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Author Matthias Eikermann

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Effect of Intraoperative Arterial Hypotension on the Risk of Perioperative Stroke After Noncardiac Surgery: A Retrospective Multicenter Cohort Study.

Karuna Wongtangman, Luca J Wachtendorf, Michael Blank, Stephanie D Grabitz, Felix C Linhardt, Omid Azimaraghi, Dana Raub, Stephanie Pham, Samir M Kendale, Ying H Low, Timothy T Houle, Matthias Eikermann, Richard J Pollard,

<h4>Background</h4>Intraoperative cerebral blood flow is mainly determined by cerebral perfusion pressure and cerebral autoregulation of vasomotor tone. About 1% of patients undergoing noncardiac surgery develop ischemic stroke. We hypothesized that intraoperative hypotension within a range frequently observed in clinical practice is associated with an increased risk of perioperative ischemic stroke ... Read more >>

Anesth Analg (Anesthesia and analgesia)
[2021, 133(4):1000-1008]

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The authors reply.

Karuna Wongtangman, Matthias Eikermann,

Crit Care Med (Critical care medicine)
[2021, 49(11):e1188-e1189]

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Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019-Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study.

Karuna Wongtangman, Peter Santer, Luca J Wachtendorf, Omid Azimaraghi, Elias Baedorf Kassis, Bijan Teja, Kadhiresan R Murugappan, Shahla Siddiqui, Matthias Eikermann, ,

<h4>Objectives</h4>In patients with coronavirus disease 2019-associated acute respiratory distress syndrome, sedatives and opioids are commonly administered which may lead to increased vulnerability to neurologic dysfunction. We tested the hypothesis that patients with coronavirus disease 2019-associated acute respiratory distress syndrome are at higher risk of in-hospital mortality due to prolonged coma ... Read more >>

Crit Care Med (Critical care medicine)
[2021, 49(9):1524-1534]

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The association of nitrous oxide on length of stay in the postanesthesia care unit: a retrospective observational study.

Salameh Sameh Obeidat, Karuna Wongtangman, Michael Blank, Luca J Wachtendorf, Maximilian Hammer, Maximilian S Schaefer, Peter Santer, Matthias Eikermann, Eswar Sundar,

<h4>Purpose</h4>To assess whether intraoperative use of nitrous oxide (N<sub>2</sub>O) as an adjunct to general anesthesia is associated with a shorter length of stay in the postanesthesia care unit (PACU).<h4>Methods</h4>We analyzed data from adult patients who underwent non-cardiothoracic surgery under general anesthesia between May 2008 and December 2018. We assessed the ... Read more >>

Can J Anaesth (Canadian journal of anaesthesia = Journal canadien d'anesthesie)
[2021, 68(11):1630-1640]

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REsidual Neuromuscular Block Prediction Score Versus Train-of-Four Ratio and Respiratory Outcomes: A Retrospective Cohort Study.

Maria D Patrocínio, Denys Shay, Maíra I Rudolph, Peter Santer, Stephanie D Grabitz, Xinling Xu, Sarah Nabel, Somnath Bose, Matthias Eikermann,

<h4>Background</h4>Residual neuromuscular blockade is associated with an increased incidence of postoperative respiratory complications. The REsidual neuromuscular block Prediction Score (REPS) identifies patients at high risk for residual neuromuscular blockade after surgery.<h4>Methods</h4>A total of 101,510 adults undergoing noncardiac surgery under general anesthesia from October 2005 to December 2018 at a tertiary ... Read more >>

Anesth Analg (Anesthesia and analgesia)
[2021, 133(3):610-619]

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Association Between Intraoperative Arterial Hypotension and Postoperative Delirium After Noncardiac Surgery: A Retrospective Multicenter Cohort Study.

Luca J Wachtendorf, Omid Azimaraghi, Peter Santer, Felix C Linhardt, Michael Blank, Aiman Suleiman, Curie Ahn, Ying H Low, Bijan Teja, Samir M Kendale, Maximilian S Schaefer, Timothy T Houle, Richard J Pollard, Balachundhar Subramaniam, Matthias Eikermann, Karuna Wongtangman,

<h4>Background</h4>It is unclear whether intraoperative arterial hypotension is associated with postoperative delirium. We hypothesized that intraoperative hypotension within a range frequently observed in clinical practice is associated with increased odds of delirium after surgery.<h4>Methods</h4>Adult noncardiac surgical patients undergoing general anesthesia at 2 academic medical centers between 2005 and 2017 were ... Read more >>

Anesth Analg (Anesthesia and analgesia)
[2021, :]

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Development and external validation of a prognostic model for ischaemic stroke after surgery.

