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Local Anesthetic Infiltration, Awake Veno-Venous Extracorporeal Membrane Oxygenation, and Airway Management for Resection of a Giant Mediastinal Cyst: A Narrative Review and Case Report.
J Clin Med
December 2024
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.
View Article and Find Full Text PDFPredicting loss of independence among geriatric patients following gastrointestinal surgery.
Patient Saf Surg
January 2025
Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
Background: While existing risk calculators focus on mortality and complications, elderly patients are concerned with how operations will affect their quality of life, especially their independence. We sought to develop a novel clinically relevant and easy-to-use score to predict elderly patients' loss of independence after gastrointestinal surgery.
Methods: This retrospective cohort study included patients age ≥ 65 years enrolled in the American College of Surgeons National Surgical Quality Improvement Program database and Geriatric Pilot Project who underwent pancreatic, colorectal, or hepatic surgery (January 1, 2014- December 31, 2018).
Reviewing "Nil Per Os" Guidance for Clear Fluids in Children Before Anesthesia: Survey of the Pediatric Anesthesia Leadership Council.
Anesth Analg
November 2024
Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, California.
Background: Several international pediatric anesthesia societies have endorsed a change in the traditional nil per os (NPO) cutoff of clear fluids (CF) from 2 hours to 1 hour. These recommendations were compiled from large-scale outcomes, gastric ultrasound, and quality improvement studies. The American Society of Anesthesiologists (ASA) recently published their updated guidelines.
View Article and Find Full Text PDFHierarchy in surgeon-anaesthetist relationships.
Br J Anaesth
January 2025
Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Auckland City Hospital Department of Anaesthesia and Perioperative Medicine, Auckland, New Zealand; Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia. Electronic address:
Operating theatres are steeply hierarchical, and yet the hierarchy between surgeons and anaesthetists is unclear, even blurry. Both the steep hierarchy and the blurriness at the top can present a risk to patient safety through inhibiting speaking up with concerns and negotiating safe patient care. A recent study in the British Journal of Anaesthesia explores hierarchy in the surgeon-anaesthesia dyad in China, in particular, the effect of increased seniority gap between surgeons and anaesthetists on anaesthesia-related adverse outcomes.
View Article and Find Full Text PDFThe anesthesiologist's guide to critically assessing machine learning research: a narrative review.
BMC Anesthesiol
December 2024
Unidad de Inteligencia Artificial, Fundación Valle del Lili, Cra 98 Num.18-49, Cali, 760032, Valle del Cauca, Colombia.
Artificial Intelligence (AI), especially Machine Learning (ML), has developed systems capable of performing tasks that require human intelligence. In anesthesiology and other medical fields, AI applications can improve the precision and efficiency of daily clinical practice, and can also facilitate a personalized approach to patient care, which can lead to improved outcomes and quality of care. ML has been successfully applied in various settings of daily anesthesiology practice, such as predicting acute kidney injury, optimizing anesthetic doses, and managing postoperative nausea and vomiting.
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