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ANAESTHESIOLOGY (121 journals)                     

Showing 1 - 121 of 121 Journals sorted alphabetically
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 62)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 6)
Acute Pain     Full-text available via subscription   (Followers: 16)
Advances in Anesthesia     Full-text available via subscription   (Followers: 31)
African Journal of Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 9)
Ain-Shams Journal of Anaesthesiology     Open Access   (Followers: 2)
Ain-Shams Journal of Anesthesiology     Open Access   (Followers: 1)
Ambulatory Anesthesia     Open Access   (Followers: 9)
Anaesthesia     Hybrid Journal   (Followers: 239)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 72)
Anaesthesia and Intensive Care     Full-text available via subscription   (Followers: 62)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 28)
Anaesthesia Reports     Hybrid Journal  
Anaesthesia, Pain & Intensive Care     Open Access  
Anaesthesiology Intensive Therapy     Open Access   (Followers: 9)
Analgesia & Resuscitation : Current Research     Hybrid Journal   (Followers: 7)
Anestesia Analgesia Reanimación     Open Access   (Followers: 1)
Anestesia en México     Open Access   (Followers: 1)
Anesthesia & Analgesia     Hybrid Journal   (Followers: 275)
Anesthesia : Essays and Researches     Open Access   (Followers: 10)
Anesthesia Progress     Hybrid Journal   (Followers: 6)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 2)
Anesthesiology     Hybrid Journal   (Followers: 232)
Anesthesiology and Pain Medicine     Open Access   (Followers: 23)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 25)
Anesthesiology Research and Practice     Open Access   (Followers: 15)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Annales Françaises d'Anesthésie et de Réanimation     Full-text available via subscription   (Followers: 4)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 15)
BDJ Team     Open Access   (Followers: 1)
Best Practice & Research Clinical Anaesthesiology     Hybrid Journal   (Followers: 15)
BJA : British Journal of Anaesthesia     Hybrid Journal   (Followers: 245)
BJA Education     Hybrid Journal   (Followers: 70)
BMC Anesthesiology     Open Access   (Followers: 18)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 47)
Brazilian Journal of Anesthesiology     Open Access   (Followers: 5)
Brazilian Journal of Anesthesiology (Edicion en espanol)     Open Access  
Brazilian Journal of Anesthesiology (English edition)     Open Access   (Followers: 1)
Brazilian Journal of Pain (BrJP)     Open Access  
British Journal of Pain     Hybrid Journal   (Followers: 28)
Canadian Journal of Anesthesia/Journal canadien d'anesthésie     Hybrid Journal   (Followers: 48)
Case Reports in Anesthesiology     Open Access   (Followers: 11)
Clinical Journal of Pain     Hybrid Journal   (Followers: 19)
Colombian Journal of Anesthesiology : Revista Colombiana de Anestesiología     Hybrid Journal   (Followers: 1)
Current Anaesthesia & Critical Care     Full-text available via subscription   (Followers: 36)
Current Anesthesiology Reports     Hybrid Journal   (Followers: 4)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 61)
Current Pain and Headache Reports     Hybrid Journal   (Followers: 2)
Der Anaesthesist     Hybrid Journal   (Followers: 9)
Der Schmerz     Hybrid Journal   (Followers: 4)
Der Schmerzpatient     Hybrid Journal  
Douleur et Analgésie     Hybrid Journal  
Egyptian Journal of Anaesthesia     Open Access   (Followers: 3)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
EMC - Anestesia-Reanimación     Hybrid Journal  
EMC - Anestesia-Rianimazione     Hybrid Journal  
EMC - Urgenze     Full-text available via subscription  
European Journal of Anaesthesiology     Hybrid Journal   (Followers: 30)
European Journal of Pain     Full-text available via subscription   (Followers: 27)
European Journal of Pain Supplements     Full-text available via subscription   (Followers: 5)
Global Journal of Anesthesiology     Open Access   (Followers: 2)
Headache The Journal of Head and Face Pain     Hybrid Journal   (Followers: 5)
Indian Journal of Anaesthesia     Open Access   (Followers: 7)
Indian Journal of Pain     Open Access   (Followers: 2)
Indian Journal of Palliative Care     Open Access   (Followers: 8)
International Anesthesiology Clinics     Hybrid Journal   (Followers: 9)
International Journal of Clinical Anesthesia and Research     Open Access  
