Trends in Anaesthesia and Critical Care最新文献_第6页

Alternative sources for high flow nasal oxygen in low-resource settings: Exploring the potential of auxiliary oxygen ports and wall flowmeters 低资源环境下高流量鼻氧的替代来源：探索辅助氧口和壁流量计的潜力

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-03-07 DOI: 10.1016/j.tacc.2025.101542

Johan J Swart , Claire Pfister , Hayli Geffen , Ross Hofmeyr

Background

High flow nasal oxygen (HFNO) therapy delivers pure oxygen at rates over 40 L/min during preoxygenation and 60 L/min during apnoea, preventing hypoxia and extending safe apnoeic time. HFNO is beneficial in certain clinical scenarios. However, cost and limited availability of HFNO devices restrict routine use. Auxiliary oxygen outlets on anaesthesia workstations present a potential alternative HFNO source.

Aim

This study aimed to assess the maximum flow rates from auxiliary oxygen outlets on various anaesthesia workstations and wall flowmeters, to explore their viability as a source for HFNO.

Methods

After calibration in Switzerland, a CITREX H4 gas flow analyser was used to measure flow rates across multiple anaesthesia workstations and wall-mounted flowmeters at five hospitals affiliated with one academic anaesthesia department.

Results

Only two of nine tested workstations could reliably support flows sufficient for high flow apnoeic oxygenation. The General Electric (GE) CS 650 workstation had the highest average flow rate (120 L/min) while the Dräger Fabius GS Premium had the lowest (13 L/min). Wall flowmeters had flow rates ranging from 108 to 28 L/min, with most supporting flow rates greater than 60L/min.

Conclusion

The auxiliary oxygen outlet on anaesthetic workstations and general oxygen flowmeters is underutilised. Sufficient flow rates to function as a source of HFNO are attainable with many types, but should be individually tested. In a resource-limited environment, this could provide a cost-effective alternative in providing apnoeic oxygenation for a time-limited period, although safety has not yet been established.

高流量鼻氧（HFNO）治疗在预充氧期间以超过40 L/min的速率提供纯氧，在呼吸暂停期间以60 L/min的速率提供纯氧，防止缺氧并延长安全呼吸暂停时间。HFNO在某些临床情况下是有益的。然而，HFNO设备的成本和有限的可用性限制了常规使用。麻醉工作站的辅助供氧口是一种潜在的替代HFNO来源。目的本研究旨在评估不同麻醉工作站和壁式流量计辅助供氧口的最大流量，探讨其作为高流量一氧化氮来源的可行性。方法在瑞士校准后，使用CITREX H4气体流量分析仪测量一个学术麻醉科所属五家医院的多个麻醉工作站和壁挂式流量计的流量。结果9个测试工作站中只有2个能够可靠地支持足够的高流量呼吸性氧合。通用电气（GE） CS 650工作站的平均流速最高（120 L/min），而Dräger Fabius GS Premium最低（13 L/min）。壁式流量计的流量范围为108 ~ 28l /min，大多数配套流量大于60L/min。结论麻醉工作站及普通氧流量计辅助供氧口利用不足。许多类型都可以达到足够的流量作为HFNO的来源，但应单独测试。在资源有限的环境中，这可能是一种具有成本效益的替代方法，可以在有限的时间内提供呼吸暂停氧合，尽管安全性尚未确定。

{"title":"Alternative sources for high flow nasal oxygen in low-resource settings: Exploring the potential of auxiliary oxygen ports and wall flowmeters","authors":"Johan J Swart , Claire Pfister , Hayli Geffen , Ross Hofmeyr","doi":"10.1016/j.tacc.2025.101542","DOIUrl":"10.1016/j.tacc.2025.101542","url":null,"abstract":"<div><h3>Background</h3><div>High flow nasal oxygen (HFNO) therapy delivers pure oxygen at rates over 40 L/min during preoxygenation and 60 L/min during apnoea, preventing hypoxia and extending safe apnoeic time. HFNO is beneficial in certain clinical scenarios. However, cost and limited availability of HFNO devices restrict routine use. Auxiliary oxygen outlets on anaesthesia workstations present a potential alternative HFNO source.</div></div><div><h3>Aim</h3><div>This study aimed to assess the maximum flow rates from auxiliary oxygen outlets on various anaesthesia workstations and wall flowmeters, to explore their viability as a source for HFNO.</div></div><div><h3>Methods</h3><div>After calibration in Switzerland, a CITREX H4 gas flow analyser was used to measure flow rates across multiple anaesthesia workstations and wall-mounted flowmeters at five hospitals affiliated with one academic anaesthesia department.</div></div><div><h3>Results</h3><div>Only two of nine tested workstations could reliably support flows sufficient for high flow apnoeic oxygenation. The General Electric (GE) CS 650 workstation had the highest average flow rate (120 L/min) while the Dräger Fabius GS Premium had the lowest (13 L/min). Wall flowmeters had flow rates ranging from 108 to 28 L/min, with most supporting flow rates greater than 60L/min.</div></div><div><h3>Conclusion</h3><div>The auxiliary oxygen outlet on anaesthetic workstations and general oxygen flowmeters is underutilised. Sufficient flow rates to function as a source of HFNO are attainable with many types, but should be individually tested. In a resource-limited environment, this could provide a cost-effective alternative in providing apnoeic oxygenation for a time-limited period, although safety has not yet been established.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101542"},"PeriodicalIF":1.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing tracheostomy anesthesia: A comparative study of nerve blocks 优化气管切开术麻醉：神经阻滞的比较研究

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-03-01 DOI: 10.1016/j.tacc.2025.101541

Tarek I. Ismail , Rabab S.S. Mahrous , Ahmed A. Bedewy

Background

Tracheostomy is increasingly performed as a planned procedure for a wide range of indications. While superficial cervical plexus block (SCPB) is widely used as regional anesthesia for tracheostomy, its limitation in suppressing laryngeal reflexes may lead to discomfort and complications. Combining bilateral SCPB with bilateral superior laryngeal nerve block (SLNB) could potentially improve patient outcomes by reducing airway reflexes.

