Research Overview

Dr. Goobie has an interest in management of pediatric patients undergoing major surgery such as neurosurgery, craniofacial surgery and orthopedic surgery with particular emphasis on blood conservation methods, coagulation disorders, thromboelastography and pharmacological research. She is currently investigating the PK/PD profile of the antifibrinolytic, tranexamic acid (TXA) and its role in reducing blood loss in non-cardiac surgery. She and her colleagues showed that TXA significantly reduced blood loss and blood transfusion peri-operatively in children undergoing craniofacial surgery.

She published a manuscript entitled, 'Population Pharmacokinetics of TXA in Pediatric Patients Undergoing Craniosynostosis Surgery' in which she predicts the safest dose of TXA for this population. She has a double-blind placebo-controlled study in progress investigating TXA and the reduction in blood transfusion in children undergoing idiopathic scoliosis surgery. She also is recruiting for a multicenter international study entitled 'The Efficacy and Population Pharmacokinetics and Pharmacogenetics of a Reduced Dose of TXA for Craniosynostosis Surgery'. This trial will hopefully answer many questions regarding the appropriate dose of TXA, safety, the PK characteristics and unique patient factors which influence peri-operative bleeding.

Education

Undergraduate School

Memorial University of Newfoundland
1988 Newfoundland Canada

Graduate School

Memorial University of Newfoundland
1992 Newfoundland Canada

Medical School

Memorial University of Newfoundland
1992 Newfoundland Canada

Internship

Memorial University of Newfoundland
1993 Newfoundland Canada

Residency

Anesthesia Memorial University of Newfoundland
1997 Newfoundland Canada

Fellowship

Pediatric Anesthesia Boston Children's Hospital
1998 Boston MA

Fellowship

Pediatric Anesthesia Research Boston Children's Hospital
1999 Boston MA

Publications

  1. Perioperative paediatric patient blood management: a narrative review. Br J Anaesth. 2025 Jan; 134(1):168-179. View Abstract
  2. Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy. BJA Open. 2024 Dec; 12:100310. View Abstract
  3. Trends in Gender of Authors of Patient Blood Management Publications. Anesth Analg. 2024 Jun 01; 138(6):1267-1274. View Abstract
  4. Dexmedetomidine and neurophysiologic monitoring-A call for evidence to guide contemporary best practice for pediatric anesthesiologists. Paediatr Anaesth. 2024 02; 34(2):101-103. View Abstract
  5. Implementation of an Enhanced Recovery after Surgery Pathway for Transgender and Gender-Diverse Individuals Undergoing Chest Reconstruction Surgery: An Observational Cohort Study. J Clin Med. 2023 Nov 14; 12(22). View Abstract
  6. Regional Tissue Oximetry in Pediatric Patient Blood Management: A New Physiologic Tool in the Transfusion Toolbox? Anesth Analg. 2023 11 01; 137(5):983-986. View Abstract
  7. Can identifying disparities in neonatal transfusion practices in low and middle resource countries improve postoperative outcomes through patient blood management? Paediatr Anaesth. 2023 09; 33(9):689-690. View Abstract
  8. Tranexamic Acid Use in Pediatric Craniotomies at a Large Tertiary Care Pediatric Hospital: A Five Year Retrospective Study. J Clin Med. 2023 Jun 30; 12(13). View Abstract
  9. Error traps in Pediatric Patient Blood Management in the Perioperative Period. Paediatr Anaesth. 2023 08; 33(8):609-619. View Abstract
  10. Evaluation of a Pre-Filled Table and a Flowchart-Based Algorithm as Cognitive Aids to Reduce Deviations in Dose Calculation for Intraoperative Red Blood Cell Transfusions in Children-An International Web-Based Simulation. Children (Basel). 2023 Apr 29; 10(5). View Abstract
