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Perioperative Care for Spine Surgery: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-09-18 Jairo R Moyano A
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Perioperative Care for Spine Surgery: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-09-18 Louanne M Carabini,John F Bebawy
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Perioperative Care for Spine Surgery: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-09-18 Todd Nelson
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Heart under Pressure: Intrathoracic Impact of Large Hiatal Hernia. Anesthesiology (IF 9.1) Pub Date : 2024-09-16 Youlei Li,Dahyun Kang,Michael Gonzalez,Alexander Doyal
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Complications during Awake Flexible Bronchoscopic Intubation: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Isabelle T Yang,Avery Tung,Yvon F Bryan
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Complications during Awake Flexible Bronchoscopic Intubation: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Richard M Pino,Mack A Thomas
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Liposomal Bupivacaine in Peripheral Nerve Blocks: Duration and Meaningful Differences. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Brian M Ilfeld,Daniel I Sessler
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The Child Opportunity Index: Another Dimension of Addressing Perioperative Disparities in Anesthesiology. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Jonathan M Tan,Annery G Garcia-Marcinkiewicz,Allan F Simpao
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Greenhorn Volume 1: A Catheter in Hand Is Worth Two Sticks in the Back. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Brendan J O'Shea
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An Analysis of Ultraviolet-C Light Irradiation in Reducing Bacterial Contamination of the Anesthesia Work Area. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Stephanie Gibbons,Franklin Dexter,Randy W Loftus,Carmen T Brindeiro,Kaitlin Walker,Michelle C Parra,Debra J Szeluga,Melinda S Seering,Brent A Hadder,Chase P Loftus,Jonathan E Charnin
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Complications during Awake Flexible Bronchoscopic Intubation: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Heyu Ji,Xulei Cui
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Lung Ultrasound and Regional Heterogeneity: A Bedside Solution to an Underrecognized Problem? Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Arun Sett,Sophia I Dahm,David G Tingay
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Challenge of Neonatal Anesthesia: Which Optimal EEG Target? Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Isabelle Constant
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Diagnosis and Treatment of Perioperative Anemia: A Society for Perioperative Assessment and Quality Improvement Collaborative Review. Anesthesiology (IF 9.1) Pub Date : 2024-09-12 Mandeep Kumar,David L Hepner,Erin S Grawe,Maureen Keshock,Maleka Khambaty,Manish S Patel,BobbieJean Sweitzer
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Ex Utero Intrapartum Intubation for Giant Fetal Neck Mass. Anesthesiology (IF 9.1) Pub Date : 2024-09-12 Mengyun Zhao,Lijian Pei,Yulin Jiang,Jingsong Gao
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Polygenic Score for the Prediction of Postoperative Nausea and Vomiting: A Retrospective Derivation and Validation Cohort Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-09 Nicholas J Douville,Lisa Bastarache,Jing He,Kuan-Han H Wu,Brett Vanderwerff,Emily Bertucci-Richter,Whitney E Hornsby,Adam Lewis,Elizabeth S Jewell,Sachin Kheterpal,Nirav Shah,Michael Mathis,Milo C Engoren,Christopher B Douville,Ida Surakka,Cristen Willer,Miklos D Kertai
BACKGROUND Postoperative nausea and vomiting (PONV) is a key driver of unplanned admission and patient satisfaction following surgery. Because traditional risk factors do not completely explain variability in risk, we hypothesize that genetics may contribute to the overall risk for this complication. The objective of this research is to perform a genome-wide association study of PONV, derive a polygenic
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Association between Glucagon-Like Peptide-1 Receptor Agonists and Aspiration Pneumonia during Endoscopic Procedures. Anesthesiology (IF 9.1) Pub Date : 2024-09-06 Chun-Yu Peng,Yu-Cheng Chang,Changlin Gong,Yu Chang,Kuan-Yu Chi,Chieh-Lien Hsiao,Cho-Hung Chiang,Cho-Han Chiang
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Systematized Serendipity: Fishing Expeditions for Anesthetic Drugs and Targets. Anesthesiology (IF 9.1) Pub Date : 2024-09-06 C Michael Crowder,Stuart A Forman
