European Journal of Anaesthesiology最新文献

{"title":"Stillbirth labour pain still matters: an anaesthesiology call to action for parent-centred care.","authors":"Sarah Saxena, Aslihan Gulec Kilic, Mia Gisselbaek, Emilia Guasch-Arevalo, Idit Matot","doi":"10.1097/EJA.0000000000002396","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002396","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"469-472"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying the interpretation of patient-centred outcomes in liberal pre-operative fluid intake.","authors":"Ming-Hui Hung","doi":"10.1097/EJA.0000000000002379","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002379","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"559-560"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of perioperative fluid balance and acute kidney injury in patients undergoing elective colorectal surgery: A pre-planned secondary analysis of a multicentre prospective observational study.","authors":"Alejandro Suárez-de-la-Rica, Javier Ripollés-Melchor, Ane Abad-Motos, César Aldecoa, Carlos Ferrando, Alfredo Abad-Gurumeta, Mariana Díaz-Almirón, Rubén Casans-Francés, Margarita Logroño-Egea, José Antonio García-Erce, José M Ramírez Rodríguez, Ana Cuellar-Martínez, Sandra Marmaña-Mezquita, Emilio Maseda","doi":"10.1097/EJA.0000000000002339","DOIUrl":"10.1097/EJA.0000000000002339","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication after surgery. Greater fluid administration has been related to an increased incidence in patients undergoing major surgery but there are no large series of patients in specific perioperative settings showing relationship between fluid balance and the occurrence of AKI.</p><p><strong>Objective: </strong>This study tested the hypothesis that higher perioperative fluid balance was associated with an increased risk of postoperative AKI.</p><p><strong>Design: </strong>Prospective observational study. Predefined secondary sub-study of the Postoperative Outcomes Within Enhanced Recovery After Surgery (POWER) study.</p><p><strong>Setting: </strong>A pre-planned secondary analysis of a multicentre study in 80 hospitals in Spain during a single period of 2 months of recruitment between September and December 2017.</p><p><strong>Patients: </strong>Patients undergoing elective primary colorectal surgery with a planned overnight stay were included if they had complete data regarding postoperative fluid balance. Patients who underwent urgent or emergency surgery or with estimated glomerular filtration rate less than 30 ml min -1 were excluded.</p><p><strong>Main outcomes measures: </strong>The primary outcome was the occurrence of AKI (mild, moderate, or severe) at 30 days following surgery. AKI was defined according to KDIGO and EPCO guidelines, incorporating serum creatinine and urine output criteria.</p><p><strong>Results: </strong>A total of 1139 patients were included in the study. Of these, 73 patients (6.4%) developed acute kidney injury in the postoperative period. The adjusted relative risks (RR) that compared the quartile with the lowest perioperative fluid balance (Q1) with other quartiles were 4.10 [95% confidence interval (CI), 1.60 to 10.51] for Q3 and 4.81 (95% CI, 1.91 to 12.11) for Q4. In the Poisson loglinear model after adjusting by sex, ASA grade, Enhanced Recovery After Surgery (ERAS) adherence and intraoperative bleeding, RR for AKI were higher with a higher positive perioperative fluid balance (quadratic nonlinear P  < 0.01).</p><p><strong>Conclusions: </strong>In this secondary analysis, we found that higher positive perioperative fluid balance during the first 24 h was associated with an increased risk of postoperative acute kidney injury in patients undergoing elective colorectal surgery.</p><p><strong>Trial registration: </strong>Clinicaltrials.com identifier: NCT03012802.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"528-536"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145932935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Con: we should fully utilise the preload reserve in high-risk patients undergoing noncardiac surgery.","authors":"Bernd Saugel, Karim Kouz, Michael Sander, Daniel A Reuter","doi":"10.1097/EJA.0000000000002378","DOIUrl":"10.1097/EJA.0000000000002378","url":null,"abstract":"<p><p>In the German guidelines on intra-operative haemodynamic management, we emphasise that 'even in fluid-responsive patients, the indication for fluid administration should be determined individually based on haemodynamics and clinical context'. Being 'fluid responsive' is a normal physiological state and does not necessarily indicate that a patient requires fluids. The Frank-Starling mechanism does not illustrate a causal relationship where an increase in cardiac preload (as an independent variable) leads to a subsequent increase in cardiac output (as a dependent variable). Rather, the evolutionary purpose of the Frank-Starling mechanism is to match cardiac output to variations in venous return caused by exercise or changes in posture. Clinicians should not routinely attempt to maximise stroke volume or cardiac output by giving fluids in patients having surgery because it is unlikely that surgical patients require their maximal cardiac output, as energy expenditure during major surgery with general anaesthesia is roughly one quarter lower than resting awake energy expenditure. In summary, clinicians should not routinely give repeated fluid boluses simply to use the full preload reserve in patients having major noncardiac surgery. Decisions to give - or not give - fluids must incorporate considerations that extend far beyond the physiological condition of 'fluid responsiveness'.