Anaesthesiology

'We knew what was coming': U of T pharmacist on working in the ICU during COVID-19

Christopher.Sorensen — Fri, 18 Sep 2020 13:52:40 +0000

'We knew what was coming': U of T pharmacist on working in the ICU during COVID-19

Christopher.Sorensen Fri, 09/18/2020 - 09:52

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Lisa Burry, an assistant professor at U of T’s Leslie Dan Faculty of Pharmacy, says there were significant drug requirements for COVID-19 patients who were put on ventilators for an extended period (photo courtesy of Faculty of Medicine)

Eileen Hoftyzer

Topic

Our Community

Coronavirus

Anaesthesiology

Faculty of Medicine

Leslie Dan Faculty of Pharmacy

Mount Sinai Hospital

Sunnybrook Hospital

Health-care professionals working in the intensive care unit (ICU) are familiar with unpredictable and stressful situations, and complex patient loads. But a highly contagious viral pandemic and global shortages of critically important drugs created new challenges, even for seasoned professionals.

Lisa Burry, an assistant professor at the ��Ƶ’s Leslie Dan Faculty of Pharmacy, is an experienced ICU pharmacist at Mount Sinai Hospital. Burry worked in the ICU during the SARS outbreak in 2003, giving her and her colleagues a sense of what was to come as COVID-19 intensified.

“Some of the fear and anxiety that we dealt with through SARS probably helped us cope better with COVID-19. We had some insight as to the potential impact,” she says. “However, we were also fearful because we knew what was coming.”

That included familiarity with the discomfort associated with wearing personal protective equipment all day long, the stress of being exposed to highly contagious patients for full shifts and demanding case loads. It also meant preparing for a surge of ICU patients and potential drug shortages.

As a member of the Society of Critical Care Medicine’s Fundamental Disaster Management Working Group and the American College of Chest Physicians’ Task Force for Mass Critical Care and Disaster Management Steering Committee, Burry had important insight and access to resources, which she says was key to helping the ICU prepare for COVID-19.

The hospital prepared for the height of the pandemic when ICU capacity threatened to be overwhelmed by creating temporary ICUs in areas of the hospital that were no longer being used such as post-op recovery rooms.

Burry’s research expertise – sedation and delirium in the ICU – put her in high demand to lead and support various research projects. Current practice for many conditions recommends that patients on ventilators receive pain medication to be calm and comfortable, but as alert and interactive as possible. However, this wasn’t possible with patients with COVID-19 who were put on ventilators, as they needed to be deeply sedated.

“Patients with COVID-19 in the ICU were ventilated for very long periods of time and had huge drug requirements for pain, agitation and delirium just to make their ventilation safe,” Burry says.

Hospitals across the country all experienced the same scenario and tried to access the same sedatives, causing supplies to run low. Now, on top of dealing with high numbers of patients and complex cases, pharmacists were facing shortages of criticial drugs.

“In the beginning, those of us in critical care were trying to solve these problems in isolation and not recognizing that another site was dealing with the same thing,” says Burry. “That led to a group of us working together to deal with the issue on a provincial level and ultimately led to research to test new strategies to manage it.”

Challenges in patient care leads to new clinical trials

At a time when Burry’s clinical work was busier than ever, research opportunities were also growing rapidly. She worked closely with multi-disciplinary teams to develop research proposals to study potential solutions to the drug shortages they were facing in the ICU – two of which were successful. As a co-investigator, Burry brings a valuable pharmacy perspective to research examining alternatives to traditionally used intravenous sedatives for patients on ventilators.

One trial, led by Angela Jerath and Brian Cuthbertson from Sunnybrook Health Sciences Centre and U of T’s Faculty of Medicine, as well as Claudio Martin and Marat Slessarev from London Health Sciences Centre, will compare inhaled gases typically used in the operating room to intravenous sedatives for COVID-19 patients on ventilators. Inhaled sedatives are not used outside of operating rooms in North America, but are cheap, widely available and reduce lung inflammation and improve oxygen levels.

“We know the way in which we sedate people, the drug we select, how we do it and how long we do it can all impact how long they spend with us and their overall recovery,” says Burry.

