SURGICAL RESEARCH

The Department of Surgical Education at Orlando Regional Medical Center is actively involved in both basic science and clinical research. Each resident and fellow is encouraged to conceive and implement a research project leading to presentation at a national meeting and subsequent publication on a yearly basis. Most residents complete the program having published at least one, if not multiple, papers in the scientific literature. This is due to strong support from the academic faculty, all of whom are actively involved in scientific research.

Clinical research in the Department of Surgical Education is facilitated by a full-time clinical research project manager assisted by extensive computerized clinical databases. In addition to a comprehensive online database which records resident procedural and operative experience as well as all facets of daily patient care, the department is also a participant in the American College of Surgeons NTRACS trauma database and the Society of Critical Care Medicine Project Impact critical care database.

CURRENT AREAS OF RESEARCH

• Shock resuscitation
• Hemodynamic monitoring
• Right ventricular volumetric pulmonary artery catheters
• Oxygen Transport
• Abdominal compartment syndrome
• Surgical Nutrition
• Weaning from mechanical ventilation
• Acute Respiratory Distress Syndrome (ARDS)
• Commercial airline travel following trauma
• Personal watercraft injuries
• Use of percutaneous dilatational tracheostomy

PUBLICATIONS FROM THE DEPARTMENT OF SURGICAL EDUCATION: 1993-2007

General Surgery

• A meta-analysis of selective versus routine nasogastric decompression following elective laparotomy. Cheatham ML, Chapman WC, Key SK, Sawyers JL. Ann Surg 1995; 221(5):469-478.
• A structured curriculum for improved resident education in statistics. Cheatham ML. Am Surg 2000; 66:585-588.
• Solid Organ Transplantation. Richie RE, Pierson RN, Fox M, Cheatham ML, Pinson CW. In: Surgical Care for the Elderly (2nd Ed.) Adkins BA, Scott HW, eds. Philadelphia; Lippincott-Raven, 1998.
• Pancreaticoduodenectomy in a Community General Surgery Residency Program. Smith CP, Lube MW, Cheatham ML, Safcsak K. Am Surg 2006; ;72(8):750-753.

Trauma Surgery

• Evaluation of acute mental status change in the non-head injured trauma patient. Cheatham ML, Block EFJ, Nelson LD. Am Surg 1998; 64:900-906.
• Predictors of mortality in patients with open abdomens. Cheatham ML, Safcsak K, Block EFJ, Nelson LD. Crit Care Med 1999; 27(1):A170.
• Intra-abdominal hypertension and abdominal compartment syndrome in the geriatric patient. Sagraves SG, Johnson JL, Cheatham ML, Block EFJ, Nelson LD. Crit Care Med 1999; 27(12):A146.
• Intra-abdominal hypertension and abdominal compartment syndrome. Cheatham ML. New Horizons 1999; 7:96-115.
• The underestimated impact of personal watercraft accidents. White MW, Cheatham ML. Am Surg 1999; 65:865-869.
• Air travel following traumatic pneumothorax. Cheatham ML, Safcsak K. Am Surg 1999; 65:1160-1164.
• Life threatening nail gun injuries. Beaver AC, Cheatham ML. Am Surg 1999; 65:1113-1116.
• Ingested endotracheal tube in an adult following intubation attempt for head injury. Block EFJ, Cheatham ML, Parrish GA, Nelson LD, Beam N. Am Surg 1999; 65:1134-1136.
• Closing the abdomen that won't close. Block EFJ, Cheatham ML. In: Current Surgical Therapy (6th Ed). Cameron JL. St. Louis: Mosby, 2001, pp. 1129-1135.
• Results from the International Consensus Definitions Conference on Intra-abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS): Part I Definitions. Malbrain MLNG, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, D’Amours S, Wilmer A, Wendon J, Hillman K. Intensive Care Med 2006; 32: 1722-1732.
• Results from the International Consensus Definitions Conference on Intra-abdominal Hypertension (IAH) and Abdominal Compartment Syndrome (ACS): Part II Recommendations. Cheatham ML, Malbrain MLNG, Kirkpatrick A, Sugrue M, Parr M, De Waele J, Balogh Z, Leppäniemi A, Olvera C, Ivatury R, D’Amours S, Wilmer A, Wendon J, Hillman K. Intensive Care Med 2007; 33:951-962.
• Effect of patient positioning on intra-abdominal pressure monitoring. McBeth PB, Zygun DA, Widder S, Cheatham ML, Kirkpatrick AW. Am J Surgery 2007; 193: 644–647.
• Nitrogen Balance, Protein Loss, and the Open Abdomen. Cheatham ML, Safcsak K, Brzezinski S, Lube MW. Crit Care Med 2007 35(1):127-131.
  
