Anesthesiology最新文献

{"title":"A Quantitative Analysis on Depictions of Chronic Pain Generated via DALL-E 3, a Text-to-Image Artificial Intelligence Tool.","authors":"Morgan King, Serena Zahra, Ethan Patterson","doi":"10.1097/ALN.0000000000005364","DOIUrl":"10.1097/ALN.0000000000005364","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"764-766"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397669","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.0000000000005422","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005422","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 4","pages":"A7-A9"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603585","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":"Science, Medicine, and the Anesthesiologist.","authors":"","doi":"10.1097/ALN.0000000000005419","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005419","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"142 4","pages":"A13-A15"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603603","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":"TAK-925 (Danavorexton), an Orexin Receptor 2 Agonist, Reduces Opioid-induced Respiratory Depression and Sedation without Affecting Analgesia in Healthy Men.","authors":"Maarten van Lemmen, Albert Dahan, Yaming Hang, Simone C Jansen, Hong Lu, Melissa Naylor, Tina Olsson, Sarah Sheikh, Danielle Sullivan, Max Tolkoff, Rutger van der Schrier, Monique van Velzen, Philipp von Rosenstiel, Rebecca L Wu, Seetha Meyer","doi":"10.1097/ALN.0000000000005375","DOIUrl":"10.1097/ALN.0000000000005375","url":null,"abstract":"<p><strong>Background: </strong>Orexin neuropeptides help regulate sleep/wake states, respiration, and pain. However, their potential role in regulating breathing, particularly in perioperative settings, is not well understood. TAK-925 (danavorexton), a novel orexin receptor 2-selective agonist, directly activates neurons associated with respiratory control in the brain and improves respiratory parameters in rodents undergoing fentanyl-induced sedation. This study assessed the safety and effect of danavorexton on ventilation in healthy men in an established remifentanil-induced respiratory depression model.</p><p><strong>Methods: </strong>This single-center, double-blind, placebo-controlled, two-way crossover, phase 1 trial randomized (1:1) 13 healthy men to danavorexton (11 mg [low-dose], then 19 mg [high-dose]) or placebo, under remifentanil infusion, on two occasions separated by a 36-h or longer washout period. Remifentanil infusion was titrated under isohypercapnic conditions to achieve an approximately 30 to 40% decrease in minute ventilation (from approximately 20 to approximately 14 l/min) before danavorexton/placebo administration. Assessments included safety, ventilation measurements, sedation, and pain tolerance.</p><p><strong>Results: </strong>A total of four (30.8%) danavorexton-treated participants and one (8.3%) placebo-treated participant experienced treatment-emergent adverse events (all mild in severity). Insomnia, lasting 1 day, occurred in one participant, and was considered related to danavorexton. Compared with placebo, low- and high-dose danavorexton significantly increased ventilation variables (observed mean [95% CI] change, sensitivity analysis model-based P values) including minute volume (8.2 [95% CI, 5.0 to 11.4] and 13.0 [95% CI, 9.4 to 16.5] l/min), tidal volume (312 [95% CI, 180 to 443] and 483 [95% CI, 309 to 657] ml), and respiratory rate (3.8 [95% CI, 1.9 to 5.7] and 5.2 [95% CI, 2.7 to 7.7] breaths/min; all P < 0.001). High-dose danavorexton significantly decreased sedation on a visual analog scale (-29.7 [95% CI, -54.1 to -5.3] mm; P < 0.001) and the Richmond Agitation Sedation Scale (0.4 [95% CI, 0.0 to 0.7]; P < 0.001) compared with placebo. Improvements in respiratory variables continued beyond completion of danavorexton infusion. No significant differences in pain tolerance were observed between danavorexton doses or between danavorexton and placebo (approximately 13% increase from baseline; low dose, P = 0.491; high dose, P = 0.140).</p><p><strong>Conclusions: </strong>Danavorexton has effects on respiration and wakefulness in an opioid-induced respiratory depression setting without reversing opioid analgesia.