Scholars@Duke
Mark Stafford-Smith

Mark Stafford-Smith

Professor Emeritus of Anesthesiology
Anesthesiology, Cardiothoracic
staff002@mc.duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2301 Erwin Road, 5688B Hafs Building, Durham, NC 27710

Selected Publications

Preface

Journal Article Dryland Social-Ecological Systems in Changing Environments · January 1, 2024 Cite

Evolution of Accredited Pediatric Cardiac Anesthesiology Fellowship Training in the United States: A Step in the Right Direction.

Journal Article Anesth Analg · August 1, 2023 Pediatric cardiac anesthesiology has developed as a subsubspecialty of anesthesiology over the past 70 years. The evolution of this specialty has led to the establishment in 2005 of a dedicated professional society, the Congenital Cardiac Anesthesia Societ ... 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

Identification of Trajectory-Based Acute Kidney Injury Phenotypes Among Cardiac Surgery Patients.

Journal Article Ann Thorac Surg · December 2022 BACKGROUND: Acute kidney injury (AKI) is a common and serious complication of cardiac surgical procedures for which unrecognized heterogeneity may underpin poor success in identifying effective therapies. We aimed to identify phenotypically similar groups ... Full text Link to item Cite

Renal-Resistive Index for Prediction of Acute Kidney Injury in the Setting of Aortic Insufficiency.

Journal Article J Cardiothorac Vasc Anesth · December 2021 Acute kidney injury (AKI) is a common postoperative complication after cardiac surgery with cardiopulmonary bypass (CPB), and leads to significant morbidity, mortality, and cost. Although early recognition and management of AKI may reduce the burden of ren ... Full text Link to item Cite

The Epidural "Test Dose" - Time to Rethink Our Thoracic Practice?

Journal Article J Cardiothorac Vasc Anesth · October 2021 Full text 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

Sex and race differences of cerebrospinal fluid metabolites in healthy individuals.

Journal Article Metabolomics · January 18, 2021 INTRODUCTION: Analyses of cerebrospinal fluid (CSF) metabolites in large, healthy samples have been limited and potential demographic moderators of brain metabolism are largely unknown. OBJECTIVE: Our objective in this study was to examine sex and race dif ... 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

Association between levosimendan, postoperative AKI, and mortality in cardiac surgery: Insights from the LEVO-CTS trial.

Journal Article Am Heart J · January 2021 OBJECTIVES: We aimed to evaluate the association between levosimendan treatment and acute kidney injury (AKI) as well as assess the clinical sequelae of AKI in cardiac surgery patients with depressed left ventricular function (ejection fraction <35%). METH ... Full text Link to item Cite

Preservation of Renal Function

Chapter · January 1, 2021 Acute kidney injury (AKI) remains a frequent and serious complication of surgical procedures and critical illness that is consistently associated with worse outcomes and increased long-term morbidity and mortality. Much work has gone into finding kidney pr ... Full text Cite

Apolipoprotein L1 (APOL1) Coding Variants Are Associated With Creatinine Rise After Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · December 2020 OBJECTIVE: Acute kidney injury (AKI) is a complication of cardiac surgery that is considerably more common in African Americans (1.5-fold). Although homozygous status for apolipoprotein L1 (APOL1) risk alleles is associated with chronic kidney disease in i ... Full text Link to item Cite

Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.

Journal Article Transpl Int · August 2020 Acute kidney injury (AKI) and primary graft dysfunction (PGD) are serious complications after heart transplantation (HT). The relationship between AKI and PGD is poorly understood. We sought to examine the incidence of AKI and identify risk factors associa ... Full text Link to item Cite

Intraoperative renal resistive index threshold as an acute kidney injury biomarker.

Journal Article J Clin Anesth · May 2020 STUDY OBJECTIVE: The lag in creatinine-mediated diagnosis of cardiac surgery-associated acute kidney injury (AKI) may be impeding the development of renoprotection therapies. Postoperative renal resistive index (RRI) measured by transabdominal Doppler ultr ... Full text Link to item Cite

Renal Failure and Dialysis

Chapter · January 1, 2020 Acute kidney injury (AKI) is a common and serious complication of cardiac surgery. The spectrum of cardiac surgery-associated AKI (CS-AKI) ranges from transient loss of renal reserve, through AKI, to long-term irreversible renal failure requiring renal rep ... Full text Cite

Cardiac Surgery and the Kidney

Chapter · January 1, 2020 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

Implementation of an Innovative Residency Leadership Development Curriculum.

Journal Article A A Pract · April 1, 2019 The role of the anesthesiologist in the perioperative environment requires facility in leadership; however, leadership education is not part of the traditional curriculum for anesthesiology trainees. To address this educational gap, we developed a leadersh ... Full text Link to item Cite

Renal Angina Is a Sensitive, but Nonspecific Identifier of Postcardiac Surgery Acute Kidney Injury.

Journal Article J Cardiothorac Vasc Anesth · February 2019 OBJECTIVES: Acute kidney injury (AKI) is a common complication of cardiac surgery, and early detection is difficult. This study was performed to determine the sensitivity, specificity, positive predictive value, negative predictive value, and statistical p ... Full text Link to item Cite

Temporary autonomic modulation with botulinum toxin type A to reduce atrial fibrillation after cardiac surgery.

Journal Article Heart Rhythm · February 2019 BACKGROUND: Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery and is associated with worse outcomes. The cardiac autonomic nervous system is implicated in the pathogenesis of POAF. OBJECTIVE: The purpose of this study was to d ... Full text Link to item Cite

Frailty and Clinical Outcomes in Chronic Obstructive Pulmonary Disease.

Journal Article Ann Am Thorac Soc · February 2019 RATIONALE: Frailty represents an increased vulnerability to adverse health outcomes. The frailty phenotype conceptual model (three or more patient attributes of wasting, exhaustion, low activity, slowness, and weakness) is associated with increased morbidi ... Full text Link to item Cite

Low income as a determinant of exercise capacity in COPD.

Journal Article Chron Respir Dis · 2019 Exercise capacity (EC) is a critical outcome in chronic obstructive lung disease (chronic obstructive pulmonary disease (COPD)). It measures the impact of the disease and the effect of specific interventions like pulmonary rehabilitation (PR). EC determine ... Full text Link to item Cite

In Response.

Journal Article Anesth Analg · December 2018 Full text Link to item Cite

In Reply.

Journal Article Anesthesiology · November 2018 Full text Link to item Cite

Intraoperative Renal Resistive Index as an Acute Kidney Injury Biomarker: Development and Validation of an Automated Analysis Algorithm.

