• Whyte, Simon

    Titles

    Investigator, BC Children's Hospital Paediatric Anaesthesiologist, Department of Anaesthesia, BC Children's Hospital
    Clinical Associate Professor, Department of Anesthesia, University of British Columbia
    Chair, Canadian Pediatric Anesthesia Society

    Degrees / Designations

    MBBS, FRCA, FRCPC

    Primary Area of Research
    Evidence to Innovation
    Secondary Area(s) of Research
    Phone
    604-875-2711
    Fax
    604-875-3221
    Lab Phone
    Mailing Address

    Clinical Support Building
    Room V3-355
    948 West 28th Ave.
    Vancouver, BC V6H 3N1

    Affiliate Websites
    Research Areas
    • Paediatric perioperative pharmacology
    • Pharmacokinetic-pharmacodynamic infusion modelling
    • Myocardial repolarization dynamics
    • Quality improvement in perioperative thermoregulation
    • Patient safety
    Summary
    I am involved in diverse studies that include defining clinically relevant pharmacodynamic endpoints for drugs used in paediatric anaesthetic and perioperative care, and providing feedback on aspects of quality of intraoperative care, with the common goal of improving patients' experiences & safety.

    Examples of such studies include: examining the effects of anaesthetic drugs on myocardial repolarization, with the aim of producing evidence-based advice on the safety of these agents in children with, or at risk of, long QT syndromes; analyzing intraoperative Code Blue data to help focus preventative strategies; correlating perioperative thermoregulation management with surgical outcomes in scoliosis correction surgery and in the National Surgical Quality Improvement Programme – Pediatrics (NSQIP-P).
    Current Projects

    Dexmedetomidine & Myocardial Repolarization Dynamics
    This randomised, double-blinded clinical trial will investigate the effect of three clinically relevant doses of dexmedetomidine on the dispersion of myocardial repolarization. Increases in dispersion of repolarization are pro-arrhythmogenic and facilitate torsades de pointes in patients with or at risk of long QT syndromes. As many of these patients are undiagnosed, and as the peri-operative period represents a time of increased risk for them, identifying anaesthetic agents that do not further increase this risk is an important undertaking.

    Anonymised Individual Feedback of Thermoregulation Parameters in Scoliosis Correction Surgery
    Maintaining normothermia in children undergoing anaesthesia is challenging; it is also widely regarded as a useful metric of quality of one aspect of anaesthesia care. As part of a continuous quality improvement program, the anaesthesia spine team receives & reviews regular, detailed analysis of intraoperative thermoregulation management. This has resulted in reduced variations in practice and an overall improvement in the standard of care delivered in this domain.

    The Effects of Prewarming on Perioperative Outcomes in Scoliosis Correction Surgery
    As part of a continuous quality improvement program, we investigated the effect of prewarming on surgical outcomes in children undergoing scoliosis correction surgery. Prewarming is associate with a reduction in intraoperative blood transfusion, and may contribute to reductions in surgical site infection and length of stay; studying these associations is generating hypotheses for prospective trials.

    Anesthesia-Related Variables and NSQIP-P
    NSQIP-P provides risk-adjusted benchmarking for surgical outcomes across North American pediatric surgical centres. The model adjusts for over 100 variables, but notably absent are disruptions in intraoperative physiological homeostasis. We collect this data locally & correlate it with local complication rates. This in turn provides data to feed back to clinicians to focus and drive quality improvement efforts in perioperative care.
    Selected Publications
    Long QT Syndromes; Anaesthesia and Myocardial Repolarisation:

    Matthias Görges, Simon D Whyte, Shubhayan Sanatani, Joy Dawes, Carolyne J Montgomery & J Mark Ansermino. The effect of a rapid bolus dose of dexmedetomidine on corrected QT interval. Pediatr Anesth 2015; 25: 1287-93. PMID: 26507917

