Korean Journal of Anesthesiology最新文献_第8页

Response to "Comment on Association between non-anemic iron deficiency and outcomes following off-pump coronary artery bypass surgery: a retrospective analysis". 对“重新评估非泵外心脏手术术前非贫血性缺铁的作用：超越负相关的见解”的回应。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.4097/kja.251069

Young-Lan Kwak

引用次数: 0

Effect of individualized positive end-expiratory pressure titration guided by electrical impedance tomography on oxygenation in patients undergoing laparoscopic surgery in the lateral decubitus position: a randomized controlled study. 电阻抗断层扫描引导个体化呼气末正压滴定对侧卧位腹腔镜手术患者氧合的影响：一项随机对照研究。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-03-17 DOI: 10.4097/kja.25704

Yoon Jung Kim, Hyeonhoon Lee, Hyun-Kyu Yoon, Hee-Soo Kim

{"title":"Effect of individualized positive end-expiratory pressure titration guided by electrical impedance tomography on oxygenation in patients undergoing laparoscopic surgery in the lateral decubitus position: a randomized controlled study.","authors":"Yoon Jung Kim, Hyeonhoon Lee, Hyun-Kyu Yoon, Hee-Soo Kim","doi":"10.4097/kja.25704","DOIUrl":"10.4097/kja.25704","url":null,"abstract":"Background: Laparoscopic surgery in the lateral decubitus position can alter pulmonary mechanics and oxygenation. Although positive end-expiratory pressure (PEEP) may alleviate these effects, the optimal level remains unclear. This study evaluated whether electrical impedance tomography (EIT)-guided PEEP titration improves oxygenation compared to a fixed PEEP of 5 cmH2O.Methods: In this randomized controlled trial, 74 adult patients undergoing robot-assisted or laparoscopic urologic surgery in the lateral decubitus position were assigned to either the EIT-guided or standard care group. The EIT-guided group underwent decremental PEEP titration to determine and maintain optimal PEEP throughout surgery. The standard care group received a fixed PEEP of 5 cmH2O. The primary outcome was ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) at the end of surgery. Secondary outcomes included intraoperative respiratory mechanics and postoperative pulmonary complications (PPCs) until discharge.Results: Seventy-one patients completed the study (EIT-guided: 35, standard care: 36). The PaO2/FiO2 ratio at the end of surgery was higher in the EIT-guided group than in the standard care group (523.8 ± 82.4 vs. 414.6 ± 96.7 mmHg, P < 0.001). Driving pressure was lower in the EIT-guided group at 30 min after pneumoperitoneum initiation (15.8 [12.5, 17.4] vs. 19.9 [17.2, 22.5] cmH2O, P < 0.001) and at the end of surgery (9.1 [8.0, 10.4] vs. 10.0 [8.8, 12.6] cmH2O, P = 0.033). PPCs did not differ between groups.Conclusions: EIT-guided PEEP titration improved intraoperative oxygenation. Further studies are needed to assess clinical outcomes.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"201-212"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Receptor subtype-dependent effects of propofol on metalloproteinase activity, NKG2D ligand expression, and NK cell-mediated cytotoxicity in breast cancer: an in vitro study. 受体亚型依赖性丙泊酚对乳腺癌中金属蛋白酶活性、NKG2D配体表达和NK细胞介导的细胞毒性的影响：一项体外研究

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2025-05-07 DOI: 10.4097/kja.25011

Hyun-Su Ri, Hyeon Jeong Lee, Jaeho Bae, Ah-Reum Cho, Jae Rin Kim, Seungbin Park, Kah Young Lee, Soeun Jeon

{"title":"Receptor subtype-dependent effects of propofol on metalloproteinase activity, NKG2D ligand expression, and NK cell-mediated cytotoxicity in breast cancer: an in vitro study.","authors":"Hyun-Su Ri, Hyeon Jeong Lee, Jaeho Bae, Ah-Reum Cho, Jae Rin Kim, Seungbin Park, Kah Young Lee, Soeun Jeon","doi":"10.4097/kja.25011","DOIUrl":"10.4097/kja.25011","url":null,"abstract":"Background: The effects of propofol, a commonly used intravenous anesthetic, on the breast cancer tumor microenvironment are not well understood. This study examined the influence of propofol on natural killer group 2, member D (NKG2D) ligand expression, matrix metalloproteinase (MMP)-mediated immune evasion, and natural killer (NK) cell-mediated cytotoxicity in breast cancer cells.Methods: We studied three human breast cancer cell lines representing distinct receptor subtypes: MCF-7 (estrogen receptor - and progesterone receptor-positive), MDA-MB-453 (human epidermal growth factor receptor 2-positive), and HCC-70 (triple-negative). Cells were treated with propofol at concentrations of 0 μg/ml (control; C), 4 μg/ml (P4), or 8 μg/ml (P8). Assessments included mRNA and protein expression of NKG2D ligands, NK cell cytotoxicity, protein levels of MMP-1 and MMP-2, and concentrations of soluble NKG2D ligands.Results: In MCF-7 and HCC-70 cell lines, propofol upregulated the mRNA and protein expression of NKG2D ligands in a dose-dependent manner, enhancing NK cell-mediated lysis. In contrast, in MDA-MB-453 cell lines, propofol downregulated the mRNA and protein expression of NKG2D ligands, resulting in diminished NK cell-mediated lysis. Across all receptor subtypes, propofol did not affect the expression of MMP-1 or MMP-2 or the concentration of soluble NKG2D ligands.Conclusions: Our results demonstrate that propofol exerts receptor subtype-dependent effects on NK cell-mediated immunosurveillance in breast cancer cell lines, potentially mediated by changes in the transcription of NKG2D ligands rather than by alterations in MMP expression or their proteolytic activity.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"233-244"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of electroencephalographic changes induced by different hypnotics in elderly patients: a narrative review. 不同催眠药诱发老年患者脑电图变化的特点：叙述性回顾。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.4097/kja.251020

