Department of Anesthesia News · The critical role of certi"ed registered nurse anesthetists...

Department Helps New ZSFG Deliver Perioperative Improvements

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The changes underway at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) begin with the spectacular new physical space.

“But the new space also reflects a system-wide effort to enhance patient access and improve care at ZSFG. Physicians from the Department of Anesthesia and Perioperative Care area have been instrumental in the transition and in driving change in a number of key areas,” says Jim Marks, MD, PhD, the hospital’s chief of the medical staff.

The stories below offer a few examples.

Complex Transition to the New Operating Rooms Proves SuccessfulAs exhilarating as it’s been to move to the new hospital, preparing the clinical staff to smoothly transition its operations was an enormously complex challenge.

“When the clock flipped from 6:59 to 7:00 AM on May 21, 2016, we had to move from our last case in the old hospital to being ready to handle a potential major trauma – like an airplane crash – in the new hospital,” says the ZSFG’s medical director of the anesthesia workroom, Stefan Simon, MD.

Thankfully, there was no airplane crash that morning, but the transition in the operating rooms (ORs) and perioperative area was smoother than anyone could

Department of Anesthesia and Perioperative CareAnesthesia

News

Fall 2016 | Vol. 16

Also in this issue: ■■ Improvements in Patient Safety and Patient-Centered Care Emerge in UCSF ICUs

■■ Undergraduate Research Internship

■■ Ask the Expert: Jeremy Lieberman, MD

■■ Seeking Physician Well-Being

■■ Expanding the Role of CRNAs

■■ Carlos Carillo: Moonlighting Giant

■■ WARC 2016 and AUA 2016

■■ Mark Rosen Educational Endowment and Bill Young Research Endowment

■■ New Faculty

■■ Awards, Publications, Grants

■■ Upcoming Events

Jim Marks (left) is the chief of medical staff at Zuckerberg San Francisco General

UCSF Department of Anesthesia and Perioperative Care | Anesthesia News | Fall 2016 | 1

http://www.iculiberation.org/Pages/default.aspx

Since the Institute of Medicine (now the National Academies of Sciences, Engineering, and Medicine) released its sentinel 2011 report, “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research,” there has been growing

nationwide recognition of the public health challenges associated with chronic pain and the attendant opioid epidemic, as well as the need for a truly interprofessional approach to tackle these problems. In this issue, we describe some of the interdisciplinary efforts made by the Anesthesia Spine Surgery team with UCSF Spine Surgeons to reduce the postoperative pain and opioid burden for our spine surgery patients. Our faculty have also been instrumental in the successful build and launch of the new Zuckerberg San Francisco General Hospital and Trauma Center, including its new comprehensive pain clinic, now offering underserved patients with access to a full menu of pain relief options while minimizing addiction risks. Several of our faculty members’ 2016 peer reviewed publications (see page 21) also reflect these efforts.

Our team-based transdisciplinary approach to improve patient safety and the patient-centered care of critically ill patients in the UCSF ICUs is highlighted in our Emerge story. As part of these endeavors, the innovative Emerge application, which aggregates data from patients’ electronic medical records with patient and family input was created, along with a patient-family advisory council and the Critical Care Innovations Group website, providing resources for care givers, patients, and families. The critical role of certified registered nurse anesthetists (CRNAs) in the team-based care of both pediatric and adult surgical patients is described in our CRNA story.

With our focus on interprofessional and team based patient care comes the recognition that we must always strive to provide a supportive, collaborative, and open environment for our faculty, trainees, and staff. In addition, the Department is firmly committed to having a workforce and trainees that reflect the diversity of the San Francisco Bay Area. To that end, we highlight the work by Anesthesia faculty member Jennifer Lucero in her role as Director of the Undergraduate Research Internship in anesthesia, which aims to attract and support underrepresented groups to medicine. Work by our faculty well being committee and a highlight of staff member Carlos Carrillo are also featured in this issue.

Finally, we describe the establishment of the Mark Rosen Education and William Young Research endowments, intended to support the teaching and research careers of junior to mid-career faculty. We are delighted to share these updates with you and look forward to your comments and ongoing support of our department and university. We hope to see many of you at the ASA in October. Details about our alumni reception can be found on page 28. ■

Michael Gropper, MD, PhD Professor and Chair

Message from the ChairAddressing an Epidemic


reasonably expect, in part due to the efforts of Simon, Perioperative Medical Director Jens Krombach, MD, and Krishna Parekh, MD, who took special assignments to work on a number of specific aspects of the transition.

“We were a team,” says Simon, noting that Parekh handled everything from setting up simulations in the new hospital to helping determine where to place various types of equipment and that Krombach created an extensive plan for patient flow in the new hospital’s many anesthesia work places.

The process began with a detailed analysis of how to achieve a safe and successful transition without a so-called “soft opening” of the new hospital. “With the flip of a switch, we had to be ready to run 6 or 7 ORs and every anesthesia provider had to be familiar with the new equipment – monitoring equipment, anesthesia machines and computer systems – as well as the layout of the new building, the new rooms, the new patient flow, how patient transport would work and the new communication system,” says Simon.

A Methodical, Multi-Pronged ApproachThe team decided to take a multi-pronged approach over the course of the few months leading up to the day of the move. Once they had worked out the preliminary details about the layout of the ORs, the anesthesia workroom and patient flow – and had access to the new hospital – they designed three morning-long sessions where providers could move from station to station and receive training on all the new equipment. Part of the training involved simulations: What if a patient comes in with a gunshot wound to the chest? How to handle a pediatric patient who enters from the emergency department? How would a patient be transported to get an MRI? Which elevator would they use?

“The anesthesia equipment alone was a real challenge, because it is substantially different from what we’d been using in the old hospital,” says Simon. Therefore, the team didn’t stop at simulations, but created three new anesthesia workstations in the old hospital. This made it possible – once

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they’d completed their simulation training in the new facility – to use the equipment with live patients and fine-tune the setup. “Every anesthesia provider, including the anesthesia technicians, needed to fulfill the training for all new equipment,” says Simon.

In addition, the team created a “treasure hunt” in the new building, so that whenever work slowed in the old facility, providers could go to the new building to continue to familiarize themselves with the new rooms, layouts and workflow implications.

Finally, the team coordinated its work closely with the many different departments at ZSFG to troubleshoot any and all potential problems.

“Our goal was to eliminate as many hiccups as possible before we made the move,” says Simon. “It was a process of constant problem solving and working as a team and was important because every time we looked at a problem, something would arise that some of us had not thought about at all.”

When the first urgent case appeared for the new hospital – at 10 AM on May continued on page 4

21 – the team felt ready. Simon says, “Getting to a smoothly oiled machine will take months, but it was gratifying that we were fully functional and ready to safely operate at the time of the move.”

More Resources, Improved Design, Enhanced Access for Trauma and Preoperative CareIn addition to being the city’s safety net hospital, ZSFG is San Francisco’s trauma center. Marc Steurer, MD, director of Trauma Anesthesiology at ZSFG, says the new hospital does a remarkable job of accommodating modern patient flow in ways that simultaneously enhance efficiency and patient care. Among the improvements: ■■ The ambulance bay is just feet away from the trauma resuscitation room.■■ The CT scanner is right next to the resuscitation rooms. ■■ A dedicated elevator transports patients to the operating rooms (ORs), interventional radiology or the intensive care unit (ICU).

“It was a process of constant problem solving and working as a team and was important because every time we looked at a problem, something would arise that some of us had not thought about at all.”— Stefan Simon, MD

Krishna Parekh and Stefan Simon

Jens Krombach


■■ The trauma OR has a large footprint, state-of-the-art equipment and an adjacent blood bank. ■■ A hybrid OR gives clinicians the ability to do both surgical and interventional radiology procedures. ■■ The dedicated trauma ICU has larger, well-equipped and light-filled rooms. “All of these resources eliminate a lot

of hurdles and barriers, allowing us to focus more on our patients,” says Steurer.

Perioperative Process Improvements Center on Patient NeedsOther improvements have been in motion for a few years now – and the new facility enhances those improvements.

Take perioperative care. About three and half years ago, Laura Lang, MD, medical director of ZSFG’s preoperative clinic saw an opportunity to implement a number of innovations that could increase access to care for underserved patients while improving patient outcomes and patient satisfaction. Led by experienced attending physicians, nurse practitioners and registered nurses – and consistently one of the highest performing clinics at ZSFG, with only 8 percent no-shows per month – the clinic was well-positioned to identify opportunities for change and implement them.

One of the first things Lang and her colleagues did was opt to see every patient scheduled for elective surgery in person, rather than only seeing high-risk patients in clinic and doing the rest of their screening by phone, as is common in other hospitals.

“In person screening is more effective for many of our patients,” says Lang. “For example, we can be much more effective in preparing patients for surgery who don’t speak English or need pre-operative testing. And for those who have had limited access to healthcare, we can do a full work-up and then get them connected to health care providers and, where necessary, social services.”

Such an approach also has a financial advantage in that it decreases cancellations and their associated costs, while reducing patient wait times. Lang

and Steurer believed the reduced wait times would increase patient satisfaction.

To find out – and to give patients a voice – in January 2016 they implemented a survey in the clinic to close the loop on patients’ experience. “The data shows a direct correlation between how likely a patient is to recommend us with how satisfied they are with their wait time and instructions,” says Steurer.

Larger Space, Creative SolutionsAll of this work will bear even more fruit when the preoperative clinic moves into a larger, self-contained space in the fall of 2016 to accommodate increased volumes. At the moment, it shares space with other surgical services where the waiting room and check-in process is centralized. “When we have our own waiting area and check-in desk, we expect to be able to improve workflow and further improve wait times,” says Steurer.

But he and Lang have not limited their innovations to onsite services. “One of the things we’ve discovered is that sometimes our patients can’t show up due to limited transport –

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they don’t have a car and can’t afford bus fare on any given day,” says Lang. “So we’ve created a partnership with Lyft where we will offer department-sponsored rides back and forth to our patients who need it on the days of their preop exam and surgery.”

In fact, the Lyft program is part of a comprehensive effort to provide services across the entire spectrum of care. “The preop clinic is a logical connection point in the perioperative episode,” says Steurer. “We are in a position to become more of a perioperative guiding entity by doing everything from helping to decrease infections to coordinating postoperative respite at home.”

Bringing Comprehensive Pain Management to ZSFG’s UnderservedIt’s an interesting time to be a pain physician.

On the one hand, demand is intense. With about 100 million Americans suffering from chronic pain, outpatient clinics are overflowing. Meanwhile, inpatient settings are under regulatory pressure to ensure adequate pain control.

“We are in a position to become more of a perioperative guiding entity by doing everything from helping to decrease infections to coordinating postoperative respite at home.”— Marc Steurer, MD

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Marc Steurer

Laura Lang


Yet even as physicians try to address these demands, epidemic levels of opioid abuse and overdose deaths have dominated the headlines. An article in the August 2015 issue of the Journal of Urban Health reported that from 2010 to 2012, 331 people in San Francisco died from accidental opioid overdose, most of them from prescription opioids – and these cases disproportionately affected the city’s poorest residents.

Anesthesiologist and pain physician Arthur Wood, MD, is determined to offer his patients access to a full menu of pain relief options while minimizing addiction risks. He leads what is rapidly becoming a comprehensive pain management center at ZSFG, where many of the city’s poor receive their care.

Expanding CapacityWood arrived at UCSF in 2015 as the first physician on the ZSFG staff to have completed the Accreditation Council for Graduate Medical Education’s (ACGME’s) anesthesiology pain fellowship. His vision was to extend ZSFG’s pain clinic hours beyond a half-day a week and to bring

together a full complement of pain management services in one place, including medications, injections, integrative medicine approaches, cognitive-behavioral therapies and procedures. He has moved quickly to realize this vision.

“We’ve co-located our pain clinic with our already established outpatient preoperative clinic and extended it to two half days a week, which has already reduced wait time,” says Wood. “And we’ve successfully recruited and hired two pain-fellowship trained anesthesiologists who will enable us to move to five full days a week some time in the fall of 2016.”

He is confident that demand will justify that level of expansion, in part because transitioning to an electronic referral system – which has made it easier for primary care physicians to get their patients into the clinic – quickly resulted in a doubling of volume.

“We are monitoring whether those increases continue, but given the number of people that suffer from chronic pain in San Francisco, I believe they will,” says Wood.

In anticipation, the pain clinic has secured a new and larger space, which will facilitate an improved patient

experience that includes more reductions in wait times and the ability to see multiple providers in one visit.

“We also can do ultrasound guided pain injections in the new space – and will continue to do fluoroscopic-based injections in the operating rooms,” says Wood.

At the same time, he is looking to bring additional services into the clinic, so providers can more easily communicate about complex patients. The possibilities include: the Healthy Spine Clinic, which is staffed by two experienced nurse practitioners; a pharmacist who is helping to develop medication tapers; addiction medicine physicians; onsite physical therapists; and, possibly in the future, the department’s expert in neurostimulation.

In addition, Wood and his colleagues are capturing patient-reported outcomes using the NIH’s PROMIS measures of pain, function, sleep and anxiety to help refine the services they offer to patients.

“We expect this to be a one-stop shop that offers our often underserved patients access to all of the latest treatments for pain,” says Wood. ■

“We expect this to be a one-stop shop that offers our often underserved patients access to all of the latest treatments for pain.”— Arthur Wood, MD

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In 2012, UCSF Department of Anesthesia and Perioperative Care Chair Michael Gropper, MD, PhD,

was called to a meeting with UCSF Chancellor Sam Hawgood and a representative from the Gordon and Betty Moore Foundation. The Moore Foundation representative believed the ICU could be an ideal place to study changes aimed at improving hospital efficiency, outcomes and patient satisfaction – priorities in today’s era of value-based care.

For more than a decade, Gropper had been among those leading efforts to improve ICU care across the country. The meeting offered an opportunity to catalyze and provide an evidence base for the changes he and others were pursuing, including the Society of Critical Care Medicine’s ICU Liberation campaign.

