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  1. Article ; Online: A Case Report of Tension Hydrothorax Incited by Bowel Perforation.

    Sanchez, Kyle J / Walsh, Elisa C / Bittner, Edward A / Ruscic, Katarina J

    A&A practice

    2023  Volume 17, Issue 12, Page(s) e01729

    Abstract: We report the case of a 34-year-old man who developed cardiac arrest due to tension hydrothorax from colonic perforation. Tension hydrothorax, an entity characterized by pleural effusion leading to mediastinal compression, has not been reported in ... ...

    Abstract We report the case of a 34-year-old man who developed cardiac arrest due to tension hydrothorax from colonic perforation. Tension hydrothorax, an entity characterized by pleural effusion leading to mediastinal compression, has not been reported in association with intraabdominal inflammation. Our patient developed respiratory insufficiency after repair of colonic perforation, followed by respiratory failure and cardiac arrest. Transthoracic echocardiography provided rapid diagnosis during decompensation and prompted a lifesaving thoracostomy. Clinicians should consider tension hydrothorax as a rare cause of hemodynamic collapse, even in the absence of liver failure, and use bedside tools like transthoracic echocardiography to facilitate diagnosis and intervention.
    MeSH term(s) Adult ; Humans ; Male ; Heart Arrest ; Hydrothorax/diagnostic imaging ; Hydrothorax/etiology ; Hydrothorax/surgery ; Intestinal Perforation/complications ; Intestinal Perforation/surgery ; Pleural Effusion/diagnostic imaging ; Pleural Effusion/etiology ; Pleural Effusion/surgery ; Thoracostomy
    Language English
    Publishing date 2023-12-13
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000001729
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Silence of the lymphs: some anaesthetic regimens inhibit lymphatic pumping.

    Ruscic, Katarina J / Padera, Timothy P

    The Journal of physiology

    2019  Volume 597, Issue 11, Page(s) 2827–2828

    MeSH term(s) Anesthesia ; Anesthetics ; Lymph ; Lymphatic Vessels
    Chemical Substances Anesthetics
    Language English
    Publishing date 2019-05-12
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 3115-x
    ISSN 1469-7793 ; 0022-3751
    ISSN (online) 1469-7793
    ISSN 0022-3751
    DOI 10.1113/JP277914
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  3. Article: The Neuroma Startle Sign: A Surgical Indicator of Proximity to an Injured Nerve.

    Karinja, Sarah J / Gorky, Jonathon / Valerio, Ian L / Ruscic, Katarina J / Eberlin, Kyle R

    Plastic and reconstructive surgery. Global open

    2023  Volume 11, Issue 3, Page(s) e4890

    Abstract: During operative intervention for the treatment of symptomatic neuromas, the authors have observed a hypersensitive "startle" response to stimulation in proximity to the painful nerve. This physiologic sign is an indicator of the specific anatomic ... ...

    Abstract During operative intervention for the treatment of symptomatic neuromas, the authors have observed a hypersensitive "startle" response to stimulation in proximity to the painful nerve. This physiologic sign is an indicator of the specific anatomic localization of the painful stimulus, commonly a symptomatic neuroma, that appears to be reproducible. The aim of this article is to describe this "neuroma startle sign," posit the underlying mechanism for this observation, and propose how this phenomenon could be clinically harnessed for innovation and optimization in both surgery and anesthesia for more effective symptomatic neuroma localization.
    Language English
    Publishing date 2023-03-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000004890
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  4. Article: Proper selection of sedative drugs improves outcomes: volatile anesthetics are surgeons' best friends.

    Farhan, Hassan / Grabitz, Stephanie D / Ruscic, Katarina J / Eikermann, Matthias

    Annals of translational medicine

    2017  Volume 5, Issue 5, Page(s) 122

    Language English
    Publishing date 2017-03-16
    Publishing country China
    Document type Journal Article ; Comment
    ZDB-ID 2893931-1
    ISSN 2305-5847 ; 2305-5839
    ISSN (online) 2305-5847
    ISSN 2305-5839
    DOI 10.21037/atm.2017.02.24
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  5. Article ; Online: Systems Anesthesiology: Integrating Insights From Diverse Disciplines to Improve Perioperative Care.

    Ruscic, Katarina Jennifer / Hanidziar, Dusan / Shaw, Kendrick Matthew / Wiener-Kronish, Jeanine / Shelton, Kenneth Tierney

    Anesthesia and analgesia

    2022  Volume 135, Issue 4, Page(s) 673–677

    MeSH term(s) Anesthesiology ; Humans ; Perioperative Care
    Language English
    Publishing date 2022-09-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000006166
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  6. Article ; Online: Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement.

    Ruscic, Katarina J / Grabitz, Stephanie D / Rudolph, Maíra I / Eikermann, Matthias

    Current opinion in anaesthesiology

    2017  Volume 30, Issue 3, Page(s) 399–408

    Abstract: Purpose of review: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common.: Recent findings!# ...

