DEPARTMENT OF ANESTHESIOLOGY AND PERIOPERATIVE MEDICINE NEWS December 2018 Message from the Chair Fall 2018 was another successful era for our department, with many outstanding faculty, CRNA, resident, fellow, and staff achievements and contributions celebrated in this edition of the newsletter. Two annual award ceremonies that commend clinicians for their excellence – ACES and Cameos of Caring – honored our CRNAs Christine King, Kim Wysocki, Mary Beth Czerniak, and Bettina Dixon and UPMC Horizon/James Chief Dr. Cynthia Wells. Faculty, residents, and fellows presented their work at several scientific meetings – ASRA, Med Ed Day, and ANESTHESIOLOGY 2018, where we delivered over 60 presentations and served on many ASA committees. During my first few months as Chair, I have been honored to work with so many talented and accomplished individuals. As impressive as our department is and has been, as I begin my tenure as the newly appointed Chair, I am sharply focused on where we are going in the future and how we can push for even greater excellence. After meeting with all our Vice Chairs, Chiefs, Directors, and divisions, learning about different perspectives, and analyzing all aspects of our department over the past few months, I posit the following question to all our staff: What are our missions? What kind of department do we want to be? We’ve established quite a legacy as one of the best at what we do. How can we lead the way to undertake the changing healthcare landscape? Many new initiatives in the planning stages and currently underway will address these questions. First, in conjunction with our name change to the Department of Anesthesiology and Perioperative Medicine, we are expanding the role of anesthesiology in the health system and as a specialty. A wealth of patient data is already at our fingertips; we can leverage this valuable information into research that could transform patient care, translating into better and safer care and cost savings. We aim to establish a perioperative medicine database and we’re leading the charge to create a “Center for Perioperative Care” to optimize surgical patient care. With support from the health system, we’re building a Perioperative Data and Analytics team to improve patient care, quality, and operating room (OR) efficiency and explore new research topics. We’ve already proven success in this arena with our instrumental role in UPMC’s Enhanced Recovery Program, which implemented protocols that have reduced hospital length of stay by two to three days and decreased patient-controlled analgesia by 80% after complex abdominal surgery. Another important progression underway is that we are moving towards enhancement of our care team model that will expand the role of our CRNAs in managing patient care. This model allows physicians to shift their focus to patient needs, especially the cases that need the closest attention. We’ve been engaging all providers to work to the maximum abilities of their skill set to develop this new care team model. Our ultimate goal is to maximize our CRNAs’ skill set and create workflow efficiencies while maintaining a safe patient environment under the direction of the physician. We’re formulating a new infrastructure for our clinical and translational research. We recruited Kimberly Howard-Quijano MD, MS to serve in a newly developed role as our department’s Director of Translational Research. She is leading efforts to form a Clinical and Translational Research Committee and bring on some statisticians to support our research efforts. New investigators, including Drs. Bradley K. Taylor and Suzanne Doolen, were recruited over the past year to invigorate our basic science research. Key areas of scientific innovation currently underway include structure-based drug discovery, novel receptor engineering to develop new chronic pain treatments, genetic engineering advances to produce human and non-human disease models, and structural and computational approaches to solve neuronal receptor structures. Last, we’re focusing on faculty career development to foster our department’s next generation of leaders. Such efforts include FFAST (Faculty Fellow Advanced Scholarship Training Program) and a new perioperative medicine fellowship. We’re encouraging faculty to pursue advanced degrees in other health fields to launch subspecialty teams. One subspecialty we’re already had great success with is healthcare business and management. Numerous faculty members in our department have earned MBAs and led research on topics such as OR management, cost savings models, and OR staffing strategies. Our efforts in this area have led to successes such as seven consecutive years of awards won at the annual ASA Practice Management conference and our resident Dr. Evan Lebovitz receiving the ASA’s PRACTICE MANAGEMENT 2019 Emerging Leaders Scholarship. These initiatives are just the beginning. I expect us to keep evolving and improving as our legacy shows we can do. I thank every member of our department for their valuable contributions to our past successes and for their feedback and perspectives that have helped conceive these new efforts to launch our next era of prominence. Happy holidays to all our newsletter readers, which includes not only members of the department but alumni, supporters, and colleagues. Thanks so much for your interest in what we do. We look forward to updating you on our progress in our next newsletter. Aman Mahajan, MD, PhD, MBA Peter and Eva Safar Professor and Chair Director of Perioperative Services, University of Pittsburgh Physicians/UPMC
Transcript
DEPARTMENT OF ANESTHESIOLOGY AND PERIOPERATIVE MEDICINE
NEWS December 2018
Message from the Chair
Fall 2018 was another successful era for our department, with many outstanding faculty, CRNA, resident, fellow, and staff achievements and contributions celebrated in this edition of the newsletter. Two annual award ceremonies that commend clinicians for their excellence – ACES and Cameos of Caring – honored our CRNAs Christine King, Kim Wysocki, Mary Beth Czerniak, and Bettina Dixon and UPMC Horizon/James Chief Dr. Cynthia Wells. Faculty, residents, and fellows presented their work at several scientific meetings – ASRA, Med Ed Day, and ANESTHESIOLOGY 2018, where we delivered over 60 presentations and served on many ASA committees. During my first few months as Chair, I have been honored to work with so many talented and accomplished individuals.
As impressive as our department is and has been, as I begin my tenure as the newly appointed Chair, I am sharply focused on where we are going in the future and how we can push for even greater excellence. After meeting with all our Vice Chairs, Chiefs, Directors, and divisions, learning about different perspectives, and analyzing all aspects of our department over the past few months, I posit the following question to all our staff: What are our missions? What kind of department do we want to be? We’ve established quite a legacy as one of the best at what we do. How can we lead the way to undertake the changing healthcare landscape? Many new initiatives in the planning stages and currently underway will address these questions.
