BMC Anesthesiology最新文献

{"title":"Effectiveness of a new thermal insulation blanket in the control of inadvertent perioperative hypothermia and comfort: a randomized controlled trial.","authors":"Isaura Carvalho, Miguel Carvalho, Fernando Abelha, Teresa Martins","doi":"10.1186/s12871-024-02830-0","DOIUrl":"https://doi.org/10.1186/s12871-024-02830-0","url":null,"abstract":"<p><strong>Background: </strong>Disturbances in the thermoregulatory system can precipitate inadvertent hypothermia in patients undergoing surgeries lasting over 60 min, causing serious complications in the recovery process. Cutaneous thermal protection is relevant for the control of temperature of patients in the perioperative setting. The standard thermal protection widely utilized is an electric forced warm air blanket. This study compared a new layered textile blanket with the standard protection. The hypothesis posited that the textile blanket could provide cutaneous thermal protection comparable to that of the standard protection (forced-air warming blanket), in terms of temperature variation and safety.</p><p><strong>Methods: </strong>This randomized controlled trial was conducted at a Portuguese orthopedic hospital from October 2018 to January 2019, comprising 124 adult patients undergoing elective total knee arthroplasty. Participants were randomly allocated to either the intervention group, receiving the textile blanket, or to the control group, receiving standard measures. Tympanic temperature, shivering, and thermal comfort perception were evaluated at six time points. Comfort dimensions and ergonomic aspects were also assessed. Parametric statistics were performed, and independent samples t-tests and repeated measures were used to compare temperature variations and thermal comfort.</p><p><strong>Results: </strong>No statistically significant differences were found between groups in mean temperature variation, visual perception of thermal comfort, and thermal and perioperative comfort scales. The intervention group (n = 65) scored significantly higher in ergonomic evaluations compared to the control group (n = 59) for: fit to body and general comfort (p = 0.004), touch (p = 0.005), and feeling of comfort with the inner layer texture and shape (p < 0.001).</p><p><strong>Conclusion: </strong>The tested blanket had a comparable performance to the standard protection, suggesting it as a potential sustainable alternative to the recommended measures for thermal protection. However, further investigations across diverse contexts and populations are needed to validate these findings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"455"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of dexmedetomidine on acute kidney injury after elective major abdominal surgery : a retrospective single-center propensity score matched study.","authors":"Haibei Liu, Rong Luo, Liu Qian, Yujun Zhang, Wensheng Zhang, Juan Tan, Ling Ye","doi":"10.1186/s12871-024-02845-7","DOIUrl":"https://doi.org/10.1186/s12871-024-02845-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Major abdominal surgery is a kind of high-risk surgery type for postoperative acute kidney injury (AKI) among non-cardiac surgeries. Despite dexmedetomidine exerts significant renal protective effects in cardiac surgeries and animal studies, whether it is associated with a lower incidence of AKI in major abdominal surgeries remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From January 2019 to July 2021, patients undergoing elective major abdominal surgery in West China Hospital were enrolled. Participants were divided into two groups based on exposure to continuous intravenous dexmedetomidine: the Dex group (exposed) and the Control group (not exposed). The primary outcome was the incidence of AKI in the postoperative 7 days. Secondary outcomes included intraopertive average urine output, renal function on the first day after surgery, incidence of postoperative dialysis, postoperative intensive care unit (ICU) admission, in-hospital mortality, length of hospital stay, incidence of intraoperative hypotension and bradycardia, and intraoperative use of inotropes and vasopressors. Propensity score matching (PSM), based on participants' baseline and intraoperative characteristics, was performed to minimize potential bias. Furthermore, a subgroup analysis was conducted based on the infusion rate and the use of a loading dose to explore the effects of different methods of dexmedetomidine administration on AKI. The subgroups included: loading dose, non-loading dose, low-infusion rate (infusion rate ≤ 0.4 µg/kg/h), and high-infusion rate (infusion rate &gt; 0.4 µg/kg/h).