    Abstract Purpose of review: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common.
    Recent findings: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders.
    Summary: Preoperatively, patients should be risk-stratified for PRCs to individualize intraoperative choices and postoperative pathways. Laparoscopic compared with open surgery improves respiratory outcomes. High-risk patients should be treated by experienced providers based on locally developed bundle-interventions to optimize intraoperative treatment and ICU bed utilization. Intraoperatively, lung-protective ventilation (procedure-specific positive end-expiratory pressure utilization, and low driving pressure) and moderately restrictive fluid therapy should be used. To achieve surgical relaxation, high-dose neuromuscular blocking agents (and reversal agents) as well as high-dose opioids should be avoided; inhaled anesthetics improve surgical conditions while protecting the lungs. Patients should be extubated in reverse Trendelenburg position. Postoperatively, continuous positive airway pressure helps prevent airway collapse and protocolized, early mobilization improves cognitive and respiratory function.
    Language English
    Publishing date 2017-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645203-6
    ISSN 1473-6500 ; 0952-7907
    ISSN (online) 1473-6500
    ISSN 0952-7907
    DOI 10.1097/ACO.0000000000000465
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  7. Article: Lymphatic muscle cells are unique cells that undergo aging induced changes.

    Lei, Pin-Ji / Ruscic, Katarina J / Roh, Kangsan / Rajotte, Johanna J / O'Melia, Meghan J / Bouta, Echoe M / Marquez, Marla / Pereira, Ethel R / Kumar, Ashwin S / Arroyo-Ataz, Guillermo / Razavi, Mohammad S / Zhou, Hengbo / Menzel, Lutz / Kumra, Heena / Duquette, Mark / Huang, Peigen / Baish, James W / Munn, Lance L / Ubellacker, Jessalyn M /
    Jones, Dennis / Padera, Timothy P

    bioRxiv : the preprint server for biology

    2023  

    Abstract: Lymphatic muscle cells (LMCs) within the wall of collecting lymphatic vessels exhibit tonic and autonomous phasic contractions, which drive active lymph transport to maintain tissue-fluid homeostasis and support immune surveillance. Damage to LMCs ... ...

    Abstract Lymphatic muscle cells (LMCs) within the wall of collecting lymphatic vessels exhibit tonic and autonomous phasic contractions, which drive active lymph transport to maintain tissue-fluid homeostasis and support immune surveillance. Damage to LMCs disrupts lymphatic function and is related to various diseases. Despite their importance, knowledge of the transcriptional signatures in LMCs and how they relate to lymphatic function in normal and disease contexts is largely missing. We have generated a comprehensive transcriptional single-cell atlas-including LMCs-of collecting lymphatic vessels in mouse dermis at various ages. We identified genes that distinguish LMCs from other types of muscle cells, characterized the phenotypical and transcriptomic changes in LMCs in aged vessels, and uncovered a pro-inflammatory microenvironment that suppresses the contractile apparatus in advanced-aged LMCs. Our findings provide a valuable resource to accelerate future research for the identification of potential drug targets on LMCs to preserve lymphatic vessel function as well as supporting studies to identify genetic causes of primary lymphedema currently with unknown molecular explanation.
    Language English
    Publishing date 2023-11-19
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.11.18.567621
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  8. Article ; Online: Intraoperative Dexamethasone Decreases Infectious Complications After Pancreaticoduodenectomy and is Associated with Long-Term Survival in Pancreatic Cancer.

    Sandini, Marta / Ruscic, Katarina J / Ferrone, Cristina R / Warshaw, Andrew L / Qadan, Motaz / Eikermann, Matthias / Lillemoe, Keith D / Fernández-Del Castillo, Carlos

    Annals of surgical oncology

    2018  Volume 25, Issue 13, Page(s) 4020–4026

    Abstract: Background: Dexamethasone is administered intraoperatively to prevent anesthesia-related nausea and vomiting and to reduce postoperative opioid administration. However, the adverse effects of corticosteroids on anastomotic healing and wound infection as ...

