DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

Under her leadership, the newly energized
division has moved forward with
several initiatives including; the Perioperative
Outcomes Database, the
General Surgery Pilot Study (designed
to allow GVT faculty members to run
the surgical schedule on a daily basis),
support and participation in the Human
Pharmacology Laboratory and development
of a strategic plan for improving
the process and patient flow in the
PACU. The first annual GVTCCM retreat
was a huge success, and with participation
from our M.D. and CRNA faculty,
we gained insight into the various clinical,
research and teaching initiatives
administrated by our divisional members.
Dr. Robertson headed a Taskforce
on CRNA Recruitment and Retention
which successfully resolved salary and
benefits issues that were impeding our
recruitment of additional CRNA faculty.
A consistently strong endeavor has
been the high quality of perioperative
care that the Liver Transplant Faculty
have provided to transplant recipients,
and the enthusiasm with which the residents
now actively participate in this
program. As Chief of Transplant
Services, Dr. Robertson coordinates
clinical, research and teaching activities
and provides the necessary liason with
our surgical colleagues which make this
a successful cohesive and cooperative
multidisciplinary effort.
T.J. Gan is an Associate Professor
and Director of Clinical Research for
the department. He also serves as
Medical Director of the PACU. During
the 2000 academic year, T.J. coordinated
the activities of 18 active IRBapproved
research protocols which
focused on the use of physiologically
balanced colloid solutions for fluid
resuscitation, novel drugs and drug
delivery systems and improving the
care of elderly patients undergoing
surgery. He is an acknowledged world
expert on antiemetic drug therapies to
reduce postoperative nausea and vomiting.
He will soon be expanding his therapeutic
strategies to include acupuncture
techniques. T.J. is the driving force
behind the divisional project of establishing
a comprehensive postoperative
database to measure perioperative outcome
and ultimately establish “best
practice” for patient care.
Jacques Somma joined our department
two years ago with a unique background
in engineering, medicine and
two years of fellowship training in Dr.
Steven Shafer’s Pharmacology Laboratory
at Stanford University. Dr. Somma
is director of the Human Pharmacology
Laboratory (www.pharmacokin.com)
which is a fully equipped state of the art
laboratory supported by a comprehensive
team of Duke faculty who have the
skills required to efficiently design, perform
and analyze data for Phase I studies.
Two protocols are currently active:
“A Double Blind Randomized Study to
Compare the Analgesia and Respiratory
Effect of Dexmedetomidine and
Remifentanil,” and “Age Effect on the
Interaction between Propofol and
Remifentanil.” His support staff includes
Aaron Harrison (Clinical Trail Research
Associate), Karen Ramsey (Non-cardiac
Clinical Research Coordinator) and
Yung-Wei Hsu, M.D., (Research
Associate)
Eugene Moretti is a Duke anesthesia
graduate, who has subsequently
completed his board certification in
anesthesiology and critical care medicine
and his first of two years towards
a Master's degree of Health Sciences in
Clinical Research. Gene’s participation
in the clinical research training program
at Duke is intimately tied to the
Duke Clinical Research Institute (DCRI)
and meets an existing need for formalized
academic training in the quantitative
and methodological principles of
clinical research. In addition, Dr.
Moretti’s continuing commitment to
pursuing excellence in patient care
finds him in the Duke North OR, as
an intensivist in the surgical ICU and
as an active participant on the Liver
Transplant Team.
The Laboratory for Tissue
Engineering under Laura E. Niklason’s
guidance continues to focus on topics
CLINICAL ACTIVITIES
related to vascular biology and design
of vascular replacement tissues. Current
topics of study include:
1. Biochemical and theoretical
modeling approaches to understanding
and improving the mechanical characteristics
of engineered tissues.
2. Life span extension of vascular cells
via over-expression of the human telomerase
reverse transcriptase gene.
3. Utilization of adult human pluripotent
stem cells as precursor cells for
engineered cardiovascular tissues.
4. Effects of controlled mechanical and
electrical stimuli on vascular cell function
and phenotype.
Additionally, the laboratory is
conducting a collaborative study on a
possible etiology for delayed vasospasm
following subarachnoid hemorrhage.
Funding for these efforts are derived
from multiple sources, including the
NIH, private foundations, and private
corporations.
Ronald P. Olson, M.D., CCFP,
Medical Supervisor of the Preoperative
Screening Unit (POSU) and his team
continued to serve as the focal point for
preoperative coordination for most surgical
patients during the year 2000.
They strive to offer the most complete
preoperative service anywhere.
Their strengths continue to be conducting
a complete history and physical
exam which allows accurate risk stratification
and choosing of appropriate
investigations. With continual feedback
from anesthesiologists and surgeons,
they provide consistency in investigation
and education of the patients. The
POSU coordinates appropriate consultation
and testing and manages minor
medical conditions. By the morning
of surgery, the patient has already been
educated on the perioperative event,
and the paperwork is organized and
delivered. Therefore, the POSU minimizes
morning of surgery surprises.
Changes during this year have
been progress with the electronic
record, use of the POSU for research
recruitment, and initiation of billing for
CLINICAL ACTIVITIES 53