2021
Variation 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 patients
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 mortalityA Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia
Chen EY, Sukumar N, Dai F, Akhtar S, Schonberger RB. A Pilot Analysis of the Association Between Types of Monitored Anesthesia Care Drugs and Outcomes in Transfemoral Aortic Valve Replacement Performed Without General Anesthesia. Journal Of Cardiothoracic And Vascular Anesthesia 2017, 32: 666-671. PMID: 29277298, PMCID: PMC5766429, DOI: 10.1053/j.jvca.2017.07.009.Peer-Reviewed Original ResearchConceptsTransfemoral aortic valve replacementMonitored Anesthesia CareAortic valve replacementGeneral anesthesiaValve replacementAge incrementsMedication dose adjustmentUse of dexmedetomidineRetrospective observational studyType of sedationTertiary teaching hospitalHospital lengthPostoperative deliriumTAVR patientsDose adjustmentConscious sedationAnesthesia careCare drugsPossible differential effectsTeaching hospitalObservational studyAnesthetic agentsDose reductionDrug dosingPilot analysis
2016
Does intravenous induction dosing among patients undergoing gastrointestinal surgical procedures follow current recommendations: a study of contemporary practice
Akhtar S, Liu J, Heng J, Dai F, Schonberger RB, Burg MM. Does intravenous induction dosing among patients undergoing gastrointestinal surgical procedures follow current recommendations: a study of contemporary practice. Journal Of Clinical Anesthesia 2016, 33: 208-215. PMID: 27555166, DOI: 10.1016/j.jclinane.2016.02.001.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAgingAlgorithmsAnesthesia, IntravenousAnesthetics, IntravenousBody WeightDigestive System Surgical ProceduresFemaleFentanylGuidelines as TopicHumansHypotensionIntraoperative ComplicationsMaleMidazolamMiddle AgedPropofolRetrospective StudiesSeverity of Illness IndexConceptsASA-PS classAge groupsInduction dosesSurgical proceduresAnesthesiologists physical status classMean arterial pressure changesYounger groupOlder groupAge-adjusted doseRate of hypotensionMean arterial pressureRetrospective chart reviewAnesthetic induction agentGastrointestinal surgical proceduresArterial pressure changesGI surgical proceduresAcademic medical centerCochran-Armitage trend testDifferent age groupsPostinduction hypotensionOlder patientsAdult patientsArterial pressureChart reviewIntravenous induction
2015
Geriatric Pharmacology
Akhtar S, Ramani R. Geriatric Pharmacology. Anesthesiology Clinics 2015, 33: 457-469. PMID: 26315631, DOI: 10.1016/j.anclin.2015.05.004.Peer-Reviewed Original ResearchConceptsElderly patientsLong-term outcomesEnd-organ sensitivityFurther pharmacologic studiesOlder patientsAnesthetic medicationsGeriatric pharmacologyPharmacologic studiesAnesthetic drugsPatientsDrug overdosingDecreased volumePhysiologic processesContinuous variablesTrue extentMedicationsAnesthetics
2014
Case 3–2015 Preventing Adverse Outcomes in the Very Elderly Cardiac Surgical Patients
Akhtar S, Morris B, Roy R, Balogun SA. Case 3–2015 Preventing Adverse Outcomes in the Very Elderly Cardiac Surgical Patients. Journal Of Cardiothoracic And Vascular Anesthesia 2014, 29: 510-521. PMID: 25440648, DOI: 10.1053/j.jvca.2014.07.014.Peer-Reviewed Original Research