John Feiner, MD

Professor of Clinical Anesthesia

Biography: 

My research addresses clinical questions by studying human subjects or patients. I collaborate with other faculty in the department on my research and provide expertise in the following areas: data analysis and statistics; mathematical modeling; data acquisition programming; human studies; respiratory physiology.

My research involvement has included multiple different projects:

• Accuracy of pulse oximetry, including determination of methemoglobin, carboxyhemoglobin, and the accuracy of cerebral oximetry.
• Organ transplantation and efforts to improve the quality of cadaveric organs.
• Acute normovolemic hemodilution to study the tolerance of acute anemia, as a way to examine red cell transfusion thresholds. Additionally, we have used this model to study other issues in transfusion, including TRALI.
• The utility of somatosensory and motor evoked potential, which are used in major spine surgery to assess the integrity of spinal cord function.
• The physiology of breathholding and drug-induced apnea.
• High altitude physiology
• Clinical effects of neuromuscular blockade

Publications: 
Bickler P, Feiner J, Rollins M, Meng L. Tissue Oximetry and Clinical Outcomes. Anesth Analg. 2017 Jan; 124(1):72-82.
Bickler PE, Feiner JR, Lipnick MS, Batchelder P, MacLeod DB, Severinghaus JW. Effects of Acute, Profound Hypoxia on Healthy Humans: Implications for Safety of Tests Evaluating Pulse Oximetry or Tissue Oximetry Performance. Anesth Analg. 2016 Aug 12.
Kulcke A, Feiner J, Menn I, Holmer A, Hayoz J, Bickler P. The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin. Anesth Analg. 2016 Jun; 122(6):1856-65.
Whitlock EL, Feiner JR, Chen LL. In Reply. Anesthesiology. 2016 Jun; 124(6):1419.
Lipshutz AK, Feiner JR, Grimes B, Gropper MA. Predicting mortality in the intensive care unit: a comparison of the University Health Consortium expected probability of mortality and the Mortality Prediction Model III. J Intensive Care. 2016; 4:35.
Lipnick MS, Feiner JR, Au P, Bernstein M, Bickler PE. The Accuracy of 6 Inexpensive Pulse Oximeters Not Cleared by the Food and Drug Administration: The Possible Global Public Health Implications. Anesth Analg. 2016 Apr 13.
Whitlock EL, Feiner JR, Chen LL. Perioperative Mortality, 2010 to 2014: A Retrospective Cohort Study Using the National Anesthesia Clinical Outcomes Registry. Anesthesiology. 2015 Dec; 123(6):1312-21.
Olmos A, Feiner J, Hirose R, Swain S, Blasi A, Roberts JP, Niemann CU. Impact of a quality improvement project on deceased organ donor management. Prog Transplant. 2015 Dec; 25(4):351-60.
Niemann CU, Feiner J, Swain S, Bunting S, Friedman M, Crutchfield M, Broglio K, Hirose R, Roberts JP, Malinoski D. Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function. N Engl J Med. 2015 Jul 30; 373(5):405-14.
Abou-Arab MH, Feiner JR, Spigset O, Heier T. Alfentanil during rapid sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg: tracheal intubation conditions. Acta Anaesthesiol Scand. 2015 Nov; 59(10):1278-86.
Feiner JR, Gropper MA, Toy P, Lieberman J, Twiford J, Weiskopf RB. A Clinical Trial to Detect Subclinical Transfusion-induced Lung Injury during Surgery. Anesthesiology. 2015 Jul; 123(1):126-35.
Rollins MD, Feiner JR, Lee JM, Shah S, Larson M. Pupillary effects of high-dose opioid quantified with infrared pupillometry. Anesthesiology. 2014 Nov; 121(5):1037-44.
Lieberman JA, Feiner J, Lyon R, Rollins MD. Effect of hemorrhage and hypotension on transcranial motor-evoked potentials in swine. Anesthesiology. 2013 Nov; 119(5):1109-19.
Bickler PE, Feiner JR, Rollins MD. Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Anesth Analg. 2013 Oct; 117(4):813-23.
Dubowitz G, Breyer K, Lipnick M, Sall JW, Feiner J, Ikeda K, MacLeod DB, Bickler PE. Accuracy of the Lifebox pulse oximeter during hypoxia in healthy volunteers. Anaesthesia. 2013 Dec; 68(12):1220-3.
