association between early postoperative nutritional supplement utilisation and length of stay in malnourished hip fracture patients.

Journal Article Br J Anaesth · March 2021 BACKGROUND: Malnutrition in older hip fracture patients is associated with increased complication rates and mortality. As postoperative nutrition delivery is essential to surgical recovery, postoperative nutritional supplements including oral nutritional s ... Full text Link to item Cite

A scoring system derived from electronic health records to identify patients at high risk for noninvasive ventilation failure.

Journal Article BMC Pulm Med · February 5, 2021 OBJECTIVE: To develop and validate a clinical risk prediction score for noninvasive ventilation (NIV) failure defined as intubation after a trial of NIV in non-surgical patients. DESIGN: Retrospective cohort study of a multihospital electronic health recor ... Full text Link to item Cite

Exploring Factors Associated With Morbidity and Mortality in Patients With Do-Not-Resuscitate Orders: A National Surgical Quality Improvement Program Database Analysis Within Surgical Groups.

Journal Article Anesth Analg · February 1, 2021 BACKGROUND: Anesthesiologists caring for patients with do-not-resuscitate (DNR) orders may have ethical concerns because of their resuscitative wishes and may have clinical concerns because of their known increased risk of morbidity/mortality. Patient hete ... Full text Link to item Cite

Unplanned hospital admission after ambulatory surgery: a retrospective, single cohort study.

Journal Article Can J Anaesth · January 2021 PURPOSE: We estimated the rate of unplanned hospital and intensive care unit (ICU) admissions following ambulatory surgery centre (ASC) procedures, and identified factors associated with their occurrence. METHODS: This retrospective cohort included adult p ... Full text Link to item Cite

Perioperative colloid choice and bleeding in patients undergoing musculoskeletal surgery: An observational administrative database study.

Journal Article Int J Crit Illn Inj Sci · 2021 BACKGROUND: The synthetic colloid hydroxyethyl starch (HES) received a black box warning, issued by the US Food and Drug Administration (FDA) in June 2013, in patients with sepsis, due to increased risk of bleeding, renal injury, and death. Risks of HES in ... Full text Link to item Cite

Geospatial Variations and Neighborhood Deprivation in Drug-Related Admissions and Overdoses.

Journal Article J Urban Health · December 2020 Drug overdoses are a national and global epidemic. However, while overdoses are inextricably linked to social, demographic, and geographical determinants, geospatial patterns of drug-related admissions and overdoses at the neighborhood level remain poorly ... Full text Link to item Cite

The Impact of Nonsteroidal Anti-inflammatory Drugs on Older Adult Trauma Patients With Hip Fractures.

Journal Article J Surg Res · November 2020 BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) use is frequently recommended for multimodal analgesia to reduce opioid use. We hypothesized that increased NSAID utilization will decrease opioid requirements without leading to significant complicat ... Full text Link to item Cite

Effects of Acetaminophen, NSAIDs, Gabapentinoids, and Their Combinations on Postoperative Pulmonary Complications After Total Hip or Knee Arthroplasty.

Journal Article Pain Med · October 1, 2020 OBJECTIVE: Multimodal analgesia has gained popularity in total hip arthroplasty (THA) and total knee arthroplasty (TKA), but large multicenter studies evaluating specific analgesic combinations are lacking. DESIGN: A retrospective study using the Premier H ... Full text Open Access Link to item Cite

Causal inference in perioperative medicine observational research: part 2, advanced methods.

Journal Article Br J Anaesth · September 2020 Although RCTs represent the gold standard in clinical research, most clinical questions cannot be answered using this technique, because of ethical considerations, time, and cost. The goal of observational research in clinical medicine is to gain insight i ... Full text Link to item Cite

Causal inference in perioperative medicine observational research: part 1, a graphical introduction.

Journal Article Br J Anaesth · September 2020 Graphical models have emerged as a tool to map out the interplay between multiple measured and unmeasured variables, and can help strengthen the case for a causal association between exposures and outcomes in observational studies. In Part 1 of this method ... Full text Link to item Cite

A clinical investigation into the benefits of using charge codes in perioperative and critical care epidemiology: A retrospective cohort database study.

