2022
Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial.
Neuman MD, Feng R, Ellenberg SS, Sieber F, Sessler DI, Magaziner J, Elkassabany N, Schwenk ES, Dillane D, Marcantonio ER, Menio D, Ayad S, Hassan M, Stone T, Papp S, Donegan D, Marshall M, Jaffe JD, Luke C, Sharma B, Azim S, Hymes R, Chin KJ, Sheppard R, Perlman B, Sappenfield J, Hauck E, Hoeft MA, Tierney A, Gaskins LJ, Horan AD, Brown T, Dattilo J, Carson JL, Looke T, Bent S, Franco-Mora A, Hedrick P, Newbern M, Tadros R, Pealer K, Vlassakov K, Buckley C, Gavin L, Gorbatov S, Gosnell J, Steen T, Vafai A, Zeballos J, Hruslinski J, Cardenas L, Berry A, Getchell J, Quercetti N, Bajracharya G, Billow D, Bloomfield M, Cuko E, Elyaderani MK, Hampton R, Honar H, Khoshknabi D, Kim D, Krahe D, Lew MM, Maheshwer CB, Niazi A, Saha P, Salih A, de Swart RJ, Volio A, Bolkus K, DeAngelis M, Dodson G, Gerritsen J, McEniry B, Mitrev L, Kwofie MK, Belliveau A, Bonazza F, Lloyd V, Panek I, Dabiri J, Chavez C, Craig J, Davidson T, Dietrichs C, Fleetwood C, Foley M, Getto C, Hailes S, Hermes S, Hooper A, Koener G, Kohls K, Law L, Lipp A, Losey A, Nelson W, Nieto M, Rogers P, Rutman S, Scales G, Sebastian B, Stanciu T, Lobel G, Giampiccolo M, Herman D, Kaufman M, Murphy B, Pau C, Puzio T, Veselsky M, Apostle K, Boyer D, Fan BC, Lee S, Lemke M, Merchant R, Moola F, Payne K, Perey B, Viskontas D, Poler M, D'Antonio P, O'Neill G, Abdullah A, Fish-Fuhrmann J, Giska M, Fidkowski C, Guthrie ST, Hakeos W, Hayes L, Hoegler J, Nowak K, Beck J, Cuff J, Gaski G, Haaser S, Holzman M, Malekzadeh AS, Ramsey L, Schulman J, Schwartzbach C, Azefor T, Davani A, Jaberi M, Masear C, Haider SB, Chungu C, Ebrahimi A, Fikry K, Marcantonio A, Shelvan A, Sanders D, Clarke C, Lawendy A, Schwartz G, Garg M, Kim J, Caruci J, Commeh E, Cuevas R, Cuff G, Franco L, Furgiuele D, Giuca M, Allman M, Barzideh O, Cossaro J, D'Arduini A, Farhi A, Gould J, Kafel J, Patel A, Peller A, Reshef H, Safur M, Toscano F, Tedore T, Akerman M, Brumberger E, Clark S, Friedlander R, Jegarl A, Lane J, Lyden JP, Mehta N, Murrell MT, Painter N, Ricci W, Sbrollini K, Sharma R, Steel PAD, Steinkamp M, Weinberg R, Wellman DS, Nader A, Fitzgerald P, Ritz M, Bryson G, Craig A, Farhat C, Gammon B, Gofton W, Harris N, Lalonde K, Liew A, Meulenkamp B, Sonnenburg K, Wai E, Wilkin G, Troxell K, Alderfer ME, Brannen J, Cupitt C, Gerhart S, McLin R, Sheidy J, Yurick K, Chen F, Dragert K, Kiss G, Malveaux H, McCloskey D, Mellender S, Mungekar SS, Noveck H, Sagebien C, Biby L, McKelvy G, Richards A, Abola R, Ayala B, Halper D, Mavarez A, Rizwan S, Choi S, Awad I, Flynn B, Henry P, Jenkinson R, Kaustov L, Lappin E, McHardy P, Singh A, Donnelly J, Gonzalez M, Haydel C, Livelsberger J, Pazionis T, Slattery B, Vazquez-Trejo M, Baratta J, Cirullo M, Deiling B, Deschamps L, Glick M, Katz D, Krieg J, Lessin J, Mojica J, Torjman M, Jin R, Salpeter MJ, Powell M, Simmons J, Lawson P, Kukreja P, Graves S, Sturdivant A, Bryant A, Crump SJ, Verrier M, Green J, Menon M, Applegate R, Arias A, Pineiro N, Uppington J, Wolinsky P, Gunnett A, Hagen J, Harris S, Hollen K, Holloway B, Horodyski MB, Pogue T, Ramani R, Smith C, Woods A, Warrick M, Flynn K, Mongan P, Ranganath Y, Fernholz S, Ingersoll-Weng E, Marian A, Seering M, Sibenaller Z, Stout L, Wagner A, Walter A, Wong C, Orwig D, Goud M, Helker C, Mezenghie L, Montgomery B, Preston P, Schwartz JS, Weber R, Fleisher LA, Mehta S, Stephens-Shields AJ, Dinh C, Chelly JE, Goel S, Goncz W, Kawabe T, Khetarpal S, Monroe A, Shick V, Breidenstein M, Dominick T, Friend A, Mathews D, Lennertz R, Sanders R, Akere