Scholars@Duke
Michael Wayne Manning

Michael Wayne Manning

Associate Professor of Anesthesiology
Anesthesiology, General, Vascular, High Risk Transplant & Critical Care
Office hours Wednesday 3pm - 5pm
Friday 3pm-5pm  

Scholarly Works - Journal articles

Variations in Intraoperative Opioid Use in Cardiac Surgical Patients With Midline Sternotomy.

Journal article Semin Cardiothorac Vasc Anesth · April 24, 2026 High-dose opioid use in cardiac anesthesia has been challenged due to its association with increased postoperative complications. We retrospectively compared postoperative opioid consumption in a cohort of adult cardiac surgery patients who received low, m ... Full text Link to item Cite

Pain Trajectories After Cardiac Surgery Performed Via Midline Sternotomy.

Journal article J Cardiothorac Vasc Anesth · December 2025 OBJECTIVES: Acute pain after cardiac surgery performed via midline sternotomy is reported to be moderate to severe in intensity in up to three-quarters of patients in the early postoperative period. This work was designed to describe different pain traject ... Full text Link to item Cite

How We Would Use Enhanced Recovery After Cardiac Surgery: What We Would Do for Ourselves During the Perioperative Period.

Journal article J Cardiothorac Vasc Anesth · August 2025 Enhanced Recovery After Cardiac Surgery (ERACS) programs have grown from their humble beginnings as a "fast-track recovery" pathway that was first described in 1994 and have now evolved into patient-centered, multidisciplinary, multimodal, comprehensive, e ... Full text 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

Pain management and opioid stewardship in adult cardiac surgery: Joint consensus report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society.

Journal article J Thorac Cardiovasc Surg · December 2023 BACKGROUND: Opioid-based anesthesia and analgesia is a traditional component of perioperative care for the cardiac surgery patient. Growing enthusiasm for Enhanced Recovery Programs (ERPs) coupled with evidence of potential harm associated with high-dose o ... Full text Link to item Cite

Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery.

Journal article Circulation · October 24, 2023 BACKGROUND: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-sel ... Full text Open Access Link to item Cite

A multidisciplinary opioid-reduction pathway for robotic prostatectomy: outcomes at year one.

Journal article Perioper Med (Lond) · August 1, 2023 BACKGROUND: Opioid use has come under increasing scrutiny, driven in part by the opioid crisis and growing concerns that up to 6% of opioid-naïve patients may become chronic opioid users. This has resulted in a revaluation of perioperative practice. For th ... Full text Link to item Cite

Bleeding Complications from Transesophageal Echocardiography for Liver Transplantation: A Systematic Review.

Journal article Semin Cardiothorac Vasc Anesth · December 2022 Transesophageal echocardiography (TEE) for liver transplant has historically been avoided due to concern it may cause bleeding from esophageal varices. However, several recent studies, as well as increasing clinical experience, have indicated that it may b ... Full text Link to item Cite

Patterns of Use in Transesophageal Echocardiography for Liver Transplantation: A Systematic Review.

Journal article Semin Cardiothorac Vasc Anesth · December 2022 Transesophageal echocardiography is frequently but not always used to guide anesthetic management during liver transplantation. We performed a systematic review of the literature to identify and summarize any studies reporting on the frequency and characte ... Full text 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

Assisted Fluid Management Software Guidance for Intraoperative Fluid Administration.

Journal article Anesthesiology · August 1, 2021 BACKGROUND: Excessive or inadequate fluid administration causes complications, but despite this, fluid administration during noncardiac surgery is highly variable. Goal-directed management helps optimize the amount and timing of fluid administration; howev ... Full text Open Access Link to item Cite

Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney Injury.

Journal article J Cardiothorac Vasc Anesth · May 2021 OBJECTIVE: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) serves to hemoconcentrate blood volume to avoid allogeneic blood transfusions. Previous studies have determined CUF volumes as a continuous variable are associated with posto ... Full text Open Access Link to item Cite

Post-Reperfusion Syndrome in Liver Transplantation-An Overview.

Journal article J Cardiothorac Vasc Anesth · February 2020 Full text Link to item Cite

Perioperative Quality Initiative (POQI) consensus statement on fundamental concepts in perioperative fluid management: fluid responsiveness and venous capacitance.

