{"title":"Comparison of Disposcope endoscope with Macintosh laryngoscope for laryngoscopy","authors":"Ziyu Gu, Liang Zhu, Zhouquan Wu","doi":"10.1007/s44254-023-00036-0","DOIUrl":"10.1007/s44254-023-00036-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Disposcope is a novel fibreoptic intubation device that allows visualization of the glottis without aligning the oral, pharyngeal, and tracheal axes. This device may offer advantages in improving glottis exposure, or reducing hemodynamic disturbance, and minimizing movement of the upper cervical spine (C-spine). In this study, we aimed to evaluate laryngoscopy using Disposcope compared to Macintosh laryngoscope.</p><h3>Methods</h3><p>This study enrolled 60 adult patients (American Society of Anesthesiologists physical status 1 and 2), both male and female, underwent lumbar spine surgery, scheduled for general anesthesia with endotracheal intubation. We compared the Cormack and Lehane grade, hemodynamic response, and the maximal change in the angle between adjacent cervical vertebrae and cumulative upper C-spine movement between Disposcope and Macintosh laryngoscope. A crossover trial design was employed, with half of the patients being exposed to the glottis using the Macintosh laryngoscope first, followed by the Disposcope, and vice versa for the other half.</p><h3>Results</h3><p>The intubation time in the Disposcope group was significantly lower than that in the Macintosh laryngoscope group (<i>P</i> < 0.01). Using the Disposcope resulted in improved views of the glottis (Z = −4.82, <i>P</i> < 0.01). Cormack and Lehane grade I views were achieved with the Disposcope in more patients than the Macintosh laryngoscope (36.7% versus 13.3%, <i>P</i> < 0.01). Grade II views were obtained in 58.3% of patients with the Disposcope, whereas a lower percentage (43.3%) was observed with the Macintosh laryngoscope. The incidence of grade III views was significantly lower with the Disposcope than with the Macintosh laryngoscope (5% versus 33.3%, <i>P</i> < 0.01). Additionally, there was significantly less hemodynamic disturbance (mean arterial pressure and heart rate) with the Disposcope compared to the Macintosh laryngoscope (<i>P</i> < 0.01). Finally, the median cumulative upper C-spine movement was greater with the Macintosh laryngoscope than with the Disposcope (26.9° versus 9.4°, <i>P</i> < 0.01).</p><h3>Conclusions</h3><p>In comparison to the Macintosh laryngoscope, the Disposcope provided improved views of the glottis and resulted in less hemodynamic disturbance and movement of the upper C-spine during laryngoscopy in patients.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00036-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142414403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effects of dexmedetomidine on postoperative tumor recurrence and patient survival after breast cancer surgery: a feasibility study","authors":"Jiamei Luo, Wei Xuan, Jiaxin Sun, Xiaoqiang Wang, Yumiao Shi, Yiqi Zhang, Wenjin Yin, Huigang Shu, Jinsong Lu, Jie Tian","doi":"10.1007/s44254-023-00037-z","DOIUrl":"10.1007/s44254-023-00037-z","url":null,"abstract":"<div><h3>Purpose</h3><p>Dexmedetomidine (Dexmed) is a highly selective alpha 2 adrenoceptor (α<sub>2</sub>-AR) agonist with excellent sedation and analgesic effects and is frequently used in breast cancer surgery. However, the exact impact of Dexmed on breast cancer prognosis is still unclear. The primary objective of this pilot study was to explore study feasibility (recruitment and dropout rates) for future large-scale randomized controlled trial (RCT) to test the hypothesis that intraoperative Dexmed reduced recurrence-free survival (RFS) and overall survival (OS) in patients after breast cancer surgery.</p><h3>Methods</h3><p>Interviews with patients were performed during the anesthetic preoperative visit for informed consent. Adult females scheduled for a mastectomy due to primary breast cancer were 1:1 randomised to saline (Group Control) or Dexmed (Group Dexmed) treatment groups. The primary outcomes were descriptions of study feasibility (recruitment and dropout rates). We also performed a preliminary analysis of RFS (time from surgery to the earliest date of recurrence/metastasis) and OS (time from surgery to the date of all-cause death) and collected data on percentages/numbers of circulating immune cells at pre- and 24 h post-operation.