Jose L.Pascual MD, PhD, FRCS(C), FRCP(C) is a clinical surgeon trained at McGill University with specialized fellowship training in trauma and critical care at the University of Pennsylvania in Philadelphia. He is the patient safety officer for the HUP Department of Surgery and serves on hospital committees to promote patient safety initiatives with residents. His clinical and research interests are in shock and head injury. His research work is shared in clinical and basic science to learn how a variety of insults including head injury and shock affect the microcirculation and how different management strategies influence their effects. This basic science work is translated into several clinical projects both retrospective and prospective evaluating the effects of different osmotherapeutic agents in traumatic brain injured patients as well as the immunemodulating effects of different resuscitation fluids in different forms of shock. Jose Pascual is also the lead physician in a series of pedagogical efforts to train medical trainees as well as advanced practitioners in the ICU using simulation based curricula.

• American College of Surgeons (Candidate Member, 1999-pres.)
• Canadian Association of General Surgeons (Member, 1997-pres.)
• Royal College of Physicians & Surgeons of Canada (Fellow, 2005-pres.)
• Society of Critical Care Medicine (Member, 2000-pres.)
• Trauma Association of Canada (Member, 1999-pres.)
• Pan-American Trauma Society (Member 2007-pres.)
• International Society of Surgery (Member 2007-pres)
• International Association for Trauma Surgery & Intensive Care (Member 2007-pres)
• Eastern Association for the Surgery of Trauma (Member 2008)
• American Medical Association (Member 2009)

• Pennsylvania Chapter of American College of Surgeons
  (member 2008-pres)

• Eastern Association of Trauma (EAST) – Membership Committee
• Society of Critical Care Medicine (SCCM) – Education Committee
• Society of Critical Care Medicine (SCCM) – Research Committee

Jose Pascual is a clinical surgeon specialized in trauma and critical care who has a special interest in shock and head injury. His research interests are shared in basic science research where he evaluates, in vivo, through intravital microscopy the real time microcirculation of pia on live rodent brains. He seeks to learn how a variety of insults including head injury and shock affect the microcirculation and how different management strategies influence these changes. This basic science work is translated into several clinical projects both retrospective and prospective evaluating the effects of different osmotherapeutic agents in traumatic brain injured patients as well as the immunemodulating effects of different resuscitation fluids in different forms of shock.