Objective

This study aimed to compare the effectiveness of bilateral SCPB alone versus bilateral SCPB combined with bilateral SLNB in sedated patients undergoing surgical tracheostomy.

Methods

A double-blind, randomized controlled trial was conducted at Alexandria University Hospital. A total of 120 adult patients, both intubated and non-intubated, requiring elective tracheostomy was randomly allocated into two groups: Group 1 received an ultrasound-guided bilateral SCPB alone, while Group 2 received a combination of ultrasound-guided bilateral SCPB and bilateral SLNB. The primary outcome was the incidence of intraoperative coughing and laryngospasm. Secondary outcomes included postoperative pain, cumulative analgesic requirements, time to first analgesic request, postoperative complications and patients’ satisfaction.

Results

Group 2 (SCPB + SLNB) demonstrated a significantly lower occurrence of coughing and laryngospasm compared to Group 1 (p < 0.05). No significant difference was observed in postoperative pain intensity between the two groups. Additionally, postoperative complications and patients’ satisfaction were comparable between both groups, with no significant differences noted.

Conclusion

The addition of bilateral SLNB to SCPB significantly suppresses airway-related reflexes during tracheostomy.

背景：气管切开术越来越多地作为一种计划手术用于广泛的适应症。虽然浅颈丛阻滞（SCPB）被广泛用于气管切开术的区域麻醉，但其在抑制喉反射方面的局限性可能导致不适和并发症。双侧SCPB联合双侧喉上神经阻滞（SLNB）可能通过减少气道反射来改善患者的预后。目的比较单用双侧SCPB与双侧SCPB联合双侧SLNB治疗镇静气管切开术患者的疗效。方法在亚历山大大学医院进行双盲、随机对照试验。120例需要择期气管切开术的成年患者，包括气管插管和非气管插管，随机分为两组：1组单独行超声引导下双侧SCPB， 2组双侧SCPB和双侧SLNB联合行超声引导下双侧SCPB。主要观察指标为术中咳嗽和喉痉挛的发生率。次要结局包括术后疼痛、累积止痛需求、到首次止痛要求的时间、术后并发症和患者满意度。结果2组（SCPB + SLNB）咳嗽和喉痉挛发生率明显低于1组(p <；0.05)。两组术后疼痛强度差异无统计学意义。此外，术后并发症和患者满意度在两组之间具有可比性，无显著差异。结论在SCPB中加入双侧SLNB可明显抑制气管切开术时气道相关反射。

{"title":"Optimizing tracheostomy anesthesia: A comparative study of nerve blocks","authors":"Tarek I. Ismail , Rabab S.S. Mahrous , Ahmed A. Bedewy","doi":"10.1016/j.tacc.2025.101541","DOIUrl":"10.1016/j.tacc.2025.101541","url":null,"abstract":"<div><h3>Background</h3><div>Tracheostomy is increasingly performed as a planned procedure for a wide range of indications. While superficial cervical plexus block (SCPB) is widely used as regional anesthesia for tracheostomy, its limitation in suppressing laryngeal reflexes may lead to discomfort and complications. Combining bilateral SCPB with bilateral superior laryngeal nerve block (SLNB) could potentially improve patient outcomes by reducing airway reflexes.</div></div><div><h3>Objective</h3><div>This study aimed to compare the effectiveness of bilateral SCPB alone versus bilateral SCPB combined with bilateral SLNB in sedated patients undergoing surgical tracheostomy.</div></div><div><h3>Methods</h3><div>A double-blind, randomized controlled trial was conducted at Alexandria University Hospital. A total of 120 adult patients, both intubated and non-intubated, requiring elective tracheostomy was randomly allocated into two groups: Group 1 received an ultrasound-guided bilateral SCPB alone, while Group 2 received a combination of ultrasound-guided bilateral SCPB and bilateral SLNB. The primary outcome was the incidence of intraoperative coughing and laryngospasm. Secondary outcomes included postoperative pain, cumulative analgesic requirements, time to first analgesic request, postoperative complications and patients’ satisfaction.</div></div><div><h3>Results</h3><div>Group 2 (SCPB + SLNB) demonstrated a significantly lower occurrence of coughing and laryngospasm compared to Group 1 (p < 0.05). No significant difference was observed in postoperative pain intensity between the two groups. Additionally, postoperative complications and patients’ satisfaction were comparable between both groups, with no significant differences noted.</div></div><div><h3>Conclusion</h3><div>The addition of bilateral SLNB to SCPB significantly suppresses airway-related reflexes during tracheostomy.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101541"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548042","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}

引用次数: 0

Effectiveness of dipyrone (metamizole) in postoperative analgesia: A systematic review and meta-analysis 双吡隆（甲氨唑）在术后镇痛中的有效性：一项系统综述和荟萃分析

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-27 DOI: 10.1016/j.tacc.2025.101540

Mariana Luz , Selma Alves Valente do Amaral Lopes , Bruna Brandao Barreto , Jamine da Silva Vieira , Julia Tavares-Pereira , Luisa Pereira Novaes , Dimitri Gusmao-Flores

Background

Postoperative pain requires effective management. This study reviews the effectiveness and safety of dipyrone/metamizole for postoperative pain management in adults and children.

