About

Joaquin D. Araos, Ph.D., MV, ACVAA, is an Associate Professor in the Section of Anesthesiology and Pain Medicine at the Department of Clinical Sciences within Cornell University College of Veterinary Medicine. His research interests focus on the development of safe mechanical ventilation protocols for veterinary species in both research and clinical settings, with a specific interest in the study of ventilator-induced lung injury, particularly in the context of acute respiratory distress syndrome. Dr. Araos has a background in veterinary medicine from Universidad Mayor in Santiago de Chile, and he completed a residency in Large and Small Animal Anesthesiology at the University of Pennsylvania, becoming a Diplomate of the American College of Veterinary Anesthesia and Analgesia in 2012. He earned his Ph.D. in Clinical Sciences from Pontificia Universidad Catolica de Chile, where he studied the effects of extracorporeal techniques to support lungs affected by acute respiratory failure. His professional experience includes practicing anesthesia since 2007, working as a clinical anesthesiologist at the University of Montreal, and serving as a lecturer at Cornell University since 2019. Dr. Araos is a founding member and former Director of the Chilean Society of Veterinary Anesthesiology (SAVECH) and has been recognized with a national Conicyt scholarship during his Ph.D. studies.

Research topics

• Anesthesia
• Medicine
• Internal medicine

Selected publications

• Flow‐controlled expiration improves gas exchange in anaesthetised horses undergoing orthopaedic surgery

  Equine Veterinary Journal · 2025-08-21

  articleOpen accessSenior author

  Abstract Background Flow‐controlled expiration (FLEX) has been shown to significantly enhance oxygenation in horses under laboratory conditions. Objective This study aims to corroborate these findings by evaluating the effects of FLEX on gas exchange in a randomised clinical trial involving a large population of clinical horses undergoing orthopaedic surgery. Study Design Prospective randomised clinical trial. Methods A total of 406 healthy adult horses scheduled for elective orthopaedic procedures were recruited for this prospective clinical trial. Horses were randomly assigned to FLEX or VCV (volume‐controlled ventilation) groups in dorsal (VCV‐D and FLEX‐D) or lateral recumbency (VCV‐L and FLEX‐L). Arterial blood gases were measured at 30, 75, and 120 min post‐induction to assess arterial oxygenation (arterial partial pressure of oxygen to inspired fraction of oxygen ratio, PaO 2 /FiO 2 ). A global index of ventilation/perfusion matching ([PaCO 2 − ETCO 2 ]/PaCO 2 ) was also calculated. Peak airway pressure (P peak ) and tidal volume were measured to calculate dynamic respiratory system compliance (Cdyn). Data were compared with repeated‐measures ANOVA. Results Horses ventilated with FLEX showed significantly higher PaO 2 /FiO 2 (FLEX‐D vs. VCV‐D, 369 ± 42 vs. 198 ± 112 mmHg, p < 0.001; FLEX‐L vs. VCV‐L, 436 ± 38 vs. 249 ± 88 mmHg, p < 0.001). FLEX also improved Cdyn (FLEX‐D vs. VCV‐D, 0.81 ± 0.1 vs. 0.64 ± 0.12, p = 0.01) and the global V̇/Q̇ index ([PaCO 2 − ETCO 2 ]/PaCO 2 ) (FLEX‐D vs. VCV‐D, 0.11 ± 0.03 vs. 0.18 ± 0.03, p = 0.03) in dorsal‐positioned but not lateral‐positioned horses. Main Limitations Anaesthesia protocols were not standardised; anaesthetists were not masked to the intervention of interest, and findings may not be generalisable to other patient populations. Conclusions These results confirm previous laboratory findings, demonstrating that FLEX improves oxygenation, ventilation–perfusion matching, and respiratory mechanics compared to VCV in a large clinical population of anaesthetised horses.

  PublisherOA PDFDOI

• Balancing the scales: using ventilator time to counter mass loading

  Journal of Applied Physiology · 2025-11-25

  articleOpen access
  PublisherDOI

• Diagnostic accuracy of pulse pressure variation, stroke volume variation and plethysmography variability index for prediction of fluid responsiveness in anesthetized and mechanically ventilated dogs: a systematic review and meta-analysis

  Veterinary Anaesthesia and Analgesia · 2025-10-27 · 1 citations

  review
  PublisherDOI

• Abstract Sun708: The Impact of Intra-Arrest TEE on Epinephrine Administration in In-Hospital Cardiac Arrest: A Resuscitative TEE Collaborative Registry (rTEECoRe) Study

  Circulation · 2025-11-03

  article

  Background: Intra-arrest transesophageal echocardiography (TEE) is increasingly used during in-hospital cardiac arrest (IHCA) to guide resuscitation with evidence that directing the area of maximal compression (AMC) may improve outcomes. While TEE offers potential benefits for real-time decision-making, limited data exist regarding the impact of intra-arrest TEE on standard CA resuscitative efforts. We analyzed the Resuscitative TEE Collaborative Registry (rTEECoRe), a multicenter registry of acute care TEE, to evaluate the safety profile of intra-arrest TEE. We examined the temporal relationship of TEE-guided AMC evaluation attempt with the delivery of standard epinephrine administration. Methods: We analyzed IHCA patients evaluated with TEE collected through the Resuscitative TEE Collaborative Registry (NCT04972526). Patients in whom TEE was used to evaluate the AMC and those without AMC evaluation were included for analysis. We investigated the association between the attempt to identify the AMC and the timing of standard resuscitation interventions, specifically the time to first epinephrine administration. Linear regression was used to assess the relationship between AMC evaluation attempt and time to first epinephrine. Statistical significance was set at p < 0.05. Results: Among 117 patients who received intra-arrest TEE during in-hospital cardiac arrest, attempts to evaluate the AMC were not associated with significant delays in the administration of the first epinephrine dose (p = 0.114). In logistic regression analysis, AMC evaluation attempt was also not associated with return of spontaneous circulation (ROSC) (odds ratio [OR] 1.53, 95% confidence interval [CI] 0.59–4.11; p = 0.39) or survival to hospital discharge (OR 0.54, 95% CI 0.15–2.06; p = 0.34). Other covariates, including age, sex, CPR modality, initial rhythm, and arrest location, were not significantly associated with either outcome. Conclusion: In this multicenter cohort of patients undergoing intra-arrest TEE during IHCA, evaluation of AMC was not associated with delays in epinephrine administration or with differences in ROSC or survival to discharge. These findings support the idea that focused intra-arrest TEE imaging, including the assessment of AMC, can be performed without compromising the timely delivery of standard resuscitation interventions.

