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مركز صحة المرأة والتعليم

Dr. Bhavani Shankar Kodali

Part I: General Information

Office Address:

Department of Anesthesiology
Brigham and Women's Hospital,
75 Francis Street,
Boston, MA 02115

Email:

bskodali@bics.bwh.harvard.edu
bhavani@capnography.com
bhavani@painfreebirthing.com

Education:

1976 - M.B.B.S JIPMER, University of Madras, India
1981 - MD JIPMER, University of Madras, India(Anesthesiology)

Postdoctoral training:

1977

Compulsory rotating Internship, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

1978-81

Anesthesia resident, JIPMER, India

1993-94

Internship at MetroWest Medical Center, Framingham, MA, USA

1994-95

Anesthesia Resident, Brigham and Women's Hospital,Harvard Medical School, Boston, MA

1996-98

Anesthesia Resident, Brigham and Women's Hospital,Harvard Medical School, Boston, MA

1994-1995
1996-1998

Clinical Fellow in Anaesthesia, Harvard Medical School, Boston, MA

1998

Fellow in Obstetric Anesthesia, (6 months)Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Licensure and Certification:

1978

Full Medical practice license in India

1982

Full Medical practice license in Guyana

1983

Full Medical practice license in Barbados

1992

ECFMG certification

1993

FLEX certification

1996

Commonwealth of Massachusetts, Board of Registration and Discipline in Medicine

1999

American Board of Anesthesiology Certification

Academic Appointments:

1981-82

Senior Registrar, JIPMER, Pondicherry, India

1986-93

Associate Lecturer
University of West Indies, Barbados

September 1998 - December 1998

Instructor of AnaesthesiaHarvard Medical School. Boston, MA

January 1999 -
December 2002

Assistant Professor of Anaesthesia Harvard Medical School, Boston, MA

2003 -

Associate Professor of AnaesthesiaHarvard Medical School, Boston, MA

Hospital or Affiliated Institution Appointments:

1981-82

Senior Resident in Anesthesiology,
JIPMER, Pondicherry, India

1982 - 1983

Anesthesiologist, McKenzie Hospital,
Guyana Mining Enterprise,
Linden, Guyana, South America

1983 - 1985

Senior Registrar in Anesthesia,
Queen Elizabeth Hospital,
Barbados, West Indies

1985 - 1993

Attending Anesthesiologist,
Queen Elizabeth Hospital,
Barbados, West Indies

1995 - 1996

Attending Anesthesiologist,
Queen Elizabeth Hospital,
Barbados, West Indies

1998

Staff Anesthesiologist,
Brigham and Women's Hospital,
Boston, MA

Major Administrative Responsibilities:

1982-1983

Chief of Intensive Care Unit.
Linden Hospital,
Guyana Mining Enterprise Hospital,
Guyana, South America

1989-1993

Senior Consultant,
Queen Elizabeth Hospital,
Barbados, West Indies

Major Committee Assignments:

Guyana Mining Enterprise Hospital, Linden, Guyana

1982-1983

Intensive Care Committee.
Chief person responsible for establishing a four bed Intensive Care Unit at
Linden, Guyana, South America.

Queen Elizabeth Hospital, Barbados, West Indies

1988 - 1993

Intensive Care Nurses training Committee - Teacher/Examiner

1988 - 1993

Advisor to the Hospital Equipment Purchase Committee (Anesthesia)

1987 - 1993

Advisor to the Committee responsible for refurbishing operating rooms and establishment of Intensive Care Unit under World Bank loan in Barbados.

1985 - 1993

Advisor for recruiting personnel to the Department of Anesthesia from Overseas

Brigham and Women's Hospital, Boston, MA

2000-

Transfusion Committee Member, Brigham and Women's Hospital,Boston, MA

National Committee Appointment:

2002-

Appointed by the President Elect of American Society of Anesthesiologists (ASA) to the Subcommittee on Equipment, Monitoring, and Engineering Technology to oversee the implementation of the goals of the Society.

Professional Society Involvement:

1978 - 1993

Indian Society of Anaesthetists, Member

1983 -

Barbados Society of Anaesthetists; Member

1985 -

National Association of Critical Care Medicine, India; Member

1987 - 1994

Association of Anaesthetists of Gr. Britain and Ireland; Member

1994 -

American Society of Anesthesiologists; Member

1994 -

International Anesthesia Research Society; Member

1994 -

Massachusetts Society of Anesthesiologists; Member

1998 -

Society of Obstetric Anesthesia and Perinatology; Member

Community Service Related to Professional Work:

Barbados

1984

Medical Coordinator for First International Barbados Marathon run. Member of emergency medical team providing emergency care to participants of initial events of "International Marathon runner" competition in Barbados. Emergency care was necessary for several visitors who were extensively dehydrated due to lack of acclimatization to tropical climate. In later years, better acclimatization by the participants to tropical climate, and training of emergency physicians to provide care, did not require anaesthesia group participation

1992

Key participant in Public Education
Participated in a short video film on "Educating the public regarding Anaesthesia", produced by Government Information Service of Barbados, 1992. This TV program was televised on the Island's television network twice so far.

