Cristian Arzola

Research Synopsis

In the past years, anesthesiologists have progressively incorporated the use of ultrasound guidance to facilitate the performance of various procedures such as vascular access and peripheral nerve blockade to improve their efficacy and safety. Furthermore, anesthesiologists have also incorporated the concept of Point-of-care ultrasonography (POCUS) that is performed and interpreted by the clinician at the bedside. Dr. Arzola's research aims to conduct clinical investigation into problems and questions related to ultrasound-assisted procedures and Point-of-Care Ultrasonography in anesthesiology with a special interest in obstetric Anesthesia.

The use of spinal ultrasound to facilitate neuraxial anesthesia has been an important line of research. His team explored spinal and epidurals in the lumbar spine for obstetric and orthopedic patients as well as epidurals in the thoracic spine. The influence of this line of research has reached national guidelines (National Institute for Health and Care Excellence-NICE, UK), publications in high impact anesthesiology journals and wide scope medical journal (British Medical Journal). As a result, this research has generated multiple national and international invited lectures and workshops. Pulmonary aspiration of gastric contents is a serious perioperative complication that carries significant morbidity and mortality and gastric content and volume assessment is a new point-of-care ultrasound application that can help determine aspiration risk. His research team has described learning curves to acquire competence in gastric ultrasound, reliability of ultrasound assessment of gastric volume and characterization of various populations such as adults and pregnant women. Furthermore, we have secured funding support from a peer-review grant to investigate the obstetric population. Other areas of research include the use of ultrasound for airway management such as crycothyrotomy in the context of surgical airway and lung ultrasound in high-risk obstetric patients.

Recent Publications

1. Arzola, C., Balki, M., Gleicher, Y., Malavade, A., & Friedman, Z. (2022). Comparison of ultrasound-assistance versus traditional palpation method for placement of thoracic epidural catheters: a randomized controlled trial. Regional Anesthesia & Pain Medicine, 47(9), 571–572. https://doi.org/10.1136/rapm-2021-103296

2. Arzola, C., Perlas, A., Siddiqui, N. T., & Carvalho, J. C. A. (2015). Bedside Gastric Ultrasonography in Term Pregnant Women Before Elective Cesarean Delivery: A Prospective Cohort Study. Anesthesia & Analgesia, 121(3), 752–758. http://doi.org/10.1213/ANE.0000000000000818
3. Arzola, C., Mikhael, R., Margarido, C., & Carvalho, J. C. A. (2015). Spinal ultrasound versus palpation for epidural catheter insertion in labour: A randomised controlled trial. European Journal of Anaesthesiology, 32(7), 499–505. http://doi.org/10.1097/EJA.0000000000000119
4. Siddiqui, N., Arzola, C., Friedman, Z., Guerina, L., & You-Ten, K. E. (2015). Ultrasound Improves Cricothyrotomy Success in Cadavers with Poorly Defined Neck Anatomy: A Randomized Control Trial. Anesthesiology, 2015. http://doi.org/10.1097/ALN.0000000000000848
5. You-Ten, K. E., Wong, C., Arzola, C., Cheung, J., Friedman, Z., Perelman, S., & Siddiqui, N. (2015). Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task. Canadian Journal of Anesthesia, 62(10), 1104–1113. http://doi.org/10.1007/s12630-015-0430-z
6. Arzola, C., Cubillos, J., Perlas, A., Downey, K., & Carvalho, J. C. A. (2014). Interrater reliability of qualitative ultrasound assessment of gastric content in the third trimester of pregnancy. British Journal of Anaesthesia, 113(6), 1018–1023. http://doi.org/10.1093/bja/aeu257
7. Kruisselbrink, R., Arzola, C., Endersby, R., Tse, C., Chan, V., & Perlas, A. (2014). Intra- and interrater reliability of ultrasound assessment of gastric volume. Anesthesiology, 121(1), 46–51. http://doi.org/10.1097/ALN.0000000000000193
8. Terblanche, N. C. S., Arzola, C., Wills, K. E., Lawson, R., Blackford, D., & Balki, M. (2014). Standardised training program in spinal ultrasound for epidural insertion: Protocol-driven versus non-protocol driven teaching approach. Anaesthesia and Intensive Care, 42(4), 460-6. Retrieved from http://search.proquest.com/docview/1543842727?accountid=14771
9. Arzola, C., Carvalho, J. C. A., Cubillos, J., Ye, X. Y., & Perlas, A. (2013). Anesthesiologists' learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study. Canadian Journal of Anesthesia, 60(8), 771–779. http://doi.org/10.1007/s12630-013-9974-y
10. Shaikh, F., Brzezinski, J., Alexander, S., Arzola, C., Carvalho, J. C. A., Beyene, J., & Sung, L. (2013). Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis. Bmj, 346, f1720. http://doi.org/10.1136/bmj.f1720
11. Arzola, C., & Wieczorek, P. M. (2011). Efficacy of low-dose bupivacaine in spinal anaesthesia for Caesarean delivery: systematic review and meta-analysis. British Journal of Anaesthesia, 107(3), 308–318. http://doi.org/10.1093/bja/aer200

Appointments

Active Staff, Department of Anesthesia and Pain Management, Mount Sinai
Anesthesiology, University of Chile
Obstetric Anesthesia Fellowship, Mount Sinai Hospital - University of Toronto
MSc Clinical Epidemiology, Universidad de la Frontera, Chile

Honours and Awards

Name: 2014-2015 Department of Anesthesia Clinical Excellence Award, Faculty of Medicine, University of Toronto. Toronto, Ontario, Canada
Description:
Name: 2012-2013 Fellowship Teaching Award, Mount Sinai Hospital-University Health Network, Department of Anesthesia and Pain Management, Toronto, Ontario, Canada
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Courses

Course Number:
Course Name: Anesthesiology Residency program, University of Toronto
Course Number:
Course Name: Obstetric anesthesia fellowship program, Mount Sinai Hospital and University of Toronto
Course Number: Co-director
Course Name: Toronto Anesthesia Symposium. MSH-UH, University of Toronto
Course Number: Ultrasound workshops
Course Name: Annual Meeting Canadian Anesthesiologists’ Society (CAS)
Course Number: Ultrasound workshops
Course Name: Society of Obstetric Anesthesia and Perinatology (SOAP)
Course Number: Ultrasound workshops
Course Name: Annual Postgraduate Assembly in Anesthesiology (PGA), The New York State Society of Anesthesiologist.
Course Number: Ultrasound workshops
Course Name: Annual Comprehensive Regional Anesthesia Workshop, State University of New York, Buffalo (SUNY)