Itch & Pain     Open Access   (Followers: 2)
JA Clinical Reports     Open Access  
Journal Club Schmerzmedizin     Hybrid Journal  
Journal of Anesthesia & Clinical Research     Open Access   (Followers: 10)
Journal of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8)
Journal of Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Anesthesia History     Full-text available via subscription   (Followers: 1)
Journal of Anesthesiology and Clinical Science     Open Access   (Followers: 1)
Journal of Cellular and Molecular Anesthesia     Open Access  
Journal of Clinical Anesthesia     Hybrid Journal   (Followers: 13)
Journal of Critical Care     Hybrid Journal   (Followers: 42)
Journal of Headache and Pain     Open Access   (Followers: 3)
Journal of Neuroanaesthesiology and Critical Care     Open Access   (Followers: 3)
Journal of Neurosurgical Anesthesiology     Hybrid Journal   (Followers: 8)
Journal of Obstetric Anaesthesia and Critical Care     Open Access   (Followers: 22)
Journal of Pain     Hybrid Journal   (Followers: 19)
Journal of Pain and Symptom Management     Hybrid Journal   (Followers: 45)
Journal of Pain Research     Open Access   (Followers: 10)
Journal of Palliative Care     Full-text available via subscription   (Followers: 20)
Journal of Society of Anesthesiologists of Nepal     Open Access   (Followers: 2)
Journal of the Bangladesh Society of Anaesthesiologists     Open Access  
Jurnal Anestesi Perioperatif     Open Access  
Jurnal Anestesiologi Indonesia     Open Access  
Karnataka Anaesthesia Journal     Open Access   (Followers: 2)
Le Praticien en Anesthésie Réanimation     Full-text available via subscription   (Followers: 2)
Local and Regional Anesthesia     Open Access   (Followers: 8)
Medical Gas Research     Open Access   (Followers: 3)
Medycyna Paliatywna w Praktyce     Open Access   (Followers: 1)
OA Anaesthetics     Open Access   (Followers: 3)
Open Anesthesia Journal     Open Access  
Open Journal of Anesthesiology     Open Access   (Followers: 10)
Pain     Hybrid Journal   (Followers: 61)
Pain Clinic     Hybrid Journal   (Followers: 1)
Pain Management     Hybrid Journal   (Followers: 18)
Pain Medicine     Hybrid Journal   (Followers: 13)
Pain Research and Management     Open Access   (Followers: 7)
Pain Research and Treatment     Open Access   (Followers: 2)
Pain Studies and Treatment     Open Access   (Followers: 2)
Research and Opinion in Anesthesia and Intensive Care     Open Access   (Followers: 3)
Revista Chilena de Anestesia     Open Access   (Followers: 1)
Revista Colombiana de Anestesiología     Open Access   (Followers: 1)
Revista Cubana de Anestesiología y Reanimación     Open Access   (Followers: 1)
Revista da Sociedade Portuguesa de Anestesiologia     Open Access  
Revista Española de Anestesiología y Reanimación     Hybrid Journal  
Revista Española de Anestesiología y Reanimación (English Edition)     Full-text available via subscription   (Followers: 2)
Romanian Journal of Anaesthesia and Intensive Care     Open Access   (Followers: 1)
Saudi Journal of Anaesthesia     Open Access   (Followers: 7)
Scandinavian Journal of Pain     Hybrid Journal   (Followers: 1)
Southern African Journal of Anaesthesia and Analgesia     Open Access   (Followers: 8)
Sri Lankan Journal of Anaesthesiology     Open Access   (Followers: 2)
Survey of Anesthesiology     Full-text available via subscription   (Followers: 12)
Techniques in Regional Anesthesia and Pain Management     Hybrid Journal   (Followers: 11)
Topics in Pain Management     Full-text available via subscription   (Followers: 2)
Trends in Anaesthesia and Critical Care     Full-text available via subscription   (Followers: 23)

           

Similar Journals
Journal Cover
European Journal of Anaesthesiology
Journal Prestige (SJR): 1.179
Citation Impact (citeScore): 2
Number of Followers: 30  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0265-0215 - ISSN (Online) 1365-2346
Published by LWW Wolters Kluwer Homepage  [301 journals]
  • BIG FIVE strategies for survival following out-of-hospital cardiac arrest
    • Authors: Böttiger; Bernd W.; Becker, Lance B.; Kern, Karl B.; Lippert, Freddy; Lockey, Andrew; Ristagno, Giuseppe; Semeraro, Federico; Wingen, Sabine
      Abstract: imageNo abstract available
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Genetic variability in postoperative nausea and vomiting: A systematic
           review
    • Authors: Klenke; Stefanie; Frey, Ulrich H.