    Simon D Whyte, Aruna Nathan, Dorothy Myers, Scott C Watkins, Prince J Kannankeril, Susan P Etheridge, Jason Andrade, Kathryn K Collins, Ian H Law, Jason Hayes & Shubhayan Sanatani. The safety of modern anesthesia for children with Long QT Syndrome. Anesth Analg 2014; 119(4): 932-8. PMID: 25076102

    Mehta DM, Sanatani S, Whyte SD. The effects of droperidol and ondansetron on dispersion of myocardial repolarisation in children. Pediatr Anesth 2010; 20: 905-12. PMID: 20849495

    Whyte SD, Sanatani S, Lim J, Booker, PD. A comparison of the effect on dispersion of repolarisation of age-adjusted MAC values of sevoflurane in children. Anesth Analg 2007; 104: 277-82. PMID: 17242080

    Whyte SD, Booker PD, Buckley DG. The effects of propofol and sevoflurane on the QT interval and transmural dispersion of repolarization in children. Anesth Analg 2005;100:71-7. PMID: 15616054

    Booker PD, Whyte SD, Ladusans EJ. Anaesthesia and the long QT syndrome (review article). Br J Anaesth 2003; 90(3):349-66. PMID: 15616054

    Thermoregulation, Quality of Care, NSQIP:

    Matthias Görges, Nicholas C West, Wesley Cheung, Guohai Zhou, Firoz Miyanji & Simon D Whyte. The effect of preoperative warming on undesired surgical and anesthesia outcomes in pediatric spine surgery – a retrospective cohort study. Pediatr Anesth 2015 (in review).

    Erik D. Skarsgard, Julie Bedford Tamara Chan, Simon Whyte, Kourosh Afshar. ACS national surgical quality improvement program: Targeting quality improvement in Canadian pediatric surgery. J Pediatr Surgery 2014; 49(5): 682-7. PMID: 24851748

    Görges M, Ansermino JM, Whyte SD. A retrospective audit to examine the effectiveness of preoperative warming on hypothermia in spine deformity surgery patients. Pediatr Anesth 2013; 23: 1054-61. PMID: 23738627

    Grants

     

    • 2016-2017 Evidence to Innovation Seed Grant:   “BCCH Pediatric Anesthesia Difficult Airway Database: A Quality Improvement Initiative to Improve Safety in Patients with Difficult Airways”

     

    Honours & Awards

    Child & Family Research Institute Pharmaceutical Outcomes and Policy Innovations - Project: "5-HT3 Antagonists and Cardiac Safety," $42,667. 2014/15.

    Child & Family Research Institute Innovations in Acute Care & Technology Trainee Clinical Investigator Seed Grant - Project: "The effect of preoperative warming on surgical complications in pediatric scoliosis repair," $5,000. 2013.

    Child & Family Research Institute Innovations in Acute Care & Technology Cluster Award - Project: "Evaluating quality improvement in the anesthesia assessment clinic," $5,000. 2012.

    Rare Diseases Foundation Microgrant Award - Project: "Anaesthesia in children with long QT syndromes – a multicentre retrospective case series," $3,500. 2011.

    British Columbia’s Children’s Hospital Foundation Telethon Award - Project: "A pilot study to investigate plasma bupivacaine concentrations in children receiving total intra-venous anaesthesia and caudal analgesia," $15,000. 2010/11.

    Child & Family Research Institute Innovations in Acute Care & Technology Cluster Award - Project: "A pilot study to investigate plasma bupivacaine concentrations in children receiving total intravenous anaesthesia and caudal analgesia," $8,000. 2010.

    British Columbia’s Children’s Hospital Foundation Telethon Award - Project: "Evaluation of the intubating laryngeal airway in children (Phase II)," $15,000. 2009/10.

    Canadian Anesthesiologists Society Baxter Corporation Canadian Research Award in Anesthesia - Project: "Evaluation of the intubating laryngeal airway in children (Phase I)," $20,000. 2009.

    Research Group Members