Journal article Perioper Med (Lond) · 2020 BACKGROUND: Optimal fluid therapy in the perioperative and critical care settings depends on understanding the underlying cardiovascular physiology and individualizing assessment of the dynamic patient state. METHODS: The Perioperative Quality Initiative ( ... Full text Open Access Link to item Cite

What Does a Red Meat Allergy Have to Do With Anesthesia? Perioperative Management of Alpha-Gal Syndrome.

Journal article Anesth Analg · November 2019 Over the past decade, there has been a growing awareness of a new allergic syndrome known as alpha-gal allergy or alpha-gal syndrome, commonly recognized as a red meat allergy. We performed a review of the literature to identify articles that provide both ... Full text Link to item Cite

Perioperative Anesthetic and Transfusion Management of Veno-Venous Extracorporeal Membrane Oxygenation Patients Undergoing Noncardiac Surgery: A Case Series of 21 Procedures.

Journal article J Cardiothorac Vasc Anesth · July 2019 OBJECTIVES: To analyze the perioperative management of veno-venous extracorporeal membrane oxygenation (VV ECMO) in patients undergoing major noncardiac surgical procedures, which is poorly described in the literature. In doing so, perioperative challenges ... Full text Link to item Cite

Outcomes of Laparoscopic Cholecystectomy in Patients Supported with a Left Ventricular Assist Device.

Journal article J Laparoendosc Adv Surg Tech A · April 2019 BACKGROUND: An increasing number of end-stage heart failure patients are supported with left ventricular assist device (LVAD) implantation and must be maintained on consistent anticoagulation. These patients are experiencing prolonged survival and, in some ... Full text Link to item Cite

Complex Role for E-Prostanoid 4 Receptors in Hypertension.

Journal article J Am Heart Assoc · February 19, 2019 Background Prostaglandin E2 ( PGE 2) is a major prostanoid with multiple actions that potentially affect blood pressure ( BP ). PGE 2 acts through 4 distinct E-prostanoid ( EP ) receptor isoforms: EP 1 to EP 4. The EP 4 receptor ( EP 4R) promotes PGE 2-dep ... Full text Open Access Link to item Cite

Impact of an enhanced recovery pathway on length of stay and complications in elective radical cystectomy: a before and after cohort study.

Journal article Perioper Med (Lond) · 2019 BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to standardize and integrate perioperative care, incorporating the best available evidence-based practice throughout the perioperative period targeted at attenuating the surgical stress respon ... Full text Open Access Link to item Cite

Enhanced Recovery After Surgery and Multimodal Strategies for Analgesia.

Journal article Surg Clin North Am · December 2018 Enhanced recovery after surgery is an evidence-based, multimodal approach to the perioperative care of a patient undergoing surgery. These pathways seek to attenuate the stress response to surgery facilitating postoperative recovery. Analgesia is a critica ... Full text Link to item Cite

Management of Patients With Left Ventricular Assist Devices Requiring Teeth Extraction: Is Halting Anticoagulation Appropriate?

Journal article J Oral Maxillofac Surg · September 2018 PURPOSE: An increasing number of patients with end-stage heart failure are supported with left ventricular assist device (LVAD) implantation and must be maintained on a consistent anticoagulation regimen. Pre-emptive extraction of carious teeth in these pa ... Full text Link to item Cite

Defining Value-Based Care in Cardiac and Vascular Anesthesiology: The Past, Present, and Future of Perioperative Cardiovascular Care.

Journal article J Cardiothorac Vasc Anesth · February 2018 Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordin ... Full text Link to item Cite

The rising tide of opioid use and abuse: the role of the anesthesiologist.

Journal article Perioper Med (Lond) · 2018 Opioid use has risen dramatically in the past three decades. In the USA, opioid overdose has become a leading cause of unintentional death, surpassing motor vehicle accidents. A patient's first exposure to opioids may be during the perioperative period, a ... Full text Open Access Link to item Cite

Fluid Management in the Elderly

Journal article Current Anesthesiology Reports · December 2017 Full text Open Access Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Perioperative fluid and hemodynamic management within an enhanced recovery pathway.

Journal article J Surg Oncol · October 2017 Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to de ... Full text Open Access Link to item Cite

Angiotensin Receptor Blockade Improves Cardiac Surgical Outcomes in Patients With Metabolic Syndrome.