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After PSM with a ratio of 1:1, a total of 8836 patients were successfully matched. Dexmedetomidine administration had no association with the incidence of postoperative AKI, serum creatinine (Scr) level on the first postoperative day, incidence of postoperative dialysis, postoperative ICU admission, in-hospital mortality, length of hospital stay, intraoperative hypotension, or the use of inotropes and vasopressors, but had association with increased intraoperative average urine output (122.95 (76.80, 189.27) vs. 104.65 (67.04, 161.07) ml/h, P &lt; 0.001), higher value of estimated glomerular filtration rate (eGFR) (97.33 ± 15.95 vs. 96.13 ± 16.35 ml/min/1.73m&lt;sup&gt;2&lt;/sup&gt;, P &lt; 0.001) on the first day after surgery and a higher incidence of intraoperative bradycardia (37.0% vs. 30.6%; P &lt; 0.001). In the loading dose subgroup, dexmedetomidine use was significantly associated with a reduced incidence of postoperative AKI (odds ratio (OR): 0.44, 95% confidence interval (CI): 0.23-0.76, P = 0.006).The association between dexmedetomidine and postoperative AKI was absent in subgroups of high or low infusion rate and no loading dose use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this single-center retrospective propensity-matched study, we did not detect a significant overall difference in post-operative AKI rates between patients treated with ","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"456"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of lactate-to-albumin ratio in patients with influenza A virus-induced acute respiratory distress syndrome: a single-center retrospective study.","authors":"Jinhui Gao, Xuanzhe Yang, Xiang Fang, Ziyi Zhang, Dapeng Wang, Jiajia Wang","doi":"10.1186/s12871-024-02843-9","DOIUrl":"https://doi.org/10.1186/s12871-024-02843-9","url":null,"abstract":"<p><strong>Background: </strong>The lactate-to-albumin ratio (LAR) is predictive of disease prognosis in some cases. However, the clinical significance of LAR in patients with influenza A virus-induced acute respiratory distress syndrome (ARDS) has yet to be explored. This study aims to investigate whether LAR can be used as a predictor of influenza A virus-induced ARDS.</p><p><strong>Methods: </strong>In this single-center retrospective study, we enrolled 105 patients with influenza A virus pneumonia into the study and divided the patients into an ARDS group (74 patients) and a non-ARDS group (31 patients) during hospitalization. Clinical characteristics and laboratory data were collected within 24 h after admission. We explored the risk factors for ARDS using logistic regression analysis. The predictive performance of potential risk factors for ARDS and ARDS-associated complications were evaluated by receiver operating characteristic (ROC) curves, and Pearson's correlation analysis was used to evaluate the correlations between risk factors and clinical and laboratory variables.</p><p><strong>Results: </strong>LAR was an independent predictor for the development of ARDS in patients with influenza A virus pneumonia and was significantly predictive for ARDS. LAR's area under the curve (AUC) was higher than that of lactate and albumin alone; its AUC was 0.878, with a sensitivity of 71.6% and a specificity of 96.8%. The optimal ROC threshold for distinguishing ARDS from non-ARDS cases was 44.81 × 10^- 3. Correlation analysis indicated that LAR was positively associated with duration of invasive ventilation, and APACHE II and SOFA scores in ARDS patients but was negatively associated with PaO₂/FiO₂ (p < 0.001). Subsequent ROC curve analysis determined that LAR was a robust predictor for the 14-day invasive ventilation (AUC = 0.924), septic shock (AUC = 0.860), and hepatic injury (AUC = 0.905) in hospitalized ARDS patients. It also showed a promising predictive value for 28-day mortality (AUC = 0.881).</p><p><strong>Conclusion: </strong>LAR strongly predicted ARDS development in patients with influenza A virus pneumonia. It showed a significant correlation with disease severity and provided promising predictive efficiency for extrapulmonary complications and 28-day mortality in patients with influenza A virus-induced ARDS.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"459"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intravenous anesthesia and inhalation anesthesia on postoperative inflammatory markers in patients with esophageal cancer: a retrospective study.","authors":"Jie Ren, Yue Ma, Ming Wei, Zhiguo Li","doi":"10.1186/s12871-024-02856-4","DOIUrl":"https://doi.org/10.1186/s12871-024-02856-4","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory markers have been confirmed to be associated with the prognosis of cancer patients. In this study, we compared the impacts of intravenous anesthesia and inhalation anesthesia on the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) after esophageal cancer surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed the electronic medical records of patients who underwent esophagectomy from January 1, 2014 to December 31, 2016. Patients respectively received total intravenous anesthesia (TIVA) or inhalational anesthesia (INHA). Inverse probability of treatment weighting (IPTW) was employed to minimize differences. The Mann-Whitney U test or Kruskal Wallis test was utilized to compare the effect of the two groups on postoperative NLR, PLR and SII.