Lewin MR, Bickler P, Heier T, Feiner J, Montauk L, Mensh B. Reversal of experimental paralysis in a human by intranasal neostigmine aerosol suggests a novel approach to the early treatment of neurotoxic envenomation. Clin Case Rep. 2013 Oct; 1(1):7-15.
Feiner JR, Rollins MD, Sall JW, Eilers H, Au P, Bickler PE. Accuracy of carboxyhemoglobin detection by pulse CO-oximetry during hypoxemia. Anesth Analg. 2013 Oct; 117(4):847-58.
Menda SK, Gregory GA, Feiner JR, Zwass MS, Ferschl MB. The effect of deep and awake tracheal extubation on turnover times and postoperative respiratory complications post adenoid-tonsillectomy. Can J Anaesth. 2012 Dec; 59(12):1158-9.
Stefanutto TB, Feiner J, Krombach J, Brown R, Caldwell JE. Hemoglobin desaturation after propofol/remifentanil-induced apnea: a study of the recovery of spontaneous ventilation in healthy volunteers. Anesth Analg. 2012 May; 114(5):980-6.
Weiskopf RB, Feiner J, Toy P, Twiford J, Shimabukuro D, Lieberman J, Looney MR, Lowell CA, Gropper MA. Fresh and stored red blood cell transfusion equivalently induce subclinical pulmonary gas exchange deficit in normal humans. Anesth Analg. 2012 Mar; 114(3):511-9.
Heier T, Feiner JR, Wright PM, Ward T, Caldwell JE. Sex-related differences in the relationship between acceleromyographic adductor pollicis train-of-four ratio and clinical manifestations of residual neuromuscular block: a study in healthy volunteers during near steady-state infusion of mivacurium. Br J Anaesth. 2012 Mar; 108(3):444-51.
Feiner JR, Finlay-Morreale HE, Toy P, Lieberman JA, Viele MK, Hopf HW, Weiskopf RB. High oxygen partial pressure decreases anemia-induced heart rate increase equivalent to transfusion. Anesthesiology. 2011 Sep; 115(3):492-8.
Liu S, Shah SJ, Wilmes LJ, Feiner J, Kodibagkar VD, Wendland MF, Mason RP, Hylton N, Hopf HW, Rollins MD. Quantitative tissue oxygen measurement in multiple organs using 19F MRI in a rat model. Magn Reson Med. 2011 Dec; 66(6):1722-30.
Martinez-Palli G, Hirose R, Liu T, Xu F, Dang K, Feiner J, Serkova NJ, Niemann CU. Donor pre-treatment with everolimus or cyclosporine does not reduce ischaemia-reperfusion injury in a rat kidney transplant model. Nephrol Dial Transplant. 2011 Jun; 26(6):1813-20.
Heier T, Caldwell JE, Feiner JR, Liu L, Ward T, Wright PM. Relationship between normalized adductor pollicis train-of-four ratio and manifestations of residual neuromuscular block: a study using acceleromyography during near steady-state concentrations of mivacurium. Anesthesiology. 2010 Oct; 113(4):825-32.
Feiner JR, Bickler PE. Improved accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia. Anesth Analg. 2010 Nov; 111(5):1160-7.
Vagefi PA, Klein I, Gelb B, Hameed B, Moff SL, Simko JP, Fix OK, Eilers H, Feiner JR, Ascher NL, Freise CE, Bass NM. Emergent orthotopic liver transplantation for hemorrhage from a giant cavernous hepatic hemangioma: case report and review. J Gastrointest Surg. 2011 Jan; 15(1):209-14.
Niemann CU, Feiner J. Quality improvement in transplant anesthesia: which way forward? Curr Opin Organ Transplant. 2010 Jun; 15(3):374-6.
Feiner JR, Bickler PE, Mannheimer PD. Accuracy of methemoglobin detection by pulse CO-oximetry during hypoxia. Anesth Analg. 2010 Jul; 111(1):143-8.
Niemann CU, Walia A, Waldman J, Davio M, Roberts JP, Hirose R, Feiner J. Acute kidney injury during liver transplantation as determined by neutrophil gelatinase-associated lipocalin. Liver Transpl. 2009 Dec; 15(12):1852-60.
