Dr. John Murkin

Professor

Biography

Dr. Murkin is currently full Senate Professor of Anesthesia and Perioperative Medicine and Director of Cardiac Anesthesia. His most recent ongoing peer-funded investigations focus on both the role of near infrared spectroscopy (NIRS) for assessment of cerebral oxygenation, as well as novel investigations on the impact of early sepsis on NIRS-detected microcirculatory vasoreactivity and tissue oxygenation.

For over 3 decades, Dr. Murkin’s studies have focused on cognitive and neurological outcomes in cardiac surgery. Following his initial series of studies investigating cerebral blood flow and cerebral metabolism during cardiopulmonary bypass employing differing pH management strategies, and which established the primacy of alpha-stat during adult moderate hypothermic cardiopulmonary bypass (CPB), these studies also demonstrated the role of cerebral emboli in the genesis of postoperative neurological and cognitive impairment. Dr. Murkin is principal author of 2 Consensus Statements on parameters for cognitive testing after cardiac surgery and was co-founder of the international multidisciplinary meeting dealing with brain injury after cardiac surgery, ‘Outcomes’, held annually for 13 years in Key West and Barbados BWI, proceedings from which were published in the Annals of Thoracic Surgery and subsequently in Heart Surgery Forum.

Dr. Murkin has been an invited discussant at a National Institutes of Health (NIH) symposium for perspectives on cardiothoracic research initiatives, and was subsequently invited to National Heart Lung and Blood Institute as member of the Protocol Review Committee to assess funding priorities for cardiac surgical studies. More recently, he has also become an invited participant in the NIH panel assessing grant proposals investigating therapeutic strategies in traumatic brain injury. Dr. Murkin has also been a panelist on the 2013 American Heart Association Emerging Science Series webcast on pediatric cerebral autoregulation during CPB.

A recipient of multiple Medical Research Council of Canada and Canadian Heart and Stroke Foundation research grants, Dr. Murkin has authored more than 125 peer-reviewed papers, 15 book chapters and 130 scientific abstracts.

Dr. Murkin has also been Guest Editor of the Annals of Thoracic Surgery and is an external reviewer for Circulation, The Journal of Cardiovascular and Thoracic Surgery, Annals of Thoracic Surgery, Anesthesia and Analgesia, The Canadian Journal of Anesthesia, British Journal of Anaesthesia and Acta Anaesthesiologica Scandica among others.

Dr. Murkin's current investigations and interests focus on non-invasive technologies for monitoring neurovascular integrity during surgery and involve not only NIRS-based modalities but are currently encompassing somatosensory evoked potentials as an automated detection system for peripheral nerve injury.

Dr. Murkin won the 2018 Canadian Anesthesiologists’ Society Critical Care Medicine Award, for his paper "Initial Soft Tissue Oxygenation is Inversely Associated With Prolonged ICU Admission".

Publications

  • 2019

  • 2016

  • 2015

  • Previous 

Murkin JM. Monitoring and optimization of the microcirculation during CPB. J Thorac Dis. 2019 Jun;11(Suppl 10):S1489-S1491. doi: 10.21037/jtd.2019.02.100.

Mrkobrada M, Hill MD, Chan MT, Sigamani A, Cowan D, Murkin J, et al. Covert stroke after non-cardiac surgery: a prospective cohort study. Br J Anaesth. 2016 Aug;117(2):191-7

Jones PM, Bainbridge D, Chu MW, Fernandes PS, Fox SA, Iglesias I, Kiaii B, Lavi R, Murkin JM. Comparison of isoflurane and sevoflurane in cardiac surgery: A randomized non-inferiority comparative effectiveness trial. Can J Anesth. 2016 Jul 27. [Epub ahead of print]

Murkin JM, Giraldo M. Alpha-stat, beach chair, cerebral autoregulation… But who is at risk? Can J Anaesth. 2016 May;63(5):513-8.