Byung-Moon Choi, Uncheol Lee

{"title":"Characteristics of electroencephalographic changes induced by different hypnotics in elderly patients: a narrative review.","authors":"Byung-Moon Choi, Uncheol Lee","doi":"10.4097/kja.251020","DOIUrl":"10.4097/kja.251020","url":null,"abstract":"Aging is associated with widespread structural and functional changes in the brain including reduced neural plasticity, slower information processing, and impaired network integration. These age-related alterations influence the brain's response to anesthetic agents, particularly electroencephalography (EEG) activity. This narrative review summarizes the characteristic EEG features induced by commonly used hypnotic agents such as propofol, inhaled anesthetics, dexmedetomidine, ketamine, and remimazolam in elderly patients and examines how aging modulates these responses. With increasing age, EEG power shows a global decline, most prominently in the alpha frequency band (8-13 Hz), reflecting reduced thalamocortical and cortical activity. Peak alpha frequency slows progressively with age, and background EEG also often exhibits characteristic slowing, both of which are associated with cognitive decline. In addition, EEG reactivity to external stimuli diminishes, and integrative brain activity, representing coordinated processing across cortical regions, is reduced in older adults. Frontoparietal feedback connectivity, essential for conscious perception and information integration, is particularly weak in the elderly. These changes are further exacerbated under anesthesia, as general anesthetics disrupt top-down connectivity and reduce network integration. Graph-theoretical EEG analyses reveal age-related reductions in global efficiency, modularity, and small-world properties, which are signatures of a less efficient, more random, and fragmented brain network. Understanding these age-specific EEG alterations can improve intraoperative monitoring, anesthetic titration, and development of age-tailored EEG-guided strategies. Future research should aim to validate EEG biomarkers that reliably reflect anesthetic depth and brain health in elderly populations, thereby fostering safer anesthesia care in the aging population.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"152-168"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Individualized PEEP guided by electrical impedance tomography: physiological promise without clear clinical benefit. 由电阻抗断层扫描引导的个体化PEEP：生理上的希望但没有明确的临床益处。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-03-17 DOI: 10.4097/kja.26194

Jong Wook Song

引用次数: 0

Temporal dissociation between cerebral blood flow and brain tissue oxygenation during CPR: observations from a porcine model. 心肺复苏期间脑血流和脑组织氧合的时间分离：来自猪模型的观察。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.4097/kja.251104

Michael G Silverman, Ki Tae Jung, Stefan A Carp, Bryce Carr, Ailis C Muldoon, Bonsung Koo, Dibbyan Mazumder, Ekaterina Creed, Kichang Lee

引用次数: 0

The effect of perioperative ketamine and esketamine administration on postoperative nausea and vomiting in patients undergoing general anesthesia: a systematic review and meta-analysis. 围手术期氯胺酮和艾氯胺酮对全身麻醉患者术后恶心呕吐的影响：一项系统回顾和荟萃分析。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2025-05-08 DOI: 10.4097/kja.24930