Lyon R, Lieberman JA, Feiner J, Burch S. Relative efficacy of transcranial motor evoked potentials, mechanically-elicited electromyography, and evoked EMG to assess nerve root function during sustained retraction in a porcine model. Spine (Phila Pa 1976). 2009 Jul 15; 34(16):E558-64.
Blasi-Ibanez A, Hirose R, Feiner J, Freise C, Stock PG, Roberts JP, Niemann CU. Predictors associated with terminal renal function in deceased organ donors in the intensive care unit. Anesthesiology. 2009 Feb; 110(2):333-41.
Weiskopf RB, Feiner J, Toy P. Red blood cell age and function. Transfusion. 2008 Sep; 48(9):2026.
Lieberman JA, Lyon R, Feiner J, Hu SS, Berven SH. The efficacy of motor evoked potentials in fixed sagittal imbalance deformity correction surgery. Spine (Phila Pa 1976). 2008 Jun 1; 33(13):E414-24.
Feiner JR, Severinghaus JW, Bickler PE. Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender. Anesth Analg. 2007 Dec; 105(6 Suppl):S18-23, tables of contents.
Weiskopf RB, Feiner J, Lieberman J, Hu SS. Visual loss after spinal surgery. Anesthesiology. 2007 Jun; 106(6):1250-1; author reply 1251-2.
Niemann CU, Feiner J, Behrends M, Eilers H, Ascher NL, Roberts JP. Central venous pressure monitoring during living right donor hepatectomy. Liver Transpl. 2007 Feb; 13(2):266-71.
Lieberman JA, Lyon R, Feiner J, Diab M, Gregory GA. The effect of age on motor evoked potentials in children under propofol/isoflurane anesthesia. Anesth Analg. 2006 Aug; 103(2):316-21, table of contents.
Weiskopf RB, Feiner J, Hopf H, Lieberman J, Finlay HE, Quah C, Kramer JH, Bostrom A, Toy P. Fresh blood and aged stored blood are equally efficacious in immediately reversing anemia-induced brain oxygenation deficits in humans. Anesthesiology. 2006 May; 104(5):911-20.
Finlay HE, Cassorla L, Feiner J, Toy P. Designing and testing a computer-based screening system for transfusion-related acute lung injury. Am J Clin Pathol. 2005 Oct; 124(4):601-9.
Bickler PE, Feiner JR, Severinghaus JW. Effects of skin pigmentation on pulse oximeter accuracy at low saturation. Anesthesiology. 2005 Apr; 102(4):715-9.
Weiskopf RB, Toy P, Hopf HW, Feiner J, Finlay HE, Takahashi M, Bostrom A, Songster C, Aminoff MJ. Acute isovolemic anemia impairs central processing as determined by P300 latency. Clin Neurophysiol. 2005 May; 116(5):1028-32.
Feiner JR, Bickler PE, Estrada S, Donohoe PH, Fahlman CS, Schuyler JA. Mild hypothermia, but not propofol, is neuroprotective in organotypic hippocampal cultures. Anesth Analg. 2005 Jan; 100(1):215-25.
Lyon R, Feiner J, Lieberman JA. Progressive suppression of motor evoked potentials during general anesthesia: the phenomenon of "anesthetic fade". J Neurosurg Anesthesiol. 2005 Jan; 17(1):13-9.
Pauli-Magnus C, Feiner J, Brett C, Lin E, Kroetz DL. No effect of MDR1 C3435T variant on loperamide disposition and central nervous system effects. Clin Pharmacol Ther. 2003 Nov; 74(5):487-98.
Weiskopf RB, Aminoff MJ, Hopf HW, Feiner J, Viele MK, Watson JJ, Ho R, Songster C, Toy P. Acute isovolemic anemia does not impair peripheral or central nerve conduction. Anesthesiology. 2003 Sep; 99(3):546-51.
Weiskopf RB, Feiner J, Hopf H, Viele MK, Watson JJ, Lieberman J, Kelley S, Toy P. Heart rate increases linearly in response to acute isovolemic anemia. Transfusion. 2003 Feb; 43(2):235-40.
Weiskopf RB, Feiner J, Hopf HW, Viele MK, Watson JJ, Kramer JH, Ho R, Toy P. Oxygen reverses deficits of cognitive function and memory and increased heart rate induced by acute severe isovolemic anemia. Anesthesiology. 2002 Apr; 96(4):871-7.