Journal Article J Cardiothorac Vasc Anesth · October 2018 OBJECTIVE: Intraoperative Doppler-determined renal resistive index (RRI) is a promising early acute kidney injury (AKI) biomarker. As RRI continues to be studied, its clinical usefulness and robustness in research settings will be linked to the ease, effic ... Full text Link to item Cite

The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.

Journal Article Ann Thorac Surg · July 2018 BACKGROUND: Acute kidney injury (AKI) is a common serious complication after cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (in ... Full text Link to item 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

Elevated Pulse Pressure, Intraoperative Hemodynamic Perturbations, and Acute Kidney Injury After Coronary Artery Bypass Grafting Surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2018 OBJECTIVE: To explore whether baseline pulse pressure (PP) confers an increased risk for acute kidney injury (AKI) independent of intraoperative hypotension or hypertension in patients who undergo coronary artery bypass grafting (CABG) surgery. DESIGN: Ret ... Full text Link to item Cite

Primary graft dysfunction after heart transplantation: Incidence, trends, and associated risk factors.

Journal Article Am J Transplant · June 2018 Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutiv ... Full text Link to item Cite

Is Compliance With Surgical Care Improvement Project Cardiac (SCIP-Card-2) Measures for Perioperative β-Blockers Associated With Reduced Incidence of Mortality and Cardiovascular-Related Critical Quality Indicators After Noncardiac Surgery?

Journal Article Anesth Analg · June 2018 BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a cont ... Full text Link to item Cite

Temporal Trends in Difficult and Failed Tracheal Intubation in a Regional Community Anesthetic Practice.

Journal Article Anesthesiology · March 2018 BACKGROUND: When tracheal intubation is difficult or unachievable before surgery or during an emergent resuscitation, this is a critical safety event. Consensus algorithms and airway devices have been introduced in hopes of reducing such occurrences. Howev ... Full text Link to item Cite

Allogeneic Mesenchymal Stem Cells for Treatment of AKI after Cardiac Surgery.

Journal Article J Am Soc Nephrol · January 2018 AKI after cardiac surgery remains strongly associated with mortality and lacks effective treatment or prevention. Preclinical studies suggest that cell-based interventions may influence functional recovery. We conducted a phase 2, randomized, double-blind, ... Full text Link to item Cite

Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study.

Journal Article Can J Anaesth · January 2018 BACKGROUND: Preoperative and postoperative anemia have been identified individually as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery. Their interrelationship with acute kidney injury (AKI) and l ... Full text Link to item Cite

Ultrafiltration on CPB Predicts AKI and Transfusion

Conference CIRCULATION · November 14, 2017 Link to item 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

Assessment of Paravalvular Leak After Transcatheter Aortic Valve Replacement: Transesophageal Echocardiography Compared With Transthoracic Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · August 2017 OBJECTIVES: Determine whether moderate or greater paravalvular leak (PVL) after transcatheter aortic valve replacement quantified using intraoperative transesophageal echocardiography (TEE) is associated with mortality and investigate the correlation betwe ... 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

In Reply.

Journal Article Anesthesiology · August 2016 Full text Link to item Cite

Gene signatures of postoperative atrial fibrillation in atrial tissue after coronary artery bypass grafting surgery in patients receiving β-blockers.

Journal Article J Mol Cell Cardiol · March 2016 Atrial tissue gene expression profiling may help to determine how differentially expressed genes in the human atrium before cardiopulmonary bypass (CPB) are related to subsequent biologic pathway activation patterns, and whether specific expression profile ... Full text Link to item Cite

Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

Journal Article Anesthesiology · February 2016 BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperat ... Full text Open Access Link to item Cite

Associations between ASA Physical Status and postoperative mortality at 48 h: a contemporary dataset analysis compared to a historical cohort.

Journal Article Perioper Med (Lond) · 2016 BACKGROUND: In this study, we examined the association between American Society of Anesthesiologists Physical Status (ASA PS) designation and 48-h mortality for both elective and emergent procedures in a large contemporary dataset (patient encounters betwe ... Full text Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal Article Kidney Int · October 2015 Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ... Full text Open Access Link to item Cite

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

Journal Article Anesth Analg · October 2015 BACKGROUND: Hypomagnesemia 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 sample size ... Full text Link to item Cite

Genome-wide association study of new-onset atrial fibrillation after coronary artery bypass grafting surgery.

Journal Article Am Heart J · September 2015 BACKGROUND: Postoperative atrial fibrillation (AF) is a potentially life-threatening complication after coronary artery bypass graft (CABG) surgery. Genetic predisposition may predict risk for developing postoperative AF. METHODS: Study subjects underwent ... Full text Link to item Cite

Right Minithoracotomy Versus Median Sternotomy for Mitral Valve Surgery: A Propensity Matched Study.

Journal Article Ann Thorac Surg · August 2015 BACKGROUND: The efficacy of conventional median sternotomy versus a right minithoracotomy (RT) approach to mitral valve surgery was evaluated in a single high-volume institution. METHODS: A retrospective analysis of a single institution's experience was pe ... Full text Open Access Link to item Cite

Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study.

Journal Article Can J Anaesth · June 2015 PURPOSE: Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein epsilon 4 (APOE4) allele is associated with worse outcomes in m ... Full text Link to item Cite

Determining eligibility for lung transplantation: A nationwide assessment of the cutoff glomerular filtration rate.

Journal Article J Heart Lung Transplant · April 2015 BACKGROUND: Historical concerns about lung transplantation in patients with a glomerular filtration rate (GFR) ≤ 50 ml/min/1.73 m(2) have not been validated. We hypothesize that a pre-transplant GFR ≤ 50 ml/min/1.73 m(2) represents a high mortality risk, e ... Full text Link to item Cite

Associations between central nervous system serotonin, fasting glucose, and hostility in African American females.

Journal Article Ann Behav Med · February 2015 BACKGROUND: Previous research has shown an association between hostility and fasting glucose in African American women. Central nervous system serotonin activity is implicated both in metabolic processes and in hostility related traits. PURPOSE: The purpos ... Full text Link to item Cite

The Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) equation best characterizes kidney function in patients being considered for lung transplantation.

Journal Article J Heart Lung Transplant · December 2014 BACKGROUND: Methods for direct measurement of glomerular filtration rate (GFR) are expensive and inconsistently applied across transplant centers. The Modified Diet in Renal Disease (MDRD) equation is commonly used for GFR estimation, but is inaccurate for ... Full text Link to item Cite

Acute kidney injury after ex vivo lung perfusion (EVLP).

Journal Article Transplant Proc · December 2014 BACKGROUND: Ex vivo lung perfusion (EVLP) identifies viability for marginal organs but complicates and lengthens lung transplantation surgery. Preliminary evidence supports equivalency for EVLP-assisted versus traditional (non-EVLP) procedures regarding gr ... Full text Link to item Cite

ABO blood group influences transfusion and survival after cardiac surgery.

