Anesthesiology最新文献

{"title":"Sharing Anesthetic Records with Patients: An Opportunity to Embrace Transparency.","authors":"James Xie, Daniel Gessner, Priya Ramaswamy, Jonathan M Tan, Patrick Guffey, Julia Gálvez Delgado, Hannah Lonsdale, Meredith Kato, Brad M Taicher, De-An Zhang, Matthew Wecksell, Daniel Asher, Allan F Simpao, Ellen Wang, Seshadri C Mudumbai, Vikas O'Reilly-Shah","doi":"10.1097/ALN.0000000000005391","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005391","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"950-951"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Underassisted Ventilation on Diaphragm Function and Structure in a Porcine Model.","authors":"Mathieu Capdevila, Joris Pensier, Audrey De Jong, Boris Jung, July Beghin, Thomas Laumon, Yassir Aarab, Lucas Deffontis, Thomas Sfara, Ambre Cuny, Julie Carr, Nicolas Molinari, Jean-Yves Le Guennec, Fabrice Raynaud, Stefan Matecki, Laurent Brochard, Alain Lacampagne, Samir Jaber","doi":"10.1097/ALN.0000000000005390","DOIUrl":"10.1097/ALN.0000000000005390","url":null,"abstract":"<p><strong>Background: </strong>Long-term controlled mechanical ventilation in the intensive care unit induces ventilator-induced diaphragm dysfunction (VIDD). The transition from controlled mechanical ventilation to assisted mechanical ventilation is a challenge that requires clinicians to balance overassistance and underassistance. While the effects of overassistance on the diaphragm are well known, the authors aimed to assess the impact of underassistance on diaphragm function and structure in a piglet model with preexisting VIDD (after long-term controlled mechanical ventilation) or without VIDD (short-term controlled mechanical ventilation).</p><p><strong>Methods: </strong>Twenty-two Large White female piglets were anesthetized, ventilated, and separated into two groups: a VIDD group (n = 10) with long-term 72-h controlled mechanical ventilation, and a no-VIDD group (n = 12) with short-term 2-h controlled mechanical ventilation. After sedation reduction at the end of the controlled mechanical ventilation period, each piglet was switched to underassisted ventilation for 2 h. Diaphragm function (supramaximal diaphragm pressure-generating capacity assessed by negative tracheal pressure after transvenous phrenic nerve stimulation) and diaphragm structure (mini-invasive in vivo biopsies) were assessed before and after underassisted ventilation.</p><p><strong>Results: </strong>In the VIDD group, supramaximal diaphragm pressure-generating capacity decreased by 22% from (mean ± SD) 69.9 ± 12.7 to 54.9 ± 19.7 cm H 2 O ( P = 0.04) after 72 h of controlled mechanical ventilation evidencing VIDD, then dropped by a further 29% from 54.9 ± 19.7 to 38.9 ± 15.5 cm H 2 O ( P < 0.01) after 2 h of underassisted ventilation. Diaphragm pressure-generating capacity remains stable from 55.3 ± 22.7 to 58.2 ± 24 cm H 2 O ( P = 0.24) in the no-VIDD group. Diaphragm structure showed that sarcomeric injuries increase from 13 ± 10% to 24 ± 19% ( P < 0.01) and lipid droplets decrease from 14 ± 8% to 11 ± 6% ( P = 0.03) of the total micrograph area after 2 h of underassisted ventilation in the VIDD group. Sarcomeric injuries and lipid droplets accounted, respectively, for 17 ± 16% and 2 ± 3% of the total micrograph area after underassisted ventilation in the no-VIDD group.</p><p><strong>Conclusions: </strong>In this porcine model, a short 2-h exposure of underassisted ventilation induces impairment of diaphragm function with damage to the diaphragm structure in intensive care unit condition with preexisting VIDD.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"896-906"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetaminophen 5-HT3 Antagonist Interaction: Reply.","authors":"Nikolai Ratajczak, Elena Ahrens, Luca J Wachtendorf, Maximilian S Schaefer","doi":"10.1097/ALN.0000000000005350","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005350","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"952-954"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic Effect of Liposomal Bupivacaine: Reply.","authors":"Stanley Sau Ching Wong, Fengfeng Wang, Christian Xinshuo Fang, Timmy Chi Wing Chan","doi":"10.1097/ALN.0000000000005385","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005385","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"966-967"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesiology.","authors":"","doi":"10.1097/ALN.0000000000005459","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005459","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"A9-A11"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesiology.","authors":"","doi":"10.1097/ALN.0000000000005482","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005482","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"777-975"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prefrontal Cortex and the Control of Arousal States.","authors":"George A Mashour","doi":"10.1097/ALN.0000000000005417","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005417","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"785-786"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilation/Perfusion and Pulmonary Complications: Reply.","authors":"Gaetano Scaramuzzo, Dan Stieper Karbing, Carlo Alberto Volta, Stephen Edward Rees, Savino Spadaro","doi":"10.1097/ALN.0000000000005362","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005362","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"964-965"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accounting for Healthcare Structures When Measuring Variation in Care.","authors":"Douglas A Colquhoun, Allison M Janda, Graciela Mentz, Clark A Fisher, Robert B Schonberger, Nirav Shah, Sachin Kheterpal, Michael R Mathis","doi":"10.1097/ALN.0000000000005395","DOIUrl":"10.1097/ALN.0000000000005395","url":null,"abstract":"<p><p>Health services research frequently focuses on variation in the structure, process, and outcomes of clinical care. Robust approaches for detection and attribution of variation are foundational to both quality improvement and outcomes research. Describing care in structured healthcare systems across hospitals in which clinicians work to provide care for patients as a multileveled structure allows the impact of organization on practice and outcome to be ascertained. Mixed-effect statistical models can describe both the partitioning of variation among levels of these structures and by inclusion of explanatory variables the valid estimation of the features of health systems, clinicians, or patients, with observed differences in processes or patient outcomes. In this Readers' Toolbox, the authors describe the rationale for considering healthcare structures when assessing clinical practice, outcomes, and sources of variation. They describe statistical considerations and methods for the estimation of analysis of structured data and assessment of variance.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"793-805"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gazing into Recovery: Processed EEG Depth of Anesthesia Algorithms for Neurologic Outcomes after Cardiac Arrest.","authors":"Alexander S Doyal, Jonathan P Wanderer, Holly B Ende","doi":"10.1097/ALN.0000000000005457","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005457","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 5","pages":"A18"},"PeriodicalIF":9.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}