BMC Anesthesiology最新文献

{"title":"Transesophageal echocardiogram contributes to high-quality cardiopulmonary resuscitation: a case report.","authors":"Qiong Wang, Bin Lu","doi":"10.1186/s12871-025-03021-1","DOIUrl":"10.1186/s12871-025-03021-1","url":null,"abstract":"<p><strong>Background: </strong>Difficulties to identify the cause of cardiac arrest in a short period of time lead to prolonging the time for cardiopulmonary resuscitation (CPR) and to poor survival. Transesophageal echocardiogram (TEE) can assist CPR of long duration and improve outcome.</p><p><strong>Case presentation: </strong>In this case report, a 50-year-old man was scheduled to undergo a endoscopic cervical discectomy under general anesthesia. The patient suffered a sudden cardiac arrest during the operation, and a high-quality CPR was performed with the the help of TEE. Although the exact etiology of cardiac arrest remained unclear and the CPR was performed for up to 90 min, the patient returned to spontaneous circulation, and was discharged after a month of treatment and rehabilitation, resuming his daily activities. After a one year of follow-up, he still was without any sequelae.</p><p><strong>Conclusions: </strong>Perioperative cardiac arrest is unpredictable and catastrophic, so high-quality CPR is essential. TEE's excellent features make it ideal for use on resuscitation and can improve the outcome of cardiac arrest.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"143"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid peak flow velocity variation as a surrogate of aortic peak flow velocity variation in a pediatric population.","authors":"Federico Cristiani, Juan Pablo Bouchacourt, Juan Riva, Pablo Motta","doi":"10.1186/s12871-025-03010-4","DOIUrl":"10.1186/s12871-025-03010-4","url":null,"abstract":"<p><strong>Background: </strong>Carotid peak velocity variation (ΔVpeak_Car) is an alternative to aortic peak velocity variation (ΔVpeak_Ao) and has been used in the pediatric population. Children's physiology and anatomy are heterogeneous throughout their growth. For this reason, the predictive value of ΔVpeakCar as a surrogate of ΔVpeakAo can vary at different ages. We hypothesize that the ability of ΔVpeak_Car as a surrogate of ΔVpeak_Ao changes throughout childhood.</p><p><strong>Aim: </strong>Analyze the concordance and the tracking ability of ΔVpeak_Car and the ΔVpeak_Ao at different stages of development.</p><p><strong>Methods: </strong>Patients from 0 to 12 years were included. Three groups were defined: under 12 months (G1), between 12 and 60 months (G2), and over 60 months (G3). After anesthesia induction and mechanical ventilation, maximal and minimal aortic and carotid peak flow were measured. ΔVpeak_Ao and ΔVpeak_Car were calculated. Pearson test and simple linear regression were performed. Bland-Altman analysis was performed to determine concordance. 4-quadrant analysis was used, followed by polar analysis of the vectors, to complement the concordance analysis and determine the tracking ability of ΔVpeak_Car to surrogate ΔVpeak_Ao.</p><p><strong>Results: </strong>Sixty-seven patients were enrolled. 22 (32.4%) patients in G1, 21 (31.3%) in G2 and 24 (35.8%) in G3. The determination coefficient (r) between ΔVpeak_Ao and ΔVpeak_Car in G1 was 0.44 (p < 0.001) with a slope value of 0.61 (SE = 0.11; 95% CI:0.3-0.91). In G2, r² = 0.56 (p < 0.001) with a slope value of 0.59 (SE = 0.14; 95% CI:0.35-0.82); and in G3, r² = 0.85 (p < 0.001) with a slope value of 1.11 (SE = 0.10; 95% CI:0.91-1.31). Bland-Altman analysis showed to G1 a mean bias of -0.37 (LOA - 7.87 to 7.53), to G2 -0.07 (LOA - 7.37 to 7.23) and G3 0.55 (-3.81 to 4.91). Concordance rates were 100% in G3, 95% in G2, and 93% in G1.</p><p><strong>Conclusions: </strong>ΔVpeak_Car showed good correlation and tracking ability with ΔVpeak_Ao in schoolchildren. In younger children, it was not reliable enough.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"140"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of adding dexmedetomidine as adjuvant with bupivacaine in ultrasound-guided intermediate cervical plexus block for thyroidectomy surgery: randomized controlled study.","authors":"Mamdouh Mahmoud Mostafa, Reham M Gamal, Aya M Ahmed Baiomy, Mohamed Elsayed Hassan, Jehan Mohamed Kamal, Thabet Ts, Tamer A Kotb, Mai M Elrawas","doi":"10.1186/s12871-025-02990-7","DOIUrl":"10.1186/s12871-025-02990-7","url":null,"abstract":"<p><strong>Background: </strong>One important aspect of a successful thyroidectomy recovery is the level of pain postoperatively. This research aimed to determine the effectiveness of an ultrasound-guided intermediate cervical plexus block (CPB) for thyroidectomy with dexmedetomidine added as an adjuvant to bupivacaine. The primary outcome was the duration of analgesia defined as the time till the first request for rescue analgesia. The secondary outcomes were the total amount of fentanyl consumed intraoperatively, total patient's opioids requirements within 24 h postoperative, VAS, and complications.