Scholars@Duke
Warwick Aubrey Ames

Warwick Aubrey Ames

Professor of Anesthesiology
Anesthesiology, Pediatrics
warwick.ames@duke.edu
Box 3094 Med Ctr, Durham, NC 27710
2905 Children's Health Center, Durham, NC 27710
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Selected Publications

Analgesic Effects of a Novel Combination of Regional Anesthesia After Pediatric Cardiac Surgery: A Retrospective Cohort Study.

Journal Article J Cardiothorac Vasc Anesth · November 2022 OBJECTIVE: The objective of this study was to determine whether the use of regional anesthesia in children undergoing congenital heart surgery was associated with differences in outcomes when compared to surgeon-delivered local anesthetic wound infiltratio ... Full text Link to item Cite

An update on the management of PONV in a pediatric patient.

Journal Article Best Pract Res Clin Anaesthesiol · December 2020 Postoperative nausea and vomiting (PONV) is a major cause of patient dissatisfaction following anesthesia. The difficulty in diagnosing nausea in much of the pediatric population has led to an emphasis on anti-emetic prophylaxis for all. Assessment scores ... Full text Link to item Cite

Recycle: Do It for the Kids.

Journal Article J Cardiothorac Vasc Anesth · December 2020 Full text Link to item Cite

Big Syringe, Little Syringe.

Journal Article J Cardiothorac Vasc Anesth · September 2020 Full text Link to item Cite

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

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

Postanesthesia Care Unit Management

Chapter · January 1, 2020 In infants, perioperative anesthetic morbidity is higher than in other age groups, which underscores the importance of the dedicated pediatric postanesthesia care unit (PACU). The pediatric PACU environment requires careful planning and ongoing maintenance ... Full text Cite

A Study of Practice Behavior for Endotracheal Intubation Site for Children With Congenital Heart Disease Undergoing Surgery: Impact of Endotracheal Intubation Site on Perioperative Outcomes-An Analysis of the Society of Thoracic Surgeons Congenital Cardiac Anesthesia Society Database.

Journal Article Anesth Analg · October 2019 BACKGROUND: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to percei ... Full text Open Access Link to item Cite

Primum Non Nocere.

Journal Article J Cardiothorac Vasc Anesth · July 2019 Full text Link to item Cite

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

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

Essentials of Nephrology

Chapter · January 1, 2019 The basic functions of the kidney are to maintain fluid and electrolyte homeostasis and metabolism. Renal disease requires the practitioner to be vigilant about fluid homeostasis, acid-base balance, electrolyte management, choice of anesthetics, and potent ... Full text Cite

Essentials of Nephrology

Chapter · January 1, 2018 The basic functions of the kidney are to maintain fluid and electrolyte homeostasis and metabolism. Renal disease requires the practitioner to be vigilant about fluid homeostasis, acid-base balance, electrolyte management, choice of anesthetics, and potent ... Full text Cite

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

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

Upper Extremity Peripheral Intravenous Line Infiltration With Concomitant Loss of Pulses Treated With Lipoaspiration: A Case Report.

Journal Article A A Case Rep · November 1, 2016 Peripheral intravenous cannulation in children is associated with occasional morbidity. We present a case where a large volume of blood, administered through a small peripheral cannula in the antecubital fossa, was found to have extravasated into the soft ... Full text Link to item Cite

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

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

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

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

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

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

Analgesic Effects of a Novel Combination of Regional Anesthesia After Pediatric Cardiac Surgery: A Retrospective Cohort Study.

Journal Article J Cardiothorac Vasc Anesth · November 2022 OBJECTIVE: The objective of this study was to determine whether the use of regional anesthesia in children undergoing congenital heart surgery was associated with differences in outcomes when compared to surgeon-delivered local anesthetic wound infiltratio ... Full text Link to item Cite

An update on the management of PONV in a pediatric patient.

Journal Article Best Pract Res Clin Anaesthesiol · December 2020 Postoperative nausea and vomiting (PONV) is a major cause of patient dissatisfaction following anesthesia. The difficulty in diagnosing nausea in much of the pediatric population has led to an emphasis on anti-emetic prophylaxis for all. Assessment scores ... Full text Link to item Cite

Recycle: Do It for the Kids.

Journal Article J Cardiothorac Vasc Anesth · December 2020 Full text Link to item Cite

Big Syringe, Little Syringe.

