Pub Date : 1900-01-01DOI: 10.1097/ea9.0000000000000017
M. Flick, A. Joosten, T. Scheeren, J. Duranteau, B. Saugel
{"title":"Haemodynamic monitoring and management in patients having noncardiac surgery","authors":"M. Flick, A. Joosten, T. Scheeren, J. Duranteau, B. Saugel","doi":"10.1097/ea9.0000000000000017","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000017","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":"125154570","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/ea9.0000000000000001
M. Van de Velde, E. Pogatzki-Zahn, A. Lukaszewicz, D. Longrois, Tom G. Hansen, P. Forget, M. Chew, Nicolas Bruder, C. Samama
{"title":"A new ESAIC open access journal","authors":"M. Van de Velde, E. Pogatzki-Zahn, A. Lukaszewicz, D. Longrois, Tom G. Hansen, P. Forget, M. Chew, Nicolas Bruder, C. Samama","doi":"10.1097/ea9.0000000000000001","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000001","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":"131096573","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/ea9.0000000000000032
P. Dony, Rémi Florquin, P. Forget
Data generation is growing with the use of ‘anaesthesia information management systems’ (AIMS), but the appropriate use of data for scientific purposes is often wasted by a lack of integration. This narrative review aims to describe the use of routinely collected data and its potential usefulness to improve the quality of care, first by defining the six levels of integration of electronic health records as proposed by the National Health Service (NHS) illustrated by examples in anaesthesia practice. Secondly, by explaining what measures can be taken to profit from those data on the micro-system level (for the patient), the meso-system (for the department and the hospital institution) and the macro-system (for healthcare and public health). We will next describe a homemade AIMS solution and the opportunities which result from his integration on the different levels and the research prospects implied. Opportunities outside of high-income countries will also be presented. All lead to the conclusion that a core dataset for peri-operative global research may facilitate a framework for the integration of large volumes of data from electronic health records. It will allow a constant re-evaluation of our practice as anaesthesiologists to offer the best care for patients. In this regard, the training of some anaesthesiologists in data science and artificial intelligence is of paramount importance. We must also take into account the ecological footprint of data centres as these are energy-consuming. It is essential to prepare for these changes and turn the speciality of anaesthesia, collaborating with data scientists, into a more prominent role of peri-operative medicine.
{"title":"Big data in anaesthesia: a narrative, nonsystematic review","authors":"P. Dony, Rémi Florquin, P. Forget","doi":"10.1097/ea9.0000000000000032","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000032","url":null,"abstract":"\u0000 \u0000 Data generation is growing with the use of ‘anaesthesia information management systems’ (AIMS), but the appropriate use of data for scientific purposes is often wasted by a lack of integration. This narrative review aims to describe the use of routinely collected data and its potential usefulness to improve the quality of care, first by defining the six levels of integration of electronic health records as proposed by the National Health Service (NHS) illustrated by examples in anaesthesia practice. Secondly, by explaining what measures can be taken to profit from those data on the micro-system level (for the patient), the meso-system (for the department and the hospital institution) and the macro-system (for healthcare and public health). We will next describe a homemade AIMS solution and the opportunities which result from his integration on the different levels and the research prospects implied. Opportunities outside of high-income countries will also be presented. All lead to the conclusion that a core dataset for peri-operative global research may facilitate a framework for the integration of large volumes of data from electronic health records. It will allow a constant re-evaluation of our practice as anaesthesiologists to offer the best care for patients. In this regard, the training of some anaesthesiologists in data science and artificial intelligence is of paramount importance. We must also take into account the ecological footprint of data centres as these are energy-consuming. It is essential to prepare for these changes and turn the speciality of anaesthesia, collaborating with data scientists, into a more prominent role of peri-operative medicine.\u0000","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":"122962093","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/ea9.0000000000000026
A. Konijn, C. Aldecoa, D. Benhamou, V. Frkovic, P. Kessler, P. Marhofer
The use of regional anaesthesia has increased and evolved over the past two decades but to what extent is unclear. Moreover, there is no clear standardisation of best practice in the current European landscape, which could result in inconsistencies in regional anaesthesia in practice. The objective of this survey was to explore regional anaesthesia practices across Europe, including the differences in procedures, use of ultrasound, reporting of complications, guidelines, training and patient safety implementation. A Faculty of European regional anaesthesia experts developed a survey of 27 questions focused on respondent and institution profile, anaesthesia services, patient and safety management, training, use of guidelines, and the implementation of NRFitTM [neuraxial device connectors that meet the International Organisation for Standardisation (ISO) requirements]. The survey was disseminated across several European countries via professional networks. There were 794 respondents from 36 European countries. The survey demonstrated that use of regional anaesthesia is growing in Europe and is supported by new technologies. Although some results are consistent with expected trends and applications (e.g. procedures predominantly performed by anaesthesiologists), there are inconsistencies in practice across European countries, especially in the specific regional anaesthesia procedures utilised for different clinical applications and the recording and reporting of regional anaesthesia complications. These inconsistencies also extended to which guidelines are primarily followed and how training is implemented. There were also variations in the general awareness and uptake of the ISO standard for NRFit. The survey results highlight a clear need for standardisation and consistency in the use and management of regional anaesthesia across Europe. The faculty put forth several calls to action that could provide major steps in the right direction towards meeting that goal, including the establishment of European best practices, development of a complication reporting system and implementation of educational programmes to highlight the importance of NRFit.
