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Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study.
Crit Care
January 2025
Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095# Jiefang Ave, Wuhan, 430030, China.
Background: Ulinastatin (UTI), recognized for its anti-inflammatory properties, holds promise for patients undergoing cardiac surgery. This study aimed to investigate the relationship between intraoperative UTI administration and the incidence of delirium following cardiac surgery.
Methods: A retrospective analysis was performed on a retrospective cohort of 6,522 adult cardiac surgery patients to evaluate the relationship between UTI treatment and the incident of postoperative delirium (POD) in patients ongoing cardiac surgery.
Improving lung protective mechanical ventilation: the individualised intraoperative open-lung approach.
Br J Anaesth
February 2025
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain.
Despite the maturity and sophistication of anaesthesia workstations, improvements in our understanding of intraoperative mechanical ventilation, and use of less invasive surgical techniques, postoperative pulmonary complications (PPCs) are still a common problem in surgical patients of all ages. PPCs are associated with a higher incidence of perioperative morbidity and mortality, longer hospital stays, and higher healthcare costs. PPCs are strongly associated with anaesthesia-induced atelectasis, which predisposes to lung damage when partially collapsed lungs are subjected to mechanical ventilation.
View Article and Find Full Text PDFFast is fine, but accuracy is everything: making intraoperative transfusion decisions using point-of-care testing.
Br J Anaesth
February 2025
Transfusion Research Unit, Department of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia; Department of Clinical Haematology, Monash Health, Clayton, VIC, Australia.
Accurate and timely diagnostic information is a vital adjunct to clinical assessment to inform therapeutic decision-making, including decisions to transfuse, or not transfuse, blood components. A prospective cohort study of diagnostic point-of-care (POC) haemoglobin measurements on arterial or central venous samples from adults undergoing major noncardiac surgery compared three widely used devices, HemoCue®, i-STAT™, and the Rad-67™ pulse CO-Oxymeter® finger sensor device, against standard laboratory haemoglobin measurements, but importantly not against a blood gas analyser. The study focused on haemoglobin results below 100 g L to establish the utility of these devices to guide red cell transfusion decisions.
View Article and Find Full Text PDFIntroduction: Iatrogenic injury to the ilioinguinal nerve and its branches during anterior inguinal hernia repair is a cause of chronic inguinal pain in up to 12 % of patients undergoing this operation. The risk of nerve injury is high, given the nerves' relatively small caliber and strictly-confined space through which they pass. In the current report, we describe using a novel fluorescence imaging system developed to detect nerve autofluorescence in a 66-year-old man who presented with a left-sided Type II inguinal hernia and underwent inguinal hernioplasty.
View Article and Find Full Text PDFAnswer to the Letter to the Editor of X. Luo, et al. concerning "A new hernia blocking system to prevent recurrent lumbar disc herniation: surgical technique, intraoperative findings and six-months post-operative outcomes" by O. Godino et al. (Eur Spine J [2024]: doi.org/10.1007/s00586-024- 08595-x).
Eur Spine J
January 2025
Neurosurgery Department, Hospital Universitari Bellvitge, Barcelona, Spain.
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