Pub Date : 2026-04-01Epub Date: 2025-11-13DOI: 10.1016/j.accpm.2025.101692
Ahmed Hasanin, Maha Mostafa, Yasmin S. Hassabelnaby
{"title":"The 3C-3V: A comprehensive mnemonic for point-of-care ultrasound in circulatory shock","authors":"Ahmed Hasanin, Maha Mostafa, Yasmin S. Hassabelnaby","doi":"10.1016/j.accpm.2025.101692","DOIUrl":"10.1016/j.accpm.2025.101692","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101692"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-04DOI: 10.1016/j.accpm.2025.101655
Ravi Pal , Joshua Le , Theodora Wingert , Oren Avram , Jiayu Yu , Aidan Adham , Patrick Schoettker , Alexandre Joosten , Maxime Cannesson
Blood pressure (BP) measurement in both acute care and outpatient settings is essential, as conditions like hypertension and hypotension are common and often asymptomatic until organ damage occurs. These conditions significantly increase the risk of morbidity and mortality but can be effectively managed through early detection and treatment. For decades, cuff-based devices have dominated non-invasive BP monitoring; however, they are often bulky, inconvenient, and limited to intermittent measurements. In recent years, machine learning (ML) and artificial intelligence (AI)–based approaches for BP estimation from non-invasive physiological signals—such as electrocardiography (ECG) and photoplethysmography (PPG)—have generated considerable interest. These innovations promise to enable continuous, cuff-less BP monitoring, expanding the reach of BP assessment into wearable devices and facilitating more dynamic, patient-centered care. This review provides a comprehensive overview of the evolution of non-invasive BP measurement technologies, with particular emphasis on emerging AI-driven methods and trends shaping the development of continuous and wearable solutions. While these technologies offer new opportunities for continuous monitoring and patient engagement, this review focuses on their conceptual and technological development rather than detailed performance evaluation or clinical validation.
{"title":"From Cuffs to Code: Machine Learning in Non-Invasive Blood Pressure Monitoring","authors":"Ravi Pal , Joshua Le , Theodora Wingert , Oren Avram , Jiayu Yu , Aidan Adham , Patrick Schoettker , Alexandre Joosten , Maxime Cannesson","doi":"10.1016/j.accpm.2025.101655","DOIUrl":"10.1016/j.accpm.2025.101655","url":null,"abstract":"<div><div>Blood pressure (BP) measurement in both acute care and outpatient settings is essential, as conditions like hypertension and hypotension are common and often asymptomatic until organ damage occurs. These conditions significantly increase the risk of morbidity and mortality but can be effectively managed through early detection and treatment. For decades, cuff-based devices have dominated non-invasive BP monitoring; however, they are often bulky, inconvenient, and limited to intermittent measurements. In recent years, machine learning (ML) and artificial intelligence (AI)–based approaches for BP estimation from non-invasive physiological signals—such as electrocardiography (ECG) and photoplethysmography (PPG)—have generated considerable interest. These innovations promise to enable continuous, cuff-less BP monitoring, expanding the reach of BP assessment into wearable devices and facilitating more dynamic, patient-centered care. This review provides a comprehensive overview of the evolution of non-invasive BP measurement technologies, with particular emphasis on emerging AI-driven methods and trends shaping the development of continuous and wearable solutions. While these technologies offer new opportunities for continuous monitoring and patient engagement, this review focuses on their conceptual and technological development rather than detailed performance evaluation or clinical validation.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101655"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-19DOI: 10.1016/j.accpm.2025.101699
Ru-Ping Dai , Wei Luo , Wen Wang , Yun-Xuan Huang , Cong Luo , Zhao-Lan Hu , Pei Zhou , Ru-Yi Luo
Background
Fiberoptic bronchoscopy (FB) procedures have become increasingly lengthy and complex. Maintaining deep sedation while preventing hypoxemia with conventional oropharyngeal/nasopharyngeal airways presents a significant clinical challenge. Supraglottic airway devices, such as the laryngeal mask airway (LMA), may provide improved oxygenation and procedural efficiency during FB. However, despite the variety of LMA designs, no previous studies have definitively established the optimal type of LMA for FB procedures.