Most of science involves making observations, forming hypotheses, and testing those hypotheses, to form valid conclusions. However, a distinct, longstanding, and very productive scientific approach does not follow this paradigm; rather, it begins with a screen through a random collection of drugs or genetic variations for a particular effect or phenotype. Subsequently, the identity of the drug or gene
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Mechanical power in decelerating flow versus square flow ventilation in pediatric ARDS. Anesthesiology (IF 9.1) Pub Date : 2024-08-27 Andrew G Percy,Garrett Keim,Anoopindar K Bhalla,Nadir Yehya
BACKGROUND Mechanical power (MP) is a summary variable quantifying the risk of ventilator-induced lung injury (VILI). The original MP equation was developed using square flow ventilation. However, most children are ventilated using decelerating flow. It is unclear whether MP differs according to mode of flow delivery. We compared MP in children with acute respiratory distress syndrome (ARDS) who received
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Ketamine Potentiates AMPA Receptor-mediated Activity in the Somatosensory Cortex. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Bushra Yasin,Damian J Williams,Carla Troyas,Neil L Harrison,Christopher D Makinson,Paul S García
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Shedding Needed Light on a Black Box Approach to Prediction of Hypotension. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Simon T Vistisen,Martin J London,Michael R Mathis,Wilton A van Klei,Snehalata Huzurbazar,Matthias Jacquet-Lagrèze
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Use of Neuromuscular Blocking and Antagonism Agents across the Spectrum of Renal Impairment Undergoing Major Inpatient Surgery: A Single-center Retrospective Observational Cohort Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Douglas A Colquhoun,Sathish Kumar,Elizabeth Jewell,Graciela Mentz,Ruth Bickett-Hickok,Sachin Kheterpal
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A Required Reconsideration of "Required Reconsideration": Pioneering a New Paradigm for Perioperative Management of Patients Presenting with Treatment Limitations. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Rachel Hadler,Rebecca A Aslakson
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Enhancing the Readability of Preoperative Patient Instructions Using Large Language Models. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Hyo Jung Hong,Clifford A Schmiesing,Alex J Goodell
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Reviewing Ethical Guidelines for the Care of Patients with Do-Not-Resuscitate Orders after 30 Years: Rethinking Our Approach at a Time of Transition. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Matthew B Allen,Shahla Siddiqui,Omonele Nwokolo,Catherine M Kuza,Nicholas Sadovnikoff,David G Mann,Michael J Souter
The American Society of Anesthesiologists (ASA) opposes automatic reversal of do-not-resuscitate orders during the perioperative period, instead advocating for a goal-directed approach that aligns decision-making with patients' priorities and clinical circumstances. Implementation of ASA guidelines continues to face significant barriers including time constraints, lack of longitudinal relationships
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Developmental Anesthesia Neurotoxicity Research in Humans: Moving the Concept. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Laszlo Vutskits,Andrew J Davidson
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Oxygen Therapy during Surgery: Decisions Need Reliable Data. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Daniel R Frei,Paul J Young,Paul S Myles
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Promise of Remimazolam in Pediatric Emergence Delirium. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Pablo M Ingelmo,Andrew J Davidson
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Deranged Balance of Hemostasis and Fibrinolysis in Disseminated Intravascular Coagulation: Assessment and Relevance in Different Clinical Settings. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Ecaterina Scarlatescu,Toshiaki Iba,Cheryl L Maier,Hunter Moore,Maha Othman,Jean Marie Connors,Jerrold H Levy
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Cardiovascular Effects of Increasing Positive End-Expiratory Pressure in A Model of Left Ventricular Cardiogenic Shock in Female Pigs. Anesthesiology (IF 9.1) Pub Date : 2024-08-26 Oskar Kjærgaard Hørsdal,Kasper Lykke Wethelund,Nigopan Gopalasingam,Mads Dam Lyhne,Mark Stoltenberg Ellegaard,Ole Kristian Møller-Helgestad,Hanne Berg Ravn,Henrik Wiggers,Steffen Christensen,Kristoffer Berg-Hansen
BACKGROUND Cardiogenic shock (CS) presents a medical challenge with limited treatment options. Positive end-expiratory pressure (PEEP) during mechanical ventilation has been linked with clinical benefits in patients with CS. We investigated if increasing PEEP levels could unload the left ventricle (LV) in CS in a large animal model of LV-CS. METHODS LV-CS was induced in 26 female pigs (60 kg) by microsphere
