Anaesthesiology intensive therapy最新文献

{"title":"Ultrasound-guided regional anaesthesia techniques for post-caesarean analgesia: a narrative review of current evidence.","authors":"Wojciech Gola, Mykhailo Kazantsev, Tomasz Jasiński","doi":"10.5114/ait/220235","DOIUrl":"https://doi.org/10.5114/ait/220235","url":null,"abstract":"<p><p>Optimal postoperative pain management after caesarean delivery is a fundamental component of perioperative care and enhanced recovery protocols in obstetric anaes-thesia. Although intrathecal morphine (ITM) remains the gold standard for post-caesarean analgesia, its use is not always feasible or desirable. This narrative review synthesises current evidence regarding ultrasound-guided regional anaesthesia techniques employed for post-caesarean analgesia, with emphasis on anatomical rationale, clinical efficacy, and their role when neuraxial opioids are omitted. Available data indicate that abdominal wall blocks provide effective somatic analgesia and meaningful opioid-sparing benefits, particularly in the absence of ITM. Careful technique selection and integration within multimodal analgesic pathways are essential to optimise postoperative outcomes.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"71-77"},"PeriodicalIF":1.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe methemoglobinemia resulting from intentional sodium hypochlorite poisoning in a 13-year-old girl hospitalized in the intensive care unit: a case report.","authors":"Magdalena Mazur, Beata Irena Mycek, Wojciech Stobiński","doi":"10.5114/ait/218164","DOIUrl":"https://doi.org/10.5114/ait/218164","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"66-70"},"PeriodicalIF":1.7,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fluid paradox: dissociation between clinical and ultrasound parameters of fluid overload - results of the INCIVEX exploratory study.","authors":"Adrian Wong, Kim Cheah, Georgios Papathanakos, Federico Stefanini, Mateusz Zawadka","doi":"10.5114/ait/217910","DOIUrl":"10.5114/ait/217910","url":null,"abstract":"<p><strong>Introduction: </strong>Fluid management in critically ill patients relies on clinical assessment, fluid balance calculations and, increasingly, point-of-care ultrasound. However, the rela-tionships between these assessment modalities remain poorly understood, with conflicting evidence regarding their correlation and clinical utility. The study aimed to eva-luate correlations between clinical indicators of fluid overload, cumulative fluid balance, and comprehensive ultrasound parameters including cardiac function, lung ultrasound, and the venous excess ultrasound (VExUS) protocol in critically ill patients.</p><p><strong>Material and methods: </strong>We conducted a cross-sectional, observational study in a tertiary intensive care unit. Adults admitted for ≥ 72 hours with clinical evidence of fluid overload but haemodynamic stability were eligible. Assessments included focused echocardiography, six-zone lung ultrasound, and comprehensive VExUS. Correlations between cumulative fluid balance, clinical oedema, and ultrasound parameters were analysed.</p><p><strong>Results: </strong>Of 195 patients screened, 50 were recruited to the study. The study population had a mean age of 59 years. Sepsis and respiratory failure were the most common admission diagnoses. The mean cumulative fluid balance was 7.1 ± 4.8 L at the time of recruitment. Peripheral oedema was present in over 70%. Ultrasound revealed left ventricular dysfunction in 16%, right ventricular dysfunction in 10%, bilateral pleural effusions in 44%, and elevated VExUS scores (> 2) in 20%. Cumulative fluid balance showed no correlation with clinical or ultrasound findings.</p><p><strong>Conclusions: </strong>Traditional fluid assessment (cumulative fluid balance and clinical signs of oedema) methods show no correlation with ultrasound parameters in critically ill patients. Future research should focus on ultrasound-guided approaches that provide cardiovascular assessment rather than on cumulative fluid balance calculations or clinical signs alone.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"59-65"},"PeriodicalIF":1.7,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508796","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":"Flexible bronchoscopy in mechanically ventilated critically ill patients: practical considerations and clinical applications - a narrative review.","authors":"Sylweriusz Kosiński, Magdalena Kluska, Jakub Stachowicz, Mirosław Ziętkiewicz, Tomasz Darocha, Artur Szlubowski","doi":"10.5114/ait/218317","DOIUrl":"10.5114/ait/218317","url":null,"abstract":"<p><p>Flexible bronchoscopy (FB) is an established diagnostic and therapeutic tool for critically ill patients. Technological advances have enabled rapid and convenient bedside availability in the intensive care unit, expanding the range of therapeutic indications for the procedure outside the endoscopy laboratory. FB in critically ill patients, especially mechanically ventilated patients, is technically challenging and requires appropriate operator qualifications. To avoid serious complications, it is essential to understand the procedure's effects on the respiratory and circulatory systems, as well as the mecha-nisms of complications, including infection transmission. A key challenge is to individually determine the expected benefit-risk balance and implement local protocols for the preparation, implementation, and supervision of the procedure. This narrative review aims to explore the practical and clinical aspects of FB in critically ill, mechanically ventilated patients in the ICU environment, emphasizing the most common interventions and safety issues.