European journal of anaesthesiology and intensive care最新文献

{"title":"Learning and reproducibility of ultrasonographic assessment of the optic nerve sheath diameter: A cohort study.","authors":"Gerrit U Herpertz, Patrick Focken, Oliver Radke","doi":"10.1097/EA9.0000000000000074","DOIUrl":"10.1097/EA9.0000000000000074","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided measurement of the optic nerve sheath diameter (ONSD) is correlated with increased intracranial pressure (ICP). It has also been recognised as being useful in predicting intracranial hypertension, monitoring ICP and predicting outcome after resuscitation. The method has been described as easy to learn and with good inter-examiner reliability. But most studies were performed with only a few experienced examiners.</p><p><strong>Objectives: </strong>This study aimed to evaluate the learning progression and inter-examiner variability in point-of-care ultrasonographic assessment of the ONSD.</p><p><strong>Design: </strong>An observational cohort study.</p><p><strong>Setting: </strong>Single tertiary centre in north-western Germany.</p><p><strong>Patients and participants: </strong>For the first part, we recruited a total of nine individuals naive to the ONSD measurement method. These were divided into two groups, one with and one without previous ultrasound experience. These individuals served as both examiners and 'volunteers' for each other during the learning phase of ONSD measurements. For the second part, two intubated and sedated intensive care patients had their ONSD measured by some of these newly trained examiners plus other more experienced examiners.</p><p><strong>Intervention: </strong>The examination was introduced following the Cognitive Apprenticeship method.</p><p><strong>Main outcome measure: </strong>Learning progress was evaluated by time needed to perform the examination and by the decrease in the difference of the examination results to the mean ONSD of each individual. For the second part, examination results of the intensive care patients were used to calculate an interclass correlation coefficient.</p><p><strong>Results: </strong>The mean examination time decreased from 79 ± 48 to 48 ± 14 s from the first to the eight measurement, nearly following an exponential manner (<i>P</i> = 0.054). The deviation of the ONSD compared to the reference ONSD of each proband did not decrease exponentially over time in general. Examiners with ultrasound experience had a significantly lower variation (0.50 ± 0.17 vs. 0.74 ± 0.29 mm; <i>P</i> = 0.012) regarding this particular point. The ICC calculated from results of measurement on the two patients was 0.832 (95% CI, 0.428 to 0.988).</p><p><strong>Conclusion: </strong>According to our findings, the ultrasonographic assessment of the ONSD is easy to learn and expertise is gained quickly, especially for individuals with previous ultrasound experience. The data show good inter-examiner reliability on everyday patients.</p><p><strong>Trial registration: </strong>Ethics Committee of the Medical Board of the State Bremen (No. 809/4).</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 3","pages":"e0074"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating patient knowledge about peri-operative neurocognitive disorders (KNOW-PND study): A feasibility study.","authors":"Alexander Heintz, Marie-Margaux Schöllner, Louis Huyghe, Mia Gisselbaek, Susana Vacas, Joana Berger-Estilita, Sarah Saxena","doi":"10.1097/EA9.0000000000000075","DOIUrl":"10.1097/EA9.0000000000000075","url":null,"abstract":"","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 3","pages":"e0075"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of two standardised protocols for prevention of vasospasm following aneurysmal subarachnoid haemorrhage: A retrospective pilot study.","authors":"Kristina Wendl, Martin Knebusch, Bernhard Hörmann, Christian Eimer, Thomas Borgmann, Hannes Egermann, Tino Münster","doi":"10.1097/EA9.0000000000000073","DOIUrl":"10.1097/EA9.0000000000000073","url":null,"abstract":"<p><strong>Background: </strong>Cerebral vasospasm is a major complication after subarachnoid haemorrhage. Yet, no standardised applicable therapy regimen has been established so far. Most previous studies concentrated on comparing single drugs, while fewer holistic therapeutic approaches have been compared.</p><p><strong>Objective: </strong>Our objective was to compare two therapy bundles with different administrations of magnesium, catecholamines, nimodipine and molsidomine, regarding the prevention of cerebral vasospasm and neurological outcome after subarachnoid haemorrhage.</p><p><strong>Design: </strong>Retrospective design, pilot study.</p><p><strong>Setting: </strong>This single-centre trial included 44 patients, 22 patients per group (matched pairs), with aneurysmal subarachnoid haemorrhage treated in the hospital of Barmherzige Brüder in Regensburg, Germany, from 2015 to 2022. Exclusion criteria were known comorbidities, such as severe liver, blood or kidney diseases.</p><p><strong>Main outcome measures: </strong>Incidence of vasospasm, survival and clinical outcome.