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Tripathi, Ravi S. MD


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410 W 10th Ave
Columbus, OH 43210

Phone: (614) 293-8487

Email: tripathi.7@osu.edu

 

Current OSU Appointments

Assistant Professor-Clinical, Anesthesiology

Physician, FGP-Anesthesiology

 

Civic Engagement

1999-present:
Volunteer, Community Health Fairs; Columbus, Ohio

Clinical Interest

Anesthesiology;Critical Care Medicine;Surgical Critical Care

Biographical

I have known I wanted to be in medicine since I was a young child. My mother was the medical director of the psychiatric hospital in Cambridge, Ohio, and my father, a practicing cardiologist. When asked if I planned to follow my parents’ in either administrative medicine or cardiology, my response was ‘neither;’ I had no interest in cardiology and wanted to be at the patient’s bedside.

My residency and fellowship projects involved the bibliometric analysis of scientific literature to identify citation classics and landmark trials in anesthesiology and critical care medicine. My mentor was impressed with how quickly I processed a literature search of an entire discipline into a single database with citation counts to identify the most referenced literature. During my critical care fellowship exit interview, my program director and long-time mentor encouraged me to pursue administrative medicine and healthcare information technology. My response was the same; I had an interest in neither. My plan was to stay at my patient’s bedside.

In pursuit of my plan to provide clinically excellent care, it was a pleasure to join the Department of Anesthesiology as an Assistant Professor Clinical at The Ohio State University Wexner Medical Center (OSUWMC) in June 2010 following postgraduate training. I completed certification by the American Board of Anesthesiologists in Anesthesiology and subspecialty certification in Critical Care Medicine. I had developed an interest in cardiopulmonary pathophysiology, completed a six-month fellowship in cardiac anesthesiology, and obtained certification by the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. My position at OSUWMC fit me perfectly as it complimented my expertise in and passion for both critical care and cardiovascular medicine.

Initially, my career was focused at the bedside with clinical duties in cardiac critical and anesthesia. My passion for cardiac critical care coupled with my mother’s mantra of “do you best and work hard” and my father’s of “work smart” fueled me to identify areas of care optimization. Starting a critical care service, I was often obtaining contents daily for routine procedures on the same patient rather then spending time at the bedside. I decided we needed an ICU consent form. Being a new attending, I did not realize what would be involved, but I was determined. Within my first year of practice, I wrote the consent and policy, met with legal and ICU leadership, and finally got approval at the Medical Staff Administrative Committees (MSAC). I realized I could do this. This first clinical project was the catalyst for the remainder of my career as I became increasingly committed to developing a stronger infrastructure for our cardiac critical care patients.

I quickly realized that an ICU consent form was the least of our problems and started championing the entire cardiac critical care program. Consulting physicians provided the critical care services for the cardiac surgery program previous to 2010, but I was not happy with being a “consultant.” When I joined OSUWMC in 2010, I was one of two dedicated cardiac intensivists and devoted 62-86% of my total clinical duties on the cardiac surgical critical service. Through leadership that involve passion, humility, altruism, and a desire for clinical excellence, we transformed the cardiac critical care service from a consulting service to a co-management understanding with the cardiac surgeons to a program today of eight anesthesiology critical care attendings providing 24/7 care.

After constructing the infrastructure for a cardiac critical care program, I led the creation of a growing and successful multi-disciplinary Extracorporeal Life Support (ECLS) program in collaboration with the surgical director. OSUWMC is one of just over 200 centers internationally that offers this complex and intensive treatment of extracorporeal membrane oxygenation (ECMO) to patients by providing total cardiac and/or pulmonary support for days to weeks. To do this, blood is circulated using a mechanical pump outside the body through a modified heart-lung machine. Patients that would not have the chance to survive in a traditional ICU are given a chance to recover from their shock-state without developing multi-system organ failure.

As we were developing the ECLS program, OSUWMC implemented a new inpatient electronic medical record system using Epic Systems in 2011. I strongly believe that technology is the vehicle to optimizing efficiency in care delivery and patient safety. But I also realize this requires balancing the workflow and the desires of the clinician or end user with the technologic solutions while keeping the end-product or the patient in mind. Through leadership and rapport built with members of the multidisciplinary cardiac surgical program—including surgeons, consulting physicians, nurses, and pharmacists—I was able to frame the workflow in cardiac surgical critical care and optimize the electronic health system infrastructure from clinical documentation to computerized physician order entry to rounding workflow. In July 2014, I was appointed Medical Director of Information Technology in the Ross Heart Hospital.

Years after my mentor had clearly identified my strengths in leadership and information technology, I am following his intuition and building a career around clinical excellence and IT. I apply these interests in education, in research, and clinical service. In education, I build digital solutions to enhance bedside teaching and developed two online curricula that have received national attention for their novelty and efficacy. In research, I use IT to create registries in the domain of critical care that generate outcome research, optimize care delivery, and improve patient care. Clinically, I use leadership to drive quality improvements in patient outcomes that can be visualized as a result of my technology innovations. I integrate my expertise in critical care and understanding of information technology to streamline clinician workflow and ultimately improve patient care.