The Moore Foundation decided to fund efforts at UCSF and Johns Hopkins Hospital. Emerge became UCSF’s flagship project and the UCSF Critical Care Innovations Group (CCIG) identified seven focus areas: 1. Preventing central line associated

bloodstream infections2. Preventing ICU-acquired weakness3. Protecting against delirium4. Preventing ventilator-associated harms

and infections 5. Preventing venous thromboembolic

disease 6. Meeting patients’ goals of care7. Promoting respect and dignity

Because Gropper believed achieving these goals depended on creating a team-based culture in which everyone in the ICU has the opportunity to maximize their contribution, he envisioned Emerge as a transdisciplinary project that would bring together physicians, nurses, pharmacists, respiratory therapists, physical therapists, engineers, administrators, patients and families. Along with ICU clinical nurse specialist Hildy Schell-Chaple, RN, MS, PhD(c), CCRN, CCNS, FAAN, who Gropper calls “an expert clinician and academic who

Improvements in Patient Safety and Patient-Centered Care Emerge in UCSF ICUs

Research

excels in creating bridges that make the huge leap from ideas to implementation,” the two initiated a project with four primary elements:■■ A patient-family advisory council (PFAC), which is one of the first such ICU-specific advisory groups at UCSF. “The PFAC meets once a month so that patients and families can tell us their experiences and provide input on how we can improve what we do,” says Denise Barchas, RN, MSN, PHN, a veteran ICU nurse who is Emerge’s project director. ■■ A comprehensive, unit-based safety program (CUSP) that empowers frontline ICU providers to quickly address safety concerns and facilitates teamwork and communication. ■■ The CCIG website, which provides important resources for ICU providers, patients and families. ■■ The Emerge application, an innovative and evolving piece of software that can be used on any computer or iPad in the ICU and which aggregates data from the patient’s electronic medical record, and patient and family input. It then feeds the aggregated data into an easy-to-read, color-coded interface that alerts the ICU team to any concerns about the patient’s care.

CARE TEAM PORTAL

03Apr2016 12:53

Harms

Monitor

Last Refresh

03April2016

12:50

Ventilator

Associated

Events (VAE)

Delirium

ICU Acquired

Weakness (IAW)

Respect and

Dignity

CLABSI

Venous

Thromboembolic

Events (VTE)

Alignment of

Goals

Patient Schedule

Patient Profile

Set Family Activities

STEVEN SMITHRoom # 1360-16

Patient Users: 1 Family Users: 1

PREFERRED NAME: Steve

SURROGATETim Miller

FAMILY SPOKESPERSONLouise Smith

AGE75

GENDERM

The Emerge application can be used on any computer or iPad in the ICU. It feeds aggregated patient data into an easy-to-read, color-coded interface that alerts the ICU team to any concerns about the patient’s care.

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http://criticalcareinnovationsgroup.org

The Patient-Family Advisory Council“Bringing in the voice of the patient has been critically important,” says intensivist Kevin Thornton, MD. “They’ve helped us build systems and mechanisms that ensure they receive care that is consistent with their goals while being treated with respect and dignity – things not traditionally considered in the quality world.”

One of the PFAC’s first contributions came as the CCIG was developing the patient portion of the web site. “They ripped it to shreds and helped us understand the patient portal was a unique way to get information that can help us really change what we do,” says Thornton.

The PFAC has also helped change the way clinicians communicate and interact with families.

“In medicine we often avoid explicit discussions of death and the process of dying,” says J. Matthew Aldrich, MD, director of adult critical care medicine at UCSF Medical Center. “But the PFAC families have told us that death is on their mind from the moment they enter the ICU and they want to know about some of the practicalities when someone dies.”

Similarly, physicians tend to believe that families don’t want to watch their loved one have a procedure done to them but the UCSF PFAC has made it clear that families often want to be present.

“This can create anxiety for clinicians and raise concerns about patient safety, but it also can be helpful to us and is important to families,” says Thornton. “It is a change though – and especially in a teaching institution, it means that we have to be very clear ahead of time about what families can expect to see and hear.”

“Elevating these patient-centered ideas helps us fight the depersonalization that can occur in the highly technical environment of the ICU,” says Gropper. “We’ve begun recognizing that a patient is not just a 70-year-old male with pneumonia and sepsis, but a retired teacher surrounded by a concerned family…this might be the most important thing that will survive out of this.”

Comprehensive Unit-Based Safety ProgramThe comprehensive unit-based safety program (CUSP) builds on the concept of putting patients and families first. It is different from traditional QI efforts because, “It is not one concentrated effort on one concern, but creates an apparatus that empowers frontline clinicians to help prevent numerous harms,” says Thornton. “That makes our ICU a much safer place.”

In the UCSF ICUs, clinical staff receive training on how to look for, report and act on anything they believe threatens patient safety. To help, the CCIG has placed cards strategically throughout the units, which remind people to consider ways to reduce potential harms.

“If something pops up, we just fill out a card and then look at these issues right away if it’s an immediate concern or at our monthly meetings,” says Barchas. Staff members have instigated changes about everything from loose cords and how drugs are labeled to how patients are transported.

“An increasing amount of research indicates that simply paying attention can make a big difference,” says Gropper, noting that empowering

EMERGE

people enhances their ability and motivation for making positive contributions. “We have all of these amazing people with different skill sets. Why shouldn’t rounds start with the nurse, who knows exactly what’s going on with the patient right now? Why shouldn’t the pharmacist contribute? Why shouldn’t professionals besides the physician have certain order sets that allow them to practice to the top of their profession? It’s an opportunity for all of us to shine.”

CCIG WebsiteThe CCIG website furthers patient safety goals by providing resources for clinicians as well as patients and families.

The site includes a checklist for families to prepare for their arrival at the ICU, and a wealth of information about the providers they’ll encounter, procedures they can anticipate during their stay, and how to cope with life after discharge.

“We realized that using the site to educate family members about the culture of the ICU could have enormous benefits,” says Thornton. “They might see 30-plus clinicians in a day and it can all be very confusing. Our hope is that by

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ICU clinical nurse specialist Hildy Schell-Chaple

Matt Aldrich


http://criticalcareinnovationsgroup.org

providing information for family members, they can become better advocates for their loved ones.”

The Emerge AppThe final piece is the Emerge app, which aggregates essential information and feeds it into a user-friendly interface – a color-coded “harms” wheel broken into the seven key elements of optimizing care in the ICU.

“It’s an easy way to focus our attention on what’s important,” says Barchas. “When something is red we can click in and get the necessary information about what has and hasn’t been done. Does the patient need a medication? Need to ambulate? It’s a good reminder that makes sure we address all of our key goals.”

A patient and family version of the app feeds into the clinician app so clinicians have more insight into the patients’ goals of care, how family members are willing to participate in caregiving and a better sense of who each patient is as an individual.

“What we’re working on now is how using the app affects workflow because it can’t make rounds longer,” says Gropper. “Our expectation is that it can shorten rounds, in its final state.”

“For years, clinicians have struggled with the implementation of electronic health records,” says Thornton. “Our hope is that the app is a step forward in deriving benefit from the vast amounts of digital data EHRs collect, so we can act on that data in a more efficient and effective manner and get back to providing the more humanistic side of medicine.”

If the app proves successful, similar apps could be used for many other patient safety concerns both in the ICU and throughout the hospital.

No Silver BulletsDespite the successes to date, any effort of this type inevitably takes time and is rarely a smooth road. Some of the bumps have to do with debugging the technology, some with changing long-ingrained behaviors.

Intensive, ongoing staff, patient and family engagement has been one important aspect of overcoming hurdles. “For example, nurse superusers help other nurses understand how investing time in doing some of these things will actually make their jobs easier,” says Barchas.

Now, says Aldrich, it’s time to examine results in some of the harder-to-achieve categories. “We were already good at preventing clinical harms like

central line infections and pneumonia, but we have to see if we can get real gains in things like workflow efficiency, patient satisfaction and family engagement, more challenging domains in part because the metrics aren’t as good,” says Aldrich.

One focus has been on time-in-motion studies that examine workflow, especially during rounds. “Rounds have evolved into a time when we communicate essential information among a team about a patient who is critically ill,” says Thornton. “Now, with the amount of data and information available, we think there’s room to realign the paradigm and the app can help.”

“Rounding is where we think we’re getting the biggest bang for the buck,” says Barchas.

The CCIG is also looking at the patient-family experience through surveys and discussions with PFAC to see if they are indeed doing better at meeting the patients’ goals of care.

“This has been an amazing project because it’s not a new drug or medical device,” says Gropper. “It’s about things like using less sedation, getting patients off the ventilator, getting them mobile, washing our hands. There’s nothing glamorous in those things and no one gets rich, but it’s where the biggest successes are in all of medicine.” ■

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Back row, from left: Geoffrey Latham, MS, RN, ACNP; Robert Brownell, MD; Kevin Thornton, MD; Front row: Theresa Lo, MD; Kelly Timothy, RN; Denise Barchas, RN, MSN, PHN


As medical schools continue efforts to increase their enrollment of underrepresented racial and

ethnic groups, most have recognized that having faculty members with an intimate understanding of the challenges ahead is essential.

Anesthesiologist and obstetrician Jennifer Lucero brings a lifetime of experience to this effort at the UCSF Department of Anesthesia and Perioperative Care. She has been the central figure in the creation of an undergraduate research internship in anesthesia and in the creation of programs for anesthesia residents who identify as underrepresented in medicine (UIM).

Bringing Firsthand UnderstandingLucero grew up in southern California, a first generation college student from a large Latino/Native American family. She wound up navigating Cal State Northridge, Yale Medical School, residencies at UCSF in both obstetrics and anesthesia and an obstetric anesthesia and anesthesia research fellowship.

But it wasn’t easy. Through those years, she experienced firsthand the many challenges facing UIM students and physicians, including open stereotyping, unconscious bias and the nagging belief that the worlds of medicine and research are reserved for those who are white and privileged.

“It didn’t matter that my family thought I was smart or how I am perceived in the white world, I carry all the burdens of being a person of color,” says Lucero. “In my mind, I’ve too often believed I’m not smart enough…not cut out for this.” Lucero managed to work through that feeling, but many UIM students don’t and turn to other professions.

This helps explain why Lucero is so passionate about the undergraduate research internship (URI) in anesthesia. Part of a broader, joint program with Kaiser Permanente that the Department

Undergraduate Research Internship Aims to Attract Underrepresented Groups to Medicine

Education

of Obstetrics initiated and leads, the URI offers undergraduate students from UC Berkeley mentorship, shadowing opportunities, research experience, and a virtual handbook for how they can make it to and through medical school.

Expanding the URILucero’s first contact with the program was in 2010, after she had finished her anesthesia residency and was doing her OB-Anesthesia and research fellowships. At the time, she began teaching an informal class that wound up being about the nuts and bolts of applying to medical school, including practical questions about the debt incurred, which Lucero says can be “terrifying.”

She continued in the program as it began to grow and other departments joined. She also became more involved with medical school admissions, where it struck her that once in medical school, very few UIM students even consider becoming a specialist, perhaps because many have had little or no exposure to medical specialties. “I know I didn’t,” she says. “I had no idea.”

This realization drove Lucero to focus her efforts on attracting UIM students to anesthesia.

Creating a Place to Let Your Hair DownShe says that aside from the practical education, one of the most important ways the URI helps achieve the goal of greater diversity is that the students develop a camaraderie that takes them far beyond their internship and helps them sustain their interest in medicine.

“It’s so important, to create a safe zone, because even in a liberal area like this, it can be hard for people who haven’t lived through it to understand the world these students walk in,” says Lucero. “Medical school and residency are hard enough, without this additional cognitive load and because you have all of this baggage, you need more than validation from the majority community; you need your own community, a place where you can detox, let your hair down and talk about these things.”

With that in mind, Lucero has gone beyond the URI to create a UIM welcome event and quarterly dinners for incoming anesthesia residents.

“It’s all about the pipeline,” she says. “About getting more students of color through medical school and getting them excited about anesthesia early on.” ■

Jennifer Lucero (center) with students Carlos Molina and Abigail Huliganga


Ask the Expert Jeremy Lieberman, MDJeremy Lieberman is chief of spine anesthesia, a team of 15 physicians from the UCSF Department of Anesthesia and Perioperative Care who work with surgeons from the Departments of Orthopedic Surgery and Neurosurgery to complete between 2,500 and 3,000 spine cases per year.

How have advances in spine anesthesia contributed to the dramatic upswing in the number of deformity surgeries for older adults? Fifteen years ago, we thought 60 was old for spine surgery, but today, 70 is the new 50. 70-year-olds are healthier and more active than they used to be so rather than be debilitated from spine-related problems, they opt for surgery. Part of why we can offer that surgery is attributable to new surgical techniques and implants, but part of it is also that advances in spine anesthesia have enhanced patient safety and improved functional outcomes. Three areas are particularly important: Doing a better job of controlling blood loss, optimizing neurological outcomes and improving pain management while minimizing the use of opioids.

In the last 20-25 years, research has helped us dramatically reduce bleeding during spine surgery. It began in the early 1990s, when our spine team – one of the first dedicated spine anesthesia teams in the country – began pushing the envelope on how low we could safely take patients’ blood pressure. Later, we moved to the use of pharmacologic agents that decrease blood loss; most recently, we’ve been using antifibrinolytic agents that stabilize clots so they last longer. Though there are still some arguments about optimal dose, and caution is advised for patients with coronary disease and those at risk for stroke, these drugs have shown themselves to be extremely safe and have become the standard of care at many centers around the country.

These days, thanks to reductions in blood loss, fewer patients need to go to the ICU after spine surgery, and we see shorter stays and fewer infections – especially important for older adults who are at greater risk.

We have also been developing and pioneering the use of advanced neuro-monitoring for spinal cord and spinal nerve protection, most notably through the use of motor-evoked and sensory-evoked potentials. During spine surgeries here, a neurophysiologist actively monitors nerve pathways and if we see something that might affect motor function, we can inform the surgeon and he or she can undo what they did. We believe we’ve seen reduced incidence of nerve injuries and reduced severity when they do occur. Together with surgeons here, we’ve produced many papers that describe how to optimally use these techniques.

Finally, there’s pain management. Historically we used to admit many patients to the ICU after surgery in order to manage uncontrollable postoperative pain. In addition, a high percentage of spine patients experience chronic pain and the older one gets, the more debilitating pain becomes because most of us lose our ability to compensate and deterioration occurs faster.