</p><p><strong>Results: </strong>The incidence of vasospasms showed no significant difference between group 1 (new therapy bundle) and group 2 (previous standard therapy, <i>P</i> = 0.34), as well as the number of surviving patients. Comparing the clinical outcome measured with the Glasgow Outcome Scale after hospitalisation, no significant difference could be seen. The hospital length of stay, group 1: 23 [16.75 to 25.50] days vs. group 2: 30 [22.5 to 34.5] days, <i>P</i> = 0.004, and the intensive care unit (ICU) length of stay (LOS), group 1: 17.50 [12.75 to 24.00] days vs. group 2: 23.50 [19.75 to 32.50] days, <i>P</i> = 0.012, were significantly shorter in group 1.</p><p><strong>Conclusion: </strong>New therapy bundle has the potential to be more effective than the standard therapy method. As a retrospective pilot study with a small sample size, this research may serve as a valuable foundation for future larger prospective studies for better comparison of the different therapeutic approaches.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 3","pages":"e0073"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different effects of epidural versus paravertebral analgesia on respiratory rate variability after oesophagectomy: A single-centre observational subanalysis from the PEPMEN trial.","authors":"Oscar F C van den Bosch, Ricardo Alvarez Jimenez, Jasper Koolwijk, Wietse J Eshuis, Mark I van Berge Henegouwen, Patrick Schober, Stephan A Loer","doi":"10.1097/EA9.0000000000000072","DOIUrl":"https://doi.org/10.1097/EA9.0000000000000072","url":null,"abstract":"","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 2","pages":"e0072"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAFE anaesthesia for patients at risk of pulmonary aspiration: A nationwide survey.","authors":"Sascha Jan Baettig, Mark Georg Filipovic, Michele Giroud, Hagen Bomberg, Christoph Karl Hofer, Urs Eichenberger, Michael Thomas Ganter","doi":"10.1097/EA9.0000000000000070","DOIUrl":"https://doi.org/10.1097/EA9.0000000000000070","url":null,"abstract":"<p><strong>Background: </strong>Clinical practice in patients at risk of pulmonary aspiration varies widely. However, data on actual management, decision-driving factors and controversial issues remain elusive.</p><p><strong>Objective: </strong>We aimed to comprehensively review the management of patients at risk of pulmonary aspiration and identify controversies among anaesthesia professionals.</p><p><strong>Design: </strong>National interprofessional survey.</p><p><strong>Setting: </strong>All anaesthesia departments in Switzerland.</p><p><strong>Participants: </strong>The survey was distributed electronically to all members of the Swiss Society of Anaesthesiology and Perioperative Medicine, members of the Swiss Interest Group for Anaesthesia Nursing and all department heads in Switzerland.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main outcome measures: </strong>Consensus and controversies in clinical practice and management of patients at risk of pulmonary aspiration.</p><p><strong>Results: </strong>A total of 684 respondents were included in the final analysis (59 department heads, 366 consultants, 99 registrars, 160 nurse anaesthetists). The response rate from physicians was 47%. Consensus (>80% agreement or disagreement) was reached on 9/12 (75%) questions regarding preparation for rapid sequence induction (RSI), 6/13 (46%) regarding RSI practice and 3/8 (38%) regarding management of aspiration incidents. Major controversies included high-flow pre-oxygenation (55% agreement), the validity of modified RSI in adults (52% agreement), the primary use of video-laryngoscope (76% agreement) and management of apparent regurgitation. Subjective factors such as clinical presentation were considered more important than objective factors such as medical history, comorbidities or gastric ultrasound.</p><p><strong>Conclusion: </strong>Across a wide range of experience and professional groups, we found a strong consensus on the indication and performance of 'traditional' RSI. However, clinical decision-making still relies heavily on subjective impressions, while newer risk stratification and management techniques remain controversial.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 2","pages":"e0070"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The in-vitro performance of a modern portable respirator in different lung models and as an alternative intensive care respirator: A simulation based cohort study.","authors":"Celine Josianne Schneider, Christian Peter Both, Daniel Fries, Pedro David Wendel-Garcia, Philipp Karl Buehler, Beate Grass, Vincenzo Cannizzaro, Christian Escher, Achim Schmitz, Jörg Thomas","doi":"10.1097/EA9.0000000000000069","DOIUrl":"https://doi.org/10.1097/EA9.0000000000000069","url":null,"abstract":"<p><strong>Background: </strong>Transporting ventilated patients safely and without loss of efficacy is a challenge. Portable ventilators are generally used to transport critically ill patients, but their performance is often limited.</p><p><strong>Objective: </strong>This study aimed to compare the in-vitro performance of a modern portable respirator with a modern intensive care respirator for different lung settings.</p><p><strong>Design: </strong>An in-vitro testing of a portable and an intensive care respirator.