Ravi Mahajan

Contact

• workRoom University Division of anaesthesia and Intensive Care Queen's Medical Centre
• work0115 8231009
• ravi.mahajan@nottingham.ac.uk

Research Summary

Interests

• Vascular reactivity.
• Development of models for assessment.
• Mechanisms, applications and strategies to influence clinical outcome in sepsis.
• Muscle dysfunction in critical care

Techniques

• Determination of vascular reactivity in vivo and ex vivo using a variety of approaches.
• Noninvasive assessment of cerebral vascular reactivity (transcranial Doppler).
• Assessment of skin vascular reactivity (Laser Doppler).

Projects

• Vascular reactivity and clinical outcome in ICU (funded by Association of Anaesthetists of Great Britain and Ireland).
• Role of various therapeutic interventions (vasopressin, steroids) in restoring vascular reactivity during sepsis (funded by Anaesthetic Research Society, UK and European Society of Anaesthesiology).
• Gene mechanisms determining myopathy in critical care (funded by European Society of Anaesthesiology)

Centre Collaborators

• Prof. Terence Bennett
• Prof. Sheila Gardiner
• Prof. Paul Greenhaff
• Dr. Vincent Wilson

Local Collaborators

• Dr K Girling (NHS, critical care)
• Dr J Hardman (Senior Lecturer, Anaesthesia)
• Prof A Perkins (Medical Physics)
• Mr D Clay (NHS, Medical Physics)
• Dr W Kinnear (NHS, Respiratory Medicine)
• Mr J Duffy (NHS, Thoracic Surgery)

UK Collaborators

• Professor PM Hopkins (Leeds)
• Professor CS Reilly (Sheffield)
• Dr Zoe Brookes (Sheffield)

International Collaborators

• Professor P Bithal (AIIMS India)

Recent Publications

• MAHAJAN RP and REILLY CS, 2012. Setting Research Priorities In Anaesthesia. British Journal Of Anaesthesia. 108(1), 1-3
• CONSTANTIN D, MCCULLOUGH J, MAHAJAN RP and GREENHAFF PL, 2011. Novel Events In The Molecular Regulation Of Muscle Mass In Critically Ill Patients. The Journal Of Physiology. 589(Pt 15), 3883-95
• MAHAJAN RP, 2011. Medication Errors: Can We Prevent Them? British Journal Of Anaesthesia. 107(1), 3-5
• MAHAJAN RP, 2011. The Who Surgical Checklist. Best Practice & Research. Clinical Anaesthesiology. 25(2), 161-8

• View all publications

Future Research

Clinical and volunteer studies using new techniques of photoglottography and acceleromyelography developed within the department. These were used to compare the effects of different muscle relaxants on laryngeal muscles, the diaphragm and peripheral muscles.