First, in conjunction with our name change to the Department of Anesthesiology and Perioperative Medicine, we are expanding the role of anesthesiology in the health system and as a specialty. A wealth of patient data is already at our fingertips; we can leverage this valuable information into research that could transform patient care, translating into better and safer care and cost savings. We aim to establish a perioperative medicine database and we’re leading the charge to create a “Center for Perioperative Care” to optimize surgical patient care. With support from the health system, we’re building a Perioperative Data and Analytics team to improve patient care, quality, and operating room (OR) efficiency and explore new research topics. We’ve already proven success in this arena with our instrumental role in UPMC’s Enhanced Recovery Program, which implemented protocols that have reduced hospital length of stay by two to three days and decreased patient-controlled analgesia by 80% after complex abdominal surgery.
Another important progression underway is that we are moving towards enhancement of our care team model that will expand the role of our CRNAs in managing patient care. This model allows physicians to shift their focus to patient needs, especially the cases that need the closest attention. We’ve been engaging all providers to work to the maximum abilities of their skill set to develop this new care team model. Our ultimate goal is to maximize our CRNAs’ skill set and create workflow efficiencies while maintaining a safe patient environment under the direction of the physician.
We’re formulating a new infrastructure for our clinical and translational research. We recruited Kimberly Howard-Quijano MD, MS to serve in a newly developed role as our department’s Director of Translational Research. She is leading efforts to form a Clinical and Translational Research Committee and bring on some statisticians to support our research efforts. New investigators, including Drs. Bradley K. Taylor and Suzanne Doolen, were recruited over the past year to invigorate our basic science research. Key areas of scientific innovation currently underway include structure-based drug discovery, novel receptor engineering to develop new chronic pain treatments, genetic engineering advances to produce human and non-human disease models, and structural and computational approaches to solve neuronal receptor structures.
Last, we’re focusing on faculty career development to foster our department’s next generation of leaders. Such efforts include FFAST (Faculty Fellow Advanced Scholarship Training Program) and a new perioperative medicine fellowship. We’re encouraging faculty to pursue advanced degrees in other health fields to launch subspecialty teams. One subspecialty we’re already had great success with is healthcare business and management. Numerous faculty members in our department have earned MBAs and led research on topics such as OR management, cost savings models, and OR staffing strategies. Our efforts in this area have led to successes such as seven consecutive years of awards won at the annual ASA Practice Management conference and our resident Dr. Evan Lebovitz receiving the ASA’s PRACTICE MANAGEMENT 2019 Emerging Leaders Scholarship.
These initiatives are just the beginning. I expect us to keep evolving and improving as our legacy shows we can do. I thank every member of our department for their valuable contributions to our past successes and for their feedback and perspectives that have helped conceive these new efforts to launch our next era of prominence.
Happy holidays to all our newsletter readers, which includes not only members of the department but alumni, supporters, and colleagues. Thanks so much for your interest in what we do. We look forward to updating you on our progress in our next newsletter.
Aman Mahajan, MD, PhD, MBA Peter and Eva Safar Professor and Chair
Director of Perioperative Services, University of Pittsburgh
Physicians/UPMC
News
Scott A. Brancolini, MD, MPH was appointed to the University of Pittsburgh School of Medicine Academy of Master Educators (AME) based upon his sustained record of excellence and achievements in medical education. The AME recognizes and rewards excellence in education, advances education through innovation and professional development of faculty, and supports and promotes educational scholarship. His appointment will become effective on January 1, 2019 for a five-year term. Read more Grace Lim, MD was invited to join the Obstetrical Anesthesiology Section in the Anesthesiology & Pain Management Faculty for F1000Prime as a contributing member. The F1000Prime Faculty comprises peer-nominated, internationally-renowned researchers across biology and medicine who review and recommend the articles they consider of greatest interest and merit. Read more Dr. Lim was also elected to the Association of University Anesthesiologists (AUA) as an Active Member. Read more Sanford M. Littwin, MD completed studies to earn his MBA from the University of Pittsburgh Joseph M. Katz Graduate School of Business in December 2018. In addition, Dr. Littwin was commended as one of the “Best and Brightest” graduates by Poets & Quants for Executives, who also posted a feature on him on their website A news story on WISER’s virtual reality work featuring William R. McIvor, MD, FASA aired on Monday, November 5, 2018 at 10PM on WPGH, Fox 53. The story also aired Tuesday, November 6, 2018 at 12PM on WPXI, Channel 11 and the weekend of November 10/11, 2018 on WPXI, Channel 11. Read more Tetsuro Sakai, MD, PhD, MHA, FASA was invited to the University of Kansas Department of Anesthesiology as part of their Visiting Professor Series. He presented the grand rounds lecture “Facilitation of Resident Scholarly Activity: A 12-Year Experience at UPMC” on October 2, 2018. Read more
Clinical Excellence Awards
Star Awards UPMC Physician Services Division “Star” awards recognize staff members for their excellence, commending those who go above and beyond and maintain a positive work attitude.
