Duke Anesthesiology Wins Resident Quality Improvement Award

The Anesthesia Patient Safety Foundation (APSF) has named a Duke Anesthesiology team as the winner of the 2017 APSF Resident Quality Improvement (RQI) Recognition Award.

The winning video is titled, “A Bedside Tool to Improve Safety and Efficiency of Cardiothoracic ICU Patient Transport: The Duke ICU Transition to OR (DITTO) Checklist.” Authors include: Suraj Yalamuri, MD, and Michael Plakke, MD (team leaders); John Haney, MD, AB, MPH; Brad Taicher, DO, MBA; Madhav Swaminathan, MD, FASE, FAHA; Cory Maxwell, MD (mentors), for the DITTO Team (Hassan Amhaz, MD; Vinca Chow, MD; Heather Pena; Joseph Deblasio; Mollie Kettle; Jhaymie Cappiello; Jessica Lumbard; Rachel Gambino; Courtney Thurman).

Dr. Eun Eoh accepting the APSF awardAccording to the project’s abstract, critically ill patients in the Cardiothoracic Intensive Care Unit often require invasive monitoring systems and life-sustaining medical therapies. When transport to the operating room for surgical procedures is needed, much coordination and preparation is required. Using a collaborative effort with stakeholders from several medical teams involved in critically ill patient transport, the authors were able to create and implement a checklist that both significantly improved efficiency and decreased variability of transport times. They were able to decrease transport times by more than 50 percent without increasing the stress and workload of the medical teams.

Winners were announced at the award ceremony on Sunday, October 22, at the annual meeting of the American Society of Anesthesiologists in Boston. Dr. Eun Eoh accepted the APSF award on behalf of the team leaders.

Chris KeithDuke Anesthesiology Wins Resident Quality Improvement Award
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2018 DIG Recipients Revealed

2018 DREAM Innovation Grant Recipients

The much anticipated 2018 DREAM Innovation Grant (DIG) recipients were announced at Duke Anesthesiology’s 29th Annual ASA Alumni Event at The Roof at Taj Boston on Saturday, October 21.

Congratulations to the 2018 DIG winners:

Qing Ma, MD

“The Role of Sirtuin-3 in Neuroinflammation and Perioperative Cerebral Injury”

Jamie Privratsky, MD, PhD

“The Role of Dendritic Cells in Acute Kidney Injury and Renal Healing”

DIGs support innovative high-risk and potentially high-reward investigations to accelerate anesthesia and pain management research. Each year, Duke Anesthesiology junior and senior faculty members compete for a DIG by submitting their most innovative research ideas to the DIG Application Review Committee. Dr. William Maixner, vice chair for research, announces the DIG recipients at the department’s annual ASA alumni event.

Each DIG recipient can receive up to $30,000 in seed money which supports their pilot study for one year and ultimately helps them apply for and obtain extramural funding. These grants are funded through a combination of private donors, private companies, alumni, faculty and executive board members. To date, $662,900 has been funded by DIGs which has led to nearly $8 million in extramural funding to further investigate the role of Alzheimer’s pathways, therapies to improve stroke outcomes, ways to prevent cognitive decline after surgery, sleep apnea during pregnancy, strategies to decrease bleeding after cardiac surgery and transplantation, blood cell rejuvenation, and more. Click here to view the 2011-2017 DIG recipients and learn more about their projects.

The DIG is part of the Duke DREAM Campaign which launched in 2007 to support Duke Anesthesiology’s research programs and initiatives. These grants create an avenue for healthy competition among faculty, inspire ingenuity, promote the careers of young physician investigators, enhance donor communication, and further the department’s academic mission. DIGs help to bridge the gap between training and progression to independent investigator status. Please consider making an online gift to the Duke DREAM Campaign to support our department’s research initiatives focused on improving patient care.

Chris Keith2018 DIG Recipients Revealed
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Dr. Terrando Receives Prestigious R01 Award

Niccolo Terrando, PhDThe National Institutes of Health/National Institute on Aging (NIH/NIA) has awarded Duke Anesthesiology’s Niccolò Terrando, BSc, DIC, PhD, a five-year, $2,815,756 R01 Award for his project, titled “Neurovascular dysfunction in delirium superimposed on dementia.”

Millions of Americans live with dementia and require common surgical interventions, such as orthopaedic surgery. According to the research statement, these potentially life-saving procedures often increase the risk for further cognitive deterioration and in many cases, even death. Dr. Terrando with his team of investigators at Duke University (Carol Colton, Gurpreet Baht, William Wetsel, Zhiquan Zhang, and Miles Berger) and University of Rochester Medical Center (Harris Gelbard) will address this public health concern by providing fundamental knowledge expected to help reduce the burdens of neurologic complications after common surgical procedures, and improve the quality of life for these high-risk patients.