Editorial Boards:

1996 -

Consultant Reviewer: Capnography related articles for "Anesthesia and Analgesia"

2001

Guest Editor: "Anesthesia And Analgesia"

2002 -

Reviewer for Capnography related articles for "Anesthesiology"

2002 -

Appointed as referee to "European Journal of Anaesthesiology"

2002 -

Appointed as referee to "Postgraduate Medicine"

Awards and Honors:

1981

Indian Society of Anaesthetists (Pondicherry Branch) medal for outstanding anesthesia resident

1992

British Journal of Anesthesia International Scholarship for the year 1992

1997

Foundation of Anesthesia Education and Research (FAER) scholar 1997

2002

'Awards in Excellence" presented by the Faculty of Brigham and Women's Hospital, Department of Anesthesiology, Perioperative Pain Medicine for outstanding contribution

2002

"Special Award" presented by the "Postgraduate Assembly in Anesthesiology" for exhibit entitled "Education in the new millennium" at the Annual Meeting held in New York, December 6th - 10th, 2002

Part II: Clinician Scholar Ladder

A: Narrative Report of Clinical Practice:

In Guyana, South America

Intensive Care Unit in Guyana:
In addition to providing anesthesia for routine operating room surgeries, established a four bed intensive care unit for Guyana Mining Hospital, Linden, Guyana, South America. This unit was declared open by Ministerial representative of Government of Guyana in 1982. The unit was under my care during my tenure in Guyana. Patients with serious mining injuries, respiratory insufficiency and coronary patients benefited from this service.

In Barbados:

Pivotal role in the development of Anesthesia Department at Queen Elizabeth Hospital, Barbados.

Provided anesthesia care for routine and emergency cases at the government owned 650 bed QEH (A teaching affiliate of University of West Indies, 6000-7000 operations/year, a referral hospital for a million population from Anguilla in the north to Grenada in the south.). I was an active member of the team responsible for refurbishing operating rooms and purchasing monitoring equipment, as well as establishing an ICU (Project undertaken with World Bank Loan). I was a key member of the group responsible for training ICU nurses required to staff the unit. In addition to routine anesthesia and teaching responsibilities, I was also instrumental in developing an anesthesia auditing program to keep track of anesthesia disposable items. Such a program was found to be necessary to prevent acute and unexpected shortage of imported disposable items in the island. In addition, I also designed and organized clinical research studies in capnography utilizing available limited resources. Furthermore, studies were also conducted in areas specific to third world developing nations such as; anesthesia without nitrous oxide (nitrous oxide is expensive); suitability and cost effectiveness of providing oxygen from oxygen concentrators to meet the demands of the hospital; and methods to prevent condensation of water in air pipelines due to excessive humidity. The development of the anesthesia department in Barbados was the focus of my special article published recently.

Brigham and Women's Hospital:

As a fellow in Obstetric anesthesia, I was a team leader in assigning day to day clinical responsibilities to residents in the labor and delivery section as well as operating room division. In addition, I was actively involved in the provision of anesthesia care to high risk obstetric patients as well as patients requiring In-vitro-fertilization.

At the conclusion of obstetric anesthesia training, I was appointed as staff anesthesiologist at Brigham and Women's Hospital. Major responsibility includes provision of anesthesia care (sub-specialty) to obstetric patients. Brigham and Women's being a high risk obstetric referral center, a substantial number of patients fall into high risk category requiring anesthesia care during delivery. Recently, a new dimension to obstetric anesthesia care has been added, which is providing care to patients undergoing in-uterus fetal surgery.

In addition to subspecialty care of obstetric anesthesia, a portion of time is spent in providing anesthesia care in main operating rooms, which includes general surgical, thoracic and vascular patients, as well to patients out side of main operating room in areas such as in MRI and CT scan.

As a member of transfusion committee, I am actively involved with other members in revising and implementing several policies in compliance with JACHO to enhance safety of transfusions in various circumstances.

B. Short Report of Research That Contributes to Care of Patients

Primary Research interest: Capnography

Clinical research is centered on capnography, thromboelastography and obstetric anesthesia. Clinical research in capnography extends over a period of 16 years resulting in publication of original papers, review articles, case reports and correspondences on capnography. The main area of clinical research in capnography is on arterial to end-tidal carbon dioxide differences in pregnancy, including those during laparoscopic surgery. I suggested a standard terminology for time capnography and highlighted current limitations of this important monitoring device. This terminology has been included in most text books including "Nunn's Respiratory Physiology". I also review papers on capnography as a consultant to editorial board of Anesthesia and Analgesia as well as guest editor to 'Anesthesiology'. Achieved the status of 'Guest Editor" for Anesthesia and Analgesia in the year 2002. I am committed to educating colleagues and residents as well as students in capnography via my participation in grand rounds and day to day clinical teaching. I produced a multimedia on capnography using computer software for teaching purposes. 'Ohmeda' (Datex-Ohmeda Inc, Manufacturer of anesthesia equipment, anesthesia machines and capnographs) considers my article entitled "Capnometry and Anaesthesia" an important teaching material for anesthesiologists, customers and employees of Ohmeda.

Web Based Education: Site on Capnography.com:

A website on capnography has been designed, produced and maintained without external sponsorship to provide a complete review on end-tidal carbon dioxide monitoring during anesthesia and intensive care. This site uses several animations designed to explain underlying physical and physiological concepts of capnography in addition to highlighting clinical applications. The purpose of this site is to fulfill my long standing goal of developing an easily accessible educational site on capnography. This is an "All-In-One" on capnography. This site has attracted several good reviews: (Approximate time spent in construction of the website - >1000 hours)

Anesthesiology - October 2001: (see the issue for full version)

"Dr Bhavani Shankar Kodali, a well published expert on the subject of capnography, has created the Capnography website without sponsorship from any equipment or pharmaceutical company.

Dr Bhavani Shankar Kodali' has put forth great effort to produce the equivalent of a capnography textbook and made it freely available on the Internet. The site provides a complete review of end-tidal carbon dioxide monitoring during anesthesia and intensive care. In addition, this website provides animated graphics that are not possible to produce in a textbook and can greatly facilitate learning. Capnography.com is truly an "all-in-one" for the subject of capnography and a great teaching contribution."

British Journal of Anaesthesia - October 2001: (see the issue for full version)

"This website, the work of Professor Shankar ....... There is lot of material on this site, and it is impossible to list all the good things....

