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Acute Care Surgery Research

The Acute Care/Trauma Surgery Division is home to a top-rated trauma center, making it part of an elite group that boasts not only superbly-skilled trauma surgeons, but also a commitment to improving safety in the community and advancing trauma research. 

The American College of Surgeons has awarded a Level 1 rating to our trauma center, one of only a handful in Massachusetts to have this coveted designation. It recognizes our commitment to trauma research as well as maintaining a trauma registry, where all patients are tracked, from the time they are rushed through our doors to when they leave our hospital. We analyze and review the care we provide to every single patient who comes through our doors. We are committed to continually studying and improving trauma patient outcomes, here at Tufts MC and at trauma centers all over the United States.

Current research projects include:

  1. Hand Hygiene and Infection Control
  2. Difficult Extubations in the Intenstive Care Unit
  3. End of Life Care and Utilization of Resources in SICU
  4. Utility of Presepsin in Distinguishing between Sepsis and SIRS (Systemic Inflammatory Response Syndrome): an exploratory, prospective observational study in critically ill patients. 2014-2015; Mochida Pharmaceuticals.
  5. Manual vs. automated monitoring accuracy of glucose IDE (MANAGE IDE). 2014-2015; Optiscan Biomedical Corporation.
  6. Changing physician hand hygiene behavior in a surgical ICU by constant monitoring from a unit coordinator coupled with monthly feedback.
  7. The relationship between rib fracture characteristics and lung inury.
  8. The safety of transferring trauma patients to the CAT scan suite.
  9. The accuracey of trauma data entry into trauma registries.
  10. The outcomes of trauma patients signing Againt Medical Advice (AMA).
  11. Bicyclists riding patterns and their relationship to trauma.
  12. Analysis of technical error identified by the departmental QI process.
  13. Symphony Transdermal Continuous Glucose Monitoring System After Surgery:  Pilot clinical protocol.

Peer-reviewed

Reich JA, Young M, Callahan S, Callahan K, Welch L, Doron S, Snydman D, Nasraway SA.  Changing physician behavior and improving hand hygiene performance in a surgical ICU:  a novel method for data collection of 20,359 observations. Crit Care Med. 2014 (in press).

Chhabra N, Holewinski S, Hudson-Jinks T, D’Achille J, O’Brien K, McLaughlin J, Nasraway SA.  Standardized Mortality Ratio: Its strengths and limitation in a single center experience.  Crit Care Med 2014 (in press).
The Boston Trauma Collaborative (including Rabinovici R). The Initial Response to the Boston Marathon Bombing: Lessons Learned to Prepare for the Next Disaster.  The Boston Trauma Consortium. Ann Surgery (in-press).

Rabinovici R, Arabian S. The Boston Trauma Chief’s Collaborative: Boston Marathon Bombings: Pre-Hospital and hospital aspects of the Boston terror attack. Ann Surg (in press).

Traa MX, Barboza L, Doron S, Snydman D, Nasraway SA.  Defying methicillin-resistant Staphylococcus aureus and eliminating bacteremia in a surgical ICU without active surveillance.  Crit Care Med. 2014; 42:2151-2157.

Wernerman J, Desaive T, Finfer S, Foubert L, Furnary A, Holzinger U, Hovorka R, Joseph J, Kosiborod M, Mesotten D, Nasraway S, Rooyackers O, Schultz MJ, Van Herpe T, Vigersky RA, Prieser J-C.  Continuous glucose control in the ICU:  Report of a 2013 Round Table meeting.  Crit Care. 13 Jun 2014; 18:226.

Rabinovici R, Arabian S. The Boston Trauma Chief’s Collaborative: Boston Marathon Bombings: Pre-Hospital and hospital aspects of the Boston terror attack. Ann Surg (in press).

Bugaev N, Al-Hazmi M, Allcorn M, Arabian S, Riesenburger R, Safain M, Burke S, Colangelo A, Rabinovici R. Blood pressure regulation to prevent progression of blunt traumatic intracranial hemorrhage in stable patients. Neurocrit Care. 2014 Feb 4.

Rabinovici R. The Boston Trauma Chief’s Collaborative: Boston Marathon Bombings: An After Action Review by the Boston Trauma Center Chief's Collaborative. J Trauma.

Bugaev N, Breeze JL, Daoud V, Arabian SS, Rabinovici R. Management and outcome of patients with blunt splenic injury and preexisting liver cirrhosis. J Trauma. 2014 Jun;76(6):1354-1356.

Rabinovici R, Bugaev N. Resuscitative thoracotomy ­-an update. Scan J Surg. 2014 April 15;103:112.

Rabinovici R, Gautchey S, Coimbra R. Trends in trauma surgery: analysis of the AAST program 1939-2012. J Trauma. 2014;76:672.

Rabinovici R. Sixty-Seven Consecutive Resuscitative Thoracotomies by a Single Surgeon. Scan J Surg. 2014 April 17;103:156.

