Volume 9, No. 4 • Winter 1994

APSF Awards 3 Safety Research Grants

Jeffrey B. Cooper, Ph.D.

Publications from Past Grant Sponsored Research Number over 100 to Date

The Anesthesia Patient Safety Foundation has selected three projects to receive research grant awards beginning on January 1, 1995. This was an especially competitive year; twenty-six applications were submitted. There were many new themes represented in the proposals and a noticeable improvement in the quality of the writing and experimental design.

This year’s grants were awarded to:

Mark A. Warner, MD and Co-investigator Denise J. Wedel, MD, Department of Anesthesiology, Mayo Clinic

Mark A. Warner, M.D.

Title: Profiles and Outcomes of Anesthetized Patients Who Have Undiagnosed Muscular Dystrophy.

This project will address the recent, controversial proposed restriction of succinylcholine use by the Food and Drug Administration. The objective of the study will be to determine the risk of an anesthesiologist encountering a young patient with undiagnosed muscular dystrophy (MD) and the rates of mortality and morbidity associated with anesthetics for patients with undiagnosed MD. If sufficient mortality or major morbidity are identified, a case-control study will be performed to determine risk factors for those outcomes.

The study will use as its source of data the unique database that has been assembled from patients in Olmsted County, MN, and the Mayo Clinic between 1957-1993. An earlier grant from the APSF to the same principal investigator contributed to analysis of other aspects of this database, resulting in numerous publications (see below). It is hoped that this study will provide more objective information that perhaps could be used to guide decision making concerning this timely issue.

Susan Black, MD, Department of Anesthesia, University of Florida, College of Medicine

Susan Black, M.D.

Title: Prolonged Postoperative Cognitive Dysfunction in Elderly Patients

Prolonged postoperative cognitive dysfunction is a recognized, but poorly characterized postoperative complication. Dr. Black will lead an effort at one of eleven institutions, each studying 200 patients and adhering to the same protocol, to identify the incidence of PPOCD in elderly patients and test the hypothesis that there is a correlation between perioperative hypoxemia and this event.

The international multi-center study has its main funding from the European Community and involves ten European hospital sites. Data will be analyzed at the University of Eindhoven in Holland. This is a unique opportunity to develop a sufficiently large database to study an elusive problem. Prior experience in psychometric testing by key investigators in the group has lead to development of a well designed battery of tests that should better quantitate the higher cognitive functions related to memory, attention, concentration, shifting ability, speed of information processing and other functions.

Davy C.H. Cheng, MD and Co-investigators Jacek Karski, MD, Charles Peniston, MD, Tirone David, MD, Alan Sandler, MD, Department of Anesthesia, The Toronto Hospital, University of Toronto

Davy C.H. Cheng, M.D.

Title: Is Early Extubation Safe in Patients Following Coronary Artery Bypass Graft Surgery? A Prospective Randomized Controlled Outcome Study

Dr. Cheng will build on a completed pilot study to examine a question of intense current interest. The larger issue is also of special importance: increasing pressures to reduce health care costs present new challenges for patient safety. This investigation will use a randomized controlled trial to assess the safety of early extubation, which is becoming a practice following coronary artery bypass graft surgery and other major procedures in an effort to move patients through the perioperative system more quickly. The hypothesis to be tested is that a modified, low-dose narcotic technique with propofol and early tracheal extubation following CABG surgery is safe compared to ‘conventional” high-dose narcotic anesthetic technique and later tracheal extubation.