Katharina Platzbecker, Stephanie D Grabitz, Dana Raub, Maíra I Rudolph, Sabine Friedrich, Nathan Vinzant, Tobias Kurth, Christian Weimar, Deepak L Bhatt, Ala Nozari, Timothy T Houle, Xinling Xu, Matthias Eikermann,

<h4>Background</h4>There is an under-recognised patient cohort at elevated risk of postoperative ischaemic stroke. We aimed to develop and validate a prognostic model for the identification of such patients at high risk of ischaemic stroke within 1 yr after noncardiac surgery.<h4>Methods</h4>This was a hospital registry study of adult patients undergoing noncardiac ... Read more >>

Br J Anaesth (British journal of anaesthesia)
[2021, 127(5):713-721]

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Optimal Sedation in Patients Who Receive Neuromuscular Blocking Agent Infusions for Treatment of Acute Respiratory Distress Syndrome-A Retrospective Cohort Study From a New England Health Care Network.

Karuna Wongtangman, Stephanie D Grabitz, Maximilian Hammer, Luca J Wachtendorf, Xinling Xu, Maximilian S Schaefer, Philipp Fassbender, Peter Santer, Elias Baedorf Kassis, Daniel Talmor, Matthias Eikermann, ,

<h4>Objectives</h4>Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ... Read more >>

Crit Care Med (Critical care medicine)
[2021, 49(7):1137-1148]

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Association of surgery type and duration of hospitalisation with the ability to live independently after surgery.

Felix C Linhardt, Luca J Wachtendorf, Karuna Wongtangman, Omid Azimaraghi, Maximilian S Schaefer, Matthias Eikermann, Samir Kendale,

Br J Anaesth (British journal of anaesthesia)
[2021, 127(3):e87-e90]

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Association between preoperative administration of gabapentinoids and 30-day hospital readmission: A retrospective hospital registry study.

Luca J Wachtendorf, Maximilian Sebastian Schaefer, Peter Santer, Omid Azimaraghi, Salameh Sameh Obeidat, Sabine Friedrich, Liana Zucco, Albert Woo, Sarah Nabel, Eswar Sundar, Matthias Eikermann, Satya Krishna Ramachandran,

<h4>Study objective</h4>To evaluate the effectiveness of preoperative gabapentinoid administration.<h4>Design</h4>Retrospective hospital registry study.<h4>Setting</h4>Tertiary referral center (Boston, MA).<h4>Patients</h4>111,008 adult non-emergency, non-cardiac surgical patients between 2014 and 2018.<h4>Interventions</h4>Preoperative administration of gabapentinoids (gabapentin or pregabalin).<h4>Measurements</h4>We tested the primary hypothesis that preoperative gabapentinoid use was associated with lower odds of hospital readmission within 30 days. Contingent ... Read more >>

J Clin Anesth (Journal of clinical anesthesia)
[2021, 73:110376]

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High-flow nasal oxygen for gastrointestinal endoscopy improves respiratory safety.

Peter Santer, Karuna Wongtangman, Mandeep S Sawhney, Matthias Eikermann,

Br J Anaesth (British journal of anaesthesia)
[2021, 127(1):7-11]

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Provider variability in the intraoperative use of neuromuscular blocking agents: a retrospective multicentre cohort study.

Friederike C Althoff, Xinling Xu, Luca J Wachtendorf, Denys Shay, Maria Patrocinio, Maximilian S Schaefer, Timothy T Houle, Philipp Fassbender, Matthias Eikermann, Karuna Wongtangman,

<h4>Objective</h4>To assess variability in the intraoperative use of non-depolarising neuromuscular blocking agents (NMBAs) across individual anaesthesia providers, surgeons and hospitals.<h4>Design</h4>Retrospective observational cohort study.<h4>Setting</h4>Two major tertiary referral centres, Boston, Massachusetts, USA.<h4>Participants</h4>265 537 adult participants undergoing non-cardiac surgery between October 2005 and September 2017.<h4>Main outcome measures</h4>We analysed the variances in NMBA use across ... Read more >>

BMJ Open (BMJ open)
[2021, 11(4):e048509]

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The effect of intraoperative dexmedetomidine administration on length of stay in the post-anesthesia care unit in ambulatory surgery: A hospital registry study.

Haobo Ma, Luca J Wachtendorf, Peter Santer, Maximilian S Schaefer, Sabine Friedrich, Sarah Nabel, Satya Krishna Ramachandran, Changyu Shen, Eswar Sundar, Matthias Eikermann,

<h4>Study objective</h4>Dexmedetomidine, which is commonly used for procedural sedation and as adjunct to general anesthesia for ambulatory procedures, may affect patient discharge from the post-anesthesia care unit (PACU). We hypothesized that intraoperative dexmedetomidine use in ambulatory surgery is associated with delayed discharge from the PACU and that this is modified ... Read more >>

J Clin Anesth (Journal of clinical anesthesia)
[2021, 72:110284]

Cited: 1 time

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Complete Endotracheal Tube Transection by Patient Bite: A Case Report and Algorithm for Fragment Identification and Extraction.