1. Pascual JL, Ferri LE, Chaudhury P, Seely AJ, Campisi G, Giannias B, Evans DC, Christou NV. Hemorrhagic shock resuscitation with a low molecular weight starch reduces neutrophil-endothelial interactions and vessel leakage in vivo. Surgical Infections 2(4):275-288, 2001.
2. Seely AJ, Naud JF, Campisi G, Giannias B, Liu S, DiCarlo A, Ferri LE, Pascual JL, Tchervenkov J, Christou NV. Alteration of chemoattractant receptor expression regulates human neutrophil chemotaxis in vivo. Annals of Surgery 235(4):550-559, Apr. 2002.
3. Pascual JL, Ferri LE, Seely AJE, Campisi G, Chaudhury P, Giannias B, Evans DC, Razek T, Michel RP, Christou NV. Hypertonic saline resuscitation of hemorrhagic shock diminishes neutrophil rolling and adherence to endothelium and reduces in vivo vascular leakage. Annals of Surgery 236(5):634-642, May 2002.
4. Ferri LE, Pascual J, Seely AJ, Chaudhury P, Christou NV. Soluble L-selectin attenuates tumor necrosis factor-alpha-mediated leukocyte adherence and vascular permeability: a protective role for elevated soluble L-selectin in sepsis. Critical Care Medicine 30(8):1842-1847, Aug. 2002.
5. Pascual JL, Khwaja KA, Ferri LE, Giannias B, Evans DC, Razek T, Michel RP, Christou NV. Hypertonic saline resuscitation attenuates neutrophil lung sequestration and transmigration by diminishing leukocyte-endothelial interactions in a two-hit model of hemorrhagic shock and infection. Journal of Trauma-Injury Infection & Critical Care 54(1):121-132, Jan. 2003.
6. Ferri LE, Pascual J, Seely AJ, Giannias B, Christou NV. Intra-abdominal sepsis attenuates local inflammation-mediated increases in microvascular permeability at remote sites in mice in vivo. Surgery 135(2):187-195, Feb. 2004.
7. Pascual JL, Maloney-Wilensky E, Reilly PM, Sicoutris C, Keutmann MK, Stein SC, LeRoux PD, Gracias VH. The effect of an institutional pathway on TBI resuscitation with 7.5% hypertonic saline. American Surgeon Vol 74(3):253-9, March 2008.
8. Oddo M, Levine JM, Frangos S, Carrera E, Maloney-Wilenski E, Pascual JL, Kofke A, Mayer SA, Leroux PD. Effect of Osmotherapy with Mannitol and Hypertonic Saline on Cerebral Tissue Oxygenation in Patients with Severe Traumatic Brain Injury and Refractory Intracranial Hypertension. J Neurol Neurosurg Psychiatry. 2009 Mar 16 [Epub]
9. Phelan, H., Velmahos, G., … Pascual, J.,…An Evaluation of Multi-Detector Computed Tomography in Detecting Pancreatic Injury: Results of a Multicenter AAST Study The Journal of Trauma 66(3):121-129, Mar 2009.
10. Babak Sarani, Brandy Temple-Lykens, Patrick Kim, Seema Sonnad, Meredith Bergey, Jose L. Pascual, Carrie Sims, Patrick Reilly. Factors Associated with Mortality and Brain Injury Following Fall from the Standing Position. Journal of Trauma 67(5):954-958 November 2009.
11. Weiwei Ding, Xingjiang Wu, Jose L. Pascual, Kun Zhao, Wu Ji, Ning Li, Jieshou Li, Temporary intravascular shunting improves survival in a hypothermic traumatic shock swine model with superior mesenteric artery injuries. Surgery 147(1):79-88, January 2010.
12. Sarani, B, Palilonis, E, Sonnad, S, Bergey, M, Sims, C, Pascual, J, Schweickert, W. Clinical Emergencies and outcomes in Patients Admitted to a Surgical vs. Medical Service. Resuscitation (accepted for publication, Sept 2010)
13. Pascual JL, Georgoff, P., Maloney-Wilensky, E., Sims, C., Sarani, B., Stiefel, MF., LeRoux, PD., Schwab, CW. Reduced Brain Tissue Oxygen in Traumatic Brain injury: Are most commonly used interventions successful? (Submitted for publication to the Journal of Trauma) September 2010.
14. Menger, R, Foreman, J, Sarani, B, Pascual, J, Reilly, P, Bergey, M. Risk Factors Associated With Chest Tube Complications Following Thoracic Injury (Submitted for publication to Injury) October 2010.
15. Jose L. Pascual, et al.Reduced Brain Tissue Oxygen in Traumatic Brain Injury: Are Most Commonly Used Interventions Successful? Journal of Trauma (accepted for publication)

1. Chughtai T, Pascual J, Partap V, Steinmetz O. Left gastric artery aneurysm: Case report and review of the literature. [Review] International Journal of Angiology 9:156-158, 2000.
2. Pascual JL, Khwaja KA, Chaudhury P, Christou NV. Hypertonic saline and the microcirculation. [Review] Journal of Trauma-Injury Infection & Critical Care 54(5 Suppl):S133-140, May 2003.
3. Seely AJ, Pascual JL, Christou NV. Science review: Cell membrane expression (connectivity) regulates neutrophil delivery, function and clearance. [Review] Critical Care (London) 7(4):291-307, Aug. 2003.
4. Sarani, B, Strong, M, Pascual, JL, Schwab, CW. Necrotizing Fasciitis: Current Concepts and review of the literature, Journal of the American College of Surgeons 208(2):279-88 Feb 2009.
5. Pascual JL, Holena D, del Portal D, Schwab CW, Blunt intrapericardial superior vena cava injury – A trap for the unwary. Injury Extra 41:4–6, Jan 2010.

1. Seely A, Naud J-F, Campisi G, Pascual J, Ferri L, Christou N. Dynamic alteration of neutrophil chemoattractant receptors regulates neutrophil chemotaxis in humans in vivo. Owen H. Wangensteen Surgical Forum LII: 2001.
2. Ferri L, Pascual J, Seely A, Christou N. Intra-abdominal sepsis attenuates inflammation mediated increases in microvascular permeability at remote sites. Owen H. Wangensteen Surgical Forum LII: 2001.