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"628-638"},"PeriodicalIF":9.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hippocampal Neural Dynamics and Postoperative Delirium-Like Behavior in Aged Mice.","authors":"Shiqi Guo, Liuyue Yang, Weihua Ding, Tewodros Mulugeta Dagnew, Yuting Gao, Wei Wang, Pei Wang, Song Huang, Chongzhao Ran, Changning Wang, Le Shen, Qian Chen, Oluwaseun Akeju, Shiqian Shen","doi":"10.1097/ALN.0000000000005478","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005478","url":null,"abstract":"<p><strong>Background: </strong>Post-operative delirium (POD) is a common and serious clinical condition that occurs following anesthesia/surgery. While its clinical impact is well recognized, the underlying electrophysiological mechanisms remain largely unknown, posing challenges for effective treatment. This study aims to investigate hippocampal neural dynamics before and after anesthesia/surgery in aged mice, which have a tendency of developing POD.</p><p><strong>Methods: </strong>This study included adult and aged mice with a POD model. POD-like behavior was assessed in N = 10 mice at baseline (the day before surgery), as well as at 9 hours and 24 hours post-anesthesia/surgery. A behavioral battery, including the open field test, Y-maze, buried food test, and novel object recognition, was used for assessment. In vivo chronic brain recordings were performed on awake, restrained mice using a high-density silicon probe (HSP) during the same time intervals. To further investigate hippocampal neural dynamics, in vivo two-photon calcium imaging was also conducted. Additionally, aged mice were pre-treated with indole 3-propionic acid (IPA), and its effects on POD-like behavior and neural activity were evaluated using electrophysiology and calcium imaging.</p><p><strong>Results: </strong>We first observed that aged mice exhibited significant POD-like behavior, as measured by z-scores, compared to adult mice following anesthesia/surgery. Our analysis revealed significant age-related differences in hippocampal neuronal activities. At 9 hours post-surgery, aged mice exhibited a marked increase in pyramidal cell activity and a reduction in interneuron activity compared to adult mice. These changes in neuronal dynamics were associated with the onset of POD-like symptoms in aged mice. By 24 hours post-surgery, both pyramidal cell and interneuron activity in aged mice had returned to pre-surgery levels, which coincided with an improvement in POD-like behavior. Additionally, IPA pre-treatment modulated neuronal activity in aged mice, attenuating pyramidal cell hyperactivity and partially ameliorating interneuron dysfunction, changes associated with mitigated POD-like behavior.</p><p><strong>Conclusion: </strong>Alterations in hippocampal neural activity may significantly contribute to brain dysfunction and POD-like behavior. IPA pre-treatment may modulate neural circuit imbalances in aged mice, potentially mitigating POD incidence.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735578","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":"Mortality in Hospitalized Patients After Elective and Nonelective Surgery.","authors":"Richard H Epstein, Franklin Dexter, Brenda G Fahy","doi":"10.1097/ALN.0000000000005477","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005477","url":null,"abstract":"<p><strong>Background: </strong>Perioperative death globally has been described as the third leading cause of death behind heart disease and malignant neoplasm and ahead of cerebrovascular disease. However, studies of all-cause perioperative mortality have not distinguished patients who were outpatients preoperatively (\"elective\") from patients having urgent surgery or having surgery on a day after their date of admission (\"nonelective\"). Strategies for reducing overall perioperative mortality are affected by whether most deaths occur after elective or nonelective surgery.