European Journal of Anaesthesiology最新文献

{"title":"Cerebral oxygenation during anaesthesia induction: More to the story than inspired oxygen alone.","authors":"Muhammad Rafay Shahzad Cheema","doi":"10.1097/EJA.0000000000002435","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002435","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 9","pages":"789-790"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663705","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":"Abnormal vital signs during recovery from noncardiac surgery on general wards: A blinded prospective observational study.","authors":"Moritz Flick, Alina Bergholz, Hannah Sadtler, Karim Kouz, Phillip Hoppe, Julia Auinger, Linda Krause, Christian Zöllner, Kristen K Thomsen, Bernd Saugel","doi":"10.1097/EJA.0000000000002398","DOIUrl":"10.1097/EJA.0000000000002398","url":null,"abstract":"<p><strong>Background: </strong>In patients recovering from noncardiac surgery on general wards, the duration and severity of postoperative vital sign abnormalities remain largely unknown.</p><p><strong>Objectives: </strong>To quantify abnormal vital signs using automated continuous monitoring.</p><p><strong>Design: </strong>Single-centre prospective observational study.</p><p><strong>Setting: </strong>University Medical Center Hamburg-Eppendorf, Hamburg, Germany.</p><p><strong>Patients: </strong>A total of 190 adults recovering from noncardiac surgery on general wards.</p><p><strong>Intervention: </strong>Automated blinded monitoring of vital signs using a wearable device for up to 5 postoperative days.</p><p><strong>Main outcome measures: </strong>The primary outcome was the percentage of monitoring time patients had any abnormal vital sign (peripheral oxygen saturation ≤91%, respiratory rate ≤8 or ≥25 breaths per min, systolic blood pressure ≤90 or ≥220 mmHg, or pulse rate ≤40 or ≥131 beats per min).</p><p><strong>Results: </strong>The median [IQR] percentage of monitoring time and the median cumulative time patients had any abnormal vital sign were 6 [3 to 12]% and 155 [58 to 375] min, respectively. 74 patients (39%) had any abnormal vital sign for at least 15 continuous minutes. The most frequently observed vital sign abnormalities were hypoxaemia and bradypnoea. Hypoxaemia occurred for a median cumulative time of 33 [7 to 123] min and lasted for at least 15 continuous minutes in 59 patients (31%). Bradypnoea occurred for a median cumulative time of 62 [17 to 159] min and lasted for at least 15 continuous minutes in 19 patients (10%). Other vital sign abnormalities were rare.</p><p><strong>Conclusions: </strong>Abnormal vital signs were common in patients recovering from noncardiac surgery on general wards. Hypoxaemia and bradypnoea were the most common vital sign abnormalities. Future research should further investigate the clinical relevance of abnormal vital signs and evaluate whether automated vital sign monitoring can facilitate early detection and timely intervention to improve patient outcomes.</p><p><strong>Study registration: </strong>German Clinical Trials Register (DRKS00030284) on 6 October 2022.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"769-778"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766260","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":"Butyrylcholinesterase activity and prolonged duration of action of mivacurium in elderly patients (≥80 years): A secondary analysis of a clinical trial.","authors":"Sebastian Kempff-Andersen, Andreas Creutzburg, Christine Linaa Rosager, Matias Vested","doi":"10.1097/EJA.0000000000002439","DOIUrl":"10.1097/EJA.0000000000002439","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"779-781"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257957","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":"Remifentanil patient-controlled analgesia for labour analgesia: addressing the clinical gap in respiratory monitoring.","authors":"Betul Kozanhan, Mahmut Sami Tutar, Munise Yildiz","doi":"10.1097/EJA.0000000000002441","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002441","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 9","pages":"790-791"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663645","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":"European simulation-based education and training in anaesthesiology and intensive care: evidence, value and inevitable evolution.","authors":"Crina L Burlacu, Yitzhak Brzezinski Sinai, Gustavo Norte, Clément Buléon, Petr Štourač, Georges