A5039135844- Cardiac, Anesthesia and Surgical Outcomes
- Hemodynamic Monitoring and Therapy
- Anesthesia and Sedative Agents
- Airway Management and Intubation Techniques
- Respiratory Support and Mechanisms
- Non-Invasive Vital Sign Monitoring
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Anesthesia and Pain Management
- Anesthesia and Neurotoxicity Research
- Blood Pressure and Hypertension Studies
- Lung Cancer Diagnosis and Treatment
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Pain Management and Opioid Use
- Electronic Health Records Systems
- Ultrasound in Clinical Applications
- Enhanced Recovery After Surgery
- Mechanical Circulatory Support Devices
- Climate Change and Health Impacts
- COVID-19 and healthcare impacts
- Traumatic Brain Injury and Neurovascular Disturbances
- Opioid Use Disorder Treatment
- Musculoskeletal pain and rehabilitation
- Healthcare Technology and Patient Monitoring
- Heart Rate Variability and Autonomic Control
University of Michigan
2016-2025
Michigan Medicine
2019-2024
Statistical Research (United States)
2024
Environmental Research Institute of Michigan
2024
University Hospitals Birmingham NHS Foundation Trust
2024
Society of Cardiovascular Anesthesiologists
2023
University of Iowa
2022
University of Virginia Health System
2011-2021
Committee on Publication Ethics
2016-2020
American Society of Anesthesiologists
2016-2020
Five percent of adult patients undergoing noncardiac inpatient surgery experience a major pulmonary complication. The authors hypothesized that the choice neuromuscular blockade reversal (neostigmine vs. sugammadex) may be associated with lower incidence complications.
Abstract Background Despite the significant healthcare impact of acute kidney injury, little is known regarding prevention. Single-center data have implicated hypotension in developing postoperative injury. The generalizability this finding and interaction between baseline patient disease burden remain unknown. authors sought to determine whether association intraoperative injury varies by preoperative risk. Methods Major noncardiac surgical procedures performed on adult patients across...
The use of lung-protective ventilation (LPV) strategies may minimize iatrogenic lung injury in surgical patients. However, the identification an ideal LPV strategy, particularly during one-lung (OLV), remains elusive. This study examines role ventilator management OLV and its impact on clinical outcomes.Data were retrospectively collected from hospital electronic medical record Society Thoracic Surgery database for subjects undergoing thoracic surgery with between 2012 2014. Mean tidal...
Compared with historic ventilation strategies, modern lung-protective includes lower tidal volumes (VT), driving pressures, and application of positive end-expiratory pressure (PEEP). The contributions each component to an overall intraoperative protective strategy aimed at reducing postoperative pulmonary complications have neither been adequately resolved, nor comprehensively evaluated within adult cardiac surgical population. authors hypothesized that a bundled was independently...
Multiple attempts at tracheal intubation are associated with mortality, and successful rescue requires a structured plan. However, there remains paucity of data to guide the choice technique after failed initial direct laryngoscopy. The authors studied large perioperative database determine success rates for commonly used techniques.Using retrospective, observational, comparative design, analyzed records from seven academic centers within Multicenter Perioperative Outcomes Group between 2004...
Background Protective ventilation may improve outcomes after major surgery. However, in the context of one-lung ventilation, such a strategy is incompletely defined. The authors hypothesized that putative protective regimen would be independently associated with decreased odds pulmonary complications thoracic Methods merged Society Thoracic Surgeons Database and Multicenter Perioperative Outcomes Group intraoperative data for lung resection procedures using across five institutions from 2012...
The use of an intraoperative lung-protective ventilation strategy through tidal volume (TV) size reduction and positive end-expiratory pressure (PEEP) has been increasingly investigated. In this article, we describe the current practice patterns trends.By using Multicenter Perioperative Outcomes Group database, identified all general endotracheal anesthetics from January 2008 December 2013 at 10 institutions. following data were calculated: (1) percentage patients receiving TV > mL/kg...
Background: Current practice guidelines do not address the use of neuromuscular blocking and antagonism agents in patients with renal impairment. The FDA label for sugammadex advises against severe impairment (eGFR < 30 ml/min). Using a multicenter electronic health record registry, we sought to understand modern blockade significant 60 Methods: Data was obtained from Multicenter Perioperative Outcomes Group (MPOG) adult (>18yrs) an estimated glomerular filtration rate (eGFR) 60ml/min,...