</p><p><strong>Methods: </strong>We studied all adult patients undergoing major diagnostic or therapeutic surgery in Florida in 2021 and 2022 hospitalized ≥2 midnights. We compared those who survived to discharge or died between the elective and nonelective groups. Major hospital-acquired complications were considered as sensitivity analyses. The diversity of procedures (ICD-10-PCS codes) was quantified using the inverse of the internal Herfindahl.</p><p><strong>Results: </strong>Among the 1,245,537 hospitalizations studied, the nonelective group accounted for 94.5% (95% CI 94.0-95.1%) of the 20,874 in-hospital deaths (p < 0.0001 vs 50% [\"most\"]). The nonelective group also accounted for most (70.0%) hospitalizations studied. The relative risk of death in the elective vs non-elective group was 0.13 (95% CI 0.12-0.14, p < 0.0001 vs. 1.0). The relative risks of acute kidney injury, hospital-acquired pneumonia, a major adverse cardiovascular event, and infection were all <1.0 in the elective group. Hundreds of different ICD-10-PCS occurred commonly among patients who died, in both groups.</p><p><strong>Conclusions: </strong>Results of previous studies of all-cause perioperative mortality should not be applied to patients having elective major surgery because most deaths (≈95%) and most cases (70%) are in patients having nonelective major surgery (i.e., already admitted to the hospital or undergoing trauma-related surgery). From a public health perspective, interventions to reduce postoperative mortality should be primarily focused on patients who are inpatients before their first major surgical procedure.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727518","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":"Longitudinal Reliability of Milestones Learning Trajectories during Anesthesiology Residency.","authors":"Ting Sun, Yoon Soo Park, Fei Chen, Sean O Hogan, Pedro Tanaka","doi":"10.1097/ALN.0000000000005388","DOIUrl":"10.1097/ALN.0000000000005388","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal Milestones data reported to the Accreditation Council for Graduate Medical Education provide a structured framework for assessing the developmental progression of residents in key competencies and subcompetencies. This study aims to investigate the previously underexplored longitudinal reliability of Milestones data, with the goal of identifying patterns in learning trajectories that can inform targeted interventions for residents and programs.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with national anesthesiology Milestones data collected from 2014 to 2020. Mixed-effects growth curve models were fit to model residents' growth trajectories. Longitudinal reliability was assessed using the indices of growth rate reliability and growth curve reliability. This study also examined variance components attributable to the factors at both the learner and program levels. Latent class growth analyses were performed to identify latent groups of learners with different learning trajectories.</p><p><strong>Results: </strong>The study included a total of 682,475 ratings for 4,976 learners in 140 programs. Growth curve model results indicated that the mean baseline Milestone rating across the 25 subcompetencies was 2.05 (95% CI, 1.96 to 2.14), with an average increase of 0.49 (95% CI, 0.48 to 0.51) units per reporting period. The growth rate reliability (mean ± SD, 0.58 ± 0.03) suggested a moderate capability of anesthesiology Milestones to detect individual differences in the growth of latent competency. Growth curve reliability estimates (mean ± SD, 0.71 ± 0.02) suggested acceptable overall reliability of Milestones across all the six assessment points. Significant variability was observed at both the program and learner levels ( P < 0.001). Latent class growth analyses identified 3 to 4 latent groups of learners with distinct learning trajectories across the 25 subcompetencies.</p><p><strong>Conclusions: </strong>The study indicated that the anesthesiology Milestones provide moderately reliable information for tracking individual progress over time. The findings underscore the importance of using a multifaceted approach to assessment and providing individualized learning plans to support resident development.