The production of scholarly work is a core mission of the department. Faculty and residents routinely collaborate in the production and presentation of intellectual work both in print and at the relevant national society meetings. It is an expectation that all residents will become familiar with the essential aspects of clinical study design and execution during the course of their training. Monthly research planning meetings are mandatory for all residents and participation in ongoing projects or initiation of new protocols is encouraged.
Areas of active interest to department faculty include:
Perioperative management of lung transplant patients
Efforts are underway to isolate the causes of post-operative delirium in this patient population. The factors leading to and implications of the need for mechanical circulatory support during lung transplantation are also being investigated.
Inhaled nitric oxide and lung transplantation
A prospective study is being implemented to isolate the effect of prophylactic inhaled nitric oxide on short and long term graft function following lung transplantation.
Pulmonary hypertension and sedation or general anesthesia
It is hypothesized that both pulmonary vascular resistance and right ventricular function are independently linked to peri-procedural complication rates. The nature and magnitude of these relationships are being studied.
Perioperative care of acute trauma patients
Hyperkalemia is an uncommon but known complication during the acute resuscitation of trauma patients in the operating room. Causative relationships are being sought with known potentiating factors.
Perioperative care management protocols
The effect of standardized care, communication and education protocols on length of hospital stay and the incidence of complications following surgery for hip fractures is being studied.
Extra-Corporeal Membrane Oxygenation (ECMO)
Understanding the local determinants of survival or futility for patients requiring support with ECMO are critical for both clinical patient management and stewardship of a limited resource. A retrospective analysis of the Temple University Hospital experience is underway to help identify these factors.
Anecdotal experience suggests that the historical "gold standard" for acute management of epiglottitis may no longer apply as a result of evolving diagnostic and airway techniques. An investigation is underway to better characterize this phenomenon.
Robotic retroperitoneal surgery
It is possible that variations in both patient body habitus and surgical technique may increase the risk of respiratory complications following robotic abdominal surgery. Prospective investigations are ongoing to better understand this pathophysiology.
Partial hepatectomy management
Conventional practice is to minimize central venous pressure during open liver resections in order to minimize blood loss. The true effect of this practice and how best to lower venous pressure is under investigation.
Goal directed fluid therapy
Goal directed fluid management has been shown to affect clinical outcomes under the strictly managed conditions of certain clinical trials. It is less certain if application of a commercially available monitoring system to a heterogeneous population of high risk surgical patients can be demonstrated to have measurably positive economic benefits.
Post-operative pain management
A variety of non-pharmacological adjuncts have been show to affect pain perception under experimental conditions. The use of music therapy in the post-operative period will be studied for its affect on the perception of acute pain and the need for analgesics.
Noncompliance in outpatient chronic pain patients
Identification of non-compliance in patients dependent on chronic opioid therapy can be challenging. Self reported questionnaire answers are being studied to determine their predictive value for violation of the patient narcotic contract.
Perioperative nerve injury
The contributing factors to perioperative peripheral nerve injury under general anesthesia are being studied using nerve conduction velocity measurements and correlation with patient and procedure specific characteristics.
Regional Anesthesia and Cesarean Section
Failed spinal anesthesia for cesarean section occurs infrequently but often unexpectedly. A retrospective review is underway to identify those parameters that may better predict failed regional anesthesia after apparently successful intrathecal injection of local anesthetics in this patient population.