</p><h3>Results</h3><p>A total of 964 patients were screened; 40% (385/964) met the inclusion criteria, among which 39% (150/385) were enrolled and randomly assigned to either Group Control (<i>n</i> = 75) or Group Dexmed (<i>n</i> = 75). The median follow-up duration was 49 months (interquartile range (IQR): 34–58 months) for Group Control and 48 months (IQR: 33–60 months) for Group Dexmed. Five percent (5%, 8/150) patients were lost to follow-up and 1% (2/150) died. There was no significant difference in RFS and OS. The percentage/number of natural killer (NK), B and T-cell subsets and the CD4<sup>+</sup>/CD8<sup>+</sup> ratio were similar between groups at 24 h post-operation.</p><h3>Conclusion</h3><p>The pilot study was feasible to deliver. In a future definitive trial, the lower recruitment rate may be improved by increasing the number of anesthesiologists involved in the study. The study about the effects of Dexmed on long-term prognoses of breast cancer patients that is planned to follow this pilot study is a large-scaled randomized control study with the aim of providing evidence-based guidelines for rational use of Dexmed in patients undergoing breast cancer surgery.</p><h3>Trial registration</h3><p>Registered at ClinicalTrials.gov on October 20, 2016 (ID: NCT03109990).</p><h3>Graphical Abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00037-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142413591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current role of perioperative intravenous ketamine: a narrative review","authors":"Zohair Khan, Malika Hameed, Fauzia Anis Khan","doi":"10.1007/s44254-023-00035-1","DOIUrl":"10.1007/s44254-023-00035-1","url":null,"abstract":"<div><p>The purpose of this review is to report on the perioperative uses of intravenous (IV) ketamine based on literature from the last five years (2018–2022). We searched MEDLINE, Embase and PubMed databases from 1st January 2018 till 15th September 2022. We primarily reviewed randomized control trials and systematic reviews with or without meta-analyses where IV ketamine was used as part of an anesthetic regimen perioperatively for general or regional anesthesia. We included studies with both pediatric and/or adult participants. We did not examine the quality of the randomized controlled trials (RCTs) included in our review. Perioperative IV ketamine consistently reduced postoperative opioid requirement especially in the early postoperative period, however, the duration of this effect was variable in different surgeries and patient populations. This effect was seen in breast, obstetric, bariatric, and orthopedic surgeries. The effect was minimal in pediatric and thoracic surgeries. It has a valuable role in multi-modal analgesic regimen, especially in orthopedic and spine procedures. Considerable heterogeneity was noted with regards to the dosage of IV ketamine. Bolus doses ranged from 0.15 to 1 mg·kg<sup>−1</sup> and infusion doses ranged from 2 to 5 ug·kg<sup>−1</sup>·min<sup>−1</sup>. Its role in prevention of chronic post-surgical pain is still under investigation. Intravenous ketamine also reduced postoperative depressive symptoms in specific patient populations. It also reduced shivering associated with spinal anesthesia. It has a potential role in prevention of emergence agitation and postoperative delirium. In conclusion, IV ketamine has a versatile range of beneficial clinical effects in perioperative practice. The most widely studied are its analgesic effects which are of variable intensity amongst different surgical specialties and subset of patients. Despite its long history of use, fresh uses of IV ketamine continue to be reported. More trials are needed to better understand ideal dosing and patient subsets that will benefit most from these effects.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00035-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142413592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term outcomes of COVID-19 survivors and an exploratory analysis of factors associated with sequela-free survival of patients treated at Leishenshan Hospital in Wuhan, China","authors":"Dan Huang, Caiyang Chen, Wei Xuan, Shuting Pan, Zhiwei Fu, Jian Chen, Wenhui Li, Xin Jiang, Hongpan Zhao, Xun Zhou, Liyang Zhang, Sihan Chen, Zhaoyan Feng, Xuliang Jiang, Lili Huang, Xiao Zhang, Hui Zhu, Song Zhang, Weifeng Yu, Diansan Su","doi":"10.1007/s44254-023-00038-y","DOIUrl":"10.1007/s44254-023-00038-y","url":null,"abstract":"<div><h3>Purpose</h3><p>While coronavirus disease 2019 (COVID-19) has emerged as a global pandemic, millions of patients with COVID-19 have recovered and returned to their families and work, although the key factors of sequela-free survival remain unknown. Here we determine key factors associated with sequela-free survival of patients with COVID-19.