Biography
My research addresses clinical questions by studying human subjects or patients. I collaborate with other faculty in the department on my research and provide expertise in the following areas: data analysis and statistics; mathematical modeling; data acquisition programming; human studies; respiratory physiology.
My research involvement has included multiple different projects:
• Accuracy of pulse oximetry, including determination of methemoglobin, carboxyhemoglobin, and the accuracy of cerebral oximetry.
• Organ transplantation and efforts to improve the quality of cadaveric organs.
• Acute normovolemic hemodilution to study the tolerance of acute anemia, as a way to examine red cell transfusion thresholds. Additionally, we have used this model to study other issues in transfusion, including TRALI.
• The utility of somatosensory and motor evoked potential, which are used in major spine surgery to assess the integrity of spinal cord function.
• The physiology of breathholding and drug-induced apnea.
• High altitude physiology
• Clinical effects of neuromuscular blockade
Education
Institution | Degree | Dept or School | End Date |
---|---|---|---|
University of California | Diversity, Equity, and Inclusion Champion Training | 2019 | |
University of California, San Francisco | Residency | School of Medicine |
Board Certifications
American Board of Anesthesiology
Clinical Expertise
Kidney Transplantation
Liver Transplantation
Pancreas Transplantation
Clinical Trials
- Accuracy of BabySat V3 With Profound Hypoxia and Motion (NCT05581394)Related Conditions: Hypoxia| Start Date: | End Date:
- Related Conditions: Hypoxia| Start Date: | End Date:
- Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDS) on Acclimatization to High Altitude (NCT02233582)Related Conditions: High Altitude| Start Date: | End Date:
- Related Conditions: Muscle Relaxation, Sex| Start Date: | End Date:
Program Affiliations
- Department of Anesthesia and Perioperative Care
- Department of Surgery, Division of Transplantation
In the News
Research Interests
Hypoxic ventilatory drive at altitude
Apnea with remifentanil and propofol
Transfusion Related Acute Lung Injury
Neuromonitoring in Spine Anesthesia
Pulse oximeter accuracy
Physiology of acute anemia
Predictors of kidney and liver donor organ function
View Research Profile at UCSF Clinical & Translational Science Institute
Publications
- The performance of 11 fingertip pulse oximeters during hypoxemia in healthy human participants with varied, quantified skin pigment.| | View in PubMed
- Low Perfusion and Missed Diagnosis of Hypoxemia by Pulse Oximetry in Darkly Pigmented Skin: A Prospective Study.| | View in PubMed
- Quantifying pulse oximeter accuracy during hypoxemia and severe anemia using an in vitro circulation system.| | View in PubMed
- Reducing Volatile Anesthetic Waste Using a Commercial Electronic Health Record Clinical Decision Support Tool to Lower Fresh Gas Flows.| | View in PubMed
- Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students.| | View in PubMed
- Pulse Oximeter Performance, Racial Inequity, and the Work Ahead.| | View in PubMed
- Perioperative Normal Saline Administration and Delayed Graft Function in Patients Undergoing Kidney Transplantation: A Retrospective Cohort Study.| | View in PubMed
- Anesthesia for Maternal-Fetal Interventions: A Survey of Fetal Therapy Centers in the North American Fetal Therapy Network.| | View in PubMed
- Pediatric Distraction on Induction of Anesthesia With Virtual Reality and Perioperative Anxiolysis: A Randomized Controlled Trial.| | View in PubMed
- "Silent" Presentation of Hypoxemia and Cardiorespiratory Compensation in COVID-19.| | View in PubMed
- The Association Between Vena Cava Implantation Technique and Acute Kidney Injury After Liver Transplantation.| | View in PubMed
- New Method of Destroying Waste Anesthetic Gases Using Gas-Phase Photochemistry.| | View in PubMed
- A Comparison of Spinal Anesthesia Versus Monitored Anesthesia Care With Local Anesthesia in Minimally Invasive Fetal Surgery.| | View in PubMed
- Response to Burtscher re: "Increased Cytokines at High Altitude: Lack of Effect of Ibuprofen on Acute Mountain Sickness, Physiological Variables, or Cytokine Levels".| | View in PubMed
- The reliability of motor evoked potentials to predict dorsiflexion injuries during lumbosacral deformity surgery: importance of multiple myotomal monitoring.| | View in PubMed
