Anesthesia & Analgesia最新文献_第3页

Wearable Diabetes Devices - Perioperative Implications 可穿戴糖尿病设备--围手术期的影响

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007334

Naveen Nathan

引用次数: 0

Blood Pressure Estimation Using Explainable Deep-Learning Models Based on Photoplethysmography 使用基于光敏血压计的可解释深度学习模型估测血压

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007295

Jade Perdereau, Thibaut Chamoux, Etienne Gayat, Arthur Le Gall, Fabrice Vallée, Jérôme Cartailler, Jona Joachim

{"title":"Blood Pressure Estimation Using Explainable Deep-Learning Models Based on Photoplethysmography","authors":"Jade Perdereau, Thibaut Chamoux, Etienne Gayat, Arthur Le Gall, Fabrice Vallée, Jérôme Cartailler, Jona Joachim","doi":"10.1213/ane.0000000000007295","DOIUrl":"https://doi.org/10.1213/ane.0000000000007295","url":null,"abstract":". We developed a deep-learning model that reconstructs continuous mean arterial pressure (MAP) using the photoplethysmograhy (PPG) signal and compared it to the arterial line gold standard. METHODS: We analyzed high-frequency PPG signals from 117 patients in neuroradiology and digestive surgery with a median of 2201 (interquartile range [IQR], 788–4775) measurements per patient. We compared models with different combinations of convolutional and recurrent layers using as inputs for our neural network high-frequency PPG and derived features including dicrotic notch relative amplitude, perfusion index, and heart rate. Mean absolute error (MAE) was used as performance metrics. Explainability of the deep-learning model was reconstructed with Grad-CAM, a visualization technique using saliency maps to highlight the parts of an input that are significant for a deep-learning model decision-making process. RESULTS: An MAP baseline model, which consisted only of standard cuff measures, reached an MAE of 6.1 (± 14.5) mm Hg. In contrast, the deep-learning model achieved an MAE of 3.5 (± 4.4) mm Hg on the external test set (a 42.6% improvement). This model also achieved the narrowest confidence intervals and met international standards used within the community (grade A). The saliency map revealed that the deep-learning model primarily extracts information near the dicrotic notch region. CONCLUSIONS: Our deep-learning model noninvasively estimates arterial pressure with high accuracy. This model may show potential as a decision-support tool in operating-room settings, particularly in scenarios where invasive blood pressure monitoring is unavailable....","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832269","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}

引用次数: 0

Large Language Models and the American Board of Anesthesiology Examination 大语言模型和美国麻醉学委员会考试

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007322

Alex Macario, Mohammed M. Minhaj, Mark T. Keegan, Ann E. Harman

引用次数: 0

Additive and Multiplicative Interactions in Factorial Randomized Trials: What, Why, and How? 因子随机试验中的加法和乘法相互作用：是什么、为什么、怎么做？

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007175

Edward J. Mascha

引用次数: 0

In Response 回应

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007163

Burhan Dost, Alessandro De Cassai

引用次数: 0

Self-Citation in Anesthesiology Journals: Methodology Concerns 麻醉学期刊中的自我引用：方法论问题

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007162

Shu-Yueh Cheng, Syu-Han Ren, Ming-Hui Hung

引用次数: 0

The Challenge of Unexplained Practice Variability 无法解释的实践差异带来的挑战

Anesthesia & Analgesia Pub Date : 2024-12-16 DOI: 10.1213/ane.0000000000007059

Avery Tung

引用次数: 0

Racial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016–2020 美国产科病人使用硬膜外血贴的种族和民族差异：2016-2020 年全国分析

Anesthesia & Analgesia Pub Date : 2024-11-15 DOI: 10.1213/ane.0000000000006754

Paul P. Potnuru, Srikar Jonna, Barbara Orlando, Omonele O. Nwokolo

{"title":"Racial and Ethnic Disparities in Epidural Blood Patch Utilization Among Obstetric Patients in the United States: A Nationwide Analysis, 2016–2020","authors":"Paul P. Potnuru, Srikar Jonna, Barbara Orlando, Omonele O. Nwokolo","doi":"10.1213/ane.0000000000006754","DOIUrl":"https://doi.org/10.1213/ane.0000000000006754","url":null,"abstract":"itating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States. METHODS: In this retrospective observational study, we used the National Inpatient Sample, a nationally representative database of discharge records for inpatient admissions in the United States, from 2016 to 2020. We analyzed delivery hospitalizations of women of childbearing age (15–49 years) diagnosed with PDPH. Adjusting for maternal and hospitalization characteristics as confounders, we used a multilevel mixed-effects logistic regression model to compare the rates of EBP utilization by race and ethnicity. Secondarily, among hospitalizations with an EBP, we examined the association between race and ethnicity and the timing of the EBP procedure. RESULTS: We analyzed 49,300 delivery hospitalizations with a diagnosis of PDPH. An EBP was performed in 24,075 (48.8%; 95% confidence interval [CI], 47.8%–49.9%) of these hospitalizations. EBP was performed in 52.7% (95% CI, 51.3%–54.1%) of White non-Hispanic patients with PDPH. Compared to White non-Hispanic patients, Black non-Hispanic (adjusted odds ratio [aOR] = 0.69; 99% CI, 0.56–0.84), Hispanic (aOR = 0.80, 99% CI, 0.68–0.95), and Asian or Pacific Islander patients (aOR = 0.74, 99% CI, 0.58–0.96) were less likely to receive an EBP. The median (interquartile range [IQR]) time to perform an EBP was 2 (1–3) days after admission, with 90% of EBP procedures completed within 4 days of admission. There was no significant association between race and ethnicity and the timing of EBP placement. CONCLUSIONS: In this nationwide analysis of delivery hospitalizations from 2016 to 2020 in the United States with a diagnosis of PDPH, we identified racial and ethnic disparities in the utilization of EBP. Minoritized patients identified as Black non-Hispanic, Hispanic, or Asian or Pacific Islander were less likely to receive an EBP for the treatment of PDPH compared to White non-Hispanic patients. Suboptimal treatment of PDPH may be associated with adverse long-term outcomes such as postpartum depression, posttraumatic stress disorder, and chronic headaches. Racial and ethnic disparities in EBP utilization should be further investigated to ensure equitable health care delivery....","PeriodicalId":7799,"journal":{"name":"Anesthesia & Analgesia","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670784","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}

引用次数: 0

It Depends on Whom You Ask: Perceptions of Dignity-Related Distress Among Critically Ill Patients and Families 这取决于你问谁：重症患者及家属对尊严相关痛苦的看法

Anesthesia & Analgesia Pub Date : 2024-11-15 DOI: 10.1213/ane.0000000000007077

Shahla Siddiqui

引用次数: 0

The World Federation of Societies of Anaesthesiologists’ Fellowship Programs: Past, Present, and Future 世界麻醉医师协会联合会的研究金计划：过去、现在和未来

Anesthesia & Analgesia Pub Date : 2024-11-15 DOI: 10.1213/ane.0000000000006984

Pauline B. Wake, Patricia Livingston, Ekta Rai, Robert J. McDougall

引用次数: 0