So we’ve worked hard to find new ways to get spine patients – particularly older spine patients – through surgery in such a way that their acute postoperative pain is manageable and they avoid chronic pain down the road, all the while minimizing the use of opiates, something of great concern today. We have become incredibly

aggressive in using drugs that reduce the need for narcotics after surgery. The added benefit is that reducing the narcotics also seems to reduce postoperative delirium in our older patients. [Jacqueline Leung, MD, is the department expert in understanding the connection between anesthesia and postoperative delirium.]

In particular, we will routinely give preoperative patients opiate-sparing agents, such as gabapentin. We will often use ketamine intraoperatively. For too long, people resisted the use of ketamine out of fear of potential side effects, but at the doses we give it is incredibly safe and the net benefit far outweighs the risk: patients who get intraoperative ketamine need less pain medication six weeks after surgery than those who don’t get the ketamine. Where appropriate, we will also use lidocaine infusions, magnesium and dexamethasone – and we maximize the use of acetaminophen, always seeking effective alternative analgesics. We also are working closely with the acute pain service to develop an ERAS (enhanced recovery after surgery) pain pathway that we hope to standardize to improve patient outcomes long after they leave the hospital, all of which is especially important for our older patients. ■


Seeking Physician Well-Being

Medicine is different now and people are much more aware of creating a life-work

balance,” says Dorre Nicholau, MD, PhD, and UCSF Department of Anesthesia and Perioperative Care’s vice chair for Professionalism and Well-Being. She says a combination of factors – including efficiency pressures, nonstop change and a generation of physicians with a different mindset and expectations – have shifted the focus.

With that in mind, Nicholau leads a faculty committee in an effort aimed at creating a more accommodating on-site environment as well as avenues for faculty to get the most from their time away from work.

“We’ve set some things in motion and are working with the administration to see what else we can get done,” says Nicholau.

Faculty Profile

“ The Work EnvironmentOn the job, the primary focus has been on reducing stress and fatigue while creating closer ties within the department.

For example, anesthesiologist Kerstin Kolodzie, MD, PhD, recommended a yoga class and when she got the go-ahead, worked with Nicholau, Department Chair Michael Gropper, MD, PhD and UCSF Fitness and Recreation to arrange a free, twice-a-week class.

“There’s been steady attendance by a group of faculty who really like it,” says Nicholau. She and her team have also added an acupuncture class on Friday afternoons for relaxation and pain management, as well as monthly departmental lunches.

“The lunches are a rare opportunity to be together as a group,” says Nicholau.

Creating Scheduling Options to Optimize Time Away from WorkPerhaps a more complex challenge than on-site concerns has been finding ways to optimize physicians’ time away

from work without breaking the bank or making scheduling unmanageable. A number of ideas have emerged.

To make it easier for those going on maternity or paternity leave, the group has created a simple, online chart that outlines the different options and their implications for disability leave, reimbursement and advancement.

The group has also proposed awarding additional nonclinical days for attending educational meetings – a challenge for a department in which most physicians carry a particularly heavy clinical load. Other possibilities include allowing people to bank their nonclinical days so they don’t feel pressured to use what they’ve accumulated in one constrained time period and creating staggered shifts to help those with obligations like getting children off to school.

“Though all of these options can potentially cause some scheduling headaches, they do give faculty more control over their schedules and Dr. Gropper has been very responsive to trying to work things out,” says Nicholau. ■

Dorre Nicholau (left) leads an effort to offer stress-reduction options for faculty, including twice-weekly free yoga classes and monthly department lunches.


Staff Profile Expanding the Role of CRNAs

Certified registered nurse anesthetists (CRNAs) have long played a vital role at UCSF

Medical Center. New hospitals at Mission Bay and limits on the number of residents, faculty hires and resident work hours have only enhanced the importance of these highly skilled professionals.

As evidence, there are now 42 CRNAs practicing between the Parnassus, Mission Bay, Mt. Zion, and Orthopaedic Institute campuses, says Leigh-Ann Langford, Lead CRNA for the UCSF Department of Anesthesia and Perioperative Care.

A Move Into Pediatric AnesthesiaThe increased demands have also caused the department to hire two dedicated pediatric CRNAs and to institute a national search for two pediatric cardiac CRNAs. “This is a first for UCSF and we will be one of only a few academic medical centers in the country to have pediatric cardiac nurse anesthetists in those roles,” says Langford. Scott Schulman, MD, MHS, chief of pediatric cardiac anesthesiology, has been instrumental in this pioneering initiative, having worked frequently with pediatric cardiac CRNAs while he was at Duke University Medical Center.

Given the UCSF Department of Anesthesia and Perioperative Care’s national and global leadership, Langford anticipates other institutions will ultimately follow suit by using CRNAs with their pediatric and pediatric cardiac populations.

Increasing Specialization, Professionalization, RecognitionLangford says that using CRNAs in the pediatric cardiac setting is an example of the innovative culture at UCSF and that department Chair Michael Gropper, MD, PhD, who has worked closely with CRNAs for years, has been a visionary in finding creative new ways to make use of their skill set.

“UCSF CRNAs have a long track record of exemplary care in the adult

clinical setting, and are a fiscally responsible way to help meet the clinical, educational and research challenges of operating an academic medical facility,” says Langford. They are also leaders in their field, having delivered local, national, and international presentations, including at UCSF’s Changing Practice of Anesthesia conference.

The expanding roles are happening at a time when CRNAs around the country are enhancing their discipline’s reputation through such innovations as

pain fellowships and the creation of a Doctorate of Nursing in Anesthesia Practice. “At UCSF, we now have five CRNAs who have completed their doctorates, and the American Association of Nurse Anesthetists will require a DNAP in order to enter the profession by 2025,” says Langford. “All of these things have enabled our profession to garner new levels of recognition for the value we deliver to health care” ■

“UCSF CRNAs have a long track record of exemplary care in the adult clinical setting, and are a fiscally responsible way to help meet the clinical, educational and research challenges of operating an academic medical facility.”— Leigh-Ann Langford (pictured above, front row, second from right)


Staff Profile Moonlighting Giant

Long before joining the UCSF staff 25 years ago, Carlos Carillo was a baseball fanatic, having played in

high school and, later, for a semi-professional team. Born and raised in the city’s Mission district, Carillo is also a lifetime fan of the San Francisco Giants.

So in 1989, when he heard the Giants were hiring extra ushers for the World Series, he managed to secure one of the jobs. It didn’t take long before it became more exciting than he could have expected. Standing in the right field corner at Candlestick Park before game three, Carillo felt a shake. “At first, I didn’t think anything of it – there were a lot of forklifts driving around hauling bags of ice – but then I heard someone say ‘earthquake,’” he says.

As any Bay Area baseball fan knows, the game was called off and the stadium evacuated. Though Carillo was as upset by the incident as anyone else, it didn’t deter him from pursuing more permanent work with the team. He became an usher and held the job for the next couple of years until he found a fulltime job with the phone bank for a UCSF HIV-AIDS project.

Within a few years, though, Carillo’s daughter Clarissa was born – his son Carlos arrived three years later – and looking to find a way to pay for private school, Carillo thought again of the Giants, this time as a moonlighting position to help make ends meet.

Monitoring the FieldThe Giants quickly rehired him as a field supervisor on the security team, a job he’s held ever since. This season is his twenty-first and he generally works every night and weekend game that the Giants play at home, as well as the occasional weekday game if he can make it fit with the demands of his current UCSF job: facilities coordinator for the UCSF Department of Anesthesia and Perioperative Care.

Before each game, Carillo makes sure everyone on the field has the proper credentials for access. Most of the time it’s not a problem, but occasionally people hoping to snag a story will try to sneak in. During the game, Carillo keeps people from going to places they’re not

supposed to be, like the time a streaker burst through the gate and onto the field.

And after the game, he says, “I escort the umpires into their clubhouse because sometimes the fans can get very hostile, especially if an ump blew a call or cost the Giants the game.”

Enjoying the Work, Embracing the GrindCarillo says he loves both of his jobs. At UCSF, he is responsible for coordinating any department moves to and from the institution’s various facilities, including preparing or renovating offices for new arrivals and addressing general maintenance issues.

“I look forward to what I have to do each day at UCSF and the department and my supervisor have been amazing about allowing me to continue working with the Giants,” he says.

He confesses, though, that during the baseball season, some days can be exhausting. When the Giants are in town, his workday will start at 7 am and end at 3:30 pm. When there is a weeknight game, he immediately hops the shuttle to Mission Bay and then walks to the ballpark where work begins at 4:30 pm. Assuming the game doesn’t go into extra innings, he is home by 1 am, only to start the routine again the following morning.

“I always think I should start cutting back, but they can’t rip me away from there,” Carillo says. “The security team is like my second family and seeing the players, seeing season ticket holders…it’s an incredible feeling, a shot of adrenaline that rejuvenates me.” ■

“The security team is like my second family and seeing the players, seeing season ticket holders…it’s an incredible feeling, a shot of adrenaline that rejuvenates me.”— Carlos Carillo


Modeled on William K. Hamilton’s 1961 midwestern anesthesia residents’ conference, the

Western Anesthesia Residents’ Conference (WARC) was established at UCSF in 1963, with the intent of providing residents and fellows with a forum for presenting their clinical and bench research, where they would not be overshadowed by their faculty mentors. The meetings have also provided residents with the rare opportunity to interact with peers from other institutions and learn about different approaches to education and research.

The 54th Annual WARC was again hosted by UCSF – for the first time in 18 years – from April 29–May 1, 2016, and was a big success. Nineteen anesthesiology residency programs and about 280 attendees participated. Some highlights from the 2016 meeting included:■■ Adding the “Poster Showcase” as a new session. The WARC 2016 Abstract Committee selected some interesting abstracts prior to the main poster session, giving twelve poster

54th Annual Conference Hosted by UCSFWARC 2016

presenters the opportunity to be recognized and answer questions in front of the entire audience.■■ 5th Annual Eger Lecture presented by UCSF active Professor Emeritus George A. Gregory, MD■■ Keynote speaker Jesse Levinson, PhD, co-founder and CTO of Zoox■■ UCSF Anesthesia Resident Josemine Carey, MD, won Best Critical Care Poster Presentation, for Atenolol toxicity in acute renal failure: an unusual presentation and its management

We’d like to thank the following people for volunteering their time to help with WARC 2016:■■ WARC Program and Signage: UCSF Anesthesia and Perioperative Care Resident Tina Vu■■ UCSF OCME Planners: Courtney Flookes, Dawn Bohlmann■■ Oral Session Moderators: UCSF Anesthesia and Perioperative Care Residents Ben Alter, Michael Bokoch, Gregory Chinn, Marisa Hernandez-Morgan, Masood Memarzadeh, Jeremy Pearl, Paul Su, and Elizabeth Whitlock

■■ Poster Session Timekeepers: Shikha Sharma, Chris Cosden; UCSF Anesthesia and Perioperative Care staff Vanessa Cheng, Cindy Chin, Marie Hollero, Bernadette Martin, Bryanna Stitt, and Morgen Ahearn; UCSF Anesthesia and Perioperative Care Residents Michael Bokoch, Melanie Hall, Mike Lubrano, Annie Park, Jeremy Pearl, and Elizabeth Whitlock ■■ Registration Staff: UCSF Anesthesia and Perioperative Care staff members Abby Binaoro, Cindy Chin, Marie Hollero, Marie Lim, Bernadette Martin, and Bryanna Stitt. UCSF OCME staff Dawn Bohlmann and Courtney Flookes■■ Professor and former UCSF Anesthesia and Perioperative Care Chair Mervyn Maze, MB ChB, and the FAER Organization, which sponsored the monetary awards

We’re looking forward to WARC 2017, to be hosted by Oregon Health and Science University. ■


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The UCSF Department of Anesthesia and Perioperative Care was delighted to host

the Association of University Anesthesiologists 63rd Annual Meeting in San Francisco this year, from May 19-21, 2016, with a special aligned meeting day at the IARS 2016 Annual Meeting and International Science Symposium on May 21. In addition to a robust program featuring education sessions highlighting cutting edge topics, we were excited to share some of our city’s attractions, including holding the host social event at the California Academy of Sciences, located in Golden Gate Park near the UCSF Parnassus campus.

Sessions presented by the AUA Educational Advisory Board focused on the science of communication and feedback, as well as producing and publishing successful educational research. Educational session speakers were: Robert Gaiser, MD; Davinder Ramasingh, MD; Alex Macario, MD, MBA; Maxine Papadakis, MD; George Gallos, MD; Charles W. Emala, MD; Mark D. Neuman, MD; Lee A. Fleisher, MD; Frederic T. (Josh) Billings, MD, MSCI; Warren S. Sandberg, MD, PhD; Rebecca D. Minehart, MD; and Keith H. Baker, MD, PhD.

A key component of the May 21 aligned meeting day was the TH Seldon Memorial Lecture by John P.A. Ioannidis, DSc, MD, “Reproducible Research: Impact in the Evidence-Based Decision Making.” In addition, a state of the art review of endothelial glycocalyx practice and critical care medicine was presented by moderator Randal Dull, MD, PhD, and panelists Sisse Ostrowski, MD, PhD; Randal Dull, MD, PhD; Patrick Singleton, PhD; Eric Schmidt, MD; and Jean François Pittet, MD. Scholars’ panels and small group sessions also offered attendees with concrete, nuts and bolts tips on research career trajectory, designing and conducting collaborative and impactful research projects, current trends in academic anesthesiology, as well as scientific manuscript and grant writing sessions. Our own Vice Chair for UCSF Anesthesia and Perioperative Care Research, Judith Hellman, MD, was a member of the “Research in the 21st

Host Program Highlights UCSF LeadershipAUA 2016

Century” Scholars’ Panel. Other aligned meeting day panelists and presenters were: Marcelo Gama de Abreu, MD, MSc, PhD, DESA; Marcos F. Vidal Melo, MD, PhD; Alex Evers, MD; Jennifer Grandis, MD; Max Kelz, MD, PhD; Anke Winter, MD, MSc; Ben Julian A. Palanca, MD, PhD, MSc; Laure Aurelian, M. Sc, PhD; Mark Neuman, MD, MSc; Eric R. Gross, MD; and May Hua, MD.

