November/December 2014 Volume 5, Issue 4
Ehrenfeld reports in from duty at Kandahar In August, Jesse Ehrenfeld, MD, MPH, associate professor of Anesthesiology, Surgery, and
Biomedical Informa cs, deployed for duty as a lieutenant commander in the United States
Navy Reserves. Following is his report from the field.
In September, a er surviving several weeks of Army combat training, I arrived at Kandahar Airfield where I am now deployed at the NATO Role 3 Mul na onal Medical Unit (MMU) with the U.S. Navy. The NATO Role 3 MMU is the primary trauma receiving and referral center for all combat casual es in southern Afghanistan. Our mission is to provide the best possible care to all injured and ill persons brought to the MMU. We are charged with suppor ng the NATO combatants, allied forces and partners in accomplishing their mis‐
sions. The hospital is a 70,000‐square‐foot rocket‐resistant, state‐of‐the‐art facility with three opera ng rooms, a procedure room, a fully equipped emergency department, intensive care unit, and two CT scanners. The facility was established in 2005 as part of an Interna‐
onal Security Assistance Force (ISAF) mission and was originally supported by the United Kingdom, Netherlands, Denmark, Australia, Canada, and the United States. Since 2009, the U.S. Navy has served as the leader partner running and staffing the facility. Combat boots are the norm in ORs at NATO Role 3
Mul na onal Medical Unit (MMU) in Kandahar.
Please see Ehrenfeld, page 2
Mul disciplinary team changes lives in Guatemala For the third consecu ve year, members of the
Vanderbilt Department of Anesthesiology, pedi‐
atric den sts from the greater Nashville area,
and the Shalom Founda on partnered to send a
team to the Moore Pediatric Surgery Center in
Guatemala City. Following is a report from Dr.
Jason Lane, assistant professor of Anesthesiology
in the Mul specialty Adult Anesthesiology Divi‐
sion, a team member on the most recent trip. CRNA Shuhanna O’Bryan takes a
pa ent from pre‐op holding to the
opera ng room.
Serving the medical needs of the underserved and teaching the local Guatemalan medical train‐ CRNA Robbyn Barber‐Anderson, le , takes care of a
pa ent along with pediatric den st Dr. Kirby Hoetker.
Please see Mul disciplinary team, page 3
Meet Alderman Sain, Page 4
Faculty/staff service awards, Page 5
ASA Annual Meeting , Pages 8-9
Volume 5, Issue 4
Ehrenfeld, con nued from page 1 In addi on to myself, we currently have two other anesthesiologists (one American and one Australian). You can imagine my delight when I discovered upon my arrival a worn copy of Pocket Anesthesia on the shelf in the anesthesia office! Thanks to a care package from Dr. Jill Boyle, I was able to redecorate the office, and we now have several Vanderbilt pennants and s ckers decora ng the walls. Go ’Dores! One of the most interes ng aspects of working in a combat hospital has been serving as a member of the trauma team. Every casualty that arrives is greeted in the trauma bay by an emergency physician, a trauma surgeon, a general surgeon, a radiologist, and an anesthesi‐
ologist – along with several nurses and corpsmen. From my posi on at the head of bed, the exper se brought to bear on whatever is thrown our way is staggering. It is inspiring to witness over and over the extraordinary teamwork that ensures each pa ent receives the highest quality care possible, which has led to a 98% overall coali on survival rate since the hospital opened. Before heading to Kandahar, Dr. Ehrenfeld, at le , completes combat‐
Working without residents, nurse anesthe sts, or anesthesia techni‐
readiness training at Fort Jackson in South Carolina.
cians has given me a tremendous apprecia on for the partnerships and support we enjoy day in and day out at Vanderbilt. Since my arrival here, I’ve go en very skilled at turning over the opera ng room a er each case, restocking our carts, and check‐
ing our five anesthesia machines each morning. Speaking of machines: You might ask why we have five anesthesia ma‐
chines, but only four anesthe zing loca‐
ons? Well, each opera ng room is large enough to accommodate two machines, Not all of his pa ents have been human. Here, Dr.
two pa ents, and two opera ng room Ehrenfeld intubates and monitors a military working
Dr. Ehrenfeld administers a flu shot to a
tables in case we experience a mass casual‐ dog that is undergoing a procedure.
fellow shipman.
ty event that requires more simultaneous surgery than we have anesthesiologists. Fortunately, that has not occurred during my me here. I have had the opportunity to assist our veterinarian during several emergency canine procedures, and as it turns out, it’s much easier to intubate a Labrador than most humans – even with a size 14 endotracheal tube! While this mobiliza on has been challenging for me personally, I cannot think of a more fi ng way to use my training and skills than to provide care to our injured personnel. I am incredibly grateful to the Department of Anesthesiology, the Medical School, and especially Dr. Sandberg for their collec ve support of my mobiliza on and me away. While I am away, if you are interested in learning more about our mission, you can find updates at: h p:// nyurl.com/mu6bm2t. I look forward to seeing everyone in the spring, and hope to be able to share some of what I’ve learned when I return home. Jesse M. Ehrenfeld, MD, MPH Lieutenant Commander, U.S. Navy Le ers/packages for Dr. Ehrenfeld? Mailing address: Jesse Ehrenfeld NATO Role 3 MMU APO AE 09355‐9997 VIA USPS, Le ers take three weeks for delivery; packages take approxi‐
mately two weeks. Send items via USPS NOW, so he’ll get them in me!! 2
Volume 5, Issue 4
Mul disciplinary team, con nued from page 1 ees were the primary goals of the mission in August. To this end, the team treated more than 90 children in three oper‐
a ng rooms over a four‐day period. In addi on, CRNAs Shuhanna O’Bryan and Robbyn Barber‐Anderson, along with Dr. Lane, taught the Guatemalan periopera ve team at the center how to administer safe, efficient nasotracheal general anesthe cs to children in a rapid‐turnover ambula‐
tory anesthesia se ng. Vanderbilt has established a presence at the Moore Pediat‐
ric Surgery Center since its opening more than four years ago. Monroe Carell Jr. Children’s Hospital at Vanderbilt sponsors one of the opera ng rooms there, and the hospi‐
tal sends pediatric anesthesia and surgical teams to the center on surgical missions throughout the year. Addi onal team members par cipa ng in the August trip included periopera ve nursing staff from the Nashville Sur‐
gery Center, former Vanderbilt recovery room nurses, and former Vanderbilt Anesthesiology Department member Dr. Shannon Hersey. Members of the department are planning to return in Au‐
gust 2015 in order to con nue to meet the needs of the underserved and teach future genera ons of Guatemalan medical trainees. Above, Robbyn Barber‐Anderson teaches intuba on techniques.