      Abstract: imageBACKGROUND Postoperative nausea and vomiting (PONV) is the most frequent side effect following anaesthesia. Predisposition to developing PONV is multifactorial with patient risk factors and anaesthetic techniques both being contributory. However, there is also a genetic susceptibility to PONV, and several studies have aimed to identify polymorphisms contributing to a genetic PONV risk.OBJECTIVE We summarised previous published studies investigating genetic contribution to PONV risk.DESIGN Systematic review without meta-analysis.DATA SOURCE We searched MEDLINE until June 2019.ELIGIBILITY CRITERIA Articles were chosen for review when PONV and polymorphisms were included. Exclusion criteria were reviews/meta-analysis/comments, articles not in the English language, nonappropriate content (e.g. PONV not as primary aim of the study, study investigated opioid-induced nausea) or if articles were pharmacogenetic studies addressing treatment of PONV.RESULTS A total of 59 studies were screened and 14 articles were reviewed including one genome-wide association study (GWAS). Seven studies were performed in East Asians, and seven in Caucasians. Seventeen polymorphisms have been positively associated with PONV in at least one study. Allele frequency of the investigated polymorphisms differs widely between the ethnicities. Furthermore, the anaesthesia regimen and the postoperative time point at which the association with PONV was reported were quite different. Only two polymorphisms, the CHRM3 rs2165870 and the KCNB2 rs349358 (both first associated with PONV in a GWAS), have been significantly associated with PONV incidence in Caucasians in independent studies.CONCLUSION There is a genetic susceptibility to the development of PONV. Two single nucleotide polymorphisms (SNPs), the CHRM3 rs2165870 and the KCNB2 rs349358 SNP, seem to have a major influence on PONV incidence, at least in Caucasians. Both SNPs were primarily identified in a GWAS and this association may lead to a better understanding of the disease aetiology. Further high-quality studies are needed to reveal more insights in genetic PONV susceptibility, particularly so in non-Caucasian ethnicities.
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Effect of two different pre-operative exercise training regimens before
           colorectal surgery on functional capacity: A randomised controlled trial
    • Authors: Minnella; Enrico M.; Ferreira, Vanessa; Awasthi, Rashami; Charlebois, Patrick; Stein, Barry; Liberman, Alexander S.; Scheede-Bergdahl, Celena; Morais, José A.; Carli, Francesco
      Abstract: imageBACKGROUND Multimodal prehabilitation, including exercise training, nutritional therapy and anxiety reduction, has been shown to attenuate functional decline associated with surgery. Due to the growing interest in functional status as a targeted surgical outcome, a better understanding of the optimal prescription of exercise is critical.OBJECTIVE The objective is to compare peri-operative functional trajectory in response to two different exercise training protocols within a 4-week, supervised, multimodal prehabilitation programme.DESIGN This was a single blinded, single centre, randomised controlled study. Participants performed four assessments: at baseline, after prehabilitation (just before surgery), and at 1 and 2 months after surgery.PATIENTS Adult patients scheduled for elective resection of nonmetastatic colorectal cancer were included provided there were no absolute contraindications to exercise nor poor language comprehension.INTERVENTION Patients followed either high-intensity interval training (HIIT), or moderate intensity continuous training (MICT), as part of a 4-week multimodal prehabilitation programme. Both groups followed the same supervised resistance training, nutritional therapy and anxiety reduction interventions. All patients followed standardised peri-operative management.MAIN OUTCOME MEASURE Changes in oxygen consumption at anaerobic threshold, measured with sequential cardio-pulmonary exercise testing, were assessed and compared between groups.RESULTS Forty two patients were included in the primary analysis (HIIT n = 21 vs. MICT n = 21), with mean ± SD age 64.5 ± 11.2 years and 62% were men. At 2 months after surgery, 13/21 (62%) in HIIT and 11/21 (52%) in MICT attended the study visits. Both protocols significantly enhanced pre-operative functional capacity, with no difference between groups: mean (95% confidence interval) oxygen consumption at anaerobic threshold 1.97 (0.75 to 3.19) ml kg−1 min−1 in HIIT vs. 1.71 (0.56 to 2.85) in MICT, P = 0.753. At 2 months after surgery, the HIIT group showed a higher improvement in physical fitness: 2.36 (0.378 to 4.34) ml kg−1 min−1, P = 0.021. No adverse events occurred during the intervention.CONCLUSION Both MICT and HIIT enhanced pre-operative functional capacity.TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03361150.
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Ultrasound-guided interscalene block combined with intermediate or
           superficial cervical plexus block for clavicle surgery: A randomised
           double blind study
    • Authors: Arjun; B. Krishna; Vinod, Chinnamaregowda N.; Puneeth, Jayanna; Narendrababu, Madappa C.