Journal Article J Cardiothorac Vasc Anesth · September 2020 Full text Link to item Cite

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

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

Postanesthesia Care Unit Management

Chapter · January 1, 2020 In infants, perioperative anesthetic morbidity is higher than in other age groups, which underscores the importance of the dedicated pediatric postanesthesia care unit (PACU). The pediatric PACU environment requires careful planning and ongoing maintenance ... Full text Cite

A Study of Practice Behavior for Endotracheal Intubation Site for Children With Congenital Heart Disease Undergoing Surgery: Impact of Endotracheal Intubation Site on Perioperative Outcomes-An Analysis of the Society of Thoracic Surgeons Congenital Cardiac Anesthesia Society Database.

Journal Article Anesth Analg · October 2019 BACKGROUND: In adults undergoing cardiopulmonary bypass surgery, oral intubation is typically preferred over nasal intubation due to reduced risk of sinusitis and infection. In children, nasal intubation is more common and sometimes preferred due to percei ... Full text Open Access Link to item Cite

Primum Non Nocere.

Journal Article J Cardiothorac Vasc Anesth · July 2019 Full text Link to item Cite

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

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

Essentials of Nephrology

Chapter · January 1, 2019 The basic functions of the kidney are to maintain fluid and electrolyte homeostasis and metabolism. Renal disease requires the practitioner to be vigilant about fluid homeostasis, acid-base balance, electrolyte management, choice of anesthetics, and potent ... Full text Cite

Essentials of Nephrology

Chapter · January 1, 2018 The basic functions of the kidney are to maintain fluid and electrolyte homeostasis and metabolism. Renal disease requires the practitioner to be vigilant about fluid homeostasis, acid-base balance, electrolyte management, choice of anesthetics, and potent ... Full text Cite

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

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

Upper Extremity Peripheral Intravenous Line Infiltration With Concomitant Loss of Pulses Treated With Lipoaspiration: A Case Report.

Journal Article A A Case Rep · November 1, 2016 Peripheral intravenous cannulation in children is associated with occasional morbidity. We present a case where a large volume of blood, administered through a small peripheral cannula in the antecubital fossa, was found to have extravasated into the soft ... Full text Link to item Cite

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

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

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

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

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

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

Rapid ventricular pacing for a basilar artery pseudoaneurysm in a pediatric patient: case report.

Journal Article J Neurosurg Pediatr · June 2015 Large cerebral aneurysms of the basilar apex are difficult to treat. Recently, endovascular treatment has mitigated much of the morbidity associated with treating these lesions. However, the morphology of aneurysms of the vertebrobasilar system can preclud ... Full text Link to item Cite

The accuracy of a near-infrared spectroscopy cerebral oximetry device and its potential value for estimating jugular venous oxygen saturation.

Journal Article Anesth Analg · December 2014 BACKGROUND: An intriguing potential clinical use of cerebral oximeter measurements (SctO2) is the ability to noninvasively estimate jugular bulb venous oxygen saturation (SjvO2). Our purpose in this study was to determine the accuracy of the FORE-SIGHT(®) ... Full text Link to item Cite

Ventricular pacing for induced hypotension in a toddler.

Journal Article A A Case Rep · August 1, 2014 Cerebral aneurysm clipping may require periods of hypotension to facilitate dissection and clip application. We describe the use of rapid ventricular pacing to facilitate establishment of controlled hypotension for an 18-month-old child during clipping for ... Full text Link to item Cite

Anesthesia in the cardiac catheterization laboratory and MRI

Chapter · January 1, 2014 Modern pediatric cardiac catheterization laboratories (CCL) have become highly specialized units with an increasing focus on interventional procedures. Furthermore, the cardiac MRI examination is being increasingly used in the management of congenital hear ... Full text Cite

Evaluation of pediatric near-infrared cerebral oximeter for cardiac disease.

Journal Article Ann Thorac Surg · November 2012 BACKGROUND: Cerebral hypoxia-ischemia remains a complication in children with congenital heart disease. Near-infrared spectroscopy can be utilized at the bedside to detect cerebral hypoxia-ischemia. This study aimed to calibrate and validate an advanced te ... Full text Link to item Cite

Paediatric cardiomyopathy and anaesthesia.

