Division of Cardiothoracic Anesthesia - Department of Anesthesiology
Ian James Welsby, BSc

Division of Cardiothoracic Anesthesia

 

Ian James Welsby, BSc, MBBS, FRCA

Ian James Welsby, BScDr. Ian Welsby received his medical degree from University College and The Middlesex Hospital School of Medicine in England and completed his residency in anesthesia at North East Thomas School of Anaesthesia, London, England. Dr. Welsby was elected a Fellow of the Royal College of Anaesthetists in 1994, came to Duke as a Fellow in Critical Care in 1996 and presently serves as Assistant Professor of Anesthesiology.

In addition to active interest in perioperative coagulation and serving as the Duke PI for an NIH funded, multicenter study on HIT led by Dr Tom Ortel from Duke Hematology,  Dr. Welsby has established a collaborative effort with the American Red Cross and the University of Alabama: The Collaborative Optimization of Transfusion Safety or CLOTS program. The current aim of the CLOTS program is to evaluate the effect of plasma and platelet donor characteristics on clinical outcome after cardiac surgery.

Grants

  1. Rare Thrombotic Diseases Clinical Research Network
    U54 HL77878 (PI Dr T Ortel) Grant amount: $871,580 (entire project)
    Grant period: 03/01/04-12/31/08
    Role: Co-Investigator (5% salary support, 5% effort)
  2. The Medicines Company: A P                                   
  3. Angiomax TMC-BIV 02-03 ON-pump
  4. Bayer Foundation for Blood Conservation in Cardiothoracic Anesthesia: “The Association of Cytokine and Adhesion Molecule Polymorphisms with Bleeding After CABG Surgery.” Grant Period: 07/04-07/05.
  5. Society of Cardiovascular Anesthesiologists: “Combination Anticoagulation Better Suppresses Thrombin Generation and Improves Outcome After Cardiac Surgery.”
  6. The Medicines Company: “A Study Comparing Angiomax (bivalirudin) to Heparin with Protamine Reversal in Patients undergoing Off-Pump Coronary Artery Bypass (OPCAB) Surgery.”
  7. Bayer Pharmaceutical Division – Research Fellowship in Blood Conservation:
  8. The Association of Platelet Glycoprotein Polymorphisms with Bleeding Following Coronary Artery Bypass Graft Surgery. Grant Period: 07/03-07/04.
  9. Bayer Foundation for Blood Conservation in Cardiothoracic Anesthesia: “The Association of plt Membrane GP Polymorphisms with Bleeding Following Primary Coronary Bypass Graft Surgery.” Grant Period: 07/02-07/03.
  10. BioMarin Pharmaceuticals Inc.: “A Phase III Comparison of Neutralase to Protamine in Patients Undergoing Primary Coronary Artery Bypass Graft Surgery.”

