Critical Care Anesthesiology

Two people in the simulation lab Division members will provide world-class care for critically ill patients in multiple intensive care units across the institution. The Division’s intensivists will plan and execute clinical research studies, including multicenter studies and prospective clinical and translational studies. All members will maintain an active leadership role as educators for medical students, residents, and fellows. Curricula and educational products will be developed and disseminated both locally and nationally. Members will play a direct role in various patient safety and quality improvement initiatives. Members from the Division will actively participate in all critical care-related committees in the institution, representing the interests of the Department of Anesthesiology, and chairing committees when appropriate. The Division Chief will coordinate and lead these efforts, providing mentoring and guidance.

The missions of the Division of Critical Care are:

Provide exemplary care for critically ill patients
Conduct cutting edge clinical and basic research
Educate the next generation of anesthesiologist-intensivists
Teach the concepts of airway management, resuscitation and pulmonary care to medical students and other health professionals
Harness initiative and innovation in all of these areas

Group of men in the operating room

Overview

Faculty members in the Division of Critical Care Medicine provide care for critically ill patients in the surgical intensive care unit (SICU), neurosciences intensive care unit, cardiac surgical intensive care unit (CSICU), and trauma/neurotrauma intensive care units. All members are board-certified in anesthesiology, with an additional subspecialty certification in critical care medicine or neurocritical care (UCNS).

Education: Medical students and residents who rotate through the Surgical ICU gain valuable experience in the management of critically ill patients and attend lectures during their rotations. All residents are required to pass the Society of Critical Care Medicine’s Fundamentals of Critical Care Support course during their initial rotation.

The Division offers a Critical Care Medicine Fellowship, accredited by the ACGME. In addition to learning all aspects of care for seriously ill patients, fellows participate in lectures and journal clubs on a weekly basis.

Faculty

Education

Critical Care Medicine Fellowship - Elizabeth Cox Williams, M.D., Program Director

To find out more about our fellowship program please click here.

Important Critical Care Links

Departmental intranet: (links to landmark critical care articles) http://anesweb.umm.edu
Maryland Critical Care Project: http://marylandccproject.org/
ATS Reading List: https://www.thoracic.org/professionals/career-development/residents-medical-students/ats-reading-list/
SCCM: https://www.sccm.org/Home
SCCM Critical eConnections (featuring monthly concise critical appraisals of key articles): https://www.sccm.org/Communications/SCCM-Connect
SCCM iCritical Care Podcasts: https://www.sccm.org/Communications/iCritical-Care
SOCCA: https://socca.org/
EmCrit: http://emcrit.org/
Critical Care Reviews: http://www.criticalcarereviews.com/
MDCalc (critical care calculators): https://www.mdcalc.com/

Publications

Endicott KM, Friedrich R, Custer JW, Sarkar R, Rowen L, Anders MG. Preventing Retained Surgical Items During Endovascular Procedures: Bridging the Gap Between Guidelines and Practice. AORN J. 2020 Dec;112(6):625-633. doi: 10.1002/aorn.13250. PMID: 33252796.

Talley DA, Dunlap E, Silverman D, Katzer S, Huffines M, Dove C, Anders M, Galvagno SM, Tisherman SA. Improving Postoperative Handoff in a Surgical Intensive Care Unit. Crit Care Nurse. 2019 Oct;39(5):e13-e21. doi: 10.4037/ccn2019523. PMID: 31575601.

Anders M, Rock P, Cartron A, Chow J, Henderson R, Martz D, Tanaka K, Mazzeffi M. Isolated platelet concentrate transfusion during surgery: a single-center observational cohort study. Transfusion. 2019 May;59(5):1661-1666. doi: 10.1111/trf.15156. Epub 2019 Jan 29. PMID: 30693940.

Kelley KM, Galvagno SM, Wallis M, Mazzeffi MA, Deatrick K, Betzold R, Scalea T, Menaker J. Tracheostomy in Patients on Venovenous Extracorporeal Membrane Oxygenation: Is It Safe? Am Surg. 2020 Dec 19:3134820979595. doi: 10.1177/0003134820979595. Epub ahead of print. PMID: 33342297.

Moeller SC, Serbanescu MA, Abernathy JH 3rd, Kostibas MP, Lawton JS, Cha SL. The Epiaortic Ultrasound Diagnosis of Iatrogenic Subadventitial Hematoma. A A Pract. 2020 Nov;14(13):e01333. doi: 10.1213/XAA.0000000000001333. PMID: 33185407.

Richards JE, Mazzeffi MA, Massey MS, Rock P, Galvagno SM Jr, Scalea TM. The Bitter and the Sweet: Relationship of Lactate, Glucose, and Mortality After Severe Blunt Trauma. Anesth Analg. 2020 Dec 30. doi: 10.1213/ANE.0000000000005335. Epub ahead of print. PMID: 33475264.

