University of Nebraska Medical Center

Research at the University of Nebraska Medical Center

Research in the Department of Anesthesiology at the University of Nebraska Medical Center (UNMC) extends across the full T0-T4 translational spectrum and is supported through multiple federal mechanisms, including R01, R21, K23 and DoD across this complete spectrum. At UNMC, we have a passion for mentoring clinician-scientists, and the department has an 8-million-dollar research endowment solely dedicated to its research mission. This allows us to support high-risk-high-reward proposals from our trainees and faculty to develop the next generation of leaders in academic anesthesiology. Another unique feature is our resident research track that offers qualified candidates a Master’s or PhD degree in Clinical Translational Research during their graduate training period at UNMC.

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Nebraska Outcomes Research Laboratory

The overarching goal of our research is to improve patient outcomes in perioperative, pain, and critical care medicine settings. We use existing large datasets in addition to conducting large pragmatic clinical trials as well as participating in conventional RCTs. Our research is highly collaborative, and we collaborate successfully with researchers in internal medicine, family medicine, cardiology, neurology, surgery, psychiatry, pediatrics, as well as basic science. A principal focus of our group is to provide meaningful mentoring to medical students, trainees, and junior faculty – we have brought >30 mentees to their first peer-reviewed publications and have received grant support from ARCS and IARS for our students.

Current Funding: NIH - National Institute on Drug Abuse (K23), SCA Leadership Award, AHRQ – Agency for Healthcare Research and Quality (R01).

Past Funding: Colorado Department of Health Care Policy & Financing, Achievement Rewards for College Scientists (ARCS) Foundation, International Anesthesia Research Society (Scholars Award), Society of Cardiovascular Anesthesiologists (Roizen Award).

  • Martin Krause, Shannon K. McWilliams, Kenneth J. Bullard, Lena M. Mayes, Leslie C. Jameson, Susan K. Mikulich-Gilbertson, Ana Fernandez-Bustamante, Karsten Bartels. Neostigmine versus Sugammadex for Reversal of Neuromuscular Blockade and Effects on Re-Intubation for Respiratory Failure or Newly Initiated Non-Invasive Ventilation – An Interrupted Time Series Design. Anesth Analg. 2020 Jul;131(1):141-151.
  • Karsten Bartels, Katharine Mahoney, Kristen M. Raymond, Shannon K. McWilliams, Ana Fernandez-Bustamante, Richard Schulick, Christian J. Hopfer, Susan K. Mikulich-Gilbertson. Opioid and Non-Opioid Utilization At Home Following Gastrointestinal Procedures - A Prospective Cohort Study. Surg Endosc. 2020 Jan;34(1):304-311.
  • Sachin Kheterpal, Michelle Vaughn, Timur Dubovoy, Nirav Shah, Lori Bash, Douglas Colquhoun, Amy Shanks, Michael Mathis, Roy Soto, Amit Bardia, Karsten Bartels, Patrick McCormick, Robert Schonberger, Leif Saager. Sugammadex versus Neostigmine for Reversal Of Neuromuscular Blockade and Postoperative Pulmonary Complications (STRONGER): A Multicenter Matched Cohort Analysis. Anesthesiology. 2020 Jun;132(6):1371-1381.
  • Jacqueline A. Carrico, Katharine Mahoney, Kristen M. Raymond, Shannon McWilliams, Susan K. Mikulich Gilbertson, Lena M. Mayes, Karsten Bartels. Predicting Opioid Utilization Following Discharge After Cesarean Section. Ann Fam Med. 2020 Mar;18(2):118-126.
  • Martin Krause, David J Douin, Kevin K Kim, Ana Fernandez-Bustamante, Karsten Bartels. Characteristics and Outcomes of Mechanically Ventilated COVID-19 Patients – an Observational Cohort Study. J Intensive Care Med. 2021 Mar;36(3):271-276.
  • Clinical Research

    The UNMC Department of Anesthesiology has several department-, industry-, and federally-funded clinical research studies led by clinical faculty as primary investigators. The majority of these studies involve medical students, residents and fellows. These studies involve both retrospective and prospective studies and have resulted in mentoring, abstract presentations, and peer-review publications. Areas of clinical research include:

    - 3D printing laboratory for manufacturing task trainers and simulators for clinical use supported by the Advanced Medical Technology Initiative Funds from the Department of Defense.

    - Gender equity, diversity, and inclusion in academia.

    - Clinical analytics and decision support. 

    - Pain management for Osteogenesis Imperfecta.

    - Clinical decision support and innovative interventions for medical education.

    - Intraoperative hemodynamic monitoring in pediatric patients.

    - Pediatric airway management.