The host program presented on May 19 adopted the theme of the UCSF campus, which is precision medicine. Although it’s tempting to think of precision medicine as a laboratory endeavor, we take a much broader view. At UCSF, we are driven by the idea that when the best research, the best teaching, and the best patient care converge, we can deliver breakthroughs that help heal the world. UCSF is host to four professional schools, medicine, dentistry, pharmacy, and nursing, all of which are ranked at the very top of their specialties. The AUA 2016 host program highlighted UCSF leadership in a number of important areas: basic laboratory discovery, translational research in neurosciences, cutting-edge care of the underserved with HIV/AIDS, and importantly, our strong commitment to building a workforce that represents the incredible diversity of the San Francisco Bay Area and California. The sessions were both enlightening and entertaining.

Our speakers included:

■■ Talmadge King, Jr, MD, Dean of the UCSF School of Medicine, and Professor of Medicine. Aside from being one of the world’s leading authorities on interstitial lung disease, he is a visionary leader of the school, and a champion of diversity in academic medicine.

■■ Joe Derisi, PhD, Professor and Chair of the UCSF Department of Biochemistry and Biophysics, Howard Hughes Investigator, and recipient of a MacArthur Genius Award. Derisi has pioneered innovative technologies using DNA micro-arrays for rapid pathogen detection.

■■ Diane Havlir, MD, Professor of Medicine and Chief of the HIV / AIDS Division at Zuckerberg San Francisco General Hospital. She leads the UCSF HIV programs, which have served as a model for both the United Nations and US AIDS efforts.

■■ Stephen Hauser, MD, Professor and Chair of the Department of Neurology at UCSF. He is internationally renowned for his work on immune mechanisms of multiple sclerosis. ■

Clockwise from left: Joe Derisi, Stephen Hauser, Michael Gropper and Talmadge King, Diane Havlir (seated at right)


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Traditionally, hospital-based departments, and especially anesthesia departments, have found it difficult to raise money for endowments, but we can’t let that stop us from aggressively pursuing fundraising

to support our academic mission of education and research,” says Michael Gropper, MD, PhD and chair of the UCSF Department of Anesthesia and Perioperative Care. “Our department has a history of leadership in these areas that it’s imperative we maintain.”

A near doubling of clinical volume over the past five or six years has only complicated the task, which is why Gropper believes it’s more important than ever for alumni and friends to support these missions. “When the NIH’s contribution to research has shrunk to about 10 or 15 percent of what people need, we can’t rely solely on external funding,” he says.

The recent successful effort establishing the Ronald D. Miller Distinguished Professorship of Anesthesia and Perioperative Care was a good start on maintaining the legacy, but establishing the Mark Rosen Educational Endowment and Bill Young Research Endowment will create sustainable support that goes beyond adding a mid- to late-career researcher. “These funds will allow grateful alumni and patients to direct their generosity to a specific area,” says Gropper, about the endowments named for two beloved former faculty members.

As residency program director for many years, Mark Rosen, MD, trained hundreds of anesthesiologists. “He set the bar high for our training program and was a fierce advocate for residents,” says Gropper. “For many of us, he guided us through training and set the course for the rest of our careers and we are very grateful.”

Bill Young, MD, who passed away in 2013, excelled at bringing diverse groups together to conduct research on complex clinical issues. A world-renowned researcher himself who authored more than 300 peer-reviewed publications, Young was also the department’s vice chair for research. “He was a wonderful and effective mentor for both junior and mid-career faculty, many of who went on to their own highly successful careers,” says Gropper.

Please honor the careers of both of these men by helping to preserve and grow our department’s legacy of groundbreaking contributions to academic medicine. ■

Opportunities to Contribute to a Legacy of Academic LeadershipMark Rosen Educational Endowment & Bill Young Research Endowment

“

To contribute to either of these endowments, contact:Olivia HerbertExecutive Director of UCSF DevelopmentPhone: 415-476-9878 or 877-499-8273Email: [email protected]

Staff Appreciation 2016Department staff gathered at the carnival-themed staff appreciation event in Stern Grove on July 15.First Row, L to R: Joice Karyadi, Dulce Mohler, Dereca Akins, Helen Lee, Marie Hollero, Frida Stone, Courtney Carter, Dominique Shields

Second Row, L to R: Alma De Leon, Vanessa Cheng, Shane Loetterle, Ed Mathews, Carroll Schreibman, Abby Binaoro, Diana Guo, Celeste Wright, Megan Moran

Back Row, L to R: Rachelle Avila, Julie Leong, Bernadette Martin, Morgen Ahearn, Serena Smith, Adam Jacobson, Jonathan Eklund

Mark Rosen

Bill Young


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Andrea Olmos, MD Health Sciences Clinical Instructor / Liver Transplant Anesthesia Fellow (Non-ACGME)Joined Faculty July 2016MEDICAL SCHOOLUCSFINTERNSHIPAnesthesiology, UCSFRESIDENCYAnesthesiology, UCSF

Jeremy Pearl, MD Health Sciences Clinical Instructor / Regional Anesthesia Fellow (Non-ACGME)Joined Faculty July 2016MEDICAL SCHOOLStanford University School of MedicineINTERNSHIPInternal Medicine, Kaiser Permanente San FranciscoRESIDENCYAnesthesiology, UCSF

Jina Sinskey, MD Health Sciences Assistant Clinical ProfessorJoined Faculty September 2016MEDICAL SCHOOLTufts University School of MedicineINTERNSHIPAnesthesiology, UCSFRESIDENCYAnesthesiology, UCSFFELLOWSHIPPediatric Anesthesiology, Boston Children’s Hospital

Elizabeth Whitlock, MA, MS, MDHealth Sciences Clinical Instructor / T32 Postdoctoral ScholarJoined Faculty July 2016ADVANCED DEGREESMA, Biological/Biomedical Sciences, Washington University MS, Clinical Investigation, Washington UniversityMEDICAL SCHOOLWashington University School of Medicine in St. LouisINTERNSHIPAnesthesiology, UCSFRESIDENCYAnesthesiology, UCSFFELLOWSHIPClinical Research, UCSF

Career FacultyMichael Bokoch, MD, PhD Health Sciences Clinical Instructor / Liver Transplant Anesthesia Fellow (Non-ACGME)Joined Faculty July 2016ADVANCED DEGREEPhD, BiophysicsStanford UniversityMEDICAL SCHOOLStanford University School of MedicineINTERNSHIPAnesthesiology, UCSFRESIDENCYAnesthesiology, UCSF

Joyce Chang, MD Health Sciences Assistant Clinical ProfessorJoined Faculty July 2016MEDICAL SCHOOLUniversity at Buffalo, State University of New York School of Medicine & Biomedical SciencesINTERNSHIPAnesthesiology, UCSFRESIDENCYAnesthesiology, UCSFFELLOWSHIPCritical Care Medicine, UCSF

Carlyle Hamsher, MD Health Sciences Assistant Clinical ProfessorJoined Faculty August 2016MEDICAL SCHOOLGeorgetown University School of MedicineINTERNSHIPAnesthesiology, Mount Sinai HospitalRESIDENCYAnesthesiology, Mount Sinai HospitalFELLOWSHIPPain Medicine, Brigham and Women’s Hospital

Brian Lee, MD Health Sciences Assistant Clinical ProfessorJoined Faculty August 2016MEDICAL SCHOOLTufts University School of MedicineINTERNSHIPTransitional, Tufts Medical Center/ Lemuel Shattuck Hospital

RESIDENCYAnesthesiology, Massachusetts General HospitalFELLOWSHIPSPerioperative Surgical Home, UC IrvinePediatric Anesthesiology, Children’s Hospital Los AngelesPREVIOUS EMPLOYMENTClinical Instructor, UC Irvine Medical Center

Stephanie Lim, MD Health Sciences Assistant Clinical ProfessorJoined Faculty September 2016MEDICAL SCHOOLUCSFINTERNSHIPInternal Medicine, Alameda County Medical CenterRESIDENCYAnesthesiology, UCSFFELLOWSHIPObstetric Anesthesiology, UCSF

William Ng, MBBS, FANZCA Health Sciences Assistant Clinical ProfessorJoined Faculty August 2016MEDICAL SCHOOLUniversity of New South Wales, AustraliaINTERNSHIPRoyal North Shore Hospital, Northern Sydney Area Health ServiceRESIDENCYSenior Resident in Critical Care, Concord Repatriation GeneralHospital, Sydney South West Area Health ServiceAnesthesiology, Westmead Hospital, Western Sydney Local Health DistrictFELLOWSHIPSAnesthetic Fellow with focus in Cardiothoracic Anesthesiology, Royal Melbourne HospitalCardiac and Thoracic Anesthesiology, Toronto General Hospital,University of TorontoPediatric Cardiac Anesthesiology, Boston Children’s Hospital,Harvard Medical SchoolPREVIOUS EMPLOYMENTVisiting Scholar in Anesthesia and House Officer, Prince of Wales Hospital, Chinese University of Hong Kong and Health Authority of Hong Kong

New Faculty


Visiting FacultyNancy Fammartino, MBBS Visiting Assistant ProfessorJoined Faculty August 2016MEDICAL SCHOOLJames Cook University, QueenslandINTERNSHIPAustin Hospital, MelbourneRESIDENCYSt. Vincent’s Hospital, MelbourneFELLOWSHIPObstetrics, Royal Women’s Hospital, Melbourne

Melissa Haque, MBBS Visiting Assistant ProfessorJoined Faculty July 2016MEDICAL SCHOOLUniversity of Western AustraliaRESIDENCIESPre-Specialty Training (3 years)University of Western AustraliaAnesthetic Training (7 years)University of Western Australia(6-month rotation each at Princess Margaret Hospital (pediatric), King Edward Memorial Hospital (maternity), Perth)FELLOWSHIPSMedical Education / SimulationJoondalup Health Campus, PerthRegional and General (ENT, Cardiac Surgery) AnesthesiaSt. Vincent’s Hospital, MelbournePREVIOUS EMPLOYMENTChief Registrar, St. Vincent’s Hospital, MelbourneConsultant Anesthetist, Perth

Andrew Milne, MBChB, FRCAVisiting Clinical Instructor and Trauma and Acute Care Fellow (Non-ACGME)Joined Faculty July 2016MEDICAL SCHOOLUniversity of AberdeenINTERNSHIPFoundation Training, North Central Thames Foundation School, LondonRESIDENCYAcute Care Common Stem, Anesthetics; Anesthetics Core Training, South East London School of Anaesthesia, London Deanery. Specialty Registrar Training, Anesthetics & Critical Care, Central School of Anaesthesia, London Deanery

Clifford Bielinski

Daniel Austin

Valeria Carcamo-Cavazos

Jacob Cecil

Aleksandras Cizas

Michelle Curry

Michael Do

L. McLean House

Steven Hur

James Rothschild

Katie Telischak

Justin Teng

Andrew Vargas

Tom Wang

Lei Xu

Jack Jeng

Michael Jung

Mina Khorashadi

Danielle Laufer

Shona Lee

Michelle Patzelt

Justin Libaw

Jay Rajan

New Residents CLASS OF 2019


Faculty Honors, Awards and Appointments

J. Matthew Aldrich, MDCAMPUS HONOR

UCSF Exceptional Physician Award, 2016

Neal Cohen, MD, MPH, MSEXTRAMURAL APPOINTMENTS

Reelected Chairman of the Board for El Camino Hospital, Mountain ViewChair, newly created ASA Committee on Health and Public PolicyChair, American Society of Anesthesiologists (ASA) Section on Professional PracticeChair, Critical Care Medicine Examination Committee, American Board of Anesthesiology (ABA)

Monica Harbell, MDCAMPUS APPOINTMENT

UCSF School of Medicine High Intensity Teaching PositionMedical Student Longitudinal Coach

Kerstin Kolodzie, MD, PhDCAMPUS HONOR

UCSF Haile T. Debas Academy of Medical EducatorsExcellence in Teaching Award, 2016

Michael Lipnick, MDCAMPUS HONOR


Oana Maties, MDCAMPUS HONOR


Manuel Pardo, MDEXTRAMURAL APPOINTMENT

President Elect, Association of Anesthesiology Core Program Directors

Oliver Radke, MD, PhDEXTRAMURAL APPOINTMENT

Scientific Committee, Ambulatory Anesthesia, German Society of Anesthesia and Intensive Care Medicine (DGAI)

Honors & AwardsDavid Robinowitz, MD, MHS, MSCAMPUS HONOR

UCSF Health Great Experience Award, September 2016

Mark Rollins, MD, PhDCAMPUS APPOINTMENT

UCSF School of Medicine High Intensity Teaching PositionDirector, Anesthesia Core Rotation

Michael Rowbotham, MDEXTRAMURAL HONOR

2016 Mitchell B. Max Award for Neuropathic Pain

Gabriel Sarah, MDCAMPUS APPOINTMENTS

UCSF School of Medicine Faculty Council, 2016 – 2019UCSF School of Medicine High Intensity Teaching PositionLGBT Topic StewardCAMPUS AWARD

Association of American Medical Colleges (AAMC) Minority Faculty Development Seminar Attendance Funding, 2016

Jessica Tashjian, MDCAMPUS HONOR


Kevin Thornton, MDCAMPUS APPOINTMENT

Program Director, Anesthesia Critical Care Medicine Fellowship Program

John Turnbull, MDCAMPUS APPOINTMENT

UCSF School of Medicine High Intensity Teaching PositionAssistant Director, Airway, Breathing, Circulation Bridges Curriculum Foundational Science Block

Arthur Wood, MDCAMPUS APPOINTMENT

UCSF School of Medicine High Intensity Teaching PositionPain Topic Steward

Trainee Honors, Awards, and Appointments

Odmara Barreto-Chang, MDEXTRAMURAL AWARD

NIH – NMA Travel Award Program for Residents Interested in Careers in Academic Medicine, 2016

Nicole Jackman, MD, PhDINTRAMURAL AWARD

2015 – 2016 UC President’s Carbon Neutrality Initiative FellowEfficient Use of Fresh Gas Flow With Inhaled Anesthetics Can Decrease Costs and Impact Medical Greenhouse Gas Emissions at UCSF

Jason Lang, MD, PhDINTRAMURAL AWARD

2015 – 2016 UC President’s Carbon Neutrality Initiative FellowRecognized for efforts to reduce carbon emissions across UCSF and beyond

Departmental Honors and Awards

Best Abstract / Poster of Meeting at the American Society of Regional Anesthesia and Pain Medicine’s (ASRA) 41st Annual Meeting, March 31 – April 2, 2016, New Orleans, LA. Implementation of an Enhanced Recovery after Surgery Pathway for Total Mastectomy. UCSF Department of Anesthesia and Perioperative Care Authors:

Catherine Chiu, MD, Intern

Pedram Aleshi, MD, Associate Clinical Professor

Christina Inglis-Arkell, MD, Assistant Clinical Professor

Candace Shavit, MD, Clinical Instructor

Edward Yap, MD, Assistant Clinical Professor

Monica Harbell, MD, Assistant Clinical Professor


UCSF Caring Wisely AwardsCaring Wisely is an organized process for engaging and supporting frontline clinicians in efforts to remove unnecessary costs from healthcare delivery systems. The program was created

and launched by the UCSF Center for Healthcare Value in November 2012.