Journal Article J Thromb Thrombolysis · October 2014 ABO dependent variation in von Willebrand factor (vWf) and procoagulant factor VIII (FVIII) is a plausible mechanism for modulating perioperative hemostasis and bleeding. Group AB has the highest and group O the lowest vWf and FVIII levels. Therefore, we t ... Full text Link to item Cite

G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers.

Other Circ Cardiovasc Genet · October 2014 BACKGROUND: We hypothesized that genetic variations in the adrenergic signaling pathway and cytochrome P450 2D6 enzyme are associated with new-onset atrial fibrillation (AF) in patients who underwent coronary artery bypass grafting and were treated with pe ... Full text Link to item Cite

Reply: To PMID 24266946.

Journal Article Ann Thorac Surg · August 2014 Full text Link to item Cite

Assessment of different threshold preoperative glomerular filtration rates as markers of outcomes in lung transplantation.

Journal Article Ann Thorac Surg · July 2014 BACKGROUND: The evidence behind the widely used pre-lung transplant glomerular filtration rate (GFR) cutoff of 50 mL/min per 1.73 m2 is limited. This study reviews data from a large cohort to assess outcomes associated with this historical cutoff and to es ... Full text Link to item Cite

Arterial hyperoxia during cardiopulmonary bypass and postoperative cognitive dysfunction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVE: To determine the effect of arterial normobaric hyperoxia during cardiopulmonary bypass (CPB) on postoperative neurocognitive function. The authors hypothesized that arterial hyperoxia during CPB is associated with neurocognitive decline at 6 wee ... Full text Link to item Cite

Preoperative CYP2D6 metabolism-dependent β-blocker use and mortality after coronary artery bypass grafting surgery.

Journal Article J Thorac Cardiovasc Surg · April 2014 OBJECTIVE: Recently, the role of β-blockers (BBs) in reducing perioperative mortality has been challenged. The conflicting results might have resulted from the extent of BB metabolism by the cytochrome P-450 (CYP2D6) isoenzyme. The purpose of the present s ... Full text Open Access Link to item Cite

The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.

Journal Article Ann Thorac Surg · March 2014 BACKGROUND: Postoperative acute kidney injury (AKI) is a common serious consequence of cardiac surgery. One recent study found higher AKI rates when anemia and hypotension occurred during cardiopulmonary bypass (CPB) relative to anemia alone. To revalidate ... Full text Link to item Cite

Pain management strategies for thoracotomy and thoracic pain syndromes.

Journal Article Semin Cardiothorac Vasc Anesth · March 2014 Pain after thoracic surgery can be severe and, in the acute phase, contribute to perioperative morbidity and mortality. Unfortunately, patients also incur a significant risk of chronic pain. Although there are guidelines for postoperative pain management i ... Full text Link to item Cite

Multinational institutional survey on patterns of intraoperative transesophageal echocardiography use in adult cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · February 2014 OBJECTIVES: To assess institutional patterns of perioperative transesophageal echocardiography (TEE) usage. DESIGN: The authors hypothesized that TEE is performed more frequently and comprehensively in academic centers, mainly by anesthesiologists, and bar ... Full text Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal Article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Lack of evidence for a remote effect of renal ischemia/reperfusion acute kidney injury on outcome from temporary focal cerebral ischemia in the rat.

Journal Article J Cardiothorac Vasc Anesth · February 2013 OBJECTIVE: Acute kidney injury (AKI) and ischemic stroke may occur in the same cardiac surgical patient. It is not known if an interaction exists between these organ injuries. Isolated renal ischemia/reperfusion is associated with dysfunction in remote, ot ... Full text Open Access Link to item Cite

Predictors of cognitive recovery after cardiac surgery.

Journal Article Anesth Analg · February 2013 BACKGROUND: Postoperative neurocognitive decline occurs frequently. Although predictors of cognitive injury have been well examined, factors that modulate recovery have not. We sought to determine the predictors of cognitive recovery after initial injury f ... Full text Link to item Cite

The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension.

Journal Article Anesthesiol Res Pract · 2013 Background. Postoperative acute kidney injury (AKI) is associated with high mortality and substantial cost after aortocoronary bypass graft (CABG) surgery. We tested the hypothesis that intraoperative systolic blood pressure variation is associated with po ... Full text Open Access Link to item Cite

Minithoracotomy versus sternotomy for mitral surgery in patients with chronic renal impairment: a propensity-matched study.

Journal Article Innovations (Phila) · 2013 OBJECTIVE: Compared with median sternotomy, a right thoracotomy (RT) approach to mitral surgery is associated with decreased postoperative acute renal failure. Therefore, we examined propensity-matched patients with chronic renal impairment to compare outc ... Full text Link to item Cite

The past, present and future of adaptation: Setting the context and naming the challenges

Journal Article Climate Adaptation Futures · 2013 This is an introductory chapter of Climate Adaptation Futures, a book that seeks to expose and debate key issues in climate change adaptation, and to report the current state of knowledge on adaptation. Many challenges surround the definition and implement ... Full text Cite

Climate Adaptation Futures

Journal Article Climate Adaptation Futures · 2013 Adaptation is the poor cousin of the climate change challenge - the glamour of international debate is around global mitigation agreements, while the bottom-up activities of adaptation, carried out in community halls and local government offices, are often ... Full text Cite

Utility of concomitant tricuspid valve procedures for patients undergoing implantation of a continuous-flow left ventricular device.

Journal Article J Thorac Cardiovasc Surg · November 2012 OBJECTIVE: Patients referred for implantable continuous-flow left ventricular assist devices (cfLVAD) frequently have preoperative right heart failure and tricuspid regurgitation (TR). The objective of this report is to examine early clinical benefits of c ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · February 2012 Full text Link to item Cite

Renal protection strategies

Chapter · December 1, 2011 The well-known quote from the renal physiologist Dr. Homer Smith as he proposed that the composition of the blood is determined not by what the mouth ingests but by what the kidneys keep.1 highlights not only the kidneys' domain of influence, but why even ... Full text Cite

Clinical impact of concomitant tricuspid valve procedures during left ventricular assist device implantation.

Journal Article Ann Thorac Surg · October 2011 BACKGROUND: Almost 50% of patients referred for implantable left ventricular assist device (LVAD) have significant tricuspid regurgitation (TR). Preoperative TR is associated with negative outcomes but the clinical benefit of concomitant tricuspid valve pr ... Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines.