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"503-505"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the climate and water footprint of artificial intelligence in anaesthesia and intensive care.","authors":"Alain F Kalmar, Guylian Stevens, Sarah Saxena, Patricio Gonzalez-Pizarro, Pascal Verdonck","doi":"10.1097/EJA.0000000000002393","DOIUrl":"10.1097/EJA.0000000000002393","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"543-546"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonographic assessment of sugammadex-enhanced early recovery of diaphragmatic function in children.","authors":"Babita Ghai, Deepanshu Rai, Komal Gandhi","doi":"10.1097/EJA.0000000000002375","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002375","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"557-558"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ETHER: a proposal for a European peri-operative data sharing and registry network.","authors":"Wilton A van Klei, Claudia Spies, Falk von Dinklage, Jona Joachim, Michel Mrf Struys, Michelle S Chew, Olegs Sabelnikovs, Oscar Díaz-Cambronero, Shruthi Madappa, Wolfgang F Buhre","doi":"10.1097/EJA.0000000000002366","DOIUrl":"10.1097/EJA.0000000000002366","url":null,"abstract":"<p><p>Peri-operative medicine is a critical component of contemporary healthcare delivery. Despite significant advancements, peri-operative complications remain a relevant concern. Obtaining reliable risk estimates, identifying potential causes, and studying new interventions, revised policies or implementation of best practices to prevent complications, requires data from a large number of participants. Electronic Patient Record systems offer the opportunity to unlock these data, but the limited standardisation of databases and sharing frameworks available across Europe limit the effective use of the available data. We propose creating a European peri-operative shared data registry with continuous data collection, integrating clinical, bedside monitoring and outcome data in a collaborative network. Such network would facilitate outcomes research, could serve as a platform to optimise clinical practices by fostering quality improvement through benchmarking of care delivered by departments or individual physicians, and could be used to evaluate policy changes. This ESAIC initiative aligns well with the development of the European Health Data Space. This article provides examples of contemporary clinical research and practice evaluation questions to illustrate the need for a European collaborative data-sharing network, highlights inspiring examples of existing data-sharing initiatives and describes a road map to establish such network.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"479-485"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid balance during surgery: still a dilemma.","authors":"Guillermo Lema","doi":"10.1097/EJA.0000000000002386","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002386","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"555"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond 'carbon tunnel vision': holistic stewardship in sustainable anaesthesia.","authors":"Takahiro Tamura","doi":"10.1097/EJA.0000000000002387","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002387","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 6","pages":"564-565"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Endothelial Activation and Stress Index as a predictor of in-hospital mortality and postoperative complications in cardiac surgery with cardiopulmonary bypass: A retrospective cohort study.","authors":"Patrick Rehn, Ioannis Tsoukakis, Peter Full, Maik von der Forst, Benjamin Niehaus, Dania Fischer, Felix C F Schmitt, Matthias Karck, Markus Alexander Weigand, Christoph Lichtenstern, Thomas Luft, Rawa Arif, Maximilian Dietrich","doi":"10.1097/EJA.0000000000002313","DOIUrl":"10.1097/EJA.0000000000002313","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk for peri-operative complications, often linked to endothelial dysfunction. The Endothelial Activation and Stress Index (EASIX) has shown potential in predicting outcomes in various patient cohorts.</p><p><strong>Objectives: </strong>We aimed to assess the prognostic value of EASIX for in-hospital mortality and postoperative outcomes in cardiac surgery patients with CPB.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A review of patients undergoing cardiac surgery with CPB at University Hospital Heidelberg from 2015 to 2023.</p><p><strong>Patients: </strong>A total of 9642 patients were considered. After applying the exclusion criteria, 7233 patients with available preoperative levels of creatinine, lactate dehydrogenase, and platelet counts for EASIX calculation were included. The cohort was divided into a training group ( n  = 4446, until December 2019) and validation group ( n  = 2787, from January 2020).</p><p><strong>Main outcome measures: </strong>The primary endpoint was in-hospital mortality, with secondary outcomes including ventilator days, ICU stay, and postoperative bleeding. Multivariate logistic regression was performed and ROC curve analyses were used to assess model performance and the added predictive value of EASIX.</p><p><strong>Results: </strong>EASIX predicted in-hospital mortality in the training cohort [odds ratio (OR) per log 2 increase 2.08, P  < 0.001]. In the validation cohort, adding EASIX to the model significantly increased the AUC from 0.74 to 0.78 ( P  = 0.012). EASIX >2.32 is associated with an OR for mortality of 9.37 in the training, and for 4.47 in the validation cohort. Patients with EASIX >2.32 had significantly more ICU and ventilator days ( P  < 0.001) and higher risk of postoperative bleeding.</p><p><strong>Conclusion: </strong>Preoperative EASIX is a validated, cost-effective tool for predicting in-hospital mortality and postoperative bleeding in patients undergoing cardiac surgery with CPB. It may enhance risk stratification and guide peri-operative management in high-risk patients.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"517-527"},"PeriodicalIF":6.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}