Anesthesiology最新文献

{"title":"Comparing Professionalism in Anesthesiology: Comment.","authors":"Taylor Choi, Rebecca Hu, Ammar Siddiqui, Michael Rahimi","doi":"10.1097/ALN.0000000000006324","DOIUrl":"https://doi.org/10.1097/ALN.0000000000006324","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178922","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":"Tidal Swing of Endotracheal Tube Cuff Pressure as a Measurement of Inspiratory Effort and Lung Stress during Pressure Support Ventilation: A Proof-of-concept Study.","authors":"Rui-Zhi Zhang, Shan-Shan Xu, Ming-Yue Miao, Xu An, Yang Liu, Yue-Fu Wang, Hong-Liang Li, Jian-Xin Zhou","doi":"10.1097/ALN.0000000000006332","DOIUrl":"10.1097/ALN.0000000000006332","url":null,"abstract":"<p><strong>Background: </strong>Esophageal pressure (P es ) is the reference standard for monitoring inspiratory effort and lung stress during assisted ventilation, but its routine application is hindered by the lack of specialized equipment and specific training. The authors aimed to determine whether endotracheal tube cuff pressure (P CUFF ) could serve as a more accessible surrogate.</p><p><strong>Methods: </strong>In this prospective study, P es and P CUFF were simultaneously recorded in 30 orally intubated adult patients undergoing pressure support ventilation. A downward pressure support titration (15 to 5 cm H 2 O) was performed. P CUFF was calibrated using occlusion-induced changes in airway pressure. The correlation between tidal swings of P CUFF and P es was analyzed using a linear mixed-effects model. Agreement between the two parameters was evaluated by Bland-Altman analysis (for repeated measures). Diagnostic performance was analyzed for P CUFF to detect extremes of inspiratory effort, using inspiratory muscle pressure (P mus ) and P mus -time product (PTP mus ) per minute as references, alongside high transpulmonary driving pressure (greater than 20 cm H 2 O) and high transpulmonary mechanical power (greater than 12 J/min).</p><p><strong>Results: </strong>Across 840 analyzed breaths, P CUFF correlated with P es (marginal R2 = 0.772; conditional R2 = 0.949) with a mean bias (limits of agreement) of 0.25 (-5.42 to 5.92) cm H 2 O. For detecting low effort (P mus less than 5 cm H 2 O or PTP mus /min less than 50 cm H 2 O · s/min), P CUFF yielded areas under the receiver operating characteristics curve (AUCs) of 0.95 (95% CI, 0.91 to 0.99) and 0.94 (95% CI, 0.86 to 1.00), respectively. For identifying high effort (P mus greater than 10 cm H 2 O or PTP mus /min greater than 150 cm H 2 O · s/min), the respective AUCs were 0.93 (95% CI, 0.89 to 0.97) and 0.82 (95% CI, 0.76 to 0.88). Utilizing a leave-one-out cross-validation framework to prevent overfitting, P CUFF successfully discriminated high transpulmonary driving pressure and transpulmonary mechanical power with AUCs of 0.89 (95% CI, 0.83 to 0.95) and 0.88 (95% CI, 0.82 to 0.93), respectively.</p><p><strong>Conclusions: </strong>Although P CUFF cannot entirely replace P es for precise quantification due to relatively wide limits of agreement, it exhibits excellent diagnostic discrimination. P CUFF holds promise as an accessible, continuous bedside monitor for identifying patients with potentially injurious levels of effort, stress, and energy intensity.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756868","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":"Permanent Residents of a Non-place.","authors":"Fernando R Altermatt","doi":"10.1097/ALN.0000000000006327","DOIUrl":"https://doi.org/10.1097/ALN.0000000000006327","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178935","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":"National Delphi Study to Inform Modernization of Anesthesiology Residency Case Log Requirements.","authors":"Daniel Saddawi-Konefka, Rachel M Kacmar, Timothy R Long, John D Mitchell, Lee Ang, Aditee P Ambardekar","doi":"10.1097/ALN.0000000000006337","DOIUrl":"10.1097/ALN.0000000000006337","url":null,"abstract":"<p><strong>Background: </strong>The Accreditation Council for Graduate Medical Education (ACGME; Chicago, Illinois) case log system establishes minimum clinical experiences for anesthesiology residency. While core program requirements were last updated in 2016, case log minimums themselves have not undergone a major revision in approximately 2 decades. Consequently, current requirements may not fully reflect changes in anesthetic practice and the evolving scope of perioperative medicine. In anticipation of major ACGME revisions in 2027, this study aimed to develop consensus-driven recommendations for modernizing residency case logs.