</p><p><strong>Settings: </strong>Anaesthesia Department at the University Children's Hospital Zurich.</p><p><strong>Main outcome measures: </strong>The portable respirator Hamilton T1 was compared with the established intensive care respirator bellavista1000 (BV) while applying different settings with the ASL 5000 (ASL) device. The ASL can simulate neonatal, paediatric, and adult lung settings with normal or impaired lung function. Accuracy of delivered tidal volumes, proximal and distal airway pressures and mechanical lung properties were assessed.</p><p><strong>Results: </strong>Bland-Altman analyses showed higher accuracy for applied tidal volumes delivered by the portable respirator, 12.6% [95% confidence interval (CI) -8.9 to 34.2], compared with the intensive care respirator, 15.9% (95% CI -18.5 to 50.3). In neonatal and infant lung models particularly, the accuracy of delivered tidal volumes by the portable respirator, 13.2% (95% CI -8.9 to 35.3) was superior to those delivered by the intensive care respirator, 20.9% (95%CI -15.9 to 57.7). Lung compliance estimation was performed more accurately by the intensive care respirator, whereas the portable respirator measured airway resistance more accurately. However, both respirators showed only moderate overall accuracy when assessing lung mechanics.</p><p><strong>Conclusion: </strong>The tested portable respirator proved to be a useful device for invasive ventilation of critically ill patients. The overall performance is non-inferior to a conventional intensive care respirator.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 2","pages":"e0069"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External review of procedure codes for intensive care, mechanical ventilation and extracorporeal membrane oxygenation for critically ill COVID-19 patients in the Swedish inpatient register: A nationwide observational cohort study.","authors":"Ebba Rosendal, Sebastian Kalucza, Helena Nyström, Matthias Schien, Ritva Kiiski Berggren, Hanna Jerndal, Osvaldo Fonseca-Rodriguez, Anne-Marie Fors Connolly","doi":"10.1097/EA9.0000000000000071","DOIUrl":"https://doi.org/10.1097/EA9.0000000000000071","url":null,"abstract":"<p><strong>Background: </strong>The quality of registry data is important for epidemiological research. The Swedish inpatient registry (IPR) is a national database with mandatory registration of all hospitalisations since 1987, and since 2007, the medical procedure codes which can be used for grading severity of infectious diseases. However, the completeness of procedure code registration has rarely been studied.</p><p><strong>Objectives: </strong>To determine the quality and completeness of procedure codes for ICU admission, mechanical ventilation and extra-corporeal membrane oxygenation (ECMO) in the Swedish IPR utilising the Swedish Intensive Care Registry (SIR) as the gold standard.</p><p><strong>Design: </strong>A Swedish nationwide observational study.</p><p><strong>Setting: </strong>Covid-19 patients in Sweden who required intensive care in Sweden between March 2020 and August 2022.</p><p><strong>Patients: </strong>Covid-19 patients with a laboratory-verified SARS-CoV-2 infection who required ICU admission (<i>n</i> = 8992), mechanical ventilation (<i>n</i> = 5262) or ECMO (<i>n</i> = 29).</p><p><strong>Main outcome measures: </strong>The sensitivity and/or positive predictive values of procedure code registration for ICU, mechanical ventilation, ECMO and Covid-19 diagnosis code registration in the IPR were evaluated using SIR as the reference. Factors associated with low reporting were explored and the dates of ICU admission registration compared between IPR and SIR.</p><p><strong>Results: </strong>For Covid-19 patients registered in SIR as needing intensive care, mechanical ventilation or ECMO, the completeness of procedure codes in the IPR was 39.7, 78.2 and 100%, respectively. Of the 39.7% with an ICU code in the IPR, the ICU date in the IPR corresponding to the actual ICU admission date was 52.3%. The completeness of ICU registration in the IPR varied from 0.6 to 96.9% between healthcare regions.</p><p><strong>Conclusions: </strong>Procedure codes for intensive care in the Swedish IPR showed low sensitivity and varied greatly between healthcare regions. This negatively influences their usability for epidemiological research and calls for updated guidelines on coding.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 2","pages":"e0071"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of culture on the benefits of awake prone positioning for adults with COVID-19 acute respiratory distress syndrome: A systematic review and meta-analysis.","authors":"Sowmyashree Kota Karanth, Saajid Z Azhar, Maria J Corrales-Martinez, Vijay Krishnamoorthy, Pattrapun T Wongsripuemtet, Julien Cobert, Mona Hashemaghaie, Karthik Raghunathan","doi":"10.1097/EA9.0000000000000068","DOIUrl":"https://doi.org/10.1097/EA9.0000000000000068","url":null,"abstract":"<p><strong>Background: </strong>Randomised controlled trials (RCTs) conducted early during the pandemic showed that awake prone positioning (APP) significantly reduced the risk of intubation among adults with COVID-19 acute respiratory distress syndrome (ARDS), but more recent studies have questioned this benefit. We hypothesise that the effects of APP may vary with the national Power Distance Index (PDI), a measure of hierarchy in local culture.