• MAHAJAN RP and REILLY CS, 2012. Setting Research Priorities In Anaesthesia. British Journal Of Anaesthesia. 108(1), 1-3
• CONSTANTIN D, MCCULLOUGH J, MAHAJAN RP and GREENHAFF PL, 2011. Novel Events In The Molecular Regulation Of Muscle Mass In Critically Ill Patients. The Journal Of Physiology. 589(Pt 15), 3883-95
• MAHAJAN RP, 2011. Medication Errors: Can We Prevent Them? British Journal Of Anaesthesia. 107(1), 3-5
• MAHAJAN RP, 2011. The Who Surgical Checklist. Best Practice & Research. Clinical Anaesthesiology. 25(2), 161-8
• STAENDER SEA and MAHAJAN RP, 2011. Anesthesia And Patient Safety: Have We Reached Our Limits? Current Opinion In Anaesthesiology. 24(3), 349-53
• EVLEY R, RUSSELL J, MATHEW D, HALL R, GEMMELL L and MAHAJAN RP, 2010. Confirming The Drugs Administered During Anaesthesia: A Feasibility Study In The Pilot National Health Service Sites, Uk. British Journal Of Anaesthesia. 105(3), 289-96
• MAHAJAN RP, 2010. Critical Incident Reporting And Learning. British Journal Of Anaesthesia. 105(1), 69-75
• NICKALLS RWD and MAHAJAN RP, 2010. Awareness And Anaesthesia: Think Dose, Think Data. British Journal Of Anaesthesia. 104(1), 1-2
• BEED, M, O'CONNOR, M B, KAUR, J, MAHAJAN, R P and MOPPETT, I K, 2009. Transient hyperaemic response to assess skin vascular reactivity: effects of heat and iontophoresed norepinephrine. British journal of anaesthesia. 102(2), 205-9
• SMITH AF and MAHAJAN RP, 2009. National Critical Incident Reporting: Improving Patient Safety. British Journal Of Anaesthesia. 103(5), 623-5
• MOPPETT, I K, SHERMAN, R W, WILD, M J, LATTER, J A and MAHAJAN, R P, 2008. Effects of norepinephrine and glyceryl trinitrate on cerebral haemodynamics: transcranial Doppler study in healthy volunteers. British journal of anaesthesia. 100(2), 240-4
• HARDMAN, J G, MOPPETT, I K and MAHAJAN, R P, 2008. Validity, credibility, and applicability: the rise and rise of the surrogate. British journal of anaesthesia. 101(5), 595-6
• MCCAHON, RA, COLUMB, MO, MAHAJAN, RP and HARDMAN, JG, 2008. Validation And Application Of A High-Fidelity, Computational Model Of Acute Respiratory Distress Syndrome To The Examination Of The Indices Of Oxygenation At Constant Lung-State British Journal Of Anaesthesia. 101(3), 358-365
• MAHAJAN RP and HUNTER JM, 2008. Volume 100: Case Reports: Should They Be Confined To The Dustbin? British Journal Of Anaesthesia. 100(6), 744-6
• QI, W, WEI, J X, DORAIRAJ, I, MAHAJAN, R P and WILSON, V G, 2007. Evidence that a prostanoid produced by cyclo-oxygenase-2 enhances contractile responses of the porcine isolated coronary artery following exposure to lipopolysaccharide. British Journal of Anaesthesia. 98(3), 323-30
• SMITH M and MAHAJAN RP, 2007. Clinical Neuroscience: Relevance To Current Practice. British Journal Of Anaesthesia. 99(1), 1-3
• THOMPSON, J P and MAHAJAN, R P, 2006. Monitoring the monitors--beyond risk management. British journal of anaesthesia. 97(1), 1-3
• HANCOCK, S M, EASTWOOD, J R and MAHAJAN, R P, 2005. Effects of inhaled nitrous oxide 50% on estimated cerebral perfusion pressure and zero flow pressure in healthy volunteers. Anaesthesia. 60(2), 129-32
• MARVAL, P. D., PERRIN, M. E., HANCOCK, S. M. and MAHAJAN, R. P., 2005. The Effects of Propofol or Sevoflurane on the Estimated Cerebral Perfusion Pressure and Zero Flow Pressure Anesthesia and Analgesia. VOL 100(NUMB 3), 835-840
• GUPTA, M. M., BITHAL, P. K., DASH, H. H., CHATURVEDI, A. and MAHAJAN, R. P., 2005. Effects of stellate ganglion block on cerebral haemodynamics as assessed by transcranial Doppler ultrasonography British Journal of Anaesthesia. VOL 95(NUMBER 5), 669-673
• BEED,M., CAMPION-SMITH,J., HOFFMAN,A., WILSON,V. and MAHAJAN,R.P., 2005. Effect of prior statin use on survival following admission to an intensive care unit with a presumed diagnosis of sepsis: a pilot study British Journal of Anaesthesia. 95(4), 566P
• ATHANASSIOU, L, HANCOCK, S M and MAHAJAN, R P, 2005. Doppler estimation of zero flow pressure during changes in downstream pressure in a bench model of a circulation using pulsatile flow. Anaesthesia. 60(2), 133-8