Journal Article Ann Thorac Surg · March 2011 BACKGROUND: Practice guidelines reflect published literature. Because of the ever changing literature base, it is necessary to update and revise guideline recommendations from time to time. The Society of Thoracic Surgeons recommends review and possible up ... Full text Link to item Cite

The relationship of plasma transfusion from female and male donors with outcome after cardiac surgery.

Journal Article J Thorac Cardiovasc Surg · December 2010 OBJECTIVE: Pulmonary dysfunction is common in transfused patients recovering from heart surgery. Plasma transfusion from female donors has been linked with rare catastrophic lung injury, but its relationship with outcome after cardiac surgery is poorly und ... Full text Link to item Cite

A clinical prediction tool to estimate the number of units of red blood cells needed in primary elective coronary artery bypass surgery.

Journal Article Transfusion · November 2010 BACKGROUND: Red blood cell (RBC) transfusion is common during cardiac surgical procedures. Empiric crossmatching, without attempting to estimate individual transfusion requirements is typical. We hypothesized that a clinical prediction tool could be develo ... Full text Link to item Cite

Storage age of transfused platelets and outcomes after cardiac surgery.

Journal Article Transfusion · November 2010 BACKGROUND: The relationship between duration of platelet (PLT) storage, currently limited to 5days, and surgical outcomes has not been established. We tested the hypothesis that PLT storage age was associated with adverse outcomes. STUDY DESIGN AND METHOD ... Full text Link to item Cite

Departures from the protocol during conduct of a clinical trial: a pattern from the data record consistent with a learning curve.

Journal Article Qual Saf Health Care · October 2010 OBJECTIVE: Recognition of learning curves in medical skill acquisition has enhanced patient safety through improved training techniques. Clinical trials research has not been similarly scrutinised. The VALsartan In Acute myocardial iNfarcTion, a large mult ... Full text Link to item Cite

Many, but not all, outcome studies support exclusion of female plasma from the blood supply.

Journal Article Expert Rev Hematol · October 2010 Transfusion-related acute lung injury (TRALI) has been identified as the most common cause of transfusion-related death. Although extensive literature supports restrictions on female-donor plasma to reduce antibody-mediated TRALI, only a few outcome studie ... Full text Link to item Cite

Central nervous system serotonin and clustering of hostility, psychosocial, metabolic, and cardiovascular endophenotypes in men.

Journal Article Psychosom Med · September 2010 OBJECTIVE: To use measures of cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5HIAA) and genotype of a functional polymorphism of the monoamine oxidase A gene promoter (MAOA-uVNTR) to study the role of central nervous system (CNS) serotonin in cluste ... Full text Link to item Cite

Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients.

Journal Article Anesthesiology · August 2010 BACKGROUND: Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 3 ... Full text Link to item Cite

Association of the 98T ELAM-1 polymorphism with increased bleeding after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: Hemorrhage continues to be a major problem after cardiac surgery despite the routine use of antifibrinolytic drugs, with striking inter-patient variability poorly explained by already known risk factors. The authors tested the hypothesis that ge ... Full text Link to item Cite

Glycosylated hemoglobin levels and outcome in non-diabetic cardiac surgery patients.

Journal Article Can J Anaesth · June 2010 PURPOSE: In diabetics, elevated preoperative hemoglobin A1c (HbA1c) levels are associated with increased complication rates after cardiac surgery. While many non-diabetics also have elevated HbA1c, the relationship with outcome in these patients is not wel ... Full text Link to item Cite

Impact of early renal recovery on survival after cardiac surgery-associated acute kidney injury.

Journal Article Ann Thorac Surg · April 2010 BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major postoperative complication. Although some early recovery is common, its effect on long-term outcomes is unclear. We tested the hypothesis that early renal recovery after CSA-AK ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · March 2010 Full text Link to item Cite

Pulse pressure and long-term survival after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 1, 2010 BACKGROUND: Data from longitudinal studies reveal that widened pulse pressure (PP) is a major predictor of coronary heart disease and mortality, but it is unknown whether PP similarly decreases survival after coronary artery bypass graft (CABG) surgery for ... Full text Link to item Cite

Cardiac surgery and acute kidney injury: emerging concepts.

Journal Article Curr Opin Crit Care · December 2009 PURPOSE OF REVIEW: To review recent advances in understanding of the occurrence, pathophysiology, prophylaxis and treatment of cardiac surgery-associated acute kidney injury (AKI). RECENT FINDINGS: New definitions and prompt diagnostic tools, enhanced risk ... Full text Link to item Cite

CT metrics of airway disease and emphysema in severe COPD.

Other Chest · August 2009 BACKGROUND: CT scan measures of emphysema and airway disease have been correlated with lung function in cohorts of subjects with a range of COPD severity. The contribution of CT scan-assessed airway disease to objective measures of lung function and respir ... Full text Link to item Cite

A prospective, double-blind, randomized clinical feasibility trial of controlling the storage age of red blood cells for transfusion in cardiac surgical patients.

Journal Article Transfusion · July 2009 BACKGROUND: Recent evidence demonstrates an association between duration of storage of red blood cells (RBC) and morbidity and mortality after cardiac surgery. We studied the feasibility of two different schemes for categorizing and randomizing age of RBC ... Full text Link to item Cite

Increasing healthcare resource utilization after coronary artery bypass graft surgery in the United States.

Journal Article Circ Cardiovasc Qual Outcomes · July 2009 BACKGROUND: Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been descri ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · July 2009 Full text Link to item Cite

Request for retraction.

Journal Article Anesth Analg · June 2009 Full text Link to item Cite

Mortality trends associated with acute renal failure requiring dialysis after CABG surgery in the United States.

Journal Article Blood Purif · 2009 BACKGROUND/AIMS: Acute renal failure is associated with a high risk of mortality when it complicates coronary artery bypass graft (CABG) surgery. We examined a large nationwide database from 1988 to 2003 and hypothesized that mortality in CABG-associated a ... Full text Link to item Cite

Trends in cardiac surgery-associated acute renal failure in the United States: a disproportionate increase after heart transplantation.

Journal Article Ren Fail · 2009 Acute renal failure (ARF) is common after cardiac surgery and more frequent after complex cardiac surgery. While the incidence of ARF is increasing after coronary artery bypass graft (CABG) surgery, trends in other forms of cardiac surgery remain unclear. ... Full text Link to item Cite

Institutional response to FDA warning on aprotinin and impact on outcomes.

