Anesthesiology open最新文献

{"title":"American Society of Anesthesiologists Guidance on Periprocedural Fasting in Patients Receiving Tube Feeding.","authors":"Jamie L Sparling, Thomas Edmiston, Prashant Nasa, Ravindra A Gupta, Kunal Karamchandani, Ashish K Khanna, Jarva Chow, Federico Bilotta, Alisha Sachdev, Roshni Sreedharan, Shahla Siddiqui, Paul E Wischmeyer, Christian Stoppe, Jeffrey I Mechanick, D Dante Yeh, Ronald G Pearl, Todd W Rice, Hassan S Dashti, Michael DeWane, Martin Rosenthal, Richard P Dutton, Alexander Nagrebetsky","doi":"10.1097/ao9.0000000000000037","DOIUrl":"https://doi.org/10.1097/ao9.0000000000000037","url":null,"abstract":"<p><p>In the absence of guidelines from professional societies, periprocedural fasting practices in enteral nutrition vary widely and often lead to preventable, clinically significant nutritional deficits. To address the heterogeneity of current clinical practice, the authors aimed to develop expert consensus on best practices for the periprocedural management of tube feeding using a modified Delphi consensus process. Draft recommendations were iteratively modified during a four-round Delphi process by a multidisciplinary international panel of experts. After iterative consolidation and modification, a total of 20 recommendations were produced by round 4, and all recommendations achieved stability. Final recommendations advocate for the protocolization of institutional perioperative fasting approaches and establish best practices for perioperative management of tube feeding in patients with and without a secure airway (cuffed endotracheal or cuffed tracheostomy tube) across a range of common clinical scenarios. The recommendations are intended to harmonize local practices internationally and safely minimize unnecessary periprocedural nutritional loss.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 3","pages":"e0037"},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149303980","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":"Erratum: Nondipping Blood Pressure Pattern Is Associated with the Development of Myocardial Injury after Noncardiac Surgery: A Single-center Prospective Observational Study: Erratum.","authors":"Tomoharu Ukiya, Yoshihiro Yamaji, Takahiro Muramatsu, Sumire Yokota, Shiroh Isono","doi":"10.1097/ao9.0000000000000035","DOIUrl":"https://doi.org/10.1097/ao9.0000000000000035","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/ao9.0000000000000012.].</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 3","pages":"e0035"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149241178","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":"Mentees' Perspectives on Mentorship and Sponsorship in Academic Anesthesiology: Findings from a Single-institution Focus Group.","authors":"Anne L Donovan, Seyedeh Ala Mokhtabad Amrei, Ting Guo, Joyce Chang, Jina L Sinskey, Oana Maties, Rachel Schwartz","doi":"10.1097/ao9.0000000000000033","DOIUrl":"https://doi.org/10.1097/ao9.0000000000000033","url":null,"abstract":"<p><p>Mentorship and sponsorship are important to career advancement and sustainability within academic anesthesiology, but unique challenges contribute to the gap that exists between optimal and actual mentorship and sponsorship. In this article, focus group data from a study conducted among 38 academic anesthesiology faculty members in a single department, stratified by self-identified gender and career stage as well as identity-specific groups, formulate three themes: (1) elevating high-impact mentorship, (2) formalizing sponsorship infrastructure, and (3) implementing a structured program. These themes and their subthemes are examined within a framework of questions that aid in constructing meaning and moving toward practical application. The results of the thematic analysis are well-supported by the literature presented in the final section of the article and also build on current literature by suggesting potential design principles for mentorship and sponsorship structures synthesized directly from academic anesthesiology faculty across diverse career and life stages and identity-specific groups.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 3","pages":"e0033"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168989","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":"An Honest Broker System for Secure Linkage of Opioid-related Clinical, Prescription, and Outcomes Data.","authors":"James Stathakios, Chad M Brummett, Vidhya Gunaseelan, Erin O Kaleba, Jennifer F Waljee, Mark C Bicket","doi":"10.1097/ao9.0000000000000024","DOIUrl":"10.1097/ao9.0000000000000024","url":null,"abstract":"<p><p>Integrating patient-reported outcomes and clinical data with external sources such as Prescription Drug Monitoring Programs (PDMPs) enables comprehensive evaluation of opioid prescribing and outcomes. The authors describe the implementation of a secure, honest broker system by the Overdose Prevention Engagement Network to link state-wide registry data with Michigan's PDMP. A trusted intermediary facilitated linkage via a process approved by the institutional review board. Merged data were encrypted and coded without personal identifiers before being released to investigators, ensuring patient privacy and compliance with the Health Insurance Portability and Accountability Act. The linkage process excluded only 0.7 to 2.0% of patient records, demonstrating high performance. Since implementation, 11 peer-reviewed publications have used the linked datasets to advance opioid stewardship research. This novel, privacy-preserving framework provides a scalable and replicable model for diverse cross-system data integration while maintaining patient confidentiality.