      Abstract: imageBACKGROUND The complex innervation of the clavicle makes general anaesthesia a preferred technique for clavicular surgeries in current practice. The role and approach of regional anaesthesia remains unanswered.OBJECTIVES This study aims to delineate the relative effectiveness between interscalene brachial plexus block with either intermediate cervical plexus or superficial cervical plexus block (CPB) as the anaesthetics for clavicular surgery.DESIGN A randomised, double-blind prospective study.SETTING Single-centre, tertiary care medical college and research institute.PATIENTS Fifty patients with American Society of Anesthesiologist's (ASA) grade I to III, aged 18 to 70 years, scheduled for clavicular surgery, during May 2018 to April 2019 were enrolled in this study.INTERVENTION All patients received interscalene block with 10 ml of 0.5% bupivacaine. Patients were randomised to undergo additional ultrasound-guided intermediate CPB (Group-1) or superficial CPB (Group-2) with 10 ml of 0.5% bupivacaine.MAIN OUTCOME MEASURES The block success rate, sensory block onset time, haemodynamic parameters, duration of postoperative analgesia and complications were noted. Categorical data were analysed using the chi-square test and Fisher's exact test. Continuous data were analysed using Student's t-test.RESULT In Group 1, block success was 100%. In Group 2, five patients failed to achieve adequate surgical anaesthesia (P = 0.02). The average sensory block onset time in Group 1 was 2.5 ± 0.4 min and was longer in Group 2, 4.3 ± 0.5 min (P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Apolipoprotein E ε4 and cognitive function after surgery in middle-aged
           and elderly Danish twins
    • Authors: Dokkedal; Unni; Wod, Mette; Thinggaard, Mikael; Hansen, Tom G.; Rasmussen, Lars S.; Christensen, Kaare; Mengel-From, Jonas
      Abstract: imageBACKGROUND Transient cognitive impairment is common in adult patients of all ages following anaesthesia and surgery. Apolipoprotein E (APOE) ε4 carriers may have a larger deterioration in short-term cognitive function after major surgery compared with APOE ε4 noncarriers.OBJECTIVES The aim was to examine the effect of APOE ε4 on the association between exposure to surgery and anaesthesia, and subsequent cognitive functioning. A more pronounced deterioration in cognitive function in APOE ε4 carriers was hypothesised.DESIGN An observational cross-sectional and a 6 to 10 years longitudinal twin cohort design.SETTING Survey and register study of 2936 Danish twins aged 45 to 92 years.MAIN OUTCOME MEASURES Cognitive function was assessed using five age-sensitive cognitive tests. In the cross-sectional study, we compared twins exposed to surgery with a reference group (unexposed). Linear regression models were used adjusting for sex and age and stratified by APOE ε4 carrier status. In the longitudinal cognitive follow-up study 1671 twins participated. Intrapair analyses were also performed using 70 same-sexed twin pairs concordant for APOE ε4 carrier status, but discordant for major surgery.RESULTS APOE ε4 carriers had lower cognitive scores compared with noncarriers, and this was statistically significant in elderly twins 70+ years of age (mean difference, −0.67; 95% CI, −1.14 to −0.17). There was no significant impact on cognitive function after surgery according to APOE ε4 carrier status in the cross-sectional study. Similarly, there was no APOE ε4 modification in the longitudinal study. Also, in the intrapair analyses no evidence was found of lower cognitive score after major surgery compared with the nonexposed cotwins among APOE ε4 carriers.CONCLUSION No evidence was found of more pronounced long-term deterioration in cognitive function after surgery among APOE ε4 carriers, but elderly APOE ε4 carriers in general performed worse on the cognitive tests than noncarriers.
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Development and performance testing of the low-cost, 3D-printed,
           smartphone-compatible ‘Tansen Videolaryngoscope’ vs. Pentax-AWS
           videolaryngoscope vs. direct Macintosh laryngoscope: A manikin study
    • Authors: Lambert; Christopher T.; John, Stephen C.; John, Anna V.
      Abstract: imageBACKGROUND While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing still and video images with a three dimensional-printed, channelled, hyperangulated blade. The computer-aided design file for the videolaryngoscope blade was emailed and printed in London before evaluation of its performance on a difficult airway manikin.OBJECTIVE To benchmark the intubation performance of the Tansen Videolaryngoscope (TVL) in a ‘difficult airway’ manikin (SimMan3G, tongue fully inflated, neck stiff), against a commercially available videolaryngoscope and a conventional Macintosh laryngoscope.DESIGN A manikin study.SETTING AND PARTICIPANTS Forty-three experienced videolaryngoscope users in two London teaching hospitals.INTERVENTION AND OUTCOME Primary outcome: Intubation success rate. Secondary outcomes: grade of laryngeal view, median time to intubation and intubator-rated ‘ease of use’.RESULTS Our device was equivalent to Pentax-AWS and superior to Macintosh laryngoscope (TVL vs. Pentax-AWS vs. Macintosh) in overall intubation success rate (88 vs. 98 vs. 67%, P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Infraglottic versus supraglottic jet-ventilation for endobronchial
           ultrasound-guided transbronchial needle aspiration: A randomised
           controlled trial
    • Authors: Anwar; Maria; Fritze, Robert; Base, Eva; Wasserscheid, Thomas; Wolfram, Nadja; Koinig, Herbert; Hackner, Klaus; Lambers, Christopher; Schweiger, Thomas; Errhalt, Peter; Hoda, Mir A.