</p><p><strong>Methods: </strong>This randomized controlled double-blinded study included 60 patients aged 18 to 60 years, all of whom underwent thyroidectomy for thyroid cancer. Patients were randomly allocated into two equal groups, the B Group (n = 30) received bilateral intermediate CPB, with 20 ml bupivacaine 0.25%, and the DB Group (n = 30) received bilateral intermediate CPB with 20 ml of bupivacaine 0.25% plus 1 µg/kg dexmedetomidine.</p><p><strong>Results: </strong>The DB Group showed a significantly longer duration of analgesia (p < 0.001), significantly less total intraoperative fentanyl consumption (p = 0.005), and significantly less total postoperative morphine consumption (p < 0.001). Also, postoperative pain scores, heart rate, and mean arterial pressure were significantly lower in the DB group than in the B Group and sometimes points.</p><p><strong>Conclusions: </strong>The addition of dexmedetomidine to bupivacaine in ultrasound-guided intermediate CPB for thyroidectomy significantly prolonged analgesia and reduced postoperative opioid consumption.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"139"},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effect of caudal epidural block on optic nerve sheath diameter in pediatric patients: randomized controlled study.","authors":"Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Erkan Cem Celik, Mirac Selcen Ozkal Yalin, Binali Firinci, Irem Ates, Muhammed Enes Aydin, Ali Ahiskalioglu","doi":"10.1186/s12871-025-03007-z","DOIUrl":"10.1186/s12871-025-03007-z","url":null,"abstract":"<p><strong>Introduction: </strong>Caudal epidural block is a widely performed procedure for postoperative pain control of pediatric patients. As the local anesthetic acts by spreading cranially after caudal block, it may lead to several effects on the cerebrospinal fluid and intracranial region.</p><p><strong>Method: </strong>Children aged 1-7, ASA I-II were included in this study. The patient population was assigned into two groups as the Caudal Block Group (Group CB) and the Control Group (Group C) Caudal block with 0.25% bupivacaine 1 ml/kg was performed on patients in Group CB. Optic nerve sheath diameter was measured at the following timeline: T₀: Following laryngeal mask placement, T₁: Following caudal block. T₁₅:15. min, T₃₀:30. min. Heart rate, non-invasive blood pressure, SpO₂ and PCO₂ values were also recorded at every time point.</p><p><strong>Results: </strong>There was no significant difference between two groups considering demographic data, intraoperative hemodynamic parameters, intraoperative SpO₂ and PCO₂ values. While optic nerve sheath diameter findings were not significantly different between the groups at T0 and T1 points(P > 0.05), the measurements at T15(4.18 ± 0.56 for Group C and 4.62 ± 0.47 for Group CB, P = 0.006) and T30(4.20 ± 0.53 for Group C and 4.76 ± 0.52 for Group CB) were statistically higher in the Caudal Group.</p><p><strong>Conclusion: </strong>Evaluation of optic nerve sheath diameter has high diagnostic precision for detecting increased intracranial pressure in children. The findings in this study display that local anesthetic applied for caudal block in pediatric surgeries spread cranially resulting in an increase in the intracranial pressure and optic nerve sheath diameter. However, this increase does not cause intraoperative hemodynamic changes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"138"},"PeriodicalIF":2.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dexamethasone vs. placebo modulation of the perioperative blood immune proteome in patients undergoing total knee arthroplasty.","authors":"Asger K Mølgaard, Kasper S Gasbjerg, Ole Mathiesen, Daniel Hägi-Pedersen, Ismail Gögenur","doi":"10.1186/s12871-025-03003-3","DOIUrl":"10.1186/s12871-025-03003-3","url":null,"abstract":"<p><strong>Background: </strong>Pre- and post-operative immune status has gained interest in recent years, as it has been shown to be related to postoperative complications and recovery. The change in immune status has also been known to constitute a large part of the surgical stress response, and it has been speculated that immunomodulatory treatment by glucocorticoids may impact it. Profiling of the impact of specific surgeries and medications on immune status are therefore needed.