Methods
96 patients were randomized to either the i-gel LMA group (group I) or Jiancheng dual-channel LMA group (group J). Remimazolam besylate, ciprofol, and sufentanil were used for anesthesia induction and maintenance in both groups. We measured and recorded the success rate of LMA insertion and entering the main airway through the LMA at first attempt, operational interference, mid-procedure LMA adjustments, procedure interruptions, vital signs, and major adverse events.
Results
The patients in group J experienced higher success rates of first-attempt LMA insertion (P < 0.01) and entry into the main airway (P < 0.01) than those in group I. The incidence of coughing was significantly higher in group I than in group J (P < 0.01). The incidence of cardiopulmonary adverse reactions, including respiratory arrest, airway obstruction, airway spasm, laryngospasm, hypertension, and hypotension, was comparable between the two groups. Group I demonstrated a tendency toward prolonged recovery time compared with group J (P = 0.05).
Conclusions
The Jiancheng dual-channel LMA is associated with higher first-attempt success for airway insertion and bronchoscopy compared to the i-gel LMA, warranting consideration for broader clinical application.
Trial registration
https://www.chictr.org.cn/showproj.html?proj=265357 (registration no. ChiCTR2500100990, principal investigator: Ru-Ping Dai, date of registration: April 17, 2025).
{"title":"Jiancheng dual-channel vs. i-gel laryngeal mask airway for fiberoptic bronchoscopy: A randomized trial","authors":"Ru-Ping Dai , Wei Luo , Wen Wang , Yun-Xuan Huang , Cong Luo , Zhao-Lan Hu , Pei Zhou , Ru-Yi Luo","doi":"10.1016/j.accpm.2025.101699","DOIUrl":"10.1016/j.accpm.2025.101699","url":null,"abstract":"<div><h3>Background</h3><div>Fiberoptic bronchoscopy (FB) procedures have become increasingly lengthy and complex. Maintaining deep sedation while preventing hypoxemia with conventional oropharyngeal/nasopharyngeal airways presents a significant clinical challenge. Supraglottic airway devices, such as the laryngeal mask airway (LMA), may provide improved oxygenation and procedural efficiency during FB. However, despite the variety of LMA designs, no previous studies have definitively established the optimal type of LMA for FB procedures.</div></div><div><h3>Methods</h3><div>96 patients were randomized to either the i-gel LMA group (group I) or Jiancheng dual-channel LMA group (group J). Remimazolam besylate, ciprofol, and sufentanil were used for anesthesia induction and maintenance in both groups. We measured and recorded the success rate of LMA insertion and entering the main airway through the LMA at first attempt, operational interference, mid-procedure LMA adjustments, procedure interruptions, vital signs, and major adverse events.</div></div><div><h3>Results</h3><div>The patients in group J experienced higher success rates of first-attempt LMA insertion (<em>P</em> < 0.01) and entry into the main airway (<em>P</em> < 0.01) than those in group I. The incidence of coughing was significantly higher in group I than in group J (<em>P</em> < 0.01). The incidence of cardiopulmonary adverse reactions, including respiratory arrest, airway obstruction, airway spasm, laryngospasm, hypertension, and hypotension, was comparable between the two groups. Group I demonstrated a tendency toward prolonged recovery time compared with group J (<em>P</em> = 0.05).</div></div><div><h3>Conclusions</h3><div>The Jiancheng dual-channel LMA is associated with higher first-attempt success for airway insertion and bronchoscopy compared to the i-gel LMA, warranting consideration for broader clinical application.</div></div><div><h3>Trial registration</h3><div><span><span>https://www.chictr.org.cn/showproj.html?proj=265357</span><svg><path></path></svg></span> (registration no. ChiCTR2500100990, principal investigator: Ru-Ping Dai, date of registration: April 17, 2025).</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101699"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-10-30DOI: 10.1016/j.accpm.2025.101661
Javier Ripollés-Melchor , Ane Abad-Motos , Ana León-Bretscher , Ángel V. Espinosa , Sonia Amoza-Pais , Maria Luz Herrero-Bogajo , Alfredo Abad-Gurumeta , Roberto de-la-Plaza-Llamas , Patricia Galán-Menéndez , Andrés Zorrilla-Vaca , Rocío González-López , Rosalía Navarro-Pérez , Carlos Jiménez-Viñas , Felipe Carlos Parreño-Manchado , Alicia Ruiz Escobar , Vanessa Concepción-Martín , Gloria Paseiro-Crespo , María Asunción Acosta-Mérida , María Puech-de-Oriol , María Ángeles Mayo-Ossorio , César Aldecoa
Background
Enhanced Recovery After Surgery (ERAS) protocols have been widely adopted in gastric cancer surgery, with consistent benefits in perioperative recovery. However, whether adherence to ERAS influences long-term oncologic outcomes remains unclear. This study aimed to evaluate the association between ERAS adherence and disease-free survival (DFS) following curative-intent gastrectomy.
