Ferric carboxymaltose with or without phosphate substitution in iron deficiency or iron deficiency anemia before elective surgery - The DeFICIT trial.

Background: Iron deficiency anemia in the perioperative setting is treated predominantly with intravenous iron formulation, of which ferric carboxymaltose may induce hypophosphatemia by modulating fibroblast growth factor 23.

Methods: In this single-center, prospective, randomized, double-blind trial, we consented 92 adult patients scheduled for elective major abdominal or thoracic surgery. These patients either had isolated iron deficiency (plasma ferritin <100 ng/mL or transferrin saturation < 20 %) or iron deficiency anemia (hemoglobin (Hb) 100-130 g/L with plasma ferritin <100 ng/mL or transferrin saturation < 20 %).

Kids Save Lives - The kids' and teachers' view: How school children and schoolteachers would alter a BLS course designed by specialists.

Background: Training schoolchildren in basic life support ('Kids-Save-Lives' training) is widely believed to improve outcomes from out-of-hospital cardiac arrest. Numerous programmes have been launched, but to our knowledge, neither children nor schoolteachers have been directly involved in designing these courses. This is unfortunate, as it is well-known that children (as the target goup of training) learn differently from adults.

Quantifying Residual Rivaroxaban Plasma Concentration after Antagonization with Andexanet Alfa: A Difficult Task in Routine Clinical Practice.

We describe the case of a 38-year-old man with a history of chronic portal vein thrombosis who presented with abdominal pain after a transjugular intrahepatic portosystemic shunt procedure. Under anticoagulation therapy with rivaroxaban, he experienced active splenic bleeding, leading to hemodynamic instability. Emergency interventions, including andexanet alfa and nanoparticle administration, successfully stopped the bleeding.

Anaesthetic efficacy and postinduction hypotension with remimazolam compared with propofol: a multicentre randomised controlled trial.

Remimazolam, a short-acting benzodiazepine, may be used for induction and maintenance of total intravenous anaesthesia, but its role in the management of patients with multiple comorbidities remains unclear. In this phase 3 randomised controlled trial, we compared the anaesthetic efficacy and the incidence of postinduction hypotension during total intravenous anaesthesia with remimazolam vs. propofol.

User Perceptions of Visual Clot in a High-Fidelity Simulation Study: Mixed Qualitative-Quantitative Study.

Background: Viscoelastic hemostatic assays, such as rotational thromboelastometry (ROTEM) or thromboelastography, enable prompt diagnosis and accelerate targeted treatment. However, the complex interpretation of the results remains challenging. Visual Clot-a situation awareness-based visualization technology-was developed to assist clinicians in interpreting viscoelastic tests.

Environmental and economic impact of sustainable anaesthesia interventions: a single-centre retrospective observational study.

Background: Anaesthesia contributes substantially to the environmental impact of healthcare. To reduce the ecological footprint of anaesthesia, a set of sustainability interventions was implemented in the University Hospital Zurich, Switzerland. This study evaluates the environmental and economic implications of these interventions.

BK channels sustain neuronal Ca oscillations to support hippocampal long-term potentiation and memory formation.

Mutations of large conductance Ca- and voltage-activated K channels (BK) are associated with cognitive impairment. Here we report that CA1 pyramidal neuron-specific conditional BK knock-out (cKO) mice display normal locomotor and anxiety behavior. They do, however, exhibit impaired memory acquisition and retrieval in the Morris Water Maze (MWM) when compared to littermate controls (CTRL).

Environmental sustainability from anesthesia providers' perspective: a qualitative study.

Background: The world faces a significant global health threat - climate change, which makes creating more environmentally sustainable healthcare systems necessary. As a resource-intensive specialty, anesthesiology contributes to a substantial fraction of healthcare's environmental impact. This alarming situation invites us to reconsider the ecological health determinants and calls us to action.

Burnout and its determinants among anaesthesia care providers in Switzerland: a multicentre cross-sectional study.

The escalating epidemic of burnout in healthcare professionals affects provider well-being, patient care and sustainability of healthcare systems. The objective of this study was to determine the prevalence of burnout among anaesthesia care providers (consultants, trainees or nurse anaesthetists) in Switzerland and identify risk factors to develop strategies for prevention. This multicentre cross-sectional study was conducted at 22 anaesthesia departments in the German-speaking part of Switzerland, using an online questionnaire.