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 2","pages":"e0024"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623669","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":"Perioperative Intravenous Infiltration: From Recognition to Prevention.","authors":"Karolina Brook, George Tewfik, Aubrey Samost-Williams","doi":"10.1097/ao9.0000000000000022","DOIUrl":"10.1097/ao9.0000000000000022","url":null,"abstract":"<p><p>Peripheral intravenous (PIV) access is nearly universal in perioperative care and beyond. It is often regarded as low-risk. Yet perioperative PIV infiltration remains a persistent source of patient harm, particularly in anesthetized or sedated patients who cannot report early symptoms. Injuries range from transient soft tissue edema to severe complications, including skin necrosis, nerve injury, and compartment syndrome requiring surgical intervention. Furthermore, if the sole PIV access is nonfunctional, administration of life-saving rescue medications and transfusions may be delayed. Despite its frequency and potential severity, perioperative PIV infiltration remains inconsistently reported and understudied. This narrative review examines the epidemiology, mechanisms, prevention, detection, and management of perioperative PIV infiltration. We particularly emphasize its implications in high-risk populations, drug-specific injury mechanisms, and perioperative system vulnerabilities. We highlight gaps in evidence and propose priorities for future research and quality improvement.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805492","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":"Educational Background and Demographic Characteristics of Anesthesiology Department Chairs in the United States.","authors":"Alexander W Estright, Kyle A Pruitt, Samantha E Pope, Maxwell Childers, Sean C Clark, Maninder Singh, Jonathan A Alter, Hannah E Hill, Luis E Tollinche","doi":"10.1097/ao9.0000000000000017","DOIUrl":"10.1097/ao9.0000000000000017","url":null,"abstract":"<p><p>Academic anesthesiology department chairs face significant responsibilities, yet formal leadership pathways remain unclear. The purpose of this study was to characterize the educational backgrounds and career trajectories of current U.S. anesthesiology department chairs. Chair information was sought for all 192 Accreditation Council for Graduate Medical Education-accredited anesthesiology residency programs. During data collection, 40 were excluded due to absence of a designated chair or insufficient publicly available information, yielding a final sample of 152 chairs. The most common medical schools that the chairs attended were the University of Washington, the University of Chicago, and Johns Hopkins University (each, n = 4; 2.6%). Massachusetts General Hospital was the most frequent residency site (13/149; 8.7%) and fellowship site (9/84, 10.7%). Median time from residency to chair appointment was 21 yr (interquartile range [IQR], 15 to 27) and median tenure was 5 yr (IQR, 3 to 9). Most chairs had modest to moderate scholarship (Hirsch Index: 1 to 15 in 54.1%) with a median of 14 (IQR, 4 to 34). These findings suggest pathways to chair are frequently diverse, often non-research-intensive, and support the imperative for structured leadership development.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 2","pages":"e0017"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13231465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166860","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":"Extracorporeal Cardiopulmonary Resuscitation for Perioperative Cardiac Arrest in Noncardiac Surgery: A Nationwide Cohort Study in Japan.","authors":"Yoshitaka Aoki, Yuki Shiko, Yohei Kawasaki, Mikio Nakajima, Kenya Oda, Koki Ubukata, Yusuke Mizobuchi, Satoshi Naruse, Yuji Suzuki, Kensuke Kobayashi, Hiromi Kato, Soichiro Mimuro, Yoshiki Nakajima","doi":"10.1097/ao9.0000000000000013","DOIUrl":"10.1097/ao9.0000000000000013","url":null,"abstract":"<p><strong>Background: </strong>Perioperative cardiac arrest is rare but often catastrophic. The use of extracorporeal cardiopulmonary resuscitation (ECPR) with veno-arterial extracorporeal membrane oxygenation in perioperative settings remains limited. This study evaluated the characteristics and outcomes of patients who underwent ECPR for perioperative cardiac arrest.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Japanese Intensive Care PAtient Database, a nationwide registry of 129 intensive care units (ICUs), covering fiscal years 2015 to 2023. Adults undergoing noncardiac surgery who experienced cardiac arrest before ICU admission were included. Patients were classified as ECPR if veno-arterial extracorporeal membrane oxygenation was documented. The primary outcome was in-hospital mortality. Secondary outcomes were discharge to home, transfer to another facility, ICU mortality, length of hospital stay, and length of ICU stay. Multivariable logistic regression, adjusted for potential confounders, was used to assess the association between ECPR and in-hospital mortality.