The trial is receiving more than $2 million from the Canadian Institutes of Health Research (CIHR) COVID-19 Rapid Response Competition.

“While the trial may be COVID-centric, it addresses issues we can apply far beyond this pandemic. This is valuable work because it has the ability to improve patient care, but also deal with drug shortages and issues without compromising patient care,” says Burry.

The second clinical trial, funded through a McMaster Medicine Associates Innovation Grant, is led by Alison Fox-Robichaud at Hamilton Health Sciences and James Downar at the Ottawa Hospital. It is examining whether adding the old beta-blocker propranolol to standard sedation regimens reduces the amount of primary sedative required, another approach to decrease the consumption of essential sedatives.

As Burry reflects on the challenges of the last several months, she says she is proud of the work that she has done serving both her patients and her profession through participating in the new research projects and the professional working groups.

“Access to drugs is an important part of disaster management and I’m proud to have contributed to guidelines and protocols that have helped in this pandemic,” she says. “I’ve been given some good opportunities to be part of championing work that we’ve published about supply shortages.

“Despite all the challenges of COVID, I’ve made new connections, built new research networks and learned to do things more quickly and efficiently. The research we are doing may improve treatment for COVID-19 and should lead to shorter ICU stays and improved outcomes. Some positive things have come out of the last few months.”

Loss of medical services and anesthetic care widening health gaps for rural communities: U of T researcher

Christopher.Sorensen — Tue, 28 Jul 2020 14:57:48 +0000

Loss of medical services and anesthetic care widening health gaps for rural communities: U of T researcher

Christopher.Sorensen Tue, 07/28/2020 - 10:57

Cutline

(photo by kupicoo via Getty Images)

Topic

Research & Innovation

Researchers from the ��Ƶ researcher and Queen’s University say Canada needs a national strategy for improving anesthesia services in rural and remote regions due to a lack of anesthesia care providers in these areas.

Beverley Orser, chair of the department of anesthesiology and pain medicine at U of T’s Faculty of Medicine, and Ruth Wilson, a professor emeritus at the department of family medicine at Queen’s University, explain that rural and remote regions are losing surgical and obstetric services, partly because there are not enough health-care providers who can offer anesthesia services.

“We know that if a person lives in a rural or remote part of Canada, they have a higher chance of dying if they experience trauma or a major illness,” says Orser. “Canadians living in rural and remote communities tend to have more health concerns and have poorer health outcomes, compared with those who live in cities.

“Rural and remote communities need more anesthesia care providers, and we wanted to identify solutions on how to address this gap and improve access to care.”

The researchers commentary was published in the Canadian Medical Association Journal.

In the report, Orser and Wilson explain that, nationally, Canada has a shortage of anesthesia providers who care for patients undergoing surgery and assist with perioperative pain management.

The researchers say the problem is aggravated in rural and remote areas due to a lower number of anesthesia care providers. Some patients must travel hours to receive care in urban centres because there are no health-care providers who can provide these services locally.

“Pregnant mothers should not have to travel hundreds of kilometres to receive maternal care from regions that previously offered maternity care. Everyone in Canada should have access to the basic care services they need, as close to home as possible,” says Orser.

“It’s time to address the gaps in health outcomes that people in rural and remote communities are experiencing by developing a strategy to remove the barriers they face.”

Rural and remote areas are some of the most underserved regions in Canada in terms of their access to health care, the researchers say. They add that, while almost 18 per cent of Canada’s population lives in rural and remote areas, only eight per cent of Canada’s workforce of physicians serve this group.

They also note that less than one per cent of the Canadian Institute for Health Research’s funding is awarded to the study of rural research and that Indigenous communities are disproportionately affected by a lack of access to anesthesia care providers. The report calls for better workforce planning and studies to measure the gap between what services are now available and what services are needed, with Orser and Wilson identifying different solutions to encourage more anesthesiologists to practise in remote and rural areas.

For example, researchers say that medical licensing authorities should consider a national medical licence that would allow physicians unrestricted access to practise throughout Canada, replacing the regional licensing systems currently in place.

“Getting a medical licence in each province and territory is a lot of work. There’s tremendous barriers, such as cost and administrative issues,” says Orser.