Journal Article Int J Crit Illn Inj Sci · September 2020 CONTEXT: Epidemiologic studies in critical care routinely rely on the codes listed in International Classification of Diseases (ICD) manuals which are primarily intended for reimbursement of claims to payers. Standardized billing codes may minimize the mea ... Full text Link to item Cite

Associations Between Perioperative Crystalloid Volume and Adverse Outcomes in Five Surgical Populations.

Journal Article J Surg Res · July 2020 BACKGROUND: Optimal administration of fluids is an important part of enhanced recovery after surgery (ERAS) protocols. We sought to examine the relationship between perioperative crystalloid volume and adverse outcomes in five common types of surgical proc ... Full text Link to item Cite

Bleeding After Musculoskeletal Surgery in Hospitals That Switched From Hydroxyethyl Starch to Albumin Following a Food and Drug Administration Warning.

Journal Article Anesth Analg · June 10, 2020 BACKGROUND: While US Food and Drug Administration (FDA) black box warnings are common, their impact on perioperative outcomes is unclear. Hydroxyethyl starch (HES) is associated with increased bleeding and kidney injury in patients with sepsis, leading to ... Full text Link to item Cite

The Association of Nicotine Replacement Therapy With Outcomes Among Smokers Hospitalized for a Major Surgical Procedure.

Journal Article Chest · May 2020 BACKGROUND: There are concerns that starting nicotine replacement therapy (NRT) in the immediate perioperative period may negatively impact wound healing. We investigated the association of NRT with postoperative outcomes among smokers hospitalized for a s ... Full text Link to item Cite

Effects of Tourniquets in the Development of Pain States: a Novel Clinical Pilot Study and Review of Utilization of Tissue Oximetry to Measure Neural Ischemia.

Journal Article Curr Pain Headache Rep · April 22, 2020 PURPOSE OF REVIEW: Approximately 20% of patients undergoing surgery develop persistent lower extremity pain following total knee arthroplasty. Animal studies have confirmed that prolonged tourniquet time increases the risk of endoneural ischemia and can me ... Full text Link to item Cite

Preoperative Disability in US Veterans.

Journal Article Anesth Analg · February 10, 2020 Using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12), we measured the prevalence of disability in all eligible patients during a 4-month period who were presenting for preoperative evaluation at a US Veterans Affairs hospi ... Full text Link to item Cite

Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.

Journal Article J Bone Joint Surg Am · February 5, 2020 BACKGROUND: Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoid ... Full text Link to item Cite

Risk Factors for Severe Opioid-Related Adverse Events in a National Cohort of Medical Hospitalizations.

Journal Article J Gen Intern Med · February 2020 BACKGROUND: Opioids are a leading cause of adverse drug events in the hospital. Guidelines recommend that physicians assess the risks of opioids and discuss them with patients when considering opioid use. There are no studies examining patient- and prescri ... Full text Link to item Cite

The Effect of Perioperative Music Listening on Patient Satisfaction, Anxiety, and Depression: A Quasiexperimental Study

Journal Article Anesthesiology Research and Practice · January 1, 2020 Background. The effect of perioperative music listening has been proven to relieve preoperative anxiety and depression, while improving patient satisfaction. However, music listening has not been extensively studied in Singapore. Therefore, the primary aim ... Full text Cite

Impact of early postoperative oral nutritional supplement utilization on clinical outcomes in colorectal surgery.

Journal Article Perioper Med (Lond) · 2020 BACKGROUND: Small randomized trials of early postoperative oral nutritional supplementation (ONS) suggest various health benefits following colorectal surgery (CRS). However, real-world evidence of the impact of early ONS on clinical outcomes in CRS is lac ... Full text Open Access Link to item Cite

Antibiotic Prophylaxis for Cesarean Delivery: A Survey of Anesthesiologists.

Journal Article Anesthesiol Res Pract · 2020 BACKGROUND: The most common complication after cesarean delivery is surgical site infection. Antibiotic prophylaxis reduces infectious morbidity and current anesthetic quality metrics include preincision antibiotic prophylaxis. Recently, studies suggest re ... Full text Link to item Cite

Association 'Between Gabapentinoids on the Day of Colorectal Surgery and Adverse Postoperative Respiratory Outcomes.

