BMC Anesthesiology最新文献

{"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}

{"title":"Overtime work of anesthesiologists is associated with increased delirium in older patients admitted to intensive care unit after noncardiac surgery: a secondary analysis.","authors":"Yi Zhao, Na-Ping Chen, Xian Su, Jia-Hui Ma, Dong-Xin Wang","doi":"10.1186/s12871-024-02825-x","DOIUrl":"https://doi.org/10.1186/s12871-024-02825-x","url":null,"abstract":"<p><strong>Background: </strong>Overtime work is common in anesthesiologists due to shortage of manpower. Herein, we analyzed if overtime work of anesthesiologists was associated with delirium development in older patients after surgery.</p><p><strong>Methods: </strong>This was a secondary analysis of the database from a randomized trial. Seven hundred older patients (aged ≥ 65 years) who were admitted to the intensive care unit (ICU) after elective noncardiac surgery were enrolled in the underlying trial. Anesthesiologists who worked continuously for more than 8 h by the end of the surgery were marked as \"work overtime\". Delirium was assessed with the Confusion Assessment Method for the ICU twice daily during the first 7 postoperative days. The association between overtime work of anesthesiologists and development of postoperative delirium was analyzed with multivariable logistic regression models.</p><p><strong>Results: </strong>All 700 patients (mean age 74.3 years, 39.6% female) were included in this analysis. Anesthesiologists of 281 patients (40.1%) were marked as \"work overtime\" at the end of surgery. When compared with patients whose anesthesiologists didn't work overtime, patients whose anesthesiologist worked overtime had a higher incidence of delirium within 7 days (20.3% [57/281] vs. 12.9% [54/419], P = 0.009). After correction for confounding factors, both overtime work (OR 1.87, 95% CI 1.19-2.94, P = 0.007) and prolonged continuous working hours of anesthesiologists (OR 1.08, 95% CI 1.01-1.15, P = 0.020) were associated with an increased risk of postoperative delirium.</p><p><strong>Conclusions: </strong>Overtime work of anesthesiologists was associated with an increased risk of delirium development in older patients admitted to ICU after major noncardiac surgery.</p><p><strong>Trial registration: </strong>The underlying trial was registered with Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=8734 ; ChiCTR-TRC-10000802; March 18, 2010).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"465"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863401","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":"Cryospray reduces pain during venous cannulation in elective surgery patients: a randomized placebo-controlled study.","authors":"Jakob Bjørbaek Pedersen, Anna Martensen, Pia Funder, Skule Arnesen Bakke, Rajesh Prabhakar Bhavsar, Thomas Strøm","doi":"10.1186/s12871-024-02858-2","DOIUrl":"https://doi.org/10.1186/s12871-024-02858-2","url":null,"abstract":"<p><strong>Background: </strong>Venous cannulation is widely used in healthcare systems, and for many patients, it is painful and distressing. We hypothesized that the rapid onset of cryospray use would reduce pain from venous cannulation compared to the use of a placebo spray.</p><p><strong>Methods: </strong>The trial was a prospective randomized placebo-controlled trial including 130 adult patients scheduled for elective surgery. Patients were randomized to receive either cryospray or placebo before venous cannulation. The primary outcome was patient-reported pain from vein puncture.</p><p><strong>Results: </strong>There were no differences in the baseline variables between the two groups with respect to age, sex, height, weight or ASA class. Patients in the cryospray group indicated more pain or discomfort with the application of the spray (0 (0-2.5)) than with the application of the placebo spray (0 (0-0)) (P < 0.005), as measured by the Numeric Rating Scale (NRS). Patients in the placebo group reported more pain with vein puncture than did those in the cryospray group (1 (0-3) vs. 3 [2-5], P < 0.005). When asked if the patient would have the same spray in case of canulation again, 57 patients from the cryospray group reported yes compared to 34 patients in the control group (P < 0.005).</p><p><strong>Conclusions: </strong>This randomized study found that cryospray significantly reduced pain during venous cannulation without increasing procedure difficulty. Patients reported lower pain scores and a greater preference for cryospray in future procedures, supporting its use as an effective pain relief method in elective surgery.</p><p><strong>Trial registration: </strong>ClinicalTrials. gov Identifier: NCT04865783 (28-04-2021).