“If we had a national medical licence, physicians might be able to form special relationships with various service regions that would allow for better models of support for these communities. Unrestricted access to practise across Canada could encourage more physicians to take their expertise to rural and remote areas.”

Another solution would be to create better mentorship and continuing professional education opportunities for physicians providing anesthetic care in rural and remote regions.

“Physicians working in rural areas need to be supported,” says Orser. “So, we need to think about how we can appropriately integrate them into the broader anesthesia community so they have opportunities for retraining, networking and places to get support when conducting highly detailed work with limited resources.”

Professional associations and academic health centres must take an active role in creating programs that support longer-term peer mentorship amongst physicians providing anesthesia services and specialty trained anesthesiologists, according the researchers. This will help retain physicians in rural areas, they say.

Medical schools and residency programs can also play a key role in helping to address the issue of providing adequate care to rural and remote regions. The researchers say that the goal of providing more trained anesthesia-care providers in rural areas may mean developing new educational strategies like admitting more medical students from rural areas. Medical schools should also be engaged in providing meaningful rural medical education experiences that are supported by rural mentors, say the researchers.

“Institutions like universities play an important role in helping to promote social accountability and offering leadership to identify long-standing problems in our health-care systems,” says Orser. “We need to structure our health-care systems so that we are solving the problems experienced by vulnerable people, and those who have poor health outcomes.”

From Canada to Uganda and beyond: U of T researchers receive funding for COVID-19 projects

lanthierj — Tue, 21 Jul 2020 16:22:13 +0000

From Canada to Uganda and beyond: U of T researchers receive funding for COVID-19 projects

lanthierj Tue, 07/21/2020 - 12:22

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Congolese asylum-seekers line up to undergo security and health screening in Zombo, near the border between Uganda and the Democratic Republic of the Congo (photo by Rocco Nuri/UNHCR)

Paul Fraumeni

Topic

Breaking Research

Coronavirus

Institute of Health Policy Management and Evaluation

Anaesthesiology

Centre for Addiction and Mental Health

Dalla Lana School of Public Health

Factor-Inwentash Faculty of Social Work

Faculty of Medicine

Hospital for Sick Children

Immunology

Laboratory Medicine and Pathobiology

Leslie Dan Faculty of Pharmacy

Molecular Genetics

Mount Sinai Hospital

Psychiatry

Research & Innovation

St. Michael's Hospital

Sunnybrook Hospital

U of T Mississauga

University Health Network

Since early June, more than 7,000 refugees and displaced persons have arrived in the African nation of Uganda, most fleeing violence in the Democratic Republic of the Congo.

“Even in the midst of a pandemic, we see people being displaced,” says the ��Ƶ’s Carmen Logie, an associate professor in the Factor-Inwentash Faculty of Social Work.

Logie’s usual research focus is on understanding and developing interventions to address stigma and other social factors associated with HIV and sexually transmitted infections. She has long placed a special emphasis on refugees and displaced persons in countries like Haiti and Uganda.

Now, Logie is turning her attention to how COVID-19 is affecting adolescents and young people who are refugees in Uganda’s capital, Kampala. She’s using social media to help these young people receive information about preventing COVID-19 – and to express their feelings and concerns.

“We already have a study in Kampala on urban refugees but we had to put it on hold when COVID-19 forced everyone into lockdown,” says Logie, who is Canada Research Chair in Global Health Equity and Social Justice With Marginalized Populations. “Our community partners in Kampala identified a lack of information tailored to preventing COVID-19 for young people in their languages. We think using social media tools will be an innovative and effective way to hear about their experiences and knowledge of the virus and to get them the information they need.”

Logie’s research team is one of 139 across Canada that are sharing more than $109 million from the Canadian Institutes of Health Research (CIHR), awarded through its second rapid research funding competition. Included are eight teams from U of T and 18 at the university’s partner hospitals. All are focused on COVID-19 research.

“The ��Ƶ is grateful to the CIHR for this important investment, one that will enable our scholars to contribute to the global effort to understand COVID-19,” says University Professor Ted Sargent, U of T’s vice-president, research and innovation, and strategic initiatives. “It’s especially notable that this funding focuses on projects, such as Professor Logie’s, in which there will be collaboration with researchers in lower and middle income countries.”

