Anesthesia & Analgesia最新文献

{"title":"Anesthetic Challenges in Hybrid Warfare: Insights From the Lebanon Pager Explosions.","authors":"Vanda G Yazbeck Karam,Dareen Jammoul,Rony Al Nawar,Krystel Malek,Georges Assaf,Caroline Chahine,Bassam Gerges,Hanane Barakat","doi":"10.1213/ane.0000000000007602","DOIUrl":"https://doi.org/10.1213/ane.0000000000007602","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370310","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 Effect of Hypotension on Cerebral Metabolism and Perfusion in Adults Undergoing Cardiopulmonary Bypass: A Prospective Cohort Study.","authors":"Marianne Suwalski,Daniel Milej,John Paul Mousseau,Ajay Rajaram,Mamadou Diop,John Murkin,Keith St Lawrence,Jason Chui","doi":"10.1213/ane.0000000000007607","DOIUrl":"https://doi.org/10.1213/ane.0000000000007607","url":null,"abstract":"BACKGROUNDCurrent blood pressure management strategies cannot accommodate large interindividual variations in cerebral autoregulation, which may result in inadvertent cerebral ischemia. A novel optical neuromonitoring device was developed to explore the relationships between blood pressure and cerebral metabolism and hemodynamics during hypotension on cardiopulmonary bypass and the transition on bypass in cardiac surgery.METHODSForty-five elective adult patients were monitored by a hybrid optical device incorporating broadband near-infrared spectroscopy for monitoring changes in tissue oxygen saturation and the oxidative state of cytochrome c oxidase (oxCCO) in the brain along with diffuse correlation spectroscopy for measuring a cerebral blood flow index. Changes in the optical variables were evaluated.RESULTSSeventy-four hypotensive events were associated with significant decreases (mean ± standard deviation) in oxCCO (-0.55 ± 0.18 μM), cerebral blood flow index (-48% ± 20%), and tissue oxygen saturation (-9% ± 5%, P < .001) when mean arterial pressure fell below 50, 35, and 25 mm Hg, respectively. Decreases in oxCCO corresponding to literature-defined cerebral blood flow lesion and functional thresholds were -1.10 and -0.87 μM. During transition on bypass, mild reductions in blood pressure and body temperature (34.9 ± 0.6°C) occurred without significant cerebral blood flow changes. Multiple linear regression demonstrated reduction in oxCCO was significantly associated with temperature and blood pressure (R2 = 0.92, P < .001), while tissue oxygen saturation and cerebral blood flow index had weaker associations (R2 = 0.75, P < .001; R2 = 0.42, P = .002, respectively). No significant changes in scalp oxCCO and tissue oxygen saturation were found during hypotensive episodes or CPB transition.CONCLUSIONSThis study identifies oxCCO as an optical variable that is highly responsive to hypotension. The work also highlights the link between blood pressure and cerebral metabolism and hemodynamics, offering potential insights into optimizing current blood pressure management.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370312","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":"Protective and Immunomodulatory Functions of Exogenous B Cells in Experimental Hyperoxic Lung Injury.","authors":"Dusan Hanidziar,Liam J Dwyer,Sylvia L Ranjeva,Eva Csizmadia,Saumya Maheshwari,Juan D Valencia,James W Aspden,Nina Farhat,Leo E Otterbein,Simon C Robson,Ruxandra F Sîrbulescu,Mark C Poznansky","doi":"10.1213/ane.0000000000007545","DOIUrl":"https://doi.org/10.1213/ane.0000000000007545","url":null,"abstract":"BACKGROUNDAcute respiratory distress syndrome (ARDS) is a result of diffuse lung injury and dysregulated inflammation. Recent studies have demonstrated that B cells can perform anti-inflammatory and tissue-protective functions. We hypothesized that systemic B-cell administration could have therapeutic effects in hyperoxic acute lung injury.METHODSAcute lung injury was modeled in adult C57BL/6J male mice through continuous exposure to hyperoxia (FiO2 >90%). Mature B cells (CD45R+/CD19+) were