CRNAs Christine King (UPMC East) and Kim Wysocki (UPMC Presbyterian) won FY18 Annual “You Are a Star” Awards. Christine and Kim were honored at an employee recognition luncheon at The University Club on August 29, 2018. As annual Star Award winners, Christine and Kim also represented Physician Services as honored guests at the system-wide UPMC ACES ceremony (see next page). View photos from the luncheon
CRNA Patricia K. Kitt (UPMC Shadyside) received a Quarterly “You are a Star” Award for the 1st quarter of fiscal year 2019 (July 1 through September 30, 2018). Read more
ACES UPMC’s Award for Commitment and Excellence in Service (ACES) honors staff who exemplify UPMC’s five core values — Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, and Excellence & Innovation. Each year, fewer than one percent of UPMC staff from across the health system receive this honor.
Christine King, Kim Wysocki, and Cynthia M. Wells, MD were honored at the ACES Recognition Dinner on November 3, 2018 at the David L. Lawrence Convention Center. Read more
Cameos of Caring
The University of Pittsburgh School of Nursing’s Cameos of Caring® awards recognize exceptional bedside nurses who work at acute care hospitals and who are role models within their facility and beyond.
UPMC Presbyterian CRNAs Mary Beth Czerniak and Bettina Dixon were named Cameos of Caring® winners for 2018. Mary and Bettina were honored at the 2018 Cameos of Caring Gala on Saturday, December 1, 2018 at the David L. Lawerence Convention Center in Pittsburgh. Read more
Education Highlights
New Educational Grants Two curriculum development grant applications were accepted for funding for our second UPMC Anesthesiology Educational Grant 2018 funding cycle:
• “The Impact of a
Mindfulness App on Anesthesia Resident Wellbeing.” PIs: Phillip Carullo, MD and Phillip Adams, DO
• “Evaluation of an Innovative Checklist Intervention on Medical Student
Performance and Perceptions of Clinical Teaching Quality in an Anesthesiology Clerkship.” PI: Amanda Monahan, MD
Alumni Pass NBE Basic TEE Exam
Our resident alumni Drs. Kelsey Bauer, Ian Brotman, Kathleen Coy, Andrew Hulme, Kaarin Michaelson, David Nelson, Eugene Raggi, Daniel Springer, Sara Straesser,
Michael Thompson, Lieu Tran, and Nicole Verdecchia passed the July 2018 National Board of Echocardiography (NBE) Basic TEE (transesophageal echocardiography) Examination. Most of these physicians completed their required clinical training (150 basic TEE procedures reviewed + personally performed) during their residency and qualified to receive basic TEE certification from the NBE. Thanks to the TEE teaching experience provided by our cardiothoracic anesthesiologists in the operating room and during didactic lectures, as well as our June 2018 TEE Bootcamp for helping to bring this recent achievement to fruition. Dr. Evan Lebovitz Receives ASA Practice Management Emerging Leaders Scholarship Our PGY-4 resident Evan Lebovitz, MD was selected by the American Society of Anesthesiologists (ASA) Committee on Practice Management to receive the PRACTICE MANAGEMENT 2019 Emerging Leaders Scholarship. This scholarship was established to recognize outstanding 2nd-4th year anesthesiology residents who demonstrate aptitude and portray interest in leadership and practice management. This scholarship comes with a $1,000 award to go towards Dr. Lebovitz’s registration and travel to the 2019 ASA Practice Management Meeting, January 18-20, in Las Vegas, NV.
2019-2020 Pain Medicine Fellows Selected After a highly competitive recruitment season, we are proud to announce our incoming pain medicine fellows for the 2019-2020 academic year!
New Staff Join Department
Please join us in welcoming the following new staff who joined our department since our last newsletter that went out in August 2018: Faculty Lindsay Stollings, MD, Clinical Assistant Professor, UPMC Children’s Hospital of Pittsburgh Raymond S. Kelley, MD, Clinical Assistant Professor, UPMC Altoona Mallory E. Bugel, MD, Clinical Assistant Professor, UPMC Children’s Hospital of Pittsburgh Kimberly Howard-Quijano, MD, MS, Associate Professor; Director of Translational Research and Academic Chief of Cardiac Anesthesiology, Administration CRNAs Kristine A. Harp, UPMC Jameson Amber R. Kondrosky, UPMC Presbyterian Megan E. Lazur, UPMC East Adam Patrick, UPMC Presbyterian Nicolette M. Petrusic, UPMC Passavant Paige A. Tejera, UPMC Shadyside Krista B. Thomas, UPMC Presbyterian Staff Constance Chosky, Administrative Assistant, Intermediate, UPMC Presbyterian Erik Beeler, Research Specialist, Homanics Lab
In Memoriam: Jean Long
We sadly announce that Jean Long passed away on September 23, 2018. Jean was a CRNA who worked for over 17 years in our department. She first worked at UPMC Braddock and later at UPMC Monroeville Surgery Center until its recent closure. Prior to her career at UPMC, Jean worked at Pittsburgh Hospital in Wilkinsburg and Forbes Regional Hospital in Monroeville. Jean will be greatly missed by her fellow CRNAs and the physicians who worked alongside her during her long time with UPMC.