Certainly it provides fun. It will be a learning resource for students- and I will be recommending it. It may become a forum for specialists, as its author hopes...."

Journal of Neurosurgical Anesthesiology - October 2001: (see the issue for full version)

"While not a book, a web-based site may also be used as a teaching tool..... developed by Dr Shankar, an assistant professor of anesthesiology from Harvard Medical School.

The site uses extensive and colorful animations to explain the concepts....

I believe that a candidate for the oral board examinations might well find that 15 minutes spent at this site shortly before the interview proves invaluable. It is also an effective teaching tool for all residents and helpful for the clinician who wishes to better understand the disease process that generates an abnormal waveform."

Capnography.com website was presented as a technical exhibit at the 'American Society of Anesthesiologists Annual Scientific meeting' at New Orleans, USA - October 2001.

In addition, several complimentary comments have been received from various sections of the medical community, manufacturing firms, and paramedical staff. Some of these comments have been coming from abroad. In addition, the website is also an invaluable tool in the preparation of reports for technology classes. One such example is the Graduate School at Northeastern University. Website statistics reveal that, on the average, 500 pages of this website are accessed on a daily basis. Over 66,000 viewers have already visited this website. Major search engines (such as Yahoo.com and Google.com) rank this website as number one in capnography among non-sponsored websites, based on its popularity and content. Many organizations have provided a link on their website to www.capnography.com in order to provide a source of information on capnography for their clients.

Frequently, permission is sought from teachers and instructors in several fields to borrow material from this website for presenting in their conferences. Very often, individuals visiting the website from several countries often ask intriguing questions about Capnography, to which I respond in detail.

Patient Education (www.painfreebirthing.com):

Patient education is an important component of clinical anesthesia. With the technical experience acquired in the designing of capnography website, a website was designed and just completed to explain the details of pain free childbirth to pregnant women seeking childbirth options. This is the first site to use computer animation graphics to explain basic concepts to lay persons about pain free childbirth procedures so that the patients can make an educated decision regarding their childbirth. The patients can look at this site at their homes during their pregnancy, or can view the site even in the labor and delivery rooms if equipped with internet computers (such as at Brigham and Women's). The chairman of the department of Obstetric and Gynecology and the director of public relations at Brigham and Women's Hospital (BWH) recognized the importance of this endeavor to women's health and education. They decided to adopt the website's content into the pregnancy and childbirth section of the BWH website. They directed their web designers to create a platform for this purpose, which is now live at www.brighamandwomens.org/painfreebirthing. The importance of this patient educational endeavor also received its due recognition at a recently concluded meeting of the Society of Obstetric Anesthesia and Perinatology, where I was asked to demonstrate the website to the entire gathering.

This website has also been selected for presentation as a technical exhibit at the 2002 Annual meeting of American Society of Anesthesiologists in October at Orlando. Over 24,000 viewers have already visited this website since its inception in March 2002. Society of Obstetric Anesthesia and Perinatology (SOAP) and Obstetric Anaesthetists Association of Great Britain have provided links on their website to the Painfreebirthing website for the benefit of their patients.

This website was presented along with the capnography website at the Scientific Exhibition of Annual Postgraduate Assembly in Anesthesiology held in New York (December, 6th-10th, 2002) under the title "Education in the new millennium." This exhibit won a "Special Award" at the meeting.

Approximate hours spent in the preparation of this website - >400 hours).

Current Research Projects:

Projects completed and the data presented at conferences. Manuscripts are under preparation for possible publication. I am the first author of the following clinical studies:

Principal Investigator:

  1. Airway changes in Labor
  2. Upper airway changes in labor using acoustic resonance reflectometry
  3. Intermittent versus continuous infusion of local analgesics during labor
  4. Cerebral oxygen saturation during cesarean delivery (primary investigator).
  5. Airway in pregnancy
  6. Effect of amniotic fluid on coagulation using Thromboelastography

Co-investigator:

  1. Duration of the supine position after an epidural blood patch.
  2. Coagulation studies in patients receiving low dose warfarin thromboprophylaxis using Thromboelastography
  3. Effect of Invitro fertilization on coagulation as studied by Thromboelsatography
  4. Complementary and alternative medicine use in patients undergoing In-vitro Fertilization procedures.

Funding:

Manufacturers of medical equipment (Abbott, Inc, 1998-1999; Haemoscope, Inc, 1999-2000) supported the acquisition of equipment for clinical studies.

Funding for laboratory investigations in clinical studies (1998-2000) was obtained from 'Anesthesia Research fund' of the department.

Websites are fully self-supported. Research, programming, designing and implementation of websites were via personal web learning and multimedia programming efforts.

C. Self Report of Teaching:

Local Contributions (Brigham and Women's Hospital):

Hospital Courses and Teaching Presentations

Grand Rounds:

1996

Capnography in Clinical Practice
Preparation time: 5 hours;
100 attendees

1997

Capnography
Preparation time: 5 hours;
100 attendees

1998

Clinical Conference on "Spinal after for failed epidural analgesia in Obstetrics"
Preparation time: 2 hours;
100 attendees

1998

Airway in pregnancy is as important to Obstetricians as to Anesthesiologists
Preparation time: 6 hours;
50 attendees.