Materials and methods

The online databases Medline, OVID, Embase, and LILACS were searched in November 2024 for randomized controlled trials comparing dipyrone/metamizole with other drugs or placebo in postoperative settings. Outcomes included immediate postoperative pain scores and opioid consumption (Oral Morphine Equivalence, OME) in the first 24 h.

Results

Thirty studies were included. In adult patients, no significant OME differences were found between dipyrone and NSAIDs (2.1 mg; 95%CI -3.4 to 7.7), paracetamol (−1.3 mg; 95%CI -5.9 to 3.3), or placebo (−2.7 mg; 95%CI -9.2 to 3.8). In the ICU study, dipyrone showed lower OME than paracetamol (−9.9 mg; 95%CI -18.2 to −1.6). In pediatric studies, there were no differences in OME between dipyrone and paracetamol (0 mg; 95%CI -0.1 to 0.1) or placebo (−0.1 mg; 95%CI -0.3 to 0.2). No significant side effects were reported.

Conclusion

Dipyrone is as effective as other non-opioid analgesics commonly used for postoperative analgesia, and more effective than paracetamol in ICU patients. The reviewed studies indicate that its use is safe, and therefore it should be considered as an option for multimodal analgesia in pain management guidelines.

术后疼痛需要有效的治疗。本研究回顾了双吡隆/安咪唑治疗成人和儿童术后疼痛的有效性和安全性。材料和方法于2024年11月检索在线数据库Medline、OVID、Embase和LILACS，以比较双吡酮/元氨唑与其他药物或安慰剂在术后环境中的随机对照试验。结果包括术后即刻疼痛评分和前24小时阿片类药物消耗（口服吗啡当量，OME）。在成人患者中，双吡隆和非甾体抗炎药(2.1 mg；95%CI -3.4 ~ 7.7)，扑热息痛(- 1.3 mg；95%CI -5.9 - 3.3)，或安慰剂(- 2.7 mg；95%CI -9.2 ~ 3.8)。在ICU的研究中，双吡喃酮的OME低于扑热息痛(- 9.9 mg；95%CI -18.2 ~−1.6)。在儿科研究中，双吡酮和扑热息痛(0 mg；95%CI -0.1 ~ 0.1)或安慰剂(-0.1 mg；95%CI -0.3 ~ 0.2)。没有明显的副作用报告。结论双吡隆用于ICU患者术后镇痛的效果与其他常用非阿片类镇痛药相当，优于扑热息痛。综述的研究表明，它的使用是安全的，因此它应该被认为是疼痛管理指南中多模式镇痛的一种选择。

{"title":"Effectiveness of dipyrone (metamizole) in postoperative analgesia: A systematic review and meta-analysis","authors":"Mariana Luz , Selma Alves Valente do Amaral Lopes , Bruna Brandao Barreto , Jamine da Silva Vieira , Julia Tavares-Pereira , Luisa Pereira Novaes , Dimitri Gusmao-Flores","doi":"10.1016/j.tacc.2025.101540","DOIUrl":"10.1016/j.tacc.2025.101540","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pain requires effective management. This study reviews the effectiveness and safety of dipyrone/metamizole for postoperative pain management in adults and children.</div></div><div><h3>Materials and methods</h3><div>The online databases Medline, OVID, Embase, and LILACS were searched in November 2024 for randomized controlled trials comparing dipyrone/metamizole with other drugs or placebo in postoperative settings. Outcomes included immediate postoperative pain scores and opioid consumption (Oral Morphine Equivalence, OME) in the first 24 h.</div></div><div><h3>Results</h3><div>Thirty studies were included. In adult patients, no significant OME differences were found between dipyrone and NSAIDs (2.1 mg; 95%CI -3.4 to 7.7), paracetamol (−1.3 mg; 95%CI -5.9 to 3.3), or placebo (−2.7 mg; 95%CI -9.2 to 3.8). In the ICU study, dipyrone showed lower OME than paracetamol (−9.9 mg; 95%CI -18.2 to −1.6). In pediatric studies, there were no differences in OME between dipyrone and paracetamol (0 mg; 95%CI -0.1 to 0.1) or placebo (−0.1 mg; 95%CI -0.3 to 0.2). No significant side effects were reported.</div></div><div><h3>Conclusion</h3><div>Dipyrone is as effective as other non-opioid analgesics commonly used for postoperative analgesia, and more effective than paracetamol in ICU patients. The reviewed studies indicate that its use is safe, and therefore it should be considered as an option for multimodal analgesia in pain management guidelines.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"61 ","pages":"Article 101540"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535233","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}

引用次数: 0

Characteristics and outcome of critical care patients undergoing tracheostomy in a medical intensive care setting: A retrospective single center analysis of 1570 procedures in 12 years 重症监护室气管切开术重症监护患者的特点和结果：12年来1570例手术的回顾性单中心分析

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101519

Tim Schroeder, Jens Nee, Sarah Kamel, Christian Storm, Carl Hinrichs, Florian Marcy , Bettina Schueler

Tracheostomy is often indicated for patients requiring prolonged ventilation, as it can facilitate weaning from the ventilator, reduce work of breathing and allow cessation of sedation. Optimal timing and mode of tracheostomy is still under debate.

Objective

To evaluate the technique, timing, and clinical outcomes of tracheostomy in a large single-center cohort of medical intensive care unit (ICU) patients.

Methods

A retrospective cohort analysis was conducted on consecutive patients undergoing tracheostomy between 2006 and 2018 in a medical ICU. Patients received either a percutaneous dilatational tracheostomy or surgical tracheostomy. Data collected included patient demographics, APACHE-II scores, ICU mortality, duration of mechanical ventilation, length of ICU stays, tracheostomy technique, and timing of tracheostomy relative to intubation and initiation of mechanical ventilation.