</p><p><strong>Results: </strong>A total of 519 patients who had undergone esophageal cancer resection were recruited in this study, among whom 339 patients were eligible (TIVA group, n = 201, INHA group, n = 138). After IPTW, there was no statistically significant difference in NLR, PLR, and SII on the first postoperative day(P = 0.1951), (P = 0.5611), (P = 0.9684) and on the third postoperative day(P = 0.5961), (P = 0.1804), (P = 0.9653) between the two groups.</p><p><strong>Conclusions: </strong>In conclusion, there was no significant difference in NLR, PLR and SII between intravenous anesthesia or inhalational anesthesia. TIVA is not superior to INHA in reducing the perioperative inflammatory response of esophageal cancer.</p><p><strong>Synopsis: </strong>Inflammatory markers play an important role in the recurrence, metastasis and survival of tumor patients after surgery. In this study, we will compare the effects of different anesthesia methods on inflammatory markers.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"462"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of continuous infusion in alleviating pain during male urethral catheterization.","authors":"Lijun Cao, Xin Qi, Dan Liu, Xincheng Mao, Liu Luo, Mengjiang Liu, Xinyi Wen, Chunhong Cui, Jia Qi, Junmei Xu, Yulong Cui","doi":"10.1186/s12871-024-02848-4","DOIUrl":"https://doi.org/10.1186/s12871-024-02848-4","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to explore whether continuous infusion causing lubrication can effectively alleviate pain during male urethral catheterization.</p><p><strong>Methods: </strong>This prospective, multicenter, double-blinded study included 190 male patients scheduled for urethral catheterization. Patients were randomly allocated into four groups: Group A: the catheter was lubricated with paraffin; Group B: the catheter was lubricated with compound lidocaine gel; Group C: the pump continuously infusing with sterilized water; Group D: the pump continuously infusing with 2% lidocaine. The primary outcome was the visual analogue scale (VAS) scores. Statistical analysis system (SAS) (version 9.4) was used to perform all the statistical analyses. Significance for all results was set at P < 0.05.</p><p><strong>Results: </strong>The VAS of Group D was the lowest (18.90 ± 11.44), followed by the Group C (33.00 ± 11.07), and the VAS of Group A was the highest (53.98 ± 14.76). There were significant differences in VAS in Group D compared to Group A(P < 0.0001), Group B(P < 0.0001) and Group C (P < 0.0001), Group C compared to Group A (P < 0.0001) and Group B(P < 0.0001), Group B compared to Group A (P < 0.0001), indicating that patients treated with lidocaine infusion (Group D) experienced significantly less pain than did those in the other three groups.</p><p><strong>Conclusions: </strong>Continuous infusion with sterilized water during catheterization is an efficient method for lubricating the urethral mucosa; furthermore, infusion with 2% lidocaine provides better analgesia as well as lubrication.</p><p><strong>Trial registration: </strong>The study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2300070866) ( https://www.chictr.org.cn/showproj.html?proj=194591 ) on Apr. 25th, 2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"457"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic assessment of gastric emptying in older adults after preoperative administration of 5% glucose solution: a randomized controlled study.","authors":"Yan Liu, Qian Yu, Run Wang, Linli Luo","doi":"10.1186/s12871-024-02847-5","DOIUrl":"https://doi.org/10.1186/s12871-024-02847-5","url":null,"abstract":"<p><strong>Background: </strong>Delayed gastric emptying of liquids may heighten the risk of aspiration reflux in elderly individuals. To investigate the gastric emptying of an oral supplement containing 5% dextrose solutions before sedation for gastroscopy.</p><p><strong>Patients and methods: </strong>A total of 100 elderly patients who were scheduled for elective gastroscopy were randomly assigned to two groups: the NPO(nil per os ) group and the dextrose solution ingestion group, which ingested a 5% dextrose solution (5 ml/kg) two hours before the procedure. The primary outcome measure was the gastric volume (GV) suctioned and measured during the gastroscopic examination. Secondary outcome measures included GV per weight (GV/kg), post-discharge blood glucose levels, patient discomfort assessed using the Visual Analog Scale (VAS), clarity of gastric mucosal visualization during gastroscopy, and the incidence of adverse events. Additionally, linear regression analysis was employed to identify factors influencing gastric volume.