Article
Anesthesiology
M. L. van Zuylen, J. M. Kampman, O. Turgman, A. Gribnau, W. ten Hoope, B. Preckel, H. C. Willems, G. J. Geurtsen, J. Hermanides
Summary: Postoperative neurocognitive disorders are common in older adult patients. Simplified and unvalidated tests are often used for diagnosis, but this study found that the Modified Telephone Interview for Cognitive Status and Montreal Cognitive Assessment should not be used in isolation to diagnose these disorders.
Review
Medicine, General & Internal
Nikolaj Travica, Mojtaba Lotfaliany, Andrew Marriott, Seyed A. A. Safavynia, Melissa M. M. Lane, Laura Gray, Nicola Veronese, Michael Berk, David Skvarc, Hajara Aslam, Elizabeth Gamage, Melissa Formica, Katie Bishop, Wolfgang Marx
Summary: This umbrella review systematically identified the peri-operative risk factors associated with post-operative cognitive dysfunction (POCD) through meta-analyses of observational studies. The review included 11 meta-analyses comprising 73 risk factors in a total population of 67,622 participants. Pre-operative risk factors were most commonly examined and there was limited evidence suggesting associations between two risk factors (pre-operative age and pre-operative diabetes) and POCD. Further large-scale studies across different surgery types are recommended due to the limited overall strength of the evidence.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Psychology, Multidisciplinary
Jun Liu, Kequn Huang, Binbin Zhu, Bin Zhou, Ahmad Khaled Ahmad Harb, Lin Liu, Xiang Wu
Summary: Post-operative cognitive dysfunction (POCD) is a common neurological complication in older individuals following anesthesia/surgery, characterized by memory loss and accompanying abnormal emotions, behaviors, and language without consciousness disorder. The diagnosis of POCD often involves the evaluation of perioperative cognitive function using neuropsychological tests.
FRONTIERS IN PSYCHOLOGY
(2021)
Article
Immunology
Klaske Oberman, Iris Hovens, Jacco de Haan, Joana Falcao-Salles, Barbara van Leeuwen, Regien Schoemaker
Summary: A single injection of ibuprofen before surgery improved short-term spatial memory and increased hippocampal neurogenesis in rats, although associated with increased microglia activity. Plasma cytokine levels were not significantly affected, but VEGF levels increased and IFABP levels decreased after ibuprofen treatment. The gut microbiome was not significantly impacted by surgery or ibuprofen, with effects in aged rats similar to those in young rats, although less pronounced.
JOURNAL OF NEUROINFLAMMATION
(2021)
Article
Oncology
Saksham Gupta, Hassan Dawood, Alexandra Giantini Larsen, Luis Fandino, Erik H. Knelson, Timothy R. Smith, Eudocia Q. Lee, Ayal Aizer, Ian F. Dunn, Wenya Linda Bi
Summary: Brain metastases are the most common brain tumors in adults, whose management remains nuanced. A nationwide, multicenter analysis was conducted with a retrospective cohort of adult patients who received craniotomy for resection of brain metastasis. Results showed that frailty and infratentorial approach were associated with increased risks of reoperation before discharge, while pre-frailty and frailty were associated with increased odds for post-discharge mortality. An optimization of metrics contributing to patient frailty and heightened surveillance in patients with infratentorial metastases may be considered in the peri-operative period.
FRONTIERS IN ONCOLOGY
(2021)
Article
Surgery
Meghan Aversa, Tereza Martinu, Christopher Patriquin, Marcelo Cypel, David Barth, Rasheed Ghany, Jin Ma, Shaf Keshavjee, Lianne G. Singer, Kathryn Tinckam
Summary: The Toronto Lung Transplant Program has been using a desensitization regimen since 2008 for DSA-positive lung transplants, and long-term follow-up showed that allograft survival and CLAD-free survival of these patients were not significantly different from other lung transplant recipients.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Review
Anesthesiology
N. S. Crouch, M. K. Molyneux
Summary: This article discusses the peri-operative implications of adolescent gynaecological surgery and considerations for this specific age group, such as consent, operative setting, and key personnel. It also addresses specialist situations likely to fall to an adolescent gynaecology setting, including management of patients with Mullerian abnormalities, history of ritual female genital cutting, trans men, and significant learning difficulties. Collaboration, reflection, and practicality are emphasized in all circumstances.
