The Division of Critical Care Anesthesiology comprises multiple members of the General and Transplant Anesthesia divisions, who have all completed additional fellowship training in critical care medicine. This group of talented anesthesiologists has done extensive training to care for the most vulnerable and critically ill medical and surgical patients. As such, we collaborate with the Department of Surgery to ensure the best care for our most critical patients in the Moses Campus Surgical Intensive Care Unit (SICU). Our role in the SICU enables our Department to contribute to patient care throughout the breadth of the perioperative experience, starting from preoperative evaluation and continuing through the intraoperative phase into the post-operative recovery period no matter the severity of illness or surgical complexity.
We have expertise in placing and interpreting invasive hemodynamic monitors, performing advanced airway and ventilator management, titrating vasoactive medications, utilizing bedside ultrasonography and POCUS to make clinical decisions, as well as coordinating and integrating care between multiple medical teams. We care for patients who come to Montefiore for liver, pancreas, and kidney transplants, hepatobiliary surgery, complex head and neck surgery, and general vascular, aortic, and thoracic surgeries. We take an active role in the Post-Anesthesia Care Unit (PACU) and are instrumental in helping navigate patients through the spectrum of perioperative care.
A commitment to excellent resident and medical student education is another pillar of our division. Together with the Department of Surgery, we have developed a rigorous curriculum for the residents’ Critical Care rotation and the anesthesiology residency curriculum at large. This includes a weekly journal club and a range of lectures on critical care medicine. While ensuring all educational goals of the ABA Certification in Anesthesiology are met, we provide additional lectures on various aspects of post-surgical recovery that are taught in conjunction with our surgical colleagues, reflecting the multidisciplinary nature of the Moses Campus SICU.
In addition to our high-quality clinical practice, our group has amassed and meticulously validated extensive perioperative and surgical ICU retrospective cohort datasets that allow for hypothesis testing and knowledge generation. With a strong peer-reviewed publication record, our team of full-time data analysts, bioinformatics experts, and statisticians have carefully studied and published work on sedation and neuromuscular blocking agents in mechanically ventilated patients, neurocognitive impairments, early mobilization in the ICU, and post-operative pulmonary complications.
Our Critical Care physicians are also involved in many multicenter randomized control trials, which focus on optimal pharmacological (e.g. delirium prevention, sedation, insomnia treatments) and non-pharmacological (e.g nutrition, exercise, early mobilization, sleep hygiene) management strategies in critically ill patients.
An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR Study
Suvorexant and Sleep/Delirium in ICU Patients
Illness Weakness, Polyneuropathy and Myopathy: Diagnosis, treatment, and long-term outcomes
Multimodal, patient-centred symptom control: a strategy to replace sedation in the ICU
Reliability and Effectiveness of the Japanese Version of the Mobilization Quantification Score
Linking our clinical research and bedside care, Montefiore’s Division of Critical Care Anesthesiology places a high value on quality assurance. Together with our nursing and medicine colleagues, we routinely track key outcomes and process measures and work to address any issues during the perioperative process. For example, we analyze the efficient transfer of patients, central line-associated blood stream infection (CLABSI), and post-operative early mobilization. We are constantly working to improve our quality assurance mechanisms.