Results

A total of 1570 tracheostomies were analyzed, comprising 1323 (84.2 %) dilatational tracheostomies and 247 (15.8 %) surgical tracheostomies. The type of tracheostomy did not significantly affect length of stays or length of mechanical ventilation. Subgroup analysis based on tracheostomy timing revealed that early tracheostomy (<7 days post-intubation) was associated with shorter length of mechanical ventilation (p < 0.001), reduced length of stays (p < 0.001), and lower mortality (p = 0.01). Multivariate regression analysis identified early tracheostomy as an independent predictor of reduced mortality, while tracheostomy type had no significant effect on mortality outcomes.

Conclusion

Early tracheostomy, within seven days of intubation, was associated with improved survival, shorter length of mechanical ventilation, and reduced ICU stays, independent of the tracheostomy technique in our retrospective cohort in medical ICU patients.

气管切开术通常适用于需要长时间通气的患者，因为它可以促进脱离呼吸机，减少呼吸工作并允许停止镇静。气管切开术的最佳时机和方式仍在争论中。目的评价重症监护病房（ICU）患者气管切开术的技术、时机和临床效果。方法对2006 - 2018年在某内科ICU连续行气管切开术的患者进行回顾性队列分析。患者接受经皮扩张性气管切开术或手术气管切开术。收集的数据包括患者人口统计学、APACHE-II评分、ICU死亡率、机械通气持续时间、ICU住院时间、气管造口术以及相对于插管和机械通气开始的气管造口术时间。结果共分析气管造口术1570例，其中扩张性气管造口术1323例（84.2%），外科气管造口术247例（15.8%）。气管造口类型对住院时间和机械通气时间无显著影响。基于气管造口时间的亚组分析显示，早期气管造口（插管后7天）与较短的机械通气时间相关(p <；0.001)，住院时间缩短(p <；0.001)，死亡率更低（p = 0.01）。多因素回归分析发现，早期气管切开术是降低死亡率的独立预测因子，而气管切开术类型对死亡率结果无显著影响。结论在我们回顾性队列的内科ICU患者中，早期气管造口术（插管后7天内）与气管造口技术无关，可提高生存率，缩短机械通气时间，缩短ICU住院时间。

{"title":"Characteristics and outcome of critical care patients undergoing tracheostomy in a medical intensive care setting: A retrospective single center analysis of 1570 procedures in 12 years","authors":"Tim Schroeder, Jens Nee, Sarah Kamel, Christian Storm, Carl Hinrichs, Florian Marcy , Bettina Schueler","doi":"10.1016/j.tacc.2025.101519","DOIUrl":"10.1016/j.tacc.2025.101519","url":null,"abstract":"<div><div>Tracheostomy is often indicated for patients requiring prolonged ventilation, as it can facilitate weaning from the ventilator, reduce work of breathing and allow cessation of sedation. Optimal timing and mode of tracheostomy is still under debate.</div></div><div><h3>Objective</h3><div>To evaluate the technique, timing, and clinical outcomes of tracheostomy in a large single-center cohort of medical intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted on consecutive patients undergoing tracheostomy between 2006 and 2018 in a medical ICU. Patients received either a percutaneous dilatational tracheostomy or surgical tracheostomy. Data collected included patient demographics, APACHE-II scores, ICU mortality, duration of mechanical ventilation, length of ICU stays, tracheostomy technique, and timing of tracheostomy relative to intubation and initiation of mechanical ventilation.</div></div><div><h3>Results</h3><div>A total of 1570 tracheostomies were analyzed, comprising 1323 (84.2 %) dilatational tracheostomies and 247 (15.8 %) surgical tracheostomies. The type of tracheostomy did not significantly affect length of stays or length of mechanical ventilation. Subgroup analysis based on tracheostomy timing revealed that early tracheostomy (<7 days post-intubation) was associated with shorter length of mechanical ventilation (p < 0.001), reduced length of stays (p < 0.001), and lower mortality (p = 0.01). Multivariate regression analysis identified early tracheostomy as an independent predictor of reduced mortality, while tracheostomy type had no significant effect on mortality outcomes.</div></div><div><h3>Conclusion</h3><div>Early tracheostomy, within seven days of intubation, was associated with improved survival, shorter length of mechanical ventilation, and reduced ICU stays, independent of the tracheostomy technique in our retrospective cohort in medical ICU patients.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101519"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges in laryngeal mask ventilation: Case of a vocal cord polyp 喉罩通气的挑战：声带息肉1例

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101517

Sangrà-Puig M, Tena B, Bergé R, Barranco de Santiago A, Garavito L, Magaldi M

The most frequent causes of airway obstruction during the use of laryngeal mask airway (LMA) devices are related to a superficial plane of anesthesia or misposition. However, uncommon causes must also be considered. This case report presents a patient scheduled for elective surgery, encountering unexpected difficulties during airway management due to a previously undiagnosed giant vocal cord polyp. The steps for managing a difficult airway were followed correctly finally leading to awakening the patient to prevent a potentially dangerous “can't intubate, can't ventilate” scenario.

This case emphasizes the importance of thorough preoperative airway assessment, early recognition of airway difficulties and the strategic use of awake intubation techniques in complex airway management situations.