Below, members of the surgical mission team enroute to Guatemala from Nashville. Front
row, le to right, Sandy Kemper, Jane Herring, Carol Foriest, and Danita Sullivan. Back
row, le to right, Robbyn Barber‐Anderson, George Adams, Laurie Gavilo‐Lane, and
Shuhanna O’Bryan.
Above, Nashville Surgery Center registered nurse
Danita Sullivan cares for a pa ent in PACU.
3
Volume 5, Issue 4
Just call her Alderman Sain
Ask data intelligence analyst Lana Sain what she’s been up to lately, and she’ll likely ra le off a long list…. Working with vari‐
ous Anesthesiology faculty members to provide the data they need to support important research studies, juggling the many ac vi es of her two busy teenage sons, Briar and Bo, running triathlons, camping, hiking…. Oh, and let’s not forget running for and winning an alderman’s seat in Manchester, Tennessee. Yes, Lana is quite busy, and she does it all with a winning smile and great a tude. In August, Lana was the top vote‐ge er in the Manchester al‐
dermanic race with 1,006 votes. She was sworn in on Septem‐
ber 2nd at a mee ng of the Board of Mayor and Alderman, and she will serve a four‐year term. Lana is a lifelong resident of Manchester, with the excep on of two years when she lived in Cambridge, Massachuse s, to pursue her educa on. She is a 1995 graduate of Coffee County High School. In a post‐elec on statement, Lana wrote “From the bo om of my heart, I thank each and every one of you for the help, the encouragement, the exper se, and the fun...The goal was, is, and will always be to further progress and increase opportunity for the ci zens of Manchester. To make ourselves transparent Lana Sain, a member of the Vanderbilt Anesthesiology & Periopera ve Infor‐
ma cs Research (VAPIR) Division, is also a Manchester City Alderman.
and accountable to tax payers, and to be united with this common goal.” Lana joined the Department of Anesthesiology in October 2013, and she works in the Vanderbilt Anesthesiology & Periopera ve Informa cs Research (VAPIR) Division. Nairobi partnership brings doctor to Vanderbilt Kenya struggles with a dearth of pediatric anesthesiolo‐
gists, having a grand total of five. And that’s for a gen‐
eral popula on of 45 million, some 43 percent of whom are under the age of 15. One of those five busy special‐
ists, Susane Nabulindo, MBChB, traveled from Nairobi to Nashville for a two‐week observership at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Nabulindo’s Vanderbilt observership was arranged by Mark Newton, MD, associate professor of Clinical Anes‐
thesiology, and Jenna Helmer Sobey, MD, assistant pro‐
fessor of Anesthesiology. Read the full story: h p://
news.vanderbilt.edu/2014/10/anesthesiologist‐from‐
nairobi‐observes‐services‐training/ Susane Nabulindo, MBChB, from the University of Nairobi,
works with Mark Newton, MD, and Jenna Helmer Sobey, MD,
during Nabulindo’s two‐week Anesthesiology observership at
Vanderbilt. (Photo by Susan Urmy, VU.)
4
Volume 5, Issue 4
2014 Faculty and Staff Service Awards
Faculty
Staff
Five Years Five Years
Julian Bick, MD Bill Furman, MD John Hall, MD Stephen Harvey, MD Koffi Kla, MD Roy Neeley, MD Nahel Saied, MD Chad Wagner, MD Laura Zeigler, MD Ten Years Chris Canlas, MD Amy Lynch, MD Stuart McGrane, MD Rigoberto Sierra‐Anderson, MD Jeffrey Walman, MD Ma Weinger, MD Fi een Years Stephen Hays, MD Heidi Smith, MD Twenty Years
John Barwise, MD Meera Chandrashekar, MD Robert Deegan, MD Michael Higgins, MD Letha Ma hews, MD Ray Paschall, MD Sally Watson, MD Twenty‐five Years
John Downing, MD Ann Walia, MD Donna Ray Anthony Kiersten Card Lianyi Chen Christal Herron York Mary Kelley Donna Kenney Thomas Koss Nadine Krueger Jennifer Morse Kerri Rios Nathan Sco Lorie Taylor Angela Woodcock Ten Years
Charlo e Anderson Dorothy Atwood Jay Bell Melissa Chont Jennifer Cook Betsy DeMarcus Susan Dixner Shuhanna O’Bryan Todd Rushing Fi een Years
Kim Alexander Stephanie Clark Jerry Ishee Joyce Speer Twenty Years
Beverly Barker Elizabeth Card Dana Sylak Ki Szmyd‐Hogan 5
Volume 5, Issue 4
Equipment, training delivered to Guyana
The Vanderbilt Department of Anesthesiology, in partnership with the American Society of Anesthesi‐
ologists’ Global Humanitarian Outreach (GHO) initia‐
tive and the Lifebox Foundation, is making strides in reducing the number of deaths caused by unsafe surgery and anesthesia in Guyana by providing needed equipment and training to healthcare pro‐
viders to meet defined deficits in hospital operating rooms. In December 2013, Joseph Schlesinger, MD, trav‐
elled to Guyana to conduct a safe surgery and safe anesthesia assessment. His findings have been pub‐
lished in the Journal of Epidemiology and Global
Health (H Vansell, J Schlesinger, A Harvey, J Rohde, S Persaud, K McQueen, Anaesthesia, surgery, obstetrics, and emergency care in Guyana, Journal of Epidemiolo‐
Guyanan health care providers surround trainers who traveled to the country as part of the
Global Humanitarian Outreach’s effort to provide Lifebox pulse oximeters, as well as train‐
ing. In the center, le to right, are Berend Mets, MD, Anesthesiology chair at Penn State,
Hershey; Cliff Gevirtz, MD (private prac ce anesthesiologist in New York); Jason Mitchell,
MD (private prac ce anesthesiologist in Chicago); and our own Joseph Schlesinger, MD.
