Zyad James Carr, MD
Associate Professor of AnesthesiologyCards
Are You a Patient?
View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileAdditional Titles
Medical Director, Pre-Surgical Evaluation Clinic, Yale New Haven Hospital, Anesthesiology
Contact Info
Anesthesiology
333 Cedar Street, TMP-3
New Haven, Connecticut 05610
United States
Are You a Patient?
View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileAdditional Titles
Medical Director, Pre-Surgical Evaluation Clinic, Yale New Haven Hospital, Anesthesiology
Contact Info
Anesthesiology
333 Cedar Street, TMP-3
New Haven, Connecticut 05610
United States
Are You a Patient?
View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileAdditional Titles
Medical Director, Pre-Surgical Evaluation Clinic, Yale New Haven Hospital, Anesthesiology
Contact Info
Anesthesiology
333 Cedar Street, TMP-3
New Haven, Connecticut 05610
United States
About
Copy Link
Titles
Associate Professor of Anesthesiology
Medical Director, Pre-Surgical Evaluation Clinic, Yale New Haven Hospital, Anesthesiology
Biography
Dr. Carr received his anesthesiology training at the University of Medicine and Dentistry, Cooper University Hospital in the physician-scientist track. He proceeded to complete a critical care medicine fellowship at Dartmouth Hitchcock Medical Center and subsequently board certified in anesthesiology, critical care medicine and advanced perioperative transesophageal echocardiography. He joined the Yale University School of Medicine, Department of Anesthesiology in May of 2020.
Appointments
Anesthesiology
Associate Professor on TermPrimary
Other Departments & Organizations
- Anesthesiology
- Yale Medicine
- Yale New Haven Health System
Education & Training
- Critical Care Fellow
- Dartmouth Hitchcock Medical Center (2014)
- Resident Physician
- University of Medicine & Dentistry of NJ, Cooper University Hospital (2010)
- MD
- University College Cork, National Univ. of Ireland, Medicine (2005)
- BSc (Hon)
- Rutgers University, Psychology (1999)
Research
Copy Link
Overview
My current research interest is identification, quantification, and mitigation of perioperative complications. Shifting the paradigm of preoperative risk assessment to a precise, individualized and patient centered approach is one of my areas of research interest. In addition, I am interested in estimation and characterization of perioperative pulmonary complications, particularly in the care of previously neglected medical populations.
Medical Research Interests
Public Health Interests
ORCID
0000-0002-6970-3340
Research at a Glance
Yale Co-Authors
Publications Timeline
Research Interests
Jean Gabriel Charchaflieh, MD, MPH, DrPH
Jill Zafar, MD, MBA, FASA
Adriana Dana Oprea, MD
Andres Brenes Bastos, MD
Hung-Mo Lin
Paul Heerdt, PhD, MD
Critical Care
Perioperative Care
Publications
Featured Publications
Implementation of Brief Submaximal Cardiopulmonary Testing in a High-Volume Presurgical Evaluation Clinic: Feasibility Cohort Study
Carr Z, Agarkov D, Li J, Charchaflieh J, Brenes-Bastos A, Freund J, Zafar J, Schonberger R, Heerdt P. Implementation of Brief Submaximal Cardiopulmonary Testing in a High-Volume Presurgical Evaluation Clinic: Feasibility Cohort Study. JMIR Perioperative Medicine 2025, 8: e65805. PMID: 39773953, PMCID: PMC11888076, DOI: 10.2196/65805.Peer-Reviewed Original ResearchThis study investigates the feasibility of implementing brief submaximal cardiopulmonary testing in high-volume presurgical clinics, showing it efficiently identifies lower functional capacity compared to traditional surveys in under 20 minutes.Preoperative submaximal cardiopulmonary exercise testing and its association with early postoperative complications
Carr Z, Charchaflieh J, Brenes-Bastos A, He H, Lin H, Jankelovits A, Gu E, Zafar J, Ghali F, Tan W, Heerdt P. Preoperative submaximal cardiopulmonary exercise testing and its association with early postoperative complications. BJA Open 2025, 14: 100407. PMID: 40421445, PMCID: PMC12105740, DOI: 10.1016/j.bjao.2025.100407.Peer-Reviewed Original ResearchCitationsAltmetricConceptsLength of staySubmaximal cardiopulmonary exercise testingInstitutional review board approvalPostoperative complication riskReview board approvalDuke Activity Status IndexCardiopulmonary exercise testingIncreased length of stayAdjusted multivariable regression modelsPostoperative complications predictionPulmonary capacitanceOpen-labelPeak oxygen uptakePerioperative surveillancePrimary endpointNoncardiac surgeryPostoperative complicationsSecondary endpointsSingle-centreComplication riskMET assessmentPeak VOBoard approvalMultivariate regression modelMetabolic equivalentsReducing Systematic Overestimation Bias in the Duke Activity Status Index Estimated Peak Oxygen Uptake: A Cross-Sectional Analysis Using Submaximal Cardiopulmonary Exercise Testing