</p><p><strong>Methods: </strong>We characterized the postoperative blood immune proteome in 83 patients receiving either placebo (n = 20) or IV 24 mg dexamethasone (n = 60) preoperative before total knee arthroplasty (TKA). The primary outcome was the effect of dexamethasone on total knee arthroplasty surgical stress by comparing postoperative immune proteome in the dexamethasone group and the placebo group. Secondary outcomes were the surgical stress by total knee arthroplasty by comparing pre- to postoperative immune proteome in the placebo group, and the combined effect of surgical stress and dexamethasone by comparing pre- to postoperative immune proteome in the dexamethasone group. Characterization was performed with the Olink Explorer Inflammation panel on blood samples from the biobank for future research collected during the randomized, clinical DEX-2-TKA Trial. Protein change was reported as log2-fold-change and p-values were corrected a.m. Benjamini-Hochberg.</p><p><strong>Results: </strong>The surgical stress (placebo) was characterized by a 4.7 log2-fold-change of IL6 (adjusted p-value < 0.01) and up-regulation of central immune signaling pathways and bone marrow mobilization. The combined effect of surgery and dexamethasone showed a less pro-inflammatory profile: IL6 2.5 log2-fold-change (adjusted p-value < 0.01), with decreased signaling for osteoclast activity and innate, immune cell reaction. The effect of dexamethasone showed upregulation of CSF3 (1.55 log2-fold-change, adjusted p-value < 0.01) and an inhibitory effect on both innate and adaptive immune response, immune cell reactivity and formation of extracellular matrix.</p><p><strong>Conclusions: </strong>Preoperative dexamethasone indicated anti-inflammatory properties on both innate and adaptive immune response, while surgery was pro-inflammatory. the combination of total knee arthroplasty and dexamethasone inhibited pathways for osteoclast-activity, indicating possible implications on aseptic prosthesis loosening. Dexamethasone showed strong modulation of the surgical stress response following total knee arthroplasty and future studies must explore the clinical associations of these findings.</p><p><strong>Trial registration: </strong>NCT03506789.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"136"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of lung ultrasound for locating bronchial blockers in pediatric thoracic surgery: a retrospective analysis.","authors":"Weiwei Cai, Yuting Song, Wei Gu, Huanhuan Ni, Huiying Shao, Hongqiang Huang","doi":"10.1186/s12871-025-03006-0","DOIUrl":"10.1186/s12871-025-03006-0","url":null,"abstract":"<p><strong>Objective: </strong>To identify the feasibility of using lung ultrasound to determine the position of bronchial blockers in pediatric patients.</p><p><strong>Methods: </strong>In this study, children aged 4-8 years who underwent elective right one-lung ventilation at our hospital between January 2019 and August 2022 were selected. We collected the results of lung ultrasound and fiberoptic bronchoscopy during the placement of bronchial blockers in these children. The accuracy, sensitivity, and specificity of lung ultrasound in determining the position of bronchial blockers were calculated. Additionally, the reproducibility of lung ultrasound in determining the appropriateness of bronchial blockers was also calculated. Furthermore, information regarding whether there were complications associated with lung ultrasound examination or fiberoptic bronchoscopy was also collected.</p><p><strong>Results: </strong>The accuracy of lung ultrasound for determining the position of bronchial blockers was 95.0%. When the position of BBs was appropriate, the sensitivity of lung ultrasound was 96.3% and the specificity was 88.9%. When the position of BBs was too shallow, the sensitivity of lung ultrasound was 75% and the specificity was 96.7%. The reproducibility test of lung ultrasound for determining the position of bronchial blockers had a weighted kappa value of 0.91, P < 0.001. In this study we found 6 children had hypoxemia and 6 children had airway mucosal bleeding during fiberoptic bronchoscopy. And no complications linked to lung ultrasound examination were observed.