</p><p><strong>Results: </strong>There were no significant differences in gastric volume (GV) (P=0.258) and GV per weight (GV/W) (P=0.137) between the NPO group and the dextrose solution group. However,the NPO group had higher discomfort scores on the Visual Analog Scale compared to the dextrose solution group, with a statistically significant difference(P<0.001). The clarity of gastric mucosal visualization during gastroscopy was also significantly different between the two groups(P=0.038). Blood glucose levels and the incidence of adverse events showed no significant differences between the two groups.Multivariate linear regression analysis revealed that younger age and higher functional dyspepsia symptom diary (FDSD) scores were associated with larger gastric volume, with the regression equation being: GV = 79.922 - 1.186 <math><mo>×</mo></math> age + 0.556 <math><mo>×</mo></math> FDSD.</p><p><strong>Conclusion: </strong>In elderly patients, drinking 5 ml/kg of a 5 % glucose solution two hours prior to gastroscopy does not significantly increase gastric volume compared to midnight fasting.</p><p><strong>Trial registration: </strong>ChiCTR2100047031 (date of registration: 7 June 2021).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"458"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An explainable and supervised machine learning model for prediction of red blood cell transfusion in patients during hip fracture surgery.","authors":"Yongchang Zhou, Suo Wang, Zhikun Wu, Weixing Chen, Dong Yang, Chaojin Chen, Gaofeng Zhao, Qingxiong Hong","doi":"10.1186/s12871-024-02832-y","DOIUrl":"https://doi.org/10.1186/s12871-024-02832-y","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to develop a predictive model with machine learning (ML) algorithm, to predict and manage the need for red blood cell (RBC) transfusion during hip fracture surgery.</p><p><strong>Methods: </strong>Data of 2785 cases that underwent hip fracture surgery from April 2016 to May 2022 were collected, covering demographics, medical history and comorbidities, type of surgery and preoperative laboratory results. The primary outcome was the intraoperative RBC transfusion. The predicting performance of six algorithms were respectively evaluated with the area under the receiver operating characteristic (AUROC). The SHapley Additive exPlanations (SHAP) package was applied to interpret the Random Forest (RF) model. Data from 122 patients at The Third Affiliated Hospital of Sun Yat-sen University were collected for external validation.</p><p><strong>Results: </strong>1417 patients (50.88%) were diagnosed with preoperative anemia (POA) and 209 patients (7.5%) received intraoperative RBC transfusion. Longer estimated duration of surgery, POA, older age, hypoproteinemia, and surgery of internal fixation were revealed as the top 5 important variables contributing to intraoperative RBC transfusion. Among the six ML models, the RF model performed the best, which achieved the highest AUC (0.887, CI 0.838 to 0.926) in the internal validation set. Further, it achieved a comparable AUC of 0.834(0.75, 0.911) in the external validation set.</p><p><strong>Conclusion: </strong>Our study firstly demonstrated that the RF model with 10 common variables might predict intraoperative RBC transfusion in hip fracture patients.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"467"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected pheochromocytoma leading to cardiac arrest during the perioperative period: a case report and literature review.","authors":"Jian Guo, Yuting Qiu, Xiaojin Zhang, Yitao Qian, Jianhong Xu","doi":"10.1186/s12871-024-02850-w","DOIUrl":"https://doi.org/10.1186/s12871-024-02850-w","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytomas (PCCs) are rare neuroendocrine catecholamine (CA)-secreting tumours that originate from chromaffin tissue and can produce and store CAs. Unexpected PCCs pose a serious threat to the perioperative safety of patients and a considerable challenge to anaesthesiologists because of the risks of fatal hypertensive crises and other stresses.</p><p><strong>Case presentation: </strong>A 37-year-old woman who was scheduled for tonsillectomy and palatopharyngoplasty under general anaesthesia experienced a malignant cardiovascular event after induction, which was characterized mainly by a sharp increase in heart rate and blood pressure, ultimately leading to cardiac arrest and the occurrence of secondary long QT syndrome. Based on the perioperative clinical manifestations, measurements of plasma and urinary CAs, postoperative bilateral adrenal computed tomography results and surgical pathological results, the patient was diagnosed with an undiagnosed PCC.</p><p><strong>Conclusions: </strong>Anaesthesiologists should pay attention to patients with recurrent chest tightness, as these patients may have an undiagnosed PCC. Extreme hypertension and tachycardia during the perioperative period may indicate a PCC. We should not automatically use beta-adrenergic receptor blockade while overlooking the importance of alpha-adrenergic receptor blockade. If a serious malignant cardiovascular event occurs in patients with an undiagnosed PCC during the perioperative period, multidisciplinary comprehensive treatment is crucial.