Journal Article HSR Proc Intensive Care Cardiovasc Anesth · 2009 INTRODUCTION: New evidence of potential risks of aprotinin in 2006 generated public concern about a previously approved drug that was routinely used. In response, we assembled a team of experts within the institution to form guidelines for the appropriate ... Link to item Cite

Emerging concepts in acute kidney injury following cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · December 2008 Acute kidney injury (AKI) remains a significant cause of morbidity and mortality following cardiac surgery. Through a more thorough understanding of perioperative genomics and the evolving role of early biomarkers of AKI, the authors seek to improve meanin ... Full text Link to item Cite

Relationship of genetic variability and depressive symptoms to adverse events after coronary artery bypass graft surgery.

Journal Article Psychosom Med · November 2008 OBJECTIVE: To assess genetic variability in two serotonin-related gene polymorphisms (MAOA-uVNTR and 5HTTLPR) and their relationships to depression and adverse cardiac events in a sample of patients undergoing coronary artery bypass surgery. METHODS: A tot ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · October 2008 Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · July 2008 Full text Link to item Cite

Acute kidney injury and chronic kidney disease after cardiac surgery.

Journal Article Adv Chronic Kidney Dis · July 2008 Featured Publication Kidney dysfunction is common after cardiac surgery and predicts mortality risk and poorer long-term outcome, particularly when acute injury superimposes upon chronic kidney disease. Numerous insults contribute to perioperative renal impairment including ma ... Full text Link to item Cite

The effect of aprotinin on outcome after coronary-artery bypass grafting.

Journal Article N Engl J Med · February 21, 2008 Featured Publication BACKGROUND: Aprotinin has recently been associated with adverse outcomes in patients undergoing cardiac surgery. We reviewed our experience with this agent in patients undergoing cardiac surgery at Duke University Medical Center. METHODS: We retrieved data ... Full text Link to item Cite

Foreword

Chapter · January 1, 2008 Full text Cite

Cardiac Surgery and the Kidney

Chapter · January 1, 2008 Full text Cite

Cardiac surgery-associated acute kidney injury: putting together the pieces of the puzzle.

Journal Article Nephron Physiol · 2008 BACKGROUND: Acute kidney injury (AKI) is a common problem in the context of cardiac surgery. There are both similarities and differences with AKI occurring in other clinical scenarios. In this paper, we discuss those aspects of AKI that are particular to c ... Full text Link to item Cite

The role of biomarkers in cardiac surgery-associated acute kidney injury

Journal Article · December 1, 2007 Cardiac surgery associated-acute kidney injury (AKI) is common, affecting up to 40 % of heart surgery patients (depending on the definition used) [1]. Five to ten percent of these patients will require new renal replacement therapy, and this carries a high ... Full text Cite

ABO blood group and bleeding after coronary artery bypass graft surgery.

Journal Article Blood Coagul Fibrinolysis · December 2007 Low circulating von Willebrand factor levels increase the risk of bleeding after cardiac surgery. Patients with blood group O may be at greatest risk owing to lower baseline levels of von Willebrand factor compared with patients with other blood groups, an ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal Article Anesthesiology · October 2007 BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Trends in acute renal failure associated with coronary artery bypass graft surgery in the United States.

Journal Article Crit Care Med · October 2007 Featured Publication OBJECTIVE: Acute renal failure remains a major complication of coronary artery bypass graft surgery that is strongly associated with in-hospital mortality. Based on similar observations in other clinical settings, we tested the hypothesis that the diagnosi ... Full text Link to item Cite

Alpha-adrenergic mRNA subtype expression in the human nasal turbinate.

Journal Article Can J Anaesth · July 2007 PURPOSE: Alpha-adrenergic receptor (AR) agonist drugs (e.g., epinephrine) are commonly used for upper airway procedures, to shrink the mucosa, retard absorption of local anesthetic agents, and improve visualization by limiting hemorrhage. Decongestant ther ... Full text Link to item Cite

Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery.

Journal Article J Am Coll Cardiol · May 15, 2007 OBJECTIVES: We hypothesized that candidate gene polymorphisms in biologic pathways regulating inflammation, cell matrix adhesion/interaction, coagulation-thrombosis, lipid metabolism, and vascular reactivity are associated with postoperative cognitive defi ... Full text Link to item Cite

Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline.

Journal Article Ann Thorac Surg · May 2007 BACKGROUND: A minority of patients having cardiac procedures (15% to 20%) consume more than 80% of the blood products transfused at operation. Blood must be viewed as a scarce resource that carries risks and benefits. A careful review of available evidence ... Full text Link to item Cite

Heart and kidneys: sharing more than just blood.

Journal Article Curr Opin Anaesthesiol · February 2007 PURPOSE OF REVIEW: To describe the relationship of renal disease and metabolic syndrome with cardiovascular disease and explore the role of toxic solutes retained due to renal impairment as mediators of cardiovascular risk. RECENT FINDINGS: Metabolic syndr ... Full text Link to item Cite

Reply.

Journal Article Can J Anaesth · January 2007 Full text Link to item Cite

The genetic determinants of renal impairment following cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · December 2006 Cardiac surgery is frequently performed, and acute renal dysfunction is a common adverse event following this procedure. Cardiac surgery-related renal injury independently predicts longer hospital stays and greater rates of morbidity and mortality. Althoug ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · October 2006 Full text Link to item Cite

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

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

Time of day effects on the incidence of anesthetic adverse events.

Journal Article Qual Saf Health Care · August 2006 BACKGROUND: We hypothesized that time of day of surgery would influence the incidence of anesthetic adverse events (AEs). METHODS: Clinical observations reported in a quality improvement database were categorized into different AEs that reflected (1) error ... Full text Link to item Cite

Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery.

Journal Article Circulation · July 4, 2006 BACKGROUND: The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary mechanism in the pathogenesis of postoperative myocardial infarction (PMI), a multifactorial disorder with significant inter-patient variabili ... Full text Link to item Cite

The association between duration of storage of transfused red blood cells and morbidity and mortality after reoperative cardiac surgery.

Journal Article Anesth Analg · July 2006 Red blood cells (RBCs) undergo numerous changes during storage; however, the clinical relevance of these storage "lesions" is unclear. We hypothesized that the duration of storage of transfused RBCs is associated with mortality after repeat sternotomy for ... Full text Link to item Cite

Efficacy of single-dose, multilevel paravertebral nerve blockade for analgesia after thoracoscopic procedures.

Journal Article Anesthesiology · May 2006 BACKGROUND: Although video-assisted thoracoscopic surgery for pulmonary resection is increasingly chosen over thoracotomy, the optimal analgesia regimen for thoracoscopy is unknown. The purpose of this trial was to compare the efficacy of analgesia from pr ... Full text Link to item Cite

Symmetry aortic connector devices and acute renal injury: a comparison of renal dysfunction after three different aortocoronary bypass surgery techniques.