Rabinovici R. Trauma Surgery ­ Controversies and shifting management paradigms. Scan J Surg. 2014;103:79.

Reich JA, Schumann R. A systems approach to the difficult airway extubation. Minerva Anestesiol. 2014 Jan;80(1):125 Epub Jul 16.

Saur NM, England MR, Menzie W, Melanson AM, Trieu MQ, Berlin J, Hurley J, Krystyniak K, Kongable GL, Nasraway SA. Accuracy of a novel noninvasive transdermal continuous glucose monitor in critically ill patients. J Diabetes Sci Technol. 2014 May 27. DOI: 10.1177/1932296814536138.

Young Jr MC, Radtka J, Frankel H, Arabian S, Rabinovici R. Fall from standing induces significant injuries. Am Surgeon. 2014 Feb;80(2):210-212. 

Bugaev N, Arabian S, Rabinovici R. Admission patterns of stable trauma patients with isolated orthopedic or neurosurgical injuries. J Trauma. 2013;74: 1151-1155.

Krinsley JS, Egi M, Amin DN, Schuetz P, Maurer P, Schultz MJ, van Hooijkonk RTM, Kiyoshi M, Mackenzie IMJ, Annane D, Stow P, Nasraway SA, Holewinski S, Prieser JC, Vincent JL, Bellomo R.  Diabetic status and the relationship of the three domains of glycemic control to mortality in critically ill patients:  an international multi-center cohort study. Crit Care  2013; Mar 1; 17(2):R38.

Rattan R, Nasraway SA. The future is now: Software-guided intensive insulin therapy in the critically ill. J Diabetes Sci and Technol. 2013; 7:548-554.

Rattan R, Nasraway SA.  Separating wheat from chaff: Examining the obesity paradox in the critically ill.  Crit Care. 2013; 17:168

Saur N, Holewinski S, O’Brien K, Kongable G, Nasraway SA.  Software-Guided Insulin Dosing Decreases Glycemic Variability in Critically Ill Patients;  Mayo Clinic Proc  2013; 88:920-929.

Jacobi J, Bircher N, Krinsley J, Agus M, Braihwaite S, Deutschman C, Freire A, Geehan D, Kohl B, Nasraway SA, Rigby M, Sands K, Schallom L,Taylor B, Umpierrez G, Mazuski J, Schunemann H.  Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients. Crit Care Med 2012; 40:3251-3276.

Traa MX, Barboza L, Doron S, Snydman D, Nasraway SA.  Defying methicillin-resistant Staphylococcus aureus and eliminating bacteremia in a surgical ICU without active surveillance.  Crit Care Med 2014 (in press).

Wernerman J, Desaive T, Finfer S, Foubert L, Furnary A, Holzinger U, Hovorka R, Joseph J, Kosiborod M, Mesotten D, Nasraway S, Rooyackers O, Schultz MJ, Van Herpe T, Vigersky RA, Prieser J-C.  Continuous glucose control in the ICU:  Report of a 2013 Round Table meeting.  Crit Care 2014 (in press).

Book Chapters:

Hojman H, Wai C, Nasraway SA.  Gastrointestinal hemorrhage.  In: Textbook of Critical Care, 6th edition; Vincent, Abraham, Moore, Kochanek, Fink, (Eds): Elsevier Science, Philadelphia: 2011; pp 746-751.

Nasraway, S. 2011. In Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel, edited by J. Erdman, M. Oria, and L. Pillsbury. Washington, DC: The National Academies Press.

Rabinovici R, Kashuk J: Coagulation issues and the trauma patient.” In John Cameron, Andrew Cameron (eds): “Current Surgical Therapy.” Elsevier, Philadelphia pp 1099, 2014.

Yende S, Nasraway SA Jr, Dellinger RP. Severe Sepsis and Septic Shock: Epidemiology, Diagnosis, and Management. In: Szalados JE, Rehm, CG (Eds). Adult Multiprofessional Critical Care Review.  Mount Prospect, IL; Society of Critical Care Medicine; 2012.

Arabian AS, Breeze J, Marcus M, Pomphrey M, Captain K, Wolfe J, Bugaev N, Rabinovici R: Variability in Trauma Data Abstraction.  28th EAST Annual Scientific Assembly. Lake Buena Vista, Florida: 2015. 

Reich J, Nasraway SA: Performance of the symphony CGM system in critically ill diabetic and non-diabetic patients.  74th annual American Diabetes Association.  San Francisco, CA: June 13-17, 2014.

Nasraway SA: “How we use point of care blood glucose meters in the ICUs at my hospital”. Hospital Diabetes meeting and Consensus Statement.  Arlington, VA: May 13, 2014.

Hojman H: Abdominal Trauma. Presented at the MetroWest Natick Surgical Specialty Grand Rounds in Natick, MA. April 16, 2014. 

Hojman H: Boston Marathon Day Bombing: The Trauma Center Experience.  Presented at the MetroWest Natick Surgical Specialty Grand Rounds in Natick, MA. January 15, 2014.

