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Rebecca Yasmin Klinger

Associate Professor of Anesthesiology
Anesthesiology, Cardiothoracic
Box 3094 Med Ctr, Durham, NC 27710
DUMC Box 3094, Durham, NC 27710

Selected Publications


Effectiveness of Simulation- Versus Didactic Video-Based Learning to Teach Advanced Lung Isolation Techniques.

Journal Article J Cardiothorac Vasc Anesth · May 2023 OBJECTIVES: Mastery of lung isolation is crucial for optimal cardiothoracic anesthesia education. The authors tested the hypothesis that simulation- is more effective than didactic video-based learning (cognitive, affective, and psychomotor) to teach anest ... 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

Transapical ProtekDuo Rapid Deployment Cannula as Temporary Left Ventricular Assist Device in a Jehovah's Witness Patient.

Journal Article J Cardiothorac Vasc Anesth · December 2021 Temporary left ventricular support aims to decompress the left ventricle and provide adequate forward flow into the arterial circulation. This can be accomplished with endovascular devices such as the Impella with an internal motor, or with the implementat ... Full text Link to item Cite

The Year in Thoracic Anesthesia: Selected Highlights from 2019.

Journal Article Journal of cardiothoracic and vascular anesthesia · July 2020 THIS special article is the 4th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan; the associate editor-in-chief, Dr. Augoustides; and the editorial board for the opportunity to ... Full text Cite

Patient-Reported Chronic Pain Outcomes After Lung Transplantation.

Journal Article Semin Cardiothorac Vasc Anesth · March 2020 Chronic pain after lung transplantation is a significant concern, in particular given the heterogeneity of the patient population and the challenges of achieving adequate pain control amid concerns related to complex immunosuppressant regimens and the poss ... Full text Link to item Cite

Intravenous Lidocaine and Postoperative Cognition: Reply.

Journal Article Anesthesiology · February 2020 Full text Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Cerebral Amyloid and Cognition after Surgery: Reply.

Journal Article Anesthesiology · July 2019 Full text Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes.

Journal Article Anesthesiology · April 2019 Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes mod ... Full text Link to item Cite

Pain Management After Thoracic Surgery

Chapter · January 1, 2019 Thoracic surgery can cause significant pain and suffering. Appropriate analgesia is important both for humanitarian reasons and to allow early mobilization and pulmonary rehabilitation. Poor pain relief can increase pulmonary complications and mortality. P ... Full text Cite

Fluid Management in Thoracic Surgery

Chapter · January 1, 2019 Lung injury after thoracic surgery is a major source of postoperative morbidity and mortality. There appears to be a link between excessive perioperative intravenous fluid administration and increased risk for lung injury in thoracic surgical patients for ... Full text Cite

Lung Transplantation

Chapter · January 1, 2019 Preoperative evaluation of the lung transplant recipient allows for optimal planning of intraoperative ventilation, hemodynamic support, and the need for extracorporeal support. Careful induction of anesthesia is required to avoid acute right ventricular f ... Full text Cite

Predictive ability of perioperative atrial fibrillation risk indices in cardiac surgery patients: a retrospective cohort study.

Journal Article Can J Anaesth · July 2018 PURPOSE: The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there i ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal Article Anesthesiology · April 2018 BackgroundAmyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in thos ... Full text Cite

The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section-a systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2018 Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review a ... Full text Link to item Cite

Effectiveness of Simulation- Versus Didactic Video-Based Learning to Teach Advanced Lung Isolation Techniques.

Journal Article J Cardiothorac Vasc Anesth · May 2023 OBJECTIVES: Mastery of lung isolation is crucial for optimal cardiothoracic anesthesia education. The authors tested the hypothesis that simulation- is more effective than didactic video-based learning (cognitive, affective, and psychomotor) to teach anest ... 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

Transapical ProtekDuo Rapid Deployment Cannula as Temporary Left Ventricular Assist Device in a Jehovah's Witness Patient.

Journal Article J Cardiothorac Vasc Anesth · December 2021 Temporary left ventricular support aims to decompress the left ventricle and provide adequate forward flow into the arterial circulation. This can be accomplished with endovascular devices such as the Impella with an internal motor, or with the implementat ... Full text Link to item Cite

The Year in Thoracic Anesthesia: Selected Highlights from 2019.

Journal Article Journal of cardiothoracic and vascular anesthesia · July 2020 THIS special article is the 4th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan; the associate editor-in-chief, Dr. Augoustides; and the editorial board for the opportunity to ... Full text Cite

Patient-Reported Chronic Pain Outcomes After Lung Transplantation.

Journal Article Semin Cardiothorac Vasc Anesth · March 2020 Chronic pain after lung transplantation is a significant concern, in particular given the heterogeneity of the patient population and the challenges of achieving adequate pain control amid concerns related to complex immunosuppressant regimens and the poss ... Full text Link to item Cite

Intravenous Lidocaine and Postoperative Cognition: Reply.

Journal Article Anesthesiology · February 2020 Full text Cite

The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2020 BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ... Full text Open Access Link to item Cite

Cerebral Amyloid and Cognition after Surgery: Reply.

Journal Article Anesthesiology · July 2019 Full text Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes.