Journal Article Anesth Analg · January 2006 Although the pathogenesis of acute renal injury after cardiac surgery is multifactorial, atherosclerosis of the ascending aorta and embolic burden are strong independent predictors. Use of the Symmetry aortic connector device (ACD) for proximal anastomosis ... Full text Link to item Cite

Invited commentary.

Journal Article Ann Thorac Surg · December 2005 Full text Link to item Cite

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

Journal Article Contemp Clin Trials · December 2005 Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection ... Full text Link to item Cite

Protamine contributes to myocardial ischemia.

Journal Article Anesthesiology · September 2005 Full text Link to item Cite

Efficacy and safety of heparinase I versus protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.

Journal Article Anesthesiology · August 2005 Featured Publication BACKGROUND: Hemodynamic protamine reactions with heparin reversal during cardiac surgery are common and associated with adverse outcomes. As an alternative to protamine, the authors examined heparinase I reversal of heparin after aortocoronary bypass graft ... Full text Link to item Cite

Markers and predictors of renal outcome after cardiac surgery

Journal Article Journal of Medical Sciences · August 1, 2005 Acute renal dysfunction remains a serious complication of cardiac surgery, even when dialysis is not required, that is strongly associated with short and long term mortality and increased resource utilization. Although difficult to study in the critically ... Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal Article J Thromb Haemost · June 2005 Featured Publication BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2005 OBJECTIVE: The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory respo ... Full text Link to item Cite

Changing systems for measuring activated clotting times: impact on the clinical practice of heparin anticoagulation during cardiac surgery.

Journal Article Clin Chim Acta · June 2005 BACKGROUND: The activated clotting time (ACT) is a standard monitor for heparin anticoagulation during cardiopulmonary bypass (CPB). This study determines the effect of upgrading our ACT system on our clinical practice with regards to the conduct and safet ... Full text Link to item Cite

Evidence-based renal protection in cardiac surgery.

Journal Article Semin Cardiothorac Vasc Anesth · March 2005 Acute renal dysfunction is a common serious complication of cardiac surgery. Although a diversity of mechanisms exist by which the kidney can be damaged during cardiac surgery, atheroembolism, ischemia-reperfusion, and inflammation are believed to be prima ... Full text Link to item Cite

Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.

Journal Article Am J Kidney Dis · March 2005 Featured Publication BACKGROUND: Post-cardiac surgery renal dysfunction is a common, serious, multifactorial disorder, with interpatient variability predicted poorly by preoperative clinical, procedural, and biological markers. Therefore, we tested the hypothesis that selected ... Full text Link to item Cite

Hemodynamic changes after protamine administration: association with mortality after coronary artery bypass surgery.

Journal Article Anesthesiology · February 2005 Featured Publication BACKGROUND: Protamine sulfate is standard therapy to reverse heparin anticoagulation. Hemodynamic responses to protamine are common, ranging from minor perturbations to cardiovascular collapse. Although severe fatal reactions occur, the relation of less ex ... Full text Link to item Cite

Renal medullary hypoxia during experimental cardiopulmonary bypass: a pilot study.

Journal Article Perfusion · January 2005 OBJECTIVES: To determine the effect of cardiopulmonary bypass (CPB) on renal medullary oxygenation. DESIGN: Observational. SETTING: Laboratory. PARTICIPANTS: Pigs (n=3). INTERVENTIONS: Following induction of general anesthesia, a Paratrend blood gas probe ... Full text Link to item Cite

Neuron specific alpha-adrenergic receptor expression in human cerebellum: implications for emerging cerebellar roles in neurologic disease.

Journal Article Neuroscience · 2005 Recent data suggest novel functional roles for cerebellar involvement in a number of neurologic diseases. Function of cerebellar neurons is known to be modulated by norepinephrine and adrenergic receptors. The distribution of adrenergic receptor subtypes h ... Full text Link to item Cite

Renal artery stenosis is not associated with the development of acute renal failure following coronary artery bypass grafting.

Journal Article Ren Fail · 2005 BACKGROUND: Acute renal failure (ARF) is a frequent complication of coronary artery bypass grafting (CABG) surgery and is strongly associated with perioperative morbidity and mortality. We hypothesized that renal artery stenosis (RAS), causing occult renal ... Link to item Cite

Effects of time of day and surgery duration on adverse events in anaesthesia

Journal Article Healthcare Systems Ergonomics and Patient Safety: Human Factor, a Bridge Between Care and Cure - Proceedings of the International Conference HEPS 2005 · 2005 While the effects of fatigue on clinical performance are measurable, these decrements in performance have not been clearly linked to adverse clinical outcomes for patients. This research evaluated existing peri-operative data from 90, 159 surgical procedur ... Cite

Transcranial Doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery.

Journal Article J Cardiothorac Vasc Anesth · October 2004 OBJECTIVE: To examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine. DESIGN ... Full text Link to item Cite

Preliminary report on the interaction of apolipoprotein E polymorphism with aortic atherosclerosis and acute nephropathy after CABG.

Journal Article Ann Thorac Surg · August 2004 BACKGROUND: Renal dysfunction is a serious complication of cardiac surgery that is highly associated with short- and long-term adverse outcome. While the apolipoprotein E (APOE) epsilon4 allele has been linked to the occurrence of both postcardiac surgery ... Full text Link to item Cite

Preliminary report on the use of high-fidelity simulation in the training of study coordinators conducting a clinical research protocol.

Journal Article Anesth Analg · August 2004 Training of health care research personnel is a critical component of quality assurance in clinical trials. Interactivity (such as simulation) is desirable compared with traditional methods of teaching. We hypothesized that the addition of an interactive s ... Full text Link to item Cite

Safety and efficacy of median sternotomy versus video-assisted thoracic surgery for lung volume reduction surgery.

Journal Article J Thorac Cardiovasc Surg · May 2004 BACKGROUND: The National Emphysema Treatment Trial, a randomized trial comparing lung volume reduction surgery with medical therapy for severe emphysema, included randomized and nonrandomized comparisons of the median sternotomy and video-assisted thoracos ... Full text Link to item Cite

Lung isolation during port-access cardiac surgery: double-lumen endotracheal tube versus single-lumen endotracheal tube with a bronchial blocker.

Journal Article J Cardiothorac Vasc Anesth · December 2003 OBJECTIVE: The purpose of this study was to compare the use of a double-lumen endotracheal tube to a single-lumen tube combined with a bronchial blocker for lung isolation during Port-Access cardiac surgery. DESIGN: Prospective, randomized, controlled tria ... Full text Link to item Cite

Cerebral embolization during cardiac surgery: impact of aortic atheroma burden.