Justin Dumont, DO, MS Medical School: Edward Via
College of Osteopathic Medicine-Carolinas Campus Residency: UPMC, Physical
Medicine and Rehab
Alyson Engle, MD Medical School: George Washington University of
Medicine and Health Sciences
Residency: Johns Hopkins Hospital, Anesthesiology
Hayden Hundley, MD, MPH Medical School: University of
South Alabama College of Medicine Residency: UPMC,
Anesthesiology
Eric Magda, MD Medical School: Drexel
University School of Medicine
Residency: UPMC, Anesthesiology
Ankur Patel, MD Medical School: Virginia
Commonwealth University School of Medicine
Residency: The NYU Langone Medical Center,
Anesthesiology
Marissa Pavlinich, MD Medical School: University
of Pittsburgh School of Medicine
Residency: UPMC, Physical Medicine and Rehab
Neeraj Sriram, MD Medical School: University
of Alabama School of Medicine
Residency: University of North Carolina Hospitals,
Anesthesiology
Brandon Staub, MD, MS Medical School: University
of Nebraska College of Medicine Residency: UPMC,
Anesthesiology
Recent Publications
Abouleish AE, Hudson ME, Whitten CW. Measuring Clinical Productivity of Anesthesiology Groups: Surgical Anesthesia at the Facility Level. Anesthesiology. 2018 Sep 19. doi: 10.1097/ALN.0000000000002398. [Epub ahead of print]. Adams PS, Vargas D, Baust T, Saenz L, Koh W, Blasiole B, Callahan PM, Phadke AS, Nguyen KN, Domnina Y, Sharma M, Kellum JA, Sanchez-de-Toledo J. Associations of Perioperative Renal Oximetry Via Near-Infrared Spectroscopy, Urinary Biomarkers, and Postoperative Acute Kidney Injury in Infants After Congenital Heart Surgery: Should Creatinine Continue to Be the Gold Standard? Pediatr Crit Care Med. 2018 Nov 2. doi: 10.1097/PCC.0000000000001767. [Epub ahead of print]. Althoff FC, Neb H, Herrmann E, Trentino KM, Vernich L, Füllenbach C, Freedman J, Waters JH, Farmer S, Leahy MF, Zacharowski K, Meybohm P, Choorapoikayil S. Multimodal Patient Blood Management Program Based on a Three-pillar Strategy: A Systematic Review and Meta-analysis. Ann Surg. 2018 Nov 9. doi: 10.1097/SLA.0000000000003095. [Epub ahead of print]. Baumgardner JE. Where Did the Gas Go? Recruitment Versus Aeration. Crit Care Med. 2018 Nov;46(11):1873-1874. doi: 10.1097/CCM.0000000000003377. PubMed PMID: 30312233. Boisen ML, Iyer MH. Transesophageal Echocardiography Diagnosis of Tricuspid Valve Injury During AngioVac Percutaneous Pulmonary Embolectomy. CASE (Phila). 2018 Jul 27;2(5):181-185. doi: 10.1016/j.case.2018.05.003. eCollection 2018 Oct. Brinser ME, Seng DL, Mandell GL, Waters J, Dalby PL, Lim G. Neuraxial morphine after unintentional dural puncture is not associated with reduced postdural puncture headache in obstetric patients. J Clin Anesth. 2018 Sep 11;52:58-62. doi: 10.1016/j.jclinane.2018.09.009. [Epub ahead of print].
Brotman I, Kocher M, McHugh S. Bovine Hemoglobin-Based Oxygen Carrier Treatment in a Severely Anemic Jehovah's Witness Patient After Cystoprostatectomy and Nephrectomy: A Case Report. A A Pract. 2018 Sep 26. doi: 10.1213/XAA.0000000000000901. [Epub ahead of print]. Bykowski MR, Sivak W, Garland C, Cladis FP, Goldstein JA, Losee JE. A Multimodal Preemptive Analgesic Protocol for Alveolar Bone Graft Surgery: Decreased Pain, Hospital Stay, and Health Care Costs. Cleft Palate Craniofac J. 2018 Aug 2:1055665618791943. doi: 10.1177/1055665618791943. [Epub ahead of print]. Chelly JE, Lacouture PG, Reyes CRD. Safety of Injectable HPβCD-Diclofenac in Older Patients with Acute Moderate-to-Severe Postoperative Pain: A Pooled Analysis of Three Phase III Trials. Drugs Aging. 2018 Mar;35(3):249-259. doi: 10.1007/s40266-018-0529-3. Chou C, Snyderman C, Phillips D, Darby J. The Difficult Airway after Endoscopic Endonasal Skull Base Surgery: A Case Series and Management Algorithm. Otolaryngol Head Neck Surg. 2018 Aug 7:194599818789099. doi: 10.1177/0194599818789099. [Epub ahead of print]. Cladis FP, Mai CL, Yaster M, Davis PJ. The Advancement of Pediatric Anesthesia Pharmacology: David Ryan Cook (Scions, Serendipity, and Six Degrees of Separation). Paediatr Anaesth. 2018 Nov 10. doi: 10.1111/pan.13543. [Epub ahead of print]. Cooper AH, Brightwell JJ, Hedden NS, Taylor BK. The left central nucleus of the amygdala contributes to mechanical allodynia and hyperalgesia following right-sided peripheral nerve injury. Neurosci Lett. 2018 Aug 13;684:187-192. doi: 10.1016/j.neulet.2018.08.013. [Epub ahead of print]. Dalby PL, Gosman G. Crisis Teams for Obstetric Patients. Crit Care Clin. 2018 Apr;34(2):221-238. doi: 10.1016/j.ccc.2017.12.003. Epub 2018 Feb 1. Review. Darby JM, Halenda G, Chou C, Quinlan JJ, Alarcon LH, Simmons RL. Emergency Surgical Airways Following Activation of a Difficult Airway Management Team in Hospitalized Critically Ill Patients: A Case Series. J Intensive Care Med. 2018 Sep;33(9):517-526. doi: 10.1177/0885066616680594. Epub 2016 Nov 30. PubMed PMID: 27899469. DeAndrade DS, Smith NF, McHugh SM. Airway Compression During Transcatheter Aortic Valve Replacement Via Subclavian Artery Approach: A Case Report. A A Pract. 2018 Nov 12. doi: 10.1213/XAA.0000000000000927. [Epub ahead of print].