  11. Perioperative management of pediatric patients undergoing juvenile angiofibroma resection. A case series and educational review highlighting patient blood management. Paediatr Anaesth. 2023 07; 33(7):510-519. View Abstract
  12. Perioperative Pediatric Erythrocyte Transfusions: Incorporating Hemoglobin Thresholds and Physiologic Parameters in Decision-making. Anesthesiology. 2022 11 01; 137(5):604-619. View Abstract
  13. Tranexamic acid for cesarean delivery: evidence of fibrinolysis? Am J Obstet Gynecol. 2023 01; 228(1):111-112. View Abstract
  14. Patient Blood Management Is a New Standard of Care to Optimize Blood Health. Anesth Analg. 2022 09 01; 135(3):443-446. View Abstract
  15. Update on Applications and Limitations of Perioperative Tranexamic Acid. Anesth Analg. 2022 09 01; 135(3):460-473. View Abstract
  16. Patient Blood Management: The Forgotten Element of Enhanced Recovery After Surgery Programs. Anesth Analg. 2022 09 01; 135(3):474-475. View Abstract
  17. Transfusion Strategies for Hemostatic Blood Products in Critically Ill Children: A Narrative Review and Update on Expert Consensus Guidelines. Anesth Analg. 2022 09 01; 135(3):545-557. View Abstract
  18. Safety of antifibrinolytics in 6583 pediatric patients having craniosynostosis surgery: A decade of data reported from the multicenter Pediatric Craniofacial Collaborative Group. Paediatr Anaesth. 2022 12; 32(12):1339-1346. View Abstract
  19. Large Vertex Encephaloceles: Management and Outcomes. J Craniofac Surg. 2023 Jan-Feb 01; 34(1):262-266. View Abstract
  20. Tranexamic acid administered during cesarean delivery in high-risk patients: maternal pharmacokinetics, pharmacodynamics, and coagulation status. Am J Obstet Gynecol. 2022 Nov; 227(5):763.e1-763.e10. View Abstract
  21. Plasma and Platelet Transfusion Strategies in Critically Ill Children Following Severe Trauma, Traumatic Brain Injury, and/or Intracranial Hemorrhage: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med. 2022 01 01; 23(13 Suppl 1 1S):e14-e24. View Abstract
  22. Plasma and Platelet Transfusion Strategies in Critically Ill Children With Malignancy, Acute Liver Failure and/or Liver Transplantation, or Sepsis: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med. 2022 01 01; 23(13 Suppl 1 1S):e37-e49. View Abstract
  23. Plasma and Platelet Transfusion Strategies in Critically Ill Children Following Noncardiac Surgery and Critically Ill Children Undergoing Invasive Procedures Outside the Operating Room: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med. 2022 01 01; 23(13 Supple 1 1S):e50-e62. View Abstract
  24. Research Priorities for Plasma and Platelet Transfusion Strategies in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding. Pediatr Crit Care Med. 2022 01 01; 23(13 Supple 1 1S):e63-e73. View Abstract
  25. Executive Summary of Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB). Pediatr Crit Care Med. 2022 01 01; 23(1):34-51. View Abstract
  26. Life-Threatening Bleeding in Children: A Prospective Observational Study. Crit Care Med. 2021 11 01; 49(11):1943-1954. View Abstract
  27. Preoperative Anemia Screening and Treatment: Is It Worth the Return on Investment? Anesth Analg. 2021 02 01; 132(2):341-343. View Abstract
  28. The Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference Methodology. Paediatr Anaesth. 2021 02; 31(2):145-149. View Abstract
  29. Enhanced recovery: The evolution of pediatric spinal fusion care. Paediatr Anaesth. 2020 10; 30(10):1066-1067. View Abstract
