Article
Anesthesiology
Xiaofan Huang, Xian Lu, Chunyan Guo, Shuchi Lin, Ying Zhang, Xiaohan Zhang, Erhong Cheng, Jindong Liu
Summary: There is a significant association between intraoperative hypotension and acute kidney injury after cardiac surgery, especially in high-risk patients.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)
Article
Anesthesiology
Tetsuya Shimada, Xuan Pu, Esra Kutlu Yalcin, Barak Cohen, Mauro Bravo, Edward J. Mascha, Daniel I. Sessler, Alparslan Turan
Summary: Postoperative hypotension, defined as the lowest postoperative mean arterial pressure < 80 mm Hg, is associated with acute kidney injury after noncardiac surgery. Further studies are needed to establish the causal relationship of this association.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Article
Nutrition & Dietetics
Ji-Hoon Sim, Ji-Yeon Bang, Sung-Hoon Kim, Sa-Jin Kang, Jun-Gol Song
Summary: Low preoperative PNI levels, especially in the Q1 group, were significantly associated with postoperative AKI and poor surgical outcomes such as hospital stay, postoperative ICU admission, and mortality.
Article
Health Care Sciences & Services
Ji Hoon Sim, In-Gu Jun, Young-Jin Moon, A. Rom Jeon, Sung-Hoon Kim, Bomi Kim, Jun-Gol Song
Summary: The study found that high preoperative PNI was significantly associated with a lower incidence of postoperative AKI and low mortality in HCC patients. These results suggest that the preoperative PNI might be a predictor of postoperative AKI and surgical prognosis in HCC patients undergoing open hepatectomy.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Urology & Nephrology
Dan-Dan Huang, Yuan-Yuan Li, Zhe Fan, Yong-Gui Wu
Summary: This meta-analysis involving 203,987 participants from 11 observational studies found that preoperative proteinuria is an independent risk factor for postoperative AKI. Further subgroup analysis revealed that preoperative proteinuria measured using dipsticks is also an independent risk factor for postoperative AKI.
Article
Medicine, General & Internal
Csaba Eke, Andras Szabo, Adam Nagy, Boglar Parkanyi, Miklos D. Kertai, Levente Fazekas, Attila Kovacs, Balint Lakatos, Istvan Hartyanszky, Janos Gal, Bela Merkely, Andrea Szekely
Summary: Hepatic venous flow patterns, particularly retrograde waves and their ratios, are strongly associated with postoperative acute kidney injury (AKI) after cardiac surgery, suggesting a predictive value in identifying patients at risk for AKI.
Article
Medical Laboratory Technology
Suwei Chen, Chenhan Zhang, Yongliang Zhong, Bing Tang, Qiang Xie, Rutao Guo, Zhiyu Qiao, Chengnan Li, Yipeng Ge, Junming Zhu
Summary: The study found a correlation between preoperative serum myoglobin concentrations and AKI after TAAD surgery, and high concentrations of serum myoglobin increased the risk of developing any-stage and severe AKI. This finding is significant for the prevention and treatment of AKI after TAAD surgery.
CLINICA CHIMICA ACTA
(2023)
Article
Health Care Sciences & Services
Kyoung-Sun Kim, Young-Jin Moon, Sung-Hoon Kim, Bomi Kim, In-Gu Jun, Hye-Mee Kwon, Jun-Gol Song, Gyu-Sam Hwang
Summary: The study found that the preoperative ATIII level is associated with postoperative AKI after LT, with a higher ATIII level correlating with a lower incidence of post-LT AKI. This suggests that preoperative ATIII may serve as a prognostic factor for predicting post-LT AKI.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Urology & Nephrology
Roy Mano, Amy L. Tin, Andrew W. Silagy, Samuel C. Haywood, Chun Huang, Nicole E. Benfante, Gregory W. Fischer, Andrew J. Vickers, Paul Russo, Jonathan A. Coleman, Patrick J. McCormick, Joshua S. Mincer, Abraham Ari Hakimi
Summary: After reviewing data from 3240 patients undergoing nephrectomy, it was found that intraoperative anaesthetic parameters have a minor impact on postoperative renal function, with limited clinical significance. Due to tight control of anaesthetic parameters during surgery, their effect on postoperative renal function is restricted under current practice.