</p><p><strong>Methods: </strong>A three-round modified Delphi study was conducted with a nationally representative panel of 60 stakeholders, including anesthesiology residency program directors and academic and private practice anesthesiologists. Panelists evaluated a comprehensive list of potential case categories across three domains: technical skills, surgical case characteristics, and patient demographics. In round 1, panelists proposed minimum numbers or suggested that no requirement was necessary. Rounds 2 and 3 utilized iterative feedback to determine consensus on the necessity of requirements and specific minimum thresholds. Consensus was defined as at least two-thirds agreement.</p><p><strong>Results: </strong>Sixty invited experts completed all three rounds (100% response rate). The panel reached consensus to recommend new minimum requirements across several areas not currently tracked with minimums, including arterial lines (40), central lines (20), fiberoptic intubation (10), one-lung ventilation (10), neuromonitoring (10), point-of-care ultrasound (10 cardiac, 10 lung), and non-operating room anesthesia (20 cases). Regarding existing requirements, consensus was reached to recommend increasing total peripheral nerve blocks from 40 to 60, with added requirements for anatomic specificity, and cardiac case minimums from 20 to 25. The panel also established consensus definitions for life-threatening pathologies to standardize reporting. The panel did not achieve consensus on several areas, including, for example, whether a minimum requirement for patients younger than 3 months should be maintained.</p><p><strong>Conclusion: </strong>These findings provide stakeholder-validated recommendations to inform upcoming ACGME requirement revisions.</p>","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787391","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":"Esophageal Duplication Cysts: Managing the Incidental and Asymptomatic Lesion.","authors":"Dip M Shukla, Nicholas Rothbard, Sudarshan Setty","doi":"10.1097/ALN.0000000000006353","DOIUrl":"https://doi.org/10.1097/ALN.0000000000006353","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178930","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":"Thank you, Larry Saidman: Comment","authors":"Elliot J. Krane","doi":"10.1097/aln.0000000000006351","DOIUrl":"https://doi.org/10.1097/aln.0000000000006351","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"48 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089166","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":"Anesthesia as a Partner in Public Health: Enabling National Pediatric SARS-CoV-2 Serosurveillance in Australia","authors":"Archana Koirala,Chantal Attard,Justin Skowno","doi":"10.1097/aln.0000000000006317","DOIUrl":"https://doi.org/10.1097/aln.0000000000006317","url":null,"abstract":"Anesthetic departments played a critical role in Australia’s COVID-19 response by facilitating the collection of residual blood samples from children undergoing elective procedures. Through a partnership with the Pediatric Active Enhanced Disease Surveillance network, this approach enabled three national SARS-CoV-2 serosurveys between 2020 and 2023. It provided an ethical, feasible, and nationally representative method for assessing infection- and vaccine-derived immunity in children, a population in whom routine blood sampling is difficult and from whom residual blood samples are not commonly available. The resulting data informed COVID-19 vaccination policy, improved understanding of infection burden and immunity, and contributed to broader public health decision-making. This experience demonstrates how anesthetic departments can extend their impact beyond perioperative care, serving as essential partners in public health surveillance and research.","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"18 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149089161","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":"Born: The Untold History of Childbirth.","authors":"Kathryn E McGoldrick","doi":"10.1097/ALN.0000000000006177","DOIUrl":"10.1097/ALN.0000000000006177","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"1083-1085"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597929","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":"Ultrasound Findings of Chronic Inflammatory Demyelinating Polyneuropathy of the Sciatic Nerve.","authors":"Hidehiko Okuma, Kaoru Ishii, Kyoichi Nakamura","doi":"10.1097/ALN.0000000000006176","DOIUrl":"10.1097/ALN.0000000000006176","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":" ","pages":"1004-1005"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597985","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":"Beyond WISHful Thinking: A Framework for Measuring Well-being Culture.","authors":"Elizabeth B Malinzak, Ji Yeon Jemma Kang","doi":"10.1097/ALN.0000000000006265","DOIUrl":"10.1097/ALN.0000000000006265","url":null,"abstract":"","PeriodicalId":7970,"journal":{"name":"Anesthesiology","volume":"145 4","pages":"815-817"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918107","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}