1998

12 sessions of high risk weekly Obstetric anesthesia rounds--February 98 to July 98.
Preparation time: 2 hours for each;
18 attendees

1998 -

70 clinical conferences / problem based learning sessions and lectures to Obstetric anesthesia residents and fellows at afternoon conferences.
Preparation time: 2 hours;
20 attendees

1998

Capnography in clinical practice
Preparation time: 5 hours;
100 attendees

1999

Coagulation issues in Obstetrics
Preparation time: 4 hours;
100 attendees

1999

Capnography
Preparation time: 4 hours;
100 attendees

2000

Capnography
Preparation time: 4 hours;
100 attendees

2001

Learning capnography via Web
Preparation time: 8 hours;
100 attendees

2002

Clinical Conference: Anesthesia outside operating room
Teaching via animated gif. Files.
Preparation time: 12 hours;
100 attendees

2002

Clinical Conference: Air in the Epidural Space
Presentation using gif. Files.
Preparation time: 20 hours;
100 attendees

2002

Capnography: What one should know
Preparation time: 4 hours
100 attendees

Regional, National or International contributions:

Invited Presentations

1987

Lecture: "Capnography"
Department of Anesthesia,
JIPMER
Pondicherry, India

1989

Lecture: "Arterial to End-tidal CO2 difference in pregnancy"
Department of Anaesthesia,
Mater Hospital, Dublin, Ireland

1992

Lecture: "Physiology and clinical applications of Capnography"
Department of Anesthesia,
Maricopa Medical Center,
Phoenix, Arizona, USA

1992

Conference presentation: Monitoring a ventilated patient.
Fourth Barbados Society of Anaesthetist Conference,
Barbados, West Indies

1992

Consultant assignment to Government of St Lucia:
A part of a two member team invited by the Government of St. Lucia to investigate bizarre cases of post-anaesthesia facial swelling in several patients. A systematic interview of anaesthesiologists, nurses and technicians was conducted in addition to examination of anaesthetic practice, sterilization of non-disposable equipment and anaesthesia machines. The problem was traced to airways and non-disposable endotracheal tubes. The airways were sterilized using cidex for 30 minutes, which was followed by inadequate water washing and soaking (approx. 10 min). The problem was easily rectified by thorough washing, rinsing, and soaking in water twice the duration of glutaraldehyde contact.

1997

Lecture: "Clinical overview of Desflurane and its economic viability for developing island nations"
Invitation by Zeneca Pharmaceuticals and Department of Anaesthesia,
Queen Elizabeth Hospital, University of West Indies,
Barbados, West Indies.

1998

Lecture: "Capnography in Clinical Practice"
University of Medical and Dental School, New Jersey

1999

Lecture: "Monitoring coagulation disorders using thromboelastography"
Anesthesiologists of Bombay, India

1999

Lecture: "Thromboelastography in Pregnancy"
Addressed to Obstetricians of Bombay,
Oberoi Towers, Bombay, India.

1999

Lecture: "Monitoring coagulation disorders using thromboelastography"
Anesthesiology and Cardiac surgery of Grant Hospital,
Bombay, India

2000

Lecture: "Capnography. What one should know"
UTMB, Galveston, Texas

2000

Lecture: "How to make your epidurals work"
Regional Anesthesia Update,
Royal Sonesta Hotel,
Cambridge, Boston, MA
Preparation time: 4 hours;
100 attendees

2001

Lecture: "Capnography. Web based lecture using animations".
Department of Anesthesiology
JIPMER, Pondicherry, India.

2001

Lecture: "Understanding Capnography via web"
Beth Israel Deaconess Medical Center,
Boston, MA
Preparation time: 6 hours;
90 attendees.

2001

Lecture: "Capnography in Clinical Practice"
University of Medical and Dental School,
New Jersey

2002

Demonstration of the patient educational website on
www.painfreebirthing.com
34th Annual meeting of Society of Anesthesiologists and Perinatalogy Conference,
Hilton Head, South Carolina, USA.

2002

Grand rounds lecture: "Capnography: What one should know"
Massachusetts General Hospital,
Boston, MA
Preparation time: 8 hours
140 Attendees.

2002 (December 27-30)

Invited guest faculty. Indian Society of Anesthesiologists, Coimbatore, India
Lectures: "Capnography in laparoscopic surgery"
"Anesthesia for laparoscopic surgery during pregnancy"
Preparation time: 14 hours
Over 600 Attendees.

2003 (February 27)

Grand rounds lecture: "Capnography".
Grand rounds lecture:"Anesthesia for laparoscopic surgery in pregnancy"
Duke University Anesthesiology department
North Carolina.

2003 (March 7-9)

Texas Anesthesia Society Conference.
Predicting Difficult Airway in Obstetrical Patient.
The Role of Capnography in the Recognition and Management of Esophageal Intubation
Educating Parturients About Their Anesthetic Options.

2003 (scheduled)

ASA Panel case discussion.

Self Report of Teaching:

Brigham and Women's Hospital, Boston MA

I take enormous interest in teaching and training residents. Periodically, I am the main speaker of grand rounds on the subject of my interest. I have organized several clinical conferences in the obstetric anesthesia sub-specialty on a regular basis for residents and fellows. I also introduced a new teaching technique to covey messages across to audiences in clinical conferences via computer based animated .gif files. Animated graphics are powerful teaching tools, which unequivocally attract the attention of the audiences. I seize every opportunity to teach residents on capnography via animated website. A considerable portion of my time is spent in updating the websites on a regular basis.

Research Supervision of Fellows and Residents

I supervise clinical fellows and clinical anesthesia (3rd year) residents to undertake clinical projects and guide them through manuscript preparation as senior author. The results of these projects have been presented at National conferences such as American Society of Anesthesiologists and Society of Obstetric Anesthesia and Perinatology. Some of the abstracts are published in journals and others in preparation for submission to journals.

India:

1981-1982

Senior Registrar, JIPMER, Pondicherry, India.

Senior Registrar is a teaching position at JIPMER. I participated in 6 seminars and several case conferences in addition to day to day teaching activities to 15 residents of the department.

Barbados:

1986-1993

Associate Lecturer at the University of West Indies, Barbados.