Article
Urology & Nephrology
Dilshan Ariyarathna, Ajinkya Bhonsle, Joseph Nim, Colin K. L. Huang, Gabriella H. Wong, Nicholle Sim, Joy Hong, Kirrolos Nan, Andy K. H. Lim
Summary: Intraoperative hypotension is associated with postoperative acute kidney injury in elderly patients, with the use of vasopressors independently linked to AKI occurrence.
Article
Gastroenterology & Hepatology
Oskar Swartling, Marie Evans, Patrik Larsson, Stefan Gilg, Marcus Holmberg, Fredrik Klevebro, Ernesto Sparrelid, Poya Ghorbani
Summary: Background: Acute kidney injury (AKI) is known to increase morbidity and mortality after general surgery, but its association with pancreatoduodenectomy outcomes is unclear. This study aimed to investigate the relationship between AKI and postoperative complications and death after pancreatoduodenectomy. Methods: All patients aged 18 years or older who underwent pancreatoduodenectomy at a university hospital in Stockholm, Sweden, between 2008 and 2019 were included. AKI was graded using standardized criteria such as estimated glomerular filtration rate (eGFR) and urine volume measurements. Results: Of the 970 patients included, 137 (14.1%) developed postoperative AKI. Risk factors for AKI included lower preoperative eGFR, cardiovascular disease, and treatment with renin-angiotensin system inhibitors or diuretics. Patients with AKI had a higher risk of severe postoperative complications and death within 30 days or 90 days. Furthermore, patients with benign histology and AKI had increased 1-year mortality. Conclusions: Postoperative AKI after pancreatoduodenectomy is associated with significant complications and an increased risk of mortality. Monitoring serum creatinine levels and urine output in the immediate perioperative period may improve outcomes.
Article
Medicine, Research & Experimental
Zbigniew Putowski, Karolina Majewska, Karol Gruca, Aleksandra Zimnoch, Anna Szczepanska, Lukasz J. Krzych, Beata Jablonska, Slawomir Mrowiec
Summary: This 5-year retrospective study from Poland found that intraoperative hypotension (IOH) is associated with post-operative acute kidney injury (AKI) in patients undergoing pancreaticoduodenectomy (PD). The study included 303 patients and identified specific IOH thresholds, such as MAP <55 mmHg and maximal % drop from preinduction MAP, as predictors of AKI. Relative IOH thresholds were found to be better suited for AKI prediction compared to absolute IOH thresholds.
MEDICAL SCIENCE MONITOR
(2023)
Article
Anesthesiology
Lisa Verwijmeren, Madeleen Bosma, Lisette M. Vernooij, Esther M. Linde, Ineke M. Dijkstra, Edgar J. Daeter, Eric P. A. Van Dongen, Wilton A. Van Klei, Peter G. Noordzij
Summary: Preoperative cardiac, inflammatory, renal, and metabolic biomarkers are associated with CSA-AKI and may improve identification of patients at risk. The use of a biomarker panel may enhance the identification of patients with CSA-AKI compared to using only clinical risk factors.
ANESTHESIA AND ANALGESIA
(2021)
Article
Medicine, General & Internal
Linling He, Silin Liang, Yu Liang, Miaoxian Fang, Jiaxin Li, Jia Deng, Heng Fang, Ying Li, Xinyi Jiang, Chunbo Chen
Summary: Acute kidney injury (AKI) is a common and fatal complication after cardiac surgery. This study found that longer periods of hypotension after cardiac surgery are associated with an increased risk of AKI.
INTERNAL AND EMERGENCY MEDICINE
(2022)
Article
Surgery
Charles Katzman, Emily C. Harker, Rizwan Ahmed, Charles A. Keilin, Joceline V. Vu, David C. Cron, Vidhya Gunaseelan, Yen-Ling Lai, Chad M. Brummett, Michael J. Englesbe, Jennifer F. Waljee
Summary: The study showed that patients with nonchronic, periodic preoperative opioid use are more likely to have prolonged postoperative opioid use. Identifying opioid use before surgery presents a critical opportunity to optimize care after surgery.