Logie is working with Richard Lester, a professor at the University of British Columbia, and Gabrielle Serafini, who have developed WelTel, a text-messaging app that assists health professionals in communicating with patients.

There are approximately 1.4 million refugees in Uganda, the largest refugee-hosting nation in Sub-Saharan Africa, with 80,000 living in Kampala.

Logie notes that adolescents and youth comprise nearly half of the world’s refugee and displaced person population.

“In humanitarian settings, the needs of people are often not understood or met,” she says. “This is also true in pandemics and, especially, with young people and adolescents. For example, we found that hand hygiene studies in Uganda did not include adolescents. They were aimed at adults and children.

“We know that adolescents have their own lived experiences and challenges, so we need to understand that and enable them to express themselves.”

With that in mind, Logie, her collaborators at UBC and refugee agencies on the ground in Kampala will adapt the WelTel technology to engage young people and adolescents who are refugees. The goal, Logie says, is to help them “talk about how COVID-19 is impacting their lives. We will develop a group chat app to send information out and enable young people to apply that information to their lives.”

While the pandemic has exacerbated problems such as isolation and poverty around the world, its impact on the people Logie studies in Uganda has been particularly harsh.

“In the refugee settlements in northern Uganda, for example, the only places they had to interact with others and to stay busy in the face of widespread unemployment were places like churches, community centres and shops,” she says. “But now that COVID-19 has forced people to stay at home or in refugee camps, they are really struggling with isolation.”

Equally troubling is the incidence of food insecurity.

“For the refugee youth in Kampala, before COVID-19, we found that 70 per cent didn’t have enough to eat. Now, our agency partners are saying it’s even worse with the lockdown not enabling people to work,” says Logie.

“This is true around the world, but among refugees in Kampala they need to make money every day just to survive that day. So the impact of the lockdown is extraordinary – it is putting people into another dimension of poverty. “

The following researchers at U of T and its partner hospitals have received CIHR funding for COVID-19-related projects:

Philip Awadalla, Ontario Institute for Cancer Research; department of molecular genetics in the Faculty of Medicine; Surveilling Prospective Population Cohorts for COVID19 Prevalence and Outcomes in Canada (SUPPORT-Canada)

Angela Cheung, University Health Network; Institute of Health Policy, Management and Evaluation (IHPME) in the Dalla Lana School of Public Health; Canadian COVID-19 Prospective Cohort Study (CanCOV)

Vladimir Dzavik, University Health Network; department of medicine in the Faculty of Medicine; Semaglutide to Reduce Myocardia Injury in Patients with COVID-19 (SEMPATICO): An Exploratory Randomized Controlled Clinical Trial

Andrea Gershon, Sunnybrook Research Institute; IHPME in the Dalla Lana School of Public Health; CovidFree@Home: Development and Validation of a Multivariable Prediction Model of deterioration in Patients Diagnosed with COVID-19 Who Are Managing at Home

Daniel Grace, Dalla Lana School of Public Health; Engage-COVID-19: A Mixed Methods Study of Biomedical, Behavioural, and Psychosocial Aspects of the COVID-19 Pandemic Among Gay, Bisexual and Other Men Who Have Sex with Men in Canada

Astrid Guttmann, Hospital for Sick Children; IHPME in the Dalla Lana School of Public Health; Deferred Care Outcomes in Canadian Children and Youth: Measuring and Mitigating Risk During COVID-19

Joanna Henderson, Centre for Addiction and Mental Health; department of psychiatry in the Faculty of Medicine; Youth Mental Health and Substance Use in the Context of COVID-19: A Rapid Response Multi-component Program of Youth-engaged Research and Action

Angela Jerath, Sunnybrook Research Institute; department of anesthesiology and pain medicine in the Faculty of Medicine; Sedating With Volatile Anesthetic Agents in Critically Ill COVID-19 Patients in ICU: Effects on Ventilatory Parameters and Survival (the SAVE-ICU trial)