The anesthesia department of QEH provides training for undergraduate and postgraduate students of University of West Indies. The postgraduate training in Anesthesia consists of a three year DM program. In addition to postgraduate clinical training, I was also involved in didactic teaching and conducting weekly clinical conferences.

Part III: Bibliography

ORIGINAL ARTICLES:

  1. Bhavani Shankar K, Moseley HSL, Gopwani H, Clarke V, Sivarajan S and Ishmael R. Halothane and topical cocaine/epinephrine: Is it safe in nasal surgery? Asian Archives of Anaesthesiology and Resuscitation. 1986;23:2:281-6.
  2. Moseley HSL, Bhavani Shankar K and Krishnan A. Flow requirements for Bain breathing circuit during anaesthesia for Caesarean section. Can Anaes Soc J 1986;33:5:583-7.
  3. Shankar KB, Moseley H, Kumar Y and Vemula V. Arterial to end-tidal carbon dioxide tension difference during Caesarean section anaesthesia. Anaesthesia 1986;41:698-702.
  4. Bhavani Shankar K, Moseley H, Kumar Y and Vemula V. Physiological dead space during general anaesthesia for Caesarean section. Canadian J Anaesth 1987;34:4:373-6.
  5. Bhavani Shankar K, Moseley H, Kumar Y, Vemula V and Krishnan A. Arterial to end-tidal carbon dioxide tension difference during anaesthesia for tubal ligations. Anaesthesia 1987;42:482-6.
  6. Moseley H, Kumar AY, Bhavani Shankar K, Rao PS and Homi J. Should air-oxygen replace nitrous oxide-oxygen in general anaesthesia. Anaesthesia 1987;42(6):609-12.
  7. Shankar KB, Moseley H. Evaluation of induction properties of Diprivan (Propofol). Indian J Anaesth 1988:36;5:248-54.
  8. Moseley H, Shankar KB, Kumar Y, Hallsworth R, Krishnan A. Propofol: a new intravenous anesthetic. West Indian Med J 1988;37(3):229-31.
  9. Shankar KB, Moseley H, Vemula V, Ramasamy M and Kumar Y. Arterial to end-tidal carbon dioxide tension difference during anaesthesia in early pregnancy. Canadian J Anaesth 1989;36(2):124-7.
  10. Bhavani Shankar K, Steinbrook RA, Mushlin PS, Freiberger D. Transcutaneous PCO2 monitoring during laparoscopic cholecystectomy in pregnancy. Canadian J Anaesth 1998;45(2):164-9.
  11. Bhavani Shankar K, Russell R, Aklog L, Mushlin PS. Dual capnography facilitates detection of a critical perfusion defect in an individual lung. Anesthesiology 1999;90(1):302-4.
  12. Bhavani Shankar K, Philips JH. Defining Segments and Phases of a Time Capnogram. Anesthesia Analgesia 2000;91(4):973-7.
  13. Bhavani Shankar K, Steinbrook R, Brooks DC, Datta S. Arterial to end-tidal carbon dioxide pressure difference during laparoscopic surgery in pregnancy. Anesthesiology 2000;93(2):370-3.
  14. Harnett MJ, Datta S, Bhavani-Shankar K. The effect of Magnesium on coagulation in parturients with preeclampsia. Anesthesia and Analgesia 2001;92(5):1257-60.
  15. Steinbrook RA, Bhavani-Shankar K. Hemodynamics during laparoscopic surgery in pregnancy. Anesthesia Analgesia 2001;93(6):1570-1.
  16. Hepner D, Concepcion M, Bhavani-Shankar K. Thromboelastography in patients receiving warfarin prophylaxis and epidural analgesia. J Clinical Anesthesia 2002;14(6):405-10.
  17. Harnett MP, Bhavani-Shankar K, Datta S, Tsen LC. In-vitro fertilization induced alterations in coagulation and fibrinolysis as measured by thromboelastography. Anesthesia and Analgesia 2002;95:1063-66.

Review articles/Book chapters/Invited papers:

  1. Bhavani Shankar K, Moseley H, Kumar Y. A Review of arterial to end-tidal carbon dioxide tensions difference during anaesthesia in pregnancy. Indian J Anaesth 1988:2.
  2. Bhavani Shankar K, Moseley H, Kumar Y. End-tidal carbon dioxide monitoring and its clinical applications. Asian Archives of Anaesthesiology and Resuscitation 1990;32:41-54.
  3. Bhavani Shankar K, Moseley H, Kumar Y. Capnography and its usefulness in the operating room. Journal de la SMAAR 1991;2:2-3.
  4. Bhavani Shankar K, Moseley H, Kumar Y and Delph Y. Capnometry and anesthesia. A Review Article. Canadian J Anaesth 1992;39:617-32.
  5. Moseley H, Bhavani Shankar K, Kumar AY. Anaesthesia without nitrous oxide. Postgraduate Doctor 1992;8(5):168-72.
  6. Bhavani Shankar K, Kumar AY, Moseley H, Hallsworth R. Terminology and the current limitations of time capnography. A brief review. Journal Clin Monit 1995;11(3):175-182
  7. Bhavani Shankar K, Moseley H, Mushlin PS, Hallsworth R, Fakoory M, Walrond ER. Anesthesia in Barbados. Canadian J Anesth 1997;44:559-68.
  8. Bhavani Shankar K, Steinbrook RA. Anesthetic considerations for minimally invasive surgery. In: Brooks DC, editor. Current Review of Minimally Invasive Surgery, Third edition. 1999. Current Medicine, Inc. Philadelphia: 28-40.
  9. Bhavani Shankar K. Anesthesia for cesarean section. In Problems in Anesthesia. Ed: Bader A, Datta S. 1999;11:3:333-43.
  10. Shay DC, Bhavani-Shankar K, Datta S. Laparoscopic surgery during pregnancy. Anesthesiol Clin North America 2001 Mar;19(1):57-67.
  11. Srinivasa V, Gilbertson LI, Bhavani-Shankar K. Thromboelastography: where is it and where is it heading? Int Anesthesiol Clin 2001;39(1):35-49.
  12. Farraghar R, Bhavani Shankar K. Obstetric Anesthesia. In: Wylie and Churchil Davidson: Text Book of Anesthesia. United Kingdom: Accepted for publication (2002).
  13. Bhavani Shankar K, Lee-Paritz A. Anesthesia for pregnant obese parturients. In: Anesthesia for High Risk Pregnancy. Editor: Datta S. Accepted for publication (2002).