Article
Anesthesiology
Bhiken Naik, Kai Kuck, Leif Saager, Sachin Kheterpal, Karen B. Domino, Karen L. Posner, Anik Sinha, Ami Stuart, Chad M. Brummett, Marcel E. Durieux, Michelle T. Vaughn, Nathan L. Pace
Summary: This study retrospectively evaluated the variation and influencing factors of intraoperative opioid administration from 2012 to 2016 in different institutions. The results showed a decrease in the use of opioids during surgery over time, with variations in dose among different genders and procedure types. Furthermore, there was substantial variability in opioid use between institutions even when adjusting for multiple variables.
ANESTHESIA AND ANALGESIA
(2022)
Article
Cardiac & Cardiovascular Systems
Robert E. Freundlich, Gen Li, Henry J. Domenico, Ryan P. Moore, Pratik P. Pandharipande, Daniel W. Byrne
Summary: Based on the analysis of a group of patients undergoing cardiac surgery, researchers developed a model to predict the risk of reintubation at the time of extubation. The model showed good discriminative capacity and can assist in improving decision-making and targeting interventions to decrease the risk of reintubation in high-risk patients.
ANNALS OF THORACIC SURGERY
(2022)
Article
Anesthesiology
J. Erlenwein, M. Maring, M. Emons, H. J. Gerbershagen, R. M. Waeschle, L. Saager, F. Petzke
Summary: Incidents in the context of acute pain management pose high risks for patients, often related to staff mistakes and lack of skills, due to time pressure, workload, and inadequate organization.
Article
Anesthesiology
Sharon C. Reale, Melissa E. Bauer, Thomas T. Klumpner, Michael F. Aziz, Kara G. Fields, Rachel Hurwitz, Manal Saad, Sachin Kheterpal, Brian T. Bateman
Summary: This study aimed to provide an updated estimate of the frequency of difficult and failed intubation in women undergoing general anesthesia for cesarean delivery. The results showed an overall risk of difficult intubation of 1:49 and a risk of failed intubation of 1:808 in over 14,000 cases. Most risk factors for difficult intubation were nonobstetric in nature.
Correction
Critical Care Medicine
Silvia Coppola, Davide Chiumello, Mattia Busana, Emanuele Giola, Paola Palermo, Tommaso Pozzi, Irene Steinberg, Stefano Roli, Federica Romitti, Stefano Lazzari, Simone Gattarello, Michela Palumbo, Peter Herrmann, Leif Saager, Michael Quintel, Konrad Meissner, Luigi Camporota, John J. Marini, Stefano Centanni, Luciano Gattinoni
INTENSIVE CARE MEDICINE
(2022)
Article
Critical Care Medicine
Sandra Rossi, Maria Michela Palumbo, Nicola Sverzellati, Mattia Busana, Laura Malchiodi, Paolo Bresciani, Patrizia Ceccarelli, Emanuele Sani, Federica Romitti, Matteo Bonifazi, Simone Gattarello, Irene Steinberg, Paola Palermo, Stefano Lazzari, Francesca Collino, Massimo Cressoni, Peter Herrmann, Leif Saager, Konrad Meissner, Michael Quintel, Luigi Camporota, John J. Marini, Luciano Gattinoni
Summary: This study aimed to investigate the mechanisms of oxygenation response to proning and recruitment maneuvers in patients with COVID-19 pneumonia. The findings indicate that the balance between resolution of dorsal atelectasis and formation of ventral atelectasis may play a key role in determining oxygenation responses. Patients assessed during the third week showed higher levels of consolidated tissue, potentially leading to fibrotic-like changes in the lung over time.
INTENSIVE CARE MEDICINE
(2022)
Article
Health Care Sciences & Services
Jacob C. Clifton, Milo Engoren, Matthew S. Shotwell, Barbara J. Martin, Elise M. Clemens, Oscar D. Guillamondegui, Robert E. Freundlich
Summary: Functional dependency is a determinant of surgical risk, with increasing dependency associated with higher odds of postoperative mortality. Preoperative functional status significantly impacts postoperative mortality following a complication, with independent patients being the most affected. Model diagnostics show accurate prediction of 30-day postoperative mortality in dependent surgical patients.