  

Surgical Critical Care

• Room Air ABG Analysis VS Non-Invasive Gas Exchange Monitoring VS Pulmonary Mechanics Criteria in Extubation from Ventilator Support. Cheatham ML, Chang MC, Eddy VA. Crit Care Med 1993; 21(suppl):S244.
• Right Ventricular End-Diastolic Volume Index and Pulmonary Artery Occlusion Pressure VS Cardiac Index During Titration of PEEP. Cheatham ML, Chang MC, Eddy VA. Chest 1993; 104(2)suppl:78S.
• Reevaluation of the Bedside Approach to Preload Assessment. Eddy VA, Chang MC, Cheatham ML,. Chest 104(2)suppl:73S, 1993.
• Thermodilution right ventricular ejection fraction (RVEF) measurements: Room vs cold temperature injectate. Safcsak K, Nelson LD. Chest 1993; 104:78S.
• Volumetric assessment of preload in the septic patient. Fusco MA, Safcsak K, Nelson LD. Chest 1994; 106:64S.
• Right Ventricular End-Diastolic Volume Index and Pulmonary Artery Occlusion Pressure vs Cardiac Index in Patients on Positive End-Expiratory Pressure. Cheatham ML, Chang MC, Eddy VA, Safcsak K, Nelson LD. Crit Care Med 1994; 22(1):A98.
• Dextrose Concentration of Total Parenteral Nutrition Determines Likelihood of Lipogenesis. Cheatham ML, Safcsak K, Nelson LD. Crit Care Med 1994; 22(1):A74.
• Pressure vs Volume Predictions of Ventricular Preload in Patients with Pulmonary Hypertension (PHTN). Safcsak K, Nelson LD, Cheatham ML, Chang M, Eddy V. Crit Care Med 1994; 22(1):A102.
• Differences in Hemodynamic and Oxygen Transport Variables Produced by Blood and Crystalloid During Resuscitation. Chang MC, Cheatham ML, Eddy VA, Safcsak K, Nelson LD. Crit Care Med 1994; 22(1):A107.
• End-Tidal Capnography and Pulse Oximetry in the Extubation of Surgical Patients. Cheatham ML, Safcsak K, Nelson LD. Chest 1994; 106(2) suppl: 63S.
• Effect of Barotrauma on Outcome in Patients with Severe Adult Respiratory Distress Syndrome. Miles WS, Fusco MA, Cheatham ML, Safcsak K, Nelson LD. Chest 1994; 106(2) suppl:63S.
• Thermodilution right ventricular ejection fraction: Room vs cold temperature injection Safcsak K, Nelson LD. Crit Care Med 1994; 22:1136-1141.
• Shunt Adjusted Tidal Volume Predicts Barotrauma in Patients with Adult Respiratory Distress Syndrome. Fusco MA, Miles WS, Cheatham ML, Safcsak K, Nelson LD. Chest 1994; 106(2) suppl 64S.
• Right Ventricular End-Diastolic Volume Index is Superior to Intracardiac Filling Pressures in Determining Preload Status. Cheatham ML, Safcsak K, Nelson LD. 1994 American College of Surgeons Surgical Forum pp.78-80.
• Gastric Tonometry Supplements Information Provided by Systemic Indicators of Oxygen Transport. Chang MC, Cheatham ML, Rutherford EJ, Nelson LD, Morris JA. J Trauma 1994; 37: 488-494.
• Nutritional support of the gut: how and why. Mainous MR, Block EFJ, Deitch EA. New Horizons 1994 May; 2(2):193-201.
• Does Transmural Pulmonary Artery Occlusion Pressure (PAOP) via Esophageal Balloon Improve Prediction of Ventricular Preload in Patients Receiving Positive End-Expiratory Pressure (PEEP)? Safcsak K, Fusco MA, Miles WS, Cheatham ML, Nelson LD. Crit Care Med 1995; 23(1): A244.