      Abstract: imageBACKGROUND For endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) under general anaesthesia, both rigid bronchoscopy and laryngeal masks (LMAs) with superimposed high-frequency jet ventilation can be used. Despite the fact that in Europe rigid bronchoscopy for EBUS-TBNA is still widely used, an increasing number of centres use jet ventilation via the LMA for this procedure. To our knowledge no clinical trials have ever been made to compare these two methods. This trial aimed to evaluate whether patients recover from the procedure more quickly when a LMA is used for ventilation compared with rigid bronchoscopy where muscle relaxants and deep anaesthesia are required.OBJECTIVES We wanted to test the hypothesis that there is no difference in the postoperative recovery of patients in the postanaesthesia care unit (PACU) after EBUS-TBNA with jet ventilation via a rigid bronchoscope and a LMA. Secondary outcomes were the difference of duration of anaesthesia, the diagnostic outcome of the procedure and drug quantities for both groups.DESIGN Prospective randomised single blinded two centre controlled trial.SETTING Two centres in Austria participated. Patients were enrolled from December 2016 until January 2018.PATIENTS Ninety patients for elective EBUS-TBNA were enrolled and assigned to one of two intervention groups. Two patients were excluded before and eleven patients were excluded after EBUS-TBNA. Seventy-seven were analysed.INTERVENTIONS Patients assigned to group 1 were ventilated with a LMA; those assigned to group 2 were ventilated via a rigid bronchoscope. Vital signs, drug dosage, duration of anaesthesia, recovery, PACU stay and Aldrete score at the PACU were recorded.MAIN OUTCOME MEASURES The primary endpoint was an integral over time of a modified Aldrete score. Secondary endpoints were the durations of the interventions, the recovery from anaesthesia and PACU stay, initial and mean Aldrete values at PACU, the effect site concentration of Propofol according to the Schnider pharmacokinetic model, the peak ultiva rates and the diagnostic outcome.RESULTS We were not able to show any significant difference regarding the postoperative recovery criteria based on the Aldrete score, the durations measured and the diagnostic outcomes. Vital signs remained stable and in an equal range in both groups. There were no differences in the mean effect site propofol concentration and the peak ultiva rates.CONCLUSION EBUS-TBNA under general anaesthesia using a LMA with SHJV is equal to rigid bronchoscopy with superimposed high-frequency jet ventilation for the variables analysed.TRIAL REGISTRATION ISRCTN (ISRCTN58911367).
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Pulmonary function decline in immediate postoperative period is not
           necessarily related to residual neuromuscular block: An observational
           study
    • Authors: Thudium; Marcus; Kornilov, Evgeniya; Raczeck, Lukas; Boehm, Olaf
      Abstract: imageBACKGROUND Previous studies have reported an association between the use of neuromuscular blocking (NMB) agents and postoperative pulmonary complications. Postoperative pulmonary function is a key indicator for postoperative pulmonary complications. Several sites can be used to assess depth and recovery from NMB.OBJECTIVES To investigate postoperative pulmonary function change in relation to train-of-four measurements at the adductor pollicis and corrugator supercilii muscles, and anaesthesia-related variables in orthopaedic patients undergoing hip or knee arthroplasty.DESIGN Observational study.SETTING University hospital.PATIENTS Orthopaedic patients undergoing hip or knee arthroplasty.MAIN OUTCOME MEASURES Postoperative pulmonary function tests in the postanaesthesia care unit.METHODS Patients scheduled for elective hip or knee arthroplasty received simultaneous corrugator supercilii and adductor pollicis measurements during anaesthesia conducted according to clinical standards. Forced expiratory volume in 1 s and forced vital capacity (FVC) were measured at the time of inclusion and postoperatively on the postanaesthesia care unit. Linear regression analysis was performed for association between risk factors and pulmonary function change.RESULTS A total of 35 patients were included. After exclusions, 20 patients remained for final analysis. Corrugator supercilii showed earlier NMB recovery than adductor pollicis. FVC decreased significantly after surgery from 2.9 ± 1.0 to 2.3 ± 1.0 (P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • A nebulised antitumour necrosis factor receptor-1 domain antibody in
           patients at risk of postoperative lung injury: A randomised,
           placebo-controlled pilot study
    • Authors: Ryan; James; Bayliffe, Andrew I.; McAuley, Daniel F.; Yeung, Joyce; Thickett, David R.; Howells, Phillip A.; O’Donnell, Ciara; Vassallo, Arlette M.; Wright, Tracey J.; McKie, Elizabeth; Hardes, Kelly; Summers, Charlotte; Shields, Martin O.; Powley, William; Wilson, Robert; Lazaar, Aili L.; Fowler, Andrew; Perkins, Gavin D.