Anastasiadis K, Murkin J, Antonitsis P, Bauer A, Ranucci M, Gygax E, Schaarschmidt J, Fromes Y, Philipp A, Eberle B, Punjabi P, Argiriadou H, Kadner A, Jenni H, Albrecht G, van Boven W, Liebold A, de Somer F, Hausmann H, Deliopoulos A, El-Essawi A, Mazzei V, Biancari F, Fernandez A, Weerwind P, Puehler T, Serrick C, Waanders F, Gunaydin S, Ohri S, Gummert J, Angelini G, Falk V, Carrel T. Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS). Interact Cardiovasc Thorac Surg. 2016 May;22(5):647-62.

Murkin JM, Kamar M, Silman Z, Balberg M, Adams SJ. Intraoperative cerebral autoregultaion assessment using ultrasound-tagged near-infrared-based cerebral blood flow in comparison to transcranial doppler cerebral flow velocity: A pilot study. J Cardiothorac Vasc Anesth. 2015 Oct;29(5):1187-93. Epub 2015 May 27.

Kim TK, Cho YJ, Min JJ, Murkin JM, Bahk JH, Hong DM, Jeon Y. Microvascular reactivity and clinical outcomes in cardiac surgery. Crit Care. 2015 Sep 4;19(1):316.

Kim TK, Cho YJ, Min JJ, Murkin JM, Bahk JH, Hong DM, Jeon Y. Tissue microcirculation measured by vascular occlusion test during anesthesia induction. J Clin Monit Comput. 2015 Mar 8. [Epub ahead of print]

Weiner MM, Wicker J, Fischer GW, Adams DH, Bronster D, Evans AS, Murkin JM, Grocott HP. Early detection and treatment of an air embolism during cardiac surgery. J Cardiothorac Vasc Anesth. 2015 Feb 4. [Epub ahead of print]

Bainbridge DT, Chu MW, Kiaii B, Cleland A, Murkin J. Percutaneous superior vena cava drainage during minimally invasive mitral valve surgery: a randomized, crossover study. J Cardiothorac Vasc Anesth. 2014 Nov. [Epub ahead of print] 

Kidane B, Chadi SA, Di Labio A, Priestap F, Haddara W, Mele T, Murkin JM. Soft tissue oxygenation and risk of mortality (STORM): an early marker of critical illness? J Crit Care. 2014 Nov 13. [Epub ahead of print]

Smith RS, Murkin JM. A novel assessment of peripheral tissue microcirculatory vasoreactivity using vascular occlusion testing during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2014 Oct;28(5):1217-20.

Min JJ, Nam K, Kim TK, Kim HJ, Seo JH, Hwang HY, Kim KB, Murkin JM, Hong DM, Jeon Y. Relationship between early postoperative C-reactive protein elevation and long-term postoperative major adverse cardiovascular and cerebral events in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study. Br J Anaesth. 2014 May 14. [Epub ahead of print].

Gofton TE, Chu MW, Norton L, Fox SA, Chase L, Murkin JM, Young GB. A prospective observational study of seizures after cardiac surgery using continuous EEG monitoring. Neurocrit Care. 2014 Apr 8. [Epub ahead of print].

Bellingham GA, Smith RS, Morley-Forster P, Murkin JM. Use of near infrared spectroscopy to detect impaired tissue oxygen saturation in patients with complex regional pain syndrome type 1. Can J Anaesth. 2014 Mar 26. [Epub ahead of print].

Acker MA, Parides MK, Perrault LP, Moskowitz AJ, Gelijns AC, Murkin J, et al. Mitral-valve repair versus replacement for severe ischemic mitral regurgitation. N Engl J Med. 2014 Jan 2;370(1):23-32.

Murkin JM. Is it better to shine a light, or rather to curse the darkness? Cerebral near-infraredspectroscopy and cardiac surgery. Eur J Cardiothorac Surg. 2013 Jun;43(6):1081-3.