</p><p><strong>Objective: </strong>To conduct a meta-analysis examining the effects of APP in adults with COVID-19 ARDS and examine whether effects differ between nations with a PDI less than 80 versus at least 80 (low versus high deference to authority).</p><p><strong>Design: </strong>Systematic review and meta-analysis of RCTs.</p><p><strong>Data sources: </strong>Cumulated Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, Embase, Medline and Scopus were searched to November 2024.</p><p><strong>Eligibility criteria: </strong>All RCTs that compared APP with standard care in adults with COVID-19-related ARDS or Acute Hypoxaemic Respiratory Failure (AHRF) were included.</p><p><strong>Results: </strong>Twenty-two RCTs were identified with 3615 patients having valid data. APP reduced the risk of intubation [relative risk (RR) 0.80, 95% confidence interval (CI), 0.72 to 0.90]. Effects were greater in nations with a PDI at least 80 (RR 0.67, 95% CI, 0.54 to 0.82), and there was equipoise in nations with a PDI less than 80 (RR 0.89, 95% CI, 0.75 to 1.05). Intubation rates in the high PDI nations decreased from 32.3% (<i>n</i> = 512) with standard care to 21.2% (<i>n</i> = 508) with APP. The reduction in intubations with APP was less pronounced in nations with low PDI, from 20.1% (<i>n</i> = 1012) with standard care to 17.1% (<i>n</i> = 1084). The risk of mortality reduced with APP (RR 0.86, 95% CI, 0.74 to 0.99). Fidelity of APP, specifically, adherence to the recommended duration, was higher in nations with PDI at least 80 (<i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>APP reduces the risk of intubation and mortality, but the significance of this benefit varies with the cultural context. Effects are strong in nations with a higher PDI, where intubation rates are lower and adherence to APP higher.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 2","pages":"e0068"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous peripheral nerve blocks for pain control after orthopaedic surgery: A prospective study during in-hospital and ambulatory care.","authors":"Ana María Espinoza, Patricio A Leyton, Marcia Robles, Javiera Vargas, Loreto A Muñoz","doi":"10.1097/EA9.0000000000000067","DOIUrl":"10.1097/EA9.0000000000000067","url":null,"abstract":"<p><strong>Background: </strong>Continuous peripheral nerve blocks (CPNB) provide an opioid-free alternative for pain control after orthopaedic surgery. However, postdischarge ambulatory patient care and follow-up concerns have prevented CPNB use at home.</p><p><strong>Objective: </strong>To address physicians' concerns about the outpatient use of CPNB.</p><p><strong>Design: </strong>Prospective, cohort, observational study.</p><p><strong>Setting: </strong>Single centre, teaching private hospital in Santiago, Chile, between July 2016 and March 2020.</p><p><strong>Patients: </strong>We included patients aged at least 18 who underwent orthopaedic surgery using CPNB for postoperative pain management. Patients scheduled simultaneously for non-orthopedic surgery on the same event were excluded.</p><p><strong>Main outcome measures: </strong>Pain scores, opioid use, and complication rates at both in-hospital and at-home sites.</p><p><strong>Results: </strong>CPNB were provided as an analgesia plan in 497 patients who met inclusion criteria, and 387 (77.87%) were discharged home with this continuous analgesia. At 48 h, 70% of the patients reported no-worse-than-mild pain. Less than 3.1% of patients reported an episode of severe pain, and less than 13% of the patients required opioid rescue medication. Transient neurological symptoms were observed in 13% (95% confidence interval (CI), 10.4 to 16.1) of the patients. No long-term or severe complications were observed. High rates of satisfaction were reached among patients.</p><p><strong>Conclusion: </strong>In-hospital and at-home use of CPNB supervised by a pain service team provides a feasible and safe alternative after orthopaedic surgery, pain control with a low requirement of opioids.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 1","pages":"e0067"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glans ischaemia after circumcision in a child: a case report with review of the management.","authors":"Claude Ecoffey, Mohamed Mahraoui, Albert Semaan, Frédéric J Mercier","doi":"10.1097/EA9.0000000000000066","DOIUrl":"10.1097/EA9.0000000000000066","url":null,"abstract":"<p><p>We present the case of a 13-year-old boy with glans ischaemia after circumcision who was treated with nitroglycerin spray, spinal block, and prostacyclin analog. The outcome was favourable without any sequelae. Several possible causes of this rare complication are described. Various treatments are reported by other authors. There is evidence that topical, oral and intravenous vasodilators and anti-sympatholytic agents are important for improving vascular flow and oxygenation to the glans penis.</p>","PeriodicalId":520410,"journal":{"name":"European journal of anaesthesiology and intensive care","volume":"4 1","pages":"e0066"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}