    Abstract Background: Dexamethasone is administered intraoperatively to prevent anesthesia-related nausea and vomiting and to reduce postoperative opioid administration. However, the adverse effects of corticosteroids on anastomotic healing and wound infection as well as oncologic outcomes remain unclear. We analyzed the effect of intraoperative dexamethasone administration on surgical outcomes after pancreaticoduodenectomy and on long-term survival in pancreatic cancer patients.
    Methods: A total of 679 pancreaticoduodenectomies from a prospectively maintained database were analyzed. Surgical outcomes were compared between patients who received intraoperative dexamethasone and those who did not. Kaplan-Meier curves and Cox-regression survival analysis were performed in patients with pancreatic cancer. A propensity analysis was done to reduce the inherent bias of retrospective design.
    Results: Patients who received dexamethasone (117, 17.2%) were younger and more likely to be female than those who did not (p = 0.001). Overall and 30-day major morbidity were similar among all resected patients, although there were fewer infectious complications in the dexamethasone group (18.8% vs. 28.5%, p = 0.032). In pancreatic cancer patients, dexamethasone was associated with significantly improved median overall survival (46 vs. 22 months, p = 0.017). This effect occurred independently of stage, pathologic characteristics, or adjuvant therapy, with adjusted hazard ratios, derived from pre-propensity and post-propensity analysis, of 0.67 (0.47-0.97) and 0.57 (0.37-0.87), respectively.
    Conclusions: A single intraoperative dose of dexamethasone did not increase morbidity after pancreaticoduodenectomy and, in fact, was associated with a decrease in infectious complications. The treatment was independently associated with improved overall survival in patients with pancreatic adenocarcinoma, an effect that cannot be explained and needs further validation in a prospective setting.
    MeSH term(s) Abdominal Abscess/etiology ; Aged ; Carcinoma, Pancreatic Ductal/surgery ; Dexamethasone/therapeutic use ; Female ; Glucocorticoids/therapeutic use ; Humans ; Intraoperative Period ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatic Fistula/etiology ; Pancreatic Fistula/microbiology ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/adverse effects ; Pneumonia/etiology ; Proportional Hazards Models ; Retrospective Studies ; Sepsis/etiology ; Surgical Wound Infection/etiology ; Survival Rate ; Time Factors ; Urinary Tract Infections/etiology
    Chemical Substances Glucocorticoids ; Dexamethasone (7S5I7G3JQL)
    Language English
    Publishing date 2018-10-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-018-6827-5
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    Zs.A 4042: Show issues Location:
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  9. Article ; Online: Epidural Anesthesia to Facilitate Organ Blood Flow During the First Penile Transplantation in the United States: A Case Report.

    Ruscic, Katarina J / Zamora-Berridi, Grettel J / McGovern, Francis J / Cetrulo, Curtis / Winograd, Jonathan M / Eberlin, Kyle R / Bojovic, Branko / Ko, Dicken S / Anderson, T Anthony

    A&A practice

    2018  Volume 10, Issue 9, Page(s) 232–234

    Abstract: Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution ...

    Abstract Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS.
    Language English
    Publishing date 2018-04-28
    Publishing country United States
    Document type Journal Article
    ISSN 2575-3126
    ISSN (online) 2575-3126
    DOI 10.1213/XAA.0000000000000672
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Dose-Dependent Protective Effect of Inhalational Anesthetics Against Postoperative Respiratory Complications: A Prospective Analysis of Data on File From Three Hospitals in New England.

    Grabitz, Stephanie D / Farhan, Hassan N / Ruscic, Katarina J / Timm, Fanny P / Shin, Christina H / Thevathasan, Tharusan / Staehr-Rye, Anne K / Kurth, Tobias / Eikermann, Matthias

    Critical care medicine

    2017  Volume 45, Issue 1, Page(s) e30–e39

    Abstract: Objectives: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications.: Design: Prospective analysis of data ...

    Abstract Objectives: Inhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications.
    Design: Prospective analysis of data on file in surgical cases between January 2007 and December 2015.
    Setting: Massachusetts General Hospital (tertiary referral center) and two affiliated community hospitals.
    Patients: A total of 124,497 adult patients (105,267 in the study cohort and 19,230 in the validation cohort) undergoing noncardiac surgical procedures and requiring general anesthesia with endotracheal intubation.
    Interventions: Median effective dose equivalent of inhalational anesthetics during surgery (derived from mean end-tidal inhalational anesthetic concentrations).
    Measurements and main results: Postoperative respiratory complications occurred in 6,979 of 124,497 cases (5.61%). High inhalational anesthetic dose of 1.20 (1.13-1.30) (median [interquartile range])-fold median effective dose equivalent versus 0.57 (0.45-0.64)-fold median effective dose equivalent was associated with lower odds of postoperative respiratory complications (odds ratio, 0.59; 95% CI, 0.53-0.65; p < 0.001). Additionally, high inhalational anesthetic dose was associated with lower 30-day mortality and lower cost. Inhalational anesthetic dose increase and reduced risk of postoperative respiratory complications remained significant in sensitivity analyses stratified by preoperative and intraoperative risk factors.
    Conclusions: Intraoperative use of higher inhalational anesthetic doses is strongly associated with lower odds of postoperative respiratory complications, lower 30-day mortality, and lower cost of hospital care. The authors speculate based on these data that sedation with inhalational anesthetics outside of the operating room may likewise have protective effects that decrease the risk of respiratory complications in vulnerable patients.
    MeSH term(s) Anesthetics, Inhalation/administration & dosage ; Dose-Response Relationship, Drug ; Female ; Hospital Costs ; Hospital Mortality ; Humans ; Intubation, Intratracheal ; Male ; Massachusetts/epidemiology ; Middle Aged ; Pneumonia/prevention & control ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Propensity Score ; Prospective Studies ; Pulmonary Edema/epidemiology ; Pulmonary Edema/prevention & control ; Respiratory Insufficiency/epidemiology ; Respiratory Insufficiency/prevention & control
    Chemical Substances Anesthetics, Inhalation
    Language English
    Publishing date 2017-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000002015
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