Pub Date : 2024-08-08DOI: 10.1097/ea9.0000000000000058
Igor Abramovich, Iulia Crișan, A. Scudellari, Federico Bilotta
{"title":"Recent educational tools in anaesthesiology residency training programs aligned with the European training requirements","authors":"Igor Abramovich, Iulia Crișan, A. Scudellari, Federico Bilotta","doi":"10.1097/ea9.0000000000000058","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000058","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1097/ea9.0000000000000057
Florian Hetzer, Stefan Horack, Gert Küchler, Jens Broscheit
The NARCOguide algorithm calculates an EEG-derived index to monitor the hypnotic component of anaesthesia. This study evaluates the accuracy of the index calculated by NARCOguide against the Narcotrend index as a reference. Secondly, the automatic detection of burst-suppression patterns as represented by the burst suppression ratio was compared. Comparative study to assess the agreement between two medical devices. At two study centres, patient data were collected from a total of 40 adults receiving general anaesthesia or sedation with propofol. Patients underwent either general anaesthesia for oral surgery with propofol/remifentanil/rocuronium (study centre 1) or light general anaesthesia/deep sedation with propofol alone for laryngoscopic upper airway exploration (study centre 2). In a posthoc analysis, the NARCOguide index was compared with the Narcotrend index. Comparison was made after averaging over 1 min at defined clinical markers using classic linear least squares regression and Bland–Altman plots. Precision and recall for the detection of burst suppression were determined using human scoring as a reference. Data analysis showed good agreement [Bland–Altman mean difference (MD) = −2.3; limits of agreement = −27.1, to +22.4; n = 1209] and high correlation (r 2 = 0.76) between the depth of anaesthesia index calculated by NARCOguide and Narcotrend. The precision and recall of NARCOguide and Narcotrend for the detection of burst suppression were in a similar range. Over the entire dataset, the NARCOguide algorithm showed higher precision and recall than the Narcotrend algorithm (56% vs. 36% and 68% vs. 58%, respectively). The NARCOguide index can be used to monitor the hypnotic component of anaesthesia in patients undergoing general anaesthesia or sedation with propofol, with a performance similar to that of the Narcotrend index. Trial registration number: 18020, regulatory authority: Ethikkommission der bayerischen Landesärztekammer, chairman: Dr med. Gerald Quitterer, applicant: Dr Gert Küchler, date of approval: 12. Jun 2018, completion of data collection: 12 December 2018, study completion: 31 March 2022.
{"title":"The NARCOguide index – a novel parameter for monitoring depth of hypnosis during anaesthesia/sedation with propofol","authors":"Florian Hetzer, Stefan Horack, Gert Küchler, Jens Broscheit","doi":"10.1097/ea9.0000000000000057","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000057","url":null,"abstract":"\u0000 \u0000 The NARCOguide algorithm calculates an EEG-derived index to monitor the hypnotic component of anaesthesia.\u0000 \u0000 \u0000 \u0000 This study evaluates the accuracy of the index calculated by NARCOguide against the Narcotrend index as a reference. Secondly, the automatic detection of burst-suppression patterns as represented by the burst suppression ratio was compared.\u0000 \u0000 \u0000 \u0000 Comparative study to assess the agreement between two medical devices.\u0000 \u0000 \u0000 \u0000 At two study centres, patient data were collected from a total of 40 adults receiving general anaesthesia or sedation with propofol.\u0000 \u0000 \u0000 \u0000 Patients underwent either general anaesthesia for oral surgery with propofol/remifentanil/rocuronium (study centre 1) or light general anaesthesia/deep sedation with propofol alone for laryngoscopic upper airway exploration (study centre 2).\u0000 \u0000 \u0000 \u0000 In a posthoc analysis, the NARCOguide index was compared with the Narcotrend index. Comparison was made after averaging over 1 min at defined clinical markers using classic linear least squares regression and Bland–Altman plots. Precision and recall for the detection of burst suppression were determined using human scoring as a reference.