gy and Global Health, 7 October 2014, ISSN 2210‐6006, http://
dx.doi.org/10.1016/j.jegh.2014.08.003.). In May 2014, Kelly McQueen, MD, MPH, chair of ASA Global Humanitarian Outreach, travelled to Guyana to provide training on Lifebox pulse oximeters and to give donated devices to those receiving training. In Novem‐
ber 2014, Joseph Schlesinger, MD, returned to Guyana for a sec‐
ond time, where he provided training on the use of Lifebox pulse than 40 percent. Lifebox is a non‐governmental organization dedi‐
cated to bringing this life‐saving intervention to low‐resource set‐
ting countries, where risk of mortality from surgery can be 100 to 1000 times greater than in high‐resource setting coun‐
tries. oximeters to health care providers with the American Society of A survey tool adapted from Anesthesiologists Global Humanitarian Outreach group led by Ber‐
the WHO Tool for Situa‐
end Mets, MD, chair of the Penn State Department of Anesthesiol‐
tional Analysis to Assess ogy. Emergency and Essential “Training anesthesia providers and providing safe anesthesia in Guyana has been a challenge for years,” said Dr. Schlesinger. “Our department here at Vanderbilt has a close working relationship with the Georgetown Public Hospital Corporation physician and nurse anesthesia training programs. By working together, com‐
bined with our support of the Lifebox Initiative in Guyana, we can provide two missing components – adequate numbers of trained providers and basic safety equipment – for a healthcare system with increasing surgical needs.” Surgical Care and used in more than 32 low‐ and middle‐income countries (LMICs) was used to assess the surgical and anesthesia infrastructure in nine region‐
Dr. Kelly McQueen trains health care
workers in Guyana
al and district hospitals within the Ministry of Health system in Guyana. In the nine hospitals across Guyana, there was an aver‐
age of 0.7 obstetricians/gynecologists, 3.5 non‐OB surgeons, and one anesthesiologist per hospital. District and regional hospitals A pulse oximeter is the only piece of equipment required to com‐
performed an annual total of 1,520 and 10,340 surgical cases, plete the World Health Organization (WHO) Surgical Safety Check‐
respectively. An average hospital has two operating rooms, six list, proven to reduce surgical complications and mortality by more out of the nine hospitals reported routine medication shortages, 6
Volume 5, Issue 4
Please see Guyana, page 7
Faculty Promo ons, July 1, 2013 – June 30, 2014
Six Anesthesiology Department faculty members received well‐deserved promo ons during the 2013‐2014 academic year. Below are those individuals and their updated tles. Please congratulate these hard‐working faculty members as their con nued efforts and dedica on contribute to our department’s excellence and outstanding na onal reputa on. Arna Banerjee, MD Associate Professor of Anesthesiology, Surgery, and Medical Educa on John Barwise, MB, ChB Associate Professor of Clinical Anesthesiology and Neurological Surgery Jerod Denton, PhD Associate Professor of Anesthesiology and Pharmacology Susan Eagle, MD Associate Professor of Anesthesiology Guyana, con nued from page 6
and four out of the nine hospitals reported routine water or electricity shortages. Among the three regional hospitals, 16.1% of pregnancies resulted in Caesarean section. As part of the Lifebox pulse oximetry outreach in Guyana, the Van‐
derbilt Department of Anesthesiology has funded 20 pulse oximeters, and the ASA Charitable Foundation has funded 30, all of which have been given to now‐trained providers in the country. “The long term goal of the ASA Global Humanitarian Out‐
reach program is to improve access to and safety of anes‐
Jon Wanderer, MD, MPhil Assistant Professor of Anesthesiology and Biomedical Informa cs Chad Wagner, MD Associate Professor of Clinical Anesthesiology thesia in LMICs,” said Dr. McQueen. “The ASA GHO Lifebox Ini a ve is commi ed to providing pulse oximetry, train‐
ing, and outcomes evalua on throughout La n America. As one of the only GHO programs invested in training and educa on, the Lifebox Ini a ve has been a popular chari‐
table program for ASA members and residents.” 7
Volume 5, Issue 4
Vanderbilt Anesthesiology Rocks ASA Annual Mee ng
Congratula ons to all who played a part in the 2014 ASA Annual Mee ng and all related specialty mee ngs. Below is a run down of all the ac vi es that our department members led in New Orleans this year. On the following pages, enjoy some photos courtesy of Michael Pilla, MD, our in‐house photographer extraordinaire. Thank you for your part in showing the world that we ARE the Anesthesiology Department of record in the U.S. Above, Vice‐chair for Educa onal Affairs Ma McEvoy confers with
other Vanderbilt a endees during the 2014 ASA Annual Mee ng in
New Orleans.
At le , le to right, Tucker Mudrick, MD; Allison Janda, MD; and
Marc Lopez, MD; with Associate Residency Program Director Mi‐
chael Pilla, MD.
