Penn State University

DEPARTMENT OF ANESTHESIOLOGY AND PERIOPERATIVE MEDICINE

BASIC SCIENCE RESEARCH

Dr. Ruiz-Velasco’s laboratory focuses on the modulation of Ca2+ and K+ channels by G proteins and other nucleotides, which has been the focus of his research career. Recently, his laboratory has started to investigate the modulation of acid-sensing ion channel (ASIC) currents by opioid peptides, as well as examining the role of single nucleotide polymorphisms in voltage-gated channels, NaV1.8 and NaV1.9 and pain. Over the years, he has employed a wide variety of techniques that have allowed him to study this biophysical transduction system in excitable cells, including neurons and smooth muscle cells.

Endomorphins potentiate ASIC currents and enhance the lactic acid-mediated increase in arterial blood pressure—an effect amplified in hindlimb ischemia. J Physiol. 2017; 595: 7167-7183

Dr. Morgan’s laboratory focuses on understanding the mechanisms responsible for the different roles of endocannabinoid signaling in human health and disease. His laboratory is engaged in multiple research projects spanning this broad topic, including work to understand the mechanisms responsible for cannabinoid tolerance, the impact of endocannabinoid signaling on drug addiction, the role of endocannabinoid signaling in tendon repair, and the contribution of cannabinoids to the sensory and affective components of chronic neuropathic pain.

Dr. Graziane’s laboratory looks to identify the molecular and cellular substrates that mediate a number of devastating brain diseases, including drug addiction and chronic pain. With established animal models for these diseases, Dr. Graziane uses electrophysiology and optogenetic approaches to examine changes in synaptic transmission and in intrinsic membrane excitability of neurons and circuits that are thought to control motivation, reward, and affective states.

CLINICAL AND TRANSLATIONAL RESEARCH

Dr. Bonavia’s work focuses on the mechanisms of innate immune dysfunction caused by septic shock and associated acute kidney injury. Both of these diseases result in very high systemic levels of resistin, a pro-inflammatory cytokine impairing chemotaxis, reactive oxygen species production, and bacterial killing by neutrophils. By using cell-based and animal models, he investigates whether resistin is responsible for immunosuppression in these disease states. The translational implications of his research are to aid better understanding of whether cytokine adsorption therapy may have a role in mitigating the secondary infectious complications that develop in critically ill patients following sepsis and acute kidney injury.

Dr. Carr’s interest is in the field of behavioral neuroscience and its application to the problems of postoperative cognitive dysfunction and delirium. Both pathological states likely arise from a common neuroinflammatory pathway, greatly affecting frontal cortex mediated cognitive control processes involved with complex task execution. His current research interests include the exploration of the role of depression in postoperative cognitive dysfunction, and this is complemented by his pre-clinical work developing an animal model for delirium.

PEDIATRICS RESEARCH

The Pediatric Anesthesia Research component, led by Dr. Priti Dalal, involves multiple projects. One of the major projects is assessment of post-operative pain using skin conductance measurements. This study, in children, is comparing pain scores with skin conductance values, and also evaluates genetic polymorphisms in relation to pain perception in children. Several other research projects that are ongoing include efficacy of an infra-red vein visualization device, music therapy in children at anesthesia induction, and multiple quality research projects including handoff communications with children’s ICU, outcomes in cases of NICU bedside procedures under anesthesia, unplanned extubations, and unplanned ICU admissions.

PERIOPERATIVE DATA SCIENCE

New opportunities to investigate and improve how perioperative care is actually delivered are afforded by electronic medical records registries which can integrate perioperative records across many academic institutions (e.g. the National Clinical Outcomes Registry [NACOR] or the Multicenter Clinical Outcomes Group [MPOG]), while still allowing examination of granular detail down to individual anesthesia provider behavior. Dr. Michael Andreae, is researching patient and provider characteristics that predict subpar care leading to inferior outcomes. For example, after identifying the impact of patients’ social characteristics on provider adherence to PONV care bundles, his group is now working on deriving irrefutable metrics of provider performance for feedback and quality improvement.