Kwon Hui Seo, Shu Chung Choi, Jueun Kwak, Na Jin Kim

{"title":"The effect of perioperative ketamine and esketamine administration on postoperative nausea and vomiting in patients undergoing general anesthesia: a systematic review and meta-analysis.","authors":"Kwon Hui Seo, Shu Chung Choi, Jueun Kwak, Na Jin Kim","doi":"10.4097/kja.24930","DOIUrl":"10.4097/kja.24930","url":null,"abstract":"Background: The effects of perioperative ketamine and esketamine on postoperative nausea and vomiting (PONV) remain unclear. This study aimed to clarify their impact on PONV and related adverse events.Methods: We performed a meta-analysis of randomized controlled trials and observational studies comparing ketamine or esketamine with control agents. The primary outcome was a pooled analysis of PONV and nausea-only data. PONV, postoperative nausea (PON), and postoperative vomiting (POV) were also analyzed separately. Subgroup analyses were conducted by comparator type (placebo, opioid, or non-opioid) and dose categories. Meta-regression was used to assess dose-response relationships.Results: Fifty-five studies (n = 6676) were included. Ketamine and esketamine did not significantly reduce the incidence of pooled PONV risk (risk ratio [RR]: 0.95, 95% CI [0.87-1.04], P = 0.274). No benefit was found versus placebo. Compared with opioids, PONV was reduced (RR = 0.50, 95% CI [0.32-0.77], P = 0.002), but not in the pooled analysis (RR = 0.69, 95% CI [0.43-1.08], P = 0.107). Conversely, compared with non-opioid controls, ketamine/esketamine increased the pooled PONV risk (RR = 1.46, 95% CI [1.03-2.05], P = 0.032). No significant dose-response relationship was found. Both agents increased hallucinations (RR = 1.73, 95% CI [1.35-2.20], P = 0.0002) and drowsiness (RR = 2.18, 95% CI [1.13-4.21], P = 0.024).Conclusions: Ketamine and esketamine did not significantly reduce PONV overall. While they showed benefits compared with opioid-based regimens, they may be less effective than non-opioid adjuvants. However, their neuropsychiatric and sedative risks warrant cautious use.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"182-200"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypotension prediction index in the prediction of better outcomes: a systematic review and meta-analysis. 低血压预测指数预测更好的结果：一项系统回顾和荟萃分析。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2025-08-18 DOI: 10.4097/kja.25249

Yi Liu, Bei Liu, Wei Xiong, Chen Wang, Kunxin Yang, Wudi Ma, Liangtian Lan, Ming Wei, Nan Jiang, Xia Feng

{"title":"Hypotension prediction index in the prediction of better outcomes: a systematic review and meta-analysis.","authors":"Yi Liu, Bei Liu, Wei Xiong, Chen Wang, Kunxin Yang, Wudi Ma, Liangtian Lan, Ming Wei, Nan Jiang, Xia Feng","doi":"10.4097/kja.25249","DOIUrl":"10.4097/kja.25249","url":null,"abstract":"Background: The hypotension prediction index (HPI) is an algorithm designed to predict hypotension. Some studies have reported that HPI-guided hemodynamic management strategies decrease intraoperative hypotension and complications; however, the effect of HPI on reducing perioperative complications is controversial. This meta-analysis aimed to assess the efficacy of the HPI in reducing major complications and intraoperative hypotension.Methods: We conducted this meta-analysis according to the PRISMA statement and Cochrane Handbook guidelines. A comprehensive literature review was conducted to identify studies focusing on the efficacy of HPI-guided management in reducing intraoperative hypotension and postoperative complications. The PubMed, Embase, Scopus, and Web of Science databases were searched, and the resulting data were combined to calculate the pooled mean differences or risk ratios (RRs) with 95% CIs of both randomized controlled trials (RCTs) and retrospective studies, as appropriate. Heterogeneity and potential publication bias were also assessed.Results: Nineteen articles (12 RCTs and 7 retrospective studies) with 2570 recruited patients were included in this meta-analysis. The critical evaluation of the study quality revealed a low risk of bias in the included RCTs. Among the non-randomized trials, one was rated 7, two were rated 8, and the remaining four were rated 9 on the Newcastle-Ottawa Scale, indicating high quality and a low risk of bias. HPI-guided management significantly reduced intraoperative hypotension and associated major complications (RR = 0.79, 95% CI [0.69-0.90], I2 = 0, P < 0.001). Blood loss and length of hospital stay were comparable between the groups.Conclusions: HPI-guided management significantly reduced intraoperative hypotension and major complications.","PeriodicalId":17855,"journal":{"name":"Korean Journal of Anesthesiology","volume":" ","pages":"169-181"},"PeriodicalIF":4.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on "Association between non-anemic iron deficiency and outcomes following off-pump coronary artery bypass surgery: a retrospective analysis". 重新评估术前非贫血性缺铁在非泵心脏手术中的作用：超越负相关的见解。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.4097/kja.25986

Hsin-An Hsu, Wen-Ting Lin, Ming-Hui Hung

引用次数: 0

Oxygen reserve index for safer oxygen titration: beyond SpO2 in pediatric one-lung ventilation. 安全氧滴定的氧储备指标：儿童单肺通气超过SpO2。

IF 4 4区医学

Korean Journal of Anesthesiology Pub Date : 2026-04-01 Epub Date: 2026-03-16 DOI: 10.4097/kja.26207

Won-Jung Shin

引用次数: 0