Journal Article Ann Surg · December 2019 OBJECTIVE: The aim of this study was to determine the association between gabapentinoids on the day of surgery and adverse postoperative outcomes in patients undergoing colorectal surgery in the United States. BACKGROUND: Gabapentinoids, gabapentin and pre ... Full text Link to item Cite

Trends in Chronic Opioid Use Around Inpatient Surgery Within the Veterans Health Administration.

Journal Article JAMA Surg · December 1, 2019 This study assesses outcomes of veterans who have undergone inpatient surgery since the Veterans Health Administration’s opioid safety initiative was initiated. ... Full text Link to item Cite

New Persistent Opioid Use After Postoperative Intensive Care in US Veterans.

Journal Article JAMA Surg · August 1, 2019 This study uses medical records of more than 800 000 US veterans treated in the intensive care unit after surgery to determine the rate at which these patients developed new persistent opioid use. ... Full text Link to item Cite

Impact of an Opioid Safety Initiative on Patients Undergoing Total Knee Arthroplasty: A Time Series Analysis.

Journal Article Anesthesiology · August 2019 BACKGROUND: The Opioid Safety Initiative decreased high-dose prescriptions across the Veterans Health Administration. This study sought to examine the impact of this intervention (i.e., the Opioid Safety Initiative) on pain scores and opioid prescriptions ... Full text Link to item Cite

Tracheostomy After Severe Acute Brain Injury: Trends and Variability in the USA.

Journal Article Neurocrit Care · June 2019 BACKGROUND/OBJECTIVE: Severe acute brain injury (SABI) is responsible for 12 million deaths annually, prolonged disability in survivors, and substantial resource utilization. Little guidance exists regarding indication or optimal timing of tracheostomy aft ... Full text Link to item Cite

Freedom From Opioids After Total Knee Arthroplasty.

Journal Article J Arthroplasty · May 2019 BACKGROUND: In the United States, opioids are commonly prescribed to treat knee pain after total knee arthroplasty (TKA). While surgery leads to decreased pain in most patients, a sizable minority continue to experience severe pain and consume opioids chro ... Full text Link to item Cite

Intraoperative Monitoring

Chapter · January 1, 2019 Continuous automated ST-segment analysis during thoracic surgery is especially important given the potential for cardiac ischemia, arrhythmias, and hemodynamic instability. Oxygenation during one-lung ventilation is determined by many factors including car ... Full text Cite

Association between albumin administration and survival in cardiac surgery: a retrospective cohort study.

Journal Article Can J Anaesth · November 2018 PURPOSE: Albumin is widely used during and after on-pump cardiac surgery, although it is unclear whether this therapy improves clinical outcomes. METHODS: This observational study utilized the Cerner Health Facts® database (a large HIPAA-compliant clinical ... Full text Link to item Cite

Response.

Journal Article Am J Crit Care · November 2018 Full text Link to item Cite

Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty.

Journal Article Reg Anesth Pain Med · October 2018 BACKGROUND AND OBJECTIVES: Pain scores are routinely reported in clinical practice, and we wanted to examine whether this routinely measured, patient-reported variable provides prognostic information, especially with regard to chronic opioid use, after tak ... Full text Link to item Cite

Implementation of Perioperative Music Using the Consolidated Framework for Implementation Research.

Journal Article Anesth Analg · September 2018 BACKGROUND: Complementary integrative health therapies have a perioperative role in the reduction of pain, analgesic use, and anxiety, and increasing patient satisfaction. However, long implementation lags have been quantified. The Consolidated Framework f ... Full text Link to item Cite

Early Blood Transfusions in Sepsis: Unchanged Survival and Increased Costs.

Journal Article Am J Crit Care · May 2018 BACKGROUND: Early red blood cell transfusions are a common treatment for adults hospitalized for sepsis without shock. However, their utility and association with mortality and costs have not been well studied. OBJECTIVES: To examine early transfusion rate ... Full text Link to item Cite

Outcomes Associated with Early Postoperative Noninvasive Ventilation in Bariatric Surgical Patients with Sleep Apnea.

