Department / Division
Anesthesiology / Anesthesiology-Cardiac Division
Durham, NC 27710
Cardiothoracic anesthesia, critical care and perioperative coagulopathy, transesophageal echocardiography, perioperative transfusion
I am currently collecting data assessing the usefulness of various scoring systems in predicting morbidity, as reflected by length of hospital stay, and suitability for "fast-track" care following cardiac surgery. This will be developed into a model allowing accurate prediction of likely Intensive Care bed utilisation in this population.
Various aspects of perioperative coagulation continue to be of interest to me. I am using the thromboelastograph (TEG) to assess hypercoagulability in patients with intracerebral tumor presenting for craniotomy and correlating these measurements to the incidemce of venous thromboembolic disease in the postoperative period as diagnosed clinically or by duplex scanning of leg veins. To continue this investigation, I am using TEG to monitor the response to anticoagulation with low molecular weight heparin in this group.
As part of an audit of the introduction of perioperative TEG monitoring in the cardiac surgery setting, I'll be looking at the economic impact of point-of-care monitoring on blood product usage in addition to establishing a point-of-care coagulation laboratory for the cardiac operating rooms and the cardiac surgery ICU (3200).
This faculty member (or a member of their immediate family) has a working relationship (i.e. consulting, research, and/or educational services) with the companies listed below. These relations have been reported to the health system leadership and, when appropriate, management plans are in place to address potential conflicts.
Lombard, FW; Welsby, IJ; Booth, JV. Systemic air embolism during off-pump coronary artery bypass surgery. Journal of Cardiothoracic and Vascular Anesthesia. 2003;17:403-404. (2003) Abstract
Mathew, JP; Grocott, HP; Phillips-Bute, B; Stafford-Smith, M; Laskowitz, DT; Rossignol, D; Blumenthal, JA; Newman, MF; Neurologic Outcome Research Group of the Duke Heart Center, ; Cardiothoracic Anesthesiology Research Endeavors Investigators of the Duke Heart Center. Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery. Stroke. 2003;34:508-513. (2003) Abstract
Welsby, IJ; Ryan, JM; Booth, JV; Flanagan, E; Messier, RH; Borel, CO. The bispectral index in the diagnosis of perioperative stroke: a case report and discussion. Anesthesia and Analgesia. 2003;96:435-437. (2003) Abstract
Booth, JV; Schinderle, D; Welsby, IJ. Pro: Vasopressin is the vasoconstrictor of choice after cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia. 2002;16:773-775. (2002) Abstract
Welsby, IJ; Bennett-Guerrero, E; Atwell, D; White, WD; Newman, MF; Smith, PK; Mythen, MG. The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass. Anesthesia and Analgesia. 2002;94:1072-1078. (2002) Abstract
Welsby, IJ; McDonnell, E; El-Moalem, H; Stafford-Smith, M; Toffaletti, JG. Activated clotting time systems vary in precision and bias and are not interchangeable when following heparin management protocols during cardiopulmonary bypass. Journal of Clinical Monitoring and Computing. 2002;17:287-292. (2002) Abstract