Anesthesiology Commons^™

Assessing The Impact Of Interprofessional Simulation Training On Perioperative Staff's Confidence In Managing Maternal Hemorrhage, Mallory Duncan, Lidia Vazquez

Scholars Week

Globally, maternal mortality rates remain a critical public health challenge, often related to inadequate healthcare infrastructure in low-income countries. Yet according to the American Journal of Obstetrics and Gynecology (ACOG), maternal mortality rates in the United States are also on the rise, with nearly 32.9 deaths per 100,000 live births. These deaths are largely contributed to maternal hemorrhage (PPH), defined by ACOG as cumulative blood loss of at least 1,000 mL accompanied by symptoms of hypovolemia within 24 hours of the birth process. These findings underscore an urgent need to strengthen the training for perioperative staff in the management of …

The Influence Of Older Age On Rbc Transfusion Decisions In Icu Patients, Caroline Schaap, Jorinde Raasveld, Florian Reizine, Boillot Corentin, Jimmy Schenk, Sanne De Bruin, Merijn Reuland, Claudia Van Den Oord,, Andrew Flint, Marcus Lance

Anaesthesiology, East Africa

Objectives: RBC transfusions are common in the ICU. Recent studies suggest that a restrictive transfusion policy is noninferior or superior to a liberal policy. However, few studies focus on the influence of age in transfusion. In elderly ICU patients, reduced physiologic reserves may shift the perceived risk-benefit balance of transfusion, potentially leading to different transfusion practices. This study examines whether transfusion practices in ICU patients differ across patient age.

Design: This is a substudy of the International Point Prevalence Study of ICU Transfusion Practices (InPUT), a global, multicenter, prospective observational cohort study.

Setting: ICUs from 233 centers …

Incidence Of High Volume Residual Gastric Content In Perioperative Patients Taking Glucagon-Like Peptide-1 Receptor Agonists, And Its Dependence On The Duration Of Preoperative Fasting And Drug Holding: A Prospective Observational Study, Marissa Huggins, Ion Hobai

Cumberland Medica

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide and dulaglutide, are increasingly prescribed for type 2 diabetes mellitus and obesity. These agents delay gastric emptying and have been associated with a higher incidence of unexpected full stomachs in procedural patients. To prevent pulmonary aspiration, current recommendations include extending preoperative fasting (e.g., 24 hours instead of the standard 8 hours) and/or withholding the GLP-1RA medication before surgery (≥1 drug half-lives). However, the efficacy of these strategies have remained unclear and are evaluated in this study.

Hypothesis: GLP-1RA use in surgical patients is associated with increased incidence and volume of residual gastric …

Airway Management In Thoracic Anesthesia: Eactaic Consensus Document, Manuel Granell, Caroline Vanpeteghem, Jo Mourisse, Mert Senturk, Laszlo Szegedi, Mohamed El Tahan, Chirojit Mukherjee, Izumi Kawagoe, Waheed Karzai, Marcus Lance

Anaesthesiology, East Africa

This article is the third in a series of articles prepared as part of a comprehensive, international and professional society–approved consensus project to advise on thoracic anesthesia. It represents the views and structured opinions of experts delegated to the Airway Management Task Force of the Thoracic Subcommittee of the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC). This review highlights the main concepts and expert opinion of international leaders on the task of lung isolation and separation, as well as the current recommendations on the benefits and disadvantages of different devices in both routine and difficult airway scenarios. The …

Monitoring In Thoracic Anesthesia: Eactaic Consensus Document, Mohamed El Tahan, Edda Tschernko, Tamás Végh, Jo Mourisse, Mert Sentürk, Katarina Lenartova, Maria Alberici, Thomas Wasserscheid, Nandor Marczin, Marcus Lance

Anaesthesiology, East Africa

This is the first part of a series of articles prepared for a comprehensive, international, and professional society–approved consensus project to advise on thoracic anesthesia. It represents the views and structured opinions of experts delegated to the General Management: Monitoring Task Force of the Thoracic Subcommittee of the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC). This review highlights international leaders’ main concepts and expert opinions on how monitoring is the core task of anesthesiologists involved in the care of thoracic patients, providing recommendations for assessing principal organ systems and using different devices in routine and specialized scenarios. The …

Propofol In Chronic Cannabis Users: A Mechanistic Link To Cannabinoid Hyperemesis?, Jonmark I. Dolendo, Sonia Frick, Jia Q. Yang, Brad A. Haubrich

Annual Research Symposium

Purpose: Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclic nausea, vomiting, and abdominal pain in chronic cannabis users, often relieved by exposure to hot water. Propofol, a widely used GABAergic anesthetic with antiemetic properties, has paradoxically been implicated in exacerbating hyperemetic episodes in some cannabis users. With the growing legalization of marijuana and social acceptance to its recreational use it is believed that this phenomenon will be more ubiquitous to clinicians. This review aims to investigate the mechanistic and clinical evidence linking propofol administration to CHS and to summarize strategies for prevention, diagnosis, and management.