</p><p><strong>Results: </strong>Among 518 patients with perioperative cardiac arrest, 44 (8.5%) received ECPR. The mean age was 66 yr and 62% were male. Patients who received ECPR had higher severity scores, higher lactate levels, and more frequent use of mechanical ventilation and catecholamines than those without ECPR. Unadjusted in-hospital mortality was significantly higher in the ECPR group (61.4 <i>vs.</i> 34.0%; <i>P</i> = 0.001). In the multivariable logistic regression analysis, no statistically significant association was observed between ECPR and in-hospital mortality (odds ratio, 0.85; 95% CI, 0.37 to 1.97).</p><p><strong>Conclusions: </strong>In this nationwide cohort, ECPR was used in 8.5% of patients with perioperative cardiac arrest in noncardiac surgery. Its effect on in-hospital mortality in the studied population remains inconclusive due to the limited sample size. Further data accumulation is warranted to clarify the clinical role of ECPR in this setting.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 1","pages":"e0013"},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725549","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":"Preoperative Cannabis Use and Postoperative Delirium in Older Adults Undergoing Major Noncardiac Surgery.","authors":"Amelie Delaporte, Theodora Wingert, Tristan Grogan, Cecila Canales, Pamela A Chia, Dan Cole, Robert A Whittington, Maxime Cannesson, Ziva D Cooper, Alexandre Joosten","doi":"10.1097/ao9.0000000000000007","DOIUrl":"10.1097/ao9.0000000000000007","url":null,"abstract":"","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221742","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":"Time and Motion Analysis of Controlled Substance Disposals: A Study of Workflows at a Single Center using Automated Dispensing Cabinets.","authors":"Cassandra W Cu, Timothy Heintz, Nicole Dundas, Hassan Farhan, Hunter Mills, Jennifer W Lee, Christian Williams, Arthur W Wallace, Julien Cobert","doi":"10.1097/ao9.0000000000000006","DOIUrl":"10.1097/ao9.0000000000000006","url":null,"abstract":"","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 1","pages":"e0006"},"PeriodicalIF":0.0,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489329","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":"Intraoperative Hypotension and Delayed Graft Function after Kidney Transplantation: A Retrospective Cohort Analysis.","authors":"Amelie Delaporte, Theodora Wingert, Laurence Weinberg, Tristan Grogan, Kiena Tan, Michael Chen, Jeffrey Veale, Maxime Cannesson, Matthieu Legrand, Dieter Adelmann, Anatole Harrois, Renaud Snanoudj, Francois Martin Carrier, Alexandre Joosten","doi":"10.1097/ao9.0000000000000004","DOIUrl":"10.1097/ao9.0000000000000004","url":null,"abstract":"<p><strong>Background: </strong>Delayed graft function is a major postoperative complication after kidney transplantation, increasing the risk of both early and late graft loss. Although many preoperative, surgical, and donor-related risk factors are unmodifiable, intraoperative hypotension may contribute to reduced kidney perfusion and affect delayed graft function incidence. However, the impact of intraoperative hypotension on the risk of delayed graft function has not been rigorously examined. It was hypothesized that intraoperative hypotension is associated with increased odds of delayed graft function after kidney transplantation.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included all consecutive patients with chronic renal failure who underwent first kidney transplantation from a deceased or living donor between 2013 and 2024. Combined transplant procedures were excluded. Intraoperative hypotension was quantified as the area under the curve (AUC) for a mean arterial pressure (MAP) less than 65 mmHg, capturing both duration and severity of intraoperative hypotension. The primary outcome was delayed graft function, defined as a dialysis requirement within the first postoperative week. Multivariable logistic regression, adjusting for prespecified clinically chosen recipient, intraoperative, and donor confounders, was used to assess the association between intraoperative hypotension and delayed graft function.</p><p><strong>Results: </strong>Among 3,825 kidney transplants (68% deceased donors, 32% living donors), the median (Q1, Q3) AUC for MAP less than 65 mmHg was 12 (0, 78) mmHg·min. Delayed graft function occurred in 1,007 patients (26.3% of all cases, 37.5% deceased donors, 3.1% living donors). Each 50 mmHg·min increase in AUC for MAP less than 65 mmHg was associated with higher odds of delayed graft function (adjusted odds ratio, 1.08; 95% CI, 1.02 to 1.14; <i>P</i> = 0.009).</p><p><strong>Conclusions: </strong>Greater duration and severity of intraoperative hypotension were associated with increased incidence of delayed graft function after kidney transplantation. Although causality cannot be established, these findings highlight the potential importance of avoiding low pressure in this vulnerable population. Transplant-specific studies, including randomized trials, are needed to determine optimal intraoperative MAP targets and clarify hemodynamic strategies that may improve graft outcomes.</p>","PeriodicalId":521279,"journal":{"name":"Anesthesiology open","volume":"1 1","pages":"e0004"},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12939988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328876","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}