Ivan M Kangrga, M.D., Ph.D.

DEPARTMENT OF Anesthesiology
Keywords: hemodynamic monitoring, pulmonary artery catheter, cardiac output, cerebral ischemia

Our multidisciplinary research group studies hemodynamic derangements in patients with end-stage liver disease undergoing orthotopic liver transplantation. This group of patients presents a unique hemodynamic challenge for perioperative physicians. In addition, the intensity of intraoperative liver post-reperfusion syndrome seems to correlate with patient and graft long-term survival. We have developed a set up foe continuous monitoring of intraoperative hemodynamic and ventilator parameters during OLT. As a part of this effort, we recently completed a study that compared two novel, minimally devices for assessment of cardiac output based on the arterial pressure waveform, to the gold standard, the pulmonary artery catheter. This study is done in collaboration with the Department of Surgery.

Another area of interest is cerebral ischemia-reperfusion, using the paradigm of carotid clamping and unclamping during carotid endarterectomy. Although the rate of overt stroke after carotid endarterectomy is low, there is growing evidence that a more subtle, subclinical ischemic insult to the brain is common. The cumulative effect of such subclinical insults may have implications on cognitive function. If a reliable and sensitive marker of subclinical cerebral ischemic insult could be identified, then perioperative interventions could be implemented to ameliorate such insult. This project is being done in collaboration with the Departments of Pathology and Surgery.