Revision as of 22:56, 7 August 2024

Ideas

What is the optimal number of evals for residents and attending to fill out? Would having fewer result in higher quality? How often do residents and attendings look at their medhub evals? Does anyone find them useful? If they are not useful, lets stop doing them, or tweak it (to be less frequent)
Having anesthesia residents/attendings assigned some complex cases 1 month in advance and then have them do the pre-anesthetic eval and interim optimization for that patient. Perhaps even a post-op follow-up call or visit.
Low-flow anesthesia real-time decision support built into EPIC (or laminated card reminder placed on workstations). See Baby Miller pg. 877.
Is there anyway to educate providers on how (or if) anesthetic management decisions affect the bill the patient sees?
Recycling and waste sortage in the OR. Also, getting rid of ProVu!

Does change in PPV/CO after SCD activation predict fluid responsiveness and how does it compare to SLR?
Does sugammadex interfere with HRT in post-menopausal and/or lactating women? (0 articles mentioning both Sugammadex and Menopause)
EEG/MEP/SSEP patterns in monkeys/humans taking THC vs controls
Buprenorphine for induction or acute pain treatment in perioperative setting
Surgical TAP block vs US guided
Choice of anesthetic for cancer resection. Is TIVA superior to inhaled anesthesia for recurrence free survival in cancer surgery?
Xenon recycling (7 relevant papers)
Yohimbine for precedex reversal
Can the difference between FiO2 and ETO2 be used to estimate VO2?
Does normocytic hemodilution reduce RBC transfusion?
What do we know about the very low frequency EEG power bands? i.e. the stuff that is less than 0.2 Hz and is usually filtered out. Analogous to looking at the tides when everyone else is looking at the waves.
Young blood transfusions.

NIBP monitoring from head/neck
Can you modulate the strength of the Bohr effect to extract more hemoglobin from oxygen (thus prolonging apnea time before desaturation)? Humpback whales (and very small animals) have a much stronger Bohr effect, presumably from hemoglobin mutations. One approach would be non-immunogenic artificial hemoglobin proteins (made with CRISPR and perhaps packaged into empty RBCs?), another option would be some drug that modulates the Bohr effect on human Hgb.
Better way of determining fluid status
Novel reversal agents (e.g. volatile anesthetics, propofol, precedex)
Permanently inhibit a nerve to prevent phantom pain after amputation.
Reversible chemical/optical/electromagnetic knockdown/inhibition/interference of pain nuclei/DRG/dorsal column/STT activity in rodents/primates. https://onlinelibrary.wiley.com/doi/pdf/10.1002/ejp.1136
Fentanyl patch instead of remifentanil infusion? What other anesthetics could you deliver via patch? Could you do a patch induction for Peds? There is no remifentanil or sufentanil patch.
What is the MoA of APAP?
Transfusion thresholds

Wearable clinical alarms (2 relevant results, 1 highly relevant result)
VR for IV placement peds (6 articles spanning 2020-2022, 5 RCTs, and a systematic-review and meta-analysis)
Does precedex really delay emergence? (2022 Anesthesia and Analgesia Systematic Review and Meta-Analysis says "NO").

Which findings on the preop note predict pressors use during the case?
EPIC timeline builder
Does setting realistic pain expectations in pre-op decrease self-reported pain scores in PACU?
Ultrasound vs blind A-line first attempt success rate and complications?
How do epidurals affect gastric emptying?

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 ==Very Ambitious, But Still Cool==
 * NIBP monitoring from head/neck
-* Can you modulate the strength of the Bohr effect to extract more hemoglobin from oxygen (thus prolonging apnea time before desaturation)? Humpback whales (and very small animals) have a much stronger Bohr effect, presumably from hemoglobin mutations. One approach would be non-immunogenic artificial hemoglobin proteins (made with CRISPR and perhaps packaged into empty RBCs?), another option would be some drug that modulates the Bohr effect on human Hgb.
+* Can you [[Bohr Effect Modulation|modulate the strength of the Bohr effect]] to extract more hemoglobin from oxygen (thus prolonging apnea time before desaturation)? Humpback whales (and very small animals) have a much stronger Bohr effect, presumably from hemoglobin mutations. One approach would be non-immunogenic artificial hemoglobin proteins (made with CRISPR and perhaps packaged into empty RBCs?), another option would be some drug that modulates the Bohr effect on human Hgb.
 * Better way of determining fluid status
 * Novel reversal agents (e.g. volatile anesthetics, propofol, precedex)