Case reports/Clinical communications:

  1. Moseley HSL, Shankar KB and Krishnan A. A method of producing normocarbia during general anaesthesia for Caesarean section. Anaesthesia 1985;40:814 (C).
  2. Shankar KB, Palkar NV, Nishkala R. Paraplegia following epidural potassium chloride. Anaesthesia 1985;40:45-7.
  3. Bhavani Shankar K, Moseley H, Kumar Y, Vemula V and Krishnan A. Arterial to end-tidal carbon dioxide tension difference. Anaesthesia 1987;42:1338-9(c).
  4. Bhavani Shankar K, Moseley H, Kumar Y and Vemula V. Arterial to endtidal carbon dioxide difference. Anaesthesia 1987;42:211-2.
  5. Bhavani Shankar K, Moseley H, Kumar Y and Ramasamy M. Bain anesthetic system, gender and obesity index. Anaesthesia 1987;42:444.
  6. Moseley H, Kumar AY, Bhavani Shankar K, Rao PS. Air-oxygen mixtures. Anaesthesia 1987;42:1336-7.
  7. Shankar KB. Deviations from international standards. Anaesthesia 1987;42:444 (C).
  8. Bhavani Shankar K. High frequency jet ventilation and (a-E)PCO2 difference. Anaesthesia 1987;42:1124-5 (c).
  9. Moseley H, Kumar AY, Bhavani Shankar K, Rao PS. Air-oxygen mixtures. Anaesthesia 1988;43:160-1(C).
  10. Moseley H, Kumar AY, Bhavani Shankar K, Rao PS and Homi J. Should air/oxygen replace nitrous oxide/oxygen in general anaesthesia. An abstract with comments from the editor. Survey of Anesthesia 1988;32:2:97.
  11. Bhavani Shankar K, Moseley H, Sam MacCoskie and Kumar Y. Continuous flow ventilators in the ICU. British J Anaesth 1988;60(1):117-8.
  12. Shankar KB, Moseley H, MacCoskie S, Kumar Y. IMV and work of breathing. British J Anaesth 1988;60:480.
  13. Shankar KB, Moseley H, Hassell TA and Sivarajan S. Hypersensitive Carotid sinus. Anaesthesia 1988;43 (1):61.
  14. Bhavani Shankar K, Moseley H, Kumar A. Prolonged bradycardia and hypotension after neostigmine administration in a patient receiving atenolol. Anaesthesia 1988;43:797-8 (c).
  15. Bhavani Shankar K, Moseley H, Kumar Y. Intranasal cocaine/adrenaline during halothane anaesthesia. Anaesthesia 1989;44(6):521.
  16. Shankar KB. Ethics of intubation. Anaesthesia 1989;44:176.
  17. Bhavani Shankar K, Moseley H, Kumar Y. Portable monitoring devices. Anaesthesia 1990;45(3):257.
  18. Shankar KB, Moseley H, Kumar AY. Relationship between PaCO2-PETCO2 gradient and physiological dead space. Can J Anaesth 1991;38(8):1072-4.
  19. Shankar KB, Moseley H, Kumar AY. Negative arterial to end-tidal gradients. Canadian J Anaesth 1991;38(2):260-1.
  20. Shankar KB, Moseley H, Kumar Y. Oxygen cylinders on anaesthesia machines. Br J Anaesth 1991;66(5):628.
  21. Bhavani Shankar K, Moseley H, Kumar Y. Cocaine, intranasal, during otolaryngologic surgery. Survey of Anesthesiology 1991;35:114-5.
  22. Kumar AY, Bhavani Shankar K, Moseley HS, Delph Y. Inspiratory valve malfunction in a circle system: pitfalls in capnography. Canadian J Anaesth 1992;39(9):997-9.
  23. Shankar KB, Moseley H, Kumar AY. Ventilatory effects of laparoscopy under general anaesthesia. Br J Anaesthesia 1992;69(5):542-3.
  24. Shankar KB, Moseley H, Kumar AY. Dual end-tidal CO2 monitoring and double-lumen tubes. Can J Anaesth 1992;39(1):100 (C).
  25. Kumar AY, Shankar KB, Moseley HSL. Capnography does not reliably detect double-lumen endotracheal tube misplacement. J Clin Monit 1993;9:207-8.
  26. Bhavani Shankar K. Negative arterial to end-tidal CO2 gradients in children. Canadian J Anaesth 1994;41(11):1125-6.
  27. Bhavani Shankar K, Hart N, Mushlin PS. Negative pressure induced airway and pulmonary injury. Canadian J Anaesth 1997;44(1):78-81.
  28. Bhavani Shankar K, Kannan S. Prevention of occlusion of sampling tubes in side-stream capnographs. Can J Anaesth 1997:44(4):453.
  29. Bhavani Shankar K, Mushlin PS. Arterial to end-tidal gradients in pregnant subjects. Anesthesiology 1997;87:1596-8.
  30. Bhavani Shankar K, Camann WR. The practice of using sevoflurane inhalation induction for emergency cesarean section and a parturient with no intravenous access. Anesthesiology 1998;88:275-6.
  31. Bhavani Shankar K. Salivary gland enlargement caused by chemical agents. Anesthesia and Analgesia 1999; 89(3):804.
  32. Kaynar AM, Shankar KB. Epidural infusion: Continuous or bolus? Anesthesia and Analgesia 1999;89(2):534.
  33. Kaynar AM, Bhavani Shankar K, Mushlin PS. Lingual hematoma as a potential cause of upper airway obstruction. Anesthesia Analgesia 1999;89(6):1573-5.
  34. Harnett MJ, Miller AD, Hurley RJ, Bhavani-Shankar K. Pregnancy, labour and delivery in a Jehovah's Witness with esophageal varices and thrombocytopenia. Can J Anaesth 2000 Dec;47(12):1253-5.
  35. Bhavani-Shankar K, Lynch EP, Datta S. Airway changes during Cesarean hysterectomy. Canadian J Anaesth 2000;47(4):338-41.
  36. Russell R, Bhavani Shankar K, Mushlin P. Another application of dual-lung capnography. Anesthesiology 2000; 92(1):288-9.
  37. Kodali, BS. www.capnography.com. J Cardiothorac Vasc Anesth. 2001;15(6):806-7.
  38. Kodali BS. www.capnography.com. An animated website. Anesth Analg. 2001;93(5):1364.
  39. Shankar KB, Posner M. A normal capnogram despite esophageal intubation. Canadian J Anaesth 2002;49(4)439.
  40. Mushlin PS, Kodali BS. Learning capnography on the World Wide Web: an educational resource for the new millennium. Acta Anaesthesiogica Scandinavica. 2002;46(3):341.
  41. Bhavani Shankar K. Business cards and Anesthetic Practice. Anesthesia and Analgesia. 2002;95(1):257-8.