</p><h3>Methods</h3><p>Sequela-free survival is defined as having none of the long-term sequelae measured with the Activity of Daily Living (ADL) Scale, modified Medical Research Council (mMRC) Dyspnoea Scale, New York Heart Association (NYHA) classification, Self-rating Depression Scale (SDS), Carcinologic Handicap Index (CHI) and Modified Telephone Interview for Cognitive Status (TICS-M). Multivariable logistic regression was used to examine the key factors of sequela-free survival.</p><h3>Results</h3><p>The follow-up period for the 464 patients was 10 August to 30 September 2020. Of these, 424 patients completed the assessment of all scales. 30.2% (128 of 424) were categorised as sequela-free at follow-up. The most common sequelae were psychosocial problems (254 [57.7%]), respiratory function abnormality (149 [32.6%]) and cardiac function abnormality (98 [21.5%]). Risk factors associated with COVID-19 sequelae were anaemia on admission, longer duration from the onset of symptoms to admission and increasing of age, whereas anaemia treatment was a protective factor against sequelae. A haemoglobin level of < 113 g/L for female patients or < 92 g/L for male patients at admission discriminated a likely higher risk of any COVID-19 sequelae.</p><h3>Conclusions</h3><p>Only one third COVID-19 survivors were sequela-free. Anaemia on admission, longer duration from the onset of symptoms to admission and increasing of age were the risk factors of any long-term sequela. Anaemia treatment was associated with beneficial outcomes in COVID-19 survivors.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00038-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preoperative pulmonary evaluation to prevent postoperative pulmonary complications","authors":"Mehmet Eren Tuna, Metin Akgün","doi":"10.1007/s44254-023-00034-2","DOIUrl":"10.1007/s44254-023-00034-2","url":null,"abstract":"<div><p>Postoperative pulmonary complications (PPCs) arise from a complex interplay of patient, surgical, and anesthesia-related factors. Despite their significant impact, there are currently no standardized guidelines recommending a comprehensive preoperative approach to assessing patients with PPC risk factors. Preoperative pulmonary evaluation (PPE) plays a pivotal role in identifying underlying patient conditions, undiagnosed diseases and optimal treatments. PPE involves systematic identification of patient, surgical, and anesthesia-related risk factors. Severe PPCs include atelectasis, pneumonia, respiratory failure, pulmonary embolism, and worsening chronic lung disease. Surgical urgency, type, duration, approach of the surgical procedure, and comorbidities influence PPC rates, with cardiac, thoracic, abdominal, and vascular surgeries being particularly vulnerable.</p><p>Patient-related risk factors encompass non-pulmonary and pulmonary factors. Aging populations increase surgical demand, with advanced age and frailty predicting higher morbidity and mortality risks. Conditions like congestive heart failure, obesity, obstructive sleep apnea, and smoking heighten PPC risks. Asthma, chronic obstructive pulmonary disease, interstitial lung diseases, pulmonary hypertension, previous pulmonary thromboembolism, acute respiratory infections, and COVID-19 impact pulmonary risk profiles. Surgery and anesthesia-related risk factors include the site of surgery, operation time, and emergency surgery. Surgery near the diaphragm elevates PPC risk, while longer operation times correlate with increased PPC incidence. Emergency surgeries pose challenges in risk assessment. Anesthetic techniques influence outcomes, with regional anesthesia often preferable. Neuromuscular blocking agents impact PPCs, and protective ventilation strategies can mitigate complications.</p><p>As current literature lacks a comprehensive approach to PPE, in this review, we present a comprehensive approach to preoperative pulmonary approach to surgical patients to help in risk stratification, further optimization, as well as shared decision making between the surgeon and the patients and their family prior to consenting for a major surgical procedure.</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00034-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135266642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Congjun Li, Ruihao Zhou, Guo Chen, Xuechao Hao, Tao Zhu