      Abstract: imageBACKGROUND Tumour necrosis factor receptor 1 (TNFR1) signalling mediates the cell death and inflammatory effects of TNF-α.OBJECTIVE The current clinical trial investigated the effects of a nebulised TNFR1 antagonist (GSK2862277) on signs of lung injury in patients undergoing oesophagectomy.DESIGN Randomised double-blind (sponsor unblind), placebo-controlled, parallel group study.SETTING Eight secondary care centres, the United Kingdom between April 2015 and June 2017.PATIENTS Thirty-three patients undergoing elective transthoracic oesophagectomy.INTERVENTIONS Patients randomly received a single nebulised dose (26 mg) of GSK2862277 (n = 17) or placebo (n = 16), given 1 to 5 h before surgery; 14 and 16, respectively competed the study.MAIN OUTCOME MEASUREMENTS Physiological and biochemical markers of lung injury, pharmacokinetic and safety endpoints were measured. The primary endpoint was the change from baseline in pulmonary vascular permeability index (PVPI) at completion of surgery, measured using single-indicator transpulmonary thermodilution. Adjusted point estimates and 95% credible intervals (analogous to conventional confidence intervals) were constructed for each treatment using Bayesian statistical models.RESULTS The mean change (with 95% credible intervals) from baseline in PVPI on completion of surgery was 0.00 (−0.23, 0.39) in the placebo and 0.00 (−0.24, 0.37) in the GSK2862277 treatment groups. There were no significant treatment-related differences in PaO2/FiO2 or Sequential Organ Failure Assessment score. Levels of free soluble TNFR1, Macrophage Inflammatory Protein-1 alpha and total protein were significantly reduced in the bronchoalveolar lavage fluid of patients treated with GSK2862277 (posterior probability of decrease with GSK2862277 vs. placebo:≥0.977; equivalent to P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Effects of high-flow nasal oxygen during prolonged deep sedation on
           postprocedural atelectasis: A randomised controlled trial
    • Authors: Shih; Chung-Chih; Liang, Po-Chin; Chuang, Yueh-Hsun; Huang, Yi-Ju; Lin, Pei-Jing; Wu, Chun-Yu
      Abstract: imageBACKGROUND Atelectasis is common in patients undergoing prolonged deep sedation outside the operating theatre. High-flow nasal oxygen (HFNO) produces positive airway pressure which, hypothetically, should improve lung atelectasis, but this has not been investigated.OBJECTIVE We investigated whether HFNO ameliorates postprocedural atelectasis and compared the influences of HFNO and facial oxygen by mask on postprocedural outcomes.DESIGN A single-blind, open-label single-institution randomised controlled trial.SETTING A single university hospital, from February 2017 to July 2019.PATIENTS A total of 59 patients undergoing computed tomography (CT)-guided hepatic tumour radiofrequency ablation were randomly allocated to two groups.INTERVENTION These patients randomly received HFNO (oxygen flow 10 l min−1 before sedation and 50 l min−1 during the procedure) or a conventional oxygen face mask (oxygen flow 10 l min−1) during the procedure.MAIN OUTCOME MEASURES Changes in the area of lung atelectasis calculated on the basis of chest CT images and also recovery profiles were compared between the two groups.RESULTS The two groups had comparable procedural profiles, but the HFNO group exhibited less postprocedural atelectasis than the face mask group (median [IQR] 7.4 [3.9 to 11.4%] vs. 10.5 [7.2 to 14.6%]; P = 0.0313). However, the numbers of patients requiring oxygen supplementation in the recovery room and during transport from the recovery room to the ward did not differ significantly between groups (24.1 vs. 50.0%; P = 0.0596).CONCLUSION Our results suggested that HFNO ameliorates lung atelectasis after prolonged deep sedation in patients receiving CT-guided hepatic tumour radiofrequency ablation.TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03019354.
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Effects of intra-operative positive end-expiratory pressure setting guided
           by oesophageal pressure measurement on oxygenation and respiratory
           mechanics during laparoscopic gynaecological surgery: A randomised
           controlled trial
    • Authors: Piriyapatsom; Annop; Phetkampang, Sanchai
      Abstract: imageBACKGROUND The creation of pneumoperitoneum during laparoscopic surgery can lead to adverse effects on the respiratory system. Positive end-expiratory pressure (PEEP) plays an important role in mechanical ventilation during laparoscopic surgery.OBJECTIVE To evaluate whether PEEP setting guided by oesophageal pressure (Poeso) measurement would affect oxygenation and respiratory mechanics during laparoscopic gynaecological surgery.DESIGN A randomised controlled study.SETTING A single-centre trial from March 2018 to June 2018.PATIENTS Forty-four adult patients undergoing laparoscopic gynaecological surgery with anticipated duration of surgery more than 2 h.INTERVENTION PEEP set according to Poeso measurement (intervention group) versus PEEP constantly set at 5 cmH2O (control group).MAIN OUTCOME MEASURES Gas exchange and respiratory mechanics after induction and intubation (T0) and at 15 and 60 min after initiation of pneumoperitoneum (T1 and T2, respectively).RESULTS PEEP during pneumoperitoneum was significantly higher in the intervention group than in the control group (T1, 12.5 ± 1.9 vs. 5.0 ± 0.0 cmH2O and T2, 12.4 ± 1.9 vs. 5.0 ± 0.0 cmH2O, both P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Pulmonary levels of biomarkers for inflammation and lung injury in
           protective versus conventional one-lung ventilation for oesophagectomy: A
           randomised clinical trial
    • Authors: van der Woude; Margaretha C.; Bormans, Laura; van der Horst, Robrecht P.; Sosef, Meindert N.; Belgers, Henricus J.; Hemmes, Sabrine N.; Tuip-de Boer, Anita; Gama de Abreu, Marcelo; Pelosi, Paolo; Spronk, Peter E.; Neto, Ary Serpo; Schultz, Marcus J.