Abstracts:

  1. Bhavani Shankar Bhavani Shankar K, Krishna S, Moseley H. Airway changes in pregnancy. Anesthesiology 1997; 87 suppl A895.
  2. Bhavani Shankar K, Bulich L, Datta S, Kral M. Airway changes in labor. Anesthesiology 1998;April SOAP suppl.
  3. Bhavani Shankar K, Wu Y, Tsen LC, Osathanondh R, Datta S. Thromboelastography in Pregnancy. Anesthesiology 1999;April SOAP suppl A67.
  4. Bhavani Shankar K, Malov S, Kannan S, Hurley R, Datta S. Efficacy of intermittent epidural flow for labor analgesia (A bupivacaine fountain in the epidural space). Anesthesiology 1999;April SOAP suppl A68.
  5. Wu Y, Bhavani Shankar K, Datta S. Hetastarch compromises blood coagulation at term pregnancy by inhibiting platelet as well as coagulation factor activity. Anesthesiology 1999;April SOAP suppl A90.
  6. Harnett MJP, Bhavani-Shankar K, Datta S. Thromboelastography in parturients receiving magnesium. Anesthesiology 2000;SOAP suppl A52.
  7. Bhavani Shankar K, Steinbrook R, Brooks DC, Datta S. Laparoscopic surgery in pregnancy - Is Invasive monitoring essential? Anesthesiology 2000;SOAP suppl A66.
  8. Amosu O, Bhavani Shankar K. Cerebral oxygenation during cesarean section. Anesthesiology 2000;SOAP suppl A85.
  9. Nelson P, Tsen LC, Bader AM, Bhavani-Shankar K(Kodali), Datta S, Segal S. Can epidural saline promote recovery from spinal anesthesia? Anesthesiology 2000;SOAP suppl A87.
  10. Harnett M, Tsen L, Datta S, Bhavani-Shankar K. In vitro fertilization induced changes in coagulation using thromboelastography. Anesthesiology 2000; ASA (September) suppl 1077.
  11. Bhavani-Shankar K, Bulich L, Kafiluddi R, Kral M, Datta S. Does labor and delivery induce airway changes? Anesthesiology 2000;ASA (September) suppl A1072.
  12. Bhavani-Shankar K, Malov S, Hurley R, Datta S. Do rapidly administered intermittent epidural boluses provide better labor analgesia? Anesthesiology 2000;ASA (September) suppl A1071.
  13. Harnett M, S. Datta, K. Bhavani-Shankar. How does amniotic fluid affect coagulation? Anesthesiology 2001; SOAP suppl A45.
  14. Bhavani-Shankar K, W. Camann. General anesthesia for cesarean delivery. The status of current resident training and experience. Anesthesiology 2001; SOAP suppl A31.
  15. Bhavani Shankar K, Sobhana, Topulos G. Airway evaluation during labor using acoustic reflectometry. Anesthesiology 2001; ASA (October) suppl A1035
  16. Hepner, DL, Bhavani-Shankar Kodali. Camann W, Harnett M, Segal S, Tsen LC. Supine position duration following an epidural blood patch. Anesthesiology 2002; SOAP suppl P103.
  17. Bhavani-Shankar Kodali, Camann W. Combined obstetric and anesthesia journal club series: A forum for collaboration. Anesthesiology 2002; SOAP suppl P12.
  18. Bhavani-Shankar Kodali. How do we educate our patients about obstetric Anesthesia? (Animated Website: - www.painfreebirthing). Anesthesiology 2002; SOAP suppl P8.

Educational Material: Websites:

www.Capnography.com

Preparation time: >1000 hours

A website on capnography has been designed, produced and maintained with no sponsorship to provide a complete review on end-tidal carbon dioxide monitoring during anesthesia and intensive care. This site uses several animations designed to explain underlying physical and physiological concepts of capnography in addition to highlighting clinical applications. This is an "All-In-One" on capnography. This capnography website has been reviewed by independent reviewers in "Anesthesiology (October 2001), British Journal of Anesthesia (October 2001) and Journal of Neurosurgical anesthesiology (October 2001). It has been summarized as a great teaching contribution on capnography and being more advantageous than a text book.