Review
Medicine, General & Internal
Shehane Mahendran, Aravinda Thiagalingam, Graham Hillis, Richard Halliwell, Henry C. C. Pleass, Clara K. Chow
Summary: Accurate peri-operative cardiovascular risk assessment is crucial in guiding surgical and anaesthetic approaches, informing the use of preventive medications, and post-operative cardiac monitoring. Specialised cardiac investigations are rarely necessary for pre-operative risk assessment, and performing pre-operative revascularisation is not evidence-based.
MEDICAL JOURNAL OF AUSTRALIA
(2023)
Article
Public, Environmental & Occupational Health
B. C. Anglim, K. Ramage, E. Sandwith, E. A. Brennand
Summary: This study identified factors contributing to postoperative urinary retention (POUR) after pelvic floor surgery, including specific surgical procedures and variables such as ASA score and placement of mid-urethral sling (MUS). Allowing for a third void decreased the number of patients requiring catheterization post-discharge, emphasizing the importance of preoperative counseling for managing postoperative expectations.
Review
Anesthesiology
R. L. H. Yim, K. M. M. Leung, C. C. M. Poon, M. G. Irwin
Summary: Parkinson's disease patients have a higher risk of peri-operative complications, necessitating multidisciplinary management and specialized care. Continuous dopaminergic treatment, peri-operative disease pathway development, and telemedicine are improving peri-operative care. Management for advanced Parkinson's disease is evolving with potential for integrated care and changes in anaesthetic management.
Review
Anesthesiology
L. Evered, K. Atkins, B. Silbert, D. A. Scott
Summary: Peri-operative neurocognitive disorders are common complications in older patients undergoing anesthesia and surgery, leading to poor long-term outcomes. Frail patients have a higher risk of cognitive decline and poor functional outcomes after surgery. Identifying vulnerable patients is crucial for preventing these disorders.
Article
Biochemistry & Molecular Biology
Johanna Ruhnau, Jonas Mueller, Stephan Nowak, Sarah Strack, Denise Sperlich, Anna Pohl, Jasmin Dilz, Angelika Saar, Yannick Veser, Frederik Behr, Sebastian Rehberg, Taras Usichenko, Klaus Hahnenkamp, Johannes Ehler, Agnes Floeel, Henry W. S. Schroeder, Jan-Uwe Mueller, Robert Fleischmann, Antje Vogelgesang
Summary: Advances in spine surgery allow for safe interventions in older patients, but postoperative delirium (POD) remains a major concern. This study investigates biomarkers that may help identify the pre-operative risk for POD, and finds higher levels of sTREM2 and Gasdermin D as potential markers for POD.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Oncology
Fahad Faruqi, Kathryn J. Ruddy, Shanda Blackmon
Summary: Integrative medicine, including techniques like acupuncture, has shown promising results in reducing peri-operative symptoms such as pain and anxiety without the adverse effects associated with conventional pharmacologic interventions.
CURRENT ONCOLOGY REPORTS
(2021)
Article
Medicine, General & Internal
Amun Georg Hofmann, Maria Elisabeth Leinweber, Afshin Assadian, Juergen Falkensammer, Fadi Taher
Summary: Age was not found to be associated with adverse outcomes in fenestrated endovascular aortic repair (FEVAR), including mortality, technical success rates, complications, and length of hospital stay. However, octogenarians had a significantly larger aortic diameter at the time of treatment, indicating potential bias in patient selection.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Multidisciplinary Sciences
Ahmad Alli, Fathima Paruk, Claire Roger, Jeffrey Lipman, Daren Calleemalay, Steven C. Wallis, Juan Scribante, Guy A. Richards, Jason A. Roberts
Summary: This study aimed to investigate the effects of cardiopulmonary bypass (CPB) on the pharmacokinetics (PK) of cefazolin and provide optimized dosing regimens for antibiotic prophylaxis during cardiac surgery. The results showed that a 2g dose of cefazolin every 4 hours was insufficient to maintain concentrations above the minimum inhibitory concentration (MIC) for relevant pathogens in patients with low serum creatinine concentrations. Simulation results suggested that an increased dose and/or dosing frequency could achieve better optimization of dosing regimens.