Methods
This was a prespecified substudy of the POWER4 cohort, a prospective, multicentre investigation of perioperative care and outcomes in patients undergoing elective gastrectomy for gastric cancer. ERAS adherence was assessed using 22 predefined components and analysed as a binary (high vs. low), continuous (per 10-point increment), and quartile-based variable. The primary endpoint was DFS, defined as the time from surgery to recurrence or death. Kaplan–Meier estimates and multivariable Cox models were used to evaluate the association between ERAS adherence and DFS, adjusting for age, sex, ASA, BMI, nutritional risk, anaemia, chronic kidney disease, surgical approach, procedure type, operative time, and tumour stage.
Results
Among 368 patients with complete oncologic follow-up, the median follow-up was 1616 days. Kaplan–Meier curves suggested a trend toward improved DFS with higher ERAS adherence (log-rank p = 0.10 for binary comparison; p = 0.05 across quartiles). In multivariable Cox models, ERAS adherence was not significantly associated with DFS. Prognosis was independently predicted by tumour stage, chronic kidney disease, ASA ≥ III, and total gastrectomy.
Conclusion
In this multicentre cohort, ERAS adherence was not independently associated with long-term DFS after gastrectomy for gastric cancer. Long-term prognosis appeared primarily driven by tumour and patient-related factors rather than perioperative protocol adherence.
The study was registered on Clinicaltrials.gov: NCT06790238.
背景：增强术后恢复（ERAS）方案在胃癌手术中被广泛采用，在围手术期恢复方面具有一致的益处。然而，坚持ERAS是否会影响长期肿瘤预后仍不清楚。本研究旨在评估胃切除术后ERAS依从性与无病生存期（DFS）之间的关系。方法：这是POWER4队列的一项预先指定的亚研究，是一项前瞻性、多中心的研究，探讨择期胃癌切除术患者的围手术期护理和预后。使用22个预定义组件评估ERAS依从性，并以二元（高与低）、连续（每10点增量）和基于四分位数的变量进行分析。主要终点是DFS，定义为从手术到复发或死亡的时间。Kaplan-Meier估计和多变量Cox模型用于评估ERAS依从性与DFS之间的关系，调整年龄、性别、ASA、BMI、营养风险、贫血、慢性肾脏疾病、手术方式、手术类型、手术时间和肿瘤分期。结果：368例患者完成肿瘤随访，中位随访时间为1616天。Kaplan-Meier曲线显示，随着ERAS依从性的提高，DFS有改善的趋势（二元比较的log-rank p = 0.10，四分位数的p = 0.05）。在多变量Cox模型中，ERAS依从性与DFS无显著相关。预后由肿瘤分期、慢性肾病、ASA≥III和全胃切除术独立预测。结论：在这个多中心队列中，ERAS依从性与胃癌切除术后的长期DFS没有独立的相关性。长期预后似乎主要由肿瘤和患者相关因素驱动，而不是围手术期协议的依从性。该研究已在Clinicaltrials.gov注册：NCT06790238。
{"title":"Disease-free survival after gastrectomy is not influenced by ERAS adherence","authors":"Javier Ripollés-Melchor , Ane Abad-Motos , Ana León-Bretscher , Ángel V. Espinosa , Sonia Amoza-Pais , Maria Luz Herrero-Bogajo , Alfredo Abad-Gurumeta , Roberto de-la-Plaza-Llamas , Patricia Galán-Menéndez , Andrés Zorrilla-Vaca , Rocío González-López , Rosalía Navarro-Pérez , Carlos Jiménez-Viñas , Felipe Carlos Parreño-Manchado , Alicia Ruiz Escobar , Vanessa Concepción-Martín , Gloria Paseiro-Crespo , María Asunción Acosta-Mérida , María Puech-de-Oriol , María Ángeles Mayo-Ossorio , César Aldecoa","doi":"10.1016/j.accpm.2025.101661","DOIUrl":"10.1016/j.accpm.2025.101661","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols have been widely adopted in gastric cancer surgery, with consistent benefits in perioperative recovery. However, whether adherence to ERAS influences long-term oncologic outcomes remains unclear. This study aimed to evaluate the association between ERAS adherence and disease-free survival (DFS) following curative-intent gastrectomy.