Journal of Clinical Anesthesia最新文献

{"title":"Proceedings from the 2025 Association of Anesthesia Clinical Directors Perioperative Leadership Summit","authors":"Thomas E. Schule MD , Chinyere A. Archie MBBS , D. Matthew Sherrer MD, MBA, FAACD , Richard Urman MD, MBA , Mitchell H. Tsai MD, MMM, FASA, FAACD , Andrew D. Franklin MD, MBA, FAACD, FASA","doi":"10.1016/j.jclinane.2025.111835","DOIUrl":"10.1016/j.jclinane.2025.111835","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111835"},"PeriodicalIF":5.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105420","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":"Addressing the role of diabetes progression and GLP-1 analog usage in perioperative aspiration risk","authors":"Uzay Cagatay , Matthew Matute , Michael Bickford , Salman Nayyer , Jonathan Elias","doi":"10.1016/j.jclinane.2025.111867","DOIUrl":"10.1016/j.jclinane.2025.111867","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111867"},"PeriodicalIF":5.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071107","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":"Perioperative management of patients on GLP-1 receptor agonists: Risks, recommendations, and future directions—A narrative review","authors":"Xiao-Yu Li MD ,&nbsp;Yun Jin MM ,&nbsp;Xiu-Ye Feng MM ,&nbsp;Rui-Chun Wang MD ,&nbsp;Jun-Ping Chen MD ,&nbsp;Bo Lu MD","doi":"10.1016/j.jclinane.2025.111871","DOIUrl":"10.1016/j.jclinane.2025.111871","url":null,"abstract":"<div><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly being used for glycemic control and weight management. One of their key mechanisms of action is thought to be delaying gastric emptying. This review explores the perioperative risks associated with GLP-1RAs use, particularly the increased risk of gastric content retention and pulmonary aspiration. Current evidence suggests that patients on GLP-1RAs should be considered at risk for having a full stomach during surgery. Recommendations include careful assessment of medication details, additional monitoring, and preventive measures such as pre-anesthesia gastric ultrasound and rapid sequence induction. Further research is needed to establish comprehensive guidelines for the perioperative management of GLP-1RAs users. Adverse events related to GLP-1RAs use during anesthesia should be thoroughly documented, which is essential to inform future guidelines and to enhance patient safety.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111871"},"PeriodicalIF":5.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071108","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 preoperative smoking with the occurrence of postoperative pulmonary complications: A post hoc analysis of an observational study in 29 countries","authors":"Galina Dorland ,&nbsp;W. Saadat ,&nbsp;David M.P. van Meenen ,&nbsp;Ary Serpa Neto ,&nbsp;Michael Hiesmayr ,&nbsp;Markus W. Hollmann ,&nbsp;Gary H. Mills ,&nbsp;Marcos F. Vidal Melo ,&nbsp;Christian Putensen ,&nbsp;Werner Schmid ,&nbsp;Paolo Severgnini ,&nbsp;Hermann Wrigge ,&nbsp;Marcelo Gama de Abreu ,&nbsp;Marcus J. Schultz ,&nbsp;Sabrine N.T. Hemmes","doi":"10.1016/j.jclinane.2025.111856","DOIUrl":"10.1016/j.jclinane.2025.111856","url":null,"abstract":"<div><h3>Introduction</h3><div>While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting.</div></div><div><h3>Aim</h3><div>We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs).</div></div><div><h3>Methods</h3><div>Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in–hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes.</div></div><div><h3>Results</h3><div>Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non–smokers had developed one or more PPCs (<em>P</em> = 0.95). Respiratory failure was more common in smokers (5.1 %) than non–smokers (3.0 %) (<em>P</em> = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings.</div></div><div><h3>Conclusion</h3><div>The occurrence of PPCs in smokers is not different from non–smokers.</div></div><div><h3>Funding</h3><div>This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands.</div></div><div><h3>Registration</h3><div>LAS VEGAS was registered at <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> (<span><span>NCT01601223</span><svg><path></path></svg></span>).</div></div><div><h3>Prior presentation</h3><div>Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111856"},"PeriodicalIF":5.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946480","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 between intravenous 5 % albumin administration and acute kidney injury after partial nephrectomy. A retrospective study","authors":"Juan Jose Guerra-Londoño MD ,&nbsp;Sergio M. Moreno-Lopez Ph.D. ,&nbsp;Satvik Gundre ,&nbsp;Azzi Jehanzeb ,&nbsp;Ryan Wong ,&nbsp;Nicolas Cortes-Mejia MD ,&nbsp;Diana Bejarano-Ramirez ,&nbsp;Cassius K.B. Mensah MD ,&nbsp;Juan P. Cata MD","doi":"10.1016/j.jclinane.2025.111873","DOIUrl":"10.1016/j.jclinane.2025.111873","url":null,"abstract":"<div><h3>Background</h3><div>Acute kidney injury (AKI) after partial nephrectomy is a frequent postoperative complication that can affect nearly half of patients, according to various studies. In the current study, we investigated the association of intraoperative administration of 5 % albumin, compared with crystalloids alone, with AKI after partial nephrectomy.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included adult patients undergoing partial nephrectomy. The primary endpoint was AKI within 72 h after surgery using the KIDGO definition. Secondary endpoints were time-to-AKI, reoperations, AKI severity and length of hospital stay. We used propensity score-based nearest-neighbor methods balance the patient baseline characteristics.</div></div><div><h3>Results</h3><div>A total of 1688 patients were included in the analysis, with 809 receiving 5 % albumin and 879 in the control group. After matching, 729 patients received 5 % albumin, while 674 were controls. The incidence of acute kidney injury (AKI) was significantly higher in the 5 % albumin group (32.78 %) compared to the control group (25.51 %). Multivariate analysis revealed that receiving 5 % albumin was associated with a 32 % increased risk of developing AKI. Furthermore, the analysis indicated that this association was dose-dependent.</div></div><div><h3>Conclusion</h3><div>Our study suggests that intraoperative administration of 5 % albumin may not be a risk factor for AKI after partial nephrectomy. Given the discrepancy between these results and previous studies, a future prospective randomized controlled trial is needed to confirm our findings.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111873"},"PeriodicalIF":5.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942514","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":"The effects of empagliflozin on kidney function and glucose metabolism in acute kidney injury","authors":"Lars I.P. Snel ,&nbsp;Maartina J.P. Oosterom-Eijmael ,&nbsp;Jeroen Hermanides ,&nbsp;Daniel H. van Raalte ,&nbsp;Abraham H. Hulst","doi":"10.1016/j.jclinane.2025.111865","DOIUrl":"10.1016/j.jclinane.2025.111865","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111865"},"PeriodicalIF":5.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946481","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":"Lung isolation with a bronchial blocker placed in the lateral position for patients undergoing thoracic surgery: A multicenter, randomized clinical trial","authors":"Hui Li M.D. ,&nbsp;Lihua Chu M.D. ,&nbsp;Hui Ye M.D. ,&nbsp;Yixiao Zhang M.M. ,&nbsp;Min Li M.M. ,&nbsp;Yejing Hua M.M. ,&nbsp;Jinhua Zhang M.M. ,&nbsp;Huiyi Hu M.M. ,&nbsp;Tingting Wen M.D. ,&nbsp;Jie Zhao M.D. ,&nbsp;Haifang Wan M.M. ,&nbsp;Lixia Huang M.M. ,&nbsp;Yi Lou M.M. ,&nbsp;Jing Tang M.D. ,&nbsp;Zhenyi Yan M.M. ,&nbsp;Gongchen Duan M.M. ,&nbsp;Jimin Wu M.D. ,&nbsp;Chuanguang Wang M.M. ,&nbsp;Yaping Lu M.M. ,&nbsp;Xu Shen M.M. ,&nbsp;Xiangming Fang M.D.","doi":"10.1016/j.jclinane.2025.111869","DOIUrl":"10.1016/j.jclinane.2025.111869","url":null,"abstract":"<div><div><strong>Study objective</strong></div><div>Accurate bronchial blocker placement is essential for effective lung isolation during thoracic surgery. Approximately one-third of patients experience bronchial blocker malposition during the transition from the supine to lateral decubitus position. It has been unclear whether bronchial blocker placement directly in the lateral position can reduce the incidence of malposition. This study investigated the incidence of bronchial blocker malposition in the lateral versus supine position and evaluated the effectiveness of lateral placement.