Bruce Spiess, M.D., expert on patient blood management and cardiothoracic anesthesia, retires

"…some of the coolest work I’ve ever done is just coming to fruition now. It’s bittersweet. So many opportunities have come from this department…”

Bruce Spiess, M.D., FAHA

Dr. Spiess judging posters at the department's Celebration of Research in 2022

Bruce Spiess, M.D., FAHA, a cardiothoracic anesthesiologist and world-renowned expert on blood management who has been an ardent proponent of research, retired in early March after six years with the Department of Anesthesiology.

Spiess, professor of anesthesiology and associate chair of research, will continue with the department as professor emeritus. He plans to continue working on several research projects, growing the Patient Blood Management (PBM) program that he created, and mentoring junior faculty researchers.

“In some ways, some of the coolest work I’ve ever done is just coming to fruition now,” Spiess said. “It’s bittersweet. So many opportunities have come from this department and the people in this department.”

Perhaps Spiess’ most important contribution is the many people he brought to the department, said Timothy E. Morey, M.D., professor and chair.

“I can’t imagine anyone leaving a more lasting footprint on the department,” Morey said.

Spiess has focused the bulk of his research efforts on blood, specifically its critical oxygen-carrying capacity, oxygen therapeutic pharmaceutical development (particularly perfluorocarbon emulsions), the risks of blood transfusion, coagulation/coagulopathy, and monitoring technologies. His work has been funded mostly by the U.S. Department of Defense (DoD), and he has led major conferences for the DoD, FDA, and other large agencies regarding critical blood issues.

Spiess credited the strong support and infrastructure in the Department of Anesthesiology in his success. “There is an absolute academic dedication to excellence here,” he said.

He hopes his legacy involves instilling an abiding enthusiasm for research.

“My enthusiasm for projects and research is one of my greatest attributes,” Spiess said. “I hope people are inspired. No. 1., I hope that the department continues to build on the outstanding research infrastructure that we have been developing.”

Spiess’ zeal for his work has motivated many to work toward making a positive impact, said Mary Jane Michael, R.N., M.S.N., CCRC, the department’s clinical research manager who has worked with Spiess for 16 years.

“Dr. Spiess has a fighting spirit, is passionate about his work, and is always willing to help those who are motivated and want to advance and make a difference,” she said.

Laurie Davies, M.D., associate professor of anesthesiology and medical director of the Shands Operating Rooms, has known Spiess for more than 25 years. She got to know him well when they were codirectors of the annual Society of Cardiovascular Anesthesiologists (SCA) ski meeting that occurred for about 10 years. The meeting was unique in that it was designed to appeal to anesthesiologists, surgeons, and perfusionists.

“I was always amazed at how many people Bruce knows around the world, and all of them were delighted to come speak and interact with him and the other faculty,” Davies said. Bruce has always had the ability to present complex information in a passionate way. I am very glad we managed to entice him to come to Gainesville as he has helped elevate our department in multiple meaningful ways.”

Roots in research

“As soon as you see that an idea that you came up with works and the rest of the world says, ‘that’s really cool, your idea works,’ you want to do it again.”

Bruce Spiess, M.D., FAHA

Drs. Spiess and Rabai discussing research at the Celebration of Research in 2019

Spiess was born to academic parents and grew up steeped in a research background; his father was a geneticist and his mother was a biochemist. He attended Denison University in Granville, Ohio, and earned his medical degree at Rush Medical College in Chicago. He completed his anesthesiology training at the Mayo Clinic, where he specialized in cardiothoracic anesthesiology and was chief resident.

Spiess returned to Rush for his first faculty position in 1983 and stayed until 1990. From there, he traveled to Seattle to become the chief of cardiothoracic anesthesiology at the University of Washington. He eventually took the position of vice chair of anesthesiology at Virginia Commonwealth University in Richmond, where he stayed for 17 years before coming to UF in May 2016.

Despite his upbringing, Spiess never intended to go into research.

“When I went to med school, I swore I’d never do a lick of research in my life,” he said. But after being cajoled into working on a research project at his first job, “it became infectious.”

“As soon as you see that an idea that you came up with works and the rest of the world says, ‘that’s really cool, your idea works,’ you want to do it again,” Spiess said. “You end up becoming an expert in some field that no one else is an expert in and that’s unique.”

Spiess has authored more than 200 peer-reviewed academic articles, more than 40 book chapters, and seven textbooks, and he has appeared on the Discovery Channel and been quoted in numerous media outlets including CNN and Men’s Health magazine.

As it pertains to coagulation management, Spiess was the first to author research studies on the use of thromboelastography for heart surgery. He has published extensively in that area, calling on clinicians to develop and use whole blood testing in conjunction with algorithms for coagulopathy treatment.