1. Pascual JL, Maloney E, Reilly PM, Keutmann MK, Stein S, Leroux PD, Gracias VH. The effect of an institutional pathway on TBI resuscitation with 7.5% hypertonic saline. Paper presented orally at the 36th Annual Western Trauma Association Scientific Meeting, Big Sky, MT, March 2006. Journal of Trauma 60(1):250, 2006.
2. Pascual J, Ferri L, Khwaja K, Giannias B, Evans D, Michel R, Christou N. Hypertonic saline in hemorrhagic shock blunts tissue injury independent of its ability to block neutrophil-endothelial adhesion. Paper presented orally at the Joint Meeting of the Trauma Association of Canada & Pan-American Trauma Society, Banff, Alberta, March 2006. Journal of Trauma 60(2):464, 2006.
3. Pascual J, Chovanes J, Waring S, Reilly P. The evolving use of CT scanning in the trauma bay of a large academic Level I trauma center. Paper presented orally at the 10th Annual Pennsylvania Committee on Trauma, Harrisburg, PA, October 2006.
4. J Pascual, J. Chovanes, S Waring, P Reilly, CW Schwab. The use of total body CT scanning in the initial evaluation of injured patients reduces trauma patient admissions. Paper presented orally at the 42nd World Congress of Surgery of the International Surgical Society, Montréal, Canada, August 2007.
5. Sims C, Jaffe R, Foreman J, Menger R, Sonnad S, Pascual J, Sarani B. Adrenal insufficiency in hemorrhagic shock. Paper presented at the 37th Annual Congress of the Society of Critical Care Medicine Crit Care Med 2008;36:A65.
6. PK Kim, JP Pryor, CW Schwab, AM Podgorski, J McMaster, JI Rohrbach, VH Gracias, BM Braslow, B Sarani, CA Sims, JL Pascual, MD, PM Reilly. Attendings Matter: Re-Focusing on Trauma Inpatients Improves Outcomes and Patient Satisfaction. Paper presented at the 2008 annual AAST Scientific Meeting, Pittsburgh, PA, September 2008.
7. Elizabeth Powell, Babak Sarani, Joseph Taddeo, Brendan Carr, Mark
   Seamon, Amy Goldberg, Jose Pascual, C. William Schwab. A Comparison of Operation and Transcatheter Arterial Embolization for the Treatment of Blunt Renal Injury, Paper presented at the 2009 annual AAST Scientific Meeting, Phoenix AZ, September 2008.
8. Weiwei Ding, Babak Sarani, Jennifer Peterson, Annamarie Horan, Nuri Abdurraheim, Majid Aized, Carrie Sims, Vicente Gracias, William Schwab, Jose L Pascual. Hypertonic Saline in the ICU Worsens Neutrophil Respiratory burst Despite Reducing Adhesion Receptor Expression. Paper presented at the 38th Annual Congress of the Society of Critical Care Medicine, Miami Beach CA Critical Care Medicine 37(12); A63, Dec 2009.
9. D Sabra, M Bergey, E Grill, B Sarani, J Pascual, E Datner, C Sims. Intimate partner violence and the trauma team: more than education is needed. Paper presented at the 5th Annual Academic Surgical Congress Feb 3-5, 2010 San Antonio, TX.
10. Weiwei Ding, Carrie Sims, Annamarie Horan, Babak Sarani, William Schwab, Jose L. Pascual Hypertonic saline in the ICU reduces inflammation and increases shedding of receptors responsible for microcirculatory inflammation. Oral paper presented at the 8th World Congress on Trauma, Shock, Inflammation and Sepsis - TSIS 2010, March 2010, Munich, Germany Inflammation.
11. Pascual J, Rosen, P, Horan, A, Sarani, B, Sims, C, Schwab, CW Hypertonic Fluids in SICU Shock Patients Reduce Fluid and Oxygen Requirements Shock. Paper presented at the 33rd Conference on Shock, Portland, ON, June 2010;33(1):78.
12. Rosenbloom, J, Guan, Y, Sawey, E., Becker, L, Sarani, B, Pascual, J, Sims, C. Posterior Pituitary Exhaustion in Hemorrhagic Shock and Resuscitation Paper presented at the 33rd Conference on Shock, Portland, ON, June 2010;33(1):38.
13. Jose L Pascual, MD, PhD, Amanda McNicholas, CRNP, Alexander Bridges, Carrie Sims*, MD, Babak Sarani*, MD, Forrest Fernandez MD, C WIlliam Schwab*, THE EFFECTS OF INSTITUTING A HOSPITAL GUIDELINE TO REVERSE THE COAGULOPATHY OF PLAVIX (CLOPIDOGREL) IN TRAUMATIC BRAIN INJURY PATIENTS Paper presented at the 2010 annual AAST Scientific Meeting, Boston MA, September 2010.
14. Carrie A Sims*, MD, Yuxia Guan, BS, Julia Rosenbloom, MD, Jose Pascual, MD, Baback Sarani*, MD, Lance Becker, MD, Patrick Reilly*, MD, CW Schwab*, RESUSCITATION OF HEMORRHAGIC SHOCK WITH VASOPRESSIN RESTORES LIVER CYTOCHROME OXIDASE ACTIVITY Paper presented at the 2010 annual AAST Scientific Meeting, Boston MA, September 2010.
15. Jose L Pascual, MD, PhD, Patrick Georgoff, Annamarie Horan, PhD, Carrie Sims* MD, Babak Sarani*, MD, Michael F Stiefel, MD, PhD, Peter D LeRoux, MD, C William Schwab*,REDUCED BRAIN TISSUE OXYGEN IN TRAUMATIC BRAIN INJURY: ARE MOST COMMONLY USED INTERVENTIONS SUCCESSFUL? Paper presented at the 2010 annual AAST Scientific Meeting, Boston MA, September 2010.
16. Taddeo, J, Pascual, JL, Cheung, A, Schwab, CW Systolic Anterior Motion in Traumatic Shock. Video Presentation delivered at 96th Annual Clinical Congress of the American College of Surgeons, Washington, DC, October 2010.
17. D. S. Morris, J. I. Rohrbach, M. P. Rogers, M. Thanka Sundaram, S. S. Sonnad, J. L. Pascual, B. Sarani, C. A. SimsThe Surgical Revolving Door: Who Gets Readmitted To The Hospital? 6th Annual Academic Surgical Congress Abstract Submission ASC 2011.
18. J.V. Sakran, B. Finneman, C. Maxwell, S. S. Sonad, B. Sarani, J. L. Pascual, C. A. Sims Trauma Leadership: Does Perception Drive Reality? 6th Annual Academic Surgical Congress Abstract Submission ASC 2011.
19. Wanfeng Gong MD Paymon Sanati Joshua A Marks MDBabak Sarani* MD, FACSCarrie Sims* MD, MS, FACS Jose L Pascual* MD, PhD, FRCS(C) HYPERTONIC SALINE RESUSCITATION OF HEMORRHAGIC SHOCK INCREASES IN VIVO NEUTROPHIL INTERACTIONS WITH ENDOTHELIUM IN THE BLOOD BRAIN MICROCIRCULATION Paper to be presented at EAST 2011
20. Jose L Pascual* MD, PhD, FRCS(C) Michael A Vella MD Daniel N Holena MD Corinna Sicoutris N, MSN, CRNP, BC Benselvan Chandrakaladharan MD Adam D Fox MD Babak Sarani* MD, ACS Carrie Sims* MD, MS, FACS Noel N Williams MB, BCh, MCh, FRCSI, FRCS(Gen)C. William Schwab* MD, FACS SHORT SIMULATION TRAINING IMPROVES OBJECTIVE SKILLS IN ESTABLISHED ADVANCED PRACTITIONERS MANAGING EMERGENCIES ON THE WARD AND SURGICAL INTENSIVE CARE UNIT Paper to be presented at EAST 2011.