Hollingsworth K, Zhao Y, Charchaflieh J, Carr Z. Reducing Systematic Overestimation Bias in the Duke Activity Status Index Estimated Peak Oxygen Uptake: A Cross-Sectional Analysis Using Submaximal Cardiopulmonary Exercise Testing. A&A Practice 2026, 20: e02160. PMID: 41729842, DOI: 10.1213/xaa.0000000000002160.Peer-Reviewed Original ResearchThis study addresses the systematic overestimation of peak oxygen uptake by the Duke Activity Status Index (DASI) by validating a new, adjusted formula. By integrating BMI, age, and sex into the formula, the authors reduced bias.Rapid Submaximal Cardiopulmonary Exercise Testing in Older Adults Undergoing Noncardiac Surgery: Workflow Integration, Acceptability, and Physiologic Characterization in an Expanded Cohort
Carr Z, Brenes-Bastos A, Longley M, Zafar J, Charchaflieh J. Rapid Submaximal Cardiopulmonary Exercise Testing in Older Adults Undergoing Noncardiac Surgery: Workflow Integration, Acceptability, and Physiologic Characterization in an Expanded Cohort. 2026, 1: e0016. DOI: 10.1097/ao9.0000000000000016.Peer-Reviewed Original ResearchAltmetricConceptsSubmaximal cardiopulmonary exercise testingCardiopulmonary exercise testingExercise capacityPerceived ExertionExercise testSelf-reported functional statusVeterans Specific Activity QuestionnaireBreath-by-breath gas exchange analysisFunctional capacityDuke Activity Status IndexAssessment of functional capacitySelf-reported activityActivity QuestionnaireGas exchange analysisOlder adultsRecruitment thresholdWorkflow integrationFunctional statusSelf-ReportCohort studyProcess outcomesClinical workflowExertionSession durationStatus indexOptimizing Perioperative Management of Sarcoidosis in Noncardiac Surgery: A Focused Review and Practical Framework
Carr Z, Sevilla J. Optimizing Perioperative Management of Sarcoidosis in Noncardiac Surgery: A Focused Review and Practical Framework. Anesthesiology 2026, 144: 1226-1235. PMID: 41701088, PMCID: PMC13089829, DOI: 10.1097/aln.0000000000005890.Peer-Reviewed Original ResearchThis study investigates perioperative management strategies for sarcoidosis patients undergoing noncardiac surgery, highlighting tailored approaches to reduce complications from multiorgan disease involvement.
2026
Defining reference intervals for submaximal cardiopulmonary exercise testing‐derived gas‐exchange derived pulmonary capacitance in older adults
Tatsuoka Y, Longley M, MacCarter D, Carr ZJ. Defining reference intervals for submaximal cardiopulmonary exercise testing‐derived gas‐exchange derived pulmonary capacitance in older adults. Clinical Physiology And Functional Imaging 2026, 46: e70076. DOI: 10.1111/cpf.70076.Peer-Reviewed Original ResearchRapid Submaximal Cardiopulmonary Exercise Testing in Older Adults Undergoing Noncardiac Surgery: Workflow Integration, Acceptability, and Physiologic Characterization in an Expanded Cohort
Carr ZJ, Brenes-Bastos A, Longley M, Zafar J, Charchaflieh J. Rapid Submaximal Cardiopulmonary Exercise Testing in Older Adults Undergoing Noncardiac Surgery: Workflow Integration, Acceptability, and Physiologic Characterization in an Expanded Cohort. Anesthesiology Open 2026, 1 DOI: 10.1097/ao9.0000000000000016.Peer-Reviewed Original ResearchThe ICU environment paradigm as a catalyst for better delirium models
Carr Z. The ICU environment paradigm as a catalyst for better delirium models. Clinical Science 2026, 140: 921-924. PMID: 42132621, PMCID: PMC13181370, DOI: 10.1042/cs20260577.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsRepositioning Sarcoidosis from a Vague Comorbidity on the Preoperative Problem List to a Prototype Condition for Precision Perioperative Medicine
Carr Z, Landreneau M, Borochov N, Rady A. Repositioning Sarcoidosis from a Vague Comorbidity on the Preoperative Problem List to a Prototype Condition for Precision Perioperative Medicine. Bali Journal Of Anesthesiology 2026, 10: 1-3. DOI: 10.4103/bjoa.bjoa_324_25.Peer-Reviewed Original Research
2025
Preliminary insights into cardiopulmonary reserve and hemodynamic stability: exploring submaximal cardiopulmonary exercise testing parameters as potential predictors of intraoperative hemodynamic instability
AUTHOR=Agarkov Daniel , Carr Zyad J. TITLE=Preliminary insights into cardiopulmonary reserve and hemodynamic stability: exploring submaximal cardiopulmonary exercise testing parameters as potential predictors of intraoperative hemodynamic instability JOURNAL=Frontiers in Anesthesiology VOLUME=Volume 4 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/anesthesiology/articles/10.3389/fanes.2025.1610632 DOI=10.3389/fanes.2025.1610632 ISSN=2813-480X ABSTRACT=BackgroundIntraoperative hypotension (IOH) is associated with serious adverse outcomes after noncardiac surgery. Preoperative predictors of IOH remain poorly characterized. Intraoperative hemodynamic instability is strongly associated with IOH. The authors hypothesized that submaximal cardiopulmonary exercise testing (smCPET) measures of forced vital capacity (FVC) and gas-exchange derived pulmonary capacitance to peak oxygen uptake slope (GXCAP-VO2) would be