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051400","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":"Suzetrigine, a Non-Opioid NaV1.8 Inhibitor for Treatment of Moderate-to-Severe Acute Pain: Two Phase 3 Randomized Clinical Trials.","authors":"Todd Bertoch, Dominick D'Aunno, Jessica McCoun, Daneshvari Solanki, Louise Taber, Joshua Urban, Jessica Oswald, Matthew W Swisher, Simon Tian, Xiaopeng Miao, Darin J Correll, Paul Negulescu, Carmen Bozic, Scott G Weiner","doi":"10.1097/ALN.0000000000005460","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005460","url":null,"abstract":"<p><strong>Background: </strong>Opioids are effective for treating acute pain but have safety, tolerability, and addiction concerns while non-opioid analgesics have limited efficacy. Suzetrigine, an oral, non-opioid, small molecule, selectively inhibits the voltage-gated sodium channel 1.8 (NaV1.8) and has potential to provide efficacious and safe relief for acute pain, without addiction concerns.</p><p><strong>Methods: </strong>To evaluate suzetrigine for treatment of acute pain, we conducted two phase 3, randomized, double-blind, placebo- and active-controlled trials in adults with moderate-to-severe acute pain on the verbal categorical rating scale and ≥4 on the numeric pain rating scale (NPRS) after abdominoplasty (N=1118) or bunionectomy (N=1073). After surgery, participants were randomized to suzetrigine (100mg then 50mg every 12hrs), hydrocodone bitartrate/acetaminophen (HB/APAP; 5/325mg every 6hrs), or placebo for 48 hours. The primary endpoint was time-weighted sum of the pain intensity difference in NPRS from 0-48hrs (SPID48) versus placebo. Key secondary endpoints were SPID48 versus HB/APAP and time to ≥2-point reduction in NPRS from baseline versus placebo.</p><p><strong>Results: </strong>The primary endpoint was achieved in both trials with suzetrigine demonstrating statistically significant and clinically meaningful reduction in pain versus placebo. The least squares mean difference in SPID48 between suzetrigine and placebo was 48.4 (95%CI:33.6,63.1;P<0.0001) after abdominoplasty and 29.3 (95%CI:14.0,44.6; P=0.0002) after bunionectomy. Neither trial achieved the first key secondary endpoint of superiority of suzetrigine versus HB/APAP on SPID48. For the second key secondary endpoint of time to ≥2-point reduction in NPRS, suzetrigine had a more rapid onset of clinically meaningful pain relief versus placebo after abdominoplasty (119min versus 480mins, nominal P<0.0001) and bunionectomy (240mins versus 480mins, nominal P=0.0016).Adverse events (AEs) were similar to those seen in post-surgical settings.</p><p><strong>Conclusions: </strong>As compared with placebo, suzetrigine reduced moderate-to-severe acute pain over 48 hours after abdominoplasty or bunionectomy. Pain reduction with suzetrigine was similar to that with HB/APAP. Suzetrigine was associated with adverse events that were mild to moderate in severity.</p><p><strong>Clinicaltrialsgov registration: </strong>NCT05558410 and NCT05553366.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673181","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":"Inhibition of Endoplasmic Reticulum Oxidoreductin 1 modulates neuronal excitability and nociceptive sensitivity in mice.","authors":"Aislinn D Maguire, Shawn M Lamothe, Muhammad Saad Yousuf, Kree Goss, Jayadeep Rao, Gustavo Tenorio, Sridhar R Kaulagari, Lori Hazlehurst, Jason R Plemel, Anna Mw Taylor, Harley T Kurata, Thomas Simmen, Bradley J Kerr","doi":"10.1097/ALN.0000000000005453","DOIUrl":"10.1097/ALN.0000000000005453","url":null,"abstract":"<p><strong>Background: </strong>In the peripheral nervous system, nociceptors become hyperexcitable in both acute and chronic pain conditions. This phenotype can be mediated by dysregulated calcium, which occurs if the endoplasmic reticulum (ER) and mitochondria fail to buffer it appropriately. The redox enzyme endoplasmic reticulum oxidoreductin 1 (ERO1) regulates calcium transfer at ER-mitochondria contact sites (ERMCS). In this study we hypothesized that inhibiting ERO1 and thereby dampening ERMCS calcium transfer might lower nociceptor hyperexcitability in sensory neurons and pain-like behaviours in mice.