- Increased Cytokines at High Altitude: Lack of Effect of Ibuprofen on Acute Mountain Sickness, Physiological Variables, or Cytokine Levels.| | View in PubMed
- Correction to: Changes in transcranial motor evoked potentials during hemorrhage are associated with increased serum propofol concentrations.| | View in PubMed
- Intraoperative Management of Liver Transplant Patients Without the Routine Use of Renal Replacement Therapy.| | View in PubMed
- Central venous pressure monitoring in living donor kidney recipients does not affect immediate graft function: A propensity score analysis.| | View in PubMed
- Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion.| | View in PubMed
- Comparison of Transcranial Doppler and Ultrasound-Tagged Near Infrared Spectroscopy for Measuring Relative Changes in Cerebral Blood Flow in Human Subjects.| | View in PubMed
- Effects of Changes in Arterial Carbon Dioxide and Oxygen Partial Pressures on Cerebral Oximeter Performance.| | View in PubMed
- Changes in transcranial motor evoked potentials during hemorrhage are associated with increased serum propofol concentrations.| | View in PubMed
- Incidence and Management of Umbilical Artery Flow Abnormalities during Open Fetal Surgery.| | View in PubMed
- Effects of Acute, Profound Hypoxia on Healthy Humans: Implications for Safety of Tests Evaluating Pulse Oximetry or Tissue Oximetry Performance.| | View in PubMed
- Evaluating Pulmonary Function: An Assessment of PaO2/FIO2.| | View in PubMed
- Tissue Oximetry and Clinical Outcomes.| | View in PubMed
- The Accuracy of 6 Inexpensive Pulse Oximeters Not Cleared by the Food and Drug Administration: The Possible Global Public Health Implications.| | View in PubMed
- In Reply.| | View in PubMed
- The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin.| | View in PubMed
- Predicting mortality in the intensive care unit: a comparison of the University Health Consortium expected probability of mortality and the Mortality Prediction Model III.| | View in PubMed
- Impact of a quality improvement project on deceased organ donor management.| | View in PubMed
- Perioperative Mortality, 2010 to 2014: A Retrospective Cohort Study Using the National Anesthesia Clinical Outcomes Registry.| | View in PubMed
- Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function.| | View in PubMed
- Alfentanil during rapid sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg: tracheal intubation conditions.| | View in PubMed
- A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery.| | View in PubMed
- Pupillary effects of high-dose opioid quantified with infrared pupillometry.| | View in PubMed
- Effect of hemorrhage and hypotension on transcranial motor-evoked potentials in swine.| | View in PubMed
- Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers.| | View in PubMed
- Accuracy of the Lifebox pulse oximeter during hypoxia in healthy volunteers.| | View in PubMed
- Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation.| | View in PubMed
- Accuracy of carboxyhemoglobin detection by pulse CO-oximetry during hypoxemia.| | View in PubMed
- The effect of deep and awake tracheal extubation on turnover times and postoperative respiratory complications post adenoid-tonsillectomy.| | View in PubMed
- Hemoglobin desaturation after propofol/remifentanil-induced apnea: a study of the recovery of spontaneous ventilation in healthy volunteers.| | View in PubMed
- Fresh and stored red blood cell transfusion equivalently induce subclinical pulmonary gas exchange deficit in normal humans.| | View in PubMed
- Sex-related differences in the relationship between acceleromyographic adductor pollicis train-of-four ratio and clinical manifestations of residual neuromuscular block: a study in healthy volunteers during near steady-state infusion of mivacurium.| | View in PubMed
- High oxygen partial pressure decreases anemia-induced heart rate increase equivalent to transfusion.| | View in PubMed
- Quantitative tissue oxygen measurement in multiple organs using 19F MRI in a rat model.| | View in PubMed
- Donor pre-treatment with everolimus or cyclosporine does not reduce ischaemia-reperfusion injury in a rat kidney transplant model.| | View in PubMed