He has served on the board of directors of various academic societies, including the SCA, as well as the boards of commercial companies.

Cultivating a vision

Mary Jane Michael and Dr. Bruce Spiess working on patient blood management

Spiess has been an exemplary proponent of PBM at UF, and his leadership has helped to encourage best practices.

During his tenure, UF Health became one of the very few institutions in the country to obtain a compassionate use license from the FDA for Hemopure, a bovine hemoglobin product that works as a “bridge” by delivering oxygen while the body regenerates its own blood. The license means it can be used when there are no other options available in patients who qualify.

The hospital has also made notable strides in applying the principles of PBM to cardiac surgery. Transfusion practices for major aortic surgical procedures have improved and waste has been reduced, Spiess said. Additionally, PBM has created opportunities for Jehovah’s Witnesses to receive care at UF Health, an important achievement to ensure equitable care.

Spiess hopes his vision of creating a culture around the principles of PBM at UF Health will endure and grow, and he also intends to continue his advocacy for PBM with the U.S. Congress and globally.

Striving for new standards

One way that Spiess hopes to build on the department’s research infrastructure is through the SOLAR SystemTM project. SOLAR, which stands for Strategies to Orient, Learn, and Achieve in Research, is a web-enabled application to guide clinician-investigators through all steps involved in a research project, from an idea to development and reporting.

“Every time a researcher approaches a project, there are various mental steps to go through, in terms of what’s my question, what’s my hypothesis, what are my objectives, what literature has been published,” Spiess said. “All of that you can do in stepwise fashion and SOLAR can walk you through it.”

The application was created by Spiess, the STatistics in Anesthesiology Research (STAR Core) team (Cynthia Garvan, Ph.D., Penny Reynolds, Ph.D., and Terrie Vasilopoulos, Ph.D.) and Keith Howell, M.D. The team plans to reveal the first iteration soon, and Spiess hopes it has a wide-ranging impact.

“This could become a standard for many in academia,” he said.

Spiess continues to advance many other research projects, including:

  • The ARCTIC trial, which involves using inhaled adenosine to treat acute respiratory distress syndrome (ARDS), including in patients with COVID-19. Animal toxicology, which is needed to take the next steps toward clinical use, is expected to begin soon.
  • A collaboration with the Department of Chemical Engineering to develop an all-natural, cost-effective, pathogen-free oxygen-carrying particle. Spiess is a Co-PI on the DoD-funded project with Whitney L. Stoppel, Ph.D., in the Department of Chemical Engineering. They are investigating how silk and salmon hemoglobin can be combined to improve the ability of all-natural nanoparticles to deliver oxygen at clinically relevant rates and hope to begin testing soon.
  • Several collaborations that investigate the use of perfluorocarbon artificial blood compounds to treat spinal cord injury and other conditions. Spiess is collaborating with Prodip Bose, M.D., Ph.D., and researchers in the McKnight Brain Institute on these initiatives.
  • A collaboration with researchers in the Department of Chemistry to develop point-of-care blood tests to detect a protein that plays an important role in anticoagulation. The work involves a new molecule, or aptamer, that detects the protein antithrombin III (AT-III), which helps the body regulate bleeding and clotting. This work could result in new point-of-care tests for key proteins in the blood. Detecting these proteins can help health care professionals intervene in disease states.

Spiess has also been involved in numerous quality improvement initiatives in the department, including helping to lead the COVID-19 mask alternative project in 2020, which garnered international attention.

A lauded career, with much more to come

Doctors Morey, Frank and Spiess at the 2019 Celebration of Research
Drs. Morey (left) and Spiess (right) with 2019 Celebration of Research keynote speaker Steven Frank, MD (middle)

In a career spanning five decades, Spiess has received many of the highest honors in his field, all since he joined UF.  In 2017, Spiess received the highest honor bestowed by his undergraduate institution, the Alumni Citation, for his work in medicine. In 2021, he received the Kathleen J. Sazama Award from the Society for the Advancement of Blood Management (SABM) for his contributions to the field.

This spring, he is set to receive the highest award given by the SCA in recognition of his lifetime achievements, joining an elite group. He is to receive the award during the society’s annual meeting this spring in Palm Springs, California, where Spiess is retiring with his wife.

“To have it come in the year I’m retiring is very meaningful,” Spiess said. “I feel very honored.”

Spiess said his primary message to others interested in research is the importance of following your heart. “Follow your passions and believe in yourself and what your knowledge base tells you,” he said.

Research, fundamentally, is about incremental steps and a dogged pursuit of something that may not yet be apparent.

“Ultimately, you look back and say, ‘I did all that?’” Spiess said. “And I’m not done yet. In some ways, I feel like I’m just hitting my stride.”