Zyad James Carr, MD
Associate Professor of AnesthesiologyDownloadHi-Res Photo
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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
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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.
Last Updated on November 04, 2023.
Appointments
Anesthesiology
Associate Professor on TermPrimary
Other Departments & Organizations
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
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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
Critical Care; Diseases; Lung Diseases, Interstitial; Perioperative Care; Perioperative Medicine; Postoperative Care
Public Health Interests
Pharmaceuticals and Medical Devices; Infectious Diseases; Cardiovascular Diseases; Bioinformatics; Antimicrobial Resistance; Emerging Infectious Diseases
ORCID
0000-0002-6970-3340
Research at a Glance
Yale Co-Authors
Frequent collaborators of Zyad James Carr's published research.
Publications Timeline
A big-picture view of Zyad James Carr's research output by year.
Research Interests
Research topics Zyad James Carr is interested in exploring.
Jill Zafar, MD, MBA, FASA
Adriana Dana Oprea, MD
Hung-Mo Lin
Jean Gabriel Charchaflieh, MD, MPH, DrPH
Paul Heerdt, PhD, MD
Andres Brenes Bastos
58Publications
431Citations
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 ResearchCitationsAltmetricMeSH Keywords and ConceptsConceptsDuke Activity Status IndexPeak oxygen uptakePeak METsEvaluation clinicParticipant satisfactionOxygen uptakeSubmaximal cardiopulmonary exercise testingFunctional capacity assessmentLow functional capacityCardiopulmonary exercise testingPerceived ExertionMET assessmentStructured surveyCapacity SurveyMedian patient satisfactionProvider-drivenExercise testMean session timePearson correlation coefficientSurvey scoresCardiopulmonary testFunctional capacityPatient satisfactionCohort studyInclusion criteriaPreoperative 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 ResearchAltmetricConceptsLength 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 equivalentsPreliminary 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
2025
Preliminary insights into cardiopulmonary reserve and hemodynamic stability: exploring submaximal cardiopulmonary exercise testing parameters as potential predictors of intraoperative hemodynamic instability
Agarkov D, Carr Z. Preliminary insights into cardiopulmonary reserve and hemodynamic stability: exploring submaximal cardiopulmonary exercise testing parameters as potential predictors of intraoperative hemodynamic instability. Frontiers In Anesthesiology 2025, 4: 1610632. DOI: 10.3389/fanes.2025.1610632.Peer-Reviewed Original ResearchAltmetricConceptsAverage real variabilityAssociated with measuresSubmaximal cardiopulmonary exercise testingSecondary outcomesHigh riskPrimary outcomePeak oxygen uptakeIntraoperative hemodynamic instabilityPotential predictorsCardiopulmonary exercise testingExercise test parametersCardiopulmonary exercise testing parametersMultivariate logistic regressionAssociated with serious adverse outcomesSystolic average real variabilitySerious adverse outcomesStandard deviation increaseVasopressor useExercise testIntraoperative vasopressor useOlder adultsOxygen uptakeSecondary analysisHemodynamic instabilityIntraoperative hypotensionThirty-day postoperative cardiopulmonary complications in sarcoidosis: Insights from a retrospective matched cohort analysis
Freund J, Gosalvez C, Rady A, Notarianni A, Carr Z. Thirty-day postoperative cardiopulmonary complications in sarcoidosis: Insights from a retrospective matched cohort analysis. Anesthesiology And Perioperative Science 2025, 3: 9. DOI: 10.1007/s44254-025-00087-5.Peer-Reviewed Original ResearchAltmetricConceptsPostoperative pulmonary complicationsPostoperative cardiopulmonary complicationsLength of staySarcoidosis patientsSarcoidosis diagnosisCardiopulmonary complicationsCohort analysisAssociated with 30-day MACEIndependent of disease stageSystemic granulomatous disorderRetrospective matched cohort analysisMethodsThis retrospective studyAssociated with higher riskCongestive heart failure eventsComparative cohort analysisHeart failure eventsPreoperative chest radiographyAdverse cardiovascular eventsMatched Cohort AnalysisCompared to controlsPulmonary complicationsSarcoidosis cohortGranulomatous disorderLung involvementThirty-dayThe role of right ventricular systolic pressure and ARISCAT score in perioperative pulmonary risk assessment