Journal article Ann Thorac Surg · July 2017 BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhib ... Full text Link to item Cite

Near-infrared spectrometry of abdominal aortic aneurysm in the ApoE-/- mouse.

Journal article Anal Chem · July 15, 2003 Abdominal aortic aneurysms (AAAs) occur in 5-7% of people over age 60 in the United States. Early intervention in the disease process could have a significant impact on the incidence of complications and on patient survival, but identifying incipient aneur ... Full text Link to item Cite

Differential effects of doxycycline, a broad-spectrum matrix metalloproteinase inhibitor, on angiotensin II-induced atherosclerosis and abdominal aortic aneurysms.

Journal article Arterioscler Thromb Vasc Biol · March 1, 2003 OBJECTIVE: Angiotensin II (AngII) infusion into hyperlipidemic mice leads to the rapid formation of atherosclerotic lesions and abdominal aortic aneurysms (AAAs). To define the role of matrix metalloproteinases (MMPs) in the development of these vascular p ... Full text Link to item Cite

Abdominal aortic aneurysms: fresh insights from a novel animal model of the disease.

Journal article Vasc Med · February 2002 Abdominal aortic aneurysms (AAA) have a high prevalence in aged populations and are responsible for a large number of deaths. Despite the widespread nature of the disease, relatively little is known regarding mechanisms for formation and progression of aor ... Full text Link to item Cite

Antagonism of AT2 receptors augments angiotensin II-induced abdominal aortic aneurysms and atherosclerosis.

Journal article Br J Pharmacol · October 2001 1. We have recently demonstrated that chronic infusion of Angiotensin II into apoE-/- mice promotes the development of abdominal aortic aneurysms. To determine the involvement of specific Angiotensin II receptors in this response, we co-infused Angiotensin ... Full text Link to item Cite

Restorative effects of GDNF on striatal dopamine release in rats treated with neurotoxic doses of methamphetamine.

Journal article Ann N Y Acad Sci · September 2000 Repeated methamphetamine (METH) administration to animals can result in long-lasting decreases in striatal dopamine (DA) release and content. Glial cell line-derived neurotrophic factor (GDNF) has pronounced effects on dopaminergic systems in vivo, includi ... Full text Link to item Cite

Angiotensin II promotes atherosclerotic lesions and aneurysms in apolipoprotein E-deficient mice.

Journal article J Clin Invest · June 2000 Increased plasma concentrations of angiotension II (Ang II) have been implicated in atherogenesis. To examine this relationship directly, we infused Ang II or vehicle for 1 month via osmotic minipumps into mature apoE(-/-) mice. These doses of Ang II did n ... Full text Link to item Cite

Recovery of presynaptic dopaminergic functioning in rats treated with neurotoxic doses of methamphetamine.

Journal article J Neurosci · September 1, 1999 Repeated administration of methamphetamine (METH) to animals can result in long-lasting decreases in striatal dopamine (DA) content. In addition, the evoked overflow of striatal DA is reduced in rats 1 week after neurotoxic doses of METH. However, whether ... Full text Link to item Cite

Augmented methamphetamine-induced overflow of striatal dopamine 1 day after GDNF administration.

Journal article Brain Res · May 8, 1999 Glial cell line-derived neurotrophic factor (GDNF) can attenuate the dopamine (DA)-depleting effects of neurotoxic doses of methamphetamine (METH) when given 1 day prior to the METH. The neurotoxic effects of METH may be due, in part, to sustained increase ... Full text Link to item Cite

GDNF protection against 6-OHDA-induced reductions in potassium-evoked overflow of striatal dopamine.

Journal article J Neurosci · February 15, 1999 Glial cell line-derived neurotrophic factor (GDNF), when administered before 6-hydroxydopamine (6-OHDA), has been shown to prevent the reduction in nigral dopamine (DA) levels and tyrosine hydroxylase-positive neurons normally observed after 6-OHDA lesions ... Full text Link to item Cite

Effects of neurotoxic doses of methamphetamine on potassium and amphetamine evoked overflow of dopamine in the striatum of awake rats.

Journal article Neurosci Lett · June 5, 1998 The effects of neurotoxic doses of methamphetamine on basal and evoked overflow of dopamine in the striatum were examined in awake rats using microdialysis. Male Fischer-344 rats were administered methamphetamine (5 mg/kg s.c.) or saline four times in 1 da ... Full text Link to item Cite