Each project has a maximum budget of $50,000 and receives project support from the Caring Wisely team.

More than 65 ideas and 20 full project proposals were collected in each of the first 3 years of the program, with 2-3 projects chosen for implementation each year.

The UCSF Department of Anesthesia and Perioperative Care had faculty involved with 2 projects accepted into the Caring Wisely Program for the 2016–2017 academic year:

■■ Perioperative OSA Pathway: Andrew Schober, MD Rachel Eshima McKay, MDSakura Kinjo, MD Jon Matthew Aldrich, MD Daniel Burkhardt, MD Matthias Braehler, MD, PhDDavid Robinowitz, MD, MHS, MS

■■ Enhanced Recovery After Surgery Pathway for Cesarean Delivery:

Monica Harbell, MD Mark Rollins, MD, PhD

Monica Harbell, MDCAMPUS APPOINTMENT

2016–2017 Caring Wisely Project Leader

Andrew Schober, MDCAMPUS APPOINTMENT

2016–2017 Caring Wisely Project Co-Leader

Sakura Kinjo, MDCAMPUS APPOINTMENT

2016–2017 Caring Wisely Project Co-Leader

Lee-Lynn Chen, MDCAMPUS APPOINTMENT

2015–2016 Caring Wisely Project Leader

Honors & Awardscontinued from previous page

Respiratory Care Services (RCS) at ZSFG had 12 abstracts accepted for presentation at this year’s International Respiratory Congress in San Antonio, TX. These abstracts represent the efforts of an 8-member

RCS research team under the direction of Rich Kallet, MS, RRT, FCCM (Director of Quality Assurance). Members of the research team include Justin Phillips, RRT; Lance Pangilinan, RRT; Earl Mangalindan, RRT; Kelly Ho, RRT; Gregory Burns, RRT; Vivian Yip, RRT; and Joseph Booze, RRT. John Kelly, Director of Respiratory Care Services, and Dr. Susan Yoo, RCS Medical Director, strongly support participation in clinical research as a pillar of the department’s mission and for the professional development of the department’s practitioners.

Two of the abstracts won the Editor’s Choice award given to the top-ten rated abstracts: Gregory Burns, RRT (Factors Influencing the Effects of Aerosolized Prostacyclin in Severe ARDS) and Vivian Yip, RRT (The Impact of SBT and DSI in ARDS). In addition, the abstract on aerosolized prostacyclin in ARDS won the 2016 Monaghan-Trudell Fellowship for Aerosol Technique Development. These three awards bring the number of national research awards received by the department to ten. Other topics that will be presented include bench studies on the performance accuracy of capnography during supplemental oxygen delivery, the performance of algorithms controlling compression volume loss during mechanical ventilation, and various aspects of physiologic dead-space ventilation in ARDS.

The Department of Anesthesia and Perioperative Care at ZSFG has a storied history of clinical research on mechanical ventilation during critical illness. This dates back to the mid-1970s with the publication of the seminal study on Optimal PEEP by H. Barrie Fairley, MD. RCS members assisted with these early research projects. In the mid-1980s RCS began to develop, execute and publish their own studies under the guidance of anesthesia faculty members Richard M. Schlobohm, MD; Jeffrey A. Katz, MD; James D. Marks, MD; Jean-Francois Pittet, MD; Michael Matthay, MD, and most recently, Michael S. Lipnick, MD. RCS has been multidisciplinary in its research, having published studies with members of the UCSF Departments of Surgery, Pulmonary and Critical Care Medicine, Neurology and the Cardiovascular Research Institute.

Respiratory Care Services at ZSFG Receives National Research Awards

AARC 2016

“We strongly support participation in clinical research as a pillar of the department’s mission and for the professional development of the department’s practitioners.”— John Kelly and Dr. Susan Yoo


Peer Reviewed Publications

continued on next page


Bickler P, Feiner J, Rollins M, Meng L. Tissue Oximetry and Clinical Outcomes. Anesth Analg. 2016 Jun 15.

Bickler PE. Enough Information to Evaluate Clinical Monitors? Anesth Analg. 2016 Jul;123(1):254-5.

Bidlingmaier S, Ha K, Lee NK, Su Y, Liu B. Proteome-wide Identification of Novel Ceramide-binding Proteins by Yeast Surface cDNA Display and Deep Sequencing. Mol Cell Proteomics. 2016 Apr;15(4):1232-45.

Brownell R, Kaminski N, Woodruff PG, Bradford WZ, Richeldi L, Martinez FJ, Collard HR. Precision Medicine: The New Frontier in Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2016 Jun 1;193(11):1213-8.

Calfee CS. Opening the Debate on the New Sepsis Definition. Precision Medicine: An Opportunity to Improve Outcomes of Patients with Sepsis. Am J Respir Crit Care Med. 2016 Jul 15;194(2):137-9.

Campion EM, Juillard C, Knudson MM, Dicker R, Cohen MJ, Mackersie R, Campbell AR, Callcut RA. Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned From the Crash of Asiana Airlines Flight 214. JAMA Surg. 2016 Jun 1;151(6):512-7.

Careskey M, Naidu R. Continuous Suprascapular Nerve Block With a Perineural Catheter for Reverse Shoulder Arthroplasty Rescue Analgesia in a Patient With Severe Chronic Obstructive Pulmonary Disease. A A Case Rep. 2016 Jul 15;7(2):37-40.

Causey MW, Amans MR, Han S, Higashida RT, Conte M. Reversible cerebral vasoconstriction syndrome is a rare cause of stroke after carotid endarterectomy. J Vasc Surg. 2016 Feb 26.

Chapman JS, Roddy E, Ueda S, Brooks R, Chen LL, Chen LM. Enhanced Recovery Pathways for Improving Outcomes After Minimally Invasive Gynecologic Oncology Surgery. Obstet Gynecol. 2016 Jul;128(1):138-44.

Chau A, Markley JC, Juang J, Tsen LC. Cytokines in the perinatal period – Part I. Int J Obstet Anesth. 2016 Jan 5.

Chau A, Markley JC, Juang J, Tsen LC. Cytokines in the perinatal period – Part II. Int J Obstet Anesth. 2016 Jan 5.

Choquet H, Trapani E, Goitre L, Trabalzini L, Akers A, Fontanella M, Hart BL, Morrison LA, Pawlikowska L, Kim H, Retta SF. Cytochrome P450 and matrix metalloproteinase genetic modifiers of disease severity in Cerebral Cavernous Malformation type 1. Free Radic Biol Med. 2016 Mar;92:100-9.

Alexander MD, Cooke DL, Hallam DK, Kim H, Hetts SW, Ghodke BV. Less can be more: Targeted embolization of aneurysms associated with arteriovenous malformations unsuitable for surgical resection. Interv Neuroradiol. 2016 Aug;22(4):445-51.

Alexander MD, Rebhun JM, Hetts SW, Kim AS, Nelson J, Kim H, Amans MR, Settecase F, Dowd CF, Halbach VV, Higashida RT, Cooke DL. Lesion location, stability, and pretreatment management: factors affecting outcomes of endovascular treatment for vertebrobasilar atherosclerosis. J Neurointerv Surg. 2016 May;8(5):466-70.

Alexander MD, Halbach V, Nicholson A, Settecase F, Darflinger RJ, Amans MR. Transvenous ethanol sclerotherapy of feeding arteries for treatment of a dural arteriovenous fistula. J Neurointerv Surg. 2016 Jul 20.

Alexander MD, Halbach V, Nicholson A, Settecase F, Darflinger RJ, Amans MR. Transvenous ethanol sclerotherapy of feeding arteries for treatment of a dural arteriovenous fistula. BMJ Case Rep. 2016 Jul 15.

Alladina JW, Levy SD, Hibbert KA, Januzzi JL, Harris RS, Matthay MA, Thompson BT, Bajwa EK; National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network. Plasma Concentrations of Soluble Suppression of Tumorigenicity-2 and Interleukin-6 Are Predictive of Successful Liberation From Mechanical Ventilation in Patients With the Acute Respiratory Distress Syndrome. Crit Care Med. 2016 Sep;44(9):1735-43.

Bansal N, Carpenter MA, Weiner DE, Levey AS, Pfeffer M, Kusek JW, Cai J, Hunsicker LG, Park M, Bennett M, Liu KD, Hsu CY. Urine Injury Biomarkers and Risk of Adverse Outcomes in Recipients of Prevalent Kidney Transplants: The Folic Acid for Vascular Outcome Reduction in Transplantation Trial. J Am Soc Nephrol. 2016 Jul;27(7):2109-21.

Beitler JR, Sands SA, Loring SH, Owens RL, Malhotra A, Spragg RG, Matthay MA, Thompson BT, Talmor D. Quantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria. Intensive Care Med. 2016 Sep;42(9):1427-36.

Beitler JR, Goligher EC, Schmidt M, Spieth PM, Zanella A, Martin-Loeches I, Calfee CS, Cavalcanti AB; ARDSne(x)t Investigators. Personalized medicine for ARDS: the 2035 research agenda. Intensive Care Med. 2016 May;42(5):756-67.

Bhattacharya M, Kallet RH, Ware LB, Matthay MA. Negative Pressure Pulmonary Edema. Chest. 2016 Apr 7.

Clark AJ, Safaee M, Chou D, Weinstein PR, Molinaro AM, Clark JP 3rd, Mummaneni PV. Comparative Sensitivity of Intraoperative Motor Evoked Potential Monitoring in Predicting Postoperative Neurologic Deficits: Nondegenerative versus Degenerative Myelopathy. Global Spine J. 2016 Aug;6(5):452-8.

Collins SA, Rozenblum R, Leung WY, Morrison CR, Stade DL, McNally K, Bourie PQ, Massaro A, Bokser S, Dwyer C, Greysen RS, Agarwal P, Thornton K, Dalal AK. Acute care patient portals: a qualitative study of stakeholder perspectives on current practices. J Am Med Inform Assoc. 2016 Jun 29.

Crowley JC, Gropper MA. IV Immunoglobulin: A Useful Tool for the Severe Pneumonia Toolbox? Crit Care Med. 2016 Jan;44(1):250-1.

Denlinger LC, Phillips BR, Ramratnam S, Ross K, Bhakta NR, Cardet JC, Castro M, Peters SP, Phipatanakul W, Aujla S, Bacharier LB, Bleecker ER, Comhair SA, Coverstone A, DeBoer M, Erzurum SC, Fain SB, Fajt M, Fitzpatrick AM, Gaffin J, Gaston B, Hastie AT, Hawkins GA, Holguin F, Irani AM, Israel E, Levy BD, Ly N, Meyers DA, Moore WC, Myers R, Opina MT, Peters MC, Schiebler ML, Sorkness RL, Teague WG, Wenzel SE, Woodruff PG, Mauger DT, Fahy JV, Jarjour NN; National Heart Lung and Blood Institute’s Severe Asthma Research Program-3 Investigators. Inflammatory and Co-Morbid Features of Patients with Severe Asthma and Frequent Exacerbations. Am J Respir Crit Care Med. 2016 Aug 24.

Derbew M, Laytin AD, Dicker RA. The surgical workforce shortage and successes in retaining surgical trainees in Ethiopia: a professional survey. Hum Resour Health. 2016 Jun 30;14(Suppl 1):29.

Detsky AS, Gropper MA. Why Physician Leaders of Health Care Organizations Should Participate in Direct Patient Care. Ann Intern Med. 2016 Jul 12.

Diamond JM, Porteous MK, Jackson Roberts L 2nd, Wickersham N, Rushefski M, Kawut SM, Shah RJ, Cantu E 3rd, Lederer DJ, Chatterjee S, Lama VN, Bhorade S, Crespo M, McDyer J, Wille K, Orens J, Weinacker A, Arcasoy S, Shah PD, Wilkes DS, Hage C, Palmer SM, Snyder L, Calfee CS, Ware LB, Christie JD; Lung Transplant Outcomes Group. The relationship between plasma lipid peroxidation products and primary graft dysfunction after lung transplantation is modified by donor smoking and reperfusion hyperoxia. J Heart Lung Transplant. 2016 Apr;35(4):500-7


Publicationscontinued from previous page


Disayabutr S, Kim EK, Cha SI, Green G, Naikawadi RP, Jones KD, Golden JA, Schroeder A, Matthay MA, Kukreja J, Erle DJ, Collard HR, Wolters PJ. miR-34 miRNAs Regulate Cellular Senescence in Type II Alveolar Epithelial Cells of Patients with Idiopathic Pulmonary Fibrosis. PLoS One. 2016 Jun 30;11(6):e0158367.

Ernecoff NC, Witteman HO, Chon K, Chen YI, Buddadhumaruk P, Chiarchiaro J, Shotsberger KJ, Shields AM, Myers BA, Hough CL, Carson SS, Lo B, Matthay MA, Anderson WG, Peterson MW, Steingrub JS, Arnold RM, White DB. Key stakeholders’ perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs. J Crit Care. 2016 Jun;33:19-25.

Evans FM, Mallepally NR, Dubowitz G, Vasilopoulos T, McClain CD, Enneking K. Factors influencing anesthesia residency selection: impact of global health opportunities. Can J Anaesth. 2016 Jun;63(6):674-681.

Fahy JV. Asthma Was Talking, But We Weren’t Listening. Missed or Ignored Signals That Have Slowed Treatment Progress. Ann Am Thorac Soc. 2016 Mar;13 Suppl 1:S78-82.

Famous KR, Delucchi K, Ware LB, Kangelaris KN, Liu KD, Thompson BT, Calfee CS. ARDS Subphenotypes Respond Differently to Randomized Fluid Management Strategy. Am J Respir Crit Care Med. 2016 Aug 11.