Inhaled anaesthetics are greenhouse gases. However, changes in the delivery of inhaled can mitigate environmental impact. We hypothesised that system-wide to anaesthesia care would reduce harm without compromising patient outcomes. launched Green Anesthesia Initiative (GAIA) March, 2022, with aims reducing use nitrous oxide, using less environmentally harmful fluorinated ethers, and increasing intravenous anaesthetic use. In this retrospective cohort study, we used electronic health record...
Health services research frequently focuses on variation in the structure, process, and outcomes of clinical care. Robust approaches for detection attribution are foundational to both quality improvement research. Describing care structured healthcare systems across hospitals which clinicians work provide patients as a multileveled structure allows impact organization practice outcome be ascertained. Mixed-effect statistical models can describe partitioning among levels these structures by...
The optimal methadone dosing regimen for children undergoing spinal surgery is uncertain because of sparse pediatric pharmacokinetic data and a paucity analgesic effect data. minimum effective concentration in opioid naïve adults 58 mcg · L(-1).Adolescents aged 12-19 years idiopathic scoliosis correction were administered 0.25 mg kg(-1) racemic IV prior to surgical incision. Arterial blood samples assay obtained at 0 min, 5 10 15 20 40 1 h, 2 4 6 8 12 24 48 h. Compartment analysis was...
Background Conflicting evidence exists regarding the risks and benefits of inotropic therapies during cardiac surgery, extent variation in clinical practice remains understudied. Therefore, authors sought to quantify patient-, anesthesiologist-, hospital-related contributions inotrope use. Methods In this observational study, nonemergent adult surgeries using cardiopulmonary bypass were reviewed across a multicenter cohort academic community hospitals from 2014 2019. Patients who moribund,...
Sugammadex was initially approved for reversal of neuromuscular blockade in adults the United States 2015. Limited data suggest sugammadex is widely used pediatric anesthesia practice however factors influencing use are not known. We explore patient, surgical, and institutional associated with decision to versus neostigmine or no reversal, 2 mg/kg vs 4 dosing.
The relationship between intraoperative physiology and postoperative stroke is incompletely understood. Preliminary data suggest that either hypo- or hypercapnia coupled with reduced cerebrovascular inflow (e.g., due to hypotension) can lead ischemia. This study tested the hypothesis combination of hypotension hypercarbia associated ischemic stroke.We conducted a retrospective, case-control via Multicenter Perioperative Outcomes Group. Noncardiac, nonintracranial, nonmajor vascular surgical...
Accurate anesthesiology procedure code data are essential to quality improvement, research, and reimbursement tasks within practices. Advanced science techniques, including machine learning natural language processing, offer opportunities develop classification tools for Current Procedural Terminology codes across anesthesia procedures.Models were created using a Train/Test dataset 1,164,343 procedures from 16 academic private hospitals. Five supervised models classify codes, with accuracy...
Surgical procedures performed on patients with recent exposure to COVID-19 infection have been associated increased mortality risk in previous studies. Accordingly, elective surgery is often delayed after infection. The study aimed compare 30-day hospital and postoperative complications (acute kidney injury, pulmonary complications) of surgical a matched cohort without known COVID-19. authors hypothesized that would be an risk.
Earlier definitions of acute renal failure are not sensitive in identifying milder forms kidney injury (AKI). The authors hypothesized that by applying the RIFLE criteria for (Risk dysfunction, Injury to kidney, Failure function, Loss and End-stage disease) thoracic lumbar spine surgery, there would be a higher incidence AKI. They also developed model predict postoperative glomerular filtration rate (GFR).A hospital data repository was used identify patients undergoing and/or surgery over...
BACKGROUND: Following the introduction of sugammadex to US clinical practice, scarce data are available understand its utilization patterns. This study aimed characterize patient, procedure, and provider factors associated with administration in patients. METHODS: retrospective observational was conducted across 24 Multicenter Perioperative Outcomes Group institutions United States on formulary at time study. All American Society Anesthesiologists (ASA) physical status I–IV adults undergoing...