在使用喉罩气道（LMA）装置时，最常见的气道阻塞原因与麻醉的表面或错位有关。然而，不常见的原因也必须考虑在内。这个病例报告提出了一个病人计划择期手术，遇到意想不到的困难在气道管理由于以前未确诊的巨大声带息肉。处理困难气道的步骤被正确地遵循，最终导致唤醒患者，以防止潜在的危险“无法插管，无法呼吸”的情况。本病例强调了全面的术前气道评估，早期识别气道困难以及在复杂气道管理情况下策略性地使用清醒插管技术的重要性。

引用次数: 0

Video laryngoscopy for obstetric airway management: A narrative review 视频喉镜在产科气道管理中的应用综述

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101522

Fernanda S.L. Oliveira, Fabricio B. Zasso, Kevin S. Chen, Kong Eric You-Ten, Naveed Siddiqui

The obstetric population has an increased risk of difficult airways due to changes, with a mortality rate of 1 death per 90 failed intubations. Recently guidelines for difficult airway management have recognized and recommended video laryngoscopy devices in difficult airway cases. Although there has been a substantial number of publications on video laryngoscopy, there is a lack of literature to help establish its use for managing obstetric airways. Therefore, we conducted a narrative review to evaluate the performance and efficacy of video laryngoscopy in obstetric patients. A literature review was performed on papers published until November 2024, studying adult patients who underwent obstetric procedures under general anesthesia. Improved glottis visualization, increased success rate in patients with predicted difficult airways, and rescue of a failed direct laryngoscopy attempt are advantages of video laryngoscopy. There are conflicting results regarding video laryngoscopy being superior to direct laryngoscopy regarding first-attempt success and time to intubation. Additionally, we discussed different types of video laryngoscope blades and video laryngoscopy with training in the obstetric population. Our review's findings are consistent with the current guidelines that recommend video laryngoscopes should be available for every obstetric general anesthesia, summed to the need for larger studies in this population.

由于改变，产科人口呼吸道困难的风险增加，死亡率为每90例插管失败死亡1例。最近气道困难管理指南已经认可并推荐在气道困难病例中使用视频喉镜设备。虽然有大量的视频喉镜的出版物，有缺乏文献，以帮助建立其用于管理产科气道。因此，我们进行了一项叙述性回顾，以评估视频喉镜在产科患者中的表现和疗效。对2024年11月之前发表的论文进行了文献综述，研究了在全身麻醉下接受产科手术的成年患者。视频喉镜的优点是改善声门的可见性，提高预测气道困难患者的成功率，挽救失败的直接喉镜检查尝试。关于首次尝试的成功率和插管时间，视频喉镜优于直接喉镜的结果存在矛盾。此外，我们讨论了不同类型的视频喉镜刀片和视频喉镜与培训的产科人口。我们的综述结果与目前的指南一致，建议在所有产科全身麻醉中都应使用视频喉镜，总结为需要在这一人群中进行更大规模的研究。

{"title":"Video laryngoscopy for obstetric airway management: A narrative review","authors":"Fernanda S.L. Oliveira, Fabricio B. Zasso, Kevin S. Chen, Kong Eric You-Ten, Naveed Siddiqui","doi":"10.1016/j.tacc.2025.101522","DOIUrl":"10.1016/j.tacc.2025.101522","url":null,"abstract":"<div><div>The obstetric population has an increased risk of difficult airways due to changes, with a mortality rate of 1 death per 90 failed intubations. Recently guidelines for difficult airway management have recognized and recommended video laryngoscopy devices in difficult airway cases. Although there has been a substantial number of publications on video laryngoscopy, there is a lack of literature to help establish its use for managing obstetric airways. Therefore, we conducted a narrative review to evaluate the performance and efficacy of video laryngoscopy in obstetric patients. A literature review was performed on papers published until November 2024, studying adult patients who underwent obstetric procedures under general anesthesia. Improved glottis visualization, increased success rate in patients with predicted difficult airways, and rescue of a failed direct laryngoscopy attempt are advantages of video laryngoscopy. There are conflicting results regarding video laryngoscopy being superior to direct laryngoscopy regarding first-attempt success and time to intubation. Additionally, we discussed different types of video laryngoscope blades and video laryngoscopy with training in the obstetric population. Our review's findings are consistent with the current guidelines that recommend video laryngoscopes should be available for every obstetric general anesthesia, summed to the need for larger studies in this population.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101522"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372719","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}

引用次数: 0

Recent advances in the development of invasive ventilator liberation 有创呼吸机解放的最新进展

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101521

Hui Liu , Xiaoyi Liu , Jiangxia Pan , Rui Zhou , Hui Ran , Lili Chen

Invasive ventilation is a critical respiratory support technology in the intensive care unit (ICU). Increasing evidence suggests that early liberation from invasive ventilation can benefit patients. However, further research is needed to establish optimal criteria for invasive ventilator liberation programs, including the ideal screening frequency, appropriate techniques and duration of spontaneous breathing trials (SBT), evaluation of airway extubation readiness, and decision-making regarding extubation. The management of the invasive ventilator liberation process should encompass feasibility screening for SBTs, conducting SBTs, evaluating SBT outcomes, assessing airway extubation readiness, performing extubation itself, identifying high-risk factors associated with weaning failure, and developing clinical strategies. Additionally, a patient-centered assessment of the risks and consequences of extubation failure may serve as crucial measures to enhance the success rate of invasive ventilator liberation. Therefore, we conduct a detailed review of the related studies on invasive mechanical ventilation weaning to determine the best invasive ventilator liberation strategy.

