DEPARTMENT OF ANESTHESIOLOGY ANNUAL REPORT

success as a physician-investigator was
recognized at the end of this year when
he was promoted to Associate Professor
of Anesthesiology. A number of other
clinical investigators have been active
this year. Dr. Sum Ping has been evaluating
the efficacy of dexmedetomidine
as a sedative-antihypertensive for
patients following cardiac surgery, and
he and Dr. Christopher Young are
actively pursuing other clinical trials
using this unique sedative, both in
intensive care patients as well as in the
departmental human pharmacology
laboratory. Technology assessment
remains another focus of the VA group.
Drs. Slaughter and Sreeram continue to
explore improved methods for bedside
evaluation of the coagulation system
and platelet function, and both have
published widely on hemostasis and
transfusion practice. In addition, Drs.
Chris Young and Jonathan Mark have
been evaluating a new method of cardiac
output measurement that does not
require pulmonary artery catheterization
and is based on ion-selective sensor
technology. Our research assistant,
Ms. Cynthia Cassell, has been instrumental
in providing support for all of
these clinical investigations. The VA
faculty continued to contribute to the
medical literature in 2000 by authoring
numerous chapters and reviews in the
fields of cardiovascular physiology, critical
care, cardiovascular monitoring,
and coagulation pathophysiology.
Teaching
Resident, fellow, and medical student
education are top priorities for the
entire faculty at the VA, as evidenced
by the fact that our clinicians are consistently
rated highly as effective teach-
ers in the department. In recognition of
this tradition that emphasizes resident
education, a VA Teaching Award was
established in 1996 by the Duke Department
of Anesthesiology and was awarded
to Dr. Tom Buchheit this past June.
Daily didactic conferences at the
VA supplement bedside SICU and operating
room training. Each morning,
from 7:00 - 7:45 a.m., a general departmental
teaching conference starts the
educational day, followed by didactic
SICU teaching rounds at 10:00 a.m.
Finally, a departmental Friday morning
Echocardiography and Cardiac Physiology
Conference is attended by faculty
and residents at the VA, Duke cardiac
anesthesia fellows, and fellows and residents
from cardiology and cardiac
surgery.
Medical students from Duke and
other institutions rotate through our
operating rooms and SICU at the VA.
All of our faculty are involved in teaching
students at the bedside and in small
group conferences, and several faculty
contribute to the first year medical
school curriculum in pharmacology
and physiology.
Goals for 2001
Operating Room Renovation. A major
renovation of the entire 40-year-old VA
operating rooms is currently in progress.
The final phase of this multi-year project
will begin in 2001. During this year, we
will modify our daily operating room
schedule to attempt to maintain workload
and clinical productivity.
Short Stay Unit. Work to make preoperative
assessment available electronically
through the VA computer system.
Intensive Care and Monitoring
Units. Promote development of multi-
CLINICAL ACTIVITIES
disciplinary care of the critically ill
patient, training housestaff from Anesthesiology,
Surgery, Family Medicine,
and Obstetrics and Gynecology. Work
more closely with the medical intensive
care unit team to develop further collaborative
efforts in intensive care medicine
and training at the VA and at Duke.
Pain Management Services. Support
pain services to meet the growing clinical
demand, including cancer pain
management and palliative care. The
greatest challenge for the upcoming year
will be to arrange expanded clinic
space and hours to accommodate our
growing pain team and patient load.
Fellowship Training. Continue
board-certified training programs in
Pain Management and Critical Care
with our faculty at Duke. Continue
to develop collaborative subspecialty
training for our cardiac anesthesia fellows,
particularly in transesophageal
echocardiography.
Clinical Research. Support Dr.
Slaughter’s research program in perioperative
hemostasis and thrombosis, linking
both clinical and laboratory investigations,
with a long term goal of establishing
a Laboratory for the Investigation
of Perioperative Hemostasis and Thrombosis
at the Durham VAMC. Continue
and expand SICU research in clinical
pharmacology (sedation) and hemodynamic
monitoring. Aid fellows in
clinical research, particularly in the
areas of transesophageal echocardiography,
cardiac physiology, clinical
monitoring, and perioperative coagulation
disorders.
Digital Echocardiography. Work to
expand the application of digital echocardiography
from clinical service to
clinical research.
CLINICAL ACTIVITIES 71