H, Balweg T, Bo A, Doro C, Goodspeed D, Lang G, Parker M, Rettammel A, Roth M, White M, Whiting P, Allen BFS, Baker T, Craven D, McEvoy M, Turnbo T, Kates S, Morgan M, Willoughby T, Weigel W, Auyong D, Fox E, Welsh T, Cusson B, Dobson S, Edwards C, Harris L, Henshaw D, Johnson K, McKinney G, Miller S, Reynolds J, Segal BS, Turner J, VanEenenaam D, Weller R, Lei J, Treggiari M, Akhtar S, Blessing M, Johnson C, Kampp M, Kunze K, O'Connor M, Looke T, Tadros R, Vlassakov K, Cardenas L, Bolkus K, Mitrev L, Kwofie MK, Dabiri J, Lobel G, Poler M, Giska M, Sanders D, Schwartz G, Giuca M, Tedore T, Nader A, Bryson G, Troxell K, Kiss G, Choi S, Powell M, Applegate R, Warrick M, Ranganath Y, Chelly JE, Lennertz R, Sanders R, Allen BFS, Kates S, Weigel W, Li J, Wijeysundera DN, Kheterpal S, Moore RH, Smith AK, Tosi LL, Looke T, Mehta S, Fleisher L, Hruslinski J, Ramsey L, Langlois C, Mezenghie L, Montgomery B, Oduwole S, Rose T. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial. Annals Of Internal Medicine 2022, 175: 952-960. PMID: 35696684, DOI: 10.7326/M22-0320.Peer-Reviewed Original ResearchResponse to comment on: “Association of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65”
Bardia A, Akhtar S, Schonberger RB. Response to comment on: “Association of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65”. Journal Of Clinical Anesthesia 2022, 81: 110911. PMID: 35780644, PMCID: PMC11146281, DOI: 10.1016/j.jclinane.2022.110911.Peer-Reviewed Original ResearchRelationship Between Glucose Time in Range in Diabetic and Non-Diabetic Patients and Mortality in Critically Ill Patients
Ammar MA, Ammar AA, Wee T, Deshpande R, Band M, Akhtar S. Relationship Between Glucose Time in Range in Diabetic and Non-Diabetic Patients and Mortality in Critically Ill Patients. Journal Of Intensive Care Medicine 2022, 37: 1625-1633. PMID: 35491687, DOI: 10.1177/08850666221098383.Peer-Reviewed Original ResearchConceptsNon-diabetic patientsBlood glucose rangeDiabetic patientsIll patientsGlucose rangeTIR 70Hospital mortalityMortality rateHospital mortality rateNon-diabetic cohortLower mortality rateAdult patientsCohort studyMortality benefitSingle centerGlucose timePercentage of timeHigh incidencePatientsMortalityDlLtDiabeticsICUHyperglycemiaAssociation of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65
Schonberger RB, Dai F, Michel G, Vaughn MT, Burg MM, Mathis M, Kheterpal S, Akhtar S, Shah N, Bardia A. Association of propofol induction dose and severe pre-incision hypotension among surgical patients over age 65. Journal Of Clinical Anesthesia 2022, 80: 110846. PMID: 35489305, PMCID: PMC11150018, DOI: 10.1016/j.jclinane.2022.110846.Peer-Reviewed Original ResearchConceptsPropofol induction doseGeneral anesthetic inductionSevere hypotensionInduction doseBlood pressure measurementsYears of ageSurgical patientsEndotracheal intubationAnesthetic inductionInvasive blood pressure measurementsGeriatric surgical patientsNon-vascular surgeryDose of propofolNon-invasive blood pressure measurementBlood pressure dropSignificant independent associationPostoperative morbidityRetrospective observationalTotal patientsMulticenter cohortPrimary outcomeAnesthesia inductionPrimary exposureIndependent associationSurgical incision
2021
Pressure-Regulated Ventilator Splitting for Disaster Relief: Design, Testing, and Clinical Experience