      Abstract: imageBACKGROUND It is uncertain whether protective ventilation reduces ventilation-induced pulmonary inflammation and injury during one-lung ventilation.OBJECTIVE To compare intra-operative protective ventilation with conventional during oesophagectomy with respect to pulmonary levels of biomarkers for inflammation and lung injury.DESIGN Randomised clinical trial.SETTING Tertiary centre for oesophageal diseases.PATIENTS Twenty-nine patients scheduled for one-lung ventilation during oesophagectomy.INTERVENTIONS Low tidal volume (VT) of 6 ml kg−1 predicted body weight (pbw) during two-lung ventilation and 3 ml kgpbw−1 during one-lung ventilation with 5 cmH2O positive end expired pressure versus intermediate VT of 10 ml kgpbw−1 during two-lung ventilation and 5 ml kgpbw−1 body weight during one-lung ventilation with no positive end-expiratory pressure.OUTCOME MEASURES The primary outcome was the change in bronchoalveolar lavage (BAL) levels of preselected biomarkers for inflammation (TNF-α, IL-6 and IL-8) and lung injury (soluble Receptor for Advanced Glycation End-products, surfactant protein-D, Clara Cell protein 16 and Krebs von den Lungen 6), from start to end of ventilation.RESULTS Median [IQR] VT in the protective ventilation group (n = 13) was 6.0 [5.7 to 7.8] and 3.1 [3.0 to 3.6] ml kgpbw−1 during two and one-lung ventilation; VT in the conventional ventilation group (n = 16) was 9.8 [7.0 to 10.1] and 5.2 [5.0 to 5.5] ml kgpbw−1 during two and one-lung ventilation. BAL levels of biomarkers for inflammation increased from start to end of ventilation in both groups; levels of soluble Receptor for Advanced Glycation End-products, Clara Cell protein 16 and Krebs von den Lungen 6 did not change, while levels of surfactant protein-D decreased. Changes in BAL biomarkers levels were not significantly different between the two ventilation strategies.CONCLUSION Intra-operative protective ventilation compared with conventional ventilation does not affect changes in pulmonary levels of biomarkers for inflammation and lung injury in patients undergoing one-lung ventilation for oesophagectomy.TRIAL REGISTRATION The ‘Low versus Conventional tidal volumes during one-lung ventilation for minimally invasive oesophagectomy trial’ (LoCo) was registered at the Netherlands Trial Register (study identifier NTR 4391).
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Predicting postoperative complications with the respiratory exchange ratio
           after high-risk noncardiac surgery: A prospective cohort study
    • Authors: Bar; Stéphane; Grenez, Charles; Nguyen, Maxime; de Broca, Bruno; Bernard, Eugénie; Abou-Arab, Osama; Bouhemad, Belaid; Lorne, Emmanuel; Guinot, Pierre-Grégoire
      Abstract: imageBACKGROUND The respiratory exchange ratio (RER), defined as the ratio of CO2 production (VCO2) to O2 consumption (VO2), is reported to be a noninvasive marker of anaerobic metabolism. The intubated, ventilated patient's inspired and expired fractions of O2 and CO2 (FiO2, FeO2, FiCO2 and FeCO2) are monitored in the operating room and can be used to calculate RER.OBJECTIVE To investigating the ability of the RER to predict postoperative complications.DESIGN An observational, prospective study.SETTING Two French university hospitals between March 2017 and September 2018.PATIENTS A total of 110 patients undergoing noncardiac high-risk surgery.MAIN OUTCOME MEASURES The RER was calculated as (FeCO2 − FiCO2)/(FiO2 − FeO2) at five time points during the operation. The primary endpoint was at the end of the surgery. The secondary endpoints were systemic oxygenation indices (pCO2 gap, pCO2 gap/arteriovenous difference in O2 ratio, central venous oxygen saturation) and the arterial lactate level at the end of the surgery. Complications were classified according to the European Peri-operative Clinical Outcome definitions.RESULTS Postoperative complications occurred in 35 patients (34%). The median [interquartile range] RER at the end of surgery was significantly greater in the subgroup with complications, 1.06 [0.84 to 1.35] than in the subgroup without complications, 0.81 [0.75 to 0.91], and correlated significantly with the arterial lactate (r = 0.31, P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Frailty predicts 30-day mortality in intensive care patients: A
           prospective prediction study
    • Authors: De Geer; Lina; Fredrikson, Mats; Tibblin, Anna O.