purified from spleens of age- and sex-matched C57BL/6J mice. B cells (107) or saline were administered intravenously after 24 hours of hyperoxia. Hyperoxia exposure was continued for up to 96 hours. The effects of adoptive B-cell therapy were assessed using histologic, physiologic (pulse oximetry, echocardiography), and immunologic (flow cytometry) readouts.RESULTSHyperoxia led to a 50% depletion of endogenous pulmonary B cells by day 3, from 30% to 15% CD45+ lung immune cells (95% confidence interval [CI], 6.16-24.45; P = .0017). B-cell administration ameliorated B-cell loss, improved lung injury scores (median score in saline-treated = 3.0 vs B-cell-treated = 2.67; P = .0101) and lung cellular infiltration (F [2,34] = 11.99; P = .0001). By day 3, B cells limited the duration of oxygen desaturations (difference 0.39 seconds; median length = 1.01 seconds in saline-treated vs 0.62 seconds in B-cell-treated; 95% CI, 0.02-0.73 seconds; P = .03) and their depth (median nadir = 82.0% in saline-treated vs 85.9% in B-cell-treated, 95% CI, -6.6% to -0.84%; P = .04). B-cell-treated mice showed a median 3.82% increase in left ventricular ejection fraction by day 3, compared to 12.35% in saline-treated mice (mean difference 7.32%; 95% CI, -5.0% to 19.6%; P = .23). Exogenous B cells represented less than 1.5% of pulmonary B cells on day 3. B-cell administration had homeostatic effects on relative abundance of pulmonary immune subsets affected by hyperoxia, including endogenous B cells, CD4+ T cells, natural killer (NK) cells, monocytes/macrophages, and neutrophils. Significant immunomodulatory effects of B-cell administration were observed in myeloid cells in the lungs and included reductions in the proportion of interleukin-17 (IL-17)-expressing Ly6Clo monocytes (F [2,14] = 19.02; P = .0001), alveolar macrophages (F [2,14] = 10.32; P = .0018), and neutrophils (F [2,14] = 6.621; P = .0095) as well as interferon-gamma (IFNγ)-expressing Ly6Clo monocytes (F [2,14] = 48.83; P = .0001).CONCLUSIONSOur data indicate that adoptive B-cell therapy ameliorates hyperoxic lung injury and may represent a novel treatment for ARDS.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370309","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":"Influence of Vitamin D on Sevoflurane-Induced Neurotoxicity in Offspring Mice.","authors":"Bayram Güleryüz,Feride Karacaer,Ebru Biricik,Demet Tunay,Murat Ilginel,Müge Can,Samet Kara,Kübra Akillioğlu,Sait Polat","doi":"10.1213/ane.0000000000007570","DOIUrl":"https://doi.org/10.1213/ane.0000000000007570","url":null,"abstract":"BACKGROUNDNumerous studies have demonstrated that sevoflurane might have neurotoxic effects on the developing brain. However, the underlying mechanisms and potential treatment are largely unknown. Vitamin D has immunomodulatory, anti-inflammatory, and neuroprotective effects. We aimed to investigate whether vitamin D could attenuate sevoflurane-induced neurotoxicity in the offspring of mice.METHODTwenty 8-week-old pregnant Swiss albino mice were randomly divided into 4 groups with 5 mice each: Control, vitamin D (Vit-D), sevoflurane (Sevo), and sevoflurane-vitamin D (Sevo-Vit-D). Throughout the pregnancy, Vit-D and Sevo-Vit-D groups were intraperitoneally administered vitamin D, while Sevo and Control groups received 1 ml of saline. On the 14th day of pregnancy, Sevo and Sevo-Vit-D were exposed to 3% sevoflurane with 100% O2 for 2 hours. Control and Vit-D were exposed to 100% O2 for 2 hours. Newborn mice from the groups were included in the study. Tissue sections of the prefrontal cortex and hippocampus were examined by immunohistochemical methods and electron microscopy (EM) on postnatal day 7 and postnatal day 45 (PN7 and PN45). The immunohistochemical methods assessed the expression levels of inflammatory cytokines, apoptotic factors, neuroprotective proteins. Open field and elevated plus maze tests were performed to assess behavioral changes at PN45.RESULTSVitamin