Journal Article Anesthesiology · April 2019 Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes mod ... Full text Link to item Cite

Pain Management After Thoracic Surgery

Chapter · January 1, 2019 Thoracic surgery can cause significant pain and suffering. Appropriate analgesia is important both for humanitarian reasons and to allow early mobilization and pulmonary rehabilitation. Poor pain relief can increase pulmonary complications and mortality. P ... Full text Cite

Fluid Management in Thoracic Surgery

Chapter · January 1, 2019 Lung injury after thoracic surgery is a major source of postoperative morbidity and mortality. There appears to be a link between excessive perioperative intravenous fluid administration and increased risk for lung injury in thoracic surgical patients for ... Full text Cite

Lung Transplantation

Chapter · January 1, 2019 Preoperative evaluation of the lung transplant recipient allows for optimal planning of intraoperative ventilation, hemodynamic support, and the need for extracorporeal support. Careful induction of anesthesia is required to avoid acute right ventricular f ... Full text Cite

Predictive ability of perioperative atrial fibrillation risk indices in cardiac surgery patients: a retrospective cohort study.

Journal Article Can J Anaesth · July 2018 PURPOSE: The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there i ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal Article Anesthesiology · April 2018 BackgroundAmyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in thos ... Full text Cite

The impact of neuraxial clonidine on postoperative analgesia and perioperative adverse effects in women having elective Caesarean section-a systematic review and meta-analysis.

Journal Article Br J Anaesth · February 2018 Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review a ... Full text Link to item Cite

Adverse outcomes associated with postoperative atrial arrhythmias after lung transplantation: A meta-analysis and systematic review of the literature.

Journal Article Clin Transplant · April 2017 BACKGROUND: Postoperative atrial arrhythmias (AAs) are common after lung transplantation, but studies are mixed regarding their impact on outcomes. We therefore performed this systematic review and meta-analysis to determine whether AAs after lung transpla ... Full text Link to item Cite

Pectoral Fascial (PECS) I and II Blocks as Rescue Analgesia in a Patient Undergoing Minimally Invasive Cardiac Surgery.

Journal Article Reg Anesth Pain Med · 2017 INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient und ... Full text Link to item Cite

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.

Journal Article Can J Anaesth · November 2016 PURPOSE: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral in ... Full text Link to item Cite

A Multicenter Pilot Study Assessing Regional Cerebral Oxygen Desaturation Frequency During Cardiopulmonary Bypass and Responsiveness to an Intervention Algorithm.

Journal Article Anesth Analg · June 2016 BACKGROUND: The purpose of this multicenter pilot study was to: (1) determine the frequency of regional cerebral oxygen saturation (rScO2) desaturations during cardiac surgery involving cardiopulmonary bypass (CPB); (2) evaluate the accuracy of clinician-i ... Full text Link to item Cite

Intraoperative Magnesium Administration Does Not Reduce Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article Anesthesia and analgesia · October 2015 BackgroundHypomagnesemia has been associated with an increased risk of postoperative atrial fibrillation (POAF). Although previous studies have suggested a beneficial effect of magnesium (Mg) therapy, almost all of these are limited by small sampl ... Full text Cite

Cortical β-amyloid levels and neurocognitive performance after cardiac surgery.

Journal Article BMJ Open · September 20, 2013 INTRODUCTION: Neurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to se ... Full text Open Access Link to item Cite

Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases.

Journal Article J Clin Anesth · May 2012 STUDY OBJECTIVE: To assess the hemodynamic impact of dexmedetomidine administration in a large cohort of patients undergoing routine noncardiac surgery. DESIGN: Retrospective database analysis. SETTING: Major academic medical center. MEASUREMENTS: A valid ... Full text Link to item Cite

Conduction block in micropatterned cardiomyocyte cultures replicating the structure of ventricular cross-sections.

Journal Article Cardiovasc Res · February 1, 2012 AIMS: Structural and functional heterogeneities in cardiac tissue have been implicated in conduction block and arrhythmogenesis. However, the propensity of specific sites within the heart to initiate conduction block has not been systematically explored. W ... Full text Link to item Cite

Cardiac fibroblast paracrine factors alter impulse conduction and ion channel expression of neonatal rat cardiomyocytes.

Journal Article Cardiovasc Res · September 1, 2009 AIMS: The pathological proliferation of cardiac fibroblasts (CFs) in response to heart injury results in fibrosis, which correlates with arrhythmia generation and heart failure. Here we systematically examined the effect of fibroblast-derived paracrine fac ... Full text Link to item Cite

Structural coupling of cardiomyocytes and noncardiomyocytes: quantitative comparisons using a novel micropatterned cell pair assay.

Journal Article Am J Physiol Heart Circ Physiol · July 2008 Well-controlled studies of the structural and functional interactions between cardiomyocytes and other cells are essential for understanding heart pathophysiology and for the further development of safe and efficient cell therapies. We established a novel ... Full text Link to item Cite

Tissue-Engineered Blood Vessels

Journal Article · March 31, 2006 Full text Cite

Relevance and safety of telomerase for human tissue engineering.

Journal Article Proc Natl Acad Sci U S A · February 21, 2006 Tissue engineering holds the promise of replacing damaged or diseased tissues and organs. The use of autologous donor cells is often not feasible because of the limited replicative lifespan of cells, particularly those derived from elderly patients. Prolif ... Full text Link to item Cite

Blood vessels engineered from human cells.

Journal Article Lancet · June 18, 2005 Tissue engineering has made considerable progress in the past decade, but advances have stopped short of clinical application for most tissues. We postulated that an obstacle in engineering human tissues is the limited replicative capacity of adult somatic ... Full text Link to item Cite