The rationale for the proposed research is that successful completion of these studies will advance and expand the understanding of how surgery affects the blood-brain interface, and will provide new insights into molecular mechanisms of relevance to delirium, neurodegeneration and aging. Such knowledge is highly significant because it has the potential to improve surgical outcomes and quality of life for millions of vulnerable, elderly patients in the United States by using new therapeutic approaches tested in this grant.

As stated in the project’s abstract, impaired cognitive function after common surgical procedures is a growing concern, especially among the more than five million people in the nation who suffer from dementia, including Alzheimer’s disease (AD), and thus have a three-fold increased risk for fracture requiring surgical repair. After orthopaedic surgery, acute changes in cognitive function, often referred to as postoperative delirium, occur in up to 89 percent of patients with preexisting dementia, and associate with poorer prognosis and even two-fold greater risk for one-year mortality compared to patients without dementia or delirium. This proposal will attempt to model postoperative delirium superimposed on dementia after orthopaedic surgery using innovative approaches to understand, and possibly attenuate, the effects of surgery on the blood–brain interface, including the neurovascular unit (NVU) and the blood-brain barrier (BBB).

The long-term goal of Dr. Terrando and his team of investigators is to define the mechanisms that underlie surgery-induced cognitive dysfunction, and to provide safe and effective approaches to reduce this potentially devastating complication.

Dr. Terrando joined Duke in 2015 and is an assistant professor in anesthesiology, the director of the Neuroinflammation and Cognitive Outcomes Laboratory, a collaborator of Duke Anesthesiology’s Center for Translational Pain Medicine and a 2016 DREAM Innovation Grant (DIG) recipient for his research project, titled “The Systemic Milieu and its Role in Postoperative Cognitive Dysfunction.”

Chris KeithDr. Terrando Receives Prestigious R01 Award
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Division Chief Awarded Duke-Singapore Collaborative Grant

Ashraf S. Habib, MBBCh, MSc, MHSc, FRCADuke University and the Duke-National University of Singapore (NUS) Medical School have awarded Duke Anesthesiology’s Ashraf Habib, MBBCh, MSc, chief of the Women’s Anesthesia Division, and his collaborator at KK Hospital in Singapore, Ban Leong Sng, MD, a $200,000 grant for their Duke/Duke-NUS pilot project, titled “Evaluation and risk assessment for persistent postsurgical pain after breast surgery: a collaborative prospective cohort study.”

The overall aim of this study is to identify clinically-relevant and genetic risk factors for persistent postsurgical pain that can be reliably distinguished statistically. Specifically, the focuses include 1) risk factors representing biopsychosocial processes that influence chronic pain, such as pain and psychological vulnerability, and 2) genetic factors relating to mechanistic pathways to persistent pain generation.

According to the project’s abstract, breast cancer is a leading cancer diagnosis among women worldwide, with more than one million new cases each year. Chronic pain following breast cancer surgery has been recognized as a major humanitarian and socioeconomic burden, affecting more than 50 percent of patients after lumpectomy and mastectomy leading to chronic physical disability and psychological distress. This chronic pain may involve the site of lumpectomy/mastectomy, axilla and even proximal medial arm. The cause of persistent postsurgical pain in breast cancer patients may be attributed to various reasons, such as surgical trauma, tumor recurrence, or factors related to radiotherapy or chemotherapy.

Despite a number of studies investigating risk factors, almost all of the information has originated from single center studies and often focuses on only a few elements. Additionally, surgical approaches and analgesic regimens have changed in recent years, therefore limiting the interpretation of previous studies. Yet, tools to identify those at high risk and preventive interventions are still lacking.

Dr. Habib and his team of investigators propose to study the risk factors related to persistent postsurgical pain in breast cancer patients, and to develop a prediction model that could serve as a screening tool for patients at high risk of developing persistent pain after breast cancer surgery. Pre-existing pain and severe postoperative pain have been predictors of persistent pain after surgery, but a complete understanding on the development of persistent pain is still lacking. A major challenge facing progress in this field has been the wide variation in patient experience of pain after similar types of surgery and the inability to identify individuals who are more likely to experience severe pain after surgery. A better understanding of the risk factors of postsurgical pain will help identify the subset of patients who are likely to develop severe acute pain and persistent pain. This could help in targeting those high-risk patients with focused perioperative interventions that could reduce their risk of developing severe acute pain and persistent pain.

