Kianusch Kiai

Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States

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Publications (6)13.25 Total impact

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    ABSTRACT: Neuromuscular blocking agents are widely used in perioperative medicine to aid in endotracheal intubation, facilitate surgery, and in critical care/emergency medicine settings. Muscle relaxants have profound clinical uses in current surgical and intensive care and emergency medical therapy. This article reviews cyclodextrins, development of selective binding agents, clinical development, and future directions of sugammadex.
    Anesthesiology Clinics 12/2010; 28(4):691-708. DOI:10.1016/j.anclin.2010.08.014
  • David Burbulys, Kianusch Kiai
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    ABSTRACT: Airway management in the emergency department is a critical skill that must be mastered by emergency physicians. When rapid-sequence induction with oral-tracheal intubation performed by way of direct laryngoscopy is difficult or impossible due to a variety of circumstances, an alternative method or device must be used for a rescue airway. Retrograde intubation requires little equipment and has few contraindications. This technique is easy to learn and has a high level of skill retention. Familiarity with this technique is a valuable addition to the airway-management armamentarium of emergency physicians caring for ill or injured patients. Variations of the technique have been described, and their use depends on the individual circumstances.
    Emergency medicine clinics of North America 12/2008; 26(4):1029-41, x. DOI:10.1016/j.emc.2008.08.007 · 0.85 Impact Factor
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    ABSTRACT: Hepatic artery thrombosis (HAT) after adult orthotopic liver transplantation (OLT) is associated with fulminant sepsis and irretrievable loss of the graft. The purpose of this study was 1) to identify recipients at risk for the development of HAT; 2) to define early signs and methods for diagnosis; 3) to determine surgical treatment strategies following diagnosis of HAT. The charts of 680 adults who underwent primary OLT were reviewed. Eleven patients were symptomatic from HAT. Operative data revealed problematic arterial reconstruction in 9/11, and were related to inadequate recipient inflow, necessitating an interposition allogeneic iliac graft in seven patients, or anastomosis to aberrant right hepatic artery in two recipients. Early HAT in 4/11 occurred within 4 weeks after transplantation, whereas late thrombosis in 7/11 was identified 30 days to 1 year after OLT. The postthrombosis course was manifested by elevated liver transaminases (7/11), sepsis and recurrent cholangitis (9/11), or gas gangrene of the liver (4/11). The treatment modalities included thrombectomy and revision of the arterial anastomosis (1/11), emergency hepatectomy with temporary portocaval shunt (2/11), and urgent retransplantation (5/11). Antibiotic therapy and elective retransplantation was the treatment in 4/11. Overall 1-year patient survival and satisfactory graft function was 45 percent.
    The American surgeon 04/1996; 62(3):237-40. · 0.92 Impact Factor
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    ABSTRACT: Bowel perforation is a frequent cause of mortality after pediatric orthotopic liver transplantation. The aims of this study were to identify the cause of this phenomenon and to examine current methods of treatment. This is a retrospective analysis of 246 pediatric patients who underwent orthotopic liver transplantation at a large, urban, tertiary care medical center between 1984 and 1992. We examined the frequency of bowel perforations after transplantation and identified predisposing factors and signs. In this series, bowel perforations occurred in 24 of 246 recipients and were common in those who had previous liver-related surgery (22 patients). Clinical signs included fever (13 patients), leukocytosis (14 patients), and free air on abdominal roentgenograms (11 patients). Perforation occurred at the Roux-en-Y limb in 15 of 24 recipients as well as in the right transverse colon (five patients), terminal ileum (three patients), and duodenum (one patient). The repair was resection and/or primary closure (18 patients), or diversion (six patients). Recurrent perforations (nine patients) could not be attributed to the method of the repair. Perforation-related sepsis was the primary cause of death in 12 patients (50%) and was more common among patients who developed recurrent perforation (seven [78%] of nine patients). The occurrence and location of bowel perforation after pediatric orthotopic liver transplantation suggests that the cause is related to bowel injury during difficult hepatectomy. Mortality may be reduced by early second-look operations in high-risk patients.
    Archives of Surgery 10/1993; 128(9):994-8; discussion 998-9. · 4.30 Impact Factor
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    ABSTRACT: The authors assessed the prevalence and clinical significance of the celiac compression syndrome in liver transplantation patients. Compression of the celiac axis by the median arcuate ligament of the diaphragm, causes a decrease in celiac artery blood flow which may lead to hepatic artery thrombosis in patients undergoing orthotopic liver transplantation. From July 1991 to July 1992, 17 (10%) cases of celiac compression syndrome were identified among 164 consecutive adult patients who underwent liver transplantation. The diagnosis was confirmed by blood flow recording demonstrating a typical pattern of accentuated decrease in celiac blood flow during expiration. Surgical transection of the median arcuate ligament resulted in normalization of the hepatic artery blood flow. In two cases (11.7%), an interposition iliac graft from the recipient supra-celiac aorta was used for the arterial reconstruction. During the follow-up period of up to 15 months, there was no incidence of hepatic artery thrombosis. The clinical significance of the celiac compression syndrome is evident in liver transplantation in which the collateral circulation to the liver is compromised and the celiac artery remains the only source of arterial blood. It is imperative to identify and remove the obstruction of the celiac axis to prevent severe complications and potential graft loss.
    Annals of Surgery 08/1993; 218(1):10-2. DOI:10.1097/00000658-199307000-00003 · 7.19 Impact Factor
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    ABSTRACT: Thesis (M.D.)--University of California, San Diego, 1994. Includes bibliographical references. No. 49. Improving follow-up among women with abnormal pap smears / Michael Jenks -- no. 50. DPT immunization, postnatal illness and sudden infant death syndrome / David M. Kaegi -- no. 51. Age and sex differences in lateral versus anterior-posterior (AP) spinal densitometry using dual energy x-ray absorptiometry (DEXA): a population study / Sunah Kang -- no. 52. Value of three-dimensional (3D) CT imaging for complex pediatric spinal disorders / Sean K. Keem -- no. 53. Liver transplantation for end-stage primary biliary cirrhosis: predictors of outcome and long term graft acceptance / Kianusch Kiai -- no. 54. Height loss as predictive index of vertebral body fractures / Sung Y. Kim -- no. 55. Auramine-stained buffy coat smears for the rapid diagnosis of mycobacteremia in patients with the acquired immunodeficiency syndrome / Anca E.A. Knoepfler, Liz Keays, Leland S. Rickman -- no. 56. Child attitudes and eating behaviors predisposing to eating disorders: a cross-cultural comparison / Elo Kuo.