• MAHAJAN, R. and MOPPETT, I., 2005. Cardiovascular support in critical care. In: Critical Care for Postgraduate Trainees Hodder Arnold, London, UK. 49-66
• BEED, M., KAUR, J., MOPPETT, I.K. and MAHAJAN, R.P., 2005. The effect of iontophoresed norepinephrine and heat on skin vascular reactivity as assessed by the transient hyperaemic response in human volunteers British Journal of Anaesthesia. 94(3), 409P-410P
• WEI,J.X., WILSON,V.G. and MAHAJAN,R.P., 2005. Procalcitonin does not modify lipopolysaccharide-induced changes in the responsiveness of the porcine coronary isolated artery British Journal of Anaesthesia. 95(4), 571P
• SHIELDS, M., GIOVANNELLI, M., MIRAKHUR, R.K., MOPPETT, I., ADAMS, J., HERMES, Y. and MAHAJAN, R.P., 2005. A selective relaxant binding agent for antagonism of prolonged rocuronium-induced neuromuscular block European Journal of Anaesthesiology. 22, A535
• SKINNER, H., MACKANESS, C., BEDFORTH, N. and MAHAJAN, R., 2005. Cerebral haemodynamics in patients with chronic renal failure: effects of haemodialysis British Journal of Anaesthesia. VOL 94(NUMBER 2), 203-205
• MOPPETT, I., WILD, M.J., SHERMAN, R., LATTER, J.A., MILLER, K. and MAHAJAN, R.P., 2004. Effects of ephidrine, dobutamine and dopexamine on cerebral haemodynamics : transcranial Doppler studies in healthy volunteers. British Journal of Anaesthesia. 92(1), 39-44
• GIOVANNELI, M., HANCOCK, S.M. and MAHAJAN, R., 2004. Effects of isoflurane anaesthesia on zero flow pressure and estimated cerebral perfusion pressure European Journal of Anaesthesiology. 21, A408
• MOPPETT, I K and MAHAJAN, R P, 2004. Transcranial Doppler ultrasonography in anaesthesia and intensive care. British Journal of Anaesthesia. 93(5), 710-24
• PERRIN, M.E., HANCOCK, S.M., MOPPETT, I. and MAHAJAN, R., 2004. Changes in total peripheral resistance and zero flow pressure in the cerebral circulation during a Valsalva manoeuvre European Journal of Anaesthesiology. 21, A408
• SULEMAN, M., ABAZA, K.T., GORNALL, C., KINNEAR, W.J., WILLS, J.S. and MAHAJAN, R., 2004. Use of mechanical glottis to convert a peak expiratory flow manoeuvre into a cough Anaesthesia.
• SULEMAN, M, ABAZA, K T, GORNALL, C, KINNEAR, W J M, WILLS, J S and MAHAJAN, R P, 2004. The effect of a mechanical glottis on peak expiratory flow rate and time to peak flow during a peak expiratory flow manoeuvre: a study in normal subjects and patients with motor neurone disease. Anaesthesia. 59(9), 872-5
• MARVAL, P.D., MOPPETT, I.K. and MAHAJAN, R.P., 2004. Moderate changes in oxygen tension in blood have no effect on the reactive hyperaemia of the forearm skin following brief tourniquet occlusion of the upper limb British Journal of Anaesthesia. 316-316
• PERRIN, M.E., MOPPETT, I.K. and MAHAJAN, R.P., 2004. Assessment of forearm skin blood flow reactivity: the effect of exercise on the transient hyperaemic response British Journal of Anaesthesia. 316-316
• ABAZA, K.T., MOPPETT, I. and MAHAJAN, R., 2004. The effect of age on the transient hyperaemic response of forearm skin Journal of Physiology. PC46a
• RICHARDSON, J., MOPPETT, I. and MAHAJAN, R., 2004. The effect of changes in end-tidal carbon dioxide on vascular reactivity of skin European Journal of Anaesthesiology. 21, A251
• HANCOCK, S.M. and MAHAJAN, R., 2004. Effects of nitrous oxide on the cerebral perfusion pressure and zero flow pressure as assessed by transcranial Doppler ultrasonography Anaesthesia.
• ATHANNASSIOU, L., HANCOCK, S.M. and MAHAJAN, R., 2004. Estimation of perfusion pressure and zerio flow pressure using Doppler ultrasonography in a bench model pulsatile flow Anaesthesia.
• BENNETT, T, MAHAJAN, R P, MARCH, J E, KEMP, P A and GARDINER, S M, 2004. Regional and temporal changes in cardiovascular responses to norepinephrine and vasopressin during continuous infusion of lipopolysaccharide in conscious rats. British journal of anaesthesia. 93(3), 400-7
• MAHAJAN, R, 2004. Breathing filters in anaesthesia and ICU: an overview. Anaesthesia and Intensive Care. 32(3), 436-7
• KNIGHT, D.J. and MAHAJAN, R.P., 2004. Patient positioning in anaesthesia Continuing Education in Anaesthesia, Critical Care & Pain. 160-163