Journal Article J Clin Sleep Med · November 15, 2016 STUDY OBJECTIVES: To examine the relationship of early initiation of noninvasive ventilation (NIV) with postoperative outcomes in patients with obstructive sleep apnea (OSA) undergoing bariatric surgery. METHODS: We included 5,266 patients with OSA undergo ... Full text Link to item Cite

Observational Research Using Propensity Scores.

Journal Article Adv Chronic Kidney Dis · November 2016 In most observational studies, treatments or other "exposures" (in an epidemiologic sense) do not occur at random. Instead, treatments or other such interventions depend on several patient-related and patient-independent characteristics. Such factors, asso ... Full text Open Access Link to item Cite

No association between donor age and recipient outcomes: transfusion of plasma in patients undergoing coronary artery bypass grafting surgery.

Journal Article Transfusion · July 2016 BACKGROUND: Recent animal studies suggest that transfusion of plasma from young donors reverses age-related neurologic and cardiac changes in older recipients. Associations between age of blood product donors and corresponding outcomes in recipients have n ... Full text Link to item Cite

Primus Inter Pares.

Journal Article Anesth Analg · May 2016 Full text Link to item Cite

Focused Transthoracic Cardiac Ultrasound: A Survey of Training Practices.

Journal Article J Cardiothorac Vasc Anesth · January 2016 OBJECTIVE: The role of focused assessment by transthoracic echocardiography or focused cardiac ultrasound (FoCUS) in the perioperative setting is uncertain and evolving. To the authors' knowledge, there are no studies that evaluate the current teaching pra ... Full text Link to item Cite

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative  (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery.

Journal Article Perioper Med (Lond) · 2016 BACKGROUND: Enhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There ... Full text Open Access Link to item Cite

Association between Initial Fluid Choice and Subsequent In-hospital Mortality during the Resuscitation of Adults with Septic Shock.

Journal Article Anesthesiology · December 2015 BACKGROUND: Currently, guidelines recommend initial resuscitation with intravenous (IV) crystalloids during severe sepsis/septic shock. Albumin is suggested as an alternative. However, fluid mixtures are often used in practice, and it is unclear whether th ... Full text Open Access Link to item Cite

Utility of Functional Hemodynamics and Echocardiography to Aid Diagnosis and Management of Shock.

Journal Article Shock · December 2015 The utility of functional hemodynamics and bedside ultrasonography is increasingly recognized as advantageous for both improved diagnosis and management of shock states. In contrast to conventional "static" measures, "dynamic" hemodynamic measures and beds ... Full text Link to item Cite

What is the ideal crystalloid?

Journal Article Curr Opin Crit Care · August 2015 PURPOSE OF REVIEW: We discuss the importance of the composition of intravenous crystalloid solutions. On the basis of current physiologic principles, evidence from basic science and clinical experiments, recent observational studies, and clinical trials, w ... Full text Link to item Cite

The authors reply.

Journal Article Crit Care Med · May 2015 Full text Link to item Cite

Fluid management in abdominal surgery: what, when, and when not to administer.

Journal Article Anesthesiol Clin · March 2015 The entire team (including anesthesiologists, surgeons, and intensive care physicians) must work together (before, during, and after abdominal surgery) to determine the optimal amount (quantity) and type (quality) of fluid necessary in the perioperative pe ... Full text Link to item Cite

Meta-analysis of high- versus low-chloride content in perioperative and critical care fluid resuscitation.

Journal Article Br J Surg · January 2015 BACKGROUND: The objective of this systematic review and meta-analysis was to assess the relationship between the chloride content of intravenous resuscitation fluids and patient outcomes in the perioperative or intensive care setting. METHODS: Systematic s ... Full text Link to item Cite

The authors reply.

Journal Article Crit Care Med · January 2015 Full text Link to item Cite

Association between intravenous chloride load during resuscitation and in-hospital mortality among patients with SIRS.

Journal Article Intensive Care Med · December 2014 PURPOSE: Recent data suggest that both elevated serum chloride levels and volume overload may be harmful during fluid resuscitation. The purpose of this study was to examine the relationship between the intravenous chloride load and in-hospital mortality a ... Full text Link to item Cite

The authors reply.