Peer-Reviewed Manuscripts

  1. Balsara KL, Morozowich ST, Lin SS, Davis RD, Phillips-Bute BG, Hartwig M, Appel JZ, Welsby IJ.  Aprotinin’s effect on blood product transfusion in off-pump bilateral lung transplantation.  Interactive Cardiovascular and Thoracic Surgery (In Press) 2008.
  2. Shaw AD, Stafford-Smith M, White WD, Welsby IJ, et al. The Effect of Aprotinin on Outcome after Coronary-Artery Bypass Grafting. N Engl J Med 2008;358(8):784-793.
  3. Welsby I, Jones R, Pylman J, Mark JB, Brudney CS, Phillips-Bute B, Mathew JP, Campbell ML, Stafford-Smith M and the Cardiothoracic Anesthesiology Research Endeavors (CARE) Investigators of the Duke Heart Center. ABO blood group and bleeding after coronary artery bypass surgery. Blood Coag Fibrinolys 2007;18:781-785.
  4. Schroder JN, Daneshmand MA, Villamizar NR, Petersen RP, Blue LJ, Welsby IJ, Lodge AJ, Ortel TL, Rogers JG, Milano CA.  Heparin-induced thrombocytopenia in left ventricular assist device bridge-to-transplant patients.  Ann Thorac Surg 2007; 84:841-846.
  5. Welsby IJ, Jones WL, Arepally G, de Lange F, Yoshitani K, Phillips-Bute B, Grocott HP, Becker R, Mackensen GB.  Effect of combined anticoagulation using heparin and bivalirudin on the hemostatic and inflammatory response to cardiopulmonary bypass in the rat.  Anesthesiology 2007; 106:295-301.
  6. Krakow EF, Goudar R, Petzold E, Suvarna S, Last M, Welsby IJ, Ortel TL, Arepally GM. Influence of sample collection and storage on the detection of platelet factor 4-heparin antibodies. Am J Clin Pathol 2007; 128;150-155.
  7. Morozowich ST, Donahue BS, Welsby IJ. . Genetics of coagulation – Considerations for cardiac surgery.  Sem Cardiovasc Thorac Anesth 2006; 10:297-313.
  8. Phillips-Bute B, Mathew JP, Blumenthal JA, Grocott HP, Laskowitz DT, Jones RH, Mark DB, Newman MF for the Neurologic Outcome Research Group (NORG).  Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery.  Psychosom Med 2006;68:369-375.
  9. Podgoreanu MV, White WD, Morris RW, Mathew JP, Stafford-Smith M, Welsby IJ, Grocott HP, Milano CA, Newman MF, Schwinn DA for the Perioperative Genetics and Safety Outcomes (PEGASUS) Investigative Team.  Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery. Circulation 2006; 114:275-281.
  10. Welsby IJ, Jiao K, Ortel TL, Brudney CS, Roche AM, Bennett-Guerrero E , Gan TJ.  The Kaolin activated Thromboelastograph® predicts bleeding after cardiac surgery. J Cardiothorac Vasc Anesth 2006; 20:531-535.
  11. Lombard FW, Welsby IJ, Alexander MJ, Borel CO.  Thromboelastography detects inadequate response to abciximab therapy during stent assisted cerebral aneurysm coil embolization complicated by stroke.  Neurocrit Care 2006; 4:32-34.
  12. Bennett-Guerrerro E, Slaughter TF, White WD, Welsby IJ, Greenberg CS, El-Moalem H, Ortel TL.  Preoperative anti-heparin/PF4 antibody level predicts adverse outcomes after cardiac surgery.  J Thorac Cardiovasc Surg 2005; 130:1567-1572.
  13. Grocott HP, White WD, Morris RW, Podgoreanu MV, Mathew JP, Nielsen DM, Schwinn, DA., Newman MF, and members of the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team.  Genetic polymorphisms and the risk of stroke after cardiac surgery.  Stroke 2005; 36:1854-1858.
  14. Welsby IJ, Monroe DM, Lawson JH, Hoffmann M.  Recombinant ACTIVATED FACtor VII and the anaesthetist.  Anaesthesia 2005; 60:1203-1207.
  15. Sreeram G, Welsby IJ, Sharma AD, Phillips-Bute B, Smith PK, Slaughter TF.  Infectious complications after cardiac surgery: lack of association with FFP and platelet transfusions. J Cardiothorac Vasc Anesth  2005; 19:430-434.
  16. Stafford Smith M, Podgoreanu MV, Madhav Swaminathan MD, Phillips-Bute B, Mathew JV, Elizabeth H Hauser, Michell P Winn MD, Carmelo A Milano MD, Mike Smith MS, Richard Morris PhD, Newman MF, Schwinn DA, and members of the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team.  Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.  Am J Kidney Disease 2005; 45:519-530.