L Savoldelli, Joana Berger-Estilita, Anne Marie Camilleri Podesta, Doris Østergaard","doi":"10.1097/EJA.0000000000002448","DOIUrl":"10.1097/EJA.0000000000002448","url":null,"abstract":"<p><p>Anaesthesiologists, intensive care, and perioperative physicians work within multidisciplinary teams in high-risk environments where adverse events may threaten patient safety and are often avoidable. They face converging challenges, including multimorbidity and increasing clinical complexity, workforce shortages and burnout, technological evolution, and rising expectations for safety, equity, and sustainability. In this expert-driven evidence-based consensus review, we aim to demonstrate that simulation-based education and training (SBET) is uniquely positioned to address these challenges. We review how SBET adds value across the professional lifespan, from initial training to high-stakes examinations and continuing professional development. We further examine how SBET enhances team performance, identifies latent system threats, and supports organisational redesign through translational simulation. We examine how SBET can prepare for the future by fostering digital and ecological competencies. We explore key barriers to implementation, as despite SBET's value, its adoption across anaesthesiology, intensive care, and perioperative medicine remains fragmented, with limited interprofessional integration and few national frameworks. Above all, we advocate for coordinated value-based adoption of SBET across education and healthcare systems, recognising it not merely as an educational method but as a strategic infrastructure for high-reliability healthcare systems. Sustained investment, protected time, faculty development, and interprofessional integration are essential to realise its full potential. Aligned strategies to close the gap between evidence and practice are crucial. Without decisive and collective action, education and healthcare risk losing one of the most effective tools for improving patient safety, enhancing individual and system resilience, and maintaining the highest standards of excellence across our specialty and interprofessional practice.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"749-761"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307611","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":"Does percutaneous cryoneurolysis spare myelinated fibres? Neurophysiological evidence after intercostal nerves freezing for pectus excavatum surgery: A retrospective pilot study.","authors":"Stefano Mariconti, Matteo Impellizzeri, Barbara Frigeni, Dario Bugada","doi":"10.1097/EJA.0000000000002449","DOIUrl":"10.1097/EJA.0000000000002449","url":null,"abstract":"","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"781-785"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367184","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":"Impaired endotoxin inactivation, rather than gut translocation, is associated with organ injury in cardiac surgery with cardiopulmonary bypass: An ancilliary analysis of a randomised control trial.","authors":"Maxime Nguyen, Marvin Alvarez, Corentin Evezard, Azrat Ibrahima, Pierre Huette, Yazine Mahjoub, Jean-Paul Pais-De-Barros, Belaïd Bouhemad, David Masson, Thomas Gautier, Pierre-Grégoire Guinot, Osama Abou-Arab","doi":"10.1097/EJA.0000000000002350","DOIUrl":"10.1097/EJA.0000000000002350","url":null,"abstract":"<p><strong>Backgrounds: </strong>In patients with cardiac surgery under cardiopulmonary bypass (CPB), postoperative inflammation is a driver of adverse outcomes. Endotoxaemia is one of the factors thought to trigger this inflammatory response. The mechanism behind high endotoxin activity (increased translocation vs. reduced inactivation capacity) has never been elucidated and may imply different therapeutic candidates.</p><p><strong>Objectives: </strong>We aimed to evaluate, in patients with cardiac surgery with prolonged CPB, mechanisms and consequences of endotoxaemia and the efficacy of haemo-adsorption to reduce the endotoxin burden.</p><p><strong>Design: </strong>Ancillary analysis of a randomised controlled trial. Patients scheduled for cardiac surgery with prolonged CPB were assigned to receive either intra-operative haemo-adsorption or standard of care. Endotoxin mass and activity were measured before surgery, at the end of CPB, 6, 24 and 48 h after the end of surgery.</p><p><strong>Setting: </strong>Operating room, Amiens University Hospital.