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"466"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863398","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 median effective dose of ciprofol combined with sufentanil in suppressing the laryngeal mask airway insertion response in both young and older adult patients.","authors":"Xuelei Zhou, Li Zhao, Wei Mao, Linlin Chen, Xianchun Liu, Linji Li","doi":"10.1186/s12871-024-02855-5","DOIUrl":"https://doi.org/10.1186/s12871-024-02855-5","url":null,"abstract":"<p><strong>Background: </strong>Ciprofol, a novel intravenous anesthetic, exhibits similar sedation mechanisms and pharmacokinetic properties to propofol. However, ciprofol demonstrates greater potency and is associated with reduced injection pain compared to propofol. Given the varying sensitivities to anesthetic agents across different age groups, this study aims to determine the median effective dose (ED₅₀) of ciprofol required to suppress the laryngeal mask airway (LMA) insertion response in both young and older adult patients, as well as to assess its potential adverse reactions.</p><p><strong>Methods: </strong>In this study, 46 patients scheduled for surgery under general anesthesia with LMA insertion were recruited. Upon entering the operating room, patients were intravenously administered ciprofol (0.4 mg·kg^- 1) and sufentanil (0.3 µg·kg^- 1), followed by LMA insertion after three minutes. To derive robust confidence intervals for both ED₅₀ and ED₉₅, we performed an analysis using a logistic regression model combined with bootstrap resampling.</p><p><strong>Results: </strong>In the young adult group, the ED₅₀ and ED₉₅ of ciprofol for suppressing the LMA insertion response were 0.38 mg·kg^- 1 (95% CI, 0.35-0.41) and 0.46 mg·kg^- 1 (95%CI, 0.40-0.56), respectively. In the older adult group, the respective ED₅₀ and ED₉₅ were 0.29 mg·kg^- 1 (95% CI, 0.26-0.32) and 0.37 mg·kg^- 1 (95% CI, 0.30-0.78). Regarding adverse reactions, although there were differences in the incidence of injection pain, hypotension, and bradycardia between the young and older groups, no statistically significant differences were observed between the two groups.</p><p><strong>Conclusion: </strong>In this study, significant differences were observed in the ED₅₀ of ciprofol for suppressing the LMA insertion response between young and older adult patients. The ED₅₀ of ciprofol for young adult patients was 0.38 mg·kg^- 1 (95% CI, 0.35-0.41), while for older adult patients it was0.29 mg·kg^- 1 (95% CI, 0.26-0.32).</p><p><strong>Trial registration: </strong>This study was registered on February 17, 2024, with the China Clinical Trial Registration Center ( www.chictr.org.cn ; Registration Number: ChiCTR2400080891).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"464"},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863386","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":"Ramelteon exposure and survival of critically Ill sepsis patients: a retrospective study from MIMIC-IV.","authors":"Yun-Yang Han, Yu Tian, Bing-Cheng Zhao, Ke-Xuan Liu","doi":"10.1186/s12871-024-02851-9","DOIUrl":"https://doi.org/10.1186/s12871-024-02851-9","url":null,"abstract":"<p><strong>Background: </strong>The effect of ramelteon, a melatonin receptor agonist, on survival in septic patients remains unknown. The purpose of this retrospective cohort study was to explore the relationship between ramelteon exposure and survival outcomes in septic patients.</p><p><strong>Methods: </strong>Data from septic patients admitted to the intensive care unit (ICU) were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, with patients categorized into ramelteon exposure and non-exposure groups based on the use of ramelteon. The primary outcome was 30-day mortality, and secondary outcomes included 90-day mortality, in-hospital mortality, length of ICU stay, and hospital stay. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were employed to address confounding variables. Kaplan-Meier (K-M) analysis and Cox proportional hazards regression models for stepwise regression were utilized to assess the impact of ramelteon exposure on survival.</p><p><strong>Results: </strong>This study included 22,152 unexposed patients and 2,708 exposed patients, resulting in 2,607 matched pairs after PSM. Following PSM, ramelteon exposure was associated with significantly lower in-hospital mortality (11.6% vs.19.7%, p < 0.001), 30-day mortality (13.4% vs. 23.2%, p < 0.001), and 90-day mortality (22.1% vs. 30%, p < 0.001).K-M curves demonstrated a significant difference in 30-day and 90-day mortality between the two groups (P < 0.001), irrespective of PSM application. Both PSM (hazard ratio [HR] = 0.53, 95% confidence intervals [CIs] 0.47-0.61, p < 0.001) and IPTW models (HR = 0.59, 95% CI 0.50-0.70, p < 0.001) indicated a significant positive effect of ramelteon usage on 30-day mortality among septic patients compared to the non-exposure group.