{"title":"Regional anaesthesia practices: insights from a European survey","authors":"A. Konijn, C. Aldecoa, D. Benhamou, V. Frkovic, P. Kessler, P. Marhofer","doi":"10.1097/ea9.0000000000000026","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000026","url":null,"abstract":"\u0000 \u0000 The use of regional anaesthesia has increased and evolved over the past two decades but to what extent is unclear. Moreover, there is no clear standardisation of best practice in the current European landscape, which could result in inconsistencies in regional anaesthesia in practice.\u0000 \u0000 \u0000 \u0000 The objective of this survey was to explore regional anaesthesia practices across Europe, including the differences in procedures, use of ultrasound, reporting of complications, guidelines, training and patient safety implementation.\u0000 \u0000 \u0000 \u0000 A Faculty of European regional anaesthesia experts developed a survey of 27 questions focused on respondent and institution profile, anaesthesia services, patient and safety management, training, use of guidelines, and the implementation of NRFitTM [neuraxial device connectors that meet the International Organisation for Standardisation (ISO) requirements].\u0000 \u0000 \u0000 \u0000 The survey was disseminated across several European countries via professional networks.\u0000 \u0000 \u0000 \u0000 There were 794 respondents from 36 European countries.\u0000 \u0000 \u0000 \u0000 The survey demonstrated that use of regional anaesthesia is growing in Europe and is supported by new technologies. Although some results are consistent with expected trends and applications (e.g. procedures predominantly performed by anaesthesiologists), there are inconsistencies in practice across European countries, especially in the specific regional anaesthesia procedures utilised for different clinical applications and the recording and reporting of regional anaesthesia complications. These inconsistencies also extended to which guidelines are primarily followed and how training is implemented. There were also variations in the general awareness and uptake of the ISO standard for NRFit.\u0000 \u0000 \u0000 \u0000 The survey results highlight a clear need for standardisation and consistency in the use and management of regional anaesthesia across Europe. The faculty put forth several calls to action that could provide major steps in the right direction towards meeting that goal, including the establishment of European best practices, development of a complication reporting system and implementation of educational programmes to highlight the importance of NRFit.\u0000","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":"123407265","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/ea9.0000000000000020
C. Böck, Christoph Mörtl, C. Mahringer, M. Huemer, Jens Meier
{"title":"Variability of expert assessments of ECG time domain parameters","authors":"C. Böck, Christoph Mörtl, C. Mahringer, M. Huemer, Jens Meier","doi":"10.1097/ea9.0000000000000020","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000020","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":"127282558","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/ea9.0000000000000029
Simone Di Filippo, Antonio Messina, P. Pelosi, C. Robba
{"title":"Eight rules for the haemodynamic management of traumatic brain-injured patients","authors":"Simone Di Filippo, Antonio Messina, P. Pelosi, C. Robba","doi":"10.1097/ea9.0000000000000029","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000029","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":"134066651","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/ea9.0000000000000030
F. Petitjeans, Sandrine Leroy, C. Pichot, M. Ghignone, L. Quintin, D. Longrois, J. Constantin
Optimisation of the respiratory drive, as early as possible in the setting of severe acute respiratory distress syndrome (ARDS) and not its suppression, could be a new paradigm in the management of severe forms of ARDS. Severe ARDS is characterised by tachypnoea and hyperpnoea, a consequence of a high respiratory drive. Some patients require endotracheal intubation, controlled mechanical ventilation (CMV) and paralysis to prevent overt ventilatory failure and self-inflicted lung injury. Nevertheless, intubation, CMV and paralysis do not address per se the high respiratory drive, they only suppress it. Optimisation of the respiratory drive could be obtained by a multimodal approach that targets attenuation of fever, agitation, systemic and peripheral acidosis, inflammation, extravascular lung water and changes in carbon dioxide levels. The paradigm we present, based on pathophysiological considerations, is that as soon as these factors have been controlled, spontaneous breathing could resume because hypoxaemia is the least important input to the respiratory drive. Hypoxaemia could be handled by combining positive end-expiratory pressure (PEEP) to prevent early expiratory closure and low pressure support to minimise the work of breathing (WOB). ‘Cooperative’ sedation with alpha-2 agonists, supplemented with neuroleptics if required, is the pharmacological adjunct, administered immediately after intubation as the first-line sedation regimen