Anesthesiology Research

Dr. Goobie is an attending anesthesiologist in the main operating room at Children’s Hospital Boston and is involved in all aspects of pediatric anesthesia preoperative clinical care.  She has a special interest in management of patients undergoing major surgery such as neurosurgery, craniofacial surgery and scoliosis surgery and is an active clinical member of the teams of anesthesiologists that provide care for these challenging patients. She has played a leadership role in advancing and improving the standard of perioperative care of these children by implementing several clinical innovations. For example in  “The Efficacy of Tranexamic Acid in Pediatric Craniofacial Surgery: A Double Blind Placebo Controlled Study” she and her colleagues showed that using tranexamic acid significantly reduced blood loss and blood transfusion peri-operatively in infants and children undergoing craniofacial surgery. This has become standard of care not only locally but nationally and internationally for this patient population.

She has put together a database which is an extensive 10 year retrospective review of infants who had craniofacial surgery at Boston Children’s Hospital and will use this information to determine risk factors for peri-operative complications. From this, she and her colleagues designed a Standardized Clinical Assessment and Management Plan for the care of infants and children having craniosynostosis surgery. This management plan will hopefully improve safety and more appropriately select patients to go to the ICU postoperatively and therefore decrease hospital length of stay and cost while potentially improving the care of these patients.  

She has keen interest in blood conservation methods, coagulation disorders and pharmacological research. She is investigating the pharmacodynamic and pharmacokinetics of the antifibrinolytic, tranexamic acid and its role in reducing blood loss in non-cardiac surgery; specifically craniofacial surgery and scoliosis surgery. She has a double-blind placebo-controlled study in progress investigating tranexamic acid and the reduction in blood transfusion in children undergoing idiopathic scoliosis surgery. She published a manuscript entitled, “Population Pharmacokinetics of Tranexamic Acid in Pediatric Patients Undergoing Craniosynostosis Surgery” in which she predicts the safest dose of TXA for this population. She is also designing a multicenter international study entitled “The Efficacy and Population Pharmacokinetics and Pharmacogenetics of a Reduced Dose of Tranexamic acid for Craniosynostosis surgery”. This trial will answer many questions regarding the appropriate dose of tranexamic acid, the pharmacokinetic characteristics and unique patient factors which influence peri-operative bleeding including genetic influences. Her research areas involve collaboration with faculty in surgery, pharmacology, genetics, and basic science.

Dr Goobie is Clinical Director of the Clinical Pharmacology and Pharmacokinetics Laboratory for Department of Anesthesia, Peri-operative and Pain Medicine, Children’s Hospital, Boston. Under her direction, and in collaboration with Dr. Luis Periera, pharmacokinetist and laboratory director, the QCPOP laboratory will undertake research which will better enable anesthesiologists to increase drug efficacy and reduce toxicity by optimizing drug selection and individualizing drug dosing schemes.

Research Interests: Craniofacial Surgery, Scoliosis Surgery, Antifibrinolytics, Conservation Methods to Reduce Blood Loss and Transfusion of Blood Products Intraoperatively, Thromboelastography, Pharmacokinetics