Image from Dr. Mihaela Visoiu Featured on Journal Cover The cover of the October 2018 issue of Pediatric Anesthesia was based on a publication co-authored by Mihaela Visoiu, MD, et al. published in the same issue. Dr. Visoiu was also directly credited for the photo.
for effective pain control after resection of large chest wall vascular malformation in a child with Phosphatase and Tensin (PTEN) hamartoma tumor syndrome. Pediatric Anesthesia. pp. 931-933, Volume 28, Issue 10, October 2018.
High Impact Publications from the Labs of Yan Xu, PhD and Pei Tang, PhD
The Journal of General Physiology research news article “Propofol’s paradox, explained” spotlighted a publication on work from the Xu/Tang labs:
• Wang Y, Yang E, Wells MM, Bondarenko V, Woll K, Carnevale V, Granata D,
Klein ML, Eckenhoff RG, Dailey W, Covarrubias M, Tang P, Xu Y. Propofol Inhibits the Voltage-Gated Sodium Channel NaChBac at Multiple Sites. J of General Physiology, doi: 10.1085/jgp.201811993 (2018)
Another Tang/Xu lab paper was published in the renowned open-access journal Nature Communications. The full text of the article can be accessed via the link in the below citation.
• Chen Q, Wells MM, Arjunan P, Tillman TS, Cohen AE, Xu Y, Tang P.
Structural basis of neurosteroid anesthetic action on GABA(A) receptors. Nat Commun. 2018 Sep 28;9(1):3972. doi: 10.1038/s41467-018-06361-4.
Ding X, Jin S, Shao Z, Xu L, Yu Z, Tong Y, Chen Z, Turnquist H, Pitt BR, Billiar TR, Zhang LM, Li Q. The IL-33-ST2 Pathway Contributes to Ventilator-Induced Lung Injury in Septic Mice in a Tidal Volume-Dependent Manner. Shock. 2018 Sep 5. doi: 10.1097/SHK.0000000000001260. [Epub ahead of print].
Ding X, Tong Y, Jin S, Chen Z, Li T, Billiar TR, Pitt BR, Li Q, Zhang LM. Mechanical ventilation enhances extrapulmonary sepsis-induced lung injury: role of WISP1-αvβ5 integrin pathway in TLR4-mediated inflammation and injury. Crit Care. 2018 Nov 16;22(1):302. doi: 10.1186/s13054-018-2237-0. Geube M, Knight J, Sale S. Severe Prosthetic Mitral Stenosis Misinterpreted as Severe Aortic Regurgitation. J Cardiothorac Vasc Anesth. 2018 Oct 19. pii: S1053-0770(18)30942-X. doi: 10.1053/j.jvca.2018.10.016. [Epub ahead of print]. Hruschak V, Cochran G, Wasan AD. Psychosocial interventions for chronic pain and comorbid prescription opioid use disorders: A narrative review of the literature. J Opioid Manag. 2018 Sep/Oct;14(5):345-358. doi: 10.5055/jom.2018.0467. Javid FA, Afshin-Javid S, Horn CC. Further investigation of the effects of 5-hydroxytryptamine, 8-OH-DPAT and DOI to mediate contraction and relaxation responses in the intestine and emesis in Suncus murinus. Eur J Pharmacol. 2018 Feb 15;821:79-87. doi: 10.1016/j.ejphar.2017.12.051. Epub 2017 Dec 23. Jonassaint CR, Rao N, Sciuto A, Switzer GE, De Castro L, Kato GJ, Jonassaint JC, Hammal Z, Shah N, Wasan A. Abstract Animations for the Communication and Assessment of Pain in Adults: Cross-Sectional Feasibility Study. J Med Internet Res. 2018 Aug 3;20(8):e10056. doi: 10.2196/10056. Kamdar N, Huverserian A, Regev A, Beck L, Mahajan A. Telemedicine for Anesthesiologists: Preoperative Evaluation and Beyond. ASA Monitor, October 2018, Vol.82, 16-19. Larach MG, Klumpner TT, Brandom BW, Vaughn MT, Belani KG, Herlich A, Kim TW, Limoncelli J, Riazi S, Sivak EL, Capacchione J, Mashman D, Kheterpal S, on behalf of the Multicenter Perioperative Outcomes Group; Succinylcholine Use and Dantrolene Availability for Malignant Hyperthermia Treatment: Database Analyses and Systematic Review. Anesthesiology 2018. doi: 10.1097/ALN.0000000000002490. Lim G. Labor Pain's Relationship With Depression: From Whence, and What Shall be Done? Anesth Analg. 2018 Oct 9. doi: 10.1213/ANE.0000000000003856. [Epub ahead of print]. Lin CJ, Luke C, Sullivan D, Kidwell R. Development of specific peripheral nerve block consent form. J Clin Anesth. 2018 Nov 1;54:33-36. doi: 10.1016/j.jclinane.2018.10.030. [Epub ahead of print]. Lin SY, Zhang SZ, An JX, Qian XY, Gao XY, Wang Y, Zhao WX, Eastwood D, Cope DK, Williams JP. The effect of ultrasound-guided percutaneous ozone injection around cervical dorsal root ganglion in zoster-associated pain: a retrospective study. J Pain Res. 2018 Oct 4;11:2179-2188. doi: 10.2147/JPR.S163340. eCollection 2018 Littwin S, Lebovitz EE. Anesthesia Clean Up: A MESI Project. ASA Monitor, October 2018, Vol.82, 58-59. Lu GF, Zhang JM, An JX, Oian XY, Wang Y, Lin SY, Williams JP. Enhanced Pain Sensitivity with Systemic Ultrastructural Changes of the Nervous Systems after Cobra Venom Injection is Reversed by Electroacupuncture Treatment. Pain Physician. 2018 Sep;21(5):E509-E521. Malek MM, Landmann A, Visiou M. Re: Abdominal wall blocks to decrease pain in pediatric surgery. Surgery. 2018 Aug 31. pii: S0039-6060(18)30383-0. doi: 10.1016/j.surg.2018.06.037. [Epub ahead of print].