  • Armijo PR, Markin NW, Nguyen S, Ho DH, Horseman TS, Lisco SJ, Schiller AM. 3D printing of face shields to meet the immediate need for PPE in an anesthesiology department during the COVID-19 pandemic. Am J Infect Control. 2021 Mar;49(3):302-308.
  • Armijo PR, Flores L, Huynh L, Strong S, Mukkamala S, Shillcutt S. Fertility and Reproductive Health in Women Physicians. J Womens Health (Larchmt). 2021 Jan 18.
  • Fremming BA, Ringenberg KJ, Berky KC, Roberts EK, Lisco SJ, Schulte TE. Perioperative pandemic protocols are also useful during a cyber-attack system downtime. J Clin Anesth. 2021 Aug; 71:110243.
  • Beethe AR, Bohannon NA, Ogun OA, Wallace MJ, Esposito PW, Lockhart TJ, Hamlin RJ, Williams JR, Goeller JK. Neuraxial and regional anesthesia in surgical patients with osteogenesis imperfecta: a narrative review of literature. Reg Anesth Pain Med. 2020 Dec;45(12):993-999.
  • Garcia-Marcinkiewicz AG, Kovatsis PG, Hunyady AI, Olomu PN, Zhang B, Sathyamoorthy M, Gonzalez A, Kanmanthreddy S, Gálvez JA, Franz AM, Peyton J, Park R, Kiss EE, Sommerfield D, Griffis H, Nishisaki A, von Ungern-Sternberg BS, Nadkarni VM, McGowan FX Jr, Fiadjoe JE; PeDI Collaborative investigators. First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial. Lancet. 2020 Dec 12;396(10266):1905-1913.
  • Lonsdale H, Jalali A, Gálvez JA, Ahumada LM, Simpao AF. Artificial Intelligence in Anesthesiology: Hype, Hope, and Hurdles. Anesth Analg. 2020 May;130(5):1111-1113.
  • Matava CT, Gálvez JA. Aerosol Retention Barriers. Anesthesiology. 2021 Jan 1;134(1):9-10.
  • McGovern PE, Wu L, Rao S, Ahumada L, Friedman DF, Nance ML, Gálvez JA. Audit of blood product utilization in the care of injured children. Paediatr Anaesth. 2021 Feb;31(2):186-196.
  • Gálvez JA. Assembling pediatric anesthesiology experts during a pandemic - a story of gratitude, resilience and cooperation. Curr Opin Anaesthesiol. 2021 Jun 1;34(3):269-270.
  • Lang SS, Vollmer E, Wu L, Bathini A, Kanuga B, Ma A, Barrett K, Galvez JA, Storm PB, Huh J, Simpao AF. A Retrospective Study of Neurological Complications in Pediatric Patients With Moyamoya Disease Undergoing General Anesthesia. Anesth Analg. 2021 Feb 1;132(2):493-499.

  • Neural Control of Cardiopulmonary Function and Pain Lab

    The lab’s research focuses on the interactions between the somatic/visceral sensory nervous system and the cardiovascular system, with a strong track record of publication productivity.The lab maintains continuous funding since 2010. As a Principal Investigator (PI) or Co-PI, Dr. Wang has successfully obtained five extramural peer-reviewed NIH R01 grants, three grants from industry, and several other seed grants from state and intra-campus sources in the past 5 years.  Three out of five R01 grants (2R01HL126796-02A0, 1R01HL152160-01 and 1R01HL151632-01) were recently received in December, 2019 and this April respectively (one PI, one MPI, one sub-contract PI). One of these five R01 grants (2R01HL126796-02A0, Zucker and Wang MPI) is a renewal. His entire grant funding amount nearly reaches 11 million dollars. 

  • Shanks J, Xia Z, Lisco SJ, Rozanski GJ, Schultz HD, Zucker IH, Wang HJ. Sympatho-excitatory response to pulmonary chemosensitive spinal afferent activation in anesthetized, vagotomized rats. Physiol Rep 2018; Jun;6(12):e13742.
  • Adam R, Xia Z, Pravoverov K, Hong J, Case AJ, Schultz HD, Lisco SJ, Zucker IH, Wang HJ. Sympatho-excitation in response to cardiac and pulmonary afferent stimulation of TRPA1 channels is attenuated in chronic heart failure rats. Am J Physiol Heart Circ Physiol. 2019 Apr 1;316(4):H862-H872.
  • Shanks J, Morais SD, Gao L, Zucker IH, Wang HJ. TRPV1 (Transient Receptor Potential Vanilloid 1) Cardiac Spinal Afferents Contribute to Hypertension in SHR. Hypertension. 2019 Oct;74(4):910-920.
  • Hong J, Lisco A, Rudebush TL, Yu L, Gao L, Kitzerow O, Zucker IH, Wang HJ. Cardiac Expression Pattern of Transient Receptor Potential Vanilloid Type 1 (TRPV1) Receptor using a Transgenic Reporter Mouse Model. Neurosci Lett. 2020 Aug 22:135320.
  • Hong J, Xia Z, Zucker IH, Wang HJ. Chronic Pro-inflammatory Cytokine Exposure Downregulates the Transient Receptor Potential Vanilloid 1 (TRPV1) Receptor in Dorsal Root Ganglion Neurons via an ERK-independent Mechanism. Molecular Pain. 2021.
  • Neuropathology of Drug Addiction Labs

    Two funded labs focus on the neurophysiology and neuropathology of drug addiction.

