Papers by Mary E Arthur, MD
Journal of Cardiothoracic and Vascular Anesthesia, Aug 2014
MedEdPORTAL, 2010
We developed this resource for anesthesia faculty to train third-and fourth-year anesthesiology r... more We developed this resource for anesthesia faculty to train third-and fourth-year anesthesiology residents as well as medical students enrolled in an anesthesiology clerkship.
Echocardiography, 2009
Background: Estimation of right atrial pressure (RAP) from variations in the diameter of the infe... more Background: Estimation of right atrial pressure (RAP) from variations in the diameter of the inferior vena cava (IVC) during the respiratory cycle using transthoracic echocardiography (TTE) is used routinely to calculate pulmonary artery systolic pressure, adding to right ventricular systolic pressure (RVSP) from the jet velocity of tricuspid regurgitation. Using transesophageal echocardiography (TEE) we sought to determine if the inferior vena cava diameter (IVCD) could be used to derive the central venous pressure (CVP) in anesthetized, mechanically ventilated patients. Methods: The IVCD was measured in its long axis (bicaval view) at the cavo-atrial junction using TEE and ECG synchronization (to coincide with the end of the T-wave) in 95 anesthetized, mechanically ventilated patients undergoing elective cardiac surgery. Each patient received a pulmonary artery catheter (PAC) that allowed for continuous monitoring of the CVP. Three independent readers were assigned to document the IVCD and the CVP. Statistical analysis was performed using bivariate correlation, variance (ANOVA), linear regression, Bland–Altman and Passing-Bablock analysis of agreement. Results: The IVCD measured in millimeters at the cavo-atrial junction showed a positive correlation with the CVP (n = 95, r = 0.860, P < 0.0001, r2= 0.737, P < 0.0001). The linear regression equation [CVPc = (IVCD−4.004/0.751] was prospectively tested in a cohort of 12 anesthetized, mechanically ventilated patients under various hemodynamic conditions with a good correlation between the mean CVP (CVPm) and the calculated CVP (CVPc) (r = 0.923, P < 0.0001, r2= 0.851, P < 0.0001). Conclusion: The TEE measured IVCD at the cavo-atrial junction showed a statistically significant correlation with the mean CVP. Using an equation derived from linear regression analysis, a reliable CVP can be estimated from the IVCD.
AMWA Journal, 2010
The control of pain associated with surgical operations and dental procedures has been a compelli... more The control of pain associated with surgical operations and dental procedures has been a compelling problem for centuries. Early surgeons relied on the use of alcoholic concoctions, pressure on nerves and blood vessels, various inhalants, and smeared substances. A high incidence of adverse outcomes led to the search for safer and more effective methods, giving birth to anesthesiology as a medical specialty. The specialty of anesthesiology has evolved into several subspecialties, with the American Society of Anesthesiologists providing standards and guidelines for the profession. Today, anesthesiologists are physicians who maintain patients in a comfortable state and manage vital life functions before, during, and after surgery. Anesthesiologists also provide medical care and consultations in intensive care units, pain management clinics, and other locations. They have a full understanding of the various anesthetic agents and use sophisticated technology to monitor vital life functions, diagnose and treat medical problems, and ensure patient safety and comfort.
This is a longer version of an article written for the Heart and Cardiovascular newsletter, GR He... more This is a longer version of an article written for the Heart and Cardiovascular newsletter, GR Heart and Cardiovascular Services.
White paper prepared for Product Assessment Committee presentation
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Papers by Mary E Arthur, MD