Peter Nagele, M.D.

Professor of Anesthesia & Critical Care

(773) 702-2545


M.D. - 1990-1995
University of Innsbruck - Innsbruck, Austria

M.S.​ - 2007-2009
Washington University in St. Louis - St. Louis, MO USA - Clinical Investigation

Internship​ - 1996-1997
Krankenhaus Hallein - Hallein, Austria - Surgery and Medicine

Residency​ - 1997 - 2004
Medical University of Vienna - Vienna, Austria - Anesthesiology and Critical Care

Fellowship​ - 2000 - 2002
Washington University School of Medicine - St. Louis, MO USA - Postdoctoral research

Clinical Interests

Trauma anesthesia
Management of urgent and emergent surgery
Massive transfusion
Cardiac arrest
Military medicine
Disaster medicine
Prehospital emergency medicine

Academic Interests

Clinical and translational research in perioperative medicine
Multicenter clinical trials

Recent Publications

Dr. Nagele's research focuses on three main areas:

(1) Cardiac outcomes after non-cardiac surgery

(2) Nitrous Oxide: Dr. Nagele has worked on the molecular mechanism of action of nitrous oxide and xenon. He has studied nitrous oxide and its effects on vitamin B12, folate and homocysteine metabolism. Recently, he is credited with the discovery of the antidepressant effect of nitrous oxide in patients with treatment-resistant major depression.

(3) Perioperative Pharmacogenetics and clinical pharmacology.

Helwani MA, Amin A, Lavigne P, Rao S, Oesterreich S, Samaha E, Brown JC, Nagele P. Etiology of Acute Coronary Syndrome after Noncardiac Surgery. Anesthesiology. 2018 Feb 26. doi: 10.1097/ALN.0000000000002107. [Epub ahead of print] PubMed PMID: 29481375.

Nagele P, Zorumski CF, Conway C. Exploring Nitrous Oxide as Treatment of Mood Disorders: Basic Concepts. J Clin Psychopharmacol. 2018 Apr;38(2):144-148. doi: 10.1097/JCP.0000000000000837. PubMed PMID: 29360650; PubMed Central PMCID: PMC5825282.

Brown JC, Samaha E, Rao S, Helwani MA, Duma A, Brown F, Gage BF, Miller JP, Jaffe AS, Apple FS, Scott MG, Nagele P. High-Sensitivity Cardiac Troponin T Improves the Diagnosis of Perioperative MI. Anesth Analg. 2017 Nov;125(5):1455-1462. doi: 10.1213/ANE.0000000000002240. PubMed PMID: 28719430.

Duma A, Pal S, Johnston J, Helwani MA, Bhat A, Gill B, Rosenkvist J, Cartmill C, Brown F, Miller JP, Scott MG, Sanchez-Conde F, Jarvis M, Farber NB, Zorumski CF, Conway C, Nagele P. High-sensitivity Cardiac Troponin Elevation after Electroconvulsive Therapy: A Prospective, Observational Cohort Study. Anesthesiology. 2017 Apr;126(4):643-652. doi: 10.1097/ALN.0000000000001531. PubMed PMID: 28166110; PubMed Central PMCID: PMC5350051.

Kopec M, Duma A, Helwani MA, Brown J, Brown F, Gage BF, Gibson DW, Miller JP, Novak E, Jaffe AS, Apple FS, Scott MG, Nagele P. Improving Prediction of Postoperative Myocardial Infarction With High-Sensitivity Cardiac Troponin T and NT-proBNP. Anesth Analg. 2017 Feb;124(2):398-405. doi: 10.1213/ANE.0000000000001736. PubMed PMID: 28002165; PubMed Central PMCID: PMC5243152.

Nagele P. The Case for a Revised Definition of Myocardial Infarction-Resolving the Ambiguity of Type 2 Myocardial Infarction. JAMA Cardiol. 2016 Jun 1;1(3):247-8. doi: 10.1001/jamacardio.2016.0511. PubMed PMID: 27438099.

Zorumski CF, Nagele P, Mennerick S, Conway CR. Treatment-Resistant Major Depression: Rationale for NMDA Receptors as Targets and Nitrous Oxide as Therapy. Front Psychiatry. 2015 Dec 9;6:172. doi: 10.3389/fpsyt.2015.00172. eCollection 2015. Review. PubMed PMID: 26696909; PubMed Central PMCID: PMC4673867 

Duma A, Pal S, Helsten D, Stein PK, Miller JP, Nagele P. High-Fidelity Analysis of Perioperative QTc Prolongation. Anesth Analg. 2016 Feb;122(2):439-48. doi: 10.1213/ANE.0000000000001023. PubMed PMID: 26505572.

Sheth T, Chan M, Butler C, Chow B, Tandon V, Nagele P, Mitha A, Mrkobrada M, Szczeklik W, Faridah Y, Biccard B, Stewart LK, Heels-Ansdell D, Devereaux PJ; Coronary Computed Tomographic Angiography and Vascular Events in Noncardiac Surgery Patients Cohort Evaluation Study Investigators. Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: prospective cohort study. BMJ. 2015 Apr 22;350:h1907. doi: 10.1136/bmj.h1907. PubMed PMID: 25902738; PubMed Central PMCID: PMC4413859.

Nagele P, Duma A, Kopec M, Gebara MA, Parsoei A, Walker M, Janski A, Panagopoulos VN, Cristancho P, Miller JP, Zorumski CF, Conway CR. Nitrous Oxide for Treatment-Resistant Major Depression: A Proof-of-Concept Trial. Biol Psychiatry. 2015 Jul 1;78(1):10-18. doi: 10.1016/j.biopsych.2014.11.016. Epub 2014 Dec 9. PubMed PMID: 25577164. 