</p><p><strong>Patients: </strong>Adults scheduled for cardiac surgery under CPB with an expected CPB time more than 90 min.</p><p><strong>Intervention: </strong>Patients were randomised to receive either haemo-adsorption or standard care during CPB.</p><p><strong>Main outcome measures: </strong>Endotoxin activity.</p><p><strong>Results: </strong>Two hundred and ninety-five samples from 66 patients were analysed. Following CPB, we observed a reduction in endotoxin mass accompanied by a relative increase in endotoxin activity. High postoperative endotoxin activity was associated with intra-operative dobutamine requirement, increased postoperative inflammatory biomarkers and organ injury. Endotoxin plasma concentration and activity were not lower in patients treated with haemo-adsoprtion.</p><p><strong>Conclusion: </strong>The capacity of individuals to inactivate endotoxin rather than raw endotoxin mass (i.e. Quantity) seemed to be a determinant of endotoxin noxious effect in cardiac surgery and CBP. Haemo-adsorption was not associated with a reduction of endotoxin plasma mass or activity in patients with cardiac surgery under CPB.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04201119NCT04201119.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":"762-768"},"PeriodicalIF":7.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965800","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":"Educational framework for harmonised minimal standards in Paediatric Anaesthesia training in Europe based on a modified Delphi approach: On behalf of The European Society of Anaesthesiology and Intensive Care and European Society for Paediatric Anaesthesiology Taskforce.","authors":"Nicola Groes Clausen, Michael Brackhahn, Ivana Budic, Wolfgang Buhre, Andras Kelecsenyi, Francesca Oppitz, Patricio Gonzalez-Pizarro, Nada Sabourdin, Marzena Zielińska, Ehrenfried Schindler","doi":"10.1097/EJA.0000000000002450","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002450","url":null,"abstract":"<p><strong>Abstract: </strong>Delivery of safe and effective anaesthesia to children of all ages requires considerable training and experience. Due to national differences in medical training and health care organizations, training in paediatric anaesthesiology is not standardized within Europe.The main purpose of this statement is to conceptualise the components necessary to obtain expert qualifications in paediatric anaesthesiology. The elements outlined represent minimum training requirements in Paediatric anaesthesia. These were defined by a panel of experienced practitioners of paediatric anaesthesia based on a modified Delphi process. Duration of education period, participant- and host clinic qualifications, requirements for the trainee and standardized skill evaluation forms are presented.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763898","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":"Surgical time, peri-operative major adverse cardiac and cerebral events and hospital stay in noncardiac surgery: insights from 7-day service implementation: A retrospective case-control study.","authors":"Weixian Xu, Penghui Zhao, Zhao-Wei Yin, Hong Cai, Lin Zeng, Mao Xu, Menglin Zhao, Cencen Wu, Yuan Xu, Jiageng Cai, Rong Li, Lingyun Zu","doi":"10.1097/EJA.0000000000002474","DOIUrl":"https://doi.org/10.1097/EJA.0000000000002474","url":null,"abstract":"<p><strong>Background: </strong>The 'out of hours effect' applies to patients undergoing surgery during night shifts, weekends or holidays, who face higher risks of complications and mortality. The 7-day service policy was implemented to ensure consistent healthcare delivery.</p><p><strong>Objective: </strong>To assess the association between surgical time and incidence of major peri-operative adverse cardiac and cerebral events (MACCE) and also the length of hospital stay, and whether this has changed following the implementation of the 7-day service.</p><p><strong>Design: </strong>Nested case-control study.</p><p><strong>Setting: </strong>Single-centre university hospital. Retrospective enrolment from January 2018 to December 2021.</p><p><strong>Patients: </strong>The study included 2543 cases and 10 683 controls.</p><p><strong>Main outcome measures: </strong>The primary outcome was peri-operative MACCE. Patients who developed MACCE after noncardiac surgery were compared with controls randomly selected from those without MACCE (1 : 4 ratio).