During my research career, my interests focused on three primary research areas: pulmonary mechanics, myocardial contractility in the presence of intravenous anesthetics/drugs, and outcome studies in anesthesiology. I started my research career by studying the mechanics of breathing and patterns of diaphragm contractility (Mayo Clinic 1986-87, and University of Maryland 1990-93). I conducted research to investigate contractility of the heart in the presence of hypothermia (Medical College of Wisconsin 1987-1990), and the effects of various intravenous anesthetics on human myocardial contractility, which was tested on human myocardium explanted from patients with end-stage heart failure undergoing heart transplant (Cleveland Clinic 1994-2000). Recent interests include studying the outcomes of cardiac arrests in a general hospital population and in patients who have anesthesia during procedures. Our team studies predictors of cardiac arrest in both an adult and a pediatric surgical population. We have defined both the incidence and mortality of these severe perioperative outcomes. In addition, we study other patient-related or procedure-related factors and their association with severe perioperative complications, such as pulmonary embolism, laryngospasm, and cardiac arrests caused by electrolyte imbalance during massive blood transfusion.

Most recently our team is exploring whether general anesthesia administered to children under the age of 3 could have a potential role on learning disabilities, hyperactivity disorder/attention deficit, or even in developmental delay. Finally, we are interested in factors that may be associated with development of acute postoperative respiratory insufficiency. We place special emphasis on exploring the role of intraoperative ventilator management, fluid administration, and hemodynamic alterations with regard to acute respiratory insufficiency. Special targets of our investigation are those in high-risk populations such as the elderly and patients who are overweight. We are also examining whether the protective ventilatory strategy (recruitment maneuvers, low tidal volume and high positive end-expiratory pressure) may have a role in decreasing postoperative pulmonary inflammatory response (release of interleukins) when compared to more conventional ventilation strategies.