Through my leadership with the ECLS program and clinical excellence in the care of cardiac ICU patients, I was appointed Medical Director of Ross Surgical Critical Care services in July 2014. Most recently, I was appointed Director of Anesthesiology Critical Care and now lead nine attending physicians in the delivery of care for four ICU services, in conjunction with the division of Surgical Critical Care. These clinical administrative responsibilities are 40% of my time, with 60% dedicated to direct patient care. While previously resistant, I am now proud to be following my mother’s and father’s footsteps as I build a career in administrative medicine and clinical medicine focused in cardiovascular critical care. I am proud of my clinical excellence that has advanced educations, research, and clinical services with academic products of medical center national recognitions, but most importantly, improved bedside patient care.

Academic Advising

2014 Ali Idrees, The Ohio State University Medical Center. Graduated 0.
2016 Stephen Sams, The Ohio State University Medical Center. Graduated 0.
2016 Joshua Trester, The Ohio State University Medical Center. Graduated 0.
2011 - 2012 Moumen Asbahi, The Ohio State University Medical Center. Graduated 2013.
2011 - 2012 Andrew N., The Ohio State University Medical Center. Graduated 2013.
2013 , Ohio State University College of Medicine.
2014 Michael Oehler, Ohio State University College of Medicine. Graduated 0. Evaluation of MEWS vs CSEWS in Cardiac Surgical Patients to predict hemodynamic compromise and/or the need for escalation of care project
2014 Amar Bhatt, The Ohio State University Medical Center. Graduated 2014.
2014 Jonathan Houser, The Ohio State University Medical Center. Graduated 2014.
2014 Prabhav Patil, The Ohio State University Medical Center. Graduated 2014.
2014 Seth Hayes, The Ohio State University Medical Center.
2014 Kasey Fiorini, The Ohio State University Medical Center. Graduated 2014.
2014 Brad J., Ohio State University College of Medicine. Graduated 2014.
2014 - 2015 Amar Bhatt, The Ohio State University Medical Center. Graduated 0.
2014 - 2015 Kathleen Marzluf, The Ohio State University Medical Center. Graduated 2015.
2014 - 2015 Ruth Labardee, The Ohio State University Medical Center. Graduated 0. Yellow Belt Project in Operational Excellence (Executive Sponsor)
2015 Rishav Aggarwal, Ohio State University College of Medicine. Graduated 0. Gastrointestinal complications following cardiac surgery
2015 - 2016 Andrew Christopher, The Ohio State University Medical Center. Graduated 2016.
2015 - 2016 George Philip, The Ohio State University Medical Center. Graduated 2016.
 

Licenses

2010 - present Diplomate: American Board of Anesthesiology
2010 - present Diplomate: American Board of Anesthesiology
2010 - present Doctor of Medicine: State Medical Board of Ohio
2012 - present Diplomate: Advanced Perioperative Transesophageal Echocardiography: National Board of Echocardiography
2008 - 2012 Doctor of Medicine: Michigan Board of Medicine
 

Chapters in Books

Phosphate

Pulmonary control and acid/base physiology

Volume of distribution

Pulmonary edema, non-cardiogenic

Anaerobic metabolism

Cor pulmonale

 

Clinical Services

07/01/2010 Critical Care Medicine & Cardiac Anesthesiology (60%) (Ross Heart Hospital)

Conferences

Lean management and A3 thinking to decrease median ventilator times and prolonged ventilation rates after coronary artery bypass surgery

Case report of spontaneous splenic rupture in tow patients with left ventricular assist devices and bacteremia

Palliative Use of Low-Dose Nitroglycerin Infusion for Shock-Induced Mottling and Cyanosis to Mitigate Family Distress During End Of Life Care.

Endothelial Function Is Decreased By Red Blood Cell Transfusion In Cardiac Surgery Patients.

MELD Score Predicts Outcomes in Cardiac Surgery Patients With and Without Liver Disease

The Relationship Between Pre-ECMO Ventilation Duration of Days of Support on Survival for Influenza H1N1 in Adult Patients: Insights from the ELSO Registry

Treatment of Diffuse Alveolar Hemorrhage with Cryotherapy and Intrapulmonary Recombinant Factor VIIa

Intravenous Nitroglycerin for Digital Ischemia and Limb Preservation in An Ecls Patient With Ards

Improving Preoperative Decision Making for Lvad Placement; A Case Report

Preoperative but not postoperative prealbumins are associated with morbidity after cardiac surgery

Impact of Extra-Corporeal Membrane Oxygenation Initiation of Therapy Versus Clinical Status In Determining Outcomes For Influenza H1N1: Insights from the ELSO International Registry

Use of a "Modified" Sequential Organ Failure Assessment Score to Predict Survival To Decannulation in Patients Undergoing Extracorporeal Life Support

 

Degrees

2001 B.S., Kent State University

2005 M.D., Northeastern Ohio Universities College of Medicine

 