</p><p><strong>Conclusion: </strong>Lung ultrasound has high accuracy, sensitivity, specificity, and repeatability in determining the position of bronchial blockers. It is a new and safe method to determine the position of bronchial blockers.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"137"},"PeriodicalIF":2.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of lidocaine via trachospray in postoperative sore throat and hemodynamic response to intubation: a randomized controlled trial.","authors":"Kübra Taşkın, Fatih Doğu Geyik, Gülten Arslan, Özlem Sezen, Banu Çevik","doi":"10.1186/s12871-025-03004-2","DOIUrl":"10.1186/s12871-025-03004-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative sore throat (POST) is a common complication following endotracheal intubation after general anesthesia. This study aimed to examine the effect of administering lidocaine via the Trachospray device on POST severity and to assess its impact on hemodynamic responses (heart rate and blood pressure) during tracheal intubation.</p><p><strong>Methods: </strong>In a double-blind, randomized controlled trial was conducted, approved by the local ethics committee and registered on ClinicalTrials.gov. 100 patients aged 18-65 undergoing elective laparoscopic cholecystectomy and classified as ASA I-III were randomly divided into two groups. Group T received 10% lidocaine through Trachospray before intubation, while Group S was given distilled water. POST severity was evaluated at 2, 6, 12, and 24 h postoperatively. POST was evaluated on a 4-point scale, with scores of 0 (none) to 3 (severe).</p><p><strong>Results: </strong>Group T showed significantly lower POST severity and incidence at all time points compared to Group S (p = 0.001; p < 0.05). Additionally, hemodynamic responses (heart rate and blood pressure) were significantly lower in Group T following intubation (heart rate, p = 0.015; systolic blood pressure, p = 0.006; diastolic blood pressure, p = 0.010).</p><p><strong>Conclusion: </strong>The use of 10% lidocaine via Trachospray before endotracheal intubation effectively decreases POST severity and incidence as well as the hemodynamic response to intubation, highlighting its potential to improve patient outcomes in the postoperative period.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"133"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting postoperative nausea and vomiting using machine learning: a model development and validation study.","authors":"Maxim Glebov, Teddy Lazebnik, Maksim Katsin, Boris Orkin, Haim Berkenstadt, Svetlana Bunimovich-Mendrazitsky","doi":"10.1186/s12871-025-02987-2","DOIUrl":"10.1186/s12871-025-02987-2","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) is a frequently observed complication in patients undergoing surgery under general anesthesia. Moreover, it is a frequent cause of distress and dissatisfaction in the early postoperative period. Currently, the classical scores used for predicting PONV have not yielded satisfactory results. Therefore, prognostic models for the prediction of early and delayed PONV were developed in this study to achieve satisfactory predictive performance.</p><p><strong>Methods: </strong>The retrospective data of inpatient adult patients admitted to the post-anesthesia care unit after undergoing surgical procedures under general anesthesia at the Sheba Medical Center, Israel, between September 1, 2018, and September 1, 2023, were used in this study. An ensemble model of machine-learning algorithms trained on the data of 35,003 patients was developed. The k-fold cross-validation method was used followed by splitting the data to train and test sets that optimally preserve the sociodemographic features of the patients.</p><p><strong>Results: </strong>Among the 35,003 patients, early and delayed PONV were observed in 1,340 (3.82%) and 6,582 (18.80%) patients, respectively. The proposed PONV prediction models correctly predicted early and delayed PONV in 83.6% and 74.8% of cases, respectively, outperforming the second-best PONV prediction score (Koivuranta score) by 13.0% and 10.4%, respectively. Feature importance analysis revealed that the performance of the proposed prediction tools aligned with previous clinical knowledge, indicating their utility.</p><p><strong>Conclusions: </strong>The machine learning-based models developed in this study enabled improved PONV prediction, thereby facilitating personalized care and improved patient outcomes.