Pre-surgical Spine Optimization Program Gains Momentum
psychologic preparation and telehealth for surgery in higher-risk patients. “The ultimate goal is to improve patient outcomes,” notes Dr. Thomas Buchheit, Duke Anesthesiology’s chief of the Division of Pain Medicine. He completed an initial In effort to establish Duke as an internapilot program last year and determined tional leader for defining and measuring that there was a clear, clinical need for an the steps for optimal care of pain and spine expanded and comprehensive program. patients, Duke Anesthesiology is collaborat- Anesthesiologist, Dr. Neil Ray, and orthoing with Duke Orthopaedic Surgery on an paedic spine surgeon, Dr. Sergio Mendoza innovative program for pre-surgical spine Lattes, have also been at the helm since optimization. The Spine Program Optimizaits inception. tion for Risk Cohorts combines medical inCurrently finalizing processes, the protervention, physical therapy prehabilitation, gram will start its phase two intervention in November of 2016 as a Perioperative Enhancement Team (POET) initiative. Additionally, there will be close measurements of outcomes, a critical step in the delivery of outcomes-based, cost conscious care within Duke Thomas E. Buchheit, MD Neil D. Ray, MD Sergio Mendoza Lattes, MD Anesthesiology. n
Pediatric Medical Mission in the Philippines With a population of nearly 102 million and a birth rate of 24 per 1,000, congenital heart disease (CHD) is a significant health concern in the Philippines. Annually, 20,000 children with CHD are born in the Philippines and one out of four of those patients dies due to lack of medical treatment. According to the World Health Organization, CHD is currently the fourth leading cause of death in Filipino children under the age of five. A multidisciplinary team from Duke University Health System (DUHS), led by Dr. Andrew Lodge, returned to the Philippine Children’s Medical Center (PCMC) on April 18 for their fifth cardiac surgery mission. During their trip, the team successfully completed ten open heart operations on children with a variety of congenital heart defects. Duke Anesthesiology’s Dr. Kelly Machovec and Emily Funk, CRNA, partici8
Dr. Kelly Machovec (left) and CRNA Emily Funk (right) assisted with ten successful open heart surgeries for Filipino children.
pated in the provision of anesthetic care for the children. Diagnoses treated on this surgical mission included total anomalous pulmonary venous connection, ventricular septal defects, atrial septal defects, patent ductus arteriosus, tetralogy of fallot, and A-V septal defect. n
Tackling Intracerebral Haemorrhage With Gender Hormones Clinician-researcher, Dr. Michael “Luke” James, has been studying two specific factors that may impact recovery Michael L. “Luke” James, after patients suffer MD, FAHA an intracerebral hemorrhage (ICH): sex and gonadal hormones. His groundbreaking research was featured in the August 2015 issue of International Innovation, a magazine that covers innovative research projects worldwide in new and exciting ways. In the interview, Dr. James reveals that by unveiling the sex differences in ICH outcomes, this may contribute to a wider clinical and research area. According to the magazine, ICH is the only stroke subtype with no effective treatment. Stroke is currently the fifth leading cause of death in the U.S. and ICH accounts for 50 percent of all stroke mortalities. With hardly any research on the effects of sex differences on ICH outcome and the extent to which demographic factors interact with each other, Dr. James’ findings may one day guide the development of novel, patient-tailored therapies for ICH. n View the Full Magazine Article: TinyURL.com/JamesInnovation
Wake Up Safe National Quality Improvement Initiative
Duke Anesthesiology is now part of a national collaboration among more than 30 children’s hospitals to make pediatric anesthesia safer than ever before by sharing and analyzing adverse events in the pediatric population. As members of the Society for Pediatric Anesthesia, and with the leadership of Dr. Nathaniel Greene, our department has access to additional resources to improve the care of children.