1. Pascual JL, Sarani B, Schwab CW. ACS criteria for surgeon presence at initial trauma resuscitations: Superfluous or necessary? [Commentary] Annals of Emergency Medicine 50(1):15-7, Jul. 2007. (Epub Dec 2006.)
2. Pascual JL, Sarani B, Schwab CW. Are surgeons superfluous to initial major trauma resuscitations? [Second commentary] Annals of Emergency Medicine 51(3):335-8, March 2008.
3. JL Pascual, VH Gracias, PD LeRoux. Injury to the Brain. In: Flint, Meredith, Schwab et al eds. Trauma: Contemporary Principles and Therapy. 1st ed. Philadelphia: Lippincott Williams & Wilkins; pgxx, 2008.
4. JL Pascual, VH Gracias. Damage Control Surgery [Control de Daños]. In: Machado, AJ, Aguilera SL, eds. Emergencias. 1st ed. Azcuenaga. Argentina: Edimed-Ediciones Medicas SRL; 673-678, 2008.
5. JL Pascual, VH Gracias. Fluid and Volume Status. In: LeRoux, PD, Levine, JM, Kofke, WA, eds. Monitoring in Neurocritical Care. 1st ed. Philadelphia: Elsevier; (in press) 2009.
6. Jin H. Ra, Jose L. Pascual, C. William Schwab Septic Response in Current Surgical Therapy, Elsevier Mosby 10th ed. Philadelphia, PA: Ed. Cameron, J.L. (in press).
7. Scott Keeney, Jose L. Pascual Abdominal Trauma in The Intensive Care Unit Manual, Elsevier Saunders 2nd ed. Philadelphia, PA: Eds. Lanken, Hanson, Manaker (in press).
8. Edgardo Salcedo, Jose L. Pascual Fluid Management in Traumatic Brain Injury in Encyclopedia of Intensive Care Medicine, Heidelberg, Germany: Eds Vincent, Hall (in press).