The resident physician-anesthesiologists and nurse anesthetists from UPMC have organized a night of good music, drinks, and appetizers at the Pittsburgh Aquarium, where attendees can enjoy networking with colleagues from around the city, share best practices, and raise money for a local organization that treats opioid addiction within the Pittsburgh community. This event is sponsored by the UPMC Health Plan, the Pennsylvania
Society of Anesthesiologists (PSA), and the Pennsylvania Association of Nurse Anesthetists (PANA). Please visit the event webpage for more info about the event, buy tickets, and/or donate to the cause. Grand Rounds: To Space and Beyond: What Space Travel Can Teach Us About Patient Safety Presented by: Matthew E. Melis, Aerospace Engineer, NASA Glenn Research Center, Cleveland, OH March 21, 2019, 4:00-7:00pm Passavant Conference Center & Legacy Theatre See the event page on our website for more details.
Methangkool E, Howard-Quijano K, Mahajan A. Cardiac Dysrhythmias: Understanding Mechanisms, Drug Treatments, and Novel Therapies. Adv Anesth. 2018 Dec;36(1):181-199. doi: 10.1016/j.aan.2018.07.008. Epub 2018 Sep 27. Review. McCrum CL, Ben-David B, Shin JJ, Wright VJ. Quadratus lumborum block provides improved immediate postoperative analgesia and decreased opioid use compared with a multimodal pain regimen following hip arthroscopy. J Hip Preserv Surg. 2018 Oct 25;5(3):233-239. doi: 10.1093/jhps/hny024. eCollection 2018 Aug. Niu K, Liu H, Chen RW, Fang QW, Wen H, Guo SM, Williams JP, An JX. Use of propofol for prevention of post-delivery nausea during cesarean section: a double-blind, randomized, placebo-controlled trial. J Anesth. 2018 Sep 12. doi: 10.1007/s00540-018-2549-x. [Epub ahead of print]. Orebaugh SL. An Afterthought on "Standard of Care". Reg Anesth Pain Med. 2018 Nov; 43(8):893-894. doi: 10.1097/AAP.0000000000000854. Pearson ACS, Dodd SE, Kraus MB, Ondecko Ligda KM, Hertzberg LB, Patel PV, Chandrabose RK. Pilot Survey of Female Anesthesiologists' Childbearing and Parental Leave Experiences. Anesth Analg. 2018 Sep 27. doi: 10.1213/ANE.0000000000003802. [Epub ahead of print]. Petty K, Waters JH, Sakamoto SB, Yazer MH. Antenatal anemia increases the risk of receiving postpartum red blood cell transfusions although the overall risk of transfusion is low. Transfusion. 2018 Feb;58(2):360-365. doi: 10.1111/trf.14434. Epub 2017 Dec 1. Phrampus PE. Simulation and Integration into Patient Safety Systems. Simul Healthc. 2018 Aug;13(4):225-226. doi: 10.1097/SIH.0000000000000332. Rompala GR, Simons A, Kihle B, Homanics GE. Paternal Preconception Chronic Variable Stress Confers Attenuated Ethanol Drinking Behavior Selectively to Male Offspring in a Pre-Stress Environment Dependent Manner. Front Behav Neurosci. 2018 Nov 2;12:257. doi: 10.3389/fnbeh.2018.00257. eCollection 2018. Saddic LA, Howard-Quijano K, Kipke J, Kubo Y, Dale EA, Hoover DB, Shivkumar K, Eghbali M, Mahajan A. Progression of myocardial ischemia leads to unique changes in immediate early gene expression in the spinal cord dorsal horn. Am J Physiol Heart Circ Physiol. 2018 Sep 14. doi: 10.1152/ajpheart.00337.2018. [Epub ahead of print]. Schott NJ, Emery SP, Garbee C, Waters J. Thromboelastography in term neonates. J Matern Fetal Neonatal Med. 2018 Oct;31(19):2599-2604. doi: 10.1080/14767058.2017.1349747. Epub 2017 Jul 11. Silverstein RG, Centore M, Pollack A, Barrieau G, Gopalan P, Lim G. Postpartum psychological distress after emergency team response during childbirth. J Psychosom Obstet Gynaecol. 2018 Sep 11:1-7. doi: 10.1080/0167482X.2018.1512095. [Epub ahead of print]. Temirov T, Ben-David B, Mustafin A, Viderman D. Erector Spinae Plane Block in Management of Pain After Kidney Transplantation. Pain Med. 2018 Nov 8. doi:10.1093/pm/pny221. [Epub ahead of print]. Tran LT, Mazariegos GV, Damian D, Davis PJ. Red Blood Cell Transfusion in Pediatric Orthotopic Liver Transplantation: What a Difference a Few Decades Make. Anesth Analg. 2018 Oct 3. doi: 10.1213/ANE.0000000000003832. [Epub ahead of print]. Visoiu M, Scholz S. Thoracoscopic and Ultrasound Guidance for Optimization of Medication Spread during Thoracic Paravertebral Nerve Blockade. Anesthesiology. 2018 Aug 24. doi: 10.1097/ALN.0000000000002411. [Epub ahead of print]. Waters JFR, OʼNeal MA, Pilato M, Waters S, Larkin JC, Waters JH. Management of Anesthesia and Delivery in Women with Chiari I Malformations. Obstet Gynecol. 2018 Oct 5. doi: 10.1097/AOG.0000000000002943. [Epub ahead of print].