Editorial Activities

2011 - present Anesthesia and Analgesia
2011 - 2012 Case Reports in Medicine
2011 - 2012 Anesthesia Board Review, American Physician Institute for Advanced Professional Studies
2012 - 2013 American Society of Anesthesiologists Annual Meeting: Respiratory Care
2012 - 2013 PAIN Medicine
2012 - 2013 American Society of Anesthesiologists Annual Meeting: Critical Care Medicine
2013 - present Drug Shortage Task Force, Society of Critical Care Medicine
2013 International Anesthesia Research Society Annual Meeting: Critical Care, Trauma, and Resuscitation
2013 - 2014 International Anesthesia Research Society Annual Meeting: Cardiovascular Anesthesiology
2014 - present ASAIO J
2014 International Anesthesia Research Society Annual Meeting: Critical Care
2015 - present BMC Anesthesiology
2016 - present PLoS One
2016 - present International Journal of Academic Medicine: Electronic Patient Information & Support
2016 Society of Critical Care Medicine Annual Congress: Cardiovascular and Education
 

Journal Articles

 

Softwares

June 2013 RS Tripathi, EE Abel."Cardiac Surgical Critical Care for House Officers (iTunes U), Co-Course Director"
June 2013 RS Tripathi, EE Abel."Cardiac Surgical Critical Care for Pulmonary Fellows (iTunes U), Co-Course Director"
July 2014 RS Tripathi."Anesthesia / Surgical Critical Care (iTunes U), Co-Course Director"

Presentations

Improved Physiologic Monitor Data Analysis Increases True Event Alarms in a ICU

Measures Associated with Right Ventricular Dysfunction in Patients with Ventricular Assist Devices

Measures Associated with Right Ventricular Dysfunction in Patients with Ventricular Assist Devices

Increased Mortality among ICU Patients Geographically Distant from a Closed Model ICU Team’s Primary ICU

Outcomes and Resource Use for Patients with Right Ventricular Dysfunction Receiving Ventricular Assist Devices Over a Ten Year Period

Measures Associated with Right Ventricular Dysfunction in Patients with Ventricular Assist Devices

Predictors of Intraoperative Lung Injury

Predictors of Potential Intraoperative Ventilator-Induced Lung Injury

Non-Technical Skills in the Management of a Complex Patient Presenting for Intracranial Aneurysm Clipping

Pulse Oximetry Saturation to Inspired Oxygen Ratio as a Measure of Hypoxia in Patients under General Anesthesia

Noninvasive markers of intraoperative arterial oxygenation (PaO2/FiO2 ratio).

Extracorporeal cardiopulmonary resuscitation in a 33-year-old patient with acute on chronic heart transplant rejection

Use of extracorporeal life support in a patient with tracheal stenosis

Extracorporeal cardiopulmonary resuscitation in a 33 year-old patient with acute on chronic heart transplant rejection

Cultural Diversity in the Approach to Care in the Critically Ill Elders

Up-regulation of endogenous opioids in post-sternotomy wound microenvironment.

Endogenous opioids in post-sternotomy wound microenvironment

Peripartum cardiomyopathy

Calciphylaxis with breast necrosis following coronary artery bypass: a plea for greater recognition

Integrating Everyday Life in the ICU

Lung and Cell Injury--Critical Care Scientific Abstract Poster Session

Use of high frequency oscillatory ventilation in the morbidly obese undergoing cardiac surgery.

Respiratory Care Scientific Abstract Poster Session

Trauma Critical Care Beyond Resuscitation

Endothelial function is decreased by red blood cell transfusion in cardiac surgery patients

Extracorporeal Life Support—Optimizing Selection and Treatment

Cardiac trauma and resuscitation

Extracorporeal Life Support: Finding the right patient

Two cases of fulminant respiratory failure requiring cesarean delivery and VV ECMO.

Model for End Stage Liver Disease Predicts 30-Day Mortality in Patients With and Without Liver Disease Undergoing Cardiac Surgery

Hanging In The Balance: Extracorporeal Life Support, Hemorrhage and Thrombosis

Use of Beta-blockade for Refractory Ventricular Fibrillation in a Patient on Extracorporeal Life Support

Bedside and Advanced Diagnostics

Optimizing oxygen delivery with beta-blockade to decrease sympathetic response while on ECLS

Fundamentals of Cardiac Resuscitation

Point/Counterpoint: Protocolization

Anesthesiology Residency Curriculum: utilizing Digital Media to Strategize for the Next Accreditation System

Serotonin syndrome in the intensive care unit following orthotopic heart transplantation

Neuro / Stroke Resuscitation of Cardiac Resuscitation

iTunes U- Implementation of a New Learning Technology into Resident Education

Use of simulation as an assessment tool in cardiac anesthesia and cardiac surgery

Digital tools for evaluation / assessment.

Cool Apps for Personal Knowledge Management

Clinical Pathways--An integrated approach to postoperative care

Critical Care Pathway

Building a Clinical Pathway IT Infrastructure for Cardiac Surgery

Early tracheostomy in patients undergoing veno-venous extracorporeal life support improves survival.

Neurocritical care in the treatment of stroke

 

Professional Activities

present 11th Annual Ohio State University Medical Center Trainee Research Day. The 11th Annual Ohio State University Wexner Medical Center Trainee Research Day.