Journal of AnesthesiaPub Date : 2024-08-01Epub Date: 2021-10-25DOI: 10.1007/s00540-021-03014-7
Shingo Kawashima, Hiroyuki Kinoshita
{"title":"Does the oxygen reserve index play a role in oxygen therapy?","authors":"Shingo Kawashima, Hiroyuki Kinoshita","doi":"10.1007/s00540-021-03014-7","DOIUrl":"10.1007/s00540-021-03014-7","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"560"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39557968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidence of sodium-glucose cotransporter-2 inhibitor-associated perioperative ketoacidosis in surgical patients: a prospective cohort study.","authors":"Hiroyuki Seki, Norifumi Kuratani, Toshiya Shiga, Yudai Iwasaki, Kanae Karita, Kazuki Yasuda, Natsuko Yamamoto, Yuko Nakanishi, Kenji Shigematsu, Kensuke Kobayashi, Junichi Saito, Ichiro Kondo, Nozomu Yaida, Hidenobu Watanabe, Midoriko Higashi, Tetsuro Shirasaka, Akira Doshu-Kajiura, Mitsutaka Edanaga, Satoshi Tanaka, Saori Ikumi, Shingo Ito, Masayuki Okada, Tomoko Yorozu","doi":"10.1007/s00540-024-03335-3","DOIUrl":"10.1007/s00540-024-03335-3","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are commonly prescribed anti-diabetic medications with various beneficial effects; however, they have also been associated with ketoacidosis. The aim of this study was to determine the incidence of SGLT2i-associated perioperative ketoacidosis (SAPKA) in surgical patients.</p><p><strong>Methods: </strong>We conducted a multicenter, prospective cohort study across 16 centers in Japan, enrolling surgical patients with diabetes who were prescribed SGLT2is between January 2021 and August 2022. Patients were monitored until the third postoperative day to screen for SAPKA, defined as urine ketone positivity with a blood pH of < 7.30 and HCO<sub>3</sub> level ≤ 18.0 mEq/L, excluding cases of respiratory acidosis.</p><p><strong>Results: </strong>In total, 759 of the 762 evaluated patients were included in the final analysis. Among these, three patients (0.40%) had urine ketones with a blood pH of < 7.30; however, blood gas analysis revealed respiratory acidosis in all three, and none of them was considered to have SAPKA. The estimated incidence of SGLT2i-associated postoperative ketoacidosis was 0% (95% confidence interval, 0%-0.4%).</p><p><strong>Conclusions: </strong>The observed incidence of SAPKA in our general surgical population was lower than expected. However, given that the study was observational in nature, interpretation of study results warrants careful considerations for biases.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"464-474"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of AnesthesiaPub Date : 2024-08-01Epub Date: 2024-06-24DOI: 10.1007/s00540-024-03355-z
Naoko Niimi, Alan Yang, Makoto Sumie, Jason Hayes, Jason T Maynes, Kazuyoshi Aoyama
{"title":"Understanding three standard study designs for randomized controlled trials.","authors":"Naoko Niimi, Alan Yang, Makoto Sumie, Jason Hayes, Jason T Maynes, Kazuyoshi Aoyama","doi":"10.1007/s00540-024-03355-z","DOIUrl":"10.1007/s00540-024-03355-z","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"421-424"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of AnesthesiaPub Date : 2024-08-01Epub Date: 2024-03-01DOI: 10.1007/s00540-024-03320-w
Weiwei Chen
{"title":"Regarding the risk factors for the emergence delirium in pediatric patients after tonsillectomy and adenoidectomy.","authors":"Weiwei Chen","doi":"10.1007/s00540-024-03320-w","DOIUrl":"10.1007/s00540-024-03320-w","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"575"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of leak fraction between the laryngeal mask airway and endotracheal tube during anesthesia: a single-center retrospective study.","authors":"Seiichi Azuma, Masaaki Asamoto, Shinichi Akabane, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida","doi":"10.1007/s00540-024-03364-y","DOIUrl":"10.1007/s00540-024-03364-y","url":null,"abstract":"<p><p>The use of the laryngeal mask airway (LMA), which offers the benefits of ease in insertion and prevention of tracheal damage, is associated with a risk of flow leakage. This study analyzed our extensive database to compare leakage associated with the use of LMA and endotracheal tube (ETT). Adult patients who underwent chest wall, abdominal wall, inguinal region, limb, transurethral, or transvaginal surgery and received either LMA or ETT between January 2007 and March 2020 were included. The leak fraction was calculated as (inspiratory tidal volume-expiratory tidal volume)/(inspiratory tidal volume) × 100% every minute during intraoperative stable positive pressure ventilation. The median leak fraction was calculated for each case. The leak fraction in the LMA group demonstrated a left-skewed distribution with a larger proportion of excessive leak fraction. The leak fraction in the LMA group (median, 7.9%; interquartile range, 4.8-11.4%) was significantly lower than that in the ETT group (median, 9.1%; interquartile range: 5.5-12.4%; P < 0.001). This tendency was consistent across subgroups divided by sex, age, type of surgery, and ventilation mode. We propose that LMA provides leakage comparable to or less than ETT in most cases if stable positive pressure ventilation is achieved.