Scientific Meeting Recap ASRA Our following department members participated in the American Society of Regional Anesthesia and Pain Medicine (ASRA) 17th Annual Pain Medicine Meeting on November 15-17, 2018 in San Antonio, TX:
• Hariharan Shankar, MBBS and Andrew Hall, MD: Matching into Your Top
Pain Medicine Fellowship: Strategies for Success
• Scott A. Brancolini, MD, MPH served as Chair of the Pain Program
Directors breakout session as President of the Association for Pain Program Directors
• Ajitpal Grewal, MD and Sharad K. Khetarpal, MBBS, MD, FFARCSI:
Complete Brachial Plexopathy after Open Reduction Internal Fixation of Clavicle Fracture: Is Interscalene Nerve Block to Blame?
Med Ed Day Several department members participated in the University of Pittsburgh School of Medicine (UPSOM) Academy of Master Educators (AME) 3rd annual Med Ed Day on September 21, 2018. The event celebrates the educational innovations and scholarship of students, fellows, residents, and faculty across all Pitt schools of the health sciences. The event is sponsored by the AME in partnership with the Office of Faculty Affairs, UPSOM Office of the Vice Dean, and the Office of Academic Career Development. Residents Luke Davanzo, MD; Daniel P. Huettner, MD; and Anusari Dewasurendra, MD; adult cardiothoracic anesthesiology fellow Daniel Mandell, MD; and faculty members Kristin M. Ondecko Ligda, MD, FASA and Phillip Adams, DO presented posters on a variety of education topics. Dr. Adams’ poster, “Faculty Demonstrate Higher Well-being than Residents: Pennsylvania Anesthesiology Programs Results of the 2017-2018 ACGME Well-being Survey” won the Best Overall Poster Award at the event. Tetsuro Sakai, MD, PhD, MHA, FASA was a panel member for the discussion "How to Turn Medical Education into Scholarship." View photos of our participants at 2018 MedEd Day ANESTHESIOLOGY 2018
The American Society of Anesthesiologists (ASA), an educational, research, and scientific association of physicians organized to raise and maintain medical practice standards of anesthesiology and improve patient
care, is one of the largest and most influential professional societies in the specialty. The ASA Annual Meeting features new scientific developments, technology, and challenging cases in the field of anesthesiology. An impressive number of medical students, residents, fellows, and faculty from our department participate in the ASA meeting every year. ANESTHESIOLOGY 2018 was held October 13-17 in San Francisco, CA. Department members delivered 62 presentations, and 24 faculty members and two fellows served on ASA and ASA-
UPMC CRNA Conference March 22-24, 2019 Nemacolin Woodlands Resort, Farmington, PA Please visit the event page on our website.
2019 Safar Symposium and Multidepartmental Trainees’ Research Day April 22-23, 2019 Day 1: Rangos Research Conference Center, UPMC Children’s Hospital of Pittsburgh Day 2: Peter M. Winter Institute for Simulation, Education and Research (WISER) This yearly event honors the late Dr. Peter Safar (founding Chair of the Department of Anesthesiology and Critical Care Medicine) and his wife Eva for their contributions to the scientific community and highlights current research in areas spanning Dr. Safar’s interests. Save the date and visit the event page on our website for more details as they are released.
UPMC Update in Anesthesia, Pain, and Intensive Care April 26-28, 2019 (All day) Nemacolin Woodlands Resort Save the date and visit the event page on our website for more info as it becomes available.
Anesthesia Team Serves on Medical Mission Trip in Guatemala Operation Walk Pittsburgh is a volunteer organization serving the mission of providing life-changing education, service, and surgery completely free of cost to patients in Pittsburgh and around the world. The group has organized many mission trips across Central America to provide the gift of mobility to patients in need. Each mission trip involves a team of surgeons, nurses, and other personnel who provide joint replacements and arthritis and joint health
education. These trips offer more than just life-changing surgeries; they are opportunities for cultural exchange and international medical cooperation. Since the group’s inception in 2009, anesthesiologists from UPMC and other hospitals and organizations both locally and across the US have participated in Operation Walk missions, including UPMC Magee-Womens, UPMC Passavant, UPMC Shadyside, and Butler Memorial Hospitals. Several anesthesiologists and CRNAs from our department participated in Operation Walk’s 2018 mission to Antigua, Guatemala. Our team members were Wende A. Goncz, DO, MMM, CJCP (Anesthesia Team Leader and Coordinator), Sharad K. Khetarpal, MBBS, MD, FFARCSI, and CRNAs Francis Feld (UPMC Passavant), Charles D. Klingensmith (UPMC Passavant), and Catherine Mock (UPMC St. Margaret). Before and during the mission, the Operation Walk team partnered with local physicians and care providers to screen nearly 70 surgical candidates; 40 patients were selected for surgery. After a group education class with patients, their families, and local staff, four patients received joint replacements. Over the next three days, the other 36 patients received 47 knee and hip replacements. The Operation Walk team, comprising 69 physicians, physician assistants, nurses, therapists, techs, translators, and other volunteer caregivers, partnered with local staff to care for the patients. Many of these patients had not walked without severe pain or deformity for most of their lives. Within just a few hours after surgery, they took their first steps towards recovery and a new-found quality of life. By the time the team left the following week, all the patients had returned to their homes. All have had their first follow up appointments with the local team and are doing remarkably well. In just one week, the Operation Walk Pittsburgh team provided life-changing services to the people and communities of Antigua, Guatemala at no cost. In addition to providing life-changing surgeries, the group also provided 15 pallets of equipment and 8,000 pounds of implants, instruments, medications, crutches, walkers and other medical supplies.