• WEI, J.X., WILSON, V.G. and MAHAJAN, R.P., 2004. Responses of the porcine isolated coronary artery; influence of temperature of incubation and presence of antibiotics British Journal of Anaesthesia. 604P-605P
• HANCOCK, S.M., MAHAJAN, R.P. and ATHANASSIOU, L., 2003. Noninvasive estimation of cerebral perfusion pressure and zero flow pressure in healthy volunteers: the effects of changes in end-tidal carbon dioxide. Anesthesia and Analgesia. 96(3), 847-851
• BROWN, H, MOPPETT, I K and MAHAJAN, R P, 2003. Transient hyperaemic response to assess vascular reactivity of skin: effect of locally iontophoresed acetylcholine, bradykinin, epinephrine and phenylephrine. British Journal of Anaesthesia. 90(4), 446-51
• MOPPETT, I K, DAVIES, J A and MAHAJAN, R P, 2003. Non-selective and cyclo-oxygenase-2-specific non-steroidal anti-inflammatory drugs impair the hyperaemic response of skin to brief axillary artery occlusion. British Journal of Anaesthesia. 91(3), 353-6
• O'CONNOR, M.B., MOPPETT, I.K. and MAHAJAN, R.P., 2003. The effects of local heat changes in temperature on skin vascular reactivity as assessed using transient hyperaemic response in the forearm British Journal of Anaesthesia. 414P-415P
• MOPPETT, I.K., JONES, L.N. and MAHAJAN, R.P., 2003. The effect of ischaemia on the transient hyperaemic response of forearm skin British Journal of Anaesthesia. 822P-822P
• MARVAL, P.D., HANCOCK, S.M. and MAHAJAN, R.P., 2003. Effects of target-controlled infusion of propofol on estimated zero flow pressure and cerebral perfusion pressure British Journal of Anaesthesia. 823P-824P
• PERRIN, M.E., HANCOCK, S.M. and MAHAJAN, R.P., 2003. Estimated cerebral perfusion pressure and zero flow pressure during sevoflurane anaesthesia British Journal of Anaesthesia. 823P-823P
• ABAZA, K.T., HANCOCK, S.M. and MAHAJAN, R.P., 2003. Effects of desflurane anaesthesia on zero flow pressure and estimated cerebral perfusion pressure British Journal of Anaesthesia. 464P-464P
• SHERMAN, R. and MAHAJAN, R.P., 2003. Estimation of critical closing pressure and cerebral perfusion pressure using transcranial Doppler British Journal of Anaesthesia. U6-U7
• BOWIE, R A, O'CONNOR, P J and MAHAJAN, R P, 2003. Cerebrovascular reactivity to carbon dioxide in sepsis syndrome. Anaesthesia. 58(3), 261-5
• SHERMAN, R, ARMORY, P, MOODY, P, HOPE, T and MAHAJAN, R P, 2003. Effects of magnesium sulphate on cerebral haemodynamics in healthy volunteers: a transcranial Doppler study. British Journal of Anaesthesia. 91(2), 273-5
• WEBSTER, V.L. and MAHAJAN, R.P., 2002. Transient hyperaemic response to assess vascular reactivity of skin: effect of locally iontophoresed sodium nitroprusside British Journal of Anaesthesia. 89(2), 265-270
• ATHANASSIOU, L., HANCOCK, S.M. and MAHAJAN, R.P., 2002. In vitro estimation of cerebral critical closing pressure during simulation of intracranial hypertension British Journal of Anaesthesia. 317P-317P
• STACEY, M., MOPPETT, I., ATHANASSIOU, L. and MAHAJAN, R., 2002. The effect of systemic compliance on the noninvasive assessment of zero-flow pressure in a bench model of pulsatile flow British Journal of Anaesthesia. 196P-196P
• MOPPETT, I.K., GORNALL, C.B., HANCOCK, S.M. and MAHAJAN, R.P., 2002. Factors affecting the siphon effect in simulated cerebral circulation using a bench model British Journal of Anaesthesia. 196P-197P
• HANCOCK, S.M., EASTWOOD, J.R. and MAHAJAN, R.P., 2002. Effects of 50% nitrous oxide on estimated cerebral perfusion pressure and zero flow pressure in healthy volunteers British Journal of Anaesthesia. 317P-318P
• MOPPETT, I.K., MILLER, K., DAVIES, J.A., BAXENDALE, B.R. and MAHAJAN, R.P., 2002. The effects of dopexamine on cerebral carbon dioxide reactivity British Journal of Anaesthesia. 204P-205P
• EASTWOOD, J.R., WARREN, A., MAHAJAN, R.P. and GIRLING, K.J., 2002. Effects of plasma from septic patients on the vascular reactivity of omental blood vessels isolated from patients undergoing routine abdominal surgery British Journal of Anaesthesia. 319P-320P