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":"556-559"},"PeriodicalIF":2.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analgesia mode after cesarean section: PCEA or EM?","authors":"Liang Sun, Xiaoning Li, Yanchao Yang, Yi Feng","doi":"10.1007/s00540-024-03381-x","DOIUrl":"10.1007/s00540-024-03381-x","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rémi Florquin, Renaud Florquin, Denis Schmartz, Philippe Dony, Giovanni Briganti
{"title":"Pediatric cardiac surgery: machine learning models for postoperative complication prediction.","authors":"Rémi Florquin, Renaud Florquin, Denis Schmartz, Philippe Dony, Giovanni Briganti","doi":"10.1007/s00540-024-03377-7","DOIUrl":"https://doi.org/10.1007/s00540-024-03377-7","url":null,"abstract":"<p><strong>Purpose: </strong>Managing children undergoing cardiac surgery with cardiopulmonary bypass (CPB) presents a significant challenge for anesthesiologists. Machine Learning (ML)-assisted tools have the potential to enhance the recognition of patients at risk of complications and predict potential issues, ultimately improving outcomes.</p><p><strong>Methods: </strong>We evaluated the prediction capacity of six models, ranging from logistic regression to support vector machine, using a dataset comprising 33 variables and 1364 subjects. The Area Under the Curve (AUC) and the F1 score served as the primary evaluation metrics. Our primary objectives were twofold: first, to develop an effective prediction model, and second, to create a user-friendly comprehensive model for identifying high-risk patients.</p><p><strong>Results: </strong>The logistic regression model demonstrated the highest effectiveness, achieving an AUC of 83.65%, and an F1 score of 0.7296, with balanced sensitivity and specificity of 77.94% and 76.47%, respectively. In comparison, the comprehensive three-layer decision tree model achieved an AUC of 72.84%, with sensitivity (79.41%) comparable to more complex models.</p><p><strong>Conclusion: </strong>Our machine learning-assisted tools provide an additional perspective and enhance the predictive capabilities of traditional scoring methods. These tools can assist anesthesiologists in making well-informed decisions. Furthermore, we have successfully demonstrated the feasibility of creating a practical white-box model. The next steps involve conducting clinical validation and multicenter cross-validation.</p><p><strong>Trial registration: </strong>NCT05537168.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High spinal block in cesarean section.","authors":"Ahmed M Hasanin, Rana M Zaki, Maha Mostafa","doi":"10.1007/s00540-024-03378-6","DOIUrl":"https://doi.org/10.1007/s00540-024-03378-6","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vasopressors in obstetrics: guidelines and good practice.","authors":"Ahmed M Hasanin, Rana M Zaki, Maha Mostafa","doi":"10.1007/s00540-024-03379-5","DOIUrl":"https://doi.org/10.1007/s00540-024-03379-5","url":null,"abstract":"","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Radial artery catheterization using a novel T-type ultrasound probe: a single-center randomized study.","authors":"Mitsutaka Edanaga, Tomohiro Chaki, Michiko Osuda, Michiaki Yamakage","doi":"10.1007/s00540-024-03376-8","DOIUrl":"https://doi.org/10.1007/s00540-024-03376-8","url":null,"abstract":"<p><p>Ultrasound guidance has been reported to facilitate radial artery catheterization compared with the palpation method. However, a recent meta-analysis showed that there was not significant differences in the first attempt success rate between the long-axis in-plane (LA-IP) method and the short-axis out-of-plane method. In 2023, we started using a novel T-type probe. We can recognize the needle first during the radial artery access with the short-axis view and then dose it with the long-axis view using the T-type probe. Therefore, we hypothesized that the T-type probe-guided method might heighten the first attempt success rate in radial artery catheterization, even for non-expert practitioners, compared with the LA-IP technique. One hundred and fifty adult patients, older than 20 years, ASA I to III, were randomly assigned to the T-type probe-guided group (Group T: n = 75) or the LA-IP group (Group L: n = 75). The primary outcome was the first attempt success rate. The first attempt success rate in Group T (49/71, 69%) was significantly higher than that in Group L (31/68, 46%) (p = 0.0062). The present study showed that the T-type probe might facilitate the radial artery catheterization rather than the LA-IP method.</p>","PeriodicalId":14997,"journal":{"name":"Journal of Anesthesia","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}