    The Yelamanchili lab focusses on four major areas of research; (1) Role of extracellular vesicles in drug addiction (2) Role of extracellular vesicles in methamphetamine and HIV induced neurotoxicity (3) Developing novel tools to establish extracellular vesicles’ cargo as therapeutic molecules (4) Establishing induced pluripotent stem cell-derived cerebral organoid cultures to model brain development.  

    The overarching goal of the Pendyala research program is to understand how chronic drug addiction (opioids, psychostimulants such as methamphetamine, nicotine) leads to brain synaptic alterations and subsequent behavioral changes. The Pendyala lab uses various model systems, including human biospecimens, rodent models and in vitro based approaches. Recently, the research focus has expanded toward understanding how prescription drug abuse during and after pregnancy impacts neurodevelopment in the exposed offspring. Additionally, this line of research also focuses on synaptic and behavioral changes in exposed offspring during the course of neurodevelopment i.e., during neonatal, juvenile and young adulthood including the role of sex differences. A common chord connecting these research arms is the emphasis on understanding the role of extracellular vesicles (EVs), which are now emerging as key molecules in a plethora of pathologies.

  • Guda RS, Odegaard KE, Tan C, Schaal VL, Yelamanchili SV, Pendyala G. Integrated Systems Analysis of Mixed Neuroglial Cultures Proteome Post Oxycodone Exposure. Int J Mol Sci. 2021 Jun 15;22(12):6421.
  • Odegaard KE, Schaal VL, Clark AR, Koul S, Sankarasubramanian J, Xia Z, Mellon M, Uberti M, Liu Y, Stothert A, Van Hook M, Wang H, Guda C, Lisco SJ, Pendyala G, Yelamanchili SV. A Holistic Systems Approach to Characterize the Impact of Pre- and Post-natal Oxycodone Exposure on Neurodevelopment and Behavior. Front Cell Dev Biol. 2021 Jan 7;8:619199.
  • Chand S, Jo A, Vellichirammal NN, Gowen A, Guda C, Schaal V, Odegaard K, Lee H, Pendyala G, Yelamanchili SV. Comprehensive Characterization of Nanosized Extracellular Vesicles from Central and Peripheral Organs : Implications for Preclinical and Clinical Applications. ACS Appl Nano Mater. 2020 Sep 25;3(9):8906-8919.
  • Odegaard KE, Schaal VL, Clark AR, Koul S, Gowen A, Sankarasubramani J, Xiao P, Guda C, Lisco SJ, Yelamanchili SV, Pendyala G. Characterization of the intergenerational impact of in utero and postnatal oxycodone exposure. Transl Psychiatry. 2020 Sep 23;10(1):329.
  • Koul S, Schaal VL, Chand S, Pittenger ST, Nanoth Vellichirammal N, Kumar V, Guda C, Bevins RA, Yelamanchili SV, Pendyala G. Role of Brain Derived Extracellular Vesicles in Decoding Sex Differences Associated with Nicotine Self-Administration. Cells. 2020 Aug 11;9(8):1883.
  • Military and Educational Lab

    The Military and Educational Lab has three areas of focus:

    1) Needs assessment of high value, low frequency lifesaving procedures in military medical personnel.

    2) Task trainer simulation. Using an in-house designed and created task trainer to determine skills transfer between task trainer and tissue. Funded by a grant through the Telemedicine and Advanced Technology Research Center (TATRC) Advanced Medical Technology Initiative (AMTI), US Army.

    3) Assessment of Sympathetic Vasomotion for Renal Denervation. A physiology-based arm focused on assessing sympathetic vasomotion for renal denervation. Using a patented technology (sympathetic vasomotion), to assess if quantification of sympathetic vasomotion can be used to effectively indicate successful ablation of the renal nerves during a renal denervation procedure.

  • Haggar, F., Young, W., Love, L. (2020). Holistic Support for Innovative Educators in the Health Professions. In Ford, C. & Groccia, J. New Directions for Teaching & Learning: Teaching and Learning in Health Professions. California: Wiley.
  • Armijo PR, Markin NW, Nguyen S, Ho DH, Horseman TS, Lisco SJ, Schiller AM. 3D printing of face shields to meet the immediate need for PPE in an anesthesiology department during the COVID-19 pandemic. Am J Infect Control. 2021 Mar;49(3):302-308.
  • Pellegrino P, Zucker IH, Chatzizisis Y, Wang HJ, and Schiller AM. Quantification of Renal Sympathetic Vasomotion as a Novel Endpoint for Renal Denervation. Hypertension. 2020 Oct;76(4):1247-1255.
  • Schiller AM, Hong J, Xia Z, Wang HJ. Increased Brain-derived Neurotrophic Factor in Lumbar Dorsal Root Ganglia Contributes to the Enhanced Exercise Pressor Reflex in Heart Failure. Int. J. Mol. Sci. 2019, 20, 1480.
  • Schiller AM, Howard JT, Lye KR, Magby CG, Convertino VA. Comparisons of Traditional Metabolic Markers and Compensatory Reserve as Early Predictors of Tolerance to Central Hypovolemia in Humans. Shock. 2018 Jul;50(1):71-77.
  • Pellegrino PR, Schiller AM, Zucker IH. Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits. Am J Physiol Heart Circ Physiol. 2014 Jul 1;307(1):H97-109.