• EASTWOOD, J. and MAHAJAN, R., 2002. One-lung anaesthesia Continuing Education in Anaesthesia, Critical Care & Pain. 83-87
• ROGERS, M L, HENDERSON, L, MAHAJAN, R P and DUFFY, J P, 2002. Preliminary findings in the neurophysiological assessment of intercostal nerve injury during thoracotomy. European Journal of Cardio-Thoracic Surgery. 21(2), 298-301
• SHERMAN, R. W., BOWIE, R. A., HENFREY, M. M. E., MAHAJAN, R. P. and BOGOD, D., 2002. Cerebral haemodynamics in pregnancy and pre-eclampsia as assessed by transcranial Doppler ultrasonography British Journal of Anaesthesia. VOL 89(PART 5), 687-692
• HARRISON, J M, GIRLING, K J and MAHAJAN, R P, 2002. Effects of propofol and nitrous oxide on middle cerebral artery flow velocity and cerebral autoregulation. Anaesthesia. 57(1), 27-32
• GIRLING, K J, SPENDLOVE, J L, QURAISHI, M S and MAHAJAN, R P, 2001. Video imaging to assess neuromuscular blockade at the larynx. Anesthesia and Analgesia. 92(1), 149-53
• TIBBLE, R.K., GIRLING, K.J. and MAHAJAN, R.P., 2001. A comparison of the transient hyperemic response test and the static autoregulation test to assess graded impairment in cerebral autoregulation during propofol, desflurane, and nitrous oxide anesthesia Anesthesia and Analgesia. 93(1), 171-176
• BEDFORTH, N.M., GIRLING, K.J., SKINNER, H.J. and MAHAJAN, R.P., 2001. Effects of desflurane on cerebral autoregulation. British Journal of Anaesthesia. 87(2), 193-197
• MAHAJAN, R.P., HANCOCK, S.M. and ATHANASSIOU, L., 2001. Bench study of the changes in estimated perfusion pressure and zero-flow pressure as assessed using Doppler ultrasonography British Journal of Anaesthesia. 174P-175P
• CARA, D.M., GIRLING, K.J., MORGAN, P.S., MOODY, A.R. and MAHAJAN, R.P., 2001. Cerebral blood flow as measured by MRI during changes in end- tidal CO2 partial pressure British Journal of Anaesthesia. 306P-306P
• WILD, M.R., SHERMAN, R.W., ARMORY, P.E., LATTER, J.A. and MAHAJAN, R.P., 2001. The effects of glyceryl trinitrate and dobutamine on cerebral haemodynamics British Journal of Anaesthesia. 668P-668P
• CARA, D M, ARMORY, P and MAHAJAN, R P, 2000. Prolonged duration of neuromuscular block with rapacuronium in the presence of sevoflurane. Anesthesia and Analgesia. 91(6), 1392-3, TOC
• O'CONNOR, P.J., BOWIE, R.A., HARDMAN, J.G. and MAHAJAN, R.P., 1999. The effect of continuous positive airway pressure on cerebral blood flow velocity British Journal of Anaesthesia. 82(6), A559
• GIRTING, K. J., CAVILL, G. and MAHAJAN, R. P., 1999. The Effects of Nitrous Oxide and Oxygen on Transient Hyperemic Response in Human Volunteers Anesthesia and Analgesia. VOL 89(NUMBER 1), 175-180
• CAVILL, G, SIMPSON, E J and MAHAJAN, R P, 1998. Factors affecting assessment of cerebral autoregulation using the transient hyperaemic response test. British Journal of Anaesthesia. 81(3), 317-21
• BEDFORTH, N. M., HARDMAN, J. G., MAHAJAN, R. P. and AITKENHEAD, A. R., 1998. Predicting the patient's response to changes in mechanical ventilation: a comparison of physicians and a physiological simulator British Journal of Anaesthesia. VOL 80(SUPP 1), A.557
• MAHAJAN, R P, CAVILL, G and SIMPSON, E J, 1998. Reliability of the transient hyperemic response test in detecting changes in cerebral autoregulation induced by the graded variations in end-tidal carbon dioxide. Anesthesia and Analgesia. 87(4), 843-9
• GIRLING, K. J. and MAHAJAN, R. P., 1996. The Effect of Stabilization on the Onset of Neuromuscular Block When Assessed Using Accelerometry Anesthesia and Analgesia. VOL 82(NUMBER 6), 1257-1260
• MAHAJAN, R P, GROVER, V K, SHARMA, S L and SINGH, H, 1987. Intraocular pressure changes during muscular hyperactivity after general anesthesia. Anesthesiology. 66(3), 419-21
• GROVER, V K, SHARMA, S and MAHAJAN, R P, 1987. Low-dose intranasal nitroglycerine attenuates pressor response. Anesthesiology. 66(5), 722
• MAHAJAN, R P, GROVER, V K, MUNJAL, V P and SINGH, H, 1987. Double-blind comparison of lidocaine, tubocurarine and diazepam pretreatment in modifying intraocular pressure increases. Canadian journal of anaesthesia = Journal canadien d'anesthésie. 34(1), 41-5