有创通气是重症监护病房（ICU）的一项关键呼吸支持技术。越来越多的证据表明，尽早摆脱有创通气对患者有益。然而，需要进一步的研究来建立有创呼吸机解放方案的最佳标准，包括理想的筛查频率、适当的技术和自主呼吸试验（SBT）的持续时间、气道拔管准备的评估以及拔管的决策。有创呼吸机释放过程的管理应包括SBT的可行性筛选、SBT的实施、SBT结果的评估、气道拔管准备情况的评估、拔管本身的实施、识别与脱机失败相关的高危因素以及制定临床策略。此外，以患者为中心评估拔管失败的风险和后果可能是提高有创呼吸机解放成功率的关键措施。因此，我们对有创机械通气脱机的相关研究进行了详细的回顾，以确定最佳的有创呼吸机解放策略。

{"title":"Recent advances in the development of invasive ventilator liberation","authors":"Hui Liu , Xiaoyi Liu , Jiangxia Pan , Rui Zhou , Hui Ran , Lili Chen","doi":"10.1016/j.tacc.2025.101521","DOIUrl":"10.1016/j.tacc.2025.101521","url":null,"abstract":"<div><div>Invasive ventilation is a critical respiratory support technology in the intensive care unit (ICU). Increasing evidence suggests that early liberation from invasive ventilation can benefit patients. However, further research is needed to establish optimal criteria for invasive ventilator liberation programs, including the ideal screening frequency, appropriate techniques and duration of spontaneous breathing trials (SBT), evaluation of airway extubation readiness, and decision-making regarding extubation. The management of the invasive ventilator liberation process should encompass feasibility screening for SBTs, conducting SBTs, evaluating SBT outcomes, assessing airway extubation readiness, performing extubation itself, identifying high-risk factors associated with weaning failure, and developing clinical strategies. Additionally, a patient-centered assessment of the risks and consequences of extubation failure may serve as crucial measures to enhance the success rate of invasive ventilator liberation. Therefore, we conduct a detailed review of the related studies on invasive mechanical ventilation weaning to determine the best invasive ventilator liberation strategy.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101521"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153847","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}

引用次数: 0

Incision depth in surgical airway management using computed tomography of the neck to minimize complications 颈部计算机断层扫描在外科气道管理中的切口深度，以减少并发症

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101518

Jungwan Yoo , Sungwoo Choi , Sangun Nah , Young Soon Cho , Jae wook Lee , Sangsoo Han

Background

Swift and accurate airway management is crucial in the emergency department. Failure to secure the airway in hypoxic individuals can lead to severe outcomes, including brain damage or death. When a difficult airway is anticipated or intubation fails, alternatives such as cricothyroidotomy or tracheostomy must be considered, taking into account patient characteristics.

Aim

Analysis of the relationship between patient's characteristics and the depth of the cricothyroid membrane (CTM) and tracheostomy sites (TSs).

Methods

We conducted a retrospective cross-sectional study of patients who underwent neck CT scans in the emergency department and 475 patients were included. The shortest distance from the skin to the innermost surface of the CTM (CTM depth) was measured in the sagittal view of the CT. For tracheostomy, depths were measured from the skin at the cricoid cartilage (1–2 cm below) to the membranes between the second and third tracheal rings (TS1) and between the third and fourth rings (TS2). Patient characteristics, including age, sex, height, and weight, were recorded to assess correlations with depth through multiple linear regression analysis.

Results

The average CTM depth was 10.87 ± 3.93 mm, while the depths at TS1 and TS2 were 12.38 ± 4.72 mm and 14.75 ± 6.30 mm, respectively. Significant correlations were found between patient age, body mass index, sex, and the depths of the CTM and TSs 1 and 2. Older age and increased obesity were associated with greater depths, particularly at TS2. Notably, females exhibited greater depths at CTM and TS1 than males, with no significant differences at TS2.

Conclusions

These findings offer valuable insights for anticipating incision depth during urgent surgical airway procedures, potentially minimizing complications and improving treatment outcomes.

快速准确的气道管理在急诊科至关重要。缺氧患者气道不安全可导致严重后果，包括脑损伤或死亡。当预期气道困难或插管失败时，必须考虑患者特征，考虑环甲状软骨切开术或气管切开术等替代方案。目的分析环甲膜深度（CTM）和气管造口部位（TSs）与患者特征的关系。方法对在急诊科接受颈部CT扫描的患者进行回顾性横断面研究，共纳入475例患者。在CT矢状位上测量皮肤到CTM最内层表面的最短距离（CTM深度）。对于气管造口术，测量从环状软骨皮肤（1-2 cm以下）到第二和第三气管环（TS1）之间以及第三和第四个气管环（TS2）之间的膜的深度。记录患者的年龄、性别、身高、体重等特征，通过多元线性回归分析评估其与深度的相关性。结果CTM的平均深度为10.87±3.93 mm， TS1和TS2的平均深度分别为12.38±4.72 mm和14.75±6.30 mm。患者年龄、体重指数、性别、CTM深度和TSs 1和2之间存在显著相关性。年龄越大，肥胖程度越高，深度越深，尤其是在TS2。值得注意的是，女性在CTM和TS1的深度大于男性，而在TS2的深度无显著差异。结论本研究结果为在紧急气道手术中预测切口深度提供了有价值的见解，有可能减少并发症并改善治疗效果。