Kevin Kain, University Health Network; department of laboratory medicine and pathobiology in the Faculty of Medicine; A Randomized Trial to Determine the Effect of Vitamin D and Zinc Supplementation for Improving Treatment Outcomes Among COVID-19 Patients in Mumbai, India

Murray Krahn, University Health Network; IHPME in the Dalla Lana School of Public Health; The Response of Provincial Health Systems to COVID-19: Service Provision and Costs Across Health Sectors, First Nations and Other Populations

Douglas Lee, University Health Network; IHPME in the Dalla Lana School of Public Health; Improving Canadian Outcomes Research on the Novel SARS-CoV-2 Using Analytics: The Corona Consortium

Jordan Lerner-Ellis, Sinai Health System; department of laboratory medicine and pathobiology in the Faculty of Medicine; Implementation of Serological and Molecular Tools to Inform COVID-19 Patient Management

Christoph Licht, Hospital for Sick Children; department of laboratory medicine and pathobiology in the Faculty of Medicine; A Central Role for the Vascular Endothelium in COVID-19 Pathogenesis

Jun Liu, department of molecular genetics in the Faculty of Medicine; Development of Safe and Effective Vaccines Against COVID-19

Carmen Logie, Factor-Inwentash Faculty of Social Work; Kukaa Salama (Staying Safe): A Pre-post Trial of a WhatsApp Social Group for Increasing COVID-19 Prevention Practices with Urban Refugee and Displaced Youth in Kampala, Uganda

David McMillen, department of chemical and physical sciences, U of T Mississauga; Development of a Yeast-Based Immunoassay for SARS-CoV-2 Serologic Testing Amenable to Inexpensive Local Production

Sharmistha Mishra, St. Michael’s Hospital; IHPME in the Dalla Lana School of Public Health; Evaluating the Differential Impact of What We Have Done As We Prioritize What to Do Next: A Multi-Provincial Intervention Modeling Study Using Population-Based Data

Peter Newman, Factor-Inwentash Faculty of Social Work; An International Multi-site, Randomized Controlled Trial of a Brief eHealth Intervention to Increase COVID-19 Knowledge and Protective Behaviors, and Reduce Pandemic Stress Among Diverse LGBT+ People

Deborah O'Connor, Sinai Health System; department of nutritional sciences in the Faculty of Medicine; Can COVID-19 and Maternal Antibodies to SARS-CoV-2 be Transmitted Through Human Milk? Implications for Breastfeeding and Human Milk Banking

Keith Pardee, Leslie Dan Faculty of Pharmacy; Portable, Low-cost Hardware for De-centralized COVID-19 Diagnostics for Canada, Colombia and Ecuador

Robert Rottapel, University Health Network; department of immunology in the Faculty of Medicine; Development of a Predictive Serologic Test for Cytopathogenic Auto-antibodies in COVID-19 Patients

Darrel Tan, Unity Health Toronto; IHPME in the Dalla Lana School of Public Health; COVID-19 Ring-based Prevention trial with Lopinavir/ritonavir (CORIPREV-LR)

Amol Verma, Unity Health Toronto; IHPME in the Dalla Lana School of Public Health; The COVID-19 Hospital Analytics Laboratory: Improving the Clinical, Organizational, and System Response to COVID-19

Tania Watts, department of immunology in the Faculty of Medicine; Towards a Comprehensive Understanding of Adaptive Immunity to SARS-CoV-2

Daniel Werb, Unity Health Toronto; IHPME in the Dalla Lana School of Public Health; Rapidly Assessing theImpact of the COVID-19 Pandemic and Response on Clinical and Social Outcomes, Service Utilization, and the Unregulated Drug Supply Experienced by People Who Use Drugs in Toronto

Jia Xue, Factor-Inwentash Faculty of Social Work: An Increased Risk of Family Violence During COVID-19 Quarantine in Canada: Strengthening Social Media-based Collaborations Between Non-profit Agencies to Save Lives

Pumped up: These 3D printers create perfect models of life-sized human hearts, spines and other body parts

noreen.rasbach — Mon, 28 Oct 2019 13:59:56 +0000

Pumped up: These 3D printers create perfect models of life-sized human hearts, spines and other body parts

noreen.rasbach Mon, 10/28/2019 - 09:59

Cutline

A 3D printed model of a heart (photos by Hamin Lee)

Topic

Faculty of Information

Faculty of Medicine

Research & Innovation

In a small, windowless room at Toronto General Hospital, a bank of seven 3D printers runs day and night, patiently laying down layer after layer of coloured plastic. When the printing is done, the pieces are trimmed and fitted together into perfect models of human hearts, life-sized and correct down to the smallest detail.