</p><p><strong>Methods: </strong>C57BL/6 mice were used for histology, behaviour, and cell culture experiments. Behaviour included thermal tail flick, the formalin hind paw injection model of acute inflammatory pain, and hind paw incision post-surgical pain. Post-mortem human dorsal root ganglia (DRGs) were used for immunohistochemistry and in vitro calcium imaging.</p><p><strong>Results: </strong>Here we demonstrate that the α isoform of ERO1 is expressed in mouse dorsal root ganglia (DRGs) across multiple subtypes of mouse sensory neurons. This led us to peripherally administer an ERO1 inhibitor in mice, which acutely reversed nociception in acute inflammatory and post-surgical pain models. We hypothesized that this may be due to reduced excitability of DRG neurons, and tested ERO1 inhibition in vitro. In cultured DRGs, ERO1 inhibition dampened nociceptor excitability and mitochondrial function, suggesting that reduced calcium transfer through ERMCS could be responsible for the behaviour we observed in vivo. We also found ERO1 α expression in human DRGs using immunohistochemistry and previously published single cell RNA sequencing data. Finally, we showed that ERO1 inhibition modulates human sensory neuronal excitability in cultured post-mortem DRGs.</p><p><strong>Conclusions: </strong>We found that ERO1 inhibition dampens mitochondrial function, sensory neuron excitability, and acute pain-like behaviour in mice. Additionally, ERO1 inhibition decreases sensory neuron excitability in post-mortem human sensory neurons in vitro. We propose that targeting ERO1 may be a viable strategy for non-narcotic acute pain relief.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662071","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":"Persistent renal hypoxia and histological changes at 4 weeks after cardiopulmonary bypass in sheep.","authors":"Taku Furukawa, Clive N May, Alemayehu H Jufar, Roger G Evans, Andrew D Cochrane, Bruno Marino, Peter R McCall, Ian E Birchall, Sally G Hood, Jaishankar Raman, Connie P C Ow, Anton Trask-Marino, Rinaldo Bellomo, Lachlan F Miles, Yugeesh R Lankadeva","doi":"10.1097/ALN.0000000000005452","DOIUrl":"https://doi.org/10.1097/ALN.0000000000005452","url":null,"abstract":"<p><strong>Background: </strong>The sustained renal effects of exposure to cardiopulmonary bypass (CPB) are unknown. We aimed to test whether CPB is associated with sustained renal tissue hypoxia and whether such hypoxia is associated with histological injury.</p><p><strong>Methods: </strong>We studied 12 adult female sheep undergoing CPB with a 2-h aortic cross-clamp. We measured systemic and renal hemodynamics and oxygen delivery, kidney function, and renal tissue oxygenation, before and during CPB, in the 48 h after CPB, and weekly for four weeks. We euthanized the sheep at four weeks and obtained renal tissue to perform histopathological assessments for comparison with an independent cohort of five healthy animals that were euthanized without undergoing surgical or experimental interventions. These histological assessments were performed by an independent, treatment-blinded pathologist.</p><p><strong>Results: </strong>Compared with baseline, renal blood flow and renal medullary tissue oxygenation decreased significantly during CPB. In the first 48 h after CPB, there was a continuing significant decrease in medullary tissue oxygenation (from 39.2 ± 13.8 mmHg at baseline to 21.7 ± 16.2 mmHg at 48 h, Ptime = 0.006) with Stage 1 acute kidney injury (AKI) in 42% of animals. Moreover, in the following 4 weeks, medullary (16.1 ± 12.9 mmHg at 4 weeks, Ptime = 0.005) and cortical (17.2 ± 6.5 mmHg at 4 weeks, Ptime = 0.005) tissue oxygenation remained significantly lower than baseline. Finally, compared with healthy sheep, at 4 weeks post-CPB sheep kidneys had significantly more peritubular inflammation (8/8 vs. 1/5, P = 0.007), interstitial fibrosis (6/8 vs. 0/5, P = 0.021) and tubular casts (8/8 vs. 1/5, P = 0.007).</p><p><strong>Conclusions: </strong>Exposure to CPB triggers sustained medullary and cortical tissue hypoxia and is associated with histopathological renal injury. These findings suggest that the renal effect of exposure to CPB may be more profound and longer lasting than currently appreciated.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662108","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}