</p><p><strong>Results: </strong>Night-shift procedures were associated with higher incidence of peri-operative MACCE (28.7 vs. 18.2%, P < 0.001), longer hospital stays (172 vs. 155 h, P < 0.01), and higher costs (48 529 vs. 37 962 yuan, P < 0.001). In multivariable logistic regression, night-shift surgery remained independently associated with MACCE [fully adjusted odds ratio (OR) 1.54, 95% confidence interval (CI), 1.3 to 1.8; P < 0.001]. Weekend surgery was not significantly associated with MACCE after full adjustment (OR 1.15, 95% CI, 0.96 to 1.38; P = 0.13), and results were consistent in a sensitivity model including both night-shift and weekend surgery (night shift OR 1.54, 95% CI, 1.3 to 1.82, P < 0.001; weekend OR 1.17, 95% CI, 0.97 to 1.4, P = 0.09). Following implementation of the 7-day service policy, night-shift procedures decreased [16.1% prepolicy vs. 3.7% postpolicy; standardised mean difference (SMD) 0.42] and weekend procedures increased (5.5 vs. 13.3%; SMD 0.27). In the postpolicy period, weekend surgery was associated with a shorter hospital stay (139 vs. 160 h, P < 0.001) without an increase in MACCE (18.7 vs. 19.4%, P = 0.53).</p><p><strong>Conclusion: </strong>Night-shift surgery was an independent risk factor for peri-operative MACCE in noncardiac surgery patients. The 7-day service policy reduced night-shift procedures and increased those at weekends, without increasing the risk of MACCE. It was also associated with shorter hospital stays.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry identifier: ChiCTR1900024645.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677805","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":"A systematic review of efforts to predict day of surgery cancellation.","authors":"Thomas Sardesai, Laura Hobbs, Caroline Phillips, Gauri Ang, Tom Bashford, Katharina Kohler, Daniel Stubbs","doi":"10.1097/EJA.0000000000002370","DOIUrl":"10.1097/EJA.0000000000002370","url":null,"abstract":"<p><strong>Background: </strong>Day of surgery cancellation (DOSC) for elective surgery occurs in 18% of elective surgeries worldwide with resultant impacts on patients and healthcare systems. Accurate prediction of such cancellations could yield significant benefit.</p><p><strong>Objective: </strong>This systematic review synthesises evidence to inform future efforts at gold-standard statistical modelling.</p><p><strong>Design: </strong>Systematic review and qualitative synthesis using the 'Synthesis Without Meta-Analysis' (SWiM) framework.</p><p><strong>Data sources: </strong>MEDLINE, Embase, Scopus and Web of Science, 2013-2024.</p><p><strong>Eligibility criteria: </strong>Studies were considered eligible if they presented the development, validation or update of a model to predict DOSC. Risk of bias for included studies was assessed using the prediction model risk of bias assessment tool (PROBAST). Data was collected on included variables, method of prediction, whether prediction was made at the level of the patient or the system, and training and assessment processes.</p><p><strong>Results: </strong>Literature searching identified 7154 unique studies, 6 of which were included in the final synthesis. These studies encompassed total of 759 337 elective surgical procedures, of which 47 609 were cancellations, across a variety of adult and paediatric surgery. Methods of prediction included logistic regression models, machine learning, and spatial regression models. These used demographic, socioeconomic, comorbidity, surgical, appointment and other factors as predictors. The best discrimination achieved by models in each study, quantified by area under the receiver operator curve, ranged from 0.75 to 0.92 in development and 0.70 to 0.74 in validation datasets. One study demonstrated better calibration at the census tract level of spatial regression models when incorporating local survey data compared with individual-prediction-aggregation models.</p><p><strong>Conclusions: </strong>Models to predict DOSC identified in this review demonstrated moderate discrimination ability but there was significant heterogeneity between studies and reports of calibration were limited. This review serves as a valuable synthesis of current models to predict DOSC and should serve as a core reference for emerging studies in this field.</p>","PeriodicalId":11920,"journal":{"name":"European Journal of Anaesthesiology","volume":"43 8","pages":"692-702"},"PeriodicalIF":7.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359993","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}