The 3D printers are part of the Lynn & Arnold Irwin Advanced Perioperative Imaging Lab at the University Health Network’s Peter Munk Cardiac Centre. Combined with advances in medical imaging and computer modelling, they are allowing doctors to get a better look at heart defects before they go in to repair them, as well as providing better training methods.

The models of the hearts use extremely detailed data from MRIs, CT scans, ultrasounds or other imaging techniques. Normally, doctors are working with two-dimensional images on a printout or a flat screen. As anyone who has ever tried to see their baby on a prenatal ultrasound can appreciate, this isn’t always easy. By turning the data from those images into three-dimensional computer models, and using those models to make solid printed hearts, the lab gives the doctor something that can be held in the hand and examined in detail.

With the printers whirring away in the background, Josh Qua Hiansen, the biomedical industrial designer at the lab, shows how the model will be used by doctors. This particular patient has a malformation of a part of the heart called the superior vena cava, which is allowing blood to mix with blood from pulmonary veins. Doctors want to fit an implant to close the malformed area, and they will use the model to make sure the implant is sized and positioned appropriately to close the area.

The lab was created in collaboration with Matt Ratto, a ��Ƶ associate professor in the Faculty of Information and the head of the university’s Critical Making Lab. Co-founders are Dr. Massimiliano Meineri, a U of T professor of anesthesia, and Dr. Azad Mashari, an anesthesiologist at Toronto General Hospital and a U of T lecturer who heads the imaging lab. The mandate is to evaluate, refine and translate 3D imaging, modelling and micromanufacturing techniques into clinical and educational practice.

Mashari says that the new techniques provide an inexpensive and flexible way to create all sorts of learning aids. These include medical “phantoms” – printed hearts, spines and other body parts. For instance, heart phantoms are used to train ultrasound technicians. And a phantom spine in flesh-like gel can be used to instruct on how to give spinal injections.

With the capability provided by in-house 3D printing, along with 3D computer models and even virtual reality, Mashari thinks that training and medical visualization will continue to become less expensive and more effective.

Close-up picture of a model of a human heart created with a 3D printer, with numbers 1-5 associated with various parts of the model

1. Left atrium and aorta. 2. Superior vena cava and right atrium. 3. Artifical conduit connecting the right ventricle to the pulmonary arteries (also green). 4. Pulmonic ventricle. 5. Systemic ventricle.

The 3D printed model of the heart above is taken from the scan of a patient with dextrocardia and transposition of the great arteries. The patient has had many surgeries in order to create a normal circulation.

This picture shows the top of the heart, so it is as if you were looking down at it from above the person’s head.

The model shows the spaces inside – as if the walls of the chambers, arteries and veins had been removed, and only the blood they contain was visible. This allows doctors to get a good look at the connections between the chambers of the heart.

To make the heart, images from CT scans were converted into 3D computer models, and then rendered into thousands of “slices.” The printer used these image slices to build up the pieces one layer at a time.

The models are fairly cheap to make, but they do take time. It took a technician about three hours to convert the CT scan for this one into a computer model. Total printer time was 30 to 40 hours.

This story first appeared in the ��Ƶ Magazine. Read the most recent issue

New U of T patent targets brain fog left behind by anesthesia

ullahnor — Thu, 09 Feb 2017 17:23:51 +0000

New U of T patent targets brain fog left behind by anesthesia

ullahnor Thu, 02/09/2017 - 12:23

Cutline

Dr. Beverley Orser will talk on Parliament Hill on Monday about her U.S. patent for a class of drugs that helps patients with memory loss due to anesthesia and funding basic research (photo by Erin Howe)

Jennifer Robinson

Author legacy

Jennifer Robinson

Topic

Twenty years of meticulous research has led to a new United States patent for a ��Ƶ anesthesiology expert.