{"title":"Knowledge mapping and research hotspots of artificial intelligence on ICU and Anesthesia: from a global bibliometric perspective","authors":"Congjun Li, Ruihao Zhou, Guo Chen, Xuechao Hao, Tao Zhu","doi":"10.1007/s44254-023-00031-5","DOIUrl":"10.1007/s44254-023-00031-5","url":null,"abstract":"<div><p>The swift advancement of technology has led to the widespread utilization of artificial intelligence (AI) in the diagnosis of diseases and prediction of prognoses, particularly in the field of intensive care unit (ICU) and Anesthesia. Numerous evidential data have demonstrated the extensive potential of AI in monitoring and predicting patient outcomes in these fields. Using bibliometric analysis, this study provides an overview of the current state of knowledge regarding the application of AI in ICU and Anesthesia and investigates prospective avenues for future research. Web of Science Core Collection was queried on May 6, 2023, to select articles and reviews regarding AI in ICU and Anesthesia. Subsequently, various analytical tools including Microsoft Excel 2022, VOSviewer (version 1.6.16), Citespace (version 6.2.R2), and an online bibliometric platform were employed to examine the publication year, citations, authors, countries, institutions, journals, and keywords associated with this subject area. This study selected 2196 articles from the literature. focusing on AI-related research within the fields of ICU and Anesthesia, which has increased exponentially over the past decade. Among them, the USA ranked first with 634 publications and had close international cooperation. Harvard Medical School was the most productive institution. In terms of publications, <i>Scientific Reports</i> (impact factor (IF) 4.996) had the most, while <i>Critical Care Medicine</i> (IF 9.296) had the most citations. According to numerous references, researchers may focus on the following research hotspots: “Early Warning Scores”, “Covid-19″, “Sepsis” and “Neural Networks”. “Procalcitonin” and “Convolutional Neural Networks” were the hottest burst keywords. The potential applications of AI in the fields of ICU and Anesthesia have garnered significant attention from scholars, prompting an increase in research endeavors. In addition, it is imperative for various countries and institutions to enhance their collaborative efforts in this area. The research focus in the upcoming years will center on sepsis and coronavirus, as well as the development of predictive models utilizing neural network algorithms to improve well-being and quality of life in surviving patients.</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00031-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances in airway management in recent 10 years from 2013 to 2023","authors":"Yurui Liu, Yuewen He, Xia Wang, Jingjing Li, Zhengze Zhang, Xuhui Zhuang, Hao Liu, Ruogen Li, Huihui Liu, Yuerong Zhuang, Qiong Wang, Zhihang Tang, Yong Wang, Wuhua Ma","doi":"10.1007/s44254-023-00029-z","DOIUrl":"10.1007/s44254-023-00029-z","url":null,"abstract":"<div><p>Difficult airway management has been the focus in the field of anesthesiology. Clinical research in difficult airway management has made some progress in the last 10 years. We searched the relevant literature and summarized the latest clinical research in the field of difficult airway management in this review to provide some practice strategies for difficult airway management for anesthesiologists as well as a range of professionals.</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00029-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135547303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yongzheng Han, Yinyin Qu, Xiaoxiao Wang, Yang Zhou, Lukun Yang, Haiming Du, Jing Zhang, Yandong Jiang, Zhengqian Li, Xiangyang Guo