Feiner JR, Miller RD, Hickey RF. Productivity versus availability as a measure of faculty clinical responsibility. Anesth Analg. 2001 Aug; 93(2):313-8, 2nd contents page.
Heier T, Feiner JR, Lin J, Brown R, Caldwell JE. Hemoglobin desaturation after succinylcholine-induced apnea: a study of the recovery of spontaneous ventilation in healthy volunteers. Anesthesiology. 2001 May; 94(5):754-9.
Hashimoto K, Hampl KF, Nakamura Y, Bollen AW, Feiner J, Drasner K. Epinephrine increases the neurotoxic potential of intrathecally administered lidocaine in the rat. Anesthesiology. 2001 May; 94(5):876-81.
Hopf HW, Viele M, Watson JJ, Feiner J, Weiskopf R, Hunt TK, Noorani M, Yeap H, Ho R, Toy P. Subcutaneous perfusion and oxygen during acute severe isovolemic hemodilution in healthy volunteers. Arch Surg. 2000 Dec; 135(12):1443-9.
Leung JM, Weiskopf RB, Feiner J, Hopf HW, Kelley S, Viele M, Lieberman J, Watson J, Noorani M, Pastor D, Yeap H, Ho R, Toy P. Electrocardiographic ST-segment changes during acute, severe isovolemic hemodilution in humans. Anesthesiology. 2000 Oct; 93(4):1004-10.
Weiskopf RB, Kramer JH, Viele M, Neumann M, Feiner JR, Watson JJ, Hopf HW, Toy P. Acute severe isovolemic anemia impairs cognitive function and memory in humans. Anesthesiology. 2000 Jun; 92(6):1646-52.
Toy P, Feiner J, Viele MK, Watson J, Yeap H, Weiskopf RB. Fatigue during acute isovolemic anemiain healthy, resting humans. Transfusion. 2000 Apr; 40(4):457-60.
Lieberman JA, Weiskopf RB, Kelley SD, Feiner J, Noorani M, Leung J, Toy P, Viele M. Critical oxygen delivery in conscious humans is less than 7.3 ml O2 x kg(-1) x min(-1). Anesthesiology. 2000 Feb; 92(2):407-13.
Gregory GA, Feiner J, Severinghaus JW. Tidal volume, PaCO2, and lung injury. Crit Care Med. 1998 Oct; 26(10):1632-3.
Weiskopf RB, Viele MK, Feiner J, Kelley S, Lieberman J, Noorani M, Leung JM, Fisher DM, Murray WR, Toy P, Moore MA. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA. 1998 Jan 21; 279(3):217-21.
Gray AT, Buck LT, Feiner JR, Bickler PE. Interactive effects of pH and temperature on N-methyl-D-aspartate receptor activity in rat cortical brain slices. J Neurosurg Anesthesiol. 1997 Apr; 9(2):180-7.
Eldridge MW, Podolsky A, Richardson RS, Johnson DH, Knight DR, Johnson EC, Hopkins SR, Michimata H, Grassi B, Feiner J, Kurdak SS, Bickler PE, Wagner PD, Severinghaus JW. Pulmonary hemodynamic response to exercise in subjects with prior high-altitude pulmonary edema. J Appl Physiol (1985). 1996 Aug; 81(2):911-21.
Podolsky A, Eldridge MW, Richardson RS, Knight DR, Johnson EC, Hopkins SR, Johnson DH, Michimata H, Grassi B, Feiner J, Kurdak SS, Bickler PE, Severinghaus JW, Wagner PD. Exercise-induced VA/Q inequality in subjects with prior high-altitude pulmonary edema. J Appl Physiol (1985). 1996 Aug; 81(2):922-32.
Bickler PE, Buck LT, Feiner JR. Volatile and intravenous anesthetics decrease glutamate release from cortical brain slices during anoxia. Anesthesiology. 1995 Dec; 83(6):1233-40.
Feiner JR, Bickler PE, Severinghaus JW. Hypoxic ventilatory response predicts the extent of maximal breath-holds in man. Respir Physiol. 1995 Jun; 100(3):213-22.
Unger RJ, Feiner JR. Hemodynamic effects of intermittent pneumatic compression of the legs. Anesthesiology. 1987 Aug; 67(2):266-8.