Article
Anesthesiology
Sebastian Wiberg, Frederik Holmgaard, Henrik Zetterberg, Jens-Christian Nilsson, Jesper Kjaergaard, Michael Wanscher, Annika R. Langkilde, Christian Hassager, Lars S. Rasmussen, Kaj Blennow, Anne Gronborg Vedel
Summary: The study evaluated the ability of biomarkers NSE, tau, NFL, and GFAP to predict postoperative cognitive dysfunction (POCD) in cardiac surgery patients. Elevated levels of tau and GFAP were found in patients with POCD at discharge, but the biomarkers only had moderate predictive abilities for POCD. Postoperative levels of NSE were not associated with POCD at discharge.
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2022)
Article
Critical Care Medicine
Josefine Baekgaard, Volkert Siersma, Rasmus Ejlersgaard Christensen, Camilla Ikast Ottosen, Katrine Bennett Gyldenkaerne, Jasmin Garoussian, Emilie S. Baekgaard, Jacob Steinmetz, Lars S. Rasmussen
Summary: This study investigated the association between fraction of inspired oxygen (FiO(2)) and one-year all-cause mortality in intubated trauma patients. The results showed that a FiO(2) above 60% for more than 2 hours during the first 24 hours of admission was associated with increased mortality in a duration-dependent manner.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2022)
Review
Anesthesiology
Thea Ellehammer Hansen, Rasmus Ejlersgaard Christensen, Josefine Baekgaard, Jacob Steinmetz, Lars S. Rasmussen
Summary: The study found limited evidence on the effect of high/low FiO(2) use for TBI patients on in-hospital mortality, with no significant difference in mortality between high and low FiO(2) groups for mechanically ventilated patients. However, the high FiO(2) group had a shorter length of stay in the intensive care unit and lower disability at 6 months compared to the low FiO(2) group.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Article
Anesthesiology
Cecilie Holse, Eske K. Aasvang, Morten Vester-Andersen, Lars S. Rasmussen, Jorn Wetterslev, Robin Christensen, Lars N. Jorgensen, Sofie S. Pedersen, Frederik C. Loft, Hannibal Troensegaard, Marie-Louise Morkenborg, Zara R. Stisen, Kim Runitz, Jonas P. Eiberg, Anna K. Hansted, Christian S. Meyhoff
Summary: In major noncardiac surgery, perioperative inspiratory oxygen fraction of 0.80 and antioxidant intervention did not affect the degree of myocardial injury within the first 3 days of surgery. This suggests that 80% oxygen is safe and that vitamin C and N-acetylcysteine do not provide cardiovascular benefits in this type of surgery.
Article
Critical Care Medicine
Joachim Hansen, Lars Simon Rasmussen, Jacob Steinmetz
Summary: After the implementation of a new regional trauma triage guideline, there was a significant decrease in the proportion of trauma patients admitted to the trauma center. Overtriage also decreased, but there were no changes in undertriage or short-term and long-term mortality.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2022)
Review
Emergency Medicine
Malene Vang, Maria Ostberg, Jacob Steinmetz, Lars S. Rasmussen
Summary: The purpose of this study was to determine whether a shock index (SI) >= 1 in adult trauma patients was associated with increased in-hospital mortality. A systematic review and meta-analysis of relevant studies found that adult trauma patients with an initial SI >= 1 had a significantly higher risk of in-hospital mortality.
EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
(2022)
Article
Public, Environmental & Occupational Health
Juliane Frydenlund, Julie Mackenhauer, Erika F. Christensen, Helle Collatz Christensen, Ulla Vaeggemose, Jacob Steinmetz, Soren Paaske Johnsen
Summary: This study found disparities in the quality of emergency medical services (EMS) based on socioeconomic status (SES). Patients with low SES were more likely to contact the hospital or EMS again after their first call or after treatment and release at the scene compared to patients with high SES, indicating a lack of appropriate help for low SES callers.