Methods: PubMed and EBSCO were …

Relationship Between Navigation Success, Diagnostic Accuracy, And Ventilation Strategy: Retrospective Chart Review Of 224 Consecutive Navigational Bronchoscopic Procedures Performed Under General Anesthesia, Basavana Goudra, Prarthna Chandar, Divakara Gouda, Harrison Yang, Ganan Muhunthan, Suvan Sundaresh, Michael Stuart Green

Department of Medicine Faculty Papers

Background: Navigational bronchoscopy (NB) enables precise sampling of peripheral and central pulmonary nodules using shape-sensing or electromagnetic guidance. A major challenge is anesthesia-induced atelectasis, which alters lung anatomy, reduces registration accuracy, and is known to lower diagnostic accuracy. To counteract this, ventilatory protocols such as the Ventilatory Strategy to Prevent Atelectasis (VESPA) and the Lung Navigation Ventilation Protocol (LNVP) have been recommended. Their adoption and clinical impact, however, remain uncertain. Methods: We conducted a retrospective review of 224 consecutive NB procedures performed under general anesthesia at a single academic medical center (January 2020–August 2024). Demographic, anesthetic, and ventilatory data were …

Patient, Family And Clinician Priorities For Critical Care Research In Asia And Africa: A James Lind Alliance Priority Setting Partnership Using Modified Delphi And Nominal Group Techniques, Ccaa Priority Setting Partnership Steering Group, Teddy Abonyo, Sumaiya Arfin, Diptesh Aryal, Abi Beane, Martina Borellini, Arjen Dondorp, Emma Donley, Punam Gautam, Tiffany Gooden

Anaesthesiology, East Africa

Background This James Lind Alliance (JLA) Priority Setting Partnership aimed to identify and prioritise unanswered questions important to adult patients, their families and health professionals with lived experience of critical care across Asia and Africa.

Methods Modified Delphi techniques were used to generate suggestions using an online survey. Following verification, literature review and content analysis, these suggestions were iteratively codified into emergent topics. Topics were presented in a second online survey for ranking, prior to an online workshop where nominal group technique was used to identify top priority questions across stakeholder groups. Surveys were disseminated using snowballing techniques.

Findings The …

A Predictive Tool Using The Society Of Thoracic Surgeons Risk Calculator For Safe Operating Room Extubation After Coronary Bypass Surgery, John G. Byrne, Farhaan Chaugle, Thomas Kessinger, Prince Thommen, Ali Asghar, Shahistha Hyder, Curtis Dickey, Nicole Blatt, Hannan Chaugle

Gulf Coast Division GME Research Day 2026

No abstract provided.

Chronic In Utero Oxycodone Exposure Alters Placental Small Ev Proteome And Fetal Cardiomyopathy-Linked Pathways, Amin Foroughi Nezhad, Dalia Moore, Victoria L. Schaal, Tousif Ahmed Hediyal, Elizabeth Stone, Sree Kolli, Pranavi Athota, Omar Shukri, Sowmya V. Yelamanchili, Gurudutt Pendyala

Journal Articles: Anesthesiology

Aim: The rising prevalence of opioid use during pregnancy poses serious public health concerns. The placenta is a critical organ during gestation, and opioid exposure can disrupt its function and fetal development. However, the molecular mechanisms through which opioids such as oxycodone affect feto-placental development remain poorly understood. This study aimed to investigate the effects of chronic in-utero oxycodone exposure on the composition and signaling functions of placenta-derived small extracellular vesicles (PSEVs) using a rat model.