Annette Ilg, Matthias Eikermann, Andrew J Synn,

We describe a case of a complete endotracheal tube (ETT) transection due to patient bite. The patient was intubated for postoperative pneumonia; during weaning of sedation, the patient was unable to tolerate pressure support ventilation (PSV) due to agitation. Adaptive support ventilation (ASV) improved patient comfort substantially. During a routine ... Read more >>

A A Pract (A&A practice)
[2021, 15(3):e01428]

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Preoperative Heart Failure Treatment Prevents Postoperative Cardiac Complications in Patients With Lower Risk: A Retrospective Cohort Study.

Denys Shay, Pauline Y Ng, David M Dudzinski, Stephanie D Grabitz, John D Mitchell, Xinling Xu, Timothy T Houle, Deepak L Bhatt, Matthias Eikermann,

<h4>Objective</h4>The objective of this study was to identify undertreated subgroups of patients with heart failure who would benefit from better perioperative optimization.<h4>Summary background data</h4>Patients with heart failure have increased risks of postoperative cardiac complications after noncardiac surgery.<h4>Methods</h4>In this analysis of hospital registry data of 130,677 patients undergoing noncardiac surgery, the ... Read more >>

Ann Surg (Annals of surgery)
[2021, :]

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What Factors Predict Adverse Discharge Disposition in Patients Older Than 60 Years Undergoing Lower-extremity Surgery? The Adverse Discharge in Older Patients after Lower-extremity Surgery (ADELES) Risk Score.

Maximilian S Schaefer, Maximilian Hammer, Katharina Platzbecker, Peter Santer, Stephanie D Grabitz, Kadhiresan R Murugappan, Tim Houle, Sheila Barnett, Edward K Rodriguez, Matthias Eikermann,

<h4>Background</h4>Adverse discharge disposition, which is discharge to a long-term nursing home or skilled nursing facility is frequent and devastating in older patients after lower-extremity orthopaedic surgery. Predicting individual patient risk allows for preventive interventions to address modifiable risk factors and helps managing expectations. Despite a variety of risk prediction tools ... Read more >>

Clin Orthop Relat Res (Clinical orthopaedics and related research)
[2021, 479(3):546-547]

Cited: 1 time

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Effects of the Level and Duration of Mobilization Therapy in the Surgical ICU on the Loss of the Ability to Live Independently: An International Prospective Cohort Study.

Flora T Scheffenbichler, Bijan Teja, Karuna Wongtangman, Nicole Mazwi, Karen Waak, Stefan J Schaller, Xinling Xu, Silvia Barbieri, Nazzareno Fagoni, Jessica Cassavaugh, Manfred Blobner, Carol L Hodgson, Nicola Latronico, Matthias Eikermann,

<h4>Objectives</h4>It is unclear whether early mobilization in the surgical ICU helps improve patients' functional recovery to a level that enables independent living. We assessed dose of mobilization (level + duration). We tested the research hypotheses that dose of mobilization predicts adverse discharge and that both duration of mobilization and maximum ... Read more >>

Crit Care Med (Critical care medicine)
[2021, 49(3):e247-e257]

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Effects of Volatile Anesthetics on Postoperative Ischemic Stroke Incidence.

Dana Raub, Katharina Platzbecker, Stephanie D Grabitz, Xinling Xu, Karuna Wongtangman, Stephanie B Pham, Kadhiresan R Murugappan, Khalid A Hanafy, Ala Nozari, Timothy T Houle, Samir M Kendale, Matthias Eikermann,

Background Preclinical studies suggest that volatile anesthetics decrease infarct volume and improve the outcome of ischemic stroke. This study aims to determine their effect during noncardiac surgery on postoperative ischemic stroke incidence. Methods and Results This was a retrospective cohort study of surgical patients undergoing general anesthesia at 2 tertiary ... Read more >>

J Am Heart Assoc (Journal of the American Heart Association)
[2021, 10(5):e018952]

Cited: 2 times

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Discharge Prediction for Patients Undergoing Inpatient Surgery: Development and validation of the DEPENDENSE score.