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Activation of α7 nicotinic acetylcholine receptors inhibits hepatic necroptosis and ameliorates acute liver injury in mice. Anesthesiology (IF 9.1) Pub Date : 2024-08-26 Fang-Fang Xu,Zi-Chen Li,Wen-Jing Zhang,Qiao Li,Dong-Jie Li,Hong-Bo Meng,Fu-Ming Shen,Hui Fu
BACKGROUND Acute liver injury (ALI) is a disease characterized by severe liver dysfunction, caused by significant infiltration of immune cells and extensive cell death with a high mortality. Previous studies demonstrated that the α7 nicotinic acetylcholine receptor (α7nAChR) played a crucial role in various liver diseases. The hypothesis of this study was that activating α7nAChR could alleviate ALI
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Factor Eight Inhibitor Bypass Activity use in cardiac surgery: A propensity matched analysis of safety outcomes. Anesthesiology (IF 9.1) Pub Date : 2024-08-26 Joshua A Nicholas,Natasha Harrison,Dipro Chakraborty,Alan L Chang,Nima Aghaeepour,Katherine Wirtz,Elaina Nielson,Cody Parsons,Ethan Jackson,Anil K Panigrahi
BACKGROUND Bleeding during cardiac surgery may be refractory to standard interventions. Off-label use of Factor Eight Inhibitor Bypass Activity (FEIBA) has been described to treat such bleeding. However, reports of safety, particularly thromboembolic outcomes, show mixed results and reported cohorts have been small. METHODS Adult patients undergoing cardiac surgery on cardiopulmonary bypass between
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Paravertebral versus Pectoralis-II (Interpectoral and Pectoserratus) Nerve Blocks for Postoperative Analgesia after Non-Mastectomy Breast Surgery: A Randomized, Controlled, Observer-Masked Noninferiority Trial. Anesthesiology (IF 9.1) Pub Date : 2024-08-26 Rodney A Gabriel,Brian P Curran,Matthew W Swisher,Jacklynn F Sztain,Paige S Tsuda,Engy T Said,Brenton Alexander,John J Finneran,Wendy B Abramson,Jessica R Black,Anne M Wallace,Sarah Blair,Michael C Donohue,Baharin Abdullah,Nicole Y Xu,Brannon J Cha,Brian M Ilfeld
BACKGROUND Pectoralis-II and paravertebral nerve blocks are both used to treat pain following breast surgery. Most previous studies involving mastectomy identified little difference of significance between the two approaches. Whether this is also accurate for non-mastectomy procedures remains unknown. METHODS Participants undergoing uni- or bilateral non-mastectomy breast surgery anticipated to have
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An Inadvertent Course of a Central Venous Catheter. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Erik Anderson,Mariah Dahmen,Cassiano Crespo Santiago,Sudarshan Setty
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PROBAST Assessment of Machine Learning: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Pietro Arina,Evangelos B Mazomenos,John Whittle,Mervyn Singer
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From Ancient Arsenal to an Anesthetic: Historical Roles of Hyoscyamine and Aconitine in Anesthesia. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Sharon Bouvette,Amir L Butt,Lacy E Harville,Kenichi A Tanaka
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PROBAST Assessment of Machine Learning: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Elena Bignami,Matteo Panizzi,Simone Allai,Valentina Bellini
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Effects of Hemorrhagic Shock and Rhabdomyolysis on Renal Microcirculation, Oxygenation, and Function in a Female Swine Model. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Benjamin Bergis,Elisabeth Laemmel,Philippe Laitselart,Pierre Isnard,Fabiola Terzi,Manon Seguret,Carine Hejl,Alice Huertas,Benoit Decante,Eric Vicaut,Jacques Duranteau,Anatole Harrois,Nicolas Libert
BACKGROUND Hemorrhagic shock (HS) and rhabdomyolysis (RM) are two important risk factors for acute kidney injury after severe trauma; however, the effects of the combination of RM and HS on kidney function are unknown. The purpose of this study was to determine the impact of RM and HS on renal function, oxygenation, perfusion, and morphology in a pig model. METHODS Forty-seven female pigs were divided
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Optimizing Resuscitation of the Donation after Circulatory Death Heart by Mitochondrial Protection in a Female Porcine Model. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Fulin Wang,Eliana Lucchinetti,Phing-How Lou,Sanaz Hatami,Akash Chakravarty,Martin Hersberger,Darren H Freed,Michael Zaugg
BACKGROUND Due to the shortage of donor organs, an increasing number of transplant organs are harvested after circulatory arrest (donation after circulatory death [DCD]). Using a translational porcine model of DCD, this study developed and evaluated a protocol based on cardioprotection by multidrug postconditioning to optimize resuscitation of DCD hearts during ex situ heart perfusion (ESHP). METHODS