Raredon MSB, Fisher C, Heerdt PM, Schonberger RB, Nargi A, Nivison S, Fajardo E, Deshpande R, Akhtar S, Greaney AM, Belter J, Raredon T, Zinter J, McKee A, Michalski M, Baevova P, Niklason LE. Pressure-Regulated Ventilator Splitting for Disaster Relief: Design, Testing, and Clinical Experience. Anesthesia & Analgesia 2021, 134: 1094-1105. PMID: 34928890, DOI: 10.1213/ane.0000000000005825.Peer-Reviewed Original ResearchConceptsPositive end-expiratory pressureClinical experienceIndividualized positive end-expiratory pressureIntensive care unitEnd-expiratory pressureCoronavirus disease 2019 (COVID-19) pandemicHealth care teamDisease 2019 pandemicVentilatory supportIll patientsCare unitCare teamVentilator sharingFuture clinical applicationsPatientsIndependent careVentilator capacityClinical applicationCOVID-19 pandemicVentilatorClinical environmentOutline recommendationsMass traumaPandemicHospitalPreoperative evaluation of geriatric patients undergoing liver transplantation
Akhtar S. Preoperative evaluation of geriatric patients undergoing liver transplantation. Current Opinion In Anaesthesiology 2021, 35: 96-104. PMID: 34878418, DOI: 10.1097/aco.0000000000001084.Peer-Reviewed Original ResearchConceptsLiver transplantationNonalcoholic steatohepatitisGeriatric patientsElderly patientsPreoperative evaluationIncidence of NASHAge-related physiological changesPercent of patientsHepatitis C virusPortopulmonary hypertensionCirrhotic cardiomyopathyHepatopulmonary syndromeMultiple comorbiditiesPulmonary evaluationMetabolic syndromeFrailty evaluationPractice advisoryHepatocellular carcinomaPatientsTransplantationSyndromePhysiological changesHypertensionComorbiditiesSteatohepatitisNeurological Aging and Pharmacological Management of Geriatric Patients
Akhtar S. Neurological Aging and Pharmacological Management of Geriatric Patients. Current Anesthesiology Reports 2021, 11: 381-386. DOI: 10.1007/s40140-021-00497-8.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPharmacological Adjuncts to Palliation in the Trauma Patient: Optimal Symptom Management
Ammar M, Ammar A, Cheung C, Akhtar S. Pharmacological Adjuncts to Palliation in the Trauma Patient: Optimal Symptom Management. Current Trauma Reports 2021, 7: 73-82. DOI: 10.1007/s40719-021-00215-z.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsTrauma patientsSymptom managementQuality of lifePalliative careOptimal symptom managementPatients' symptom managementAdequate palliative careMultidisciplinary team approachHealth care costsSummaryPalliative careEnd of lifePharmacological managementCommon symptomsEarly recognitionEffective pharmacotherapyVulnerable patientsPharmacological adjunctsLife carePatientsReviewThe purposeCare costsPatient careTeam approachCareSymptomsReply to: Comment on: Variation in propofol induction doses administered to surgical patients over 65
Akhtar S, Bardia A, Schonberger RB. Reply to: Comment on: Variation in propofol induction doses administered to surgical patients over 65. Journal Of The American Geriatrics Society 2021, 69: 2680-2681. PMID: 34185888, PMCID: PMC8440365, DOI: 10.1111/jgs.17327.Peer-Reviewed Original ResearchVariation in propofol induction doses administered to surgical patients over age 65
Schonberger RB, Bardia A, Dai F, Michel G, Yanez D, Curtis JP, Vaughn MT, Burg MM, Mathis M, Kheterpal S, Akhtar S, Shah N. Variation in propofol induction doses administered to surgical patients over age 65. Journal Of The American Geriatrics Society 2021, 69: 2195-2209. PMID: 33788251, PMCID: PMC8373684, DOI: 10.1111/jgs.17139.Peer-Reviewed Original ResearchConceptsPropofol induction dosesInduction dosesEndotracheal intubationGeneral anesthetic inductionPropofol induction dosePercent of patientsRetrospective observational studyLarge multicenter cohortSurgical patientsMulticenter cohortPropofol doseBolus doseGeneral anesthesiaInduction dosePropofol inductionPresent studyAnesthetic inductionDose administrationAdvanced agePatient variablesObservational studyProvider practicesAnaesthetic practiceClinical consequencesDosing decisions