Journal Article Crit Care Med · December 2014 Full text Link to item Cite

Association between intravenous chloride load during resuscitation and in-hospital mortality among patients with SIRS

Journal Article Intensive Care Medicine · November 21, 2014 Purpose: Recent data suggest that both elevated serum chloride levels and volume overload may be harmful during fluid resuscitation. The purpose of this study was to examine the relationship between the intravenous chloride load and in-hospital mortality a ... Full text Cite

Choice of fluid in acute illness: what should be given? An international consensus.

Journal Article Br J Anaesth · November 2014 Fluid management during critical illness is a dynamic process that may be conceptualized as occurring in four phases: rescue, optimization, stabilization, and de-escalation (mobilization). The selection and administration of resuscitation fluids is one com ... Full text Link to item Cite

State-of-the-art fluid management in the operating room.

Journal Article Best Pract Res Clin Anaesthesiol · September 2014 The underlying principles guiding fluid management in any setting are very simple: maintain central euvolemia, and avoid salt and water excess. However, these principles are frequently easier to state than to achieve. Evidence from recent literature sugges ... Full text Open Access Link to item Cite

Using Zero Balance Ultrafiltration with Dialysate as a Replacement Fluid for Hyperkalemia during Cardiopulmonary Bypass.

Journal Article J Extra Corpor Technol · September 2014 Avoiding or managing hyperkalemia during cardiac surgery, especially in a patient with chronic renal insufficiency, can be challenging. Hyperkalemic cardioplegia solution is usually administered to achieve and maintain an electrical arrest of the heart. Th ... Link to item Cite

Association between the choice of IV crystalloid and in-hospital mortality among critically ill adults with sepsis*.

Journal Article Crit Care Med · July 2014 OBJECTIVE: Isotonic saline is the most commonly used crystalloid in the ICU, but recent evidence suggests that balanced fluids like Lactated Ringer's solution may be preferable. We examined the association between choice of crystalloids and in-hospital mor ... Full text Link to item Cite

Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically ventilated patients with severe sepsis.

Journal Article Crit Care Med · January 2014 OBJECTIVES: Recent trials suggest that treatment with neuromuscular blocking agents may improve survival in patients requiring mechanical ventilation for acute respiratory distress syndrome. We examined the association between receipt of a neuromuscular bl ... Full text Link to item Cite

Intravenous fluids in sepsis: what to use and what to avoid.

Journal Article Curr Opin Crit Care · December 2013 PURPOSE OF REVIEW: Septic shock is one of the most common and life-threatening conditions afflicting critically ill patients. Intravenous volume resuscitation is considered an initial and very important step in management. The most suitable fluid for volum ... Full text Link to item Cite

Effects of body surface area-indexed calculations in the morbidly obese: a mathematical analysis.

Journal Article J Cardiothorac Vasc Anesth · December 2013 OBJECTIVE: Cardiac and stroke indices routinely are used to communicate the adequacy of circulation, especially by cardiac anesthesiologists. However, indexed values may be distorted when derived using conventional formulae on morbidly obese patients. In e ... Full text Link to item Cite

Fluids are drugs: type, dose and toxicity.

Journal Article Curr Opin Crit Care · August 2013 PURPOSE OF REVIEW: We discuss the formulation of a prescription for intravenous (i.v.) fluid therapy (a 'volume prescription') for critically ill patients: pros/cons of different fluid types; accurate dosing; and qualitative and quantitative toxicities. Up ... Full text Link to item Cite

Rebuttal from Dr Marik et al.

Journal Article Chest · August 2013 Full text Link to item Cite

Technical communication: inhaled anesthetic agent-vaporizer mismatch: management in settings with limited resources: don't try this at home.

Journal Article Anesth Analg · June 2013 Agent-specific vaporizers minimize opportunities for error and evidence our specialty's commitment to patient safety as a general principle. End-tidal anesthetic gas concentration monitoring is a useful adjunct whenever inhaled anesthetics are used in oper ... Full text Link to item Cite

Fluid management in cardiac surgery: colloid or crystalloid?

Journal Article Anesthesiol Clin · June 2013 The crystalloid-colloid debate has raged for decades, with the publication of many meta-analyses, yet no consensus. There are important differences between colloids and crystalloids, and these differences have direct relevance for cardiac surgical patients ... Full text Link to item Cite

Unwarranted variability in antibiotic prophylaxis for cesarean section delivery: a national survey of anesthesiologists.