</div></div><div><h3>Methods</h3><div>This was a prespecified substudy of the POWER4 cohort, a prospective, multicentre investigation of perioperative care and outcomes in patients undergoing elective gastrectomy for gastric cancer. ERAS adherence was assessed using 22 predefined components and analysed as a binary (high <em>vs.</em> low), continuous (per 10-point increment), and quartile-based variable. The primary endpoint was DFS, defined as the time from surgery to recurrence or death. Kaplan–Meier estimates and multivariable Cox models were used to evaluate the association between ERAS adherence and DFS, adjusting for age, sex, ASA, BMI, nutritional risk, anaemia, chronic kidney disease, surgical approach, procedure type, operative time, and tumour stage.</div></div><div><h3>Results</h3><div>Among 368 patients with complete oncologic follow-up, the median follow-up was 1616 days. Kaplan–Meier curves suggested a trend toward improved DFS with higher ERAS adherence (log-rank <em>p</em> = 0.10 for binary comparison; <em>p</em> = 0.05 across quartiles). In multivariable Cox models, ERAS adherence was not significantly associated with DFS. Prognosis was independently predicted by tumour stage, chronic kidney disease, ASA ≥ III, and total gastrectomy.</div></div><div><h3>Conclusion</h3><div>In this multicentre cohort, ERAS adherence was not independently associated with long-term DFS after gastrectomy for gastric cancer. Long-term prognosis appeared primarily driven by tumour and patient-related factors rather than perioperative protocol adherence.</div><div>The study was registered on <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span>: <span><span>NCT06790238</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101661"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-10-07DOI: 10.1016/j.accpm.2025.101639
T. Jeanmougin , X. Buzin , A. Mansour , B. Duceau , A. Carillion , P. Dureau , G. Lebreton , N. Nesseler , A. Bouglé , G. Hariri
Background
Cardiac surgery-associated acute kidney injury (CSA-AKI) is one of the most frequent and severe complications after cardiac surgery. The association between acute kidney injury and the mismatch between oxygen consumption and delivery has been well established during cardiopulmonary bypass (CPB). In this study, we aim to explore the prognostic value of the central venous-to-arterial pCO2 gap during CPB to predict CSA-AKI.
Methods
Bicentric retrospective study conducted in two teaching hospitals. All patients who underwent cardiac surgery requiring CPB in two periods between 2019 and 2023 were screened for inclusion. Patients were divided into 2 groups according to the presence or absence of an elevated pCO2 gap during CPB, which was defined as greater than 6 mmHg. The primary outcome was the occurrence of CSA-AKI.