Howie W, Scott-Herring M, Pollak AN, Galvagno SM Jr. Advanced Prehospital Trauma Resuscitation With a Physician and Certified Registered Nurse Anesthetist: The Shock Trauma "Go-Team". Air Med J. 2020 Jan-Feb;39(1):51-55. doi: 10.1016/j.amj.2019.09.004. Epub 2019 Oct 23. PMID: 32044070.

Galvagno SM Jr, Pelekhaty S, Cornachione CR, Deatrick KB, Mazzeffi MA, Scalea TM, Menaker J. Does Weight Matter? Outcomes in Adult Patients on Venovenous Extracorporeal Membrane Oxygenation When Stratified by Obesity Class. Anesth Analg. 2020 Sep;131(3):754-761. doi: 10.1213/ANE.0000000000004454. PMID: 31663965.

Richards JE, Medvecz AJ, O'Hara NN, Guillamondegui OD, O'Toole RV, Obremskey WT, Galvagno SM, Scalea TM. Musculoskeletal Trauma in Critically Injured Patients: Factors Leading to Delayed Operative Fixation and Multiple Organ Failure. Anesth Analg. 2020 Dec;131(6):1781-1788. doi: 10.1213/ANE.0000000000005252. PMID: 33186164.

Verdiner RE, Choukalas CG, Siddiqui S, Stahl DL, Galvagno Jr SM, et. al. COVID-Activated Emergency Scaling of Anesthesiology Responsibilities Intensive Care Unit. Anesth Analg. 2020;131(2):365-377. doi:10.1213/ANE.0000000000004957. PMID: 32398432.

Galvagno SM Jr, Sikorski RA, Floccare DJ, Rock P, Mazzeffi MA, DuBose JJ, Scalea TM, Miller C, Richards JE, O’Connor JV, Mackenzie CF, Hu P. Prehospital Point of Care Testing for the Early Detection of Shock and Prediction of Lifesaving Interventions [published online ahead of print, 2020 May 21]. Shock. 2020;10.1097/SHK.0000000000001567. doi:10.1097/SHK.0000000000001567.PMID: 32453248.

Engdahl AJ, Parrino CR, Wasicek PJ, Galvagnno Jr SM, Brenner M, Anders MG, Conti B, Rock P, McCunn M.. Anesthetic Management of Patients After Traumatic Injury With Resuscitative Endovascular Balloon Occlusion of the Aorta. Anesth Analg. 2019;129(5):e146-e149. doi:10.1213/ANE.0000000000004130. PMID: 31634204.

Selected Talks

Justin Richards

Vasopressors in Trauma: A never event?, Department of Anesthesiology, Grenoble Alps University, Grenoble, France
Acute Traumatic Coagulopathy: Break it down or build it up?, Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR
Multi-modal Analgesia in the Intensive Care Unit, Maryland Critical Care Project

Megan Anders

Emergency Management of the Surgically Altered Airway, Medical University of South Carolina, Charleston, SC (Virtual). 2021.
Spinal Ischemia after Aortic Surgery, Medical University of South Carolina, Charleston, SC (Virtual). 2021.
"Surgical Airway Emergencies." Maryland Critical Care Project Podcast. 2013.
"Critical Care in Pregnancy." Maryland Critical Care Project Podcast. 2014.
"Patient safety and quality improvement in the ICU." Maryland Critical Care Project Podcast. 2015.

Samuel Galvagno

Visiting Professor, “The Anesthesiologist as Resuscitationist,” Wake Forest School of Medicine, Department of Anesthesiology. April, 2021.
Panelist and Speaker, EndoVascular resuscitation and Trauma Management (EVTM) meets VEITH New Developments in Bleeding Control, Cardiac Arrest, and Shock, “ECMO May Have a Role in Trauma,” New York, NY, Webinar (due to travel restrictions) September, 2020.
"Earning the Anesthetic for RSII". Maryland Critical Care Project Podcast. 2015.
"Osmotherapy in the Neurosciences Intensive Care Unit". Maryland Critical Care Project Podcast. 2015.
"End Points of Resuscitation in Traumatic Shock." Maryland Critical Care Project Podcast. 2015.
"Perfusion-protective ventilation" Maryland Critical Care Project Podcast. 2017.
"Patient-ventilator interactions, perfusion-protection strategies". Maryland Critical Care Project Podcast. 2017.
"Molecular Adsorbent Recirculating System: Life on MARS." Maryland Critical Care Project Podcast. 2019.
"Endpoints of Resuscitation." Maryland Critical Care Project Podcast. 2020.