Other Br J Anaesth · November 2003 BACKGROUND: Aortic atheromatous disease is known to be associated with an increased risk of perioperative stroke in the setting of cardiac surgery. In this study, we sought to determine the relationship between cerebral microemboli and aortic atheroma burd ... Full text Link to item Cite

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery.

Journal Article Ann Thorac Surg · September 2003 BACKGROUND: Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary ... Full text Link to item Cite

Chronic kidney disease, mortality, and treatment strategies among patients with clinically significant coronary artery disease.

Journal Article J Am Soc Nephrol · September 2003 Cardiovascular disease is an important cause of mortality among patients with chronic kidney disease (CKD). This study describes associations between CKD, cardiac revascularization strategies, and mortality among patients with CKD and cardiovascular diseas ... Full text Link to item Cite

Serotonin-related gene polymorphisms and central nervous system serotonin function.

Journal Article Neuropsychopharmacology · March 2003 Central nervous system (CNS) serotonergic function affects a wide range of biological and behavioral functions affecting health and disease. Our objective in this study was to determine whether functional polymorphisms of the genes that encode for the sero ... Full text Link to item Cite

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Journal Article Anesth Analg · March 2003 UNLABELLED: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of a ... Full text Link to item Cite

Mitral valve surgery and acute renal injury: port access versus median sternotomy.

Journal Article Ann Thorac Surg · March 2003 BACKGROUND: Many outcomes and complications of minimally invasive and conventional cardiac surgery await comparison. Patients undergoing mitral valve surgery commonly sustain renal injury. Using peak postoperative fractional change of serum creatinine as a ... Full text Link to item Cite

Right ventricular rupture during off-pump coronary bypass surgery.

Journal Article Journal of cardiothoracic and vascular anesthesia · February 2003 Cite

Renal dysfunction after vascular surgery.

Journal Article Curr Opin Anaesthesiol · February 2003 PURPOSE OF REVIEW: The purpose of this review is to focus on the static incidence of renal dysfunction, the lack of evidence of benefit of traditional renoprotective strategies, and newer techniques that may provide an insight into the mechanisms of acute ... Full text Link to item Cite

Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.

Journal Article Stroke · February 2003 BACKGROUND AND PURPOSE: Although coronary artery bypass graft surgery (CABG) improves the quality of life and functional capacity for numerous patients, many also exhibit impairment in cognitive function immediately after surgery. Although the etiology of ... Full text Link to item Cite

Risk of anaphylaxis from aprotinin re-exposure during LVAD removal and heart transplantation.

Journal Article J Heart Lung Transplant · October 2002 Aprotinin has been shown to reduce transfusion requirements in re-operative cardiac surgery and in implantation of long-term left ventricular assist devices (LVAD). However, it is an antigenic polypeptide and re-exposure is associated with a small incidenc ... Full text Link to item Cite

Activated clotting time systems vary in precision and bias and are not interchangeable when following heparin management protocols during cardiopulmonary bypass.

Journal Article J Clin Monit Comput · July 2002 OBJECTIVE: Our aim was to test the hypothesis that new activated clotting time (ACT) technology, with modifications to instruments and reagents designed to detect earlier clot formation, would be associated with more precise but lower results. A secondary ... Full text Link to item Cite

Serum creatinine patterns in coronary bypass surgery patients with and without postoperative cognitive dysfunction.

Other Anesth Analg · July 2002 UNLABELLED: Renal dysfunction is common after coronary artery bypass graft (CABG) surgery. We have previously shown that CABG procedures complicated by stroke have a threefold greater peak serum creatinine level relative to uncomplicated surgery. However, ... Full text Link to item Cite

An unexpected intraoperative finding.

Journal Article J Cardiothorac Vasc Anesth · June 2002 Full text Link to item Cite

Association of leukocyte-depleted blood transfusions with infectious complications after cardiac surgery.

Journal Article Surg Infect (Larchmt) · 2002 BACKGROUND: To test the hypothesis that leukocyte-mediated immunosuppression may contribute to postoperative infections after blood transfusions, we compared the incidence of postoperative infections in patients undergoing elective coronary artery bypass g ... Full text Link to item Cite

The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery.

Other Anesth Analg · January 2002 UNLABELLED: Neurocognitive dysfunction is a common complication after cardiac surgery. We evaluated in this prospective study the effect of rewarming rate on neurocognitive outcome after hypothermic cardiopulmonary bypass (CPB). After IRB approval and info ... Full text Link to item Cite

Report of a substudy on warm versus cold cardiopulmonary bypass: changes in creatinine clearance.

Journal Article Ann Thorac Surg · November 2001 BACKGROUND: Renal dysfunction remains a major complication of cardiac operations. There is concern regarding the possibility of increased renal injury during warm cardiopulmonary bypass (CPB). Therefore, we tested the hypothesis that warm CPB is associated ... Full text Link to item Cite

Apolipoprotein E polymorphisms and age at first coronary artery bypass graft.

Journal Article Anesthesia and analgesia · April 2001 Apolipoprotein E (apoE) polymorphisms are heritable determinants of total and low-density lipoprotein cholesterol. The impact of apoE4 genotypes on the severity of atherosclerosis has been debated; however, recent studies have identified a correlation betw ... Cite

Central nervous system serotonin function and cardiovascular responses to stress.

Journal Article Psychosom Med · 2001 OBJECTIVE: The objective of this study was to evaluate the impact of indices of central nervous system (CNS) serotonin function on cardiovascular reactivity to mental stress. METHODS: Lumbar puncture was performed on 54 healthy volunteers to obtain cerebro ... Full text Link to item Cite

Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction.

Journal Article Anesth Analg · November 2000 UNLABELLED: Renal dysfunction is a serious complication after coronary bypass surgery with cardiopulmonary bypass (CABG). Because duration of cardiopulmonary bypass (CPB) is associated with renal outcome, it has been proposed that avoidance of CPB with off ... Full text Link to item Cite

The association of epsilon-aminocaproic acid with postoperative decrease in creatinine clearance in 1502 coronary bypass patients.

Journal Article Anesth Analg · November 2000 UNLABELLED: Renal dysfunction is a common serious complication after cardiac surgery. Reports of proteinuria and hyperkalemia after cardiac surgery with epsilon-aminocaproic acid (EACA) have therefore raised concerns for renal safety. Since EACA renders th ... Full text Link to item Cite

Preliminary report on the association of apolipoprotein E polymorphisms, with postoperative peak serum creatinine concentrations in cardiac surgical patients.

Journal Article Anesthesiology · August 2000 BACKGROUND: Renal dysfunction after cardiac surgery occurs in up to 8% of patients and is associated with major increases in morbidity, mortality, and cost. Genetic polymorphisms have been implicated as a factor in the progression of chronic renal disease, ... Full text Link to item Cite

Alpha2-adrenergic receptors in human dorsal root ganglia: predominance of alpha2b and alpha2c subtype mRNAs.