\u0000 \u0000 \u0000 \u0000 Data analysis showed good agreement [Bland–Altman mean difference (MD) = −2.3; limits of agreement = −27.1, to +22.4; n = 1209] and high correlation (r\u0000 2 = 0.76) between the depth of anaesthesia index calculated by NARCOguide and Narcotrend. The precision and recall of NARCOguide and Narcotrend for the detection of burst suppression were in a similar range. Over the entire dataset, the NARCOguide algorithm showed higher precision and recall than the Narcotrend algorithm (56% vs. 36% and 68% vs. 58%, respectively).\u0000 \u0000 \u0000 \u0000 The NARCOguide index can be used to monitor the hypnotic component of anaesthesia in patients undergoing general anaesthesia or sedation with propofol, with a performance similar to that of the Narcotrend index.\u0000 \u0000 \u0000 \u0000 Trial registration number: 18020, regulatory authority: Ethikkommission der bayerischen Landesärztekammer, chairman: Dr med. Gerald Quitterer, applicant: Dr Gert Küchler, date of approval: 12. Jun 2018, completion of data collection: 12 December 2018, study completion: 31 March 2022.\u0000","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-04DOI: 10.1097/ea9.0000000000000054
Xavier Onrubia, Estefanía Martínez, P. Charco, Joana Baldó, Laura Reviriego, Robert Greif
Game-based learning, also called edutainment, has been promoted as an alternative to the unidirectional, passive teaching of traditional medical education. Solving enigmas and problems through creativity and critical thinking, which is encapsulated in ‘escape rooms’, has been adapted to teach medicine as a way to enhance the mental models of proceeding. We considered an educational escape room as an activity to promote teaching and training in airway management, integrating knowledge, technical and nontechnical skills and collaborative teamwork during crisis situations. No published experience on this topic was found. Therefore, we created an educational escape room focused on airway management. We describe the steps undertaken from the design and development of the escape room process (as part of the curriculum of an international airway course) to the results of a survey completed by the participants at the end of the escape room process. Satisfaction with the experience was rated at least 8 points (0 to 10 numerical rating scale) by 80% of the 147 course participants. Two thirds also rated the experience as at least 8 points (0 to 10 Likert scale) as being helpful in improving behaviour in real cases, and enhance organisational teamwork skills. The airway escape room was feasible for training in airway management. Participants rated it as valuable to gain team competencies. The experience encourages further development and its possible use in other clinical settings.
{"title":"New tools for learning airway management","authors":"Xavier Onrubia, Estefanía Martínez, P. Charco, Joana Baldó, Laura Reviriego, Robert Greif","doi":"10.1097/ea9.0000000000000054","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000054","url":null,"abstract":"\u0000 \u0000 Game-based learning, also called edutainment, has been promoted as an alternative to the unidirectional, passive teaching of traditional medical education. Solving enigmas and problems through creativity and critical thinking, which is encapsulated in ‘escape rooms’, has been adapted to teach medicine as a way to enhance the mental models of proceeding.\u0000 We considered an educational escape room as an activity to promote teaching and training in airway management, integrating knowledge, technical and nontechnical skills and collaborative teamwork during crisis situations.\u0000 \u0000 \u0000 \u0000 No published experience on this topic was found. Therefore, we created an educational escape room focused on airway management.\u0000 We describe the steps undertaken from the design and development of the escape room process (as part of the curriculum of an international airway course) to the results of a survey completed by the participants at the end of the escape room process.\u0000 \u0000 \u0000 \u0000 Satisfaction with the experience was rated at least 8 points (0 to 10 numerical rating scale) by 80% of the 147 course participants. Two thirds also rated the experience as at least 8 points (0 to 10 Likert scale) as being helpful in improving behaviour in real cases, and enhance organisational teamwork skills.\u0000 \u0000 \u0000 \u0000 The airway escape room was feasible for training in airway management. Participants rated it as valuable to gain team competencies. The experience encourages further development and its possible use in other clinical settings.\u0000","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141387333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1097/ea9.0000000000000053