Ac vity
2014
2013
Best of Abstracts
Symposiums/Forums
Refresher Courses
Oral Presenta ons
Problem‐based Learning Discussions
Panel Discussions
Workshops
Medically Challenging Cases
Poster Presenta ons/Discussions
Special Mee ngs/Events
Scien fic & Educa onal Exhibits
Other: Award presenter (Kelly McQueen: humanitarian award); Program
co‐chair (Ann Walia: Interna onal Liver Transplanta on Society mee ng);
Mee ng organizer (Ann Walia: Associa on of Veterans Affairs
Anesthesiologists Annual Mee ng)
0
1
5
9
9
11
20
29
16
3
3
1
4
4
4
6
9
22
27
28
*
*
TOTAL
106
105
ac vi es ac vi es
8
Volume 5, Issue 4
Above, a large con ngent of Vanderbilt Anesthesiology Department members,
including faculty, fellows and residents, a ended, presented and lead educa onal
sessions at the 2014 ASA Annual Mee ng in New Orleans.
At le , Kara Siegrist, MD, presents a medically‐challenging case.
Below le , Jenna Helmer‐Sobey, MD, and Jessica Mudrick, MD.
Below, Brandon Lopez, MD; Jonathan Wanderer, MD, MPhil; and Kara Siegrist, MD.
9
Volume 5, Issue 4
Items listed in the Department Update are self‐reported by Division Chiefs and all department members. Any omission is not intentional. Items include all activities by department members since the last published newsletter. If you have an activity or accomplishment to list, please e‐mail information to Communications & Marketing Coordinator Jill Clendening, jill.clendening@vanderbilt.edu. Monthly e‐mail reminders are sent requesting these updates. ADQI XII Inves gators Group. The 12th consen‐
sus conference of the Acute Dialysis Quality Ini ‐
a ve (ADQI XII) Br. J. Anaesth. (2014) 113 (5): 729‐731.

The department is co‐sponsoring the Associa on of An‐
esthesia Clinical Directors (AACD) annual mee ng (March 13‐15, 2015, in Las Vegas). Poster submissions are being accepted – deadline January 15th: h p://
www.aacdhq.org/images/file/CALL%20FOR%
20ABSTRACTS%282%29.pdf It would be great to be well represented on the mee ng hall walls! 
One of our faculty/resident publica‐
ons was selected as the ar cle of the month for December for Anesthesia
and Analgesia: Epstein R, Dexter F, Lopez M, Ehrenfeld J. Anesthesiologist Staffing Considera ons Consequent to the Temporal Distribu on of Hypox‐
emic Episodes in the Postanesthesia Care Unit. Anesth Analg. Volume 119
Jesse Ehrenfeld, MD, MPH
(6), December 2014, 1322–1333. 
10
How do you earn all your AAA points in one swoop? Just take over a journal. In the November issue of the Bri sh
Journal of Anesthesia, Cardiothoracic Anesthesiology Division Chief Andrew Shaw, MD, dominates the pages: 
E. A. Hoste, K. Maitland, C. S. Brudney, R. Mehta, J.A. Kellum, M. G. Mythen, A.D. Shaw for the ADQI XII Inves gators Group. Four phases of in‐
travenous fluid therapy: a conceptual model. B J Anaesth. (2014) 113 (5): 740‐747. 
L. S. Chawla, C. Ince, D. Chappell, T. J. Gan, J. A. Kellum, M. Mythen, A. D. Shaw for the ADQI XII Fluids Workgroup. Vascular content, tone, integ‐
rity, and haemodynamics for guiding fluid thera‐
py: a conceptual approach Br. J. Anaesth. (2014) 113 (5): 748‐755. 
S. Goldstein, S. Bagshaw, M. Cecconi, M. Okusa, H. Wang, J. Kellum, M. Mythen, A. D. Shaw for the ADQI XII Inves gators Group. Pharmacologi‐
cal management of fluid overload Br. J. Anaesth. (2014) 113 (5): 756‐763. 
M. H. Rosner, M. Ostermann, R. Murugan, J. R. Prowle, C. Ronco, J. A. Kellum, M. G. Mythen, A.
D. Shaw for the ADQI XII Inves gators Group. Indica ons and management of mechanical fluid removal in cri cal illness Br. J. Anaesth. (2014) 113 (5): 764‐771. 
K. Raghunathan, P. T. Murray, W. S. Bea e, D. N. Lobo, J. Myburgh, R. Sladen, J. A. Kellum, M. G. Mythen, A. D. Shaw for the ADQI XII Inves ‐
gators Group. Choice of fluid in acute illness: what should be given? An interna onal consen‐
sus Br. J. Anaesth. (2014) 113 (5): 772‐783. 
J. A. Kellum, M. G. Mythen, A. D. Shaw for the Volume 5, Issue 4
 Elisabeth Hughes, MD, has been named Associate Program Director for the Residency Program. Jane Easdown,
MD, transi oned out of this role last summer and toward a role that will focus more on faculty development. Over the past several years, Dr. Hughes has served as Pediatric Anesthesia Rota on Director and has been a key faculty Elisabeth Hughes, MD member on departmental educa on commi ees. In her new role, Dr. Hughes will oversee the ABA BASIC Exam Series for CA‐1s and sub‐specialty rota on didac cs. Addi onally, she will work with rota on directors to update learning goals and objec ves and match these with rota on‐specific evalua‐
ons in Milestones language. 