Results
Among 318 patients included, 213 were in the low pCO2 gap group and 105 in the elevated pCO2 gap group. No significant difference in CSA-AKI occurrence was found between groups (32.4% vs. 23.8%; p = 0.14). pCO2 gap was not a good predictor of CSA-AKI, with an area under the curve for the ROC curve of 0.63 (p = 0.87). Except for SVO2 during CPB, we did not find any correlation between pCO2 gap and other tissue perfusion parameters during or after CPB.
Conclusion
We did not find any association between the presence of an elevated pCO2 gap during CPB and the occurrence of CSA-AKI. This may suggest that a single intraoperative measurement of pCO2 gap is not a reliable marker of persistent tissue hypoperfusion in this context.
背景：心脏手术相关急性肾损伤（CSA-AKI）是心脏手术后最常见和最严重的并发症之一。在体外循环（CPB）过程中，急性肾损伤与氧气消耗和输送不匹配之间的关系已经得到了很好的证实。在本研究中，我们旨在探讨CPB期间中心静脉-动脉pCO2间隙预测CSA-AKI的预后价值。方法：对两所教学医院进行双中心回顾性研究。所有在2019年至2023年两个时期接受心脏手术需要CPB的患者都被筛选纳入。根据CPB期间pCO2间隙是否升高（定义为大于6 mmHg）将患者分为两组。主要终点是CSA-AKI的发生。结果：318例患者中，低pCO2间隙组213例，高pCO2间隙组105例。两组间CSA-AKI发生率无显著差异（32.4% vs. 23.8%; p = 0.14）。pCO2间隙不是CSA-AKI的良好预测因子，ROC曲线下面积为0.63 （p = 0.87）。除CPB期间的SVO2外，我们未发现pCO2间隙与CPB期间或之后的其他组织灌注参数有任何相关性。结论：我们未发现CPB期间pCO2间隙升高与CSA-AKI发生之间存在任何关联。这可能表明，在这种情况下，术中单次测量pCO 2间隙并不是持续组织灌注不足的可靠标志。
{"title":"Prognostic value of venous-to-arterial pCO2 gap during cardiopulmonary bypass for predicting cardiac surgery-associated kidney injury: A bicentric retrospective study","authors":"T. Jeanmougin , X. Buzin , A. Mansour , B. Duceau , A. Carillion , P. Dureau , G. Lebreton , N. Nesseler , A. Bouglé , G. Hariri","doi":"10.1016/j.accpm.2025.101639","DOIUrl":"10.1016/j.accpm.2025.101639","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac surgery-associated acute kidney injury (CSA-AKI) is one of the most frequent and severe complications after cardiac surgery. The association between acute kidney injury and the mismatch between oxygen consumption and delivery has been well established during cardiopulmonary bypass (CPB). In this study, we aim to explore the prognostic value of the central venous-to-arterial pCO<sub>2</sub> gap during CPB to predict CSA-AKI.</div></div><div><h3>Methods</h3><div>Bicentric retrospective study conducted in two teaching hospitals. All patients who underwent cardiac surgery requiring CPB in two periods between 2019 and 2023 were screened for inclusion. Patients were divided into 2 groups according to the presence or absence of an elevated pCO<sub>2</sub> gap during CPB, which was defined as greater than 6 mmHg. The primary outcome was the occurrence of CSA-AKI.</div></div><div><h3>Results</h3><div>Among 318 patients included, 213 were in the low pCO<sub>2</sub> gap group and 105 in the elevated pCO<sub>2</sub> gap group. No significant difference in CSA-AKI occurrence was found between groups (32.4% <em>vs.</em> 23.8%; <em>p</em> = 0.14). pCO<sub>2</sub> gap was not a good predictor of CSA-AKI, with an area under the curve for the ROC curve of 0.63 (<em>p</em> = 0.87). Except for SVO<sub>2</sub> during CPB, we did not find any correlation between pCO<sub>2</sub> gap and other tissue perfusion parameters during or after CPB.</div></div><div><h3>Conclusion</h3><div>We did not find any association between the presence of an elevated pCO<sub>2</sub> gap during CPB and the occurrence of CSA-AKI. This may suggest that a single intraoperative measurement of pCO<sub>2</sub> gap is not a reliable marker of persistent tissue hypoperfusion in this context.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101639"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-13DOI: 10.1016/j.accpm.2025.101693
Tony Tan , Ellene Yan , Yasmin Alhamdah , Jean Wong , Frances Chung
