Marc Steurer, MD, MHA

HS Clinical Professor and Associate Chair of Finance
Biography: 

Overview:
SFGH, as the only level 1 trauma hospital for San Francisco, is where the most severely injured trauma patients are treated. As the Director for Trauma Anesthesiology, I am engaged on multiple fronts to improve the individual treatment, systems-based care and the science of acute trauma care. I embrace the critical role of blood product and coagulation management and I have been introducing best practices and new techniques for this at a local and national level. Recognizing that this is a complex endeavor requiring multiple disciplines to work in synergy, I have taken on leadership, investigative and educational roles to fulfill my vision of delivering state of the art, multidisciplinary care to the severely injured patient.

Studies:
PROPPR -Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR)is a Phase III trial designed to evaluate the difference in 24-hour and 30-day mortality among subjects predicted to receive massive transfusion ([MT] (defined as receiving 10 units or more RBCs within the first 24 hours). The goal of PROPPR is to improve the basis on which clinicians make decisions about transfusion protocols for massively bleeding patients.

PROPPR is a Resuscitation Outcomes Consortium (ROC) Protocol. ROC is funded by the National Heart, Lung, and Blood Institute (NHLBI), the United States' Department of Defense (DoD) and the Defence Research and Development Canada. PROPPR will be conducted as a Phase III trial at Level I Adult Trauma Centers in North America.