Department Hosts 2018 FAER Medical Student Anesthesia Research Fellows
The Department of Anesthesiology and Perioperative Medicine was one of 36 sites nationwide selected to host 2018 Foundation for Anesthesia Education and Research (FAER) Medical Student Anesthesia Research Fellows (MSARF). FAER created the
MSARF program to encourage talented medical students to consider careers in anesthesiology and perioperative medicine research. The program offers medical students an eight-week anesthesia-related research experience, clinical experience, and the opportunity to present research findings at the American Society of Anesthesiologists annual meeting.
related committees. Our yearly alumni reception was held on Sunday, October 14th from 6-9 pm at the San Francisco Marriott Marquis, Yerba Buena Salons 1 and 2. Our 2018 ASA flier (PDF) shows all department presentations and participation in committees at the 2018 meeting. In addition to these presentations, the following faculty members presented at subspecialty and anesthesia-related group meetings taking place in San Francisco immediately before the ASA meeting:
• Howard B. Gutstein, MD was a plenary speaker at the International Society for
Anesthetic Pharmacology meeting on October 12. He presented the lecture “Molecular Approaches to Reducing Opioid Tolerance.”
Analgesia for Liver Surgery/Liver Transplantation at the International Liver Transplantation Society/ASA Perioperative Care in Liver Transplantation Meeting on October 12.
The UPMC anesthesiology residents, led by PGY-1 residents Elizabeth Pickle, MD and Samuel Atherton, MD, organized a team, “UPMC Pavement Pushers,” to run at
the 9th Annual ASA-sponsored “Run for The Warriors” on Sunday, October 14 as part of the ASA 2018 annual meeting. The race was a fundraiser for the charity Hope for the Warriors, which benefits military members and their families who have suffered losses. The team raised over $1,100 for the cause.
Pain Medicine Competes in Halloween Pumpkin Competition The Pain Medicine Staff at UPMC Children’s Hospital of Pittsburgh (CHP), UPMC Mercy, and UPMC St. Margaret submitted these works of art for UPMC’s Halloween Pumpkin Contest!
UPMC Presbyterian/Montefiore CRNAs Continue Annual Holiday Breakfast Tradition Our CRNAs at UPMC Presbyterian/Montefiore continued their annual holiday breakfast tradition for 2018. Every year, CRNA clinical site directors Helen Defranco, Dale Fleck, and Debbie Weimer host this event to thank the Presbyterian/Montefiore CRNAs for their continuous hard work, dedication, and contributions to quality patient care. View photos from the 2018 breakfast
CHP Mercy St. Margaret
Summer 2019 Anesthesiology Research Fellowship Applications Due January 31, 2019 Our department regularly serves as a host site for the Foundation for Anesthesia Education and Research (FAER) Medical Student Anesthesia Research Fellowship (MSARF). Since 2008, the University of Pittsburgh has hosted 19 medical students in this summer research fellowship program, some from the University of Pittsburgh School of Medicine as well as from other institutions. The FAER MSARF Summer 2019 Program application website is now accepting applications through January 31, 2019. Medical students who participate in the summer anesthesia research fellowship will be provided with:
• Eight weeks of focused research related to anesthesiology in addition to clinical
shadowing time
• A dedicated mentor who will provide training in research techniques and scientific
methods (research labs are located here at the University of Pittsburgh as well as at other universities)
• The opportunity to present a scientific poster or oral presentation during the FAER
MSARF Symposium held at the at the American Society of Anesthesiology (ASA) ANESTHESIOLOGY® annual meeting
• A $400 per week student stipend, ASA student membership dues, plus additional funds
to help cover the costs of travel to the ANESTHESIOLOGY® annual meeting
Important Dates:
• Dec. 1, 2018: Application website opens
• Jan. 31, 2019: Application deadline
Please visit the FAER MSARF website for more information and to download the complete 2019 MSARF Summer Program Information guide that covers eligibility requirements, application instructions, information on the stipend and funding, and student and host department responsibilities. For questions, please contact Sandy Hirsch.
Austin Cusick is currently a second-year medical student at the Ohio University Heritage College of Osteopathic Medicine. He worked with mentor James W. Ibinson, MD, PhD on the project “Identification of an Imaging-based Biomarker for Pain.” This research analyzes the correlating connection between areas of the brain in response to a chronic pain patient’s acute exacerbation, as well as the emotional aspects of pain to see if pain is correlated to negative emotional affect. Jeffrey Johnson is currently a second-year medical student at Florida State University College of Medicine. He worked with mentor Dr. James Ibinson on a project titled “Determination of the Neural Correlates of Post-Operative Cognitive Dysfunction.” This pilot study looks at post-operative cognitive dysfunction, a process that affects the elderly who undergo surgery and perioperative care. This process is not well studied and as such, the team set out to find markers of the dysfunction in the brain through MRI imaging. An image processing pipeline was developed for MRI scans acquired at one week before, one week after, and three months after surgery to track changes in the brain. Both Austin and Jeff presented their work at the FAER MSARF Symposium at the 2018 ASA meeting. The FAER MSARF program is currently accepting applications for Summer 2019. See below for more details.
University of Pittsburgh Department of Anesthesiology and Perioperative Medicine A-1305 Scaife Hall, 3550 Terrace Street Pittsburgh, PA, 15261 (412) 647-2994 www.anesthesiology.pitt.edu
