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Moving Medicine Forward Through Knowledge Discovery: Support FAER and the Campaign for New Knowledge

This article originally appeared in the December 2014 issue of the ASA Newsletter.

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“This work and work done by others has since been transferred into new sedation guidelines by the major societies to recommend non-benzodiazepines as first-line agents for sedation of critically ill patients. Thus, the FAER-supported work has had a substantive role in shaping sedation practices among critically ill patients all over the world.”

– Pratik Pandharipande, M.D., M.S.C.I., F.C.C.M., Vanderbilt University

In last month’s FAER Report, I called upon every ASA member to support the generation and dissemination of new knowledge – the facts, information and skills acquired through scientific discovery – by making individual donations to FAER. Today, I again make this request and encourage your philanthropic support of our mission.

Charitable contributions to FAER, a 501(c)3 non-profit organization, support research grant funding that ultimately benefits all of medicine, all of society, through the creation of new knowledge. When you make a gift to FAER, you are supporting the important work of anesthesiologists and anesthesiology trainees who are actively pursuing careers as physician investigators, in all areas that are important to the specialty from basic science to health services research and education, and will see to it that the future of medicine sees as much progress as the past.

The collective body of knowledge created by the anesthesiologists who have received any number of the more than 500 grants FAER has awarded since 1986 is impressive and life-changing. Below are just a few recent examples of new knowledge created after receiving a FAER award.

Shaping Sedation Practices for Critically Ill Patients
Pratik Pandharipande, M.D., M.S.C.I., F.C.C.M., Professor of Anesthesiology and Surgery, and Chief, Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, Vanderbilt University

In 2005, Dr. Pratik Pandharipande received a Mentored Research Training Grant from FAER to study “A Randomized, Double-Blind Trial in Ventilated ICU Patients Comparing Treatment with an Alpha2 Agonist Versus a Gamma Aminobutyric Acid (GABA)-Agonist to Determine Delirium Rates, Efficacy of Sedation and Analgesia, and Clinical Outcomes Including Duration of Mechanical Ventilation and 3-Month Cognitive Status.” The preliminary data he obtained via his FAER-supported study led to successful application for independent funding from the National Heart, Lung and Blood Institute, an NIH R01, “Altering Sedation Paradigms to Improve Brain Injury and Survival in Severe Sepsis.” This study, as a follow-up to his FAER-supported work, compares propofol and dexmedetomidine, and aims to determine the best sedative medication to reduce delirium and improve survival and long-term brain function in our sickest and most vulnerable patients – the ventilated septic patients in the ICU. This study shows how FAER-supported anesthesiologists are researching outcomes that extend long after the immediate post-anesthetic period and have implications for the development of the Perioperative Surgical Home.

“My FAER project demonstrated the safe and efficacious use of non-GABAergic agents for sedation in critically ill patients and for the first time showed that patients sedated with alpha2 agonists had improved brain dysfunction outcomes as compared to benzodiazepines,” he said. “This work and work done by others has since been transferred into new sedation guidelines by the major societies to recommend non-benzodiazepines as first-line agents for sedation of critically ill patients. Thus, the FAER-supported work has had a substantive role in shaping sedation practices among critically ill patients all over the world.”

Exploring Emergence from General Anesthesia
Max Kelz, M.D., Ph.D., Associate Professor, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine

Dr. Max Kelz received a Research Training Grant from FAER in 2004 for his study “Hypocretin Neurons and Hypnosis: A Novel Site for Inhaled Anesthetic Action.” After completing the study supported by this award, Dr. Kelz received a Mentored Clinical Science Research Career Development Award, an NIH K08, in 2006, which was followed by an NIH Research Project Grant, an NIH R01, in 2010, and a second NIH R01 in 2014. Ten years after his FAER award, Dr. Kelz has demonstrated success by not only having received continuous NIH funding, but also by making discoveries that are translating to new knowledge for the specialty.

“The major finding from my work has been the recognition that emergence from general anesthesia isn’t necessarily passive nor is it merely a mirror reflection of induction,” said Dr. Kelz, who received the ASA Presidential Scholar Award in 2010. “Rather, specific circuits appear to come back online to facilitate exit from the anesthetic state. Occasionally, the process of exiting from the anesthetic state goes awry leading to delayed emergence or even delirium. As we understand more about emergence under normal conditions, we hope to ultimately identify, treat and prevent instances of pathological emergence.”

Understanding How to Improve the Quality of Acute and Post-Acute Care
Mark D. Neuman, M.D., Assistant Professor of Anesthesiology and Critical Care, University of Pennsylvania; Senior Fellow, Leonard Davis Institute of Health Economics

It was just four years ago this winter that Dr. Mark Neuman applied for and received a FAER Mentored Research Training Grant to study “Anesthesia Technique and Outcomes After Hip Fracture: Instrumental Variable Analysis.” As he neared the completion of his project, Dr. Neuman met an important career milestone: He received a career development grant from the National Institute on Aging (an NIH K08) to continue his research. The original and subsequent studies have resulted in several published papers, most notably in JAMA and Anesthesiology.

Beyond the federal funding and impactful papers is the clinical relevance and importance of Dr. Neuman’s research findings. His FAER-funded study implemented innovative statistical methods that can be applied to other projects within anesthesiology and beyond.

To quote the abstract from his NIH K08: “This project will offer new insights of importance to the design, implementation and evaluation of policy strategies intended to improve the quality of acute and post-acute care services for hip fracture, and will offer a model for understanding the role of health care facility factors in determining the outcomes of care for older U.S. adults undergoing hospitalization and surgery for a range of acute conditions.”

Support Scientific Discovery and Research, the Campaign for New Knowledge
A FAER award is a catalyst for a successful academic career and scientific discovery. Let FAER be your gateway to supporting the knowledge creation that differentiates anesthesiologists and moves medicine forward. We gratefully appreciate your support for the campaign for new knowledge.

Ways to Support FAER
1. Make a gift today. Donate online at FAER.org/donate.
Donations made online have an immediate effect ton FAER’s ability to provide ongoing support for our research grants and programs. You can make an online donation to FAER using any major credit card. Visit our secure gift form at FAER.org/donate.

2. Set up a monthly or quarterly recurring donation.
Becoming a regular donor to FAER is an excellent way to provide sustained support for anesthesia research and education. You can set up a recurring gift to FAER via our online donation form at FAER.org/donate.