Taneja R, Liaw PL, Al Ghazaly S, Priestap F, Murkin JM, Martin CM. Effect of cardiopulmonary bypass on thrombin generation and protein C pathway. J Cardiothorac Vasc Anesth. 2013 Feb;27(1):35-40.

Lamy A, Devereauz PJ, Prabhakaran D, Taggart DP, Hu S, Murkin J, et al. Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year. N Eng J Med. 2013 Mar 28;368(13):1179-88.

Murkin JM. "Primum non nocere": the role of hydroxyethyl starch 130/0.4 in cerebral resuscitation. Can J Anaesth. 2012;59(12):1089-94.

Lamy A, et al; CORONARY Investigators. Off-pump or on-pump coronary-artery bypass grafting at 30 days. N Engl J Med. 2012 Apr 19;366(16):1489-97.

Murkin JM, Adams SJ, Pardy E, Quantz M, McKenzie FN, Guo L. Monitoring brain oxygen saturation during coronary bypass surgery improves outcomes in diabetic patients: a post hoc analysis. Heart Surg Forum. 2011 Feb;14(1):E1-6 Murkin JM. (Editorial). Cerebral oximetry: monitoring the brain as the index organ. Anesthesiology. 2011 Jan;114(1):12-3.

Murkin JM, Falter F, Granton J, Young B, Burt C, Chu M. High-dose tranexamic acid is associated with nonischemic clinical seizures in cardiac surgical patients. Anesth Analg. 2010 Feb 1;110(2):350-3. Epub 2009 Dec 8

Murkin JM. Panvascular inflammation and mechanisms of injury in perioperative CNS outcomes. Semin Cardiothorac Vasc Anesth. 2010 Sep;14(3):190-5. Epub 2010 Jul 23. Review.

Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009;103 Suppl 1:i3-13.

Fergusson DA, Hébert PC, Mazer CD, Fremes S, MacAdams C, Murkin JM, et al. BART Investigators. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med. 2008 May 29;358(22):2319-31.

Murkin JM, Adams SJ, Novick RJ, Iglesias I, Bainbridge D, Schaefer B, Irwin B, Fox S. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg 2007;104(1):51-58.

Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth. 2007;11:274-81.

Murkin JM. Cerebral autoregulation: the role of CO2 in metabolic homeostasis. Semin Cardiothorac Vasc Anesth. 2007 Dec;11(4):269-73. Review

Shann KG, Likosky DS, Murkin JM, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: a focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J Thorac Cardiovasc Surg. 2006;132:283-90.

Murkin JM. Pathophysiological basis of CNS injury in cardiac surgical patients: detection and prevention. Perfusion 2006; 21:203-208.

Sellke FW, DiMaio JM, Caplan LR, Ferguson TB, Gardner TJ, Hiratzka LF,Isselbacher EM, Lytle BW, Mack MJ, Murkin JM, Robbins RC. Comparing on-pump and off-pump coronary artery bypass grafting: numerous studies but few conclusions: a scientific statement from the American Heart Association council on cardiovascular surgery and anesthesia in collaboration with the interdisciplinary working group on quality of care and outcomes research. Circulation. 2005;111:2858-64.

Murkin JM. Perioperative detection of brain oxygenation and clinical outcomes in cardiac surgery. Semin Cardiothorac Vasc Anesth 2004;8(1):13-4.

Murkin JM. Hemodynamic changes during cardiac manipulation in off-CPB surgery: televance in brain perfusion. The Heart Surgery Forum, 2002;5(3):221-22.

Murkin JM. Stroke and the elderly: Aortic atheroma and CNS outcomes after cardiac surgery. Cardiovascular Reviews & Reports. 2001;22(7):397-401

Murkin JM. Perioperative neuropsychologic testing. J Cardiothorac Vasc Anesth. 2001 Feb;15(1):1-3.