Mias Pretorius, MD, MSCI, has accepted the posi on as the new Program Direc‐
tor of the Cardiothoracic Anesthesiology Fellowship. A er considering numerous candidates in a broad search, we are excited to announce that the best candi‐
date for the posi on was already in our department. Dr. Pretorius is Associate Professor with tenure in the Cardiotho‐ Mias Pretorius, MD, MSCI
racic Anesthesiology division at Vanderbilt. Dr. Pretorius has R01 funding from the NIH to conduct research into the renin‐angiotensin axis and its role in morbidity a er cardiac surgery. He has also completed the MSCI pro‐
gram here at Vanderbilt and is well placed to mentor the next genera on of physician scien sts as they begin to develop their own careers during their fellowship in car‐
diothoracic anesthesiology. Please congratulate Dr. Pre‐
torius in this new chapter in his career. 

Jerod Denton, PhD,
gave an invited talk en ‐
tled “Hold it! Develop‐
ment of insec cides that prevent mosquito urina on” to the Arkansas Board of Health at the Rockefeller Ins tute on Pe t Jean Mountain. The department's request to expand the residency pro‐
gram from 15 to 18 residents per year has been granted by the Accredita on Council for Graduate Medical Educa‐
on Residency Review Commi ee. As such, we will be recrui ng for 18 interns for next year and recrui ng for three advanced residents to add to our current intern class. Approval of this expansion is an amazing valida on of the great accomplishments that all of our team mem‐
bers — faculty, residents, and CRNAs — are making every day. Your good work, accomplishments, and leadership in medicine are being recognized. 
In October, Anesthesiology Department staff members Kim Alexander, Donna Ray Anthony, Danielle Brentson,
Mary Ruth Brewer, Kris Hasty, Andie Regg, and Ka e
Sweeney a ended an ACGME training course, “The Ba‐
sics of Accredita on for New Program Coordinators.” Also in October, Donna Ray Anthony, Kris Hasty, and Danielle Brentson a ended Residency Program Coordinator Boot Camp. Thanks to these staff members for their willing‐
ness to learn new skills to be er support the mission of our department. If you have requests for training that would assist you in your job role, please let your supervi‐
sor know. 
The department received no fica on in November of major funding received for two new randomized controlled trials led by research nurses. The trials will examine the effec veness of using 2% chlorhexidine gluconate skin prepa‐
ra on cloths post‐opera vely for infec‐
on preven on for two pa ent groups—colorectal pa ents (PI: Ste‐
Steven Klintworth, RN
ven Klintworth, RN) and those under‐
going back surgery. (PI: Elizabeth Card, MSN, APRN, FNP.) The wipes are currently used at VUMC preopera vely only. Jerod Denton, PhD

Heidi Smith, MD, MSCI, (above le ) was the invited interna onal expert for the recent European Delirium Society mee ng in Cremona, Italy, in November. She gave the only talk on pediatric delirium during the en re conference, and, according to other a endees, she knocked it out of the ballpark. Kudos to Dr. Smith! 11
Volume 5, Issue 4
Alvis B, King A, Hester D, Hughes C, Higgins M. Randomized controlled pilot trial of the Rigid and Flexing Laryngoscope versus the fiber‐op c bronchoscope for intuba on of poten‐
ally difficult airway. Minerva Anestesiol. 2014 Oct 3 [Epub]. Andresen J, Girard T, Pandharipande P, Davidson M, Ely E, Watson P. Burst suppression on processed electroenceph‐
alography as a predictor of postcoma delirium in mechanically ven lated ICU pa ents. Crit Care Med. 2014 Oct;42(10):2244‐
51. Ashby N, Squiers J. A historical perspec ve on the develop‐
ment of modern concepts of ssue perfusion: prehistory to the twen eth century. Crit Care Nurs Clin North Am. 2014 Sep;26(3):297‐309. Billings IV F, Shaw A. Clinical trial endpoints in acute kidney injury. Nephron Clin Pract. 2014;127(1‐4):89‐93 [Epub]. Bulka C, Shotwell M, Gupta R, Sandberg W, Ehrenfeld J. Re‐
gional anesthesia, me to hospital discharge, and in‐hospital mortality: a propensity score matched analysis. Reg Anesth Pain Med. 2014 Sep‐Oct;39(5):381‐6. Delpire E. How carbonic anhydrases and pH buffers facilitate the movement of carbon dioxide through biological mem‐
branes. Focus on "Evidence from simultaneous intracellular‐ and surface‐pH transients that carbonic anhydrase II enhanc‐
es CO2 fluxes across Xenopus oocyte plasma membranes"; "Evidence from simultaneous intracellular‐ and surface‐pH transients that carbonic anhydrase IV enhances CO2 fluxes across Xenopus oocyte plasma membranes"; and "Evidence from mathema cal modeling that carbonic anhydrase II and IV enhance CO2 fluxes across Xenopus oocyte plasma mem‐
branes". Am J Physiol Cell Physiol. 2014 Nov 1;307(9):C788‐
