Richard Bowry

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PURPOSE Operating room (OR) efficiency could be improved by reducing overutilization. In this article we suggest a methodology to accurately determine the time to complete a series of surgical cases in a single cardiac OR to avoid overutilization. Our methodology includes the basic assumptions that the first case starts on time, there are no add-on cases,(More)
BACKGROUND The complex geometry of the right ventricle (RV) and poor endocardial definition make quantitative assessment of RV function difficult. Doppler tissue imaging may be helpful in quantifying RV function through measurement of tricuspid annular velocity (TAV). This prospective study assessed the feasibility of using color Doppler tissue imaging to(More)
BACKGROUND Total knee arthroplasty is a painful surgery that requires early mobilization for successful joint function. Multimodal analgesia, including spinal analgesia, nerve blocks, periarticular infiltration (PI), opioids, and coanalgesics, has been shown to effectively manage postoperative pain. Both adductor canal (AC) and PI have been shown to manage(More)
OBJECTIVE This study was designed to compare the right ventricular (RV) Doppler tissue imaging parameters of tricuspid annular isovolumic acceleration (IVA), systolic velocity (S), and basilar myocardial strain and strain rate (SR) by using both transesophageal echocardiography (TEE) (inferior wall) and transthoracic echocardiography (TTE) (free wall) in a(More)
A results-driven approach to optimizing patient flow, grounded on quality improvement, change management and organizational learning principles, is described. Tactics included collaborative governance, performance management, rapid process improvements and implementation toolkits. Results included an 83.1% decrease in emergent volumes waiting for greater(More)
PURPOSE In this prospective observational cohort study, we investigated whether tricuspid annular velocities (TAV) are altered after induction of anesthesia in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS Twenty-four elective CABG patients were assessed before and after induction of anesthesia, and a convenience sample of nine(More)
OBJECTIVES Speckle tracking is an ultrasound method that assesses B-mode features to measure tissue displacement and derive deformation parameters. The objective of this study was to assess the feasibility of using speckle tracking in the measurement of right ventricular (RV) longitudinal strain during cardiac surgery using transesophageal echocardiography(More)
We present right ventricular tissue Doppler findings in a 41-year-old man with pelvic fracture who had a near-fatal pulmonary embolus. We found small early systolic lengthening and reduced delayed systolic shortening using strain and strain rate imaging. There were also delayed and fused diastolic waves. Normal systolic tricuspid annular velocities were(More)