  30. One Size Does Not Fit All in Treating Massive Hemorrhage. Anesth Analg. 2020 08; 131(2):480-482. View Abstract
  31. Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg. 2020 08; 44(8):2482-2492. View Abstract
  32. A systematic review of outcomes reported inpediatric perioperative research: A report from the Pediatric Perioperative Outcomes Group. Paediatr Anaesth. 2020 Jul 30. View Abstract
  33. Balancing Supply and Demand for Blood during the COVID-19 Pandemic. Anesthesiology. 2020 07; 133(1):16-18. View Abstract
  34. Essential Role of Patient Blood Management in a Pandemic: A Call for Action. Anesth Analg. 2020 07; 131(1):74-85. View Abstract
  35. High-dose versus low-dose tranexamic acid for paediatric craniosynostosis surgery: a double-blind randomised controlled non-inferiority trial. Br J Anaesth. 2020 09; 125(3):336-345. View Abstract
  36. Patient blood management during the COVID-19 pandemic: a narrative review. Anaesthesia. 2020 08; 75(8):1105-1113. View Abstract
  37. Pediatric non-red cell blood product transfusion practices: what's the evidence to guide transfusion of the 'yellow' blood products? Curr Opin Anaesthesiol. 2020 Apr; 33(2):259-267. View Abstract
  38. Implementing a Multidisciplinary Clinical Pathway Can Reduce the Deep Surgical Site Infection Rate After Posterior Spinal Fusion in High-Risk Patients. Spine Deform. 2019 Jan; 7(1):33-39. View Abstract
  39. Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity. Crit Care Med. 2019 12; 47(12):1766-1772. View Abstract
  40. Minimally Invasive Endoscopic Surgery for Infantile Craniosynostosis: A Longitudinal Cohort Study. J Pediatr. 2020 01; 216:142-149.e2. View Abstract
  41. Dosing clonidine for sedation in intensive care. Paediatr Anaesth. 2019 10; 29(10):983-984. View Abstract
  42. Perioperative Outcomes and Surgical Case Volume in Pediatric Complex Cranial Vault Reconstruction: A Multicenter Observational Study From the Pediatric Craniofacial Collaborative Group. Anesth Analg. 2019 10; 129(4):1069-1078. View Abstract
  43. Tranexamic acid and perioperative bleeding in children: what do we still need to know? Curr Opin Anaesthesiol. 2019 Jun; 32(3):343-352. View Abstract
  44. Are opioids pediatric anesthesiologists' sword of Damocles? With great power comes great responsibility and risk. Paediatr Anaesth. 2019 06; 29(6):544-546. View Abstract
  45. Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version). Paediatr Anaesth. 2019 Mar; 29(3):231-236. View Abstract
  46. Corrigendum to 'Predictors of perioperative complications in paediatric cranial vault reconstruction surgery: a multicentre observational study from the Pediatric Craniofacial Collaborative Group' [Br J Anaesth 2019; 122: 215-223]. Br J Anaesth. 2019 05; 122(5):703. View Abstract
  47. Predictors of transfusion outcomes in pediatric complex cranial vault reconstruction: a multicentre observational study from the Pediatric Craniofacial Collaborative Group. Can J Anaesth. 2019 05; 66(5):512-526. View Abstract
  48. Sedative and Analgesic Drug Sequestration After a Single Bolus Injection in an Ex Vivo Extracorporeal Membrane Oxygenation Infant Circuit. ASAIO J. 2019 02; 65(2):187-191. View Abstract
  49. Implementing a Multidisciplinary Clinical Pathway Can Reduce the Deep Surgical Site Infection Rate After Posterior Spinal Fusion in High-Risk Patients. Spine Deform. 2019 01; 7(1):33-39. View Abstract
  50. Predictors of perioperative complications in paediatric cranial vault reconstruction surgery: a multicentre observational study from the Pediatric Craniofacial Collaborative Group. Br J Anaesth. 2019 Feb; 122(2):215-223. View Abstract
