Anaesthesiology intensive therapy最新文献

{"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":2.3,"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":2.3,"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":"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":2.3,"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 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":2.3,"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":"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":2.3,"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":2.3,"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}

{"title":"Comparative analysis of prespinal analgesic techniques for enhancing spinal anesthesia quality in fractured neck of femur: a randomized clinical trial.","authors":"Ayman Eldemrdash, Zaher Zaher, Soudi Hammad, Mohammed Aly, Mostafa Mohamed, Mohammed Alazhary","doi":"10.5114/ait/213925","DOIUrl":"10.5114/ait/213925","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal anesthesia (SA) is preferred for hip fracture surgery but can be difficult due to severe preoperative pain. This study compared prespinal analgesic techniques for improving the ease of SA and postoperative analgesia in neck of femur fractures.</p><p><strong>Material and methods: </strong>In a prospective, randomized, double-blind trial, 210 patients aged ≥ 60 years undergoing internal fixation of fractured neck of femur under SA were allocated to three groups. Group A received a femoral nerve block (FNB), Group B a pericapsular nerve group (PENG) block, and Group C intravenous fentanyl 1 µg kg-1 10 minutes before SA. For FNB and PENG, 20 mL of 0.25% bupivacaine was used.</p><p><strong>Results: </strong>The PENG group had the lowest Ease of Spinal Anesthesia (EOSA) score (median 7 [IQR 7-8]) vs. FNB 8 (7-9) and fentanyl 9 (9-10) (P < 0.001). Pain during positioning and puncture was lowest with PENG (P < 0.001). Time to first rescue analgesia was longest with PENG (8.8 ± 2.03 h, 95% CI: 8.3-9.3) compared with FNB (5.9 ± 1.5 h, 95% CI: 5.5-6.4) and fentanyl (4.2 ± 0.7 h, 95% CI: 4.0-4.4) (P < 0.001). Immediate postoperative visual analog scale (VAS) scores at 6 and 12 hours were lower with PENG; differences at 24 hours and 30 days were not significant. Hemodynamics and complication rates were largely similar across groups.</p><p><strong>Conclusions: </strong>In hip-fracture patients, ultrasound-guided PENG and FNB improved the ease of SA and reduced postoperative opioid use, with PENG showing the greatest benefit.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"58 1","pages":"381-389"},"PeriodicalIF":2.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950961","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":"Association between NT-proBNP and ivabradine in patients after noncardiac surgery: a per-protocol analysis of the PREVENT-MINS study.","authors":"Jacek Gorka, Zbigniew Putowski, Anna Wludarczyk, Michal Jedrusiak, Szymon Bialka, Piotr Palaczynski, Michał Borys, Paweł Kutnik, Tomasz Czarnik, Anna Szczepanska, Stanisław Wawrzyniak, Marcin Mozanski, Milena Keska, Katarzyna Kotfis, Janusz Trzebicki, Jan Aszkielaniec, Joanna Solek-Pastuszka, Pawel Grudzien, Wojciech Mudyna, Mateusz Kreczko, Zhiguo Zhao, P J Devereaux, Wojciech Szczeklik","doi":"10.5114/ait/216162","DOIUrl":"10.5114/ait/216162","url":null,"abstract":"<p><strong>Background: </strong>The PREVENT-MINS trial investigated whether perioperative heart rate reduction with ivabradine could prevent myocardial injury after noncardiac surgery (MINS). Although ivabradine modestly reduced heart rate, it did not reduce the incidence of MINS in the intention-to-treat analysis. This per-protocol analysis of the PREVENT-MINS trial, with a post-hoc biomarker substudy, evaluated whether perioperative iva-bradine modifies postoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations, a marker of perioperative cardiovascular risk.</p><p><strong>Methods: </strong>This analysis included 2008 participants who received ≥ 1 dose of study drug, underwent surgery, and had NT-proBNP and troponin measured (ivabradine: n = 1,001; placebo: n = 1,007). Postoperative NT-proBNP levels and changes from baseline (ΔNT-proBNP) were compared by treatment allocation. Clinical outcomes and safety endpoints from the parent trial were evaluated. Analysis of covariance (ANCOVA) assessed ivabradine's effect on postoperative NT-proBNP after adjustment for baseline values and clinical covariates.</p><p><strong>Results: </strong>MINS occurred in 17.7% of ivabradine-treated vs. 15.7% of placebo patients (RR 1.13; 95% CI: 0.93-1.37; P = 0.23). Median postoperative NT-proBNP was higher with ivabradine than with placebo (418.0 vs. 333.5 pg mL-1; P < 0.001), as were ΔNT-proBNP values (215.1 vs. 154.0 pg mL^-1; P < 0.001). After adjustment for baseline and relevant clinical covariates, ivabradine was independently associated with an approximately 82% increase in postoperative NT-proBNP (Δlog = 0.59 ± 0.19; 95% CI: 26-164).</p><p><strong>Conclusions: </strong>Ivabradine did not reduce the incidence of MINS and was associated with greater postoperative NT-proBNP release. Perioperative heart rate reduction with ivabradine may elevate markers of cardiac stress without measurable clinical benefit.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"391-398"},"PeriodicalIF":2.3,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888834","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":"Exploring Pandora's box: a review of thoracic compartment syndrome.","authors":"Michel Pérez-Garzón, Maria Rojas-Arrieta, Alejandro Quintero-Altare, Henry Robayo-Amortegui","doi":"10.5114/ait/214054","DOIUrl":"10.5114/ait/214054","url":null,"abstract":"<p><p>Compartment syndrome (CS) arises from increased pressure within a confined space, compromising organ function due to reduced blood flow and subsequent tissue hypo-xia and ischemia. Thoracic compartment syndrome (TCS), a subset of CS, occurs in diverse surgical and medical conditions, particularly cardiac surgery, chest trauma, and critical care scenarios, significantly contributing to morbidity and mortality. However, the absence of a standardized definition hinders timely diagnosis and treatment. This study systematically explores the clinical presentation, pathophysiology, and causes of TCS, aiming to establish a comprehensive definition to guide diagnosis and research. A multi-stage review process was employed. Two independent reviewers screened titles, abstracts, and full texts of studies identified through databases such as PubMed, Scopus, Embase, Google Scholar, and SpringerLink, complemented by gray literature searches in NTIS and EAGLE. Inclusion criteria focused on adult patients, excluding pediatric and obstetric populations. The search spanned all relevant studies published up to December 20, 2024. TCS remains under-recognized yet poses significant risks in critically ill patients. This article proposes a definition grounded in evidence and pathophysiological insights to aid diagnosis and future investigations into this life-threatening condition.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"381-387"},"PeriodicalIF":1.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848799","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 regional anaesthesia: insights from Anaesthesiology Intensive Therapy.","authors":"Szymon Zdanowski, Magdalena Anna Wujtewicz","doi":"10.5114/ait/215145","DOIUrl":"10.5114/ait/215145","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"57 1","pages":"388-390"},"PeriodicalIF":1.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848803","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}