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"463"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative incidence of chronic pain after visiting a Dutch emergency department with acute pain.","authors":"S Mol, A V Brown, T M Kuijper, M G Bouwhuis, B de Groot, A J Out, M G Ibelings, J S H A Koopman","doi":"10.1186/s12871-024-02836-8","DOIUrl":"https://doi.org/10.1186/s12871-024-02836-8","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a substantial problem in modern healthcare resulting in health care overutilization. The cumulative incidence of developing chronic pain after visiting the emergency department with acute pain has been determined for specific patient groups only. If the cumulative incidence of chronic pain in emergency department patients with acute pain is high, more proactive measures are justified to limit development of chronic pain. The primary objective was to study the cumulative incidence of chronic pain in patients visiting Dutch emergency departments with acute pain. In addition, we compared the Health-Related Quality of Life (HRQOL) and pain related interference with work.</p><p><strong>Methods: </strong>In this prospective multicenter cohort study data was collected from adult patients visiting the emergency department with acute pain. Chronic pain was defined by means of a numeric rating scale (NRS) of ≥ 1 measured 90 days after the initial visit. HRQOL was measured with European Quality of Life (EQ-5D-5 L) and Short Form (SF-36) questionnaires.</p><p><strong>Results: </strong>1906 patients were included of which 825 had complete data. Of these, 559 patients (67.8%; 95%CI: 64.5 - 70.9%) scored an NRS ≥ 1 after 90 days. Incidence with completed analyses (with imputed data) was similar. Patients with chronic pain reported a significantly lower HRQOL; EQ-5D-5 L index (median 0.82 vs. 1.00) and significantly more pain related hindrance (median 1.00 vs. 0.00).</p><p><strong>Conclusions: </strong>67.8% of the responders scored NRS ≥ 1 90 days after ED-visit with acute pain. Regardless of the used definition, chronic pain is associated with a lower HRQOL and more pain related hindrance.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"460"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of zero-positive end-expiratory pressure on blood transfusion rates in off-pump coronary artery bypass surgery: a retrospective cohort study.","authors":"Kentaroh Tarao, Kyongsuk Son, Yusei Ishizuka, Atsushi Nakagomi, Maiko Hasegawa-Moriyama","doi":"10.1186/s12871-024-02853-7","DOIUrl":"https://doi.org/10.1186/s12871-024-02853-7","url":null,"abstract":"<p><strong>Background: </strong>Bleeding are common in cardiac surgery, with significant impacts on transfusion-related complications and patient prognosis. This study aimed to determine the differences in perioperative blood loss, transfusion rates, and the incidence of postoperative pulmonary complications (PPCs) with and without the use of positive end-expiratory pressure (PEEP) in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB).</p><p><strong>Methods: </strong>This single-center, retrospective study included 106 adult patients undergoing coronary artery bypass surgery without cardiopulmonary bypass from January 2018 to March 2022. The patients were divided into two groups based on intraoperative ventilator settings: the zero-PEEP (ZEEP) group and the PEEP group. The primary outcome was the perioperative transfusion rate from the intraoperative period to postoperative 7 day. The incidence of PPCs was recorded for 1 week post-operatively. Logistic regression analysis was performed for statistical analysis.</p><p><strong>Results: </strong>The average PEEP in the PEEP group was 4.92 ± 0.42 cmH₂O. Multiple regression analysis indicated that lower mean airway pressure during surgery tend to associate with intraoperative lower blood loss. The intraoperative transfusion rates in the ZEEP group were significantly lower than those in the PEEP group (ZEEP:14%, PEEP 38.4%, P = 0.02). Logistic regression analysis revealed that ZEEP (adjusted odds ratio [OR] 0.13, 95% confidence interval [CI] 0.04-0.78) and Society of Thoracic Surgeons(STS) scores (adjusted OR 2.31, 95% CI 1.53-3.49) were significantly associated with a reduced requirement for perioperative transfusions. No significant difference was observed between the two groups in terms of PPCs (p = 0.824). Atelectasis was the most common complication in both groups (ZEEP: 35.7%, PEEP: 40%, P = 0.832).</p><p><strong>Conclusions: </strong>ZEEP and STS scores were associated with significantly reduced requirement for perioperative transfusion rates during elective OPCAB surgery. However, ZEEP did not significantly affect the incidence of PPCs.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"461"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}