- Relationship between normalized adductor pollicis train-of-four ratio and manifestations of residual neuromuscular block: a study using acceleromyography during near steady-state concentrations of mivacurium.| | View in PubMed
- Improved accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia.| | View in PubMed
- Emergent orthotopic liver transplantation for hemorrhage from a giant cavernous hepatic hemangioma: case report and review.| | View in PubMed
- Quality improvement in transplant anesthesia: which way forward?| | View in PubMed
- Accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia.| | View in PubMed
- Acute kidney injury during liver transplantation as determined by neutrophil gelatinase-associated lipocalin.| | View in PubMed
- Relative efficacy of transcranial motor evoked potentials, mechanically-elicited electromyography, and evoked EMG to assess nerve root function during sustained retraction in a porcine model.| | View in PubMed
- Predictors associated with terminal renal function in deceased organ donors in the intensive care unit.| | View in PubMed
- Red blood cell age and function.| | View in PubMed
- The efficacy of motor evoked potentials in fixed sagittal imbalance deformity correction surgery.| | View in PubMed
- Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender.| | View in PubMed
- Visual loss after spinal surgery.| | View in PubMed
- Central venous pressure monitoring during living right donor hepatectomy.| | View in PubMed
- The effect of age on motor evoked potentials in children under propofol/isoflurane anesthesia.| | View in PubMed
- Fresh blood and aged stored blood are equally efficacious in immediately reversing anemia-induced brain oxygenation deficits in humans.| | View in PubMed
- Designing and testing a computer-based screening system for transfusion-related acute lung injury.| | View in PubMed
- Effects of skin pigmentation on pulse oximeter accuracy at low saturation.| | View in PubMed
- Acute isovolemic anemia impairs central processing as determined by P300 latency.| | View in PubMed
- Mild hypothermia, but not propofol, is neuroprotective in organotypic hippocampal cultures.| | View in PubMed
- Progressive suppression of motor evoked potentials during general anesthesia: the phenomenon of "anesthetic fade".| | View in PubMed
- No effect of MDR1 C3435T variant on loperamide disposition and central nervous system effects.| | View in PubMed
- Acute isovolemic anemia does not impair peripheral or central nerve conduction.| | View in PubMed
- Heart rate increases linearly in response to acute isovolemic anemia.| | View in PubMed
- Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia.| | View in PubMed
- Productivity versus availability as a measure of faculty clinical responsibility.| | View in PubMed
- Epinephrine increases the neurotoxic potential of intrathecally administered lidocaine in the rat.| | View in PubMed
- Hemoglobin desaturation after succinylcholine-induced apnea: a study of the recovery of spontaneous ventilation in healthy volunteers.| | View in PubMed
- Subcutaneous perfusion and oxygen during acute severe isovolemic hemodilution in healthy volunteers.| | View in PubMed
- Electrocardiographic ST-segment changes during acute, severe isovolemic hemodilution in humans.| | View in PubMed
- Acute severe isovolemic anemia impairs cognitive function and memory in humans.| | View in PubMed
- Fatigue during acute isovolemic anemiain healthy, resting humans.| | View in PubMed
- Critical oxygen delivery in conscious humans is less than 7.3 ml O2 x kg(-1) x min(-1).| | View in PubMed
- Tidal volume, PaCO2, and lung injury.| | View in PubMed
- Human cardiovascular and metabolic response to acute, severe isovolemic anemia.| | View in PubMed
- Interactive effects of pH and temperature on N-methyl-D-aspartate receptor activity in rat cortical brain slices.| | View in PubMed
- Exercise-induced VA/Q inequality in subjects with prior high-altitude pulmonary edema.| | View in PubMed
- Pulmonary hemodynamic response to exercise in subjects with prior high-altitude pulmonary edema.| | View in PubMed
- Volatile and intravenous anesthetics decrease glutamate release from cortical brain slices during anoxia.| | View in PubMed
- Hypoxic ventilatory response predicts the extent of maximal breath-holds in man.| | View in PubMed
- Hemodynamic effects of intermittent pneumatic compression of the legs.| | View in PubMed