Nagele P, Brown F, Gage BF, Gibson DW, Miller JP, Jaffe AS, Apple FS, Scott MG. High-sensitivity cardiac troponin T in prediction and diagnosis of myocardial infarction and long-term mortality after noncardiac surgery. Am Heart J. 2013 Aug;166(2):325-332.e1. doi: 10.1016/j.ahj.2013.04.018. Epub 2013 Jun 24. PubMed PMID: 23895816; PubMed Central PMCID: PMC3728677.

Nagele P, Brown F, Francis A, Scott MG, Gage BF, Miller JP; VINO Study Team. Influence of nitrous oxide anesthesia, B-vitamins, and MTHFR gene polymorphisms on perioperative cardiac events: the vitamins in nitrous oxide (VINO) randomized trial. Anesthesiology. 2013 Jul;119(1):19-28. doi: 10.1097/ALN.0b013e31829761e3. PubMed PMID: 23856660; PubMed Central PMCID: PMC3919550.

Blake CM, Kharasch ED, Schwab M, Nagele P. A meta-analysis of CYP2D6 metabolizer phenotype and metoprolol pharmacokinetics. Clin Pharmacol Ther. 2013 Sep;94(3):394-9. doi: 10.1038/clpt.2013.96. Epub 2013 May 9. Review. PubMed PMID: 23665868; PubMed Central PMCID: PMC3818912.

Vascular Events In Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators, Devereaux PJ, Chan MT, Alonso-Coello P, Walsh M, Berwanger O, Villar JC, Wang CY, Garutti RI, Jacka MJ, Sigamani A, Srinathan S, Biccard BM, Chow CK, Abraham V, Tiboni M, Pettit S, Szczeklik W, Lurati Buse G, Botto F, Guyatt G, Heels-Ansdell D, Sessler DI, Thorlund K, Garg AX, Mrkobrada M, Thomas S, Rodseth RN, Pearse RM, Thabane L, McQueen MJ, VanHelder T, Bhandari M, Bosch J, Kurz A, Polanczyk C, Malaga G, Nagele P, Le Manach Y, Leuwer M, Yusuf S. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA. 2012 Jun 6;307(21):2295-304. doi: 10.1001/jama.2012.5502. Erratum in: JAMA. 2012 Jun 27;307(24):2590. PubMed PMID: 22706835.

Nagele P, Pal S, Brown F, Blood J, Miller JP, Johnston J. Postoperative QT interval prolongation in patients undergoing noncardiac surgery under general anesthesia. Anesthesiology. 2012 Aug;117(2):321-8. PubMed PMID: 22692379; PubMed Central PMCID: PMC3406265.

Nagele P, Liggett SB. Genetic variation, β-blockers, and perioperative myocardial infarction. Anesthesiology. 2011 Dec;115(6):1316-27. doi: 10.1097/ALN.0b013e3182315eb2. Review. PubMed PMID: 21918425; PubMed Central PMCID: PMC3226841.

Hüpfl M, Selig HF, Nagele P. Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Lancet. 2010 Nov 6;376(9752):1552-7. doi: 10.1016/S0140-6736(10)61454-7. Epub 2010 Oct 14. PubMed PMID: 20951422; PubMed Central PMCID: PMC2987687.

Nagele P, Rao LK, Penta M, Kallogjeri D, Spitznagel EL, Cavallone LF, Nussenbaum B, Piccirillo JF. Postoperative myocardial injury after major head and neck cancer surgery. Head Neck. 2011 Aug;33(8):1085-91. doi: 10.1002/hed.21577. Epub 2010 Sep 30. PubMed PMID: 20886662; PubMed Central PMCID: PMC3017648.

Pehböck D, Wenzel V, Voelckel W, Jonsson K, Herff H, Mittlböck M, Nagele P. Effects of preoxygenation on desaturation time during hemorrhagic shock in pigs. Anesthesiology. 2010 Sep;113(3):593-9. doi: 10.1097/ALN.0b013e3181e73f07. PubMed PMID: 20683251.

Nagele P, Zeugswetter B, Wiener C, Burger H, Hüpfl M, Mittlböck M, Födinger M. Influence of methylenetetrahydrofolate reductase gene polymorphisms on homocysteine concentrations after nitrous oxide anesthesia. Anesthesiology. 2008 Jul;109(1):36-43. doi: 10.1097/ALN.0b013e318178820b. PubMed PMID: 18580170.

Nagele P, Mendel JB, Placzek WJ, Scott BA, D'Avignon DA, Crowder CM. Volatile anesthetics bind rat synaptic snare proteins. Anesthesiology. 2005 Oct;103(4):768-78. PubMed PMID: 16192769.

Nagele P, Metz LB, Crowder CM. Xenon acts by inhibition of non-N-methyl-D-aspartate receptor-mediated glutamatergic neurotransmission in Caenorhabditis elegans. Anesthesiology. 2005 Sep;103(3):508-13. PubMed PMID: 16129975.

Nagele P, Metz LB, Crowder CM. Nitrous oxide (N(2)O) requires the N-methyl-D-aspartate receptor for its action in Caenorhabditis elegans. Proc Natl Acad Sci U S A. 2004 Jun 8;101(23):8791-6. Epub 2004 May 24. PubMed PMID: 15159532; PubMed Central PMCID: PMC423274.

Rossaint R, Reyle-Hahn M, Schulte Am Esch J, Scholz J, Scherpereel P, Vallet B, Giunta F, Del Turco M, Erdmann W, Tenbrinck R, Hammerle AF, Nagele P; Xenon Study Group. Multicenter randomized comparison of the efficacy and safety of xenon and isoflurane in patients undergoing elective surgery. Anesthesiology. 2003 Jan;98(1):6-13. PubMed PMID: 12502972.