Cees Klein Tank, Nadia Himantono, B. Verhoeven, Ignacio Malagon
Inadequately controlled postprocedural pain following sclerotherapy in patients with vascular malformations is a well recognised problem. Reliable epidemiological data and risk factors associated with postprocedural pain in children are lacking. To evaluate and quantify postprocedural pain in children and identify possible risk factors based on characteristics of the patient, treatment, and medication. A retrospective single centre cohort study. A tertiary single centre study in the Netherlands. Two hundred and nine chiuldren with ‘simple’ subtypes of congenital vascular malformation who had undergone sclerotherapy. Quantifying inadequately controlled postprocedural pain. Identifying potential patient and treatment characteristics associated with inadequately controlled postprocedural pain. A total of 209 patients who underwent 679 procedures were included in this study. The mean age at first intervention was 11.8 ± 4.5 years. Inadequately controlled postprocedural pain was found in 34.8% of the 679 procedures. Venous malformations (VM) were the most prevalent subtype of vascular malformation (80%), followed by arteriovenous malformations (AVM) (14.6%) and lymphatic malformations (LM) (5.4%). The odds ratio (OR) (95% confidence intervals), and P values obtained from multivariable mixed effect logistic regression analysis for patient and treatment characteristics found to be associated with inadequately controlled postprocedural pain were: chronic use of analgesics (OR 2.74 (1.40 to 5.34), P = 0.003), treatment with ethanol (OR 2.39 (1.01 to 5.65, P = 0.05) or esketamine (OR 7.43 (1.32 to 41.81), P = 0.02). Patients treated with lauromacrogol (OR 0.42 (0.22 to 0.82, P = 0.01) and patients receiving intra-operative NSAIDs (OR 0.32, (0.12 to 0.85), P = 0.02) were less likely to experience inadequately controlled postprocedural pain. Despite aiming to achieve best practice, the 34.8% incidence of unsatisfactory postoperative pain management in the children studied confirms that postprocedural pain after sclerotherapy is a common problem that requires further attention.
{"title":"Assessment of postoperative pain in children following sclerotherapy of vascular malformations: a retrospective single centre cohort study","authors":"Cees Klein Tank, Nadia Himantono, B. Verhoeven, Ignacio Malagon","doi":"10.1097/ea9.0000000000000053","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000053","url":null,"abstract":"\u0000 \u0000 Inadequately controlled postprocedural pain following sclerotherapy in patients with vascular malformations is a well recognised problem. Reliable epidemiological data and risk factors associated with postprocedural pain in children are lacking.\u0000 \u0000 \u0000 \u0000 To evaluate and quantify postprocedural pain in children and identify possible risk factors based on characteristics of the patient, treatment, and medication.\u0000 \u0000 \u0000 \u0000 A retrospective single centre cohort study.\u0000 \u0000 \u0000 \u0000 A tertiary single centre study in the Netherlands.\u0000 \u0000 \u0000 \u0000 Two hundred and nine chiuldren with ‘simple’ subtypes of congenital vascular malformation who had undergone sclerotherapy.\u0000 \u0000 \u0000 \u0000 Quantifying inadequately controlled postprocedural pain.\u0000 \u0000 \u0000 \u0000 Identifying potential patient and treatment characteristics associated with inadequately controlled postprocedural pain.\u0000 \u0000 \u0000 \u0000 A total of 209 patients who underwent 679 procedures were included in this study. The mean age at first intervention was 11.8 ± 4.5 years. Inadequately controlled postprocedural pain was found in 34.8% of the 679 procedures. Venous malformations (VM) were the most prevalent subtype of vascular malformation (80%), followed by arteriovenous malformations (AVM) (14.6%) and lymphatic malformations (LM) (5.4%). The odds ratio (OR) (95% confidence intervals), and P values obtained from multivariable mixed effect logistic regression analysis for patient and treatment characteristics found to be associated with inadequately controlled postprocedural pain were: chronic use of analgesics (OR 2.74 (1.40 to 5.34), P = 0.003), treatment with ethanol (OR 2.39 (1.01 to 5.65, P = 0.05) or esketamine (OR 7.43 (1.32 to 41.81), P = 0.02). Patients treated with lauromacrogol (OR 0.42 (0.22 to 0.82, P = 0.01) and patients receiving intra-operative NSAIDs (OR 0.32, (0.12 to 0.85), P = 0.02) were less likely to experience inadequately controlled postprocedural pain.