Hojman H: Social Media in Healthcare. Good or Evil? Presented at Tufts Medical Center Ethics Grand Rounds, Boston, MA January 13, 2014.

Nasraway SA: “New innovations in hemodynamic monitoring”.  34th International Symposium on Intensive Care and Emergency Medicine.  Brussels, Belgium. March 18-21, 2014.

Reich J, Nasraway SA: Performance Of  The Symphony ® CGM System In Critically Ill Diabetic and Non-Diabetic Patients. San Francisco, 2014.

Hojman H: Boston Marathon Day Bombing. Presented at the MetroWest Medical Center Surgical Grand Rounds, Framingham, MA December 4, 2013.

Hojman H: The unexpected lockdown of the Emergency Department during a Mass Casualty Incident. Presented at the Boston Marathon Bombing Session.  New England Surgical Society 93rd Annual Meeting, Hartford, CT, September 21, 2013.

Hojman H: Boston Marathon Day Bombing: The Trauma Center Experience.  Presented at the Shock Society Annual Meeting, San Diego, CA, June 4, 2013.

Hojman H: How we can say no? Presented at Tufts Medical Center Schwarz Center/Surgical Grand Rounds, Boston, MA March 28, 2013.

Nasraway SA: “Risk assessment for DVT and PE.”  42nd Critical Care Congress of the Society of Critical Care Medicine.  San Juan, Puerto Rico; January 22nd, 2013.

Rabinovici R: “The early evolving sex hormone environment is associated with significant clinical outcome and inflammatory response differences post-injury.” Discussant at the 2014 Annual meeting of the American Association for the Surgery of Trauma, Philadelphia, PA, September 2014. 

Rabinovici R: Emergency Room and Triage in the Boston Marathon Bombing. Presented at the Panel Discussion on the Marathon Bombing, Boston 2013. The Annual meeting of the Massachusetts Chapter of the American College of Surgeons.  Boston, MA: December 2013.

Rabinovici R: The Boston Marathon Bombing. Presented at the Panel Discussion on the Marathon Bombing, Boston 2013, The Annual Meeting of the Boston Surgical Society. Waltham, MA: November 2013.

Rabinovici R: Implementation of cloud-based image sharing technology significantly reduced repeat imaging in a regional trauma system. Discussant at the 2013 Annual meeting of the American Association for the Surgery of Trauma. San Francisco, CA: September 2013.

Rabinovici R, Hojman H: The Boston Bombing ­Tufts perspective.  Presented at the Pan American International Video Conference, April 2013.

Rabinovici R, Gautchy S, Coimbra RL: Trends in Trauma Surgery: Analysis of the AAST Program 1938-2012. First oral presentation at the 2013 Annual meeting of the American Association for the Surgery of Trauma, San Francisco, CA, 2013.

Rabinovici R: “Intra-Hospital Triage in the Boston Marathon Bombing.” Presented at the Panel Discussion on the Marathon Bombing, Boston 2013, The Annual Clinical Congress of the American College of Surgeons, Washington, DC, 2013.

Nasraway SA: “Surviving sepsis campaigns and stop sepsis bundles”.  Australia/New Zealand Clinical Infectious Disease Forum. August 3-4, 2012.

Nasraway SA: “Clinical study design and performance of hospital glucose sensors.”  Addressing the FDA (U.S. Food and Drug Agency).  Silver Spring, MD.  June 25, 2012.

Nasraway SA: “MRSA:  Are we at a turning point?”  PRIME Anti-Infectives Meeting.  Xian, China.  May 26, 2012.

Rabinovici R, Biffl W: The trauma patient in extremis. Presented at the 2012 Annual meeting of the American Association for the Surgery of Trauma, Kauai, HI 2012.

Nasraway SA: “Use of insulin dosing software and algorithms”.  2011 Arnold O. Beckman Conference.  Glycemic control in the hospital:  Evidence, Issues and Future Directions.  San Diego, CA. April 13, 2011.

Nikolay Bugaev, MD
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Nikolay Bugaev, MD

Title(s): Director of Trauma Research; Surgeon; Assistant Professor, Tufts University School of Medicine
Department(s): Surgery, Trauma and Critical Care
Appt. Phone: 617-636-4488
Fax #: 617-636-8172

Trauma, acute care surgery

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Stanley A. Nasraway, MD
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Stanley A. Nasraway, MD

Title(s): Director, Surgical Intensive Care Unit; Professor, Tufts University School of Medicine
Department(s): Surgery, Trauma and Critical Care
Appt. Phone: 617-636-4630
Fax #: 617-636-8172

Internal medicine, critical care medicine

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John Adam Reich, MD

John Adam Reich, MD

Title(s): Anesthesiologist; Vice Chair for Critical Care; Director, Cardiothoracic Unit; Assistant Professor, Tufts University School of Medicine
Department(s): Anesthesiology and Perioperative Medicine
Appt. Phone: 617-636-6044
Fax #: 617-636-8384

Anesthesiology, critical care medicine

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