Journal Article Anesthesiology · April 2000 BACKGROUND: Nonselective alpha2-adrenergic receptor (alpha2AR) agonists (e.g., clonidine) mediate antinociception in part through alpha2ARs in spinal cord dorsal horn; however, use of these agents for analgesia in humans is limited by unwanted sedation and ... Full text Link to item Cite

α2-Adrenergic receptors in human dorsal root ganglia: Predominance of α(2b) and α(2c) subtype mRNAs

Journal Article Anesthesiology · 2000 Background: Nonselective α2-adrenergic receptor (α2AR) agonists (e.g., clonidine) mediate antinociception in part through α2ARs in spinal cord dorsal horn; however, use of these agents for analgesia in humans is limited by unwanted sedation and hypotension ... Cite

Direct aortic cannulation for port-access mitral or coronary artery bypass grafting.

Journal Article Ann Thorac Surg · November 1999 A technique is described for direct aortic arterial cannulation during Port-Access mitral valve or coronary artery bypass grafting. Femoral arterial cannulation is avoided, and endoaortic balloon occlusion is used for cardioplegic arrest. To date, excellen ... Full text Link to item Cite

Comparison of direct aortic and femoral cannulation for port-access cardiac operations.

Journal Article Ann Thorac Surg · October 1999 BACKGROUND: Differences in outcome after direct aortic cannulation (AORT) in the chest versus standard femoral arterial cannulation (FEM) have not been defined for minimally invasive cardiac operations utilizing the port-access approach. METHODS: A retrosp ... Full text Link to item Cite

Acute renal failure following cardiac surgery.

Journal Article Nephrol Dial Transplant · May 1999 BACKGROUND: Acute renal failure requiring dialysis (ARF-D) occurs in 1.5% of patients following cardiac surgery, and remains a cause of major morbidity and mortality. While some preoperative risk factors have been characterized, the influence of preoperati ... Full text Link to item Cite

Alpha1-adrenergic receptors in human spinal cord: specific localized expression of mRNA encoding alpha1-adrenergic receptor subtypes at four distinct levels.

Journal Article Brain Res Mol Brain Res · January 8, 1999 alpha1-Adrenergic receptors (alpha1ARs) are important in lower urinary tract syndromes such as benign prostatic hypertrophy and bladder irritability. Spinal cord alpha1ARs have been postulated to play a role in modulating these diseases, yet alpha1AR subty ... Full text Link to item Cite

Anesthesia and analgesia for minimally invasive direct coronary bypass and other 'beating heart' surgical procedures

Journal Article Seminars in Cardiothoracic and Vascular Anesthesia · January 1, 1999 Minimally invasive direct coronary artery bypass and transmyocardial laser revascularization are examples of 'beating heart' surgery which embrace new medical concepts, and the philosophy that less invasive cardiac procedures (eg, smaller incisions, avoida ... Full text Cite

Mitral valve operation via Port Access versus median sternotomy.

Journal Article Eur J Cardiothorac Surg · October 1998 OBJECTIVE: The advantages and disadvantages of minimally invasive Port Access mitral valve operation have not been defined relative to standard median sternotomy. A study was therefore designed to delineate differences in outcome from mitral operation via ... Full text Link to item Cite

Acute depression of myocardial beta-adrenergic receptor signaling during cardiopulmonary bypass: impairment of the adenylyl cyclase moiety. Duke Heart Center Perioperative Desensitization Group.

Journal Article Anesthesiology · September 1998 BACKGROUND: Previously the authors showed that myocardial beta-adrenergic (betaAR) function is reduced after cardiopulmonary bypass (CPB) in a canine model Whether CPB results in similar effects on betaAR function in adult humans is not known. Therefore th ... Full text Link to item Cite

Light versus heavy sedation after cardiac surgery: myocardial ischemia and the stress response. Maritime Heart Centre and Dalhousie University.

Journal Article Anesth Analg · November 1997 UNLABELLED: The influence of light versus heavy sedation after coronary artery bypass graft (CABG) surgery on the development of postoperative myocardial ischemia has not been described. After uncomplicated CABG surgery, 50 patients were randomly assigned ... Full text Link to item Cite

In situ hybridization: identification of rare mRNAs in human tissues.

Journal Article Brain Res Brain Res Protoc · May 1997 In situ hybridization is used for detection of RNA expression when conservation of tissue architecture is important. Most in situ hybridization protocols are written for tissues from animals (i.e., rat) which can be harvested and preserved rapidly. In cont ... Full text Link to item Cite

An introduction to transoesophageal echocardiography: II. Clinical applications.

Journal Article Can J Anaesth · March 1996 PURPOSE: As progress has been made in the acquisition of cardiac images with transoesophageal echocardiography, the technique has moved from the confines of the cardiology laboratory into the operating room, the intensive care unit, and the emergency depar ... Full text Link to item Cite

Perioperative management of drug therapy, clinical considerations.

Journal Article Drugs · February 1996 The objectives for the provision of a safe anaesthetic include rendering the patient analgesic for the procedure (amnesic if appropriate), with control of adverse haemodynamic perturbations, and muscle relaxation to facilitate surgery as necessary. This mu ... Full text Link to item Cite

alpha 2-Adrenergic receptors in human spinal cord: specific localized expression of mRNA encoding alpha 2-adrenergic receptor subtypes at four distinct levels.

Journal Article Brain Res Mol Brain Res · December 1, 1995 alpha 2-Adrenergic receptor (AR) subtype mRNA (alpha 2a, alpha 2b, alpha 2c) neuronal localization in human spinal cord has not been described. We therefore performed in situ hybridization to identify cell bodies at four levels of human spinal cord (cervic ... Full text Link to item Cite

α2-Adrenergic receptors in human spinal cord: specific localized expression of mRNA encoding α2-adrenergic receptor subtypes at four distinct levels

Journal Article Molecular Brain Research · 1995 α2-Adrenergic receptor (AR) subtype mRNA (α2a, α2b, α2c) neuronal localization in human spinal cord has not been described. We therefore performed in situ hybridization to identify cell bodies at four levels of human spinal cord (cervical, thoracic, lumbar ... Cite

Bladder reconstruction

Journal Article Current Opinion in Urology · January 1, 1993 Full text Cite

Erratum

Journal Article Canadian Journal of Anesthesia · September 1, 1992 Full text Cite

'Drug allergies' in the surgical population

Journal Article Canadian Journal of Anaesthesia · January 1, 1992 Cite