{"title":"Incision depth in surgical airway management using computed tomography of the neck to minimize complications","authors":"Jungwan Yoo , Sungwoo Choi , Sangun Nah , Young Soon Cho , Jae wook Lee , Sangsoo Han","doi":"10.1016/j.tacc.2025.101518","DOIUrl":"10.1016/j.tacc.2025.101518","url":null,"abstract":"<div><h3>Background</h3><div>Swift and accurate airway management is crucial in the emergency department. Failure to secure the airway in hypoxic individuals can lead to severe outcomes, including brain damage or death. When a difficult airway is anticipated or intubation fails, alternatives such as cricothyroidotomy or tracheostomy must be considered, taking into account patient characteristics.</div></div><div><h3>Aim</h3><div>Analysis of the relationship between patient's characteristics and the depth of the cricothyroid membrane (CTM) and tracheostomy sites (TSs).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study of patients who underwent neck CT scans in the emergency department and 475 patients were included. The shortest distance from the skin to the innermost surface of the CTM (CTM depth) was measured in the sagittal view of the CT. For tracheostomy, depths were measured from the skin at the cricoid cartilage (1–2 cm below) to the membranes between the second and third tracheal rings (TS1) and between the third and fourth rings (TS2). Patient characteristics, including age, sex, height, and weight, were recorded to assess correlations with depth through multiple linear regression analysis.</div></div><div><h3>Results</h3><div>The average CTM depth was 10.87 ± 3.93 mm, while the depths at TS1 and TS2 were 12.38 ± 4.72 mm and 14.75 ± 6.30 mm, respectively. Significant correlations were found between patient age, body mass index, sex, and the depths of the CTM and TSs 1 and 2. Older age and increased obesity were associated with greater depths, particularly at TS2. Notably, females exhibited greater depths at CTM and TS1 than males, with no significant differences at TS2.</div></div><div><h3>Conclusions</h3><div>These findings offer valuable insights for anticipating incision depth during urgent surgical airway procedures, potentially minimizing complications and improving treatment outcomes.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101518"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153848","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}

引用次数: 0

Comparison of sonographic hyomental distance ratio and thyromental height as predictors of difficult intubation 超声颏部距离比和甲状腺高度预测插管困难的比较

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2025.101520

Parul Sood , Richa Saroa , Sanjeev Palta , Puja Saxena , Ravneet Kaur Gill

Background

Preoperative airway assessment has always been dynamic to quantify a single parameter that identifies difficult airway reliably and therefore newer modalities are introduced, researched and compared amongst themselves. Thyromental height (TMH) and hyomental distance ratio (HMDR) have been recently developed and validated as good diagnostic tools for difficult airway prediction. However, they have not been compared with respect to each other as to define the superiority amongst the two and thus present trial was designed to assess the same.

Method

400 patients >18 years of age undergoing elective surgery under general anaesthesia were enrolled in the study. In addition to the standard airway parameter assessment, preoperative TMH and sonographic HMDR was also recorded which was correlated with Cormack Lehane (CL) grade and percentage of glottic opening (POGO) score of laryngoscopy to grade a difficult airway.

Results

HMDR (83 %) was found to be more accurate in predicting difficult intubation than TMH (56.5 %). Though the sensitivity of TMH (70.83 %) and HMDR (68 %) were comparable, HMDR (84.66 %) was found to be more specific than TMH (54.83 %) for a difficult airway prediction. The cut off values for HMDR and TMH for predicting difficult intubation, derived from the present study from the ROC curves and AUC was found to be 1.26 and 5.05 cm respectively.

Conclusions

HMDR outstrips TMH with a good sensitivity and specificity for difficult airway prediction. In conclusion, we recommend the use of sonographically derived HMDR as a reliable airway assessment parameter to predict a difficult airway.

术前气道评估一直是动态的，以量化单一参数来可靠地识别困难气道，因此引入，研究和比较了新的模式。甲状腺高度（TMH）和眼膜距离比（HMDR）最近被发展并被证实是困难气道预测的良好诊断工具。然而，他们没有相互比较，以确定两者之间的优势，因此本试验的目的是评估相同。方法选择400例18岁全麻择期手术患者。除标准气道参数评估外，还记录术前TMH和超声HMDR，与Cormack Lehane （CL）分级和喉镜下声门开口百分比（POGO）评分对困难气道分级的相关性。结果shmdr预测插管困难的准确率（83%）高于TMH（56.5%）。虽然TMH（70.83%）和HMDR（68%）的敏感性相当，但发现HMDR（84.66%）比TMH（54.83%）更特异，难以预测气道。本研究根据ROC曲线得出的HMDR和TMH预测插管困难的截止值分别为1.26和5.05 cm。结论shmdr对困难气道预测的敏感性和特异性优于TMH。总之，我们建议使用超声衍生的HMDR作为可靠的气道评估参数来预测困难气道。

{"title":"Comparison of sonographic hyomental distance ratio and thyromental height as predictors of difficult intubation","authors":"Parul Sood , Richa Saroa , Sanjeev Palta , Puja Saxena , Ravneet Kaur Gill","doi":"10.1016/j.tacc.2025.101520","DOIUrl":"10.1016/j.tacc.2025.101520","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative airway assessment has always been dynamic to quantify a single parameter that identifies difficult airway reliably and therefore newer modalities are introduced, researched and compared amongst themselves. Thyromental height (TMH) and hyomental distance ratio (HMDR) have been recently developed and validated as good diagnostic tools for difficult airway prediction. However, they have not been compared with respect to each other as to define the superiority amongst the two and thus present trial was designed to assess the same.</div></div><div><h3>Method</h3><div>400 patients >18 years of age undergoing elective surgery under general anaesthesia were enrolled in the study. In addition to the standard airway parameter assessment, preoperative TMH and sonographic HMDR was also recorded which was correlated with Cormack Lehane (CL) grade and percentage of glottic opening (POGO) score of laryngoscopy to grade a difficult airway.</div></div><div><h3>Results</h3><div>HMDR (83 %) was found to be more accurate in predicting difficult intubation than TMH (56.5 %). Though the sensitivity of TMH (70.83 %) and HMDR (68 %) were comparable, HMDR (84.66 %) was found to be more specific than TMH (54.83 %) for a difficult airway prediction. The cut off values for HMDR and TMH for predicting difficult intubation, derived from the present study from the ROC curves and AUC was found to be 1.26 and 5.05 cm respectively.</div></div><div><h3>Conclusions</h3><div>HMDR outstrips TMH with a good sensitivity and specificity for difficult airway prediction. In conclusion, we recommend the use of sonographically derived HMDR as a reliable airway assessment parameter to predict a difficult airway.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101520"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403259","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}