D significantly attenuated the mean (95% confidence interval [CI]) sevoflurane-induced increase in the expression levels of inflammatory cytokines and apoptotic factors, such as interleukin-6 (IL-6; Sevo versus Sevo-Vit-D: 0.68 (0.66-0.7) versus 0.34 (0.32-0.35); P < .001), tumor necrosis factor alpha (TNF-α; Sevo vs Sevo-Vit-D: 0.89 (0.88-0.9) versus 0.53 (0.51-0.55); P < .001), Bax (Sevo vs Sevo-Vit-D: 0.61 (0.6-0.63) versus 0.34 (0.32-0.36); P < .001) and c-Fos (Sevo vs Sevo-Vit-D: 0.64 (0.62-0.66) vs 0.42 (0.4-0.43); P < .001) in the hippocampus at PN7. Furthermore, vitamin D improved the mean (95% CI) expression levels of antiapoptotic and neuroprotective proteins, such as Bcl-2 (Sevo vs Sevo-Vit-D: 0.46 (0.45-0.47) versus 0.56 (0.54-0.58); P < .001), BDNF (Sevo vs Sevo-Vit-D: 0.37 (0.34-0.39) vs 0.64 (0.63-0.65); P < .001), Olig2 (Sevo vs Sevo-Vit-D: 0.38 (0.36-0.39) vs 0.56 (0.54-0.58); P < .001) in the hippocampus at PN7. These changes also occurred in the prefrontal cortex at PN7 and PN45. EM images supported these data. No significant difference was found in behavioral tests between the groups.CONCLUSIONSOur findings suggested that maternal sevoflurane exposure could cause neurotoxicity in the offspring mice. Vitamin D can protect against the negative effects of sevoflurane.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370356","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":"Patient Perspectives on Accessing, Understanding, and Using Their Anesthetic Records: A Qualitative Study.","authors":"Jonathan Shi,James Xie,Cliff Schmiesing,Ellen Y Wang,Daniel M Gessner","doi":"10.1213/ane.0000000000007609","DOIUrl":"https://doi.org/10.1213/ane.0000000000007609","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"640 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370314","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":"Erratum: Ode to the Narrative (and Their Authors)","authors":"David B. Waisel","doi":"10.1213/ane.0000000000007563","DOIUrl":"https://doi.org/10.1213/ane.0000000000007563","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305451","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 Role of Trazodone Use for Delirium and Insomnia in Critical Care Patients","authors":"Daniel Polyakov, Kristen Stefanescu, Jackson Baker, Catherine Kuza","doi":"10.1213/ane.0000000000007394","DOIUrl":"https://doi.org/10.1213/ane.0000000000007394","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"343 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305452","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 Effect of Midazolam Induction on Frontal Electroencephalogram Power.","authors":"Gabrielle A White-Dzuro,Amy Du,Emery N Brown,Oluwaseun Akeju,Robert A Peterfreund","doi":"10.1213/ane.0000000000007556","DOIUrl":"https://doi.org/10.1213/ane.0000000000007556","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130688","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":"Ultrasound Gel versus Saline for Acoustic Coupling in Ultrasound-Guided Regional Anesthesia: A Randomized, Cross-Over, Simulation Study.","authors":"Garrett W Burnett,Amar Bhavsar,Stephanie Hojsak,Christina Jeng,Michael Anderson,Yuxia Ouyang,Hung-Mo Lin,Chang H Park","doi":"10.1213/ane.0000000000007585","DOIUrl":"https://doi.org/10.1213/ane.0000000000007585","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"133 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130683","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":"Sexual Orientation and Gender Identity Representation in Academic Anesthesiology Department Chairs: A Cross-Sectional Survey.","authors":"Travis L Reece-Nguyen,Samantha E Pope,Kyle J Sanchez,Faria Nisar,Hannah E Hill,Luis E Tollinche","doi":"10.1213/ane.0000000000007579","DOIUrl":"https://doi.org/10.1213/ane.0000000000007579","url":null,"abstract":"","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130682","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}