2020
Regional Anesthesia is Underutilized for Carotid Endarterectomy Despite Improved Perioperative Outcomes Compared with General Anesthesia
Lumas S, Hsiang W, Akhtar S, Ochoa Chaar CI. Regional Anesthesia is Underutilized for Carotid Endarterectomy Despite Improved Perioperative Outcomes Compared with General Anesthesia. Annals Of Vascular Surgery 2020, 73: 336-343. PMID: 33373769, DOI: 10.1016/j.avsg.2020.11.035.Peer-Reviewed Original ResearchConceptsNational Surgical Quality Improvement ProgramCarotid endarterectomyGeneral anesthesiaRegional anesthesiaImproved outcomesSurgeons National Surgical Quality Improvement ProgramChronic obstructive pulmonary diseaseOutcomes of CEASurgical Quality Improvement ProgramCombined end pointObstructive pulmonary diseaseChoice of anestheticQuality Improvement ProgramAnesthesia typeHospital lengthPerioperative outcomesBaseline characteristicsPatient characteristicsCarotid surgeryHeart failurePropensity matchingPulmonary diseaseGA patientsMyocardial infarctionAmerican CollegeAn Analysis of Anesthesia Induction Dosing in Female Older Adults
Chen EY, Michel G, Zhou B, Dai F, Akhtar S, Schonberger RB. An Analysis of Anesthesia Induction Dosing in Female Older Adults. Drugs & Aging 2020, 37: 435-446. PMID: 32300966, PMCID: PMC7359723, DOI: 10.1007/s40266-020-00760-3.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPostinduction hypotensionGeneral anesthesiaPresent cohortPostoperative acute kidney injuryLarge tertiary teaching hospitalOlder adultsFrailty of patientsGynecologic oncology surgeryImmediate hemodynamic effectsPropofol induction dosesPercentage of patientsRetrospective observational studyTertiary teaching hospitalPerioperative vital signsHigher propofol dosesFemale older adultsAKI associationInotrope administrationKidney injurySurgical populationHemodynamic effectsDose adjustmentPrimary outcomeFemale patients321: RELATIONSHIP BETWEEN GLUCOSE TIME IN RANGE IN DIABETIC AND NONDIABETIC PATIENTS AND MORTALITY
Ammar M, Ammar A, Deshpande R, Band M, Akhtar S. 321: RELATIONSHIP BETWEEN GLUCOSE TIME IN RANGE IN DIABETIC AND NONDIABETIC PATIENTS AND MORTALITY. Critical Care Medicine 2020, 48: 143-143. DOI: 10.1097/01.ccm.0000619640.00502.9a.Peer-Reviewed Original Research
2018
Safety of 4-factor prothrombin complex concentrate (4F-PCC) for emergent reversal of factor Xa inhibitors
Tao J, Bukanova EN, Akhtar S. Safety of 4-factor prothrombin complex concentrate (4F-PCC) for emergent reversal of factor Xa inhibitors. Journal Of Intensive Care 2018, 6: 34. PMID: 29942519, PMCID: PMC6001072, DOI: 10.1186/s40560-018-0303-y.Peer-Reviewed Original ResearchSequential compression devicesFactor Xa inhibitorsThrombotic eventsProthrombin complex concentrateXa inhibitorsMajor bleedingEmergent reversalComplex concentrateInvasive proceduresIU/Single-center retrospective reviewChronic oral anticoagulationEmergent decompressive craniotomyRate of thromboembolismResultsForty-three patientsUpper extremity DVTMulticenter prospective trialDeep vein thrombosisTreatment of choiceCerebral vascular accidentMinor invasive proceduresTraumatic intracranial hemorrhageRisk of thrombosisEmergent invasive proceduresDVT prophylaxisPerioperative Outcome in Geriatric Patients