Web based patient education: www.painfreebirthing.com

Preparation time: > 400 hours

Designed, programmed, and produced a website for pregnant women on pain free child birth options. This is the first site to use computer animation graphics to explain concepts of pain free child birth. The patients can access the information at home or in the labor and delivery suites equipped with computer Internet access such as ours. This patient educational website was demonstrated at a recently concluded Society of Obstetric Anesthesia and Perinatology.

Anesthesia video Film for Govt. Of Barbados:

Participated in a short video film on "Educating the public regarding Anesthesia", produced by Government Information Service of Barbados, 1992.

MD Thesis for Anesthesiology:

Oxygen saturation of hemoglobin after general anesthesia using IPPR. A dissertation submitted to the University of Madras, 1981, in partial fulfillment for the degree of MD.

Multi-Media Presentation in Capnography:

Comprehensive review on Capnography produced in computer software: Madison- Avenue and Harvard Graphics: This is probably the first review on capnography in multimedia presentation format.

Scientific exhibition:

  1. Internet and World Wide Web - A teaching tool of anesthesia education for this new millennium (www.capnography.com ). Presented at American Society of Anesthesiologists Annual Conference at NewOrleans, October 2001.
  2. How do we educate our patients? www.painfreebirthing.com - Presented at American Society of Anesthesiologists Annual Conference at Orlando, October 2002.
  3. Education in the New Millennium. Invited to present both websites at 56th Postgraduate Assembly in Anesthesiology at New York City in December 2002 as examples of educational tools of the new millennium.

Subject of interest and expertise:

Capnography: Published original papers, clinical communications and invited papers/review articles on capnography. Designed and produced a website on capnography, which has been reviewed in Anesthesiology and British Journal of Anaesthesia. Presently serving as a consultant reviewer/guest reviewer for capnography related articles for 'Anesthesiology', 'Anesthesia Analgesia' and European Journal of Anaesthesiology.

CONFERENCE PRESENTATIONS:

  1. Bhavani Shankar K, Moseley H, Kumar AY, Vemula V. Arterial to end-tidal CO2 difference during general anaesthesia for tubal ligation. First Caribbean Anesthetists Conference - Barbados, 1986.

  2. Moseley H, Bhavani Shankar K, Vemula V, Srikanthan K. Halothane and topical cocaine/epinephrine: Is it safe in nasal surgery?. First Caribbean Anesthetists Conference - Barbados, 1986.

  3. Moseley H, Bhavani Shankar K, Gibson E, Procope N. Compensation for stress in marathon runners. First Caribbean Anesthetists Conference - Barbados, 1986.

  4. Moseley H, Kumar AY, Bhavani Shankar K, Rao PS. Can compressed air/oxygen replace N2O/oxygen in general anaesthesia. First Caribbean Anesthetists Conference - Barbados, 1986.

  5. Bhavani Shankar K. A review of arterial to end-tidal carbon dioxide tension difference during pregnancy. Second Caribbean Anesthetists Conference - Barbados, 1987.

  6. Moseley H, Bhavani Shankar K, Kumar Y, Hallsworth R. Multicenter drug trial of "Diprivan", a new intravenous induction agent by ICI limited, UK. Second Caribbean Anesthetists Conference - Barbados, 1987.

  7. Bhavani Shankar K, Moseley H, Kumar AY. Assessment of Bain circuit in obese patients. Second Caribbean Anesthetists Conference - Barbados, 1987.

  8. Bhavani Shankar K. Carotid sinus hypersensitivity. A case report. Second Caribbean Anesthetists Conference - Barbados, 1987.

  9. Wahyd A, Moseley H, Bhavani Shankar K, Ramasamy M. Low dose ketamine for dilatation and curettage. Second Caribbean Anesthetists Conference - Barbados, 1987.

  10. Ali S, Bhavani Shankar K, Moseley H. Changes in serum potassium following Diprivan and succinylcholine. Third Caribbean Anesthetists Conference - Barbados, 1988.

  11. Bhavani Shankar K. Anesthesia Budget. Expenditure involved in staffing anesthesia department at Queen Elizabeth Hospital, Barbados. Third Caribbean Anesthetists Conference - Barbados, 1988.

  12. Bhavani Shankar K, Moseley H, Kumar AY. End-tidal carbon dioxide estimations in pregnancy. 39th Indian Society of Anaesthetists Conference, 1990.

  13. Kumar AY, Bhavani Shankar K, Moseley H. The computerized auditing of disposable anaesthetic equipment and anaesthetic drugs. Deuxieme Journees Internationales d'anesthesie-reanimation. Conference held in Martinique, 1992.

  14. Bhavani Shankar K. Monitoring a ventilated patient. Fourth Barbados Societyey of Anaesthetists Conference, 1993.

  15. Kumar AY, Bhavani Shankar K, Moseley H. Cost evaluation for use of Isoflurane in low flow circuit with air and oxygen. Fourth Barbados Society of Anaesthetists Conference, 1993.

  16. Moseley H, Bhavani Shankar K, Moseley H, Kumar AY, Kannan S. Total Intravenous anaesthesia for day care surgery using propofol and diclofenac. Fourth Barbados Society of Anaesthetists Conference, 1993.

  17. Kannan S, Bhavani Shankar K, Moseley H, Kumar AY. Fibreoptic bronchoscopy in management of difficult airway. Fourth Barbados Society of Anaesthetists Conference, 1993.

  18. Bhavani Shankar K, Camann W. General anesthesia for cesarean delivery. The status of current resident training and experience. Society of Obstetric Anesthesia and Perinatology. (SOAP), San Diego, 2001.
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