引用次数: 0

Identifying and analyzing extremely productive authors in intensive care medicine: A scientometric analysis 识别和分析重症监护医学中极具生产力的作者：科学计量分析

IF 1.4 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-02-01 DOI: 10.1016/j.tacc.2024.101515

Francesco Zarantonello , Nicolò Sella , Alessandro De Cassai , Giulia Aviani Fulvio , Annalisa Boscolo , Tommaso Pettenuzzo , Giulia Mormando , Paolo Navalesi

Introduction

Clinical progress relies heavily on research, however, recent years have seen distortions in this process due to the “publish or perish” model. This model is further amplified by team science, leading to inflated author counts and metrics. Recently the rise of hyperprolific (HA) and almost hyperprolific (AHA) authors has been highlighted in the global literature scenario, but data on intensive care medicine (ICM) is lacking. This study aims to investigate HA and AHA authors in ICM and the impact of COVID-19 pandemic on publication rates.

Material and methods

We identified authors publishing in ICM journals indexed by Scopus from 2019 to 2023, retrieving their Scopus IDs, publication details, and gender. HA were defined as authors who published at least 73 articles per year, while AHA as authors who published more than 60. The effect of COVID-19 literature was assessed by excluding COVID-related articles from the dataset.

Results

We identified 42860 articles in ICM journals, involving 186150 unique authors with a median of 5 publications per author. Only 248 (0.1 %) were extremely productive, with 131 being hyperprolific (HA). Removing COVID-19 papers significantly reduced HA and AHA counts by up to 40 %. Extremely productive authors were predominantly male (91.5 %) and globally distributed, primarily from Europe, Asia, and the Americas.

Conclusions

Hyperprolific authors in ICM represent a very small minority. These authors are typically related to ICM, male, senior researchers with a global distribution, who publish high-quality research through a significant research network.

临床进展在很大程度上依赖于研究，然而，近年来由于“发表或消亡”模式，这一过程出现了扭曲。这个模型被团队科学进一步放大，导致作者数量和指标膨胀。近年来，高高产（HA）和几乎高产（AHA）作者的兴起在全球文献中得到了突出的关注，但关于重症监护医学（ICM）的数据缺乏。本研究旨在调查ICM中HA和AHA作者以及COVID-19大流行对发表率的影响。材料和方法我们确定了2019年至2023年在Scopus索引的ICM期刊上发表文章的作者，检索了他们的Scopus id、发表详细信息和性别。HA被定义为每年至少发表73篇文章的作者，而AHA被定义为每年发表60篇以上文章的作者。通过从数据集中排除与COVID-19相关的文章来评估COVID-19文献的影响。结果我们在ICM期刊中发现了42860篇文章，涉及186150位独立作者，平均每位作者发表5篇文章。只有248个（0.1%）是高产的，131个是高产的（HA）。去除COVID-19论文可显著减少HA和AHA计数，最多可减少40%。高产作者主要是男性（91.5%），分布在全球，主要来自欧洲、亚洲和美洲。结论ICM高产作者只占极少数。这些作者通常与ICM有关，男性，全球分布的高级研究人员，通过重要的研究网络发表高质量的研究。

{"title":"Identifying and analyzing extremely productive authors in intensive care medicine: A scientometric analysis","authors":"Francesco Zarantonello , Nicolò Sella , Alessandro De Cassai , Giulia Aviani Fulvio , Annalisa Boscolo , Tommaso Pettenuzzo , Giulia Mormando , Paolo Navalesi","doi":"10.1016/j.tacc.2024.101515","DOIUrl":"10.1016/j.tacc.2024.101515","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical progress relies heavily on research, however, recent years have seen distortions in this process due to the “publish or perish” model. This model is further amplified by team science, leading to inflated author counts and metrics. Recently the rise of hyperprolific (HA) and almost hyperprolific (AHA) authors has been highlighted in the global literature scenario, but data on intensive care medicine (ICM) is lacking. This study aims to investigate HA and AHA authors in ICM and the impact of COVID-19 pandemic on publication rates.</div></div><div><h3>Material and methods</h3><div>We identified authors publishing in ICM journals indexed by Scopus from 2019 to 2023, retrieving their Scopus IDs, publication details, and gender. HA were defined as authors who published at least 73 articles per year, while AHA as authors who published more than 60. The effect of COVID-19 literature was assessed by excluding COVID-related articles from the dataset.</div></div><div><h3>Results</h3><div>We identified 42860 articles in ICM journals, involving 186150 unique authors with a median of 5 publications per author. Only 248 (0.1 %) were extremely productive, with 131 being hyperprolific (HA). Removing COVID-19 papers significantly reduced HA and AHA counts by up to 40 %. Extremely productive authors were predominantly male (91.5 %) and globally distributed, primarily from Europe, Asia, and the Americas.</div></div><div><h3>Conclusions</h3><div>Hyperprolific authors in ICM represent a very small minority. These authors are typically related to ICM, male, senior researchers with a global distribution, who publish high-quality research through a significant research network.</div></div>","PeriodicalId":44534,"journal":{"name":"Trends in Anaesthesia and Critical Care","volume":"60 ","pages":"Article 101515"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0