Temple University

Traumatology

Temple University hosts one of the busiest level 1 trauma centers in the Eastern Pennsylvanian / Southern New Jersey region. The Department of Anesthesiology fosters several ongoing investigations dealing with the optimal care of and common complications experienced by trauma patients. For example, the incidence and pathophysiology of acute hyperkalemia in the immediate aftermath of polytrauma is not well defined. Current efforts are targeted at elucidating the underlying mechanisms of this problem as well as crafting mitigation strategies. Additional studies are examining the effect of triage and clearance protocols on the time to surgery and ultimate outcome for orthopedic trauma patients.

Robotic Surgery

The past decade has seen an explosion of robotic techniques for urological, general, gynecological, thoracic, and cardiac surgery. However, in many instances the effects of a robotically assisted approach on both perioperative physiology and anesthetically important outcomes have not been well described. Prolonged CO2 insufflation and extreme positioning are just two factors presenting unique challenges to the perioperative team. Currently, Temple University anesthesiologists are studying the incidence and possible etiology of late respiratory failure in patients undergoing prolonged retroperitoneal dissections under robotic guidance.

Safer Surgery

The Temple Safer Surgery Initiative is a multidisciplinary effort to identify and modify the significant number of patient and provider behaviors that represent shared responsibilities and contribute meaningfully to adverse outcomes following elective surgery. Program components include preoperative risk factor identification and modification, pre-admission patient education and training, uniform perioperative standards of practice with regard to respiratory care and early ambulation, and branding of the program to the entire admission-to-discharge patient care team. Within this framework live several scholarly efforts. For example, preliminary work has required the careful study of the various means for calculating perioperative risk scores as they apply to the unique local population. Another ongoing study is quantifying the effect of various educational and training techniques on patient behaviors and perceptions.

Pulmonary Hypertension

Pulmonary hypertension has been described as an independent risk factor for perioperative morbidity and mortality. However, the precise interaction between various aspects of this disease and patient outcomes remains unclear; for example – the effect of measured pulmonary vascular resistance as a continuous variable and its interaction with advanced stages of right ventricular dysfunction. Furthermore, the inherent risk of various anesthetic techniques (general, regional, sedation, controlled versus spontaneous respiration) have never been described. The large population of patients passing through the Temple Pulmonary Hypertension clinic has provided fertile ground to investigate these issues in patients undergoing both non-cardiac surgery and lung transplantation.