  51. Tranexamic Acid Is Efficacious at Decreasing the Rate of Blood Loss in Adolescent Scoliosis Surgery: A Randomized Placebo-Controlled Trial. J Bone Joint Surg Am. 2018 Dec 05; 100(23):2024-2032. View Abstract
  52. Patient Blood Management in Pediatric Cardiac Surgery: A Review. Anesth Analg. 2018 10; 127(4):1002-1016. View Abstract
  53. Improving venous thromboembolism management in children undergoing surgery. Paediatr Anaesth. 2018 05; 28(5):378-379. View Abstract
  54. Multi-modal 3D Simulation Makes the Impossible Possible. Plast Reconstr Surg Glob Open. 2018 Apr; 6(4):e1751. View Abstract
  55. Endoscopic Versus Open Repair for Craniosynostosis in Infants Using Propensity Score Matching to Compare Outcomes: A Multicenter Study from the Pediatric Craniofacial Collaborative Group. Anesth Analg. 2018 03; 126(3):968-975. View Abstract
  56. High-dose Versus Low-dose Tranexamic Acid to Reduce Transfusion Requirements in Pediatric Scoliosis Surgery. J Pediatr Orthop. 2017 Dec; 37(8):e552-e557. View Abstract
  57. Ceftaroline pharmacokinetics and pharmacodynamics in patients with cystic fibrosis. J Cyst Fibros. 2018 05; 17(3):e25-e31. View Abstract
  58. Tranexamic Acid: What Is Known and Unknown, and Where Do We Go From Here? Anesthesiology. 2017 09; 127(3):405-407. View Abstract
  59. Incidence and predictors of massive bleeding in children undergoing liver transplantation: A single-center retrospective analysis. Paediatr Anaesth. 2017 Jul; 27(7):718-725. View Abstract
  60. Tranexamic acid: still far to go. Br J Anaesth. 2017 03 01; 118(3):293-295. View Abstract
  61. Safety of antifibrinolytics in cranial vault reconstructive surgery: a report from the pediatric craniofacial collaborative group. Paediatr Anaesth. 2017 03; 27(3):271-281. View Abstract
  62. Perioperative Outcomes and Management in Pediatric Complex Cranial Vault Reconstruction: A Multicenter Study from the Pediatric Craniofacial Collaborative Group. Anesthesiology. 2017 02; 126(2):276-287. View Abstract
  63. Association of Preoperative Anemia With Postoperative Mortality in Neonates-Reply. JAMA Pediatr. 2017 02 01; 171(2):196-197. View Abstract
  64. Relationship Between Preoperative Anemia and In-Hospital Mortality in Children Undergoing Noncardiac Surgery. Anesth Analg. 2016 12; 123(6):1582-1587. View Abstract
  65. The translational value of chart reviews and the need for trials. Paediatr Anaesth. 2016 Sep; 26(9):864-5. View Abstract
  66. Association of Preoperative Anemia With Postoperative Mortality in Neonates. JAMA Pediatr. 2016 09 01; 170(9):855-62. View Abstract
  67. Multivariable predictors of substantial blood loss in children undergoing craniosynostosis repair: implications for risk stratification. Paediatr Anaesth. 2016 Oct; 26(10):960-9. View Abstract
  68. Relationship between transfusion volume and outcomes in children undergoing noncardiac surgery. Transfusion. 2016 Oct; 56(10):2487-2494. View Abstract
  69. Perioperative bleeding management in pediatric patients. Curr Opin Anaesthesiol. 2016 Jun; 29(3):352-8. View Abstract
  70. Tranexamic Acid Use in United States Children's Hospitals. J Emerg Med. 2016 Jun; 50(6):868-874.e1. View Abstract
  71. Post-Operative Outcomes in Children With and Without Congenital Heart Disease Undergoing Noncardiac Surgery. J Am Coll Cardiol. 2016 Feb 23; 67(7):793-801. View Abstract
  72. A blood transfusion can save a child's life or threaten it. Paediatr Anaesth. 2015 Dec; 25(12):1182-3. View Abstract
  73. Quantification of Fibrinolysis Using Velocity Curves Measured with Thromboelastometry in Children with Congenital Heart Disease. Anesth Analg. 2015 Aug; 121(2):486-91. View Abstract