Akhtar S. Perioperative Outcome in Geriatric Patients. Current Anesthesiology Reports 2018, 8: 232-237. DOI: 10.1007/s40140-018-0267-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsNon-cardiac surgeryPerioperative outcomesOlder patientsNon-home dispositionEmergency general surgeryRate of complicationsIntensive care unitPostoperative admissionPostoperative mortalityPerioperative morbidityCancer resectionPerioperative careCardiac operationsCare unitGeriatric patientsGeneral surgeryHigh riskInvasive proceduresElderly individualsPatientsSurgeryOctogenariansMortalityOverall rateOutcomesPharmacological considerations in the elderly
Akhtar S. Pharmacological considerations in the elderly. Current Opinion In Anaesthesiology 2018, 31: 11-18. PMID: 29189287, DOI: 10.1097/aco.0000000000000544.Peer-Reviewed Original ResearchConceptsAnesthetic drugsNeurophysiological changesPoor perioperative outcomesCurrent practice patternsLarge database studiesDepth of anesthesiaIntraoperative hypotensionPerioperative outcomesElderly patientsAnesthetic medicationsDose adjustmentCNS depressionGeriatric patientsPractice patternsDrug managementPharmacologic studiesReceptor levelsPharmacological considerationsCurrent recommendationsDatabase studyElderly populationFunctional connectivityAnesthetic dosingHypotensionDrugsChapter 9 Electrocardiographic Monitoring
Freudzon L, Akhtar S, London M, Barash P, Badescu G, Sherman B, Zaidan J. Chapter 9 Electrocardiographic Monitoring. 2018, 168-202. DOI: 10.1016/b978-0-323-49798-5.00009-7.Chapters
2017
Association of red blood cell transfusion and short- and longer-term mortality after coronary artery bypass graft surgery
Tantawy H, Li A, Dai F, Elgammal M, Sukumar N, Elefteriades J, Akhtar S. Association of red blood cell transfusion and short- and longer-term mortality after coronary artery bypass graft surgery. Journal Of Cardiothoracic And Vascular Anesthesia 2017, 32: 1225-1232. PMID: 29402623, DOI: 10.1053/j.jvca.2017.12.033.Peer-Reviewed Original ResearchConceptsCoronary artery bypass graft surgeryPacked red blood cellsArtery bypass graft surgeryRed blood cell transfusionTertiary care academic medical centerBypass graft surgeryBlood cell transfusionAcademic medical centerMortality rateCABG surgeryCell transfusionGraft surgeryMedical CenterAdult cardiac surgery patientsLong-term mortality outcomesRetrospective medical record reviewCardiothoracic intensive care unitPropensity Score Matching AnalysisCardiac surgery patientsLong-term mortalityMedical record reviewIntensive care unitSignificant differencesStatistical significant differenceHospital mortalityCardiovascular System
Akhtar S, Ebert T. Cardiovascular System. 2017, 161-178. DOI: 10.1007/978-3-319-66878-9_11.ChaptersCardiovascular diseaseCardiovascular systemBest possible patient outcomesFrequency of dysrhythmiasPerioperative stress responseCoronary blood flowValvular heart diseaseAge-related disease processesPossible patient outcomesCardiac conduction systemAge-related changesElderly patientsCardiovascular reserveMyocardial dysfunctionDiastolic fillingCardiac functionHeart diseasePatient outcomesPathophysiological principlesCardiovascular stressHeart rateNeuroendocrine responsesAutonomic regulationBlood flowDisease process- Factor VIIIFactor replacementHemophilia AFactor XIFactor IXExogenous factor VIIIRecessive inheritance patternCoagulation workupElevated aPTTPlatelet countProthrombin concentrateSevere haemophiliaPlatelet functionCongenital deficiencyFactor VIIPatientsHemophiliaSpecific mutationsDisordersFIX concentrationInheritance patternLow levelsDeficiencyAntifibrinolyticsNSAIDs