Fan Y, Barash JR, Lou J, Conrad F, Marks JD, Arnon SS. Immunological Characterization and Neutralizing Ability of Monoclonal Antibodies Directed Against Botulinum Neurotoxin Type H. J Infect Dis. 2016 May 15;213(10):1606-14.

Federspiel CK, Liu KD. Does Changing the Volume Matter? The Relationship of Urine Volume and Dialysis Intensity. Clin J Am Soc Nephrol. 2016 Aug 8;11(8):1321-3.

Frederick HJ, Wofford K, de Lisle Dear G, Schulman SR. A Randomized Controlled Trial to Determine the Effect of Depth of Anesthesia on Emergence Agitation in Children. Anesth Analg. 2016 Apr;122(4):1141-6.

Ge L, Wu Y, Soleimani M, Khazalpour M, Takaba K, Tartibi M, Zhang Z, Acevedo-Bolton G, Saloner DA, Wallace AW, Mishra R, Grossi EA, Guccione JM, Ratcliffe MB. Moderate Ischemic Mitral Regurgitation After Posterolateral Myocardial Infarction in Sheep Alters Left Ventricular Shear but Not Normal Strain in the Infarct and Infarct Borderzone. Ann Thorac Surg. 2016 May;101(5):1691-9.

Gordon ED, Simpson LJ, Rios CL, Ringel L, Lachowicz-Scroggins ME, Peters MC, Wesolowska-Andersen A, Gonzalez JR, MacLeod HJ, Christian LS, Yuan S, Barry L, Woodruff PG, Ansel KM, Nocka K,

Seibold MA, Fahy JV. Alternative splicing of interleukin-33 and type 2 inflammation in asthma. Proc Natl Acad Sci U S A. 2016 Aug 2;113(31):8765-70.

Gordon ED, Locksley RM, Fahy JV. Cross-Talk between Epithelial Cells and Type 2 Immune Signaling. The Role of IL-25. Am J Respir Crit Care Med. 2016 May 1;193(9):935-6.

Gotts JE, Matthay MA. Sepsis: pathophysiology and clinical management. BMJ. 2016 May 23;353:i1585.

Guan Z, Kuhn JA, Wang X, Colquitt B, Solorzano C, Vaman S, Guan AK, Evans-Reinsch Z, Braz J, Devor M, Abboud-Werner SL, Lanier LL, Lomvardas S, Basbaum AI. Injured sensory neuron-derived CSF1 induces microglial proliferation and DAP12-dependent pain. Nat Neurosci. 2016 Jan;19(1):94-101.

Guérin C, Matthay MA. Acute cor pulmonale and the acute respiratory distress syndrome. Intensive Care Med. 2016 May;42(5):934-6.

Han Z, Shen F, He Y, Degos V, Camus M, Maze M, Young WL, Su H. Correction: Activation of �-7 Nicotinic Acetylcholine Receptor Reduces Ischemic Stroke Injury through Reduction of Pro-Inflammatory Macrophages and Oxidative Stress. PLoS One. 2016 Mar 17;11(3):e0152218.

Hannam JA, Borrat X, Trocóniz IF, Valencia JF, Jensen EW, Pedroso A, Muñoz J, Castellví-Bel S, Castells A, Gambús PL. Modeling Respiratory Depression Induced by Remifentanil and Propofol during Sedation and Analgesia Using a Continuous Noninvasive Measurement of pCO2. J Pharmacol Exp Ther. 2016 Mar;356(3):563-73.

Harbell M, Cohen JM, Kolodzie K, Behrends M, Braehler MR, Kinjo S, Feeley BT, Aleshi P. Combined preoperative femoral and sciatic nerve blockade improves analgesia after anterior cruciate ligament reconstruction: a randomized controlled clinical trial J Clin Anesth. 2016 Sep;33:68–74.

Hendrickson CM, Howard BM, Kornblith LZ, Conroy AS, Nelson MF, Zhuo H, Liu KD, Manley GT, Matthay MA, Calfee CS, Cohen MJ. The acute respiratory distress syndrome following isolated severe traumatic brain injury. J Trauma Acute Care Surg. 2016 Jun;80(6):989-97.

Hetts SW, Moftakhar P, Maluste N, Fullerton HJ, Cooke DL, Amans MR, Dowd CF, Higashida RT, Halbach VV. Pediatric intracranial dural arteriovenous fistulas: age-related differences in clinical features, angioarchitecture, and treatment outcomes. J Neurosurg Pediatr. 2016 Aug 19:1-9.

Hibma JE, Zur AA, Castro RA, Wittwer MB, Keizer RJ, Yee SW, Goswami S, Stocker SL, Zhang X, Huang Y, Brett CM, Savic RM, Giacomini KM. The Effect of Famotidine, a MATE1-Selective Inhibitor, on the Pharmacokinetics and Pharmacodynamics of Metformin. Clin Pharmacokinet. 2016 Jun;55(6):711-21.

Hill KD, Sampson MR, Li JS, Tunks RD, Schulman SR, Cohen-Wolkowiez M. Pharmacokinetics of intravenous sildenafil in children with palliated single ventricle heart defects: effect of elevated hepatic pressures. Cardiol Young. 2016 Feb;26(2):354-62.

Hirsch J, Generoso JR, Latoures R, Acar Y, Fidler RL. Simulation Manikin Modifications for High-Fidelity Training of Advanced Airway Procedures. A A Case Rep. 2016 Jan 8.

Huffmyer JL, Moncrief M, Tashjian JA, Kleiman AM, Scalzo DC, Cox DJ, Nemergut EC. Driving Performance of Residents after Six Consecutive Overnight Work Shifts. Anesthesiology. 2016 Jun;124(6):1396-403.

Isquick S, Henry D, Nakagawa S, Moghadassi M, Thiet MP, Norton M, Lucero J. The association between nitroglycerin use and adverse outcomes in women undergoing cesarean delivery in the second stage of labor. J Matern Fetal Neonatal Med. 2016 Aug 2:1-5.

Jackson MV, Morrison TJ, Doherty DF, McAuley DF, Matthay MA, Kissenpfennig A, O’Kane CM, Krasnodembskaya AD. Mitochondrial Transfer via Tunneling Nanotubes is an Important Mechanism by Which Mesenchymal Stem Cells Enhance Macrophage Phagocytosis in the In Vitro and In Vivo Models of ARDS. Stem Cells. 2016 Aug;34(8):2210-23.

Janelle GM, London MJ. Perioperative Ultrasound: The Future Is Now. Anesth Analg. 2016 Jun;122(6):1734-6.

Kangelaris KN, Ware LB, Matthay MA, Calfee CS. The authors reply. Crit Care Med. 2016 Aug;44(8):e771.

Kangelaris KN, Ware LB, Matthay MA, Calfee CS. The authors reply. Crit Care Med. 2016 Aug;44(8):e769-70.

Kangelaris KN, Ware LB, Wang CY, Janz DR, Zhuo H, Matthay MA, Calfee CS. Timing of Intubation and Clinical Outcomes in Adults With Acute Respiratory Distress Syndrome. Crit Care Med. 2016 Jan;44(1):120-9.

Keene JD, Jacobson S, Kechris K, Kinney GL, Foreman MG, Doerschuk CM, Make BJ, Curtis JL, Rennard SI, Barr RG, Bleecker ER, Kanner RE, Kleerup EC, Hansel NN, Woodruff PG, Han MK, Paine Iii R, Martinez FJ, Bowler RP, O’Neal WK; for COPDGene and SPIROMICS Investigators. Biomarkers Predictive of Exacerbations in the SPIROMICS and COPDGene Cohorts. Am J Respir Crit Care Med. 2016 Aug 31.

Kerr SC, Fischer GJ, Sinha M, McCabe O, Palmer JM, Choera T, Lim FY, Wimmerova M, Carrington SD, Yuan S, Lowell CA, Oscarson S, Keller NP, Fahy JV. FleA Expression in Aspergillus fumigatus Is Recognized by Fucosylated Structures on Mucins and Macrophages to Prevent Lung Infection. PLoS Pathog. 2016 Apr 8;12(4):e1005555.




Khurana RN, Porco TC, Claman DM, Boldrey EE, Palmer JD, Wieland MR. INCREASING SLEEP DURATION IS ASSOCIATED WITH GEOGRAPHIC ATROPHY AND AGE-RELATED MACULAR DEGENERATION. Retina. 2016 Feb;36(2):255-8.

Kisitu DK, Eyler LE, Kajja I, Waiswa G, Beyeza T, Feldhaus I, Juillard C, Dicker RA. A pilot orthopedic trauma registry in Ugandan district hospitals. J Surg Res. 2016 May 15;202(2):481-8.

Korai M, Kitazato KT, Tada Y, Miyamoto T, Shimada K, Matsushita N, Kanematsu Y, Satomi J, Hashimoto T, Nagahiro S. Hyperhomocysteinemia induced by excessive methionine intake promotes rupture of cerebral aneurysms in ovariectomized rats. J Neuroinflammation. 2016 Jun 27;13(1):165.

Krigbaum H, Takemoto S, Kim HT, Kuo AC. Costs and Complications of Short Versus Long Cephalomedullary Nailing of OTA 31-A2 Proximal Femur Fractures in U.S. Veterans. J Orthop Trauma. 2016 Mar;30(3):125-9.

Kulcke A, Feiner J, Menn I, Holmer A, Hayoz J, Bickler P. The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin. Anesth Analg. 2016 Jun;122(6):1856-65.

Laitio R, Hynninen M, Arola O, Virtanen S, Parkkola R, Saunavaara J, Roine RO, Grönlund J, Ylikoski E, Wennervirta J, Bäcklund M, Silvasti P, Nukarinen E, Tiainen M, Saraste A, Pietilä M, Airaksinen J, Valanne L, Martola J, Silvennoinen H, Scheinin H, Harjola VP, Niiranen J, Korpi K, Varpula M, Inkinen O, Olkkola KT, Maze M, Vahlberg T, Laitio T. Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2016 Mar 15;315(11):1120-8.

Lancman BM. Night shift fatigue among anaesthesia trainees at a major metropolitan teaching hospital. Anaesth Intensive Care. 2016 May;44(3):364-70.

Landesberg G, London MJ. The Enigma of Postoperative Troponin Elevation. Anesth Analg. 2016 Jul;123(1):5-7.

Larson MD, Singh V. Portable infrared pupillometry in critical care. Crit Care. 2016 Jun 22;20(1):161.

Lawton MT, Abla AA, Rutledge WC, Benet A, Zador Z, Rayz VL, Saloner D, Halbach VV. Bypass Surgery for the Treatment of Dolichoectatic Basilar Trunk Aneurysms: A Work in Progress. Neurosurgery. 2016 Jul;79(1):83-99.

Lee BH, Sarah GE, Rosbe KW, Alemi S. Pneumothorax after tracheostomy closure with successful nonsurgical management. J Clin Anesth. 2016 Jun;31:115-8.

Lee SM, Takemoto S, Wallace AW. In Reply. Anesthesiology. 2016 Feb;124(2):513-4.

Leslie M, Paradis E, Gropper MA, Milic MM, Kitto S, Reeves S, Pronovost P. A Typology of ICU Patients and Families from the Clinician Perspective: Toward Improving Communication. Health Commun. 2016 Jul 8:1-7.

Leung JM, Chen V, Hollander Z, Dai D, Tebbutt SJ, Aaron SD, Vandemheen KL, Rennard SI, FitzGerald JM, Woodruff PG, Lazarus SC, Connett JE, Coxson HO, Miller B, Borchers C, McManus BM, Ng RT, Sin DD. COPD Exacerbation Biomarkers Validated Using Multiple Reaction Monitoring Mass Spectrometry. PLoS One. 2016 Aug 15;11(8):e0161129.

Li J, Gelb AW, Flexman AM, Ji F, Meng L. Definition, evaluation, and management of brain relaxation during craniotomy. Br J Anaesth. 2016 Jun;116(6):759-69.

Li J, Shalabi A, Ji F, Meng L. Monitoring cerebral ischemia during carotid endarterectomy and stenting. J Biomed Res. 2016 Mar 3;31.

Lin N, Han R, Zhou J, Gelb AW. Mild Sedation Exacerbates or Unmasks Focal Neurologic Dysfunction in Neurosurgical Patients with Supratentorial Brain Mass Lesions in a Drug-specific Manner. Anesthesiology. 2016 Mar;124(3):598-607.

Lipnick MS, Feiner JR, Au P, Bernstein M, Bickler PE. The Accuracy of 6 Inexpensive Pulse Oximeters Not Cleared by the Food and Drug Administration: The Possible Global Public Health Implications. Anesth Analg. 2016 Aug;123(2):338-45.

Lipshutz AK, Feiner JR, Grimes B, Gropper MA. Predicting mortality in the intensive care unit: a comparison of the University Health Consortium expected probability of mortality and the Mortality Prediction Model III. J Intensive Care. 2016 May 23;4:35.

Lipshutz AK, Gropper MA. Intensive Care Unit-acquired Muscle Weakness: An Ounce of Prevention Is Worth a Pound of Cure. Anesthesiology. 2016 Jan;124(1):7-9.

Liu KD, Vijayan A, Rosner MH, Shi J, Chawla LS, Kellum JA. Clinical adjudication in acute kidney injury studies: findings from the pivotal TIMP-2*IGFBP7 biomarker study. Nephrol Dial Transplant. 2016 Jun 23.

Liu KD. Changing Faces of Critical Care Nephrology. Adv Chronic Kidney Dis. 2016 May;23(3):134-5.

Liu J, Kuwabara A, Kamio Y, Hu S, Park J, Hashimoto T, Lee JW. Human Mesenchymal Stem Cell-Derived Microvesicles Prevent the Rupture of Intracranial Aneurysm in Part by Suppression of Mast Cell Activation Via a PGE2-Dependent Mechanism. Stem Cells. 2016 Jun 28.

Liu J, Su H, Qu QM. Carnosic Acid Prevents Beta-Amyloid-Induced Injury in Human Neuroblastoma SH-SY5Y Cells via the Induction of Autophagy. Neurochem Res. 2016 Sep;41(9):2311-23.

London MJ. Perioperative Stress Cardiomyopathy: Case Reports Matter! A A Case Rep. 2016 Jan 1;6(1):1-2.

London MJ. Intraoperative Mean Blood Pressure and Outcome: Is 80 (mmHg) the “New” 60? Anesthesiology. 2016 Jan;124(1):4-6.