90. Ding J, Delpire E. Dele on of KCC3 in parvalbumin neurons leads to locomotor deficit in a condi onal mouse model of peripheral neuropathy associated with agenesis of the corpus callosum. Behav Brain Res. 2014 Nov 1;274:128‐36. Du on R, Lee L, Stephens L, Posner K, Davies J, Domino K. Massive hemorrhage: a report from the anesthesia closed claims project. Anesthesiology. 2014 Sep;121(3):450‐8. Bulka C, Wanderer J, Ehrenfeld J. Anesthesia technique and outcomes a er hip fracture surgery. JAMA. 2014 Nov 5;312
(17):1801. Epstein R, Dexter F, Lopez M, Ehrenfeld J. Anesthesiologist Staffing Considera ons Consequent to the Temporal Distribu‐
on of Hypoxemic Episodes in the Postanesthesia Care Unit. Anesth Analg. 2014 Sep 11 [Epub]. Chawla L, Ince C, Chappell D, Gan T, Kellum J, Mythen M, Shaw A; ADQI XII Fluids Workgroup. Vascular content, tone, integrity, and haemodynamics for guiding fluid therapy: a conceptual approach‡. Br J Anaesth. 2014 Nov;113(5):748‐55. Goldstein S, Bagshaw S, Cecconi M, Okusa M, Wang H, Kellum J, Mythen M, Shaw A; ADQI XII Inves gators Group. Pharma‐
cological management of fluid overload. Br J Anaesth. 2014 Nov;113(5):756‐63. Franklin A, Lorinc A, Donahue B. Malignant hyperthermia‐like manifesta ons in a two‐month‐old child with holt‐oram syn‐
drome undergoing cardiac surgery. J Cardiothorac Vasc Anesth. 2014 Oct;28(5):1326‐7. Haglund N, Maltais S, Bick J, Costello W, Keebler M, Davis M, Tricarico N, Wagner C. Hemodynamic transesophageal echo‐
cardiography a er le ventricular assist device implanta on. J Cardiothorac Vasc Anesth. 2014 Oct;28(5):1184‐90. Delpire E, Staley K. Novel determinants of the neuronal Cl‐ concentra on. J Physiol. 2014 Oct 1;592(Pt 19):4099‐4114. Hamlin S, Parmley C. Monitoring ssue perfusion and oxygen‐
a on. Crit Care Nurs Clin North Am. 2014 Sep;26(3):ix‐x. 12
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Hamlin S, Parmley C, Hanneman S. Microcirculatory altera‐
ons in shock states. Crit Care Nurs Clin North Am. 2014 Sep;26(3):399‐412. Hamlin S, Parmley C, Hanneman S. Microcirculatory oxygen transport and u liza on. Crit Care Nurs Clin North Am. 2014 Sep;26(3):311‐24. Harvey S, Corey J, Townley K. A modifica on of the single‐
penetra on, dual‐injec on technique for combined scia c and saphenous nerve blocks. Reg Anesth Pain Med. 2014 Nov‐
Dec;39(6):561. Hata J, Togashi K, Kumar A, Hodges L, Kaiser E, Tessmann P, Faust C, Sessler D. The effect of the pressure‐volume curve for posi ve end‐expiratory pressure tra on on clinical outcomes in acute respiratory distress syndrome: a systema c review. J Intensive Care Med. 2014 Nov;29(6):348‐56. Hernandez A, Shaw A. Projec ng clinical insight from quality simula on data. Respir Care. 2014 Sep;59(9):1456‐7. Hoste E, McCullough P, Kashani K, Chawla L, Joannidis M, Shaw A, Feldkamp T, Ue willer‐Geiger D, McCarthy P, Shi J, Walker M, Kellum J; Sapphire Inves gators. Deriva on and valida on of cutoffs for clinical use of cell cycle arrest bi‐
omarkers. Nephrol Dial Transplant. 2014 Nov;29(11):2054‐61. Hoste E, Maitland K, Brudney C, Mehta R, Vincent J, Yates D, Kellum J, Mythen M, Shaw A; ADQI XII Inves gators Group. Four phases of intravenous fluid therapy: a conceptual mod‐
el†. Br J Anaesth. 2014 Nov;113(5):740‐7. Huntoon M, Buvanendran A. Transforaminal epidural steroid injec ons: anatomical and imaging analysis trumps other agendas. Reg Anesth Pain Med. 2014 Nov‐Dec;39(6):445‐6. Kassebaum NJ, Bertozzi‐Villa A, Lam H, et al. Global, regional, and na onal levels and causes of maternal mortality during 1990‐2013: a systema c analysis for the Global Burden of Dis‐
ease Study 2013. Lancet. 2014 Sep 13;384(9947):980‐1004. Kellum J, Mythen M, Shaw A for the ADQI XII Inves gators Group. The 12th consensus conference of the Acute Dialysis Quality Ini a ve (ADQI XII) Br. J. Anaesth. (2014) 113 (5):729‐
731. Kumar A, Shi Y, Shotwell M, Richards J, Ehrenfeld J. Hyper‐
natremia is a Significant Risk Factor for Acute Kidney Injury A er Subarachnoid Hemorrhage: A Retrospec ve Analysis. Neurocrit Care. 2014 Sep 18. [Epub]. Markadieu N, Rios K, Spiller B, McDonald W, Welling P, Del‐
pire E. Short Forms of Ste20‐related Proline/Alanine‐rich Ki‐
nase (SPAK) in the Kidney Are Created by Aspartyl Aminopep‐
dase (Dnpep)‐mediated Proteoly c Cleavage. J Biol Chem. 2014 Oct 17;289(42):29273‐84. Mathews L, Kla K, Marolen K, Sandberg W, Ehrenfeld J. Meas‐
uring and Improving First Case On‐Time Starts and Analysis of Factors Predic ng Delay in Neurosurgical Opera ng Rooms. J Neurosurg Anesthesiol. 2014 Sep 30 [Epub]. McDavid S, Bauer M, Brindley R, Jewell M, Currie K. Butanol isomers exert dis nct effects on voltage‐gated calcium chan‐
nel currents and thus catecholamine secre on in adrenal chromaffin cells. PLoS One. 2014 Oct 2;9(10):e109203. McDonald M, Bulka C, Thakore R, Obremskey W, Ehrenfeld J, Jahangir A, Sethi M. Ankle radiographs in the early postopera‐