Methods: Extracellular vesicles (EVs) were isolated from placental tissue and characterized through nanoparticle tracking analysis, transmission electron microscopy, western blotting, and label-free quantitative proteomics. …

Compensatory Responses To Glaucoma Pathology In The Dorsolateral Geniculate Nucleus, Shaylah Mccool, Arnav Jain, Jennie C. Smith, Victoria L. Schaal, Gurudutt Pendyala, Sowmya V. Yelamanchili, Matthew J. Van Hook

Journal Articles: Anesthesiology

Glaucoma disrupts the conveyance of retinal signals to visual regions of the brain such as the dorsolateral geniculate nucleus (dLGN) due to degeneration of retinal ganglion cells (RGCs) and their axons. Although plasticity during development allows altered visual experience to modulate dLGN synapses and excitability, evidence for experience-dependent dLGN plasticity in adults is limited. However, glaucoma might trigger compensatory plasticity in adult dLGN, thereby compensating for diminished RGC synaptic drive. Here, we tested this theory using aged DBA/2J mice, which develop high intraocular pressure and glaucoma. In brain slice recordings, we found that diminished RGC inputs could drive robust action …

Improving Low Fresh Gas Flow Adherence To Lower Co2e Emissions, Luke Charles Ricci

Honors Theses and Capstones

Volatile anesthetic gases contribute significantly to healthcare-related greenhouse gas emissions. These greenhouse gas emissions can be increased due to higher fresh gas flows. At Dartmouth-Hitchcock Medical Center (DHMC), open and semi-open systems with fresh gas flow (FGF) rates above two liters per minute result in anesthetic gas waste. Literature suggests multifaceted quality improvement interventions are effective in improving low fresh gas flow adherence in anesthesia provider practices. The purpose of this study was to evaluate the potential reduction in anesthetic gas waste and carbon dioxide equivalent (CO₂e) emissions at Dartmouth-Hitchcock Medical Center through improved adherence to low fresh gas flow …

Successful Anesthetic Management Of Patient With Marfan Syndrome: Optimizing Cardiovascular Stability And Maternal Outcomes, M Roberts, C Cox, K Leavitt

South Atlantic Division GME Research Days 2026

No abstract provided.

Persistent Peristomal Pain Due To An Exposed Cutaneous Nerve, Iain Noel Encarnacion, Kaylin Beiter, Natasha Hakkal, Emily Hejazi, Paul Hernandez, Melissa Laughter, Shannon Nugent, Samir Thaker, Xiaowei Xu, Misha Rosenbach

Department of Medicine Faculty Publications

[Introduction]

Case description

A 25-year-old woman with a history of ulcerative colitis treated with multiple abdominal surgeries complicated by peristomal pyoderma gangrenosum (PPG) presented with severe peristomal pain and ulceration. Treatment course was complicated; disease control was achieved via combination infliximab 10 mg/kg every 4 weeks, corticosteroids (topical triamcinolone 0.1% ointment, intralesional 10 mg/ml injections, and oral prednisone 30 mg daily with a gradual taper), and cyclosporine 125 mg tapering by 25 mg every 3 weeks, ultimately tapered to infliximab monotherapy.

Percutaneous Vegetectomy As An Emerging Alternative For Tricuspid Valve Endocarditis, Alexander Patel, Elias Wakim, William Zvagelsky, Ebad Ur Rahman, Youssef Al-Saghir, Ahmed Zaky

South Atlantic Division GME Research Days 2026

No abstract provided.

7-Hydroxymitragynine Induced Perioperative Hyperalgesia In 27-Year-Old Trauma Patient, William Hickman, Katherine David, Vincent Hoffman, Ruzanna Nalbandyan

South Atlantic Division GME Research Days 2026

No abstract provided.

Case Report: Acute Rv Failure Post Cabg In The Setting Of Pectus Excavatum, Kim Nguyen, Mclean Beson, Heather Palomino, Derek Horstemeyer, Bryan Lee, Savan Ghandi

South Atlantic Division GME Research Days 2026

No abstract provided.

A Multidisciplinary Approach To Acute-On-Chronic Pain Management In The Emergency Department, Lisa Persaud, Cameron Burr, Ursula Des Bordes, Noah Novembre, Abhishek Desai, Kaitlyn Phelps, Desiree Aird

South Atlantic Division GME Research Days 2026

No abstract provided.

Atypical Post–Dural Puncture Headache: Bilateral Subdural Hematomas Four Weeks After Epidural Placement, Katherine David, Akash Patel, Megan Roberts, Andrew Criser

South Atlantic Division GME Research Days 2026

No abstract provided.

Recurrent Pericardial Effusion After Atrial Perforation From Pacemaker Lead As Identified On Intraoperative 3d Trans-Esophageal Echo - A Case Report, Mclean Beson, Kim Nguyen, Nishank Nooli, Kate Hoffman

South Atlantic Division GME Research Days 2026

No abstract provided.