Ma L, Shen F, Jun K, Bao C, Kuo R, Young WL, Nishimura SL, Su H. Integrin �8 Deletion Enhances Vascular Dysplasia and Hemorrhage in the Brain of Adult Alk1 Heterozygous Mice. Transl Stroke Res. 2016 Jun 29.

Mabray MC, Talbott JF, Whetstone WD, Dhall SS, Phillips DB, Pan JZ, Manley GT, Bresnahan JC, Beattie MS, Haefeli J, Ferguson AR. Multidimensional Analysis of Magnetic Resonance Imaging Predicts Early Impairment in Thoracic and Thoracolumbar Spinal Cord Injury. J Neurotrauma. 2016 May 15;33(10):954-62.

Martinez CH, Diaz AA, Meldrum C, Curtis JL, Cooper CB, Pirozzi C, Kanner RE, Paine Iii R, Woodruff PG, Bleecker ER, Hansel NN, Barr RG, Marchetti N, Criner GJ, Kazerooni EA, Hoffman EA, Ross BD, Galban CJ, Cigolle CT, Martinez FJ, Han MK; SPIROMICS Investigators. Age and Small Airway Imaging Abnormalities in Subjects With and Without Airflow Obstruction in SPIROMICS. Am J Respir Crit Care Med. 2016 Aug 26.

Matthay MA, Liu KD. New Strategies for Effective Therapeutics in Critically Ill Patients. JAMA. 2016 Feb 23;315(8):747-8.

Maze M, Pirracchio R. Will Xenon Be a Valuable Addition in Perioperative and Critical Care Settings? Anesth Analg. 2016 Mar;122(3):593-6.

Maze M. Preclinical neuroprotective actions of xenon and possible implications for human therapeutics: a narrative review. Can J Anaesth. 2016 Feb;63(2):212-226. Epub 2015 Oct 27.

Maze M. From Bench to Bedside and Back Again: A Personal Journey with Dexmedetomidine. Anesthesiology. 2016 Jun 24.

McKay RE, Hall KT, Hills N. The Effect of Anesthetic Choice (Sevoflurane Versus Desflurane) and Neuromuscular Management on Speed of Airway Reflex Recovery. Anesth Analg. 2016 Feb;122(2):393-401.

McSparron JI, Hayes MM, Poston JT, Thomson CC, Fessler HE, Stapleton RD, Carlos WG, Hinkle L, Liu K, Shieh S, Ali A, Rogers A, Shah NG, Slack D, Patel B, Wolfe K, Schweickert WD, Bakhru RN, Shin S, Sell RE, Luks AM. ATS Core Curriculum 2016: Part II. Adult Critical Care Medicine. Ann Am Thorac Soc. 2016 May;13(5):731-40.




Meng L, Han SJ, Rollins MD, Gelb AW, Chang EF. Awake brain tumor resection during pregnancy: Decision making and technical nuances. J Clin Neurosci. 2016 Feb;24:160-2.

Meng L, Settecase F, Xiao J, Yu Z, Flexman AM, Higashida RT. Initial clinical experience with near-infrared spectroscopy in assessing cerebral tissue oxygen saturation in cerebral vasospasm before and after intra-arterial verapamil injection. J Clin Neurosci. 2016 Jan 4.

Meng L, Hall M, Settecase F, Higashida RT, Gelb AW. Monitoring cerebral tissue oxygen saturation at frontal and parietal regions during carotid artery stenting. J Anesth. 2016 Apr;30(2):340-4.

Meyers PM, Higashida RT, McDougall CG, Hussein MS, Hirsch JA, Rasmussen PA. Editorial: Discipline and training. J Neurosurg. 2016 Jan;124(1):9-11.

Moazed F, Burnham EL, Vandivier RW, O’Kane CM, Shyamsundar M, Hamid U, Abbott J, Thickett DR, Matthay MA, McAuley DF, Calfee CS. Cigarette smokers have exaggerated alveolar barrier disruption in response to lipopolysaccharide inhalation. Thorax. 2016 Feb 2.

Monsel A, Calfee CS. Focusing on the alveolar epithelium: Alveolar fluid clearance in diffuse versus focal acute respiratory distress syndrome. Anaesth Crit Care Pain Med. 2016 Apr;35(2):75-7.

Morrissey KM, Stocker SL, Chen EC, Castro RA, Brett CM, Giacomini KM. The Effect of Nizatidine, a MATE2K Selective Inhibitor, on the Pharmacokinetics and Pharmacodynamics of Metformin in Healthy Volunteers. Clin Pharmacokinet. 2016 Apr;55(4):495-506.

Muffly MK, Muffly TM, Weterings R, Singleton M, Honkanen A. The Current Landscape of US Pediatric Anesthesiologists: Demographic Characteristics and Geographic Distribution. Anesth Analg. 2016 Jul;123(1):179-85.

Narvid J, Amans MR, Cooke DL, Hetts SW, Dillon WP, Higashida RT, Dowd CF, Halbach VV. Spontaneous retroclival hematoma: a case series. J Neurosurg. 2016 Mar;124(3):716-9.

Nurok M, Hong G, Cohen NH. Anesthesiologists and Fatigue: A Call to Action ASA Monitor. 2016 Jun;80(6):26-29.

Nwanna-Nzewunwa OC, Ajiko MM, Kirya F, Epodoi J, Kabagenyi F, Batibwe E, Feldhaus I, Juillard C, Dicker R. Barriers and facilitators of surgical care in rural Uganda: a mixed methods study. J Surg Res. 2016 Jul;204(1):242-50.

Papazian L, Calfee CS, Chiumello D, Luyt CE, Meyer NJ, Sekiguchi H, Matthay MA, Meduri GU. Diagnostic workup for ARDS patients. Intensive Care Med. 2016 May;42(5):674-85.

Parks M, Liu KD. Acute kidney injury: Clinical trials in AKI: is the end in sight? Nat Rev Nephrol. 2016 May;12(5):263-4.

Pekmezci M, Nelson J, Su H, Hess C, Lawton MT, Sonmez M, Young WL, Kim H, Tihan T. Morphometric characterization of brain arteriovenous malformations for clinical and radiological studies to identify silent intralesional microhemorrhages. Clin Neuropathol. 2016 May-Jun;35(3):114-21.

Pérez XL, Liu KD. Critical Care Updates for the Nephrologist, 2016. Adv Chronic Kidney Dis. 2016 May;23(3):136-40.

Peters MC, Fahy JV. Metabolic consequences of obesity as an “outside in” mechanism of disease severity in asthma. Eur Respir J. 2016 Aug;48(2):291-3.

Peters MC, McGrath KW, Hawkins GA, Hastie AT, Levy BD, Israel E, Phillips BR, Mauger DT, Comhair SA, Erzurum SC, Johansson MW, Jarjour NN, Coverstone AM, Castro M, Holguin F, Wenzel SE, Woodruff PG, Bleecker ER, Fahy JV; National Heart, Lung, and Blood Institute Severe Asthma Research Program. Plasma interleukin-6 concentrations, metabolic dysfunction, and asthma severity: a cross-sectional analysis of two cohorts. Lancet Respir Med. 2016 Jul;4(7):574-84.

Prescott HC, Calfee CS, Thompson BT, Angus DC, Liu VX. Toward Smarter Lumping and Smarter Splitting: Rethinking Strategies for Sepsis and Acute Respiratory Distress Syndrome Clinical Trial Design. Am J Respir Crit Care Med. 2016 Jul 15;194(2):147-55.

Puntillo KA, Naidu R. Chronic pain disorders after critical illness and ICU-acquired opioid dependence: two clinical conundra. Curr Opin Crit Care. 2016 Aug 3.

Putcha N, Barr RG, Han MK, Woodruff PG, Bleecker ER, Kanner RE, Martinez FJ, Smith BM, Tashkin DP, Bowler RP, Eisner MD, Rennard SI, Wise RA, Hansel NN; SPIROMICS Investigators. Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the SPIROMICS cohort. Thorax. 2016 Mar 9.

Ramstein J, Broos CE, Simpson LJ, Ansel KM, Sun SA, Ho ME, Woodruff PG, Bhakta NR, Christian L, Nguyen CP, Antalek BJ, Benn BS, Hendriks RW, van den Blink B, Kool M, Koth LL. IFN-�-Producing T-Helper 17.1 Cells Are Increased in Sarcoidosis and Are More Prevalent than T-Helper Type 1 Cells. Am J Respir Crit Care Med. 2016 Jun 1;193(11):1281-91.

Razo-Vazquez AO, Thornton K. Extracorporeal Membrane Oxygenation-What the Nephrologist Needs to Know. Adv Chronic Kidney Dis. 2016 May;23(3):146-51.

Readdy WJ, Saigal R, Whetstone WD, Mefford A, Ferguson AR, Talbott JF, Inoue T, Bresnahan JC, Beattie MS, Pan J, Manley GT, Dhall SS. Failure of Mean Arterial Pressure Goals to Improve Outcomes Following Penetrating Spinal Cord Injury. Neurosurgery. 2016 May 3.

Reber LL, Fahy JV. Mast cells in asthma: biomarker and therapeutic target. Eur Respir J. 2016 Apr;47(4):1040-2.

Rocha C, Mendonça T, Silva ME, Gambús P. Erratum to: Individualizing propofol dosage: a multivariate linear model approach. J Clin Monit Comput. 2016 Feb 10.

Sapru A, Liu KD, Wiemels J, Hansen H, Pawlikowska L, Poon A, Jorgenson E, Witte JS, Calfee CS, Ware LB, Matthay MA; NHLBI ARDS Network. Association of common genetic variation in the protein C pathway genes with clinical outcomes in acute respiratory distress syndrome. Crit Care. 2016 May 23;20(1):151.

Sarin A, Litonius ES, Naidu R, Yost CS, Varma MG, Chen LL. Successful implementation of an Enhanced Recovery After Surgery program shortens length of stay and improves postoperative pain, and bowel and bladder function after colorectal surgery. BMC Anesthesiol. 2016 Aug 3;16(1):55.

Settecase F, Nicholson AD, Amans MR, Higashida RT, Halbach VV, Cooke DL, Dowd CF, Hetts SW. Onyx embolization of an intraosseous pseudoaneurysm of the middle meningeal artery in a patient with meningiomatosis, McCune-Albright syndrome, and gray platelet syndrome. J Neurosurg Pediatr. 2016 Mar;17(3):324-9.

Severinghaus JW. The Most Important Discovery of Science. Adv Exp Med Biol. 2016 876:1-16.

Severinghaus JW. Eight sages over five centuries share oxygen’s discovery. Adv Physiol Educ. 2016 Sep;40(3):370-6.

Seymour ZA, Sneed PK, Gupta N, Lawton MT, Molinaro AM, Young W, Dowd CF, Halbach VV, Higashida RT, McDermott MW. Volume-staged radiosurgery for large arteriovenous malformations: an evolving paradigm. J Neurosurg. 2016 Jan;124(1):163-74.

Sieren JP, Newell JD Jr, Barr RG, Bleecker ER, Burnette N, Carretta EE, Couper D, Goldin J, Guo J, Han MK, Hansel NN, Kanner RE, Kazerooni EA, Martinez FJ, Rennard S, Woodruff PG, Hoffman EA; SPIROMICS Research Group. SPIROMICS Protocol for Multicenter Quantitative CT to Phenotype the Lungs. Am J Respir Crit Care Med. 2016 Aug 2.



Spicer AC, Calfee CS, Zinter MS, Khemani RG, Lo VP, Alkhouli MF, Orwoll BE, Graciano AL, Boriosi JP, Howard JP, Flori HR, Matthay MA, Sapru A. A Simple and Robust Bedside Model for Mortality Risk in Pediatric Patients With Acute Respiratory Distress Syndrome. Pediatr Crit Care Med. 2016 Aug 3.

Stumpner J, Tischer-Zeitz T, Lotz C, Umminger J, Neuwirth A, Smul TM, Redel A, Kehl F, Roewer N, Lange M. The second window of desflurane-induced preconditioning is mediated by STAT3: role of Pim-1 kinase. Acta Anaesthesiol Scand. 2016 Jan;60(1):103-16.

Sun W, Kechris K, Jacobson S, Drummond MB, Hawkins GA, Yang J, Chen TH, Quibrera PM, Anderson W, Barr RG, Basta PV, Bleecker ER, Beaty T, Casaburi R, Castaldi P, Cho MH, Comellas A, Crapo JD, Criner G, Demeo D, Christenson SA, Couper DJ, Curtis JL, Doerschuk CM, Freeman CM, Gouskova NA, Han MK, Hanania NA, Hansel NN, Hersh CP, Hoffman EA, Kaner RJ, Kanner RE, Kleerup EC, Lutz S, Martinez FJ, Meyers DA, Peters SP, Regan EA, Rennard SI, Scholand MB, Silverman EK, Woodruff PG, O’Neal WK, Bowler RP; SPIROMICS Research Group; COPDGene Investigators. Common Genetic Polymorphisms Influence Blood Biomarker Measurements in COPD. PLoS Genet. 2016 Aug 17;12(8):e1006011.

Sun Z, Yue Y, Leung CC, Chan MT, Gelb AW; Study Group for Perioperative Stroke In China (POSIC); Study Group for Perioperative Stroke In China POSIC. Clinical diagnostic tools for screening of perioperative stroke in general surgery: a systematic review. Br J Anaesth. 2016 Mar;116(3):328-38.

Swann NC, de Hemptinne C, Maher RB, Stapleton CA, Meng L, Gelb AW, Starr PA. Motor System Interactions in the Beta Band Decrease during Loss of Consciousness. J Cogn Neurosci. 2016 Jan;28(1):84-95.

Sweerus K, Lachowicz-Scroggins M, Gordon E, LaFemina M, Huang X, Parikh M, Kanegai C, Fahy JV, Frank JA. Claudin-18 deficiency is associated with airway epithelial barrier dysfunction and asthma. J Allergy Clin Immunol. 2016 Apr 20.

Turner JA, Fitzsimons MG, Pardo MC Jr, Hawkins JL, Huang YM, Rudolph MD, Keyes MA, Howard-Quijano KJ, Naim NZ, Buckley JC, Grogan TR, Steadman RH. Effect of Performance Deficiencies on Graduation and Board Certification Rates: A 10-yr Multicenter Study of Anesthesiology Residents. Anesthesiology. 2016 Jul;125(1):221-9.

