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Anesthesiology Research

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Basic Science Research Expand answer

Dr. Victor Ruiz-Velasco’s laboratory focuses on the modulation of Ca2+ and K+ channels by G proteins and other nucleotides, which has been the focus of his research career. Recently, his laboratory has started to investigate the modulation of acid-sensing ion channel (ASIC) currents by opioid peptides, as well as examining the role of single nucleotide polymorphisms in voltage-gated channels, NaV1.8 and NaV1.9 and pain. Over the years, he has employed a wide variety of techniques that have allowed him to study this biophysical transduction system in excitable cells, including neurons and smooth muscle cells.

Dr. Nicholas Graziane’s laboratory looks to identify the molecular and cellular substrates that mediate a number of devastating brain diseases, including drug addiction and chronic pain. With established animal models for these diseases, Dr. Graziane uses electrophysiology and optogenetic approaches to examine changes in synaptic transmission and in intrinsic membrane excitability of neurons and circuits that are thought to control motivation, reward, and affective states.

Dr. Zheng-Ming Ding’s laboratory utilizes rat models to investigate neurobiological mechanisms underlying the development of drug abuse and addiction. A combination of behavioral, neurochemical, molecular biological techniques are employed to identify drug-induced neuro-adaptations that can drive the progression of addiction. Distinct neuro-circuits critical to the drug-taking and -seeking behaviors are also a focus of Dr. Ding’s research.

Dr. Patrick Randall’s laboratory focuses on the role of neuroimmune function in drug addiction. Much of his work has focused on pathogen detecting toll-like receptors and their role in the initiation and maintenance of alcohol use and dependence. Recently, he has broadened that focus to assess the role of neuroimmune function in combined nicotine-alcohol dependence, an area of addiction that he has also studied extensively. He utilizes a combination of rodent behavioral models, chemogenetics and comprehensive molecular analysis to better understand the underlying neurobiology of drug addiction.

Clinical and Translational Research Expand answer

Dr. Anthony Bonavia’s work focuses on the mechanisms of innate immune dysfunction caused by septic shock and associated acute kidney injury. Both of these diseases result in very high systemic levels of resistin, a pro-inflammatory cytokine impairing chemotaxis, reactive oxygen species production, and bacterial killing by neutrophils. By using cell-based and animal models, he investigates whether resistin is responsible for immunosuppression in these disease states. The translational implications of his research are to aid better understanding of whether cytokine adsorption therapy may have a role in mitigating the secondary infectious complications that develop in critically ill patients following sepsis and acute kidney injury.

Perioperative Data Science Expand answer

New opportunities to investigate and improve how perioperative care is actually delivered are afforded by electronic medical records registries which can integrate perioperative records across many academic institutions (e.g., the National Clinical Outcomes Registry [NACOR] or the Multicenter Clinical Outcomes Group [MPOG]), while still allowing examination of granular detail down to individual anesthesia provider behavior. Dr. Michael Andreae is researching patient and provider characteristics that predict subpar care leading to inferior outcomes.

Clinical Research Expand answer

The Pediatric Anesthesia Research component, led by Dr. Priti Dalal, involves multiple projects. One of the major projects is assessment of post-operative pain using skin conductance measurements. Several other research projects that are ongoing include efficacy of an infra-red vein visualization device, music therapy in children at anesthesia induction, and multiple quality research projects including handoff communications with children’s ICU, outcomes in cases of NICU bedside procedures under anesthesia, unplanned extubations and unplanned ICU admissions.

The Intensive Care team, led by Dr. Kunal Karamchandani, has been working on research targeted toward improving patient outcomes following surgery as well as critical illness. The team is especially interested in identifying factors that could improve the quality of care and improve patient safety in the perioperative arena. The team has published extensively on management of pain and sedation in critically ill patients affected by the opioid epidemic as well as inappropriate continuation of medications upon hospital discharge in ICU survivors. Current work is focusing on identifying the role of sugammadex in preventing postoperative pulmonary complications and identifying intraoperative factors associated with postoperative atrial fibrillation.

The Cardiac Anesthesia Division, led by Dr. Shayne “Mike” Roberts, has a number of interesting projects. One of the endeavors has been an echocardiographic study comparing different measures of RV function using TEE and TTE. The goal is to help determine what parameters should be used for intraoperative decision-making. Other interests include the use of three-dimensional echocardiography to predict certain conditions after valve surgery. The group is also focused on different methods of teaching residents and is currently collaborating with other institutions on a novel curriculum for perioperative ultrasound. One of the division’s other research interests involves vasoplegia, a condition that is characterized by low blood pressure in the setting of cardiac surgery.

The Division of Transplant Anesthesia performs multiple investigations related to patient outcomes after liver transplantation. The research group, led by Dr. Dmitri Bezinover, investigates hypercoagulability, specifically the incidence of portal vein thromboses in patients with end stage liver disease. Another important research topic of this team is the effect of hyponatremia on perioperative complications in patients undergoing liver transplantation.

The Clinical Simulation Center, led by Dr. Elizabeth Sinz, provides support for research related to education, system assessment, product development, quality/safety issues and human factors. Large grants can include support for use of Simulation Center resources and small grants are available to support research projects from the endowment. Investigators can contact Sim Center leadership to discuss options for research projects — they would be happy to help.

The Regional Anesthesia and Acute Pain Medicine (RAAPM) research component is involved with multiple clinical studies and quality improvement initiatives and is led by Dr. Hillenn Cruz Eng. A core focus for this team is orthopedic surgery, assessing both time-based cost analysis involving total joint arthroplasties as well as the efficacy of adductor canal catheters during physical rehabilitation post total knee replacement. Current initiatives also include Enhanced Recovery After Surgery protocols for breast surgery, traumatic rib fracture patients and the use of ketamine infusions for acute pain management. Other areas of interest consist of simulation-based training for resident and fellow education. The RAAPM team has contributed to multiple high-quality publications, textbook chapters and both internal and external grant applications. One of the team’s collective goals is to advance this specialty within the medical field.