  PublisherDOI

• Comparison of early and late time-controlled adaptive ventilation on pulmonary gas exchange in anesthetized horses

  Veterinary Anaesthesia and Analgesia · 2025-06-25 · 1 citations

  articleSenior author
  PublisherDOI

• Speed of reversal by sugammadex or neostigmine after vecuronium-induced neuromuscular block in dogs: Randomized clinical trial and pharmacological modeling

  Veterinary Anaesthesia and Analgesia · 2025-03-11

  article
  PublisherDOI

• Air-test for assessing gas exchange and the potential benefit of alveolar recruitment manoeuvre in anaesthetized dogs

  Veterinary Anaesthesia and Analgesia · 2025-07-26

  articleOpen accessSenior author
  PublisherOA PDFDOI

• The effects of positive end-expiratory pressure and end-inspiratory pause on dead space and alveolar ventilation in mechanically ventilated dogs

  Veterinary Anaesthesia and Analgesia · 2025-08-20 · 1 citations

  article
  PublisherDOI

• Abstract Or108: Divergent Biventricular Mechano-Energetic Responses to VA-ECMO Flow Ramping After Cardiac Arrest: A Preclinical ECPR Swine Model

  Circulation · 2025-11-03

  articleSenior author

  Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used in cardiac arrest (CA) resuscitation, yet its effects on biventricular mechanics remain poorly defined. Given that early on-ECMO hemodynamics associate with survival, we used a swine model with real-time pressure-volume (PV) loop analysis to assess ventricular-arterial coupling and mechano-energetics during graded ECMO flow after CA. Methods: In a ventricular fibrillation swine model, high-fidelity conductance catheterization was performed to measure real-time PV loops in left ventricle (LV) and right ventricle (RV). Baseline (pre-arrest) data were acquired, followed by 20 minutes of CA and VA-ECMO initiation. PV data were obtained across multiple ECMO flow rates (Q [cc/kg/min]). Ventricular elastance (Ees), arterial elastance (Ea), Ees/Ea coupling ratio, stroke work (SW), potential energy (PE), pressure-volume area (PVA), and mechanical energy efficiency (MEE = SW/PVA) were quantified. Results: Both ventricles demonstrated acute post-arrest dysfunction; however, the trajectories diverged thereafter. RV Findings: Ees/Ea declined from 1.7 (baseline) to <0.4 across ECMO flows, reflecting uncoupling. This was driven by disproportionate increases in Ea and declines in stroke volume, despite modest changes in contractility (Ees). RV volumes (EDV/ESV) remained elevated, indicating sustained dilation. SW remained flat while PE and PVA increased, resulting in a drop in MEE from >80% to ~40%. LV Findings: The LV exhibited partial recovery in Ees with ECMO ramping. Despite increased Ea (likely from retrograde flow and reduced ejection), Ees/Ea remained stable (~0.7). SW and PVA both declined, consistent with unloading, yet MEE was preserved. PV loop morphology showed progressive LV volume reduction with preserved loop geometry, while RV loops demonstrated early dilation, impaired ejection, and rising energetic burden. Conclusions: This model shows that following CA and VA-ECMO initiation, the RV and LV display distinct mechano-energetic and coupling patterns. The RV demonstrated persistent uncoupling and inefficiency, potentially due to post-arrest pulmonary changes, while the LV showed partial recovery and preserved efficiency. These results support the need for individualized biventricular assessment during ECMO-supported resuscitation.

  PublisherDOI

• Rocuronium and sugammadex in neonatal and juvenile foals

  Veterinary Anaesthesia and Analgesia · 2025-07-03 · 1 citations

  letter
  PublisherDOI

Frequent coauthors

• Alejandro Bruhn

  Medicina

  117 shared

• Pablo Cruces

  Universidad Andrés Bello

  114 shared

• Jaime Retamal

  Pontificia Universidad Católica de Chile

  114 shared

• Guillermo Bugedo

  Pontificia Universidad Católica de Chile

  111 shared

• Rodrigo Cornejo

  Hospital Clínico de la Universidad de Chile

  110 shared

• Dagoberto Soto

  Pontificia Universidad Católica de Chile

  109 shared

• Leyla Alegría

  Pontificia Universidad Católica de Chile

  109 shared

• Patricio García

  Pontificia Universidad Católica de Chile

  108 shared

Education

• PhD, School of Medicine

  Pontificia Universidad Católica de Chile

  2017

• DVM

  Universidad Mayor

  2007

Awards & honors

• Founding member and former Director, Chilean society of vete…
• Recipient of the national Conicyt scholarship, covering full…
• Diplomate, American College of Veterinary Anesthesia and Ana…