associated with two measures of intraoperative hemodynamic instability: intraoperative vasopressor use and systolic average real variability (ARV), respectively.MethodsThis secondary analysis of a feasibility study included adults >60 years undergoing elective noncardiac surgery and completed preoperative smCPET. Multiple cardiopulmonary measures, including FVC, peak oxygen uptake (VO2) and GXCAP-VO2 slope were collected. The primary outcome of intraoperative vasopressor use, and secondary outcome of ARV were tested with multivariable logistic regression and generalized linear models to assess associations supported by decision boundary and mediation analysis.ResultsAmong 101 participants, 54 had measured FVC (median 2.56 L) and 101 had measured GXCAP-VO2 slope (median 29.8). After adjustment, each standard deviation increase in FVC (0.89 L) was associated with halved odds of vasopressor use [2.47 L (SD 0.88) vs. 2.9 L (SD 0.86) adjusted Odds Ratio: 0.496 (95% CI: 0.25–1.01) p = 0.052]. Participants with FVC <2.18 L and surgery duration >152 min had the highest risk of vasopressor use. Systolic ARV was negatively associated with increasing surgical time (p < 0.001). For each 10-unit increase in GXCAP-VO2 slope, systolic ARV is expected to decrease by 9.8% [incidence rate ratio = 0.902, 95% CI (0.84, 0.97)].ConclusionLower measured FVC and GXCAP-VO2 slope were associated with measures of intraoperative hemodynamic instability in older adults undergoing noncardiac surgery. Preoperative assessment of pulmonary function and cardiopulmonary reserve may identify patients at higher risk for intraoperative hemodynamic instability. These exploratory observations establish a foundation for future research on smCPET measures for the prediction of perioperative complications, recognizing intraoperative hemodynamic instability as a complex interplay of patient, anesthetic, and surgical factors.Peer-Reviewed Original Research
Academic Achievements & Community Involvement
Copy Link
Featured
activity BMC Perioperative Medicine
07/01/2025 - PresentJournal ServiceEditorDetailsBMC Perioperative Medicine is a leading journal in perioperative medicine.
Activities
activity Society of Critical Care Anesthesiologists, Scientific Abstract Committee
2018 - PresentProfessional OrganizationsAbstract Graderactivity Journal of Intensive Care Medicine
2020 - PresentJournal ServiceRevieweractivity Drugs
2019 - PresentJournal ServiceRevieweractivity Bioscience Reports
2019 - PresentJournal ServiceRevieweractivity Clinical Interventions in Aging
2018 - PresentJournal ServiceReviewer
Honors
honor MSARF (medical student anesthesia research fellowship) mentor 2023
12/07/2022National AwardFoundation for Anesthesia Education and Research (FAER)DetailsUnited Stateshonor Fellow of the American Society of Anesthesiologists
02/01/2019Other AwardAmerican Society of AnesthesiologistsDetailsUnited Stateshonor Faculty Career Development Professorship in Anesthesiology
07/01/2017Other AwardPenn State University College of Medicine, Department of AnesthesiologyDetailsUnited Stateshonor HCAHPS 99% Percentile, Patient Satisfaction Award
01/01/2017Regional AwardHospital Consumer Assessment of Healthcare Providers and SystemsDetailsUnited Stateshonor Junior Faculty Teaching Award 2016
07/01/2016Other AwardPenn State University College of Medicine, Department of AnesthesiologyDetailsUnited States
Clinical Care
Copy Link
Overview
Zyad James Carr, MD, is an anesthesiologist who specializes in critical care, helping patients navigate the challenges of surgery and recovery. He uses advanced methods to monitor vital functions, including breathing and circulation, for individuals who require high levels of support during and after procedures.
As an associate professor of anesthesiology at Yale School of Medicine, Dr. Carr focuses his research on identifying, measuring, and reducing complications that can arise in the time around surgery. He seeks to customize risk assessment to the needs of each patient, especially those at greater risk for lung issues and other serious conditions.
Dr. Carr completed his medical training at University College Cork, National University of Ireland. He pursued residency training in anesthesiology at the University of Medicine and Dentistry of New Jersey, Cooper University Hospital, followed by a fellowship in critical care medicine at Dartmouth Hitchcock Medical Center.
Clinical Specialties
Board Certifications
Anesthesiology
- Certification Organization
- AB of Anesthesiology
- Original Certification Date
- 2011
Are You a Patient?
View this doctor's clinical profile on the Yale Medicine website for information about the services we offer and making an appointment.
View Doctor ProfileLinks
Copy Link
Media
- Rapid determination of the cause of postoperative hypoxia in ILD patients is critical to successful rescue.
Get In Touch
Copy Link
Contacts
Anesthesiology
333 Cedar Street, TMP-3
New Haven, Connecticut 05610
United States