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"49-58"},"PeriodicalIF":1.7,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484359","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":"Haemorrhagic intracranial metastasis: a diagnostic and therapeutic challenge in the Emergency Department.","authors":"Edward Clarke, James Lardner","doi":"10.5114/ait/219074","DOIUrl":"10.5114/ait/219074","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"47-48"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13085034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472424","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":"In-vitro evaluation of the Singularity Air laryngeal mask: a randomized controlled comparison between medical personnel trained and untrained in airway management.","authors":"Danijel Novina, JoEllen Welter, Alexander Dullenkopf","doi":"10.5114/ait/217697","DOIUrl":"10.5114/ait/217697","url":null,"abstract":"<p><strong>Introduction: </strong>Supraglottic airway devices (SGAs) are essential tools in anesthesia and emergency medicine and are easier to teach than endotracheal intubation. The Singularity Air is a recently introduced second-generation laryngeal mask featuring an adjustable shaft angle to improve sealing. This study compared its bench performance between medical personnel with and without airway management training.</p><p><strong>Material and methods: </strong>In this randomized, controlled in-vitro study, medical personnel each performed five consecutive insertions using the Singularity Air and a comparator device. Study Part A included 20 participants without anesthesia training, who used the LMA Unique. Study Part B included 20 anesthesia-trained staff, who used the Ambu AuraGain. The primary endpoint was time to successful ventilation, defined as visible chest movement of the mannequin. Participants rated insertion difficulty on a 0-10 scale.</p><p><strong>Results: </strong>Overall insertion success was 99-100% across all devices. For the Singularity Air, median time to successful ventilation on the first attempt was 17 seconds (IQR 10-22) in the non-anesthesiology group and 12 seconds (IQR 10-14) in the anesthesia-trained group (P = 0.287). By the fifth attempt, both groups achieved 7.5 seconds (IQR 5-10 and 6-8, respectively; P = 0.674). Time to ventilation and difficulty ratings were low and comparable to the established devices. The non-anesthesiology participants improved more between the first and fifth attempts than anesthesia-trained participants (P = 0.152).</p><p><strong>Conclusions: </strong>The Singularity Air laryngeal mask achieved a high success rate and comparable time to ventilation in an in-vitro study when used by acute care medical personnel, regardless of prior airway management training. Larger clinical studies are warranted to confirm these findings and evaluate performance in real patients.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"42-46"},"PeriodicalIF":1.7,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347099","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 ROSE framework for fluid therapy in critically ill pediatric patients.","authors":"Romina Aparecida Dos Santos Gomes, Manu L N G Malbrain, Adriana Teixeira Rodrigues, Maria do Carmo Barros De Melo, Flávia Cordeiro Valério, Jaisson Gustavo Da Fonseca, Gabriel Carlos Santos Dutra, Alexandre Rodrigues Ferreira","doi":"10.5114/ait/217698","DOIUrl":"10.5114/ait/217698","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to assess the applicability of the ROSE conceptual framework (Resuscitation, Optimization, Stabilization, Evacuation) for fluid therapy in critically ill pediatric patients, focusing on its distinct phases, prevention of fluid accumulation, and clinical outcomes.</p><p><strong>Material and methods: </strong>A quasi-experimental study was conducted including 122 (retrospective: n = 71; prospective: n = 51) mechanically ventilated and vasoactive-dependent children. A retrospective cohort was compared with a prospective cohort following structured training on ROSE-guided fluid management. Outcomes included fluid accumulation percentage (FA%), duration of mechanical ventilation, pediatric intensive care unit (PICU) length of stay, and need for renal replacement therapy (RRT). Adherence to phase-specific FA% targets was also assessed.</p><p><strong>Results: </strong>FA% was similar between cohorts (retrospective vs. prospective) on PICU days 1, 3, and 10 (median [IQR] 1.8% [0.2-4.3] vs. 1.9% [0.8-3.2], P = 0.934; 5.5% [1.7-10.3] vs. 6.1% [3.8-10.2], P = 0.565; 8.3% [0.8-24.8] vs. 7.2% [2.6-18.7], P = 0.848). By ROSE phase, FA% was comparable in Resuscitation (3.5% [2.0-6.0] vs. 4.7% [2.4-6.9], P = 0.244), Optimization (3.0% [0.1-6.7] vs. 4.2% [1.0-7.9], P = 0.261), and Evacuation (2.5% [-2.6-5.3] vs. 2.4% [-0.0-7.4], P = 0.256), but higher during Stabilization (2.5% [0.0-6.9] vs. 4.2% [2.0-8.9], P = 0.043). Mechanical ventilation, length of PICU stay, RRT, and fluid elimination were similar. No independent predictors emerged in logistic regression. FA% target adherence rose from 67.9% to 72.4% after ROSE.</p><p><strong>Conclusions: </strong>The ROSE framework in pediatric fluid management is feasible, provides benchmarking for FA% control, and shows promise for individualizing fluid management. Future validation in ROSE-naive centers is warranted.