Prof. W.S. Schlack (b. 1963) has been appointed professor of Anaesthesiology at the Faculty of Medicine of the Universiteit van Amsterdam (UvA). Schlack has also been appointed president of the department of Anaesthesiology of the Academic Medical Center (AMC-UvA).
With the aging of the population and the increasing numbers of elderly people undergoing major surgery, co-morbidities have a significant impact on anaesthesia.
The most important co-morbidity in our elderly patients is coronary artery disease, which is responsible for one third of all perioperative complications and every second perioperative death. In this context, it increasingly recognised by anaesthesiologists that the choice of anaesthetic drugs is not only important for an optimum control of the anaesthetic depth and for maintaining haemodynamic stability, but that some of the available substances (namely the volatile anaesthetics) have also pronounced cardioprotective properties that might protect the heart during ischaemia (insufficient blood flow) –reperfusion (recovery of the blood circulation) episodes.
In recent years, Wolgang Schlack’s research group has been busy with the characterisation of the basic and molecular mechanisms of this anaesthetic-mediated cardioprotection. In various animal models, they were able to show that inhalation of a volatile anaesthetic can reduce the size of an experimental infarct by about 50%. This cardioprotection lasts even longer than the exposure to the anaesthetic substance (for hours to days) and is mediated by defined acute changes in the protein structure of the heart and by stimulating the synthesis of new protective proteins within the cell. These findings have recently been translated into clinical practice; mainly for patients undergoing heart surgery who always experience a period of myocardial ischaemia (lack of oxygen in the cardiac muscle) while the heart is arrested and not perfused during surgery. In this clinical setting, a rapidly increasing number of studies confirms the cardioprotective effects of volatile anaesthetics in patients. Not only markers of myocardial damage like Troponin release after cardiac surgery were reduced, but also the length of ICU and hospital stays were found to be shorter after anaesthesia with volatile anaesthetic for cardiac surgery with cardiopulmonary bypass and one recent study could also demonstrate a better one-year outcome. Choice of the right anaesthetic may thus have an important impact on patient outcome. At the AMC department of Anaesthesiology Schlack will continue his focus on the protective mechanisms involved and on how they can be best used for the benefit of patients.
Schlack has been working at University Hospital Düsseldorf since 1992, since 1996 as senior anaesthetist since 2000 also as ‘chef de clinique’ of the department of Anaesthesiology of the university hospital. He was also professor of Anaesthesiology and interim director of the department from 2003 till 2006.