  74. Predictors of clinically significant postoperative events after open craniosynostosis surgery. Anesthesiology. 2015 May; 122(5):1021-32. View Abstract
  75. Progressive Postnatal Pansynostosis. Cleft Palate Craniofac J. 2015 11; 52(6):751-7. View Abstract
  76. Use of tranexamic acid in infants undergoing choroid plexus papilloma surgery: a report of two cases. Paediatr Anaesth. 2014 Jul; 24(7):791-3. View Abstract
  77. Bleeding management for pediatric craniotomies and craniofacial surgery. Paediatr Anaesth. 2014 Jul; 24(7):678-89. View Abstract
  78. The efficacy of antifibrinolytic drugs in children undergoing noncardiac surgery: a systematic review of the literature. Anesth Analg. 2014 Mar; 118(3):628-36. View Abstract
  79. Should aprotinin be reconsidered for use in pediatric surgery? Paediatr Anaesth. 2014 Feb; 24(2):137-40. View Abstract
  80. Improvements in patient blood management for pediatric craniosynostosis surgery using a ROTEM(®) -assisted strategy - feasibility and costs. Paediatr Anaesth. 2014 Jul; 24(7):774-80. View Abstract
  81. New insights about the use of tranexamic acid in children undergoing cardiac surgery: from pharmacokinetics to pharmacodynamics. Anesth Analg. 2013 Oct; 117(4):760-762. View Abstract
  82. Autosomal recessive hereditary spastic paraplegia-clinical and genetic characteristics of a well-defined cohort. Neurogenetics. 2013 Nov; 14(3-4):181-8. View Abstract
  83. Population pharmacokinetics of tranexamic acid in paediatric patients undergoing craniosynostosis surgery. Clin Pharmacokinet. 2013 Apr; 52(4):267-76. View Abstract
  84. Intraoperative management of blood loss during craniosynostosis surgery. Paediatr Anaesth. 2013 Mar; 23(3):278-80. View Abstract
  85. The case for the use of tranexamic acid. Paediatr Anaesth. 2013 Mar; 23(3):281-4. View Abstract
  86. Efficacy of tranexamic acid in pediatric craniosynostosis surgery: a double-blind, placebo-controlled trial. Anesthesiology. 2011 Apr; 114(4):862-71. View Abstract
  87. Endoscopic strip craniectomy in early infancy: the initial five years of anesthesia experience. Anesth Analg. 2011 Feb; 112(2):407-14. View Abstract
  88. Molecular and clinical characterization of de novo and familial cases with microduplication 3q29: guidelines for copy number variation case reporting. Cytogenet Genome Res. 2008; 123(1-4):65-78. View Abstract
  89. The use of a laryngeal mask airway for emergent airway management in a prone child. Anesth Analg. 2005 Mar; 100(3):670-671. View Abstract
  90. Confirmation of direct epidural catheter placement using nerve stimulation in pediatric anesthesia. Anesth Analg. 2003 Oct; 97(4):984-988. View Abstract
  91. An admixture of 3 mg x kg(-1) of propofol and 3 mg x kg(-1) of thiopentone reduces pain on injection in pediatric anesthesia. Can J Anaesth. 2002 Dec; 49(10):1064-9. View Abstract
  92. Hemostatic changes in pediatric neurosurgical patients as evaluated by thrombelastograph. Anesth Analg. 2001 Oct; 93(4):887-92. View Abstract
  93. Shwachman-Diamond syndrome with exocrine pancreatic dysfunction and bone marrow failure maps to the centromeric region of chromosome 7. Am J Hum Genet. 2001 Apr; 68(4):1048-54. View Abstract
  94. Segregation analysis in Shwachman-Diamond syndrome: evidence for recessive inheritance. Am J Hum Genet. 2000 Apr; 66(4):1413-6. View Abstract
  95. Exclusion of linkage of Shwachman-Diamond syndrome to chromosome regions 6q and 12q implicated by a de novo translocation. Am J Med Genet. 1999 Jul 16; 85(2):171-4. View Abstract

Contact Susan Goobie