Maximilian Hammer, Friederike C Althoff, Katharina Platzbecker, Luca J Wachtendorf, Bijan Teja, Dana Raub, Maximilian S Schaefer, Karuna Wongtangman, Xinling Xu, Timothy T Houle, Matthias Eikermann, Kadhiresan R Murugappan,

<h4>Background</h4>A substantial proportion of patients undergoing inpatient surgery each year is at risk for postoperative institutionalization and loss of independence. Reliable individualized preoperative prediction of adverse discharge can facilitate advanced care planning and shared decision making.<h4>Methods</h4>Using hospital registry data from previously home-dwelling adults undergoing inpatient surgery, we retrospectively developed and ... Read more >>

Acta Anaesthesiol Scand (Acta anaesthesiologica Scandinavica)
[2021, 65(5):607-617]

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Effect of peripheral nerve blocks on postanesthesia care unit length of stay in patients undergoing ambulatory surgery: a retrospective cohort study.

Victor Polshin, Julie Petro, Luca J Wachtendorf, Maximilian Hammer, Thomas Simopoulos, Matthias Eikermann, Peter Santer,

<h4>Background</h4>Peripheral regional anesthesia and analgesia may increase the efficiency of ambulatory surgical centers by reducing pain and preventing nausea and vomiting, which are important modifiable causes of prolonged postanesthesia care unit (PACU) length of stay. We hypothesized that the use of peripheral nerve blocks (PNB) was associated with shorter PACU ... Read more >>

Reg Anesth Pain Med (Regional anesthesia and pain medicine)
[2021, 46(3):233-239]

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High-dose midodrine is not effective for treatment of persistent hypotension in the intensive care unit.

Peter Santer, Matthias Eikermann,

Intensive Care Med (Intensive care medicine)
[2021, 47(2):252-253]

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Differential Transcriptomic Profiling Between Patients With Sepsis-Induced Ards And Sepsis Without Ards 

George Kasotakis, Wei Chen, David Corcoran, Judie Howrylak, Joshua Englert, Bruce Sullenger, Kirsten Kangelaris, Matthias Eikermann, Todd Purves, Krista Haines, Scott Palmer, Suresh Agarwal, Brent Stanfield,

<h4>Introduction: </h4> Acute Respiratory Distress Syndrome (ARDS) develops in the lungs as a response to potent inflammatory triggers, and sepsis represents one of the most common causes of ARDS. It is a highly lethal syndrome with no effective therapies, and little is known about the pathways that trigger it. In ... Read more >>

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Anesthetic management of unruptured intracranial aneurysms: a qualitative systematic review.

Shooka Esmaeeli, Juan Valencia, Lauren K Buhl, Andres Brenes Bastos, Sogand Goudarzi, Matthias Eikermann, Corey Fehnel, Richard Pollard, Ajith Thomas, Christopher S Ogilvy, Shahzad Shaefi, Ala Nozari,

Intracranial aneurysms (IA) occur in 3-5% of the general population and may require surgical or endovascular obliteration if the patient is symptomatic or has an increased risk of rupture. These procedures carry an inherent risk of neurological complications, and the outcome can be influenced by the physiological and pharmacological effects ... Read more >>

Neurosurg Rev (Neurosurgical review)
[2021, 44(5):2477-2492]

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Supraglottic airway device versus tracheal intubation and the risk of emergent postoperative intubation after general anaesthesia in adults: a retrospective cohort study.

Maximilian Hammer, Peter Santer, Maximilian S Schaefer, Friederike C Althoff, Karuna Wongtangman, Ulrich H Frey, Xinling Xu, Matthias Eikermann, Philipp Fassbender,

<h4>Background</h4>We examined the association between emergent postoperative tracheal intubation and the use of supraglottic airway devices (SGAs) vs tracheal tubes.<h4>Methods</h4>We included data from adult noncardiac surgical cases under general anaesthesia between 2008 and 2018. We only included cases (n=59 991) in which both airways were deemed to be feasible options. ... Read more >>

Br J Anaesth (British journal of anaesthesia)
[2021, 126(3):738-745]

Cited: 2 times

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Outcomes after endoscopic retrograde cholangiopancreatography with general anaesthesia versus sedation.

Friederike C Althoff, Abhishek Agnihotri, Stephanie D Grabitz, Peter Santer, Sarah Nabel, Tuyet Tran, Tyler M Berzin, Eswar Sundar, Xinling Xu, Mandeep S Sawhney, Matthias Eikermann,

<h4>Background</h4>We tested the primary hypothesis that use of general anaesthesia vs sedation increases vulnerability to adverse discharge (in-hospital mortality or new discharge to a nursing facility) after endoscopic retrograde cholangiopancreatography (ERCP).<h4>Methods</h4>In this retrospective cohort study, adult patients undergoing ERCP with general anaesthesia or sedation at a tertiary care hospital were ... Read more >>

Br J Anaesth (British journal of anaesthesia)
[2021, 126(1):191-200]

Cited: 1 time

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