• Survival in patients with severe adult respiratory distress syndrome treated with high level positive end-expiratory pressure. DiRusso SM, Nelson LD, Safcsak K, Miller RS. Crit Care Med 1995; 23:1485-1496.
• Ventilatory risk factors for barotrauma in surgical patients with severe ARDS. Nelson LD, Safcsak K, Worrell J, Carroll F, Youree C. Chest 1995; 108:124S.
• Radiographic appearance of ARDS in surgical patients: Temporal patterns and correlations with physiologic parameters. Worrell J, Carroll F, Youree C, Safcsak K, Nelson LD. Chest 1995; 108:123S.
• Radiographic progression and treatment of barotrauma (BT) in surgical patients with severe ARDS. Nelson LD, Safcsak K, Worrell J, Carroll F, Youree C. Chest 1995; 108:124S.
• Acute limb ischemia in the ICU. Cheatham ML, Nelson LD. In: Critical Care: Clinical Pearls (2nd ed.) Sahn SA, Heffner JE (eds). Philadelphia; Hanley and Belfus, 1997.
• Right ventricular end-distolic volume index as a predictor of preload status in abdominal compartment syndrome. Cheatham ML, Safcsak K, Zoha Z, Block EFJ, Nelson LD. Crit Care Med 1998; 26(1):A38.
• Preload assessment in patients with open abdomens. Cheatham ML, Safcsak K, Block EFJ, Nelson LD. J Trauma 1999; 46:16-22.
• Right ventricular end-diastolic volume index as a predictor of preload status in patients on positive end-expiratory pressure. Cheatham ML, Safcsak K, Chang MC, Nelson LD. Crit Care Med 1998; 26(11):1801-1806.
• Assessment of patient level of consciousness and degree of agitation in the ICU: The LOCA scale. Aragon D, Feild C, Cheatham ML. Crit Care Med 1998; 26(1):A124.
• Intra-abdominal pressure: A revised method for measurement. Cheatham ML, Safcsak K. Journal of the American College of Surgeons 1998; 186: 594-595.
• Superior predictor of the hemodynamic response to fluid challenge in critically ill patients. Cheatham ML, Block EFJ, Nelson LD, Safcsak K. Chest 1998; 114:1126-1127.
• Mathematical coupling does not explain relationship between right ventricular end-diastolic volume (RVEDV) and thermodilution cardiac output (TDCO)., Nelson LD, Safcsak K, Cheatham ML, Block EFJ. Crit Care Med 1999; 27(1):A151.
• Dry wall fluid warmers fail to heat crystalloid fluids at low to moderate infusion rates. Block EFJ, Cheatham ML, Safcsak K, Nelson LD. Crit Care Med 1999; 27(1):A172.
• Intravesicular pressure monitoring does not increase the risk of urinary tract or systemic infection. Sagraves SG, Cheatham ML, Johnson JL, White MW, Block EFJ, Nelson LD. Crit Care Med 1999; 27(12):A48.
• Prospective, randomized comparison of single vs. multiple dilator percutaneous dilatational tracheostomy. Sagraves SG, Johnson JL, Cheatham ML, Block EFJ, Nelson LD. Crit Care Med 1999; 27(12):A56.
• Early acute care risk factors for decubitus ulcer formation in acute spinal cord injury. Sullivan TL, Dere K, Sagraves SG, Cheatham ML. Crit Care Med 1999; 27(12):A74.
• Shock: An overview. Cheatham ML, Block EFJ, Nelson LD. In: Irwin RS, Cerra FB, Rippe JM, eds. Intensive Care Medicine. 4th Ed. Philadelphia: Lippincott-Raven, 1999, pp. 1961-1979.
• Evaluation of a new computer algorithm to determine continual right ventricular ejection fraction and end-diastolic volume. Cheatham ML, Safcsak K, Block EFJ, Nelson LD. Crit Care Med 1999; 27(12):A88.
