Clinical Focus

  • Anesthesia

Academic Appointments

  • Clinical Assistant Professor, Anesthesiology, Perioperative and Pain Medicine

Professional Education

  • Fellowship:Stanford Medicine Pulmonary and Critical Care Fellowship (2012) CA
  • Medical Education:Northeastern Ohio Universities (2005) OH
  • Internship:University of Pittsburgh Medical Center (2006) PA
  • Residency:University of Pittsburgh Medical Center (2009) PA
  • Board Certification: Anesthesia, American Board of Anesthesiology (2010)
  • Fellowship:Stanford University School of Medicine (2011) CA
  • Board Certification: Perioperative Transesophageal Echocardiography, National Board of Echocardiography (2012)
  • Board Certification: Critical Care Medicine, American Board of Anesthesiology (2012)
  • Fellowship:Lucile Packard Children's Hospital


Graduate and Fellowship Programs


All Publications

  • Comparative effectiveness of epsilon-aminocaproic acid and tranexamic acid on postoperative bleeding following cardiac surgery during a national medication shortage JOURNAL OF CLINICAL ANESTHESIA Blaine, K. P., Press, C., Lau, K., Sliwa, J., Rao, V. K., Hill, C. 2016; 35: 516-523


    The aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (εACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage.A retrospective cohort study.The study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage.Demographic, clinical, and outcomes data were compared by descriptive statistics using χ(2) and t test. Surgical drainage and transfusions were compared by multivariate linear regression for patients receiving εACA before the shortage and TXA during the shortage.In multivariate analysis, no statistical difference was found for surgical drain output (OR 1.10, CI 0.97-1.26, P=.460) or red blood cell transfusion requirement (OR 1.79, CI 0.79-2.73, P=.176). Patients receiving εACA were more likely to receive rescue hemostatic medications (OR 1.62, CI 1.02-2.55, P=.041).Substitution of εACA with TXA during a national medication shortage produced equivalent postoperative bleeding and red cell transfusions, although patients receiving εACA were more likely to require supplemental hemostatic agents.

    View details for DOI 10.1016/j.jclinane.2016.08.037

    View details for Web of Science ID 000389785600092

    View details for PubMedID 27871586

  • Salvage Extracorporeal Membrane Oxygenation Prior to "Bridge" Transcatheter Aortic Valve Replacement. Journal of cardiac surgery Chiu, P., Fearon, W. F., Raleigh, L. A., Burdon, G., Rao, V., Boyd, J. H., Yeung, A. C., Miller, D. C., Fischbein, M. P. 2016; 31 (6): 403-405


    We describe a patient who presented in profound cardiogenic shock due to bioprosthetic aortic valve stenosis requiring salvage Extracorporeal Membrane Oxygenation followed by a "bridge" valve-in-valve transcatheter aortic valve replacement. doi: 10.1111/jocs.12750 (J Card Surg 2016;31:403-405).

    View details for DOI 10.1111/jocs.12750

    View details for PubMedID 27109017

    View details for PubMedCentralID PMC4951207

  • Factor VIII Inhibitor Bypass Activity and Recombinant Activated Factor VII in Cardiac Surgery JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA Rao, V. K., Lobato, R. L., Bartlett, B., Klanjac, M., Mora-Mangano, C. T., Soran, P. D., Oakes, D. A., Hill, C. C., van der Starre, P. J. 2014; 28 (5): 1221-1226
  • A cost study of postoperative cell salvage in the setting of elective primary hip and knee arthroplasty TRANSFUSION Rao, V. K., Dyga, R., Bartels, C., Waters, J. H. 2012; 52 (8): 1750-1760