during the multimodal approach. Given relative contraindications (hypovolaemia, auriculoventricular block, sick sinus syndrome), alpha-2 agonists can help attenuate or moderate fever, increased oxygen consumption VO2, agitation, high cardiac output, inflammation and acidosis. They may also help to preserve microcirculation, cognition and respiratory rhythm generation, thus promoting spontaneous breathing. Returning the physiology of respiratory, ventilatory, circulatory and autonomic systems to normal will support the paradigm of optimised respiratory drive favouring early spontaneous ventilation, at variance with deep sedation, extended paralysis, CMV and use of the prone position as therapeutic strategies in severe ARDS. Glossary and Abbreviations_SDC, http://links.lww.com/EJAIC/A55
{"title":"Improved understanding of the respiratory drive pathophysiology could lead to earlier spontaneous breathing in severe acute respiratory distress syndrome","authors":"F. Petitjeans, Sandrine Leroy, C. Pichot, M. Ghignone, L. Quintin, D. Longrois, J. Constantin","doi":"10.1097/ea9.0000000000000030","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000030","url":null,"abstract":"\u0000 \u0000 Optimisation of the respiratory drive, as early as possible in the setting of severe acute respiratory distress syndrome (ARDS) and not its suppression, could be a new paradigm in the management of severe forms of ARDS. Severe ARDS is characterised by tachypnoea and hyperpnoea, a consequence of a high respiratory drive. Some patients require endotracheal intubation, controlled mechanical ventilation (CMV) and paralysis to prevent overt ventilatory failure and self-inflicted lung injury. Nevertheless, intubation, CMV and paralysis do not address per se the high respiratory drive, they only suppress it. Optimisation of the respiratory drive could be obtained by a multimodal approach that targets attenuation of fever, agitation, systemic and peripheral acidosis, inflammation, extravascular lung water and changes in carbon dioxide levels. The paradigm we present, based on pathophysiological considerations, is that as soon as these factors have been controlled, spontaneous breathing could resume because hypoxaemia is the least important input to the respiratory drive. Hypoxaemia could be handled by combining positive end-expiratory pressure (PEEP) to prevent early expiratory closure and low pressure support to minimise the work of breathing (WOB). ‘Cooperative’ sedation with alpha-2 agonists, supplemented with neuroleptics if required, is the pharmacological adjunct, administered immediately after intubation as the first-line sedation regimen during the multimodal approach. Given relative contraindications (hypovolaemia, auriculoventricular block, sick sinus syndrome), alpha-2 agonists can help attenuate or moderate fever, increased oxygen consumption VO2, agitation, high cardiac output, inflammation and acidosis. They may also help to preserve microcirculation, cognition and respiratory rhythm generation, thus promoting spontaneous breathing. Returning the physiology of respiratory, ventilatory, circulatory and autonomic systems to normal will support the paradigm of optimised respiratory drive favouring early spontaneous ventilation, at variance with deep sedation, extended paralysis, CMV and use of the prone position as therapeutic strategies in severe ARDS.\u0000 \u0000 \u0000 \u0000 Glossary and Abbreviations_SDC, http://links.lww.com/EJAIC/A55\u0000 \u0000","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":"121194650","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/ea9.0000000000000019
P. Aceto, C. Galletta, C. Cambise, G. Punzo, E. Luca, C. Schipa, L. Sollazzi
{"title":"Challenges for anaesthesia for robotic-assisted surgery in the elderly","authors":"P. Aceto, C. Galletta, C. Cambise, G. Punzo, E. Luca, C. Schipa, L. Sollazzi","doi":"10.1097/ea9.0000000000000019","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000019","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":"130470347","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/ea9.0000000000000004
P. Guinot, Stefan Andrei, D. Longrois
{"title":"Ventriculo-arterial coupling: from physiological concept to clinical application in peri-operative care and ICUs","authors":"P. Guinot, Stefan Andrei, D. Longrois","doi":"10.1097/ea9.0000000000000004","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000004","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":"127493405","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/ea9.0000000000000005
D. Hoogma, L. Al Tmimi, S. Fieuws, J. Tournoy, A. Kowark, R. Rossaint, M. Coburn, S. Rex
{"title":"Circadian effect of time of anaesthesia on postoperative outcomes in major elective and urgent intervention: a secondary analysis of the Peri-interventional Outcome Study in the Elderly (POSE)","authors":"D. Hoogma, L. Al Tmimi, S. Fieuws, J. Tournoy, A. Kowark, R. Rossaint, M. Coburn, S. Rex","doi":"10.1097/ea9.0000000000000005","DOIUrl":"https://doi.org/10.1097/ea9.0000000000000005","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":"128333400","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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