Undurraga Perl VJ, Leroux B, Cook MR, Watson J, Fair K, Martin DT, Kerby JD, Williams C, Inaba K, Wade CE, Cotton BA, Del Junco DJ, Fox EE, Scalea TM, Tilley BC, Holcomb JB, Schreiber MA; PROPPR Study Group. Collaborator: Steurer MP. Damage-

control resuscitation and emergency laparotomy: Findings from the PROPPR study. J Trauma Acute Care Surg. 2016 Apr;80(4):568-74; discussion 574-5.

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Pedram AleshiPrincipal InvestigatorAnesthesia Dept, 10/1/2014–9/30/2016Anesthesia Department Clinical Research Award$16,000

Benedict AlterPrincipal InvestigatorFAER, 7/1/2016–6/30/2017Mechanisms and Translational Application of Conditioned Analgesia in Post-operative Pain$75,000

Roland BaintonPrincipal InvestigatorAnesthesia Dept, 7/1/2015–6/30/2017Anesthesia Department Research Award$80,000

Principal InvestigatorNIH/NINDS, 2/1/2013–1/31/2017Discovering fundamental metabolic control processes of the blood brain barrier$430,002

Principal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department New Directions Award$20,000

Matthias BehrendsPrincipal InvestigatorAnesthesia Dept, 10/1/2014–6/30/2017Anesthesia Department Clinical Research Award$30,882

Philip BicklerPrincipal InvestigatorVarious Industry Sponsors, 9/1/1986–12/31/2016Accuracy of pulse oximeters with profound hypoxia$400,000

Marek BrzezinskiPrincipal InvestigatorGrifols Therapeutics Inc, 10/1/2015–10/31/2017A Prospective, Multicenter, Randomized, Double Blind, Placebo-Controlled Study to Evaluate the Safety and

Efficacy of Preoperative Antithrombin Supplementation in Patients Undergoing High-Risk Cardiac Surgery with Cardiopulmonary Bypass$300,000

Principal InvestigatorTrevena Inc, 10/1/2016–10/31/2017A Phase 3, open-label Study to Evaluate the Safety of Oliceridine (TRV130) in Patients with Acute Pain for Which Parenteral Opioid Therapy is Warranted$100,000

Anne DonovanPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Clinical Research Award$27,052

Richard FidlerPrincipal InvestigatorUC Center for Accelerated Innovation, 9/1/2016–8/31/2018UC Center for Accelerated Innovation$200,000

Michael GropperPrincipal InvestigatorGordon and Betty Moore Foundation, 10/1/2014–12/31/2016Implementation Grant for EMERGE at University of California, San Francisco$4,490,281

Principal InvestigatorFAER, 1/1/2016–12/31/20162016 Medical Student Anesthesia Research Fellowship Program$6,200

Zhonghui GuanPrincipal InvestigatorNIH/NINDS, 9/30/2012–8/31/2017Epigenetic regulation in neuropathic pain$947,160

Principal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Research Award$80,000

Monica HarbellPrincipal InvestigatorAnesthesia Dept, 10/1/2014–9/30/2017Anesthesia Department Clinical Research Award$16,000

Principal InvestigatorAnesthesia Dept, 10/1/2016-9/30/2017Anesthesia Department Clinical Research Award$35,867

Principal InvestigatorMt Zion Health Fund, 4/1/2015–3/31/2017Enhanced Recovery Program for Total Mastectomy Patients$29,420

Principal InvestigatorMt. Zion Health Fund, 6/1/2016–5/31/2017Enhancing Patient Care in Anesthesia through Use of a Cuff Manometer to Inflate the Endotracheal Tube Pilot Ballon$3,800

Tomoki HashimotoPrincipal InvestigatorNIH/NINDS, 3/15/2011–2/28/2017Intracranial aneurysm pathogenesis-roles of vascular remodeling and inflammation$1,674,637

Principal InvestigatorNIH/NINDS, 9/1/2013–5/31/2018The Role of Mast Cells in the Pathophysiology of Intracranial Aneurysm$1,726,306


Judith HellmanPrincipal InvestigatorNIH/NIGMS, 7/1/2012–6/30/2017Comprehensive Anesthesia Research Training$949,368

Principal InvestigatorSan Francisco Foundation, 1/1/2016–12/31/2016

San Francisco Foundation Award$125,000

Principal InvestigatorInternational Anesthesia Research Society, 7/1/2015–6/30/2018Endothelial Inflammatory Pathways in Septic Vasculopathy and Organ Injury$750,000

Principal InvestigatorMassachusetts General Hospital, 11/1/2015–10/31/2018Species Inspired Research for Innovative Treatments (SPIRIT)$482,050

Jan Hirsch Principal InvestigatorVA Office of Academic Affairs, 7/1/2013–6/30/2017VA Advanced Fellowship Program in Simulation$500,000

Irfan KathiriyaPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Research Award$80,000

Principal InvestigatorSociety for Pediatric Anesthesia, 1/1/2016–12/31/2016Mechanisms for Ventricular Septation$25,000

Helen KimPrincipal InvestigatorNIH/NINDS, 7/1/2013–6/30/2018Predictors of spontaneous cerebral AVM hemorrhage$2,335,649

Co-LeaderNIH/NINDS, 9/30/2014–7/31/2019Project 1: Modifiers of Disease Severity and Progression in Cerebral Cavernous Malformation$559,086

Sakura KinjoPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017

Anesthesia Department Clinical Research Award$31,699

Kerstin KolodziePrincipal InvestigatorAnesthesia Dept, 10/1/2014–6/30/2017Anesthesia Department Clinical Research Award$6,000

Jens KrombachPrincipal InvestigatorAnesthesia Dept, 10/1/2014–9/30/2016Anesthesia Department Clinical Research Award$16,000

Philip KurienPrincipal InvestigatorFAER, 1/1/2016–12/31/2017The Roles and Applications of Orexin/Hypocretin System in Anesthesia$175,000

Michael LawtonPrincipal InvestigatorNIH/NINDS, 9/30/2014–7/31/2019Brain Vascular Malformation Consortium: Predictors of Clinical Course$6,179,248

Jae-Woo LeePrincipal InvestigatorNIH/NHLBI, 5/1/2012–4/30/2017Human mesenchymal stem cell microvesicles for the treatment of acute lung injury$1,899,191

Co-Principal InvestigatorNina Ireland Program for Lung Health, 1/1/2015–12/31/2016Integrin Alpha-v Beta-5 Drive Pulmonary Vascular Leak from Ischemia-Reperfusion in Lung Transplantation$24,083


Active Research Grants

Grantscontinued from previous page



Jacqueline LeungPrincipal InvestigatorNIH/NIA, 6/1/2015–5/31/2017The Effects of Light vs Deep Anesthesia on Postoperative Cognitive Outcomes$444,033

Michael LipnickPrincipal InvestigatorHellman Fellows Fund, 7/1/2016–6/30/20182016-2017 Hellman Family Awards for Early Career Faculty$49,812

Bin LiuPrincipal InvestigatorNIH/NCI, 8/6/2012–7/31/2017Internalizing human antibody-targeted nanosized siRNA therapeutics$1,607,090

Principal InvestigatorMultiple Myeloma Research Foundation, 10/1/2015–9/30/2017Translational Development of a Novel Antibody-Drug Conjugates Against Myeloma$200,000

Martin LondonPrincipal InvestigatorAnesthesia Dept, 7/1/2015–6/30/2017Anesthesia Department Research Award $5,500

Jennifer LuceroPrincipal InvestigatorAnesthesia Dept, 7/1/2014–6/30/2017Anesthesia Department Research Award$20,520

Principal InvestigatorUCSF Academic Senate, 8/1/2015–1/31/2017Intravenous Nitroglycerin for Prevention of Hysterotomy Extension During Cesarean Delivery in the Second Stage of Labor$29,321

James MarksPrincipal InvestigatorNIH/NIAID, 2/1/2013–1/31/2018Generation of therapeutic antibodies for serotype F botulism$5,448,316

Principal InvestigatorCA Dept of Public Health, 10/15/2012–10/14/2016Identification of monoclonal antibody combinations that neutralize variant botulinum neurotoxins$-

Principal InvestigatorNIH/NCI, 9/24/2014–8/31/2019Antibody Technology Research Center$5,779,613

Principal InvestigatorNIH/NIAID, 6/20/2014–5/31/2017Trispecific Monoclonal Antibody for Botulinum Neurotoxin Intoxication Therapy$1,336,571

Principal InvestigatorDNA 2.0 Inc, 2/5/2013–2/5/2018Improve the CHO Expression of a scFv Fragment that is moving towards the clinic optimizing the DNA sequence of the scFv and/or leader sequence$–

Mervyn MazePrincipal InvestigatorNIH/NIGMS, 9/1/2013–8/31/2017Inflammation resolving mechanism dysregulation in postoperative cognitive decline$1,212,399

Co-Principal InvestigatorUCSF REAC, 7/1/2016–6/30/2017The Effects of Exercise “Prehabilitation” on Cognitive and Functional Recovery after Surgery in Older Adults$40,000

Claus NiemannPrincipal InvestigatorOregon Health and Science University, 1/1/2016–12/31/2018Donor Management Research Institute$2,027,268

Jonathan PanPrincipal InvestigatorFAER, 7/1/2014–3/31/2017Dexmedetomidine Renders Neuroprotection via Modulation of Systemic and Local Immune Responses Following Rodent Spinal Cord Injury$175,000


Ludmila PawlikowskaCo-LeaderNIH/NINDS, 9/30/2014–7/31/2019Genetic and Statistical Analysis Core (GSAC)$414,128

Arun Prakash BuddePrincipal InvestigatorNIH/NIGMS, 2/1/2015–1/31/2019Role of Innate Immune Cells and Pathways in Ventilated Lung Ischemia Reperfusion$790,560


Jeffrey SallPrincipal InvestigatorNIH/NIGMS, 3/1/2015–2/29/2020Testosterone’s role in sex-specific outcomes after early anesthesia$1,524,496

Jennifer Sasaki-RussellPrincipal InvestigatorUCSF Clinical Translational Research Institute, 7/1/2016–5/31/2017 Sex-specific Developmental Windows of Vulnerability in Early Anesthesia Exposure$45,444

Mark SchumacherPrincipal InvestigatorAnesthesia Dept, 1/1/2016–6/30/2017Anesthesia Department Research Award$80,000

David ShimabukuroPrincipal InvestigatorDascena, 8/1/2016–12/31/2016STTR Phase I: An Integrated Platform for the Analysis of Patient Health Record to Enable Predictive Clinical Decision Support$67,476

Una SrejicPrincipal InvestigatorAnesthesia Dept, 7/1/2015–6/30/2017Anesthesia Department Clinical Research Award$20,000

Hua SuPrincipal InvestigatorNIH/NINDS, 1/1/2014–12/31/2018Hemodynamics of Cerebral Arteriovenous Malformations$1,633,786

Principal InvestigatorNIH/NINDS, 4/15/2014–3/31/2017Soluble VEGF Receptor Therapy for Brain Arteriovenous Malformation$790,313

Principal InvestigatorNIH/NHLBI, 1/16/2015–12/31/2018Cell Type-Specific Influences on HHT Pathogenesis$1,582,037

Principal InvestigatorThe Community Foundation of Orange, 1/1/2013–OngoingMichael Ryan Zodda Foundation$10,000

Charlene SwiftPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Clinical Research Award$28,008

Pekka TalkePrincipal InvestigatorMasimo, 8/14/2013–12/31/2016Noninvasive hemoglobin (SpHb) measured with Pulse CO-Oximetry technology$71,440

Arthur WallacePrincipal InvestigatorNCIRE, 3/1/2012–3/1/2017Perioperative Outcomes Epidemiologic Consortium$150,000

Principal InvestigatorVA National Anesthesia Office, 1/2/2014–1/1/2017VA Anesthesia Quality Improvement Program$100,000

Principal InvestigatorECOM Medical, 8/1/2016–7/31/2017Impedance Cardiography: Clinical Evaluation of Endotracheal Cardiac Output Monitor (ECOM)$10,000

Principal InvestigatorObelab, 8/1/2016–7/31/2017Clinical Testing of NIRS for Quantitative Assessment of Depression and PTSD$100,000

Xiaobing YuPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Clinical Research Award$17,996

Wei ZhouPrincipal InvestigatorAnesthesia Dept, 7/1/2016–6/30/2017Anesthesia Department Research Award$65,839

Principal InvestigatorInternational Anesthesia Research Society, 7/1/2016–6/30/2018The Roles and Applications of Orexin/Hypocretin System in Anesthesia$150,000

Wan ZhuPrincipal InvestigatorHereditary Hemorrhagic Telanglectasia Foundation, 6/1/2015–9/30/2016An Innovative Gene Therapy by Selective and Regulative Neutralizing VEGF in HHT Associated Brain Arteriovenous Malformation$30,000

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DEPARTMENT CHAIR AND EDITOR-IN-CHIEF: Michael Gropper, MD, PhD

EDITOR:Morgen Ahearn

PRINCIPAL WRITER:Andrew Schwartz

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AnesthesiaNews


UCSF Anesthesia and Perioperative Care Annual Alumni Reception American Society of Anesthesiologists (ASA) MeetingSaturday, October 22, 2016 | 6:30pm – 10:30pmThe Gage Restaurant | 24 South Michigan Avenue | Chicago, IL 60603Passed Hors d’Oeuvres and Hosted BarPlease RSVP to Paperless Post Invitation. If not received, please contact: [email protected]

UCSF Maintenance of Certification in Anesthesia Simulator CourseThe American Board of Medical Specialties requires the American Board of Anesthesiology (ABA) to include practice performance assessment and improvement in Part IV of the Maintenance of Certification in Anesthesiology (MOCA®). The ABA recognizes simulation training as an innovative approach to assess a physician’s clinical and teamwork skills in managing critical events and included it in the Part IV Maintenance of Certification in Anesthesiology (MOCA®) requirements.

The Anesthesia Simulation Center of the UCSF Department of Anesthesia & Perioperative Care is endorsed by the American Society of Anesthesiologists for meeting the standards required for conducting ABA MOCA simulation courses.

Upcoming Course Dates:Friday, March 24, 2017Friday, April 21, 2017Friday, June 16, 2017For more information or to register, go to http://tiny.ucsf.edu/moca.

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