Journal Article Anesth Analg · March 2013 BACKGROUND: Current guidelines from the American College of Obstetricians and Gynecologists recommend antibiotic prophylaxis for cesarean delivery immediately before incision. The purpose of this study was to measure and describe correlates of adherence to ... Full text Link to item Cite

Hydroxyethyl starch or saline in intensive care.

Journal Article N Engl J Med · February 21, 2013 Full text Link to item Cite

Importance of intravenous fluid dose and composition in surgical ICU patients.

Journal Article Curr Opin Crit Care · August 2012 PURPOSE OF REVIEW: This review discusses the importance of intravenous fluid dose and composition in surgical ICU patients. On the basis of updated physiologic postulates, we suggest guidelines for the use of crystalloids and colloids. Goal-directed fluid ... Full text Link to item Cite

Checklists, safety, my culture and me.

Journal Article BMJ Qual Saf · July 2012 The world is not flat. Hierarchy is a fact of life in society and in healthcare institutions. National, specialty-specific and institutional cultures may play an important role in shaping today's patient-safety climate. The influence of power distance on s ... Full text Link to item Cite

Why the gray zone may shift within the fog.

Journal Article Anesthesiology · March 2012 Full text Link to item Cite

Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl.

Journal Article J Clin Anesth · June 2011 STUDY OBJECTIVE: To evaluate the analgesic effects of the addition of epinephrine to a bupivacaine epidural infusion in early labor after a fentanyl bolus, following a lidocaine-epinephrine test dose. DESIGN: Randomized, double-blinded study. SETTING: Labo ... Full text Link to item Cite

Control charts and control limits.

Journal Article Anesth Analg · March 2011 Full text Link to item Cite

General anesthesia is not defined by a BIS level.

Journal Article J Clin Anesth · February 2011 Full text Link to item Cite

ε-Aminocaproic acid and clinical value in cardiac anesthesia.

Journal Article J Cardiothorac Vasc Anesth · February 2011 OBJECTIVE: The primary aim was to compare the "clinical value" of tranexamic acid (TXA) with ε-aminocaproic acid (EACA) when used for blood conservation during high-risk cardiac surgery. DESIGN: Data previously reported by the Blood Conservation Using Anti ... Full text Link to item Cite

The value of the P-value.

Journal Article J Clin Anesth · March 2010 Full text Link to item Cite

Inhaled epoprostenol during one-lung ventilation.

Journal Article Ann Thorac Surg · March 2010 We used inhaled epoprostenol (with intravenous phenylephrine) during one-lung ventilation to improve oxygenation in a patient with severe interstitial lung disease undergoing video-assisted thoracoscopic surgery. The pharmacologic manipulation of pulmonary ... Full text Link to item Cite

The need for perspective.

Journal Article Anesthesiology · December 2009 Full text Link to item Cite

Difficult venous access.

Journal Article Paediatr Anaesth · January 2009 Full text Link to item Cite

Anesthesia and mitochondrial disorders.

Journal Article Paediatr Anaesth · January 2009 Full text Link to item Cite

Determining the accuracy of caudal needle placement in children: a comparison of the swoosh test and ultrasonography.

Journal Article Paediatr Anaesth · July 2008 BACKGROUND: The aim of the present study was to compare two confirmatory tests - the 'swoosh' test (auscultation during caudal injection) and real time ultrasound imaging (both transverse 2D imaging and color flow Doppler imaging) in pediatric patients rec ... Full text Link to item Cite

Reply

Journal Article Paediatric Anaesthesia · April 1, 2008 Full text Cite

Ultrasonography and pediatric caudals.

Journal Article Anesth Analg · January 2008 Ultrasound is an important tool for performing pediatric regional blocks, including caudal blocks. We present a case in which the availability of ultrasound allowed us to proceed with a successful caudal block which we otherwise might have abandoned in an ... Full text Link to item Cite

Commentary

Journal Article Journal of Clinical Anesthesia · January 1, 2007 Full text Cite

Maternal outcomes by mode of delivery among pregnant patients with eclampsia: a retrospective cohort study.

Conference Maternal outcomes by mode of delivery among pregnant patients with eclampsia: a retrospective cohort study. ... Cite