Chris KeithDivision Chief Awarded Duke-Singapore Collaborative Grant
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Dr. Privratsky Receives Mentored Research Award

Jamie Privratsky, MD, PhDThe International Anesthesia Research Society (IARS) has awarded Duke Anesthesiology’s Jamie Privratsky, MD, PhD, a two-year, $175,000 2017 Mentored Research Award for his project, titled “The role of macrophage IL-1 signaling in acute kidney injury and recovery.”

According to the project statement, acute kidney injury (AKI) dramatically increases morbidity and mortality and can lead to downstream chronic kidney disease (CKD). The mechanisms that direct renal recovery after AKI and prevent the AKI to CKD transition are poorly understood.

Based on preliminary data, Dr. Privratsky’s central hypothesis is that IL-1R1 activation sustains detrimental macrophage polarization to drive acute renal injury and promote the AKI to CKD transition, culminating in kidney fibrosis. The specific aims of he and his team of investigators include: Aim 1) determine the effects of IL-1R1 signaling on renal macrophage polarization during AKI. Mice with macrophage-specific deletion of IL-1R1 (IL-1R1 MKO) and controls will be subjected to ischemia/reperfusion (I/R)-induced AKI. They will measure the severity of kidney damage, assess the polarization of infiltrating macrophages via fluorescent cell sorting and RT-PCR, and characterize injury in renal tubular cells following co-culture with isolated WT and IL-1R1 MKO macrophages from injured kidneys. Aim 2) determine the effect of IL-1R1 receptor signaling on the development of renal fibrosis following AKI. Investigators will subject IL-1R1 MKO mice and littermate controls (WT) to I/R-induced AKI and 28 days later examine the extent of kidney fibrosis. At multiple time points, intra-renal macrophages will be phenotyped by fluorescent cell sorting and analyzed for pro-inflammatory and pro-fibrotic gene expression by RNAseq. The capacity of a commercially available IL-1R1 antagonist to alter macrophage polarization and prevent renal fibrosis following AKI will be tested.

According to Dr. Privratsky, an assistant professor of anesthesiology in Duke Anesthesiology’s Critical Care Medicine Division, these studies should underpin the development of novel immunomodulatory therapies for AKI, which are expected to have a significant positive impact on perioperative and critically ill patients.

Chris KeithDr. Privratsky Receives Mentored Research Award
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Duke Anesthesiology Career Service Awards

Duke Anesthesiology proudly recognizes members of the department who have demonstrated outstanding service and dedication to Duke! We thank them for their commitment to this team and the patients we serve!

Janet E. Goral

Narda Croughwell
Dianne L. Scott

Robin B. Coleman
Gary W. Massey

Christine Eaton
Nancy W. Knudsen
Jonathan B. Mark
Mark F. Newman

Jennifer Parsons
Allison K. Ross
E. June Santa
Christopher Young

Patricia M. Allushuski
Maurice L. Begin
John B. Eck

Nancy M. Kota
John F. Pierce
Melanie M. Sennett

Laura L. Booth
Karen Clemmons
Stuart A. Grant
Victoria Grossman
Paula Hawkns

Katharine S. Heinkel
Carrie A. Hines
William P. Norcross
Caswell S. Patmore

Earl S. Ransom
Jennifer Sanford
Cheryl J. Stetson
Marcy S. Tucker

Debra T. Allen
Wendy Bush
Natalie S. Clarke
Brian J. Colin
Sonia B. Crabtree
Charles E. Creel

Allan S. Fabito
Ilene B. Farkas
Patricia P. Fletcher
Stephen M. Melton
Sarah Miller
Timothy E. Miller

Allison Mooney
Michael A. Neal
Srinivas Pyati
Aaron J. Sandler
Mark W. Schontz
Erlinda Yeh

Rory Camasura
Shannon Currie
Jennifer Dominguez
Jennifer Easterling
Eric Ehieli
Lisa M. Einhorn
Reginald Enierga
Merrie Gough
Kirk Hamilton
Scott Helms

Lori A. Hester
Ru-Rong Ji
Amber Johnson
Courtney H. Kalkhof
Kelly A. Machovec
Erin Manning
Janina Marcenaro
Karen McCain
Collins Mogbo

Rachel E. Morales
Jennifer Neifeld
Karthik Raghunathan
Richard Runkle
Zaneta Y. Strouch
Dharamdeo Surujpaul
Zebulon Thomeczek
Elizabeth Wilder
Magan Zani

Chris KeithDuke Anesthesiology Career Service Awards
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