A Bright Future for Research in Anesthesiology: The 2023 Kosaka Best Abstract Awards Session

Jane S. Moon, MD

During a time when the future of academic anesthesiology is in flux, the Kosaka Best Abstract Awards Session on Sunday, April 16, at the IARS 2023 Annual Meeting was a powerful reminder that scholarly activity is still alive and well in our specialty. Nine talented researchers presented the top abstracts from the conference in the clinical research, basic science, and scholars categories.

Aiman Suleiman, MD, MSc, Research Fellow and Chief of the Perioperative Outcomes Lab at the Center for Anesthesia Research Excellence in the Department of Anesthesia, Intensive Care and Pain Management at Beth Israel Deaconess Medical Center, won the award for Best Clinical Research Abstract. Dr. Suleiman presented on “Lung Entropic Hysteresis: The Concept of Retained Energy in Mechanically Ventilated ARDS Patients.” In his research, he explored the idea that mechanical ventilation, although a life-saving therapy in acute respiratory distress syndrome (ARDS), can lead to ventilator-induced lung injury (VILI) via “retained energy” from the mechanical delivery of positive pressure. Applying the concept that “entropic hysteresis” of the lung reflects this retained energy, his team found that mechanically ventilated adult ARDS patients who died within 28 days showed a higher median entropic hysteresis level than their counterparts who remained alive. His study included 76 patients, of whom 21 (27.6%) died within 28 days, but his findings hold promise that a larger study could further increase understanding of the concept of lung entropy production leading to adverse outcomes in ARDS.

Richard Levy, MD, Professor of Anesthesiology and Pediatrics and Vice Chair for Pediatric Laboratory Research in the Department of Anesthesiology at Columbia University Medical Center, won the award for Best Basic Science Research Abstract. Dr. Levy’s presentation, “Discovery of a New Quinone Anesthetic Leads to Identification of a Novel Pharmacological Target in Mice,” explored the topic of mechanisms of anesthetic-induced unconsciousness, amnesia, and immobilization. Through their research study, Dr. Levy’s team had discovered not only a new propofol-like anesthetic — ubiquinone-5 (Ub5) — but also a novel pharmacological target for anesthetics. His team had previously discovered that propofol-induced excessive proton leak within the mitochondria by interfering with electron transfer at the level of coenzyme Q (CoQ). Dr. Levy hypothesized that uniquinone-5 (Ub5), a synthetic CoQ analog, would also induce propofol-like sedation. After randomizing 51 young adult male mice to either Ub5 or vehicle, his team found that Ub5 indeed induced unconsciousness and immobilization in a manner similar to propofol by causing excessive proton leak in isolated forebrain mitochondria. In addition, they identified Aralar, a mitochondrial aspartate-glutamate carrier, as the major source of Ub5-induced leak and thus as a novel pharmacological anesthetic target. Future studies will further delineate Ub5’s mechanism of action, safety profile, and efficacy as an anesthetic agent, while also determining if Aralar is a target of other anesthetics.

Annika Witt, BS, Research Fellow at Montefiore Medical Center, won the award for Best Scholars Abstract. Ms. Witt presented on “Hispanic Ethnicity and Postoperative Discharge to a Nursing Home: A New York City Hospital Retrospective Study.” As previous studies had shown evidence for the “Hispanic paradox” — better health outcomes in Hispanic patients compared to non-Hispanic White (NHW) patients in spite of lower overall socioeconomic status and higher severe comorbidity rates. Ms. Witt’s team designed a retrospective cohort study that analyzed data from 97,016 surgical cases performed at a tertiary academic healthcare network to determine if the Hispanic paradox also applies to “postoperative adverse discharge to a nursing home”— a measure that reflects a decreased ability to live independently after surgery. Ms. Witt indeed found that Hispanic ethnicity was associated with a lower overall risk of postoperative adverse discharge to a nursing home. However, she also discovered that the patient’s residential area — an indicator of socioeconomic status — explains more variance of discharge-to-nursing-home rates than ethnicity alone.

The Kosaka Best Abstracts Awards Session was moderated by the judges of the competition: Vivianne Tawfik, MD, PhD, IARS Trustee, Assistant Director of the Fellowship in Anesthesia Research and Medicine Program and Associate Professor in the Department of Anesthesiology, Perioperative & Pain Medicine at Stanford University; Y.S. Prakash, MD, PhD, IARS Trustee, Chair of the Department of Physiology and Biomedical Engineering and Professor of Anesthesiology and Physiology at Mayo Clinic; Max Kelz, MD, PhD, IARS Journal Liaison, Distinguished Professor and Vice Chair of Research in the Department of Anesthesiology & Critical Care at the University of Pennsylvania; and George Mashour, MD, PhD, IARS Trustee, Robert B. Sweet Professor and Chair of the Department of Anesthesiology at the University of Michigan.

Additional Kosaka Top Abstract Finalists who presented during this session included:

Top Basic Science Abstract Finalists

• “Tissue-protective and immunomodulatory functions of mature B cells in a murine model of hyperoxic lung injury”
  Dusan Hanidziar, MD, PhD, Massachusetts General Hospital, Boston, MA

• “Enolase-2 in circulating extracellular vesicles as a biomarker to predict the severity of traumatic brain injury in male mice”
  Balaji Krishnamachary, PhD, University of Maryland School of Medicine, Baltimore, MD

Top Clinical Research Abstract Finalists

• “The causes of hypoxemia and their relative contribution in COVID-19 respiratory failure: a combined Multiple Inert Gas Elimination Technique and Dual-Energy Computed Tomography study”
  Mattia Busana, MD, University Medical Center Goettingen, Goettingen, Germany

• “Effect of simulated blood pressure elevation during hypotensive noncardiac surgical procedures upon 30-day all-cause postoperative mortality as projected by the sluscore”
  Wolf Stapelfeldt, MD, Richard L. Roudebush VA Medical Center, Indianapolis, IN

Top Scholars Abstract Finalists

• “The influence of intraoperative opioid administration on postoperative pain and opioid requirements”
  Laura A. Santa Cruz Mercado, MD, Beth Israel Deaconess Medical Center, Boston, MA

• “Neonatally sevoflurane-exposed and unexposed male rat cagemates affect each other’s neurodevelopmental phenotypes”
  Ling-sha Ju, MD, MSc, University of Florida, Gainesville, FL

Before the judges deliberated and announced the winners, Dr. Prakash congratulated all the finalists and delivered an inspiring message about the future of research within anesthesiology. “Exciting, humbling, and really more exciting and beyond!” He said, “Our field is going beyond what used to be anesthesia research.”

About Kosaka Best Abstract Awards

The Kosaka Best Abstract Awards are supported by the Japan Society for Clinical Anesthesia (JSCA) and the International Anesthesia Research Society (IARS). The founder of the JSCA, Dr. Futami Kosaka, started a cooperative relationship with IARS in 1990 and developed the foundation for today’s Kosaka Best Abstract Awards Session.