</p><p><strong>Conclusions: </strong>This exploratory, retrospective study suggests an association between ramelteon exposure and reduced 30-day and 90-day mortality in septic patients compared with the non-exposure group. Considering the limitations of the retrospective design and the potential for unmeasured confounding, well-designed prospective studies and randomized controlled trials will be needed to confirm these findings.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"454"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852874","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":"Unravelling intubation challenges: a machine learning approach incorporating multiple predictive parameters.","authors":"Parisa Sezari, Zeinab Kohzadi, Ali Dabbagh, Alireza Jafari, Saba Khoshtinatan, Kamran Mottaghi, Zahra Kohzadi, Shahabedin Rahmatizadeh","doi":"10.1186/s12871-024-02842-w","DOIUrl":"https://doi.org/10.1186/s12871-024-02842-w","url":null,"abstract":"<p><strong>Background: </strong>To protect patients during anesthesia, difficult airway management is a serious issue that needs to be carefully planned for and carried out. Machine learning prediction tools have recently become increasingly common in medicine, frequently surpassing more established techniques. This study aims to utilize machine learning techniques on predictive parameters for challenging airway management.</p><p><strong>Methods: </strong>This study was cross-sectional. The Shahid Beheshti University of Medical Sciences in Iran's Loghman Hakim and Shahid Labbafinezhad hospitals provided 622 records in total for analysis. Using the forest of trees approach and feature importance, important features were chosen. The Synthetic Minority Oversampling Technique (SMOTE) and repeated edited nearest neighbor under-sampling were used to balance the data. Using Python and 10-fold cross-validation, seven machine learning algorithms were assessed: Logistic Regression, Support Vector Machines (SVM), Random Forest (INFORMATION-GAIN and GINI-INDEX), Decision Tree, and K-Nearest Neighbors (KNN). Metrics like F-measure, AUC, Recall, Accuracy, Specificity, and Precision were used to evaluate the performance of the model.</p><p><strong>Results: </strong>Twenty-four important features were chosen from the original 32 features. The under-sampling strategy produced better results than SMOTE. Among the algorithms, KNN (Euclidean, Minkowski) had better performance than other algorithms. The highest values ​​for accuracy, precision, recall, F-measure, and AUC were obtained at 0.87, 0.88, 0.82, 0.85, and 0.87, respectively.</p><p><strong>Conclusion: </strong>Algorithms for machine learning provide insightful information for anticipating challenging airway management. By making it possible to forecast airway difficulties more accurately, these techniques can potentially improve clinical practice and patient outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"453"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852826","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 anesthesiologist's guide to critically assessing machine learning research: a narrative review.","authors":"Felipe Ocampo Osorio, Sergio Alzate-Ricaurte, Tomas Eduardo Mejia Vallecilla, Gustavo Adolfo Cruz-Suarez","doi":"10.1186/s12871-024-02840-y","DOIUrl":"https://doi.org/10.1186/s12871-024-02840-y","url":null,"abstract":"<p><p>Artificial Intelligence (AI), especially Machine Learning (ML), has developed systems capable of performing tasks that require human intelligence. In anesthesiology and other medical fields, AI applications can improve the precision and efficiency of daily clinical practice, and can also facilitate a personalized approach to patient care, which can lead to improved outcomes and quality of care. ML has been successfully applied in various settings of daily anesthesiology practice, such as predicting acute kidney injury, optimizing anesthetic doses, and managing postoperative nausea and vomiting. The critical evaluation of ML models in healthcare is crucial to assess their validity, safety, and clinical applicability. Evaluation metrics allow an objective statistical assessment of model performance. Tools such as Shapley Values (SHAP) help interpret how individual variables contribute to model predictions. Transparency in reporting is key in maintaining trust in these technologies and to ensure their use follows ethical principles, aiming to reduce safety concerns while also benefiting patients. Understanding evaluation metrics is essential, as they provide detailed information on model performance and their ability to discriminate between individual class rates. This article offers a comprehensive framework in assessing the validity, applicability, and limitations of models, guiding responsible and effective integration of ML technologies into clinical practice. A balance between innovation, patient safety and ethical considerations must be pursued.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"452"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852875","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}