\u0000 \u0000 \u0000 \u0000 Despite aiming to achieve best practice, the 34.8% incidence of unsatisfactory postoperative pain management in the children studied confirms that postprocedural pain after sclerotherapy is a common problem that requires further attention.\u0000","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141103933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-06DOI: 10.1097/ea9.0000000000000042
Maria Madalena Nabais, Lionel Müller, Sylvain Picard, Sebastian Schramm
{"title":"Acute lung toxicity from nitrofurantoin in an immunosuppressed patient","authors":"Maria Madalena Nabais, Lionel Müller, Sylvain Picard, Sebastian Schramm","doi":"10.1097/ea9.0000000000000042","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000042","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138595191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-21DOI: 10.1097/ea9.0000000000000014
O. Old, Benjamin Friedrichson, K. Zacharowski, J. Kloka
{"title":"Entering the new digital era of intensive care medicine: an overview of interdisciplinary approaches to use artificial intelligence for patients’ benefit","authors":"O. Old, Benjamin Friedrichson, K. Zacharowski, J. Kloka","doi":"10.1097/ea9.0000000000000014","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000014","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116015487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-19DOI: 10.1097/ea9.0000000000000015
Laura Gorman, Andrew N. Dickson, Myles Monaghan, Frank Vaughan, B. Murphy, D. Dowling, C. McCaul, James F. X. Jones
{"title":"Novel co-axial, disposable, low-cost 3D printed videolaryngoscopes for patients with COVID-19: a manikin study","authors":"Laura Gorman, Andrew N. Dickson, Myles Monaghan, Frank Vaughan, B. Murphy, D. Dowling, C. McCaul, James F. X. Jones","doi":"10.1097/ea9.0000000000000015","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000015","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117306397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-08DOI: 10.1097/ea9.0000000000000010
J. Fliegenschmidt, N. Hulde, Maria Gedinha Preising, Silvia Ruggeri, Ralph Szymanowsky, Laurent Meesseman, Hong Sun, M. Dahlweid, V. von Dossow
{"title":"Leveraging artificial intelligence for the management of postoperative delirium following cardiac surgery","authors":"J. Fliegenschmidt, N. Hulde, Maria Gedinha Preising, Silvia Ruggeri, Ralph Szymanowsky, Laurent Meesseman, Hong Sun, M. Dahlweid, V. von Dossow","doi":"10.1097/ea9.0000000000000010","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000010","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129901307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-08DOI: 10.1097/ea9.0000000000000012
A. Rau, O. Moerer, M. Winkler
{"title":"Indications for extracorporeal membrane oxygenation in coronavirus disease 2019: is the Berlin definition still adequate to adjust therapeutic interventions? A case report","authors":"A. Rau, O. Moerer, M. Winkler","doi":"10.1097/ea9.0000000000000012","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000012","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122213897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1097/ea9.0000000000000016
P. Buehler, M. Weiss, P. Wendel-Garcia, C. Both, A. R. Schmidt, Martin P. Wehren, Jörg Thomas
{"title":"The importance of post marketing quality control","authors":"P. Buehler, M. Weiss, P. Wendel-Garcia, C. Both, A. R. Schmidt, Martin P. Wehren, Jörg Thomas","doi":"10.1097/ea9.0000000000000016","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000016","url":null,"abstract":"","PeriodicalId":300330,"journal":{"name":"European Journal of Anaesthesiology Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116780579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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