The patent, “Methods for the prevention and/or treatment of memory impairment,” is for a class of drugs that may help mitigate troubling and costly disorders such as delirium and cognitive dysfunction that plague some patients after surgeries requiring general anesthesia.

It’s like patients – both young and old – wake up but they’re “not working on all cylinders,” explains Dr. Beverley Orser, a professor at U of T's Faculty of Medicine and staff anesthesiologist at Sunnybrook Hospital.

“They are not themselves,” she says. “Sometimes it’s really overt such as when they have delirium [hallucinations, frequent mood changes], and sometimes it’s more subtle – like when suddenly in the postoperative period Grandma just isn’t getting it [when people are telling her new information].”

On Monday, Orser will share the news of her patent and the importance of funding basic research during a talk on Parliament Hill with federal Science Minister Kirsty Duncan and 40 members of Parliament in attendance.

Orser’s patent (no. 9,517,265) is for a class of drugs that target a receptor in the brain that blocks the ability to make new memories. It’s one of more than 100 U.S. patents awarded to U of T researchers since 2011 with the help of U of T’s Innovations & Partnerships Office (IPO).

“We’re very excited by Bev’s accomplishment,” says Jennifer Fraser, U of T’s director of innovations. “Getting a U.S. patent issued helps attract commercial interest and will hopefully lead to industry engagement.”

Already, patents issued to U of T researchers have generated more than $49 million through such agreements.

When asked if she may spin her patent off into her own company, Orser laughs but doesn’t dismiss the possibility out right.

“I have a twin sister who is a professor involved in entrepreneurship, and she’s been pushing me to think about it,” she says.

Her goal is to just see her research make the leap from the lab to the operating room as soon as possible to help people most at risk.

“We are still focused on celebrating that people just survive surgery,” she says. “That’s not enough. They need to be thriving and surviving.”

Interest in Orser’s patent should be promising since the ability to curtail postoperative delirium and cognitive dysfunction would mean huge savings for the health-care system, as well as peace of mind for families who are often bewildered the condition lasts long after a loved one’s hospital stay has ended.

A study by the University Health Network (UHN) found post-op disorders is costing its four centres alone $17 million annually because of longer hospital stays and additional treatment required by patients.

The length of time the cognitive disability can last varies, and it’s hotly debated whether the deficits are permanent. In fact, one in three patients diagnosed are still suffering when discharged from hospital. One in 10 still have symptoms three months after their surgery, she says.

The culprit is strong drugs such as inhaled anesthetics that are similar to ether or propofol – the drug involved in singer Michael Jackson’s death – which induce unconsciousness during surgery.

Orser’s team has found anesthesia and inflammation caused by surgery can increase the activity of a receptor in the brain that blocks the ability to make new memories. She describes the post-op condition as a residual “footprint” on the brain from general anesthesia.

And it’s surprisingly common. For reasons that aren’t exactly clear, patients are at a higher risk if they’re undergoing cardiac or major vascular surgery (such as a cardiac bypass), are placed in intensive care for surgery, or are elderly patients undergoing hip-fracture surgery, Orser says.

In fact, a third of hip-fracture surgeries results in these post-op conditions, she says.

Avoiding anesthesia is not an option for patients undergoing these surgeries. Until her patent leads to new drugs that are widely available, she encourages people to always practice “good brain hygiene” by exercising, getting a good night’s sleep, treating hypertension and liming alcohol and recreational drug consumption to limit their risk.

Anaesthesiology

'We knew what was coming': U of T pharmacist on working in the ICU during COVID-19

Challenges in patient care leads to new clinical trials

Loss of medical services and anesthetic care widening health gaps for rural communities: U of T researcher

From Canada to Uganda and beyond: U of T researchers receive funding for COVID-19 projects

Pumped up: These 3D printers create perfect models of life-sized human hearts, spines and other body parts

This story first appeared in the ������Ƶ Magazine. Read the most recent issue

New U of T patent targets brain fog left behind by anesthesia

This story first appeared in the ��Ƶ Magazine. Read the most recent issue