• Clinical evaluation of a continuous right ventricular ejection fraction / right ventricular end-diastolic volume index / cardiac index algorithm. Safcsak K, Cheatham ML, Block EFJ. Crit Care Med 2000; 28(12):A73.
• Comparison of continuous vs. intermittent pulmonary artery catheters: Are we missing too much? Lombardozzi KAK, Cheatham ML, Safcsak K, Block EFJ. Crit Care Med 2000; 28(12):A63.
• Right ventricular end-diastolic volume measurements in the resuscitation of trauma victims. Cheatham ML. Int J Crit Care 2000; 7:165-176.
• Abdominal perfusion pressure: A superior parameter in the assessment of intra-abdominal hypertension. Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EFJ. J Trauma 2000; 49:621-627.
• An Unusual Case of Corneal Perforation Secondary to Pseudomonas Keratitis. Johnson JL, Sagraves SG, Cheatham ML, Block EFJ. Am Surg 2000; 66:972-974.
• Need for heightened awareness and rapid treatment (editorial). Cheatham ML. Infections in Medicine 2000; 17(11):750.
• Percutaneous dilatational tracheostomy: Comparison of single vs. multiple dilator techniques. Johnson JL, Cheatham ML, Sagraves SG, Block EFJ, Nelson LD. Crit Care Med 2001; 29:1251-1254.
• Mathematical Coupling does not explain the relationship between right ventricular end-diastolic volume and cardiac output. Nelson LD, Safcsak K, Cheatham ML, Block EFJ. Crit Care Med 2001; 29:940-943.
• Comprehensive trauma patient care by nonphysician providers. Sole ML, Hunkar-huie AM, Schiller JS, Cheatham ML. AACN Clinical Issues 2001; 12:438-446.
• Percutaneous endoscopic gastrostomy in patients with an open abdomen. Block EFJ, Cheatham ML, Bee TK. Am Surg 2001; 67:913-914.
• Shock: An overview. Cheatham ML, Block EFJ, Promes JT, Smith HG, In: Irwin RS, Cerra FB, Rippe JM, eds. Intensive Care Medicine. 5th Ed. Philadelphia: Lippincott-Raven, 2003, pp. 1761-1778.
• Independent lung ventilation in the management of traumatic bronchopleural fistula. Cheatham ML, Promes JT Am Surg 2006, 72(6):530-533.
• Intravesicular pressure monitoring does not cause urinary tract infection. Cheatham ML, Sagraves SG, Johnson JL, White MW. Intensive Care Med. 2006, 32(10):1640-1643.
• A planned complex suicide: need for a high index of suspicion. Parra MW, Lube MW, Al-Khayat H, Cheatham ML. Am Surg 2006; 72(5):454-455.
• Cardiovascular effects and optimal preload markers in intra-abdominal hypertension. Malbrain ML, Cheatham ML. In: Vincent JL, editor. Yearbook of Intensive Care and Emergency Medicine. Berlin: Springer-Verlag, 2004.
• Abdominal perfusion pressure. Cheatham ML, Malbrain MLNG. In: Ivatury RR, Cheatham ML, Malbrain MLNG, Sugrue M, editors. Abdominal Compartment Syndrome. Landes Biomedical, 2006.
• Abdominal Compartment Syndrome: It’s Time to Pay Attention! Malbrain ML, Cheatham ML¸ Kirkpatrick A, Sugrue M, De Waele J, Ivatury R. Intensive Care Med 2006; 32:1912-1914.
• Cardiovascular implications of elevated intra-abdominal pressure. Cheatham ML, Malbrain MLNG. In: Ivatury RR, Cheatham ML, Malbrain MLNG,