{"title":"The 100 most cited articles in malignant hyperthermia","authors":"Yongzheng Han, Yinyin Qu, Xiaoxiao Wang, Yang Zhou, Lukun Yang, Haiming Du, Jing Zhang, Yandong Jiang, Zhengqian Li, Xiangyang Guo","doi":"10.1007/s44254-023-00030-6","DOIUrl":"10.1007/s44254-023-00030-6","url":null,"abstract":"<div><p>Bibliometric analysis is a widely used method to identify and evaluate the trends and characteristics of the scientific publications in a specific research field. A large volume of literature has been published in the field of malignant hyperthermia (MH). However, no bibliometric studies have been conducted to describe the characteristics of highly cited articles on MH. Therefore, this study aims to identify the 100 most frequently cited articles about malignant hyperthermia, describe their characteristics, and investigate research trends. Searches were performed in Web of Science Core Collection, Google Scholar, and Scopus from January 1900 to March 2023, with no language limitation. The 100 most frequently cited articles were selected and analyzed. Characteristics including publication year, journal, impact factor, authors, authors countries, citation number, journal citation indicator, study design, and topics were analyzed. For the 100 most cited articles, the number of times each article was cited ranged from 84 to 1254, with a median of 133. The number of articles published peaked in the decade of 1990s (<i>n</i> = 30). The articles were published in 39 journals, with Anesthesiology leading with 13 publications and then the British Journal of Anaesthesia with 12 publications. The authors were from 21 countries, led by the United States (<i>n</i> = 37). Forty articles focused on genetic susceptibility screening, 27 articles were about MH etiology, and 11 articles were about diagnosis and treatment. The mortality rate of MH and dantrolene availability are known to be uneven worldwide. This may partly be explained by the fact that scientific publications primarily report by authors from developed countries. This bibliometric analysis highlights the characteristics of the most influential research related to malignant hyperthermia, providing a reference for conducting future research.</p></div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00030-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135816751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederic Michard, Lorenzo Foti, Gianluca Villa, Zaccaria Ricci, Stefano Romagnoli
{"title":"The impact of underdamping on the maximum rate of the radial pressure rise during systole (dP/dtMAX)","authors":"Frederic Michard, Lorenzo Foti, Gianluca Villa, Zaccaria Ricci, Stefano Romagnoli","doi":"10.1007/s44254-023-00033-3","DOIUrl":"10.1007/s44254-023-00033-3","url":null,"abstract":"<div><h3>Purpose</h3><p>In patients with a radial arterial catheter, underdamping of the pressure signal is common and responsible for an overestimation of systolic arterial pressure (SAP). The maximum rate of the arterial pressure rise during systole (dP/dt<sub>MAX</sub>) has been proposed to assess left ventricular systolic function. The impact of underdamping on dP/dt<sub>MAX</sub> is likely but has never been quantified.</p><h3>Methods</h3><p>We analyzed data from 70 critically ill patients monitored with a radial catheter in whom underdamping of the arterial pressure waveform was confirmed by the Gardner’s method. Invasive SAP and dP/dt<sub>MAX</sub> were recorded at baseline and after the correction of underdamping with a resonance filter.</p><h3>Results</h3><p>With resonance filtering, SAP decreased from 159 ± 25 to 139 ± 22 mmHg (<i>p</i> < 0.001) and dP/dt<sub>MAX</sub> from 2.0 ± 0.6 to 1.1 ± 0.3 mmHg/ms (<i>p</i> < 0.001). The underdamping-induced overestimation of SAP (delta-SAP) ranged from 6 to 41 mmHg (mean 21 ± 9 mmHg or + 15%) and the overestimation of dP/dt<sub>MAX</sub> (delta-dP/dt<sub>MAX</sub>) ranged from 0.2 to 2.0 mmHg/ms (mean 0.9 ± 0.4 mmHg/ms or + 84%). A significant linear relationship (<i>p</i> < 0.001, <i>r</i> = 0.6) was observed between delta-SAP and delta-dP/dt<sub>MAX</sub> such that the higher was delta-SAP, the higher was delta-dP/dt<sub>MAX</sub>.</p><h3>Conclusions</h3><p>Radial arterial pressure underdamping has a major impact on dP/dt<sub>MAX</sub>. In case of underdamping, the overestimation of dP/dt<sub>MAX</sub> is > fivefold higher than SAP overestimation. Therefore, caution should be exercised before using radial dP/dt<sub>MAX</sub> as a marker of left ventricular systolic function.</p><h3>Trial registration</h3><p>Registered at ClinicalTrials.gov on December 22, 2021 (NCT05166993).</p><h3>Graphical Abstract</h3>\u0000 <div><figure><div><div><picture><source><img></source></picture></div></div></figure></div>\u0000 </div>","PeriodicalId":100082,"journal":{"name":"Anesthesiology and Perioperative Science","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s44254-023-00033-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136010539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}