Short CV
Dr. Kertai received his medical degree from Semmelweis University in Budapest, Hungary, and his PhD degree from Erasmus University in Rotterdam, the Netherlands. He completed his residency in Anesthesiology and Intensive Care Medicine at Semmelweis University in Budapest, Hungary. Dr. Kertai then went on to complete his Fellowship training in Cardiothoracic Anesthesiology at Royal Brompton and Harefield Hospital in Harefield, the United Kingdom prior to taking a position as Faculty at Washington University School of Medicine in St Louis, Missouri, USA. After two years as Faculty at Washington University School of Medicine in St Louis, Missouri, he went on taking a position as a Faculty at Duke University Medical Center in Durham, North Carolina, USA. Currently as an Assistant Professor in the Department of Anesthesiology, Dr. Kertai serves as a Cardiothoracic Anesthesiologist and has been involved in perioperative outcome research. His research interests include perioperative and long-term cardiac risk assessment and management, and the study of anesthesia-related factors and their possible association with short- and long-term survival after surgery. Dr. Kertai is the author and co-author of several book chapters in the field of cardiovascular anesthesiology and surgery. He has been a frequent speaker at international conferences about the importance of perioperative risk assessment and management. He has published over 60 peer-reviewed articles as a first author or as a co-author in scholarly journals with national and international circulation.
Abstract
The rates of short- and long-term postoperative mortality can be substantial in patients undergoing surgery. Several patient- and surgery-related factors that may impact the survival of surgical patients have been identified during the past several decades. In contrast, less attention has been focused on anesthesia-related factors and their possible associations with short- and long-term survival after surgery. It has been suggested that, when a processed electroencephalographic (BIS) index is used during general anesthesia, patients generally receive lower doses of hypnotic drugs and emerge faster from anesthesia with less postoperative nausea and vomiting. It has also been proposed that lower doses of anesthetics could lead to a reduction in serious morbidity or mortality through avoidance of intraoperative hypotension and potential organ toxicity. Recently, it has been reported that postoperative mortality was associated with cumulative anesthetic duration below an arbitrary BIS threshold. This observation has led to speculation of a mortality-hypnosis association, whereby a relative overdose of anesthetic agents causes poorer outcomes in patients with anesthetic hypersensitivity. The aim of this presentation is to summarize data on a possible link between cumulative anesthetic duration and postoperative mortality, and to question whether, in a clinically relevant range increasing anesthetic exposure is dangerous.