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Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Frederic T Billings,David R McIlroy,Matthew S Shotwell,Marcos G Lopez,Michelle T Vaughn,Jennifer L Morse,Cassandra J Hennessey,Jonathan P Wanderer,Matthew W Semler,Todd W Rice,Hannah Wunsch,Sachin Kheterpal
BACKGROUND The best approaches to supplemental oxygen administration during surgery remain unclear, which may contribute to variation in practice. This study aimed to assess determinants of oxygen administration and its variability during surgery. METHODS Using multivariable linear mixed-effects regression, the study measured the associations between intraoperative fraction of inspired oxygen and patient
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Effect of Remimazolam on Emergence Delirium in Children Undergoing Laparoscopic Surgery: A Double-blinded Randomized Trial. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Yu-Hang Cai,John Wei Zhong,Hong-Yu Ma,Peter Szmuk,Cheng-Yu Wang,Zhen Wang,Xu-Lin Zhang,Le-Qi Dong,Hua-Cheng Liu
BACKGROUND Preventing emergence delirium is a clinical goal for pediatric anesthesia, yet there is no consensus on its prevention. This study investigated the hypothesis that a continuous infusion or a single bolus of remimazolam can reduce the incidence of emergence delirium in children. METHODS A total of 120 children aged 1 to 6 yr were randomly and equally allocated into three groups: group RC
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Gastric Pressure Monitoring Unveils Abnormal Patient-Ventilator Interaction Related to Active Expiration: A Retrospective Observational Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Evangelia Akoumianaki,Katerina Vaporidi,Vaia Stamatopoulou,Stella Soundoulounaki,Meropi Panagiotarakou,Eumorfia Kondili,Dimitris Georgopoulos
BACKGROUND Patient-ventilator dyssynchrony is frequently observed during assisted mechanical ventilation. However, the effects of expiratory muscle contraction on patient-ventilator interaction are underexplored. The authors hypothesized that active expiration would affect patient-ventilator interaction and they tested their hypothesis in a mixed cohort of invasively ventilated patients with spontaneous
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Exposure to Operative Anesthesia in Childhood and Subsequent Neurobehavioral Diagnoses: A Natural Experiment Using Appendectomy. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Jeffrey H Silber,Paul R Rosenbaum,Joseph G Reiter,Siddharth Jain,Alexander S Hill,Sean Hashemi,Sydney Brown,Mark Olfson,Caleb Ing
BACKGROUND Observational studies of anesthetic neurotoxicity may be biased because children requiring anesthesia commonly have medical conditions associated with neurobehavioral problems. This study takes advantage of a natural experiment associated with appendicitis to determine whether anesthesia and surgery in childhood were specifically associated with subsequent neurobehavioral outcomes. METHODS
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Preoperative N-terminal Pro-B-type Natriuretic Peptide and High-sensitivity Cardiac Troponin T and Outcomes after Major Noncardiac Surgery: A Prospective Cohort Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Bing-Cheng Zhao,Shao-Hui Lei,Pei-Pei Zhuang,Xiao Yang,Wei-Jie Feng,Shi-Da Qiu,Huan Yang,Ke-Xuan Liu,
BACKGROUND Patients undergoing noncardiac surgery have varying risk of cardiovascular complications. This study evaluated preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T to enhance cardiovascular events prediction for major noncardiac surgery. METHODS This prospective cohort study included adult patients with cardiovascular disease or risk
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Single-dose Intraoperative Methadone for Pain Management in Pediatric Tonsillectomy: A Randomized Double-blind Clinical Trial. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Lisa M Einhorn,Julia Hoang,Jong Ok La,Evan D Kharasch
BACKGROUND More than 500,000 elective tonsillectomies are performed in U.S. children annually. Pain after pediatric tonsillectomy is common, often severe, and undertreated. There is no consensus on the optimal management of perioperative tonsillectomy pain. Methadone, with an elimination half-life of 1 to 2 days, has a longer duration of effect than short-duration opioids such as fentanyl. The primary
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Identification and Treatment of Pediatric Perioperative Anxiety. Anesthesiology (IF 9.1) Pub Date : 2024-08-20 Romy Yun,Thomas J Caruso
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Hypotension Prediction Index Is Equally Effective in Predicting Intraoperative Hypotension during Noncardiac Surgery Compared to a Mean Arterial Pressure Threshold: A Prospective Observational Study. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Marijn P Mulder,Mirjam Harmannij-Markusse,Libera Fresiello,Dirk W Donker,Jan-Willem Potters