JOURNAL OF MEDICAL SYSTEMS
(2022)
Article
Health Care Sciences & Services
Olivia P. Henry, Gen Li, Robert E. Freundlich, Warren S. Sandberg, Jonathan P. Wanderer
Summary: Discharge planning is essential for managing hospital capacity, and early planning can reduce length of stay and readmissions. This study found that discharge estimates became more accurate as the estimated and actual discharge dates got closer. There was no difference in discharge estimates between surgical and non-surgical patients, but providers' accuracy varied based on their role and certain patient factors.
JOURNAL OF MEDICAL SYSTEMS
(2022)
Article
Health Care Sciences & Services
Bryan D. Steitz, Gen Li, Adam Wright, Brent Dunworth, Robert E. Freundlich, Jonathan P. Wanderer
Summary: Positive patient identification is crucial for ensuring correct patient identity before healthcare delivery. A study found that using a clinical decision support tool can significantly improve the success rate of patient identification, thereby enhancing patient safety workflows.
JOURNAL OF MEDICAL SYSTEMS
(2022)
Article
Engineering, Biomedical
Benjamin Simpson, Michael Burns, Robert P. Dick, Leif Saager
Summary: The study developed a system to measure tissue viscoelastic response during epidural needle placement, aiming to provide assistance to clinical providers. Results showed that the system can reliably detect when the needle is close to bone, but does not provide the expected 5mm warning distance. Further technical advances may enhance the system's utility in clinical settings.
IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE
(2022)
Article
Anesthesiology
Clemens Miller, Anselm Braeuer, Thomas Asendorf, Marielle Ernst, Philipp von Gottberg, Juliane Richter, Leif Saager, Marcus Nemeth
Summary: This study aimed to determine the target depth of nasopharyngeal temperature probe insertion in children by measuring distances on magnetic resonance imaging. The results showed that height had the strongest correlation with insertion depth, and a formula of 40.8 + height [cm] x 0.32 could achieve the target position in 67% of cases. Categorizing height ranges and corresponding insertion depths also achieved similar probabilities.
PEDIATRIC ANESTHESIA
(2022)
Article
Anesthesiology
Douglas A. Colquhoun, Michelle T. Vaughn, Lori D. Bash, Allison Janda, Nirav Shah, Amir Ghaferi, Michael Sjoding, Graciela Mentz, Sachin Kheterpal
Summary: In this retrospective cohort study, the association between neuromuscular blocking agent reversal agent and postoperative pulmonary complications was assessed. The use of sugammadex was independently associated with a reduced risk of subsequent development of pneumonia or respiratory failure compared to neostigmine.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Medicine, General & Internal
Bethany R. Tellor Pennington, Douglas A. Colquhoun, Mark D. Neuman, Mary C. Politi, Allison M. Janda, Cathie Spino, Steven Thelen-Perry, Zhenke Wu, Sathish S. Kumar, Stephen H. Gregory, Michael S. Avidan, Sachin Kheterpal
Summary: This pilot study aims to assess the feasibility of conducting a comparative effectiveness trial on patient experiences and outcomes after receiving propofol TIVA or INVA. The study will recruit 300 patients and collect data to evaluate the feasibility of the research. If the study meets the predetermined thresholds, a larger trial can be conducted successfully.
Article
Health Care Sciences & Services
Tiffany Christine Veinot, Brenda Gillespie, Marissa Argentina, Jennifer Bragg-Gresham, Dinesh Chatoth, Kelli Collins Damron, Michael Heung, Sarah Krein, Rebecca Wingard, Kai Zheng, Rajiv Saran
Summary: This study aims to evaluate the effectiveness of two interventions on reducing intradialytic hypotension (IDH) in hemodialysis facilities. The interventions include provider education and patient activation. The primary outcome is the proportion of treatments with IDH, and secondary outcomes include patient symptoms, hospitalizations, and mortality.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Anesthesiology
Xinyu Yan, Jeff Goldsmith, Sumit Mohan, Zachary A. Turnbull, Robert E. Freundlich, Frederic T. Billings, Ravi P. Kiran, Guohua Li, Minjae Kim
Summary: This study evaluated the performance of machine learning algorithms in predicting 30-day mortality in intra-abdominal surgery patients. The results showed that excellent discrimination can be achieved using only preoperative variables, and the addition of intraoperative data did not improve the model performance.
ANESTHESIA AND ANALGESIA
(2022)