Tatsuoka Y, He Z, Lin H, Notarianni A, Carr Z. The role of right ventricular systolic pressure and ARISCAT score in perioperative pulmonary risk assessment. Brazilian Journal Of Anesthesiology 2025, 75: 844597. PMID: 39971234, PMCID: PMC11914786, DOI: 10.1016/j.bjane.2025.844597.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsConceptsRight ventricular systolic pressurePostoperative pulmonary complicationsArea under the curveARISCAT scoreVentricular systolic pressureReceiver operating characteristic curvePulmonary hypertensionRespiratory failureHigh-risk populationPrimary endpointRisk stratificationSurgical proceduresSystolic pressurePostoperative pulmonary complications incidenceSource of increased morbidityAssess Respiratory RiskDiagnosis of PHPreoperative risk assessmentAdjusted multivariable logistic regression modelsMultivariate logistic regression modelComposite of pneumoniaPulmonary complicationsPreoperative investigationsSecondary endpointsPulmonary aspirationPerioperative Pulmonary Complications in the Older Adults The Forgotten System
Carr Z, Siller S, McDowell B. Perioperative Pulmonary Complications in the Older Adults The Forgotten System. Clinics In Geriatric Medicine 2025, 41: 1-18. PMID: 39551535, DOI: 10.1016/j.cger.2024.03.003.Peer-Reviewed Original ResearchMeSH Keywords and ConceptsPheochromocytoma and MEN Syndromes
Carr Z, Farela A, Oprea A. Pheochromocytoma and MEN Syndromes. 2025, 333-342. DOI: 10.1093/med/9780190902001.003.0030.Peer-Reviewed Original ResearchConceptsMultiple endocrine neoplasiaInadequate surgical resectionManagement of PPGLsRare neuroendocrine tumorsDefinitive surgical managementResection of pheochromocytomaPreoperative medical managementDiligent postoperative careHigh-risk procedurePersistent vasoplegiaResected patientsSurgical resectionNeuroendocrine tumorsPostoperative bleedingRefractory hypertensionVasopressor supportHypertensive crisisPreoperative optimizationEndocrine neoplasiaABSTRACT PheochromocytomaPostoperative periodPerioperative considerationsVentricular dysrhythmiasAnesthesia techniquesPotential complications
2024
The Impact of Cannabis Use Disorder on Critical Illness
Carr Z, Strand E. The Impact of Cannabis Use Disorder on Critical Illness. 2024, 95-105. DOI: 10.1007/978-3-031-67069-5_7.Peer-Reviewed Original ResearchConceptsIntensive care unitImpacts of cannabis use disordersCannabis use disorderManagement of patientsIntensive care managementIntensive care management of patientsChronic adverse effectsCannabis useClinical evidenceCare management of patientsBotanical cannabisCannabis usageCare unitUse disorderCannabisOrgan systemsAdverse effectsPatientsDownstream effectsIntensive care unit providersMedical careCare managementDoes a single oral administration of amiloride affect spontaneous arterial baroreflex sensitivity and blood pressure variability in healthy young adults?
Fernandes I, Stavres J, Hamaoka T, Ojikutu Q, Sabino-Carvalho J, Vianna L, Luck J, Blaha C, Cauffman A, Dalton P, Herr M, Ruiz-Velasco V, Carr Z, Janicki P, Cui J. Does a single oral administration of amiloride affect spontaneous arterial baroreflex sensitivity and blood pressure variability in healthy young adults? Journal Of Neurophysiology 2024, 132: 922-928. PMID: 39110514, PMCID: PMC12121373, DOI: 10.1152/jn.00264.2024.Peer-Reviewed Original ResearchCitationsAltmetricConceptsAdministration of amilorideArterial baroreflex sensitivityCardiac autonomic modulationBaroreflex sensitivityOral administrationBP variabilityBlood pressureOral administration of placeboAutonomic modulationSpontaneous cardiac baroreflexSympathetic arterial baroreflexAdministration of placeboIndices of BP variabilityMuscle sympathetic activitySympathetic baroreflex sensitivityHealthy young adultsPre-clinical modelsSingle oral administrationBlood pressure variabilityBeat-to-beat BPYoung adultsWeighted linear regression analysisHealthy young humansSympathetic baroreflexAmiloride
Academic Achievements & Community Involvement
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Featured
activity BMC Perioperative Medicine
07/01/2025 - PresentJournal ServiceEditorDetailsBMC Perioperative Medicine is a leading journal in perioperative medicine.
Activities
activity Journal of Intensive Care Medicine
2020 - PresentJournal ServiceRevieweractivity Drugs
2019 - PresentJournal ServiceRevieweractivity Bioscience Reports
2019 - PresentJournal ServiceRevieweractivity Clinical Interventions in Aging
2018 - PresentJournal ServiceRevieweractivity Journal of Neurosurgical Anesthesiology
2016 - 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
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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
Anesthesiology; Critical Care Anesthesiology
Board Certifications
Advanced Perioperative Transesophageal Echocardiography
- Certification Organization
- National Board of Echocardiography
- Original Certification Date
- 2015
Anesthesiology
- Certification Organization
- AB of Anesthesiology
- Original Certification Date
- 2011
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Media
- Rapid determination of the cause of postoperative hypoxia in ILD patients is critical to successful rescue.
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Email
Mailing Address
Anesthesiology
333 Cedar Street, TMP-3
New Haven, Connecticut 05610
United States