  17. Stafford-Smith M, Lefrak EA, Qazi AG, Welsby IJ, Barber L, Hoeft A, Dorenbaum A, Mathias J, Rochon JJ, Newman MF.  Efficacy and safety of Heparinase I versus Protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.  Anesthesiology 2005; 103:229-240.
  18. Welsby IJ, Podgoreanu MV, Phillips-Bute B, Mathew JV, Smith PK,  Newman MF, Schwinn DA, Stafford-Smith M and members of the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team.  Genetic factors contribute to bleeding after cardiac surgery. J Thromb Haemost 2005; 3:1206-1213.
  19. Patteril M, Stafford-Smith M, Toffaletti JG, Phillips Bute B, Milano CA, Welsby IJ.  Changing systems for measuring activated clotting times: Impact on the clinical practice of heparin anticoagulation during cardiac surgery. Clinica Chimica Acta 2005; 356:218-224.
  20. Welsby IJ, Newman MF, Phillips-Bute B, Messier RH, Stafford-Smith M.  Hemodynamic changes after protamine administration:  Association with mortality following coronary artery bypass surgery.  Anesthesiology 2005;102:308-314.
  21. Smigla GR, Lawson DS, Shearer IR, Jaggers J, Milano C, Welsby I.  An alternative technique for re-infusing residual cardiopulmonary bypass blood.  J Extracorp Circ 2004; 36:154-159.
  22. Bar-Yosef S, Anders M, Mackensen GB, Ti LK, Mathew JP, Phillips-Bute B, Messier RH, Grocott HP, and the Neurological Outcome Research Group and CARE Investigators of the Duke Heart Center.  Aortic atheroma burden and cognitive dysfunction after coronary artery bypass graft surgery.  Ann Thorac Surg 2004;78:1556-1563.
  23. Toffaletti JG, McDonnell EH, Welsby IJ, Shearer IR, Sketch MH, Tcheng JE.  Implementing a new method for activated clotting time:  Comparisons between the hemochron and Actalyke-MaxACT systems.  Point of Care (The Journal of Near-patient Testing and Technology) 2003; 2:125-128.
  24. Lombard FW, Welsby IJ, Booth JV.  Systemic air embolism during off-pump coronary artery bypass surgery.  J Cardiothorac Vasc Anesth 2003; 17:403-404.
  25. Mathew JP, Grocott HP, Philips-Bute B, Stafford-Smith M, Loskowitz DB, Rossignol D, Blumenthal JA, Newman MF for the Neurologic Outcome Research Group (NORG) and Cardiothoracic Anesthesiology Research Endeavors (C.A.R.E.).  Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.  Stroke 2003; 34:508-513.
  26. Welsby IJ, Ryan JM, Booth JV, Flanagan E, Messier RH, Borel CO.  The bispectral index (BIS) and the diagnosis of perioperative stroke - a case report and discussion.  Anesth Analg 2003; 96:435-437.
  27. Booth JV, Schinderle D, Welsby IJ.  Pro: Vasopressin is the vasoconstrictor of choice after cardiopulmonary bypass.  J Cardiothor & Vasc Anes 2002; 16:773-775.
  28. Welsby IJ, McDonnell E, El-Moalem H, Stafford-Smith M, Toffaletti JG.  Activated clotting time systems vary in precision and bias and are not interchangeable when following heparin management protocols during cardiopulmonary bypass. J Clin Monit 2002; 17:287-292.
  29. Welsby IJ, Bennett-Guerrero D, Atwell D, White WW., Newman MF, Smith PK, Mythen MG.  The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass. Anesth Analg 2002;94:1072-1078.
  30. Klein SM, Slaughter TF, Vail PT, Ginsberg B, El-Moalem HE, Alexander R, D’Ercole F, Greengrass RA, Thangam TM, Welsby IJ, Gan TJ. Thromboelastography as a perioperative measure of anticoagulation resulting from low molecular weight heparin : A comparison with anti-Xa concentrations. Anesth Analg 2000; 91:1091-1095.
  31. Bennett-Guerrero E, Welsby IJ, Dunn TJ, Young LR, Wahl TA, Diers TL, Phillips-Bute BG, Newman MF, Mythen MG.  The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalisation after routine, moderate-risk, elective surgery.  Anesth Analg 1999; 89:514-519.

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