ve period: do they ma er? J Orthop Trauma. 2014 Sep;28
(9):538‐41. McEvoy M, Hand W, Furse C, Field L, Clark C, Moitra V, Nietert P, O'Connor M, Nunnally M. Validity and reliability assessment of detailed scoring checklists for use during periopera ve emergency simula on training. Simul Healthc. 2014 Oct;9
(5):295‐303. Miller O, Yang L, Wang C, Hargroder E, Zhang Y, Delpire E, Hall B. GluN2B‐containing NMDA receptors regulate depression‐
like behavior and are cri cal for the rapid an depressant ac‐
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ons of ketamine. Elife. 2014 Oct 23;3. DOI: h p://dx.doi.org/10.7554/eLife.03581. Raghunathan K, Murray P, Bea e W, Lobo D, Myburgh J, Sladen R, Kellum J, Mythen M, Shaw A; ADQI XII Inves gators Group. Choice of fluid in acute illness: what should be given? An interna onal consensus‡. Br J Anaesth. 2014 Nov;113
(5):772‐83. Raphemot R, Rouhier M, Swale D, Days E, Weaver C, Lovell K, Konkel L, Engers D, Bollinger S, Hopkins C, Piermarini P, Den‐
ton J. Discovery and Characteriza on of a Potent and Selec‐
ve Inhibitor of Aedes aegyp Inward Rec fier Potassium Channels. PLoS One. 2014 Nov 6;9(11):e110772. Riess M, Matsuura T, Bartos J, Bienengraeber M, Aldakkak M, McKnite S, Rees J, Aufderheide T, Sarraf M, Neumar R, Yan‐
nopoulos D. Anaesthe c postcondi oning at the ini a on of CPR improves myocardial and mitochondrial func on in a pig model of prolonged untreated ventricular fibrilla on. Resusci‐
ta on. 2014 Oct 2 [Epub]. Rosner M, Ostermann M, Murugan R, Prowle J, Ronco C, Kel‐
lum J, Mythen M, Shaw A; ADQI XII Inves gators Group. Indi‐
ca ons and management of mechanical fluid removal in cri ‐
cal illness. Br J Anaesth. 2014 Nov;113(5):764‐71. Rouhier M, Hine R, Park S, Raphemot R, Denton J, Pier‐
marini P, Beyenbach K. Excre on of NaCl and KCl loads in mosquitoes. 2. Effects of the small molecule Kir channel modulator VU573 and its inac ve analog VU342. Am J Phys‐
iol Regul Integr Comp Physiol. 2014 Oct 1;307(7):R850‐61. Schildcrout J, Han X, Ehrenfeld J, Wagner C, Pretorius M. In reply. Anesthesiology. 2014 Nov;121(5):1128‐30. Shaw A, Raghunathan K, Peyerl F, Munson S, Paluszkiewicz S, Schermer C. Associa on between intravenous chloride load during resuscita on and in‐hospital mortality among pa ents with SIRS. Intensive Care Med. 2014 Oct 8 [Epub]. 14
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Shisler D, Aus n T, Delpire E, Sawyer D, Pandey A. Syndrome of severe pain associated with a con nuous bumetanide in‐
fusion. Int J Cardiol. 2014 Oct 5 [Epub]. Sileshi B, Shaw A. Sepsis: Protocolized care for cri cally ill pa ents with AKI. Nat Rev Nephrol. 2014 Nov 4 [Epub]. Talbot T, Wang D, Swi M, St Jacques P, Johnson S, Brinsko V, Thayer V, Dail T, Feistritzer N, Polancich S. Implementa on of an enhanced safety‐engineered sharp device oversight and bloodborne pathogen protec on program at a large aca‐
demic medical center. Infect Control Hosp Epidemiol. 2014 Nov;35(11):1383‐90. Wanderer J, Rathmell J. Massive hemorrhage and malprac‐
ce claims. Anesthesiology. 2014 Sep;121(3):A21. Wanderer J, Rathmell J. Care transi ons: handover carefully! Anesthesiology. 2014 Oct;121(4):A21. Wanderer J, Rathmell J. Epidural injec ons and the new sub‐
speciality of pain medicine. Anesthesiology. 2014 Nov;121
(5):A23. Wanderer J, Shi Y, Schildcrout J, Ehrenfeld J, Epstein R. Su‐
pervising Anesthesiologists Cannot Be Effec vely Compared According to Their Pa ents' Postanesthesia Care Unit Admis‐
sion Pain Scores. Anesth Analg. 2014 Oct 16 [Epub]. Wanderer J, Shaw A, Ehrenfeld J. Automated data transmis‐
sion for the society of thoracic surgeons' adult cardiac anes‐
thesia module. Anesth Analg. 2014 Nov;119(5):1221‐2. Wang H, Liddell CA, Banerjee A, et al. Global, regional, and na onal levels of neonatal, infant, and under‐5 mortality during 1990‐2013: a systema c analysis for the Global Bur‐
den of Disease Study 2013. Lancet. 2014 Sep 13;384
(9947):957‐79. Erratum in: Lancet. 2014 Sep 13;384
(9947):956. Watkins S, Williamson K, Davidson M, Donahue B. Long‐
term mortality associated with acute kidney injury in chil‐
dren following congenital cardiac surgery. Paediatr Anaesth. 2014 Sep;24(9):919‐26. the medical system, Leslie decided to change her career path. She wanted to make an impact by helping educate future doctors. And, she’s doing just that in her role with our department today. Weinger M, Burden A, Steadman R, Gaba D. This is not a test!: Misconcep ons surrounding the maintenance of cer fica on in anesthesiology simula on course. Anes‐
thesiology. 2014 Sep;121(3):655‐9. Leslie’s story and her journey to her career was featured in the Clemson University alumni newle er in October. Read the story here: h p://newsstand.clemson.edu/how‐one‐alumnas‐mother‐
inspired‐her‐career‐path‐and‐vice‐versa/?