Journal Article Br J Anaesth · January 2012 'Cardiomyopathy' (CM) is defined by the World Health Organization as 'a disease of the myocardium associated with cardiac dysfunction'. In a child, it is associated with a significant risk for anaesthesia. In addition, cardiac arrest under anaesthesia has ... Full text Link to item Cite

Postanesthesia care unit management

Journal Article · December 9, 2011 The pediatric postanesthesia care unit is an environment where a child is able to recover from their anesthesia safely and comfortably. However, there are many requirements that must be met for these goals to be achieved. The equipment and monitoring that ... Full text Cite

The novel use of computer-generated virtual imaging to assess the difficult pediatric airway.

Journal Article Anesth Analg · May 2007 Featured Publication In a patient with a known difficult airway, history and examination may be of limited use in formulating a management plan for subsequent tracheal intubation. Further detailed and descriptive review of the airway is necessary. Virtual imaging is a recent a ... Full text Link to item Cite

Paediatric renal transplantation: a single centre study.

Journal Article Eur J Anaesthesiol · January 2007 Full text Link to item Cite

Long-term use of the laryngeal mask airway in a neonate.

Journal Article Anesth Analg · September 2006 Featured Publication Full text Link to item Cite

Anesthetic management of children with Moebius sequence.

Journal Article Can J Anaesth · October 2005 BACKGROUND: Moebius sequence is a rare congenital absence of the sixth and seventh cranial nerves, although there may be additional congenital cranial neuropathies. Developmental delay, cardiac and musculoskeletal abnormalities may also co-exist. Oro-facia ... Full text Link to item Cite

Loss of resistance to normal saline is preferred to identify the epidural space: a survey of Canadian pediatric anesthesiologists.

Journal Article Can J Anaesth · 2005 PURPOSE: Several methods have been described to locate the epidural space, but the loss-of-resistance (LOR) technique is the most commonly used. Expert opinion states that LOR to air is the best medium for neonates and infants. We conducted a Canada-wide p ... Full text Link to item Cite

Facial nerve palsy: a complication following anaesthesia in a child with Treacher Collins syndrome.

Journal Article Paediatr Anaesth · July 2004 Featured Publication We report a case of facial nerve palsy following anaesthesia in a child with Treacher Collins syndrome. Children in whom intubation is difficult may be at increased risk of this complication. ... Full text Link to item Cite

Response to review by Herod et al.

Journal Article Paediatr Anaesth · May 2003 Full text Link to item Cite

Adult epiglottitis: an under-recognized, life-threatening condition.

Journal Article Br J Anaesth · November 2000 Epiglottitis in the adult can be fatal and should be treated with the same degree of concern and suspicion in respect of airway patency as in children. We present three cases of adult epiglottitis in which the airway was lost prior to or during the interve ... Full text Link to item Cite

How to skin a bearded cat.

Journal Article Anaesthesia · June 2000 Full text Link to item Cite

Local anaesthesia for laminectomy surgery.

Journal Article Br J Neurosurg · December 1999 Neurosurgical patients presenting for laminectomy surgery may have premorbid pathology that either contraindicates general anaesthesia or at least represents a significant risk to the patient. We present a sample case from a series of ten patients in whom ... Full text Link to item Cite

The effect of ionised magnesium on coagulation using thromboelastography.

Journal Article Anaesthesia · October 1999 Magnesium is an ionised mineral with therapeutic uses. There is laboratory evidence that it may have an anticoagulant activity although recent research has been to the contrary. The clinical implications of the effect of a therapeutic dose of magnesium on ... Full text Link to item Cite

Management of the major burn

Journal Article Update in Anaesthesia · January 1, 1999 Cite

Complication of the transtracheal catheter.

Journal Article Br J Anaesth · November 1998 Full text Link to item Cite

The bearded airway.

Journal Article Anaesthesia · October 1998 Full text Link to item Cite

Hepatotoxic effects of CCl4 on English sole (Parophrys vetulus): possible indicators of liver dysfunction.

Journal Article Comp Biochem Physiol C Comp Pharmacol Toxicol · 1986 Selected serum parameters (enzyme activities and triglycerides) and liver glutathione and vitamin C concentrations were measured in English sole (Parophrys vetulus) after i.p. injection of carbon tetrachloride (CCl4), a hepatotoxin in fish. Serum lactate d ... Full text Link to item Cite