    The increasing costs, limited supply, and clinical risks associated with allogeneic blood transfusion have prompted investigation into autologous blood management strategies, such as postoperative red blood cell (RBC) salvage. This study provides a cost comparison of transfusing washed postoperatively salvaged RBCs using an orthopedic perioperative autotransfusion device (OrthoPat, Haemonetics Corporation) versus unwashed shed blood and banked allogeneic blood.Cell salvage data were retrospectively reviewed for a sample of 392 patients who underwent primary hip or knee arthroplasty. Mean unit costs were calculated for washed salvaged RBCs, equivalent units of unwashed shed blood, and therapeutically equivalent volumes of allogeneic RBCs.No initial capital investment was required for the establishment of the postoperative cell salvage program. For patients undergoing total knee arthroplasty (TKA), the mean unit costs for washed postoperatively salvaged cells, unwashed shed blood, and allogeneic banked blood were $758.80, $474.95, and $765.49, respectively. In patients undergoing total hip arthroplasty (THA), the mean unit costs for washed postoperatively salvaged cells, unwashed shed blood, and allogeneic banked blood were $1827.41, $1167.41, and $2609.44, respectively.This analysis suggests that transfusing washed postoperatively salvaged cells using the OrthoPat device is more costly than using unwashed shed blood in both THA and TKA. When compared to allogeneic transfusion, washed postoperatively salvaged cells carry a comparable cost in TKA, but potentially represent a significant savings in patients undergoing THA. Sensitivity analysis suggests that in the case of TKA, however, cost comparability exists within a narrow range of units collected and infused.

    View details for DOI 10.1111/j.1537-2995.2011.03531.x

    View details for Web of Science ID 000307392800017

    View details for PubMedID 22339139

  • Recognition of local anesthetic maldistribution in axillary brachial plexus block guided by ultrasound and nerve stimulation JOURNAL OF CLINICAL ANESTHESIA Veneziano, G. C., Rao, V. K., Orebaugh, S. L. 2012; 24 (2): 141-144


    Nerve stimulation may occur despite the presence of a fascial barrier between the needle tip and the nerve, which may prevent appropriate flow or distribution of local anesthetic solution. During an axillary nerve block, ultrasound (US) guidance was used to identify the median nerve. Insertion of a needle with US and nerve stimulator guidance resulted in the appearance of the needle tip in contact with the nerve. However, as local anesthetic injection was begun, it was clear that the injectate was accumulating superficial to the investing fascia of the neurovascular bundle. No injectate was seen below the fascia. With US guidance, the needle was repositioned at a greater depth. Repeat injection of local anesthetic clearly flowed around the nerve.

    View details for DOI 10.1016/j.jclinane.2011.06.009

    View details for Web of Science ID 000301894600012

    View details for PubMedID 22414707

  • Analysis of major complications associated with arterial catheterisation QUALITY & SAFETY IN HEALTH CARE Salmon, A. A., Galhotra, S., Rao, V., DeVita, M. A., Darby, J., Hilmi, I., SIMMONS, R. L. 2010; 19 (3): 208-212


    Arterial catheterisation is used for continuous haemodynamic monitoring in patients undergoing surgery and in critical care units. Although it is considered a safe procedure, a major complication such as arterial occlusion and limb gangrene can occur.To determine the incidence, outcome and potential to avoid complications associated with arterial catheterisation.The number of arterial catheterisation was determined using an anaesthesiology and critical care medicine billing database over a period of 4 years (1 January 2003 to 31 December 2006). Possible major complications were identified from two hospital databases; all identified charts were screened and then reviewed by an expert panel that determined causation. A major complication was defined as requiring operative intervention and/or resulting in permanent harm.15 (0.084%) major complications were identified among 17 840 instances of arterial catheterisation insertions. Of 15 arterial catheterisations, nine were performed in the operating room and six in the intensive care unit. Nine patients suffered ischaemic injury, which progressed to gangrene in three patients. Three patients developed haematoma that required surgical evacuation; two of these required vascular repair. One patient had compartment syndrome requiring fasciotomy and two patients had sheared catheter fragments that needed to be removed. All 15 patients had multiple comorbidities, and those in the operating room had an American Society of Anesthesiologists score of >or=3. Seven (46.6%) had arterial catheterisation done under emergent circumstances. Six (40%) died during hospitalisation because of complications unrelated to arterial catheterisation.Arterial catheterisation had a very low rate of major complications. They seem associated with high severity of illness and emergency surgery.

    View details for DOI 10.1136/qshc.2008.028597

    View details for Web of Science ID 000279355700010

    View details for PubMedID 20194221