Christian S Guay

• Doctor of Medicine
• Assistant Professor at University of Utah

This case report presents a unique challenge of complete aortomitral curtain dehiscence and a large pseudoaneurysm 6 weeks post-aortic root replacement in a patient with infective endocarditis. It underscores the importance of meticulous follow-up in patients who have undergone complex aortic surgeries, especially those with infective endocarditis....

Real-time estimation of patient cardiovascular states, including cardiac output and systemic vascular resistance, is necessary for personalized hemodynamic monitoring and management. Highly invasive measurements enable reliable estimation of these states but increase patient risk. Prior methods using minimally invasive measurements reduce patient r...

Background The alpha-2 adrenergic agonist dexmedetomidine induces EEG patterns resembling those of non-rapid eye movement (NREM) sleep. Fulfilment of slow wave sleep (SWS) homeostatic needs would address the assumption that dexmedetomidine induces functional biomimetic sleep states. Methods In-home sleep EEG recordings were obtained from 13 health...

The effects of critical illness on electroencephalographic (EEG) signatures of sedatives have not been described, limiting the use of EEG-guided sedation in the intensive care unit (ICU). We report the case of a 36-year-old man recovering from acute respiratory distress syndrome (ARDS). Severe ARDS was characterized by slow-delta (0.1-4 Hz) and the...

Chronic post-surgical pain is known to be a common complication of thoracic surgery and has been associated with a lower quality of life, increased healthcare utilisation, substantial direct and indirect costs, and increased long-term use of opioids. This systematic review with meta-analysis aimed to identify and summarise the evidence of all progn...

Background: Conscious states are typically inferred through responses to auditory tasks and noxious stimulation. We report the use of a stimulus-free behavioural paradigm to track state transitions in responsiveness during dexmedetomidine sedation. We hypothesised that estimated dexmedetomidine effect-site (Ce) concentrations would be higher at lo...

Objective: To investigate the feasibility of passive functional mapping in the receptive language cortex during general anesthesia using electrocorticographic (ECoG) signals. Methods: We used subdurally placed ECoG grids to record cortical responses to speech stimuli during awake and anesthesia conditions. We identified the cortical areas with s...

Objective Periods of low-amplitude electroencephalographic (EEG) signal (quiescence) are present during both anesthetic-induced burst suppression (BS) and postictal generalized electroencephalographic suppression (PGES). PGES following generalized seizures induced by electroconvulsive therapy (ECT) has been previously linked to antidepressant respo...

BACKGROUND: Delirium is an acute syndrome characterized by inattention, disorganized thinking, and an altered level of consciousness. A reliable biomarker for tracking delirium does not exist, but oscillations in the electroencephalogram (EEG) could address this need. We evaluated whether the frequencies of EEG oscillations are associated with del...

Purpose of Review This review considers the anesthetic management for patients undergoing transcatheter mitral valve replacement and repair (TMVR and TMVRep) and transcatheter aortic valve replacement (TAVR). Clinical indications and preoperative considerations will be discussed before exploring intraoperative anesthetic management and potential co...

Objective There is currently a paucity of clinical evidence that guides perioperative glycemia management in patients undergoing craniotomy for brain tumor resection. The purpose of this study was to better understand current global perceptions and practices related to glycemia management in these patients. Methods Neuroanesthesiologists throughou...

Introduction Chronic post-surgical pain (CPSP) after lung or pleural surgery is a common complication and associated with a decrease in quality of life, long-term use of pain medication and substantial economic costs. An abundant number of primary prognostic factor studies are published each year, but findings are often inconsistent, methods hetero...

Background: Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Med...

Introduction The relative power of slow-delta oscillations in the electroencephalogram (EEG), termed slow-wave activity (SWA), correlates with level of unconsciousness. Acoustic enhancement of SWA has been reported for sleep states, but it remains unknown if pharmacologically induced SWA can be enhanced using sound. Dexmedetomidine is a sedative wh...

Objective Postictal generalized electroencephalographic suppression (PGES) has been defined as electroencephalographic (EEG) activity less than 10 microvolts following a generalized seizure. PGES is associated with an increased risk of sudden unexplained death in epilepsy, as well as treatment efficacy of electroconvulsive therapy (ECT). We investi...

Introduction Delirium is a potentially preventable disorder characterised by acute disturbances in attention and cognition with fluctuating severity. Postoperative delirium is associated with prolonged intensive care unit and hospital stay, cognitive decline and mortality. The development of biomarkers for tracking delirium could potentially aid in...

The endocrine system closely interacts with the nervous system to regulate numerous physiological functions in the human body. Disorders of the endocrine system are common in the neurosurgical patient, and the perioperative care of these patients requires an in-depth understanding of how endocrine dysfunction affects neurophysiology and postoperati...

Objective: Concussion with transient loss of consciousness (tLOC) is a commonly observed but poorly understood phenomenon with mounting clinical significance. This study aimed to examine the relationship between head motion in varying planes and tLOC in athletes with brain injuries. Study design: A case-control design was utilized. The Ultimate...

Purpose Response to commands is the gold standard to assess the level of consciousness during anesthesia induction but it only provides an intermittent, binary measure with low temporal resolution. To overcome these limitations, we combined the object hold method with handgrip dynamometry to continuously record the force applied to hold a dynamomet...

Sleep is a tranquil process that contributes substantially to our overall health and well-being. Yet sleep creates certain vulnerabilities. These sometimes require urgent management decisions for prehospital emergency medical services and on-call medical providers alike. Some of these emergencies may be directly due to sleep itself, whereas others...