      Abstract: imageBACKGROUND Frailty is a multidimensional syndrome characterised by a loss of reserve and an increased risk of adverse outcomes.OBJECTIVE To study the impact of frailty on mortality in unselected intensive care patients, and to compare its discriminatory ability to an established model for outcome prediction in intensive care.DESIGN A prospective study with a comparison of two prediction models.SETTING A tertiary mixed ICU, from January 2017 to June 2018.PATIENTS AND MAIN OUTCOME MEASURES Data on premorbid frailty (clinical frailty scale; CFS), severity of illness (the simplified acute physiology score, third version; SAPS3), therapeutic procedures, limitations of care and outcome were collected in 872 adult ICU patients. A cut-off level of CFS for predicting death within 30 days was identified and unadjusted and adjusted analyses were used to evaluate the association of frailty to outcome.RESULTS The receiver operating curve, area under the curve of CFS [0.74 (95% confidence interval, 0.69 to 0.79)] did not differ significantly from that of SAPS3 [0.79 (0.75 to 0.83), P = 0.53], whereas combining the two resulted in an improved discriminatory ability [area under the curve = 0.82 (0.79 to 0.86), CFS + SAPS3 vs. SAPS3 alone, P = 0.02]. The correlation of CFS to SAPS3 was moderate (r = 0.4). A cut-off level was identified at CFS at least 5, defining 43% (n=375) of the patients as frail. Frail patients were older with higher SAPS3 and more comorbidities. Treatment in the ICU was more often withheld or withdrawn in frail patients, and mortality was higher. After adjustment for SAPS3, comorbidities, limitations of treatment, age and sex, frailty remained a strong predictor of death within 30 days [hazard ratio 2.12 (95% confidence interval, 1.44 to 3.14), P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Cognitive decline after carotid endarterectomy: Systematic review and
           meta-analysis
    • Authors: Aceto; Paola; Lai, Carlo; De Crescenzo, Franco; Crea, Maria A.; Di Franco, Valeria; Pellicano, Gaia R.; Perilli, Valter; Lai, Silvia; Papanice, Domenico; Sollazzi, Liliana
      Abstract: imageBACKGROUND Postoperative cognitive decline (pCD) occurs frequently (6 to 30%) after carotid endarterectomy (CEA), although there are no exact estimates and risk factors are still unclear.OBJECTIVE The objective of this study was to determine pCD incidence and risk factors in CEA patients.DESIGN We performed a systematic review and meta-analysis of both randomised and nonrandomised trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.DATA SOURCES We searched Cochrane, PubMed/Medline and Embase databases from the date of database inception to 1 December 2018.ELIGIBILITY CRITERIA We selected longitudinal studies including CEA patients with both pre-operative and postoperative cognitive assessments. Primary outcome was pCD incidence, differentiating delayed neurocognitive recovery (dNCR) and postoperative neurocognitive disorder (pNCD). dNCR and pNCD incidences were expressed as proportions of cases on total CEA sample and pooled as weighted estimates from proportions. Postoperative delirium was excluded from the study design. Secondary outcomes were patient-related (i.e. age, sex, diabetes, hypertension, contralateral stenosis, pre-operative symptoms, dyslipidaemia and statin use) and procedure-related (i.e. hyperperfusion, cross-clamping duration and shunting placement) risk factors for pCD. We estimated odds ratios (ORs) and mean differences through a random effects model by using STATA 13.1 and RevMan 5.3.RESULTS Our search identified 5311 publications and 60 studies met inclusion criteria reporting a total of 4823 CEA patients. dNCR and pNCD incidence were 20.5% [95% confidence interval (CI), 17.1 to 24.0] and 14.1% (95% CI, 9.5 to 18.6), respectively. pCD risk was higher in patients experiencing hyperperfusion during surgery (OR, 35.68; 95% CI, 16.64 to 76.51; P 
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Usefulness of computer-assisted ECG analysis in the pre-operative
           evaluation of noncardiac surgery
    • Authors: Sanz-García; Ancor; Cecconi, Alberto; Alday, Enrique; Cecconi, Maurizio; Perez-Romero, Miriam; Garrido, Jesús; Moreno, Juan M.C.; Planas, Antonio; Alfonso, Fernando; Ortega, Guillermo J.; Jimenez-Borreguero, Luis J.
      Abstract: imageNo abstract available
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
  • Mechanical insufflation/exsufflation compared with standard of care in
           patients with pneumonia: A randomised controlled trial
    • Authors: Knudtzen; Fredrikke C.; Sprehn, Michael; Vestbo, Jørgen; Johansen, Isik S.
      Abstract: imageNo abstract available
      PubDate: Sun, 01 Nov 2020 00:00:00 GMT-
       
 
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