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"135"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia for bronchoscopy interventional therapy in a patient with Gorham-Stout disease, lung cancer, and right lung atelectasis: a case report.","authors":"Yuxue Yao, Hong Li, Qinghao Cheng, Mingyuan Yang","doi":"10.1186/s12871-025-03001-5","DOIUrl":"10.1186/s12871-025-03001-5","url":null,"abstract":"<p><strong>Background: </strong>Gorham-Stout disease (GSD) is an extremely rare disease of unknown etiology, characterized by painless and progressive bone resorption that may affect multiple bones throughout the body. GSD primarily involves the maxillofacial region, leading to facial disfigurement and reduced joint stability, thereby increasing the risk of challenging tracheal intubation. Limited cases have been reported on the co-occurrence of GSD in the maxillofacial region with lung cancer and right lung atelectasis, particularly regarding anesthesia management for bronchoscopy interventional therapy in such patients.</p><p><strong>Case presentation: </strong>This report presents a successful case of a patient with maxillary GSD and right lung atelectasis secondary to lung cancer who underwent bronchoscopy interventional therapy under general anesthesia. The perioperative course was uneventful, with no complications observed.</p><p><strong>Conclusion: </strong>Anesthesia management is critical in the surgical treatment of patients with GSD. Airway management poses unique challenges, necessitating thorough preoperative evaluation and implementation of strategies to address potential intubation difficulties. Additionally, vigilance for intraoperative complications is essential.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"132"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory and limb muscles' ability to repeatedly generate maximal isometric strength in patients with intensive care unit-acquired weakness: an observational study.","authors":"Margaux Machefert, Guillaume Prieur, Solène Aubry, Yann Combret, Clément Medrinal","doi":"10.1186/s12871-025-03008-y","DOIUrl":"10.1186/s12871-025-03008-y","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit-acquired weakness (ICU-Aw) is a prevalent complication in critically ill patients, affecting both limb and respiratory muscles, individually or concurrently. The precise mechanisms by which muscle weakness influences the distinct functional roles of each muscle group remain to be fully elucidated. The objective of this study was to compare the time course evolution of inspiratory and quadriceps muscles strength during repeated maximal isometric contractions in patients with limb muscles and inspiratory muscles weakness.</p><p><strong>Methods: </strong>A single-center, observational study was conducted in critically ill patients after extubation, presenting with both inspiratory and limb muscle weakness (defined as maximal inspiratory pressure (Pi_max) < 30 cmH₂O and an MRC score < 48). The patients' ability to sustain maximal voluntary effort was measured using electronic manometers and dynamometers, with repeated efforts performed 10 times. Following each measurement, a 10-second rest period was observed, and strength measurements were repeated to evaluate recovery.</p><p><strong>Results: </strong>A total of 20 patients (90% male, mean age 61 ± 10 years, SAPS II score 28 ± 17) were included. The mean first maximal inspiratory pressure was 32.6 ± 17 cmH₂O, and the mean first quadriceps maximal force was 135 ± 90 Newtons (N). Investigation revealed a decline in quadriceps muscle force of -15.45 ± 28.61 N (95% CI: -28.84 to -2.05) while inspiratory muscles demonstrated stability (mean difference: 1.75 ± 7.57 cmH₂O (95% CI: -1.80 to 5.30)). A statistically significant interaction between time and muscle group was identified (p = 0.0017), suggesting a different time course evolution of maximal voluntary strength between muscle groups. After a one-minute recovery, significant improvement in quadriceps strength was observed (p = 0.009), while no statistically significant change was detected in inspiratory muscle strength (p = 0.16).</p><p><strong>Conclusions: </strong>The results of this study indicate potential disparities in the maximum force maintenance capacity between the quadriceps muscles and inspiratory muscles in patients with ICU-acquired weakness.</p><p><strong>Trial registration: </strong>Registered on ClinicalTrials.gov Identifier NCT05396066.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"134"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}