utm_campaign=headon&utm_source=echo&utm_medium=email Whyte S, Nathan A, Myers D, Watkins S, Kannankeril P, Ether‐
idge S, Andrade J, Collins K, Law I, Hayes J, Sanatani S. The safe‐
ty of modern anesthesia for children with long QT syndrome. Anesth Analg. 2014 Oct;119(4):932‐8. Zuckerman S, Forbes J, Mistry A, Krishnamoorthi H, Weaver S,
Mathews L, Cheng J, McGirt M. Electrophysiologic deteriora on in surgery for thoracic disc hernia on: impact of mean arterial pressures on surgical outcome. Eur Spine J. 2014 Nov;23
(11):2279‐90. Accepted for Publica on Ghamari‐Langroudi M, Digby G, Sebag J, Millhauser G, Palomino R, Ma hews R, Gillyard T, Tough I, Cox H, Denton, J, Cone, R. a‐
MSH and AGRP are G‐protein independent diametric agonists of Kri channel func on in hypothalamic neurons. Nature (In press) When Leslie Fowler, MEd, director of Edu‐
ca on Development and Research in the Office of Educa onal Affairs, was a middle school teacher her mother was diag‐
nosed with stage‐four breast cancer. As she watched her mother struggle both with her illness and with suc‐
cessfully naviga ng Ella Marie Hughes, daughter of Anesthesiology Department faculty members Drs. Chris and Liz Hughes, was born prematurely at 26 weeks on August 9, 2014, at 11:28 pm, weighing just 1 lb. 12 oz. She spent her first 10 weeks, three days in NICU. She arrived home on Tuesday, October 21, weighing 4 lbs. 13 oz. The Hughes family is very grateful for all of your thoughts, prayers, and support during this challenging me. We all look forward to ge ng to know our newest department member! 15
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Important Reminders
 The department receives a significant Self‐insurance Trust Rebate (up to 10%) of our medical mal‐
practice premium for meeting certain metrics. All faculty, fellows, residents, and interns must re‐
view two policies, which have been emailed. We must document and report 100% compliance. Al‐
so, new department members MUST review a presentation: “Addressing Behaviors That Under‐
mine a Culture of Safety,” and complete a post‐test. This information has been emailed to those who need to review the presentation. REMINDERS on these items have been sent.  The department’s new Global Anesthesia Fellowship (see no ce above) is seeking applicants, so if you know of great candidates, send them to Kelly McQueen, MD, Global Anesthesia Fellowship pro‐
gram director. More informa on on the fellowship and the applica on can be found at: h p://www.mc.vanderbilt.edu/global_anesthesiology_fellowship 16
Volume 5, Issue 4
Message from the Chair, Dr. Warren Sandberg As we close out 2014, I’d like to thank you
all for your hard work and dedica on to
the mission of our department—exemplary
pa ent care; top‐notch educa on for our
medical students, residents, and fellows;
and the pursuit of cu ng‐edge basic,
transla onal, and clinical research.
I’m looking forward to another banner
year with you in 2015!
Get Your Flu Shot — It’s Now Mandatory! To protect both employees and pa ents at VUMC from poten al harm, the Medical Center has revised its influenza vaccina on plan and is manda ng the influenza vac‐
cine for all VUMC employees. The mandatory program applies to all VUMC employees, faculty, staff, residents and fellows, temporary workers, trainees, volunteers, students, vendors, and voluntary medical staff. The following changes have been made to the influenza vaccina on exemp on pro‐
cess for the 2014‐2015 season. 
All VUMC employees must be compliant (vaccinated or exempted) by 12/31/2014. Self report: h p://healthandwellness.vanderbilt.edu/occupa onal‐health/ 
Any VUMC employee reques ng an exemp on to vaccina on must do so by 12/8/14. 
Flu vaccina on exemp ons are limited to three categories: medical, allergy, and sincerely held religious/
personal belief. Personnel who received an exemp on prior to Nov. 7, 2014, will be no fied if they need to sub‐
mit a new request. For more informa on, visit h p://healthandwellness.vanderbilt.edu/occupa onal‐health/flu/index.php to view the 2014‐2015 Influenza Vaccina on Plan for VUMC Employees and Frequently Asked Ques ons (FAQs). 17
Volume 5, Issue 4
Vanderbilt team seeks to enhance nuclear power plant opera ons
Taking the knowledge they have of engineering and human factors research as it applys to manag‐
ing a complex medical environment, a Vanderbilt team has received an $800,000 Department of En‐
ergy grant to help nuclear power plant operators be er perform their jobs. Principal inves gator for the grant, Ma hew B. Weinger, MD, professor of Anesthesiology, Bio‐
medical Informa cs, and Medical Educa on, is a na onally known leader in the field of human fac‐
tors research. Weinger is the director of the Van‐
derbilt Center for Research and Innova on in Sys‐
tems Safety (CRISS), as well as a physician at the VA Tennessee Valley Healthcare System. Read more: h p://news.vanderbilt.edu/2014/11/team‐seeks‐to‐
enhance‐nuclear‐power‐plant‐opera ons/ The team , le to right, Julie Adams, PhD, associate professor of Computer Science and
Computer Engineering; Shilo Anders, PhD, research assistant professor of Anesthesiolo‐
gy; Sankaran Mahadevan, PhD, professor of Civil and Environmental Engineering and
Mechanical Engineering; and the grant’s principal inves gator Ma hew B. Weinger, MD,
professor of Anesthesiology, Biomedical Informa cs, and Medical Educa on. Not pic‐
tured is Dan France, PhD, MPH, research associate professor of Anesthesiology and Bio‐
medical Engineering. (Photo by Anne Rayner, VU.) Please send us your news to share with other Vanderbilt alumni and faculty. News can include personal news, accomplishments, and achievements. In addition, send us your mailing address, e‐mail address and other current contact information so we can keep you updated on all the latest news and upcoming events. Please send news via e‐mail to Communications & Marketing Coordinator Jill Clendening at: jill.clendening@vanderbilt.edu , or by calling 615‐322‐4841.
Vanderbilt University Department of Anesthesiology 1211 21st Avenue South 722 Medical Arts Building Nashville, TN 37212 24
Volume 5, Issue 4