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School of Medicine
The Johns Hopkins University
Attending Physician and Chair
Department of Anesthesiology/Critical Care Medicine
The Johns Hopkins Bayview Medical Center
4940 Eastern Avenue, Room A5W-588
Baltimore, MD 21224
The research of Dr. Frederick "Fritz" Sieber focuses on prevention of postoperative delirium in geriatric patients. Through a multidisciplinary clinical research team, he studies elderly surgical patients, especially those undergoing orthopedic and pelvic procedures. Several trials are ongoing. In an NIH-funded clinical trial for which Dr. Sieber is principle investigator, his research team is investigating the effect of sedation depth (as measured by processed electroencephalography and a clinical sedation score) during spinal anesthesia and the effect of using propofol for sedation on the incidence of postoperative delirium, cognitive dysfunction, and mortality in elderly patients undergoing hip fracture repair. This trial addresses the question of whether anesthetic dose and depth are possible risk factors of postoperative delirium in the elderly. In addition, Dr. Sieber is working closely with Dr. Esther Oh in the Department of Geriatrics to determine whether blood and cerebrospinal fluid samples obtained during this trial might provide useful biomarkers for early detection of patients at risk for cognitive problems after surgery. In another trial that uses near-infrared spectroscopy to analyze cerebrovascular autoregulation, Dr. Sieber and his team are examining the effects of surgical positioning and the use of robotics on cerebrovascular physiology. The information provided by this study will provide information about the effects of the robot and surgical positioning on cerebral blood flow. Dr. Sieber has an active clinical practice and will see patients before and after surgery in consultation regarding perioperative cognitive dysfunction.
- Society for Advancement of Geriatric Anesthesia
- American Society of Anesthesiologists
- Association of University Anesthesiologists
- De Jonge KE, Christmas C, Andersen R, Franckowiak SC, Mears SC, Levy P, Wenz JF, Sieber F. Hip Fracture Service: an interdisciplinary model of care. J Am Geriatr Soc 49(12):1737-8, 2001.
- Zakriya KJ, Christmas C, Wenz JF Sr, Franckowiak S, Andersen RA, Sieber FE. Preoperative factors associated with postoperative change in confusion assessment method score in hip fracture patients. Anesth Analg 94:1628-32, 2002.
- Zakriya K, Sieber FE, Christmas C, Wenz JF Sr., Franckowiak S. Brief postoperative delirium in hip fracture patients affects functional outcome at three months. Anesth Analg 98:1798-802, 2004.
- Viscusi ER, Martin G, Hartrick CT, Singla N, Manvelian G, the EREM Study Group. forty-eight hours of postoperative pain relief after total hip arthroplasty with a novel, extended-release epidural morphine formulation. Anesthesiology 102:1014-22, 2005.
- Sharma PT, Sieber FE, Zakriya KJ, Pauldine RW, Gerold KB, Hang J, Smith TH. Recovery room delirium predicts postoperative delirium after hip fracture repair. Anesth Analg 101:1215-20, 2005.
- Lee HB, DeLoatch CJ, Cho S, Rosenberg P, Mears SC, Sieber FE. Detection and management of pre-existing cognitive impairment and associated behavioral symptoms in the critical care unit. Crit Care Clin 24(4):723-36, 2008.
- Pauldine R, Sieber FE. Considerations for intensive care of the geriatric patient. Contemp Crit Care 6(8):1-12, 2009.
- Sieber FE, Zakriya KJ, Gottschalk A, Blute MR, Lee HB, Rosenberg PB, Mears SC. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc 85(1):18-26, 2010. Paper has accompanying editorial.
- Sieber FE, Gottschalk A, Zakriya KJ, Mears SC, Lee H. General anesthesia occurs frequently in elderly patients during propofol-based sedation and spinal anesthesia. J Clin Anesth 22:179-83, 2010.
- Neufeld KJ, Leoutsakos JMS, Sieber FE, Joshi D, Wanamaker BL, Rios-Robles J, MD, and Needham DM. Evaluation of two delirium screening tools for detecting post-operative delirium in the elderly. Br J Anaesth 2013;111:612-8.
- Neufeld KJ, Leoutsakos JMS, Sieber FE, Wanamaker BL, Gibson Chambers JJ, Rao V, Schretlen DJ, Needham DM. Outcomes of early delirium diagnosis after general anesthesia in the elderly. Anesth Analg 2013 117:471-8.
- Strike SA, Sieber FE, Gottschalk A, Mears SC. Role of fracture and repair type on pain and opioid use after hip fracture in the elderly. Geriatr Orthop Surg Rehabil 2013;4:103-8.
- Strom C, Rasmussen LS, Sieber FE. Should general anaesthesia be avoided in the elderly? Anaesthesia 2013;69 Suppl 1:35-44.
- Ouanes JP, Tomas VG, Sieber F. Special anesthetic consideration for the patient with a fragility fracture. Clin Geriatr Med 2014;30(2):243-59.
- Brown CH 4th, Azman AS, Gottschalk A, Mears SC, Sieber FE. Sedation depth during spinal anesthesia and survival in elderly patients undergoing hip fracture repair. Anesth Analg 2014;118(5):977-80.
- Hori D, Brown C, Ono M, Rappold T, Sieber F, Gottschalk A, Neufeld KJ, Gottesman R, Adachi H, Hogue CW. Arterial pressure above the upper cerebral autoregulation limit during cardiopulmonary bypass is associated with postoperative delirium. Br J Anaesth. 2014;113(6):1009-17.
- Oh ES, Li M, Fafowora TM, Inouye SK, Chen CH, Rosman LM, Lyketsos CG, Sieber FE, Puhan MA. Preoperative risk factors for postoperative delirium following hip fracture repair: A systematic review. Int J Geriatr Psychiatry. 2014 Dec 11. doi: 10.1002/gps.4233. [Epub ahead of print].
- Gottschalk A, Hubbs J, Vikani AR, Gottschalk LB, Sieber FE. the impact of incident postoperative delirium on survival of elderly patients after surgery for hip fracture repair. Anesth Analg. 2015 Jan 14. [Epub ahead of print]
- Carson JL, Sieber F, Cook DR, Hoover DR, Noveck H, Chaitman BR, Fleisher L, Beaupre L, Macaulay W, Rhoads GG, Paris B, Zagorin A, Sanders DW, Zakriya KJ, Magaziner J. Liberal versus restrictive blood transfusion strategy: 3-year survival and cause of death results from the FOCUS randomised controlled trial. Lancet. 2014 Dec 9. doi: 10.1016/S0140-6736(14)62286-8. [Epub ahead of print]
Laboratory Members/Key Associates
Clinical Research Coordinator
Esther Oh, MD
Karin Neufeld, MD
Nae-Yuh Wang, PhD
George Bigelow, PhD