</div></div><div><h3>Patients</h3><div>Adults aged ≥18 years scheduled for thoracic surgery were enrolled.</div></div><div><h3>Setting</h3><div>Seven tertiary hospitals in China.</div></div><div><h3>Interventions</h3><div>Bronchial blockers were placed either in the lateral or supine position.</div></div><div><h3>Measurements</h3><div>The primary outcome was the incidence of bronchial blocker malposition. Secondary outcomes included the times of bronchial blocker reposition, perioperative complications, intubation duration, and satisfaction scores.</div></div><div><h3>Main results</h3><div>Among 324 patients who underwent randomization, 306 completed the study (152 in the lateral group and 154 in the supine group). The incidence of bronchial blocker malposition was significantly lower in the lateral group (1/152 (0.7 %)) than in the supine group 39/154 (25.3 %), <em>P</em> &lt; 0.001). The times of bronchial blocker reposition was also lower in the lateral group (median [interquartile range]: 0 [0,0]) than in the supine group (1.0 [1.0, 2.0], <em>P</em> &lt; 0.001). Lateral bronchial blocker placement was associated with lower incidences of postural injury (<em>P</em> &lt; 0.001). The median intubation duration (single-lumen tube intubation plus bronchial blocker placement) was similar between the two groups (<em>P</em> = 0.089). Patients and surgeons reported higher satisfaction scores in the lateral group (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Lateral bronchial blocker placement reduced the incidence of malposition in patients undergoing thoracic surgery; it was associated with fewer complications and higher satisfaction scores. These findings indicate that lateral placement is an effective approach with substantial advantages over conventional supine placement.</div><div><strong>Clinial trial registration:</strong> <span><span>NCT05482230</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111869"},"PeriodicalIF":5.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934670","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":"Morphological findings in the sciatic nerve after intraneural injection","authors":"Rafael Boscolo-Berto ,&nbsp;Alessandra Maggiolo ,&nbsp;Aron Emmi ,&nbsp;Veronica Macchi ,&nbsp;Paolo Navalesi ,&nbsp;Alessandro De Cassai","doi":"10.1016/j.jclinane.2025.111868","DOIUrl":"10.1016/j.jclinane.2025.111868","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111868"},"PeriodicalIF":5.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934671","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":"Evacuating the contaminated airway with a novel, simple, readily available setup (“Evacu8”)","authors":"Christiana K. Prucnal MD, ScM ,&nbsp;Matteo Parotto MD, PhD ,&nbsp;Ryan M. Gardner MD ,&nbsp;Stephen D. Hallisey MD ,&nbsp;Paul S. Jansson MD, MS ,&nbsp;Barret Zimmerman MD ,&nbsp;Raghu R. Seethala MD, MSc ,&nbsp;Annette M. Ilg MD","doi":"10.1016/j.jclinane.2025.111866","DOIUrl":"10.1016/j.jclinane.2025.111866","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111866"},"PeriodicalIF":5.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143934667","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":"Copilot, not autopilot: Clinician oversight as the linchpin of safe AI-driven clinical decision making","authors":"Yan Jiang ,&nbsp;Hui Wang ,&nbsp;Hong Wang","doi":"10.1016/j.jclinane.2025.111863","DOIUrl":"10.1016/j.jclinane.2025.111863","url":null,"abstract":"","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"104 ","pages":"Article 111863"},"PeriodicalIF":5.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928952","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}