Publications: 
Erben HC, Hess F, Welter J, Graf N, Steurer MP, Neff TA, Zettl R, Dullenkopf A. Perioperative blood transfusions in hip and knee arthroplasty: a retrospective assessment of combined risk factors. Arch Orthop Trauma Surg. 2022 Aug; 142(8):1817-1822.
Dullenkopf A, Horn K, Steurer MP, Hess F, Welter J. Placement of TOF-Cuff® on the lower leg for neuromuscular and blood pressure monitoring during anesthetic induction for shoulder surgeries. J Anesth. 2020 02; 34(1):79-85.
Hegland N, Schnitzler S, Ellensohn J, Steurer MP, Weiss M, Dullenkopf A. Dimensional Variations of Left-Sided Double-Lumen Endobronchial Tubes. Anesthesiol Res Pract. 2019; 2019:3634202.
Mohler T, Welter J, Steurer M, Neumann L, Zueger M, Kraemer T, Dullenkopf A. Measuring the accuracy of propofol target-controlled infusion (TCI) before and after surgery with major blood loss. J Clin Monit Comput. 2020 Feb; 34(1):97-103.
Blaine KP, Steurer MP. Viscoelastic Monitoring to Guide the Correction of Perioperative Coagulopathy and Massive Transfusion in Patients with Life-Threatening Hemorrhage. Anesthesiol Clin. 2019 Mar; 37(1):51-66.
Jones AR, Patel RP, Marques MB, Donnelly JP, Griffin RL, Pittet JF, Kerby JD, Stephens SW, DeSantis SM, Hess JR, Wang HE, PROPPR Study Group. Older Blood Is Associated With Increased Mortality and Adverse Events in Massively Transfused Trauma Patients: Secondary Analysis of the PROPPR Trial. Ann Emerg Med. 2019 06; 73(6):650-661.
Wei S, Gonzalez Rodriguez E, Chang R, Holcomb JB, Kao LS, Wade CE, PROPPR Study Group. Elevated Syndecan-1 after Trauma and Risk of Sepsis: A Secondary Analysis of Patients from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. J Am Coll Surg. 2018 12; 227(6):587-595.
Aeppli N, Lindauer B, Steurer MP, Weiss M, Dullenkopf A. Endotracheal tube cuff pressure changes during manual cuff pressure control manoeuvres: An in-vitro assessment. Acta Anaesthesiol Scand. 2019 01; 63(1):55-60.
Marc P. Steurer, Michael T. Ganter. Coagulation Monitoring of the Bleeding Trauma Patient. Essentials of Trauma Anesthesia. 2017 Nov 9; 154-163.
Bruderer U, Fisler A, Steurer MP, Steurer M, Dullenkopf A. Post-discharge nausea and vomiting after total intravenous anaesthesia and standardised PONV prophylaxis for ambulatory surgery. Acta Anaesthesiol Scand. 2017 Aug; 61(7):758-766.
McCully BH, Connelly CR, Fair KA, Holcomb JB, Fox EE, Wade CE, Bulger EM, Schreiber MA, PROPPR Study Group. Onset of Coagulation Function Recovery Is Delayed in Severely Injured Trauma Patients with Venous Thromboembolism. J Am Coll Surg. 2017 Jul; 225(1):42-51.
Wieser T, Steurer MP, Steurer M, Dullenkopf A. Factors influencing the level of patients using the internet to gather information before anaesthesia: a single-centre survey of 815 patients in Switzerland : The internet for patient information before anaesthesia. BMC Anesthesiol. 2017 03 08; 17(1):39.
Steiner C, Steurer MP, Mueller D, Zueger M, Dullenkopf A. Midazolam plasma concentration after anesthesia premedication in clinical routine - an observational study : Midazolam plasma concentration after anesthesia premedication. BMC Anesthesiol. 2016 10 24; 16(1):105.
Undurraga Perl VJ, Leroux B, Cook MR, Watson J, Fair K, Martin DT, Kerby JD, Williams C, Inaba K, Wade CE, Cotton BA, Del Junco DJ, Fox EE, Scalea TM, Tilley BC, Holcomb JB, Schreiber MA, PROPPR Study Group. Damage-control resuscitation and emergency laparotomy: Findings from the PROPPR study. J Trauma Acute Care Surg. 2016 Apr; 80(4):568-74; discussion 574-5.
Catherine Heim, Marc P. Steurer, Karim Brohi. Damage Control Resuscitation: More Than Just Transfusion Strategies. Current Anesthesiology Reports. 2016 Mar 1; 6(1):72-78.
Winter A, Steurer MP, Dullenkopf A. Postoperative delirium assessed by post anesthesia care unit staff utilizing the Nursing Delirium Screening Scale: a prospective observational study of 1000 patients in a single Swiss institution. BMC Anesthesiol. 2015 Dec 18; 15:184.
Novak DJ, Bai Y, Cooke RK, Marques MB, Fontaine MJ, Gottschall JL, Carey PM, Scanlan RM, Fiebig EW, Shulman IA, Nelson JM, Flax S, Duncan V, Daniel-Johnson JA, Callum JL, Holcomb JB, Fox EE, Baraniuk S, Tilley BC, Schreiber MA, Inaba K, Rizoli S, Podbielski JM, Cotton BA, Hess JR, PROPPR Study Group. Making thawed universal donor plasma available rapidly for massively bleeding trauma patients: experience from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial. Transfusion. 2015 Jun; 55(6):1331-9.
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G, PROPPR Study Group. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015 Feb 03; 313(5):471-82.
Lindauer B, Steurer MP, Müller MK, Dullenkopf A. Anesthetic management of patients undergoing bariatric surgery: two year experience in a single institution in Switzerland. BMC Anesthesiol. 2014; 14:125.
Marc P. Steurer, Michael T. Ganter. Trauma and Massive Blood Transfusions. Current Anesthesiology Reports. 2014 Sep 1; 4(3):200-208.
Baraniuk S, Tilley BC, del Junco DJ, Fox EE, van Belle G, Wade CE, Podbielski JM, Beeler AM, Hess JR, Bulger EM, Schreiber MA, Inaba K, Fabian TC, Kerby JD, Cohen MJ, Miller CN, Rizoli S, Scalea TM, O'Keeffe T, Brasel KJ, Cotton BA, Muskat P, Holcomb JB, PROPPR Study Group. Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial: design, rationale and implementation. Injury. 2014 Sep; 45(9):1287-95.
Steurer MP, Steurer MA, Baulig W, Piegeler T, Schläpfer M, Spahn DR, Falk V, Dreessen P, Theusinger OM, Schmid ER, Schwartz D, Neff TA, Beck-Schimmer B. Late pharmacologic conditioning with volatile anesthetics after cardiac surgery. Crit Care. 2012 Oct 14; 16(5):R191.
De Conno E, Steurer MP, Wittlinger M, Zalunardo MP, Weder W, Schneiter D, Schimmer RC, Klaghofer R, Neff TA, Schmid ER, Spahn DR, Z'graggen BR, Urner M, Beck-Schimmer B. Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 2009 Jun; 110(6):1316-26.
Steurer M, Schläpfer M, Steurer M, Z'graggen BR, Booy C, Reyes L, Spahn DR, Beck-Schimmer B. The volatile anaesthetic sevoflurane attenuates lipopolysaccharide-induced injury in alveolar macrophages. Clin Exp Immunol. 2009 Feb; 155(2):224-30.
Yue T, Roth Z'graggen B, Blumenthal S, Neff SB, Reyes L, Booy C, Steurer M, Spahn DR, Neff TA, Schmid ER, Beck-Schimmer B. Postconditioning with a volatile anaesthetic in alveolar epithelial cells in vitro. Eur Respir J. 2008 Jan; 31(1):118-25.
Beer GM, Burg D, Zehnder A, Seifert B, Steurer M, Grimaldi H, Meyer VE. Functional, electrophysiologic, and morphometric evaluation of nerve regeneration from coaptation on regenerated nerve fibers: experimental study in rabbits. J Reconstr Microsurg. 2004 Feb; 20(2):159-66.
Honors and Awards: 
President, Trauma Anesthesiology Society, 2013-2016