CLINICAL EPIDEMIOLOGY
(2022)
Article
Anesthesiology
Caroline Hjelmdal, Christina Draegert, Morten Vester-Andersen, Ana Kowark, Mark S. Coburn, Lars H. Rasmussen, Lars Lundstrom, Jacob Steinmetz, POSE Study Grp
Summary: The study aimed to assess the association between chronic antithrombotic therapy and intra-operative transfusion of red blood cells in elderly patients undergoing elective procedures. The results showed a correlation between chronic antithrombotic therapy and intra-operative transfusion of red blood cells in elderly patients, but not in a multivariate adjusted model.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Medicine, General & Internal
Josefine Baekgaard, Tobias Arleth, Volkert Siersma, Jochen Hinkelbein, Sirin Yuecetepe, Markus Klimek, Mark G. van Vledder, Esther M. M. Van Lieshout, Soren Mikkelsen, Stine Thorhauge Zwisler, Mikkel Andersen, Christian Fenger-Eriksen, Dan L. Isbye, Lars S. Rasmussen, Jacob Steinmetz
Summary: The TRACUMOX2 trial aims to compare the effects of restrictive and liberal oxygen strategies within the first 8 hours following trauma. The study includes adult patients and focuses on the primary outcome of 30-day mortality and/or major respiratory complications. With 710 participants in each arm, a potential 33% risk reduction with the restrictive oxygen strategy can be detected if the incidence of the primary outcome is 15% in the liberal group.
Article
Anesthesiology
Tobias Arleth, Josefine Baekgaard, Volkert Siersma, Markus Klimek, Jochen Hinkelbein, Lars Simon Rasmussen, Jacob Steinmetz
Summary: The TRAUMOX2 trial aims to evaluate the impact of restrictive and liberal oxygen strategies on trauma patients. The study will include 1420 patients and compare the primary composite outcome and key secondary outcomes between the two allocated groups using randomization and statistical analysis. This study will provide further evidence on oxygen therapy strategies for trauma patients.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Surgery
Trine O. O. Eskesen, Martin Sillesen, Jacob Krabbe Pedersen, Dorthe Almind Pedersen, Kaare Christensen, Lars S. S. Rasmussen, Jacob Steinmetz
Summary: A study found that moderate to severe trauma is associated with long-term increased risk of death or immune-mediated or cancer disease. This study highlights the significant impact of trauma on long-term health outcomes.
Article
Anesthesiology
Anne Louise de Barros Garioud, Lars Peter Kloster Andersen, Aksel Karl Georg Jensen, Hien Quoc Do, Janus Christian Jakobsen, Lars Brokso Holst, Lars Simon Rasmussen, Arash Afshari
Summary: The MELA-PAED trial aims to investigate the efficacy and safety of intraoperative intravenous melatonin for the prevention of emergence agitation in pediatric surgical patients. This randomized, double-blind trial will compare intravenous melatonin with placebo in 400 participants, aged 1-6 years. The primary outcome is the incidence of emergence agitation, and secondary outcomes include opioid consumption and adverse events. The results may provide valuable insights into the use of melatonin in pediatric perioperative care.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Medical Informatics
Pernille B. Nielsen, Caroline S. Langkjaer, Martin Schultz, Anne Marie Kodal, Niels Egholm Pedersen, John Asger Petersen, Theis Lange, Michael Dan Arvig, Christian S. Meyhoff, Morten H. Bestle, Bibi Holge-Hazelton, Gitte Bunkenborg, Anne Lippert, Ove Andersen, Lars Simon Rasmussen, Kasper Karmark Iversen
Summary: This study aimed to investigate whether the combination of clinical assessment and Early Warning Scores (EWSs) would reduce the number of routine measurements without increasing mortality. Comparing the Individual EWS (I-EWS) with the National Early Warning Score (NEWS), it was found that I-EWS, which included clinical assessment, was not inferior to NEWS in terms of all-cause mortality at 30 days, and the number of routine measurements was minimally reduced.
LANCET DIGITAL HEALTH
(2022)