Using Visual Patient to Show Vital Sign Predictions, a Computer-Based Mixed Quantitative and Qualitative Simulation Study.

Background: Machine learning can analyze vast amounts of data and make predictions for events in the future. Our group created machine learning models for vital sign predictions. To transport the information of these predictions without numbers and numerical values and make them easily usable for human caregivers, we aimed to integrate them into the Philips Visual-Patient-avatar, an avatar-based visualization of patient monitoring.

Coagulation Management of Critically Bleeding Patients With Viscoelastic Testing Presented as a 3D-Animated Blood Clot (The Visual Clot): Randomized Controlled High-Fidelity Simulation Study.

Background: Guidelines recommend using viscoelastic coagulation tests to guide coagulation management, but interpreting the results remains challenging. Visual Clot, a 3D animated blood clot, facilitates interpretation through a user-centered and situation awareness-oriented design.

Objective: This study aims to compare the effects of Visual Clot versus conventional viscoelastic test results (rotational thrombelastometry [ROTEM] temograms) on the coagulation management performance of anesthesia teams in critical bleeding situations.

Achieving a preoperative haemoglobin above 130 g L may be more important in female than in male patients before cardiac surgery.

Sex-specific preoperative haemoglobin levels and the need for perioperative red cell transfusion in men and women are still debated. Cavalli and colleagues examined the appropriateness of World Health Organization (WHO) anaemia thresholds (haemoglobin <130 g L for males and <120 g L for females) in a retrospective cohort analysis of >6000 adult patients undergoing cardiac surgery with cardiopulmonary bypass. The authors concluded that the WHO anaemia threshold disproportionately disadvantages female cardiac surgery patients, and a preoperative haemoglobin level of at least 130 g L should be targeted in all cardiac surgical patients regardless of sex.

Patient Blood Management in Pregnancy.

Background: Patient blood management (PBM) is a multidisciplinary and patient-centered treatment approach, comprising the detection and treatment of anemia, the minimization of blood loss, and the rational use of allogeneic transfusions. Pregnancy, delivery, and the puerperium are associated with increased rates of iron deficiency and anemia, which correlates with worse maternal and fetal outcomes and places pregnant women at increased risk of obstetric hemorrhage.

Summary: Early screening for iron deficiency before the onset of anemia, as well as the use of oral and intravenous iron to treat iron deficiency anemia, has been shown to be beneficial.

Human-centered visualization technologies for patient monitoring are the future: a narrative review.

Medical technology innovation has improved patient monitoring in perioperative and intensive care medicine and continuous improvement in the technology is now a central focus in this field. Because data density increases with the number of parameters captured by patient-monitoring devices, its interpretation has become more challenging. Therefore, it is necessary to support clinicians in managing information overload while improving their awareness and understanding about the patient's health status.

Penny-wise and pound-foolish: the challenges of preoperative anaemia management.

The timely correction of anaemia before major surgery is important for optimising perioperative patient outcomes. However, multiple barriers have precluded the global expansion of preoperative anaemia treatment programmes, including misconceptions about the true cost/benefit ratio for patient care and health system economics. Institutional investment and buy-in from stakeholders could lead to significant cost savings through avoided complications of anaemia and red blood cell transfusions, and through containment of direct and variable costs of blood bank laboratories.

Avatar-based patient monitoring improves information transfer, diagnostic confidence and reduces perceived workload in intensive care units: computer-based, multicentre comparison study.

Patient monitoring is the foundation of intensive care medicine. High workload and information overload can impair situation awareness of staff, thus leading to loss of important information about patients' conditions. To facilitate mental processing of patient monitoring data, we developed the Visual-Patient-avatar Intensive Care Unit (ICU), a virtual patient model animated from vital signs and patient installation data.

Attitudes of Anesthesiologists toward Artificial Intelligence in Anesthesia: A Multicenter, Mixed Qualitative-Quantitative Study.

Artificial intelligence (AI) is predicted to play an increasingly important role in perioperative medicine in the very near future. However, little is known about what anesthesiologists know and think about AI in this context. This is important because the successful introduction of new technologies depends on the understanding and cooperation of end users.