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"20-29"},"PeriodicalIF":1.7,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347161","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":"Trends in complete blood count and derived inflammatory indices in ICU patients undergoing percutaneous tracheostomy: a retrospective exploratory study in Italy.","authors":"Antonio Romanelli, Antonella Langone, Alessandro Calicchio, Salvatore Palmese, Nicola Anselmi, Alessio Galardo, Ludovica Iovine, Renato Gammaldi","doi":"10.5114/ait/217417","DOIUrl":"10.5114/ait/217417","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory responses induced by percutaneous dilatational tracheo-stomy (PDT) are underexplored in critical patients. We examined trends in laboratory values in patients after undergoing PDT and their association with mortality.</p><p><strong>Material and methods: </strong>An analysis of critical patients who underwent PDT was performed. Laboratory values were collected before PDT and at 24, 48, 72, and 96 hours after. Pre-PDT values were divided into tertiles: Low, Medium, and High. Differences between survivors and non-survivors were assessed using appropriate tests. The Aligned Rank Transform (ART) test was used to analyze the tertile-time interaction by outcome. Post-hoc analyses were conducted as necessary. Tertile-outcome associations were evaluated with univariate and multivariate logistic regression, reporting odds ratios (OR) and 95% confidence intervals (95% CI). Survival differences for significant associations were analyzed with the log-rank test. A P-value < 0.05 was considered significant.</p><p><strong>Results: </strong>114 patients who underwent PDT were included. ART demonstrated significant interactions with monocytes and the Aggregate Index of Systemic Inflammation (AISI) relating to outcomes. Monocytes in the Low tertile significantly increased over time (P < 0.001). In multivariate analysis, patients in the Medium (OR: 0.323, 95% CI: 0.101-0.937, P = 0.044) and High (OR: 0.287, 95% CI: 0.087-0.847, P = 0.029) tertiles had a lower probability of death compared with the Low tertile. AISI trends in the Low, Medium, and High tertiles were significant (all P < 0.05). The Low tertile consistently increased over time (all pairwise P < 0.05). Multivariate regression indicated that high AISI was associated with outcomes (OR: 0.270, 95% CI: 0.074-0.861, P = 0.034). Log-rank tests for survival were not significant for monocytes or AISI.</p><p><strong>Conclusions: </strong>Monocyte and AISI trends after PDT may correlate with short-term morta-lity. Routine hematologic indices can be useful for early risk assessment. Further studies are needed to confirm these findings.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"30-41"},"PeriodicalIF":1.7,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347136","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 use of Sedaconda in suspected venous gas embolism after emergency cesarean section: a case report.","authors":"Duccio Conti, Maddalena Pazzi, Peggy Ruggiano, Laura Salucci, Vittorio Pavoni","doi":"10.5114/ait/217545","DOIUrl":"10.5114/ait/217545","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"17-19"},"PeriodicalIF":1.7,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269549","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":"Predictors of patient satisfaction with anesthesia using the Press Ganey patient satisfaction survey.","authors":"Dan Drzymalski, Evan Liu, Miki Calderon, Joseph Jung","doi":"10.5114/ait/216697","DOIUrl":"10.5114/ait/216697","url":null,"abstract":"<p><strong>Background: </strong>While patient satisfaction is a major marker of quality in healthcare, predictors of Press Ganey scores for anesthesia survey questions have not been well explored. This study aimed to explore factors associated with anesthesia-specific patient satisfaction scores.</p><p><strong>Material and methods: </strong>Univariable and multivariable regression analyses were performed to identify predictors of percentile ranking on patient satisfaction questions. We conducted a retrospective analysis of the patient experiences with anesthesia at our institution. Three questions were added to the Press Ganey surveys: (1) rating of anesthesia services, (2) explanations provided by the anesthesiologists, (3) friendliness/courtesy of the anesthesiologist. A total of 3,218, 3,294, and 3,200 patients, respectively, answered the questions on a Likert scale. Covariates included attending anesthesiologist workload, number of comparator healthcare institutions, and season of year.</p><p><strong>Results: </strong>Lower percentile rank with rating of anesthesia services was associated with greater attending anesthesiologist workload (-13.7; 95% CI: -24.8 to -2.6; P = 0.017), season of year (-9.0; 95% CI: -16.2 to -1.8; P = 0.016), and smaller number of comparator healthcare institutions (2.4; 95% CI: 0.5 to 4.3; P = 0.015). Lower percentile rank with explanations provided by the anesthesiologists (0.7; 95% CI: 0.1 to 1.3; P = 0.021) and friendliness/courtesy of the anesthesiologist (0.9; 95% CI: 0.2 to 1.5; P = 0.008) were associated with decreasing number of comparator healthcare institutions.</p><p><strong>Conclusions: </strong>Improving patient satisfaction may require reduction or redistribution of anesthesiologist workload, improvement in resident communication skills, and increased supervision of junior residents. Anesthesia-specific patient satisfaction scores should be risk-adjusted for contextual factors such as seasonality, workload, and number of comparator institutions before being tied to payment.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"10-16"},"PeriodicalIF":1.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148874","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}