BACKGROUND The Hypotension Prediction Index is designed to predict intraoperative hypotension in a timely manner and is based on arterial waveform analysis using machine learning. It has recently been suggested that this algorithm is highly correlated with the mean arterial pressure itself. Therefore, the aim of this study was to compare the index with mean arterial pressure-based prediction methods
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Comparison of Differences in Cohort (Forward) and Case Control (Backward) Methodologic Approaches for Validation of the Hypotension Prediction Index. Anesthesiology (IF 9.1) Pub Date : 2024-09-01 Simon J Davies,Daniel I Sessler,Zhongping Jian,Neal W Fleming,Monty Mythen,Kamal Maheshwari,Denise P Veelo,Alexander P J Vlaar,Jos Settels,Thomas Scheeren,B J P van der Ster,Michael Sander,Maxime Cannesson,Feras Hatib
BACKGROUND The Hypotension Prediction Index (the index) software is a machine learning algorithm that detects physiologic changes that may lead to hypotension. The original validation used a case control (backward) analysis that has been suggested to be biased. This study therefore conducted a cohort (forward) analysis and compared this to the original validation technique. METHODS A retrospective
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NIRS during Organ Donation in Brain-dead Donors: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Martin Dworschak,Ekaterina Pataraia
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Reducing Adverse Outcomes from Handovers: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Sajal Kulhari,Aaron Ahn,Arshia Faghri,Ali G Ali
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One-year Outcomes of Spinal versus General Anesthesia: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Mark D Neuman,Emily A Vail,Rui Feng
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NIRS during Organ Donation in Brain-dead Donors: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Martin Soehle,Juliane Langer,Ehrenfried Schindler,Steffen Manekeller,Mark Coburn,Marcus Thudium
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Reducing Adverse Outcomes from Handovers: Reply. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Amit K Saha,Scott Segal
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One-year Outcomes of Spinal versus General Anesthesia: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Timothy R Petersen,Evan M Braithwaite,Eli L Torgeson
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Sublingual Hematoma: A Rare Anesthetic Complication. Anesthesiology (IF 9.1) Pub Date : 2024-08-19 Adam Warrick,Kevin Backfish,Sachin Vimal Bahadur
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Navigating Hemolysis, Hemoglobin Toxicity, and Its Renal Implications in Cardiac Surgery. Anesthesiology (IF 9.1) Pub Date : 2024-08-19 Dominik J Schaer,Christian A Schaer,Rok Humar,Florence Vallelian,Reney Henderson,Kenichi A Tanaka,Jerrold H Levy,Paul W Buehler
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Management of Depression and Anxiety in Perioperative Medicine. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 Megan L Rolfzen,Peter Nagele,Charles Conway,Robert Gibbons,Karsten Bartels
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Perioperative Mortality after COVID-19 Exposure: Comment. Anesthesiology (IF 9.1) Pub Date : 2024-10-01 María Claudia Niño,Daniel Guerra,Juan A Mejía,Juan P Cáceres,Daniel S Benitez
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Neuropeptide Y Y2 Receptors in Sensory Neurons Tonically Suppress Nociception and Itch but Facilitate Postsurgical and Neuropathic Pain Hypersensitivity. Anesthesiology (IF 9.1) Pub Date : 2024-08-09 Paramita Basu,Akshitha Maddula,Tyler S Nelson,Pranav Prasoon,Michelle K Winter,Herbert Herzog,Kenneth E McCarson,Bradley K Taylor
BACKGROUND Neuropeptide Y (NPY) Y2 receptor (Y2) antagonist BIIE0246 can both inhibit and facilitate nociception. We hypothesized that Y2 function depends on inflammation or nerve injury status. METHODS We implemented a battery of behavioral tests in mice of both sexes that received: 1) no injury; 2) an incision model of postoperative pain; 3) a spared nerve injury (SNI) model of neuropathic pain;
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CORRECTION OF TRAUMA-INDUCED COAGULOPATHY BY GOAL DIRECTED THERAPY: A SECONDARY ANALYSIS OF THE ITACTIC TRIAL. Anesthesiology (IF 9.1) Pub Date : 2024-08-08 Charlotte Lindsay,Ross Davenport,Kjersti Baksaas-Aasen,Knut Magne Kolstadbråten,Pål Aksel Naess,Nicola Curry,Marc Maegele,Nicole Juffermans,Simon Stanworth,Jakob Stensballe,Per Ingemar Johansson,Christine Gaarder,Karim Brohi
BACKGROUND Trauma hemorrhage induces a coagulopathy with a high associated mortality rate. The Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy (ITACTIC) randomized trial tested two goal-directed treatment algorithms for coagulation management, one guided by conventional coagulation tests and one by viscoelastic hemostatic assays (viscoelastic). The lack of a difference