{"title":"Longitudinal prevalence of perioperative neurocognitive disorders in older surgical patients: A multicenter prospective cohort study","authors":"Tony Tan , Ellene Yan , Yasmin Alhamdah , Jean Wong , Frances Chung","doi":"10.1016/j.accpm.2025.101693","DOIUrl":"10.1016/j.accpm.2025.101693","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101693"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145531016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-11-13DOI: 10.1016/j.accpm.2025.101689
Frank Bidar , Baptiste Thibault , Jean-François Carabalona , Matthieu Petit , Thomas Rimmelé
{"title":"Continuous hemodialysis in patients at risk of citrate accumulation: The Stewart approach can help","authors":"Frank Bidar , Baptiste Thibault , Jean-François Carabalona , Matthieu Petit , Thomas Rimmelé","doi":"10.1016/j.accpm.2025.101689","DOIUrl":"10.1016/j.accpm.2025.101689","url":null,"abstract":"","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101689"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2025-10-29DOI: 10.1016/j.accpm.2025.101647
Frederic Michard , Osama Abou-Arab
The concept of integrating hemodynamic variables to define specific profiles or phenotypes has been established for decades. Describing hemodynamic phenotypes plays a key role in educating healthcare professionals about cardiovascular physiology, enhancing the understanding of shock mechanisms, and informing treatment strategies. Recently, two notable innovations have emerged to support bedside identification of hemodynamic phenotypes: machine learning (ML) algorithms and visual decision support tools. When it comes to “small data,” such as a limited set of hemodynamic variables, ML algorithms may not be essential for data integration or interpretation. In addition, the hemodynamic phenotypes identified by ML techniques often mirror traditional textbook profiles, though occasionally with inconsistencies that may impact patient safety. This raises valid questions about the need to integrate complex and proprietary ML algorithms for bedside hemodynamic assessment. By contrast, visual tools leverage clinicians' innate ability to process graphical information rapidly, improving the understanding of cardiovascular physiology and enabling recognition of hemodynamic profiles at a glance. As such, they may offer a practical, accessible, and cost-effective alternative to ML-based solutions. Future studies comparing the clinical impact of visual versus ML-driven phenotyping are now needed to guide further development and implementation.
{"title":"Hemodynamic phenotyping 4.0","authors":"Frederic Michard , Osama Abou-Arab","doi":"10.1016/j.accpm.2025.101647","DOIUrl":"10.1016/j.accpm.2025.101647","url":null,"abstract":"<div><div>The concept of integrating hemodynamic variables to define specific profiles or phenotypes has been established for decades. Describing hemodynamic phenotypes plays a key role in educating healthcare professionals about cardiovascular physiology, enhancing the understanding of shock mechanisms, and informing treatment strategies. Recently, two notable innovations have emerged to support bedside identification of hemodynamic phenotypes: machine learning (ML) algorithms and visual decision support tools. When it comes to “small data,” such as a limited set of hemodynamic variables, ML algorithms may not be essential for data integration or interpretation. In addition, the hemodynamic phenotypes identified by ML techniques often mirror traditional textbook profiles, though occasionally with inconsistencies that may impact patient safety. This raises valid questions about the need to integrate complex and proprietary ML algorithms for bedside hemodynamic assessment. By contrast, visual tools leverage clinicians' innate ability to process graphical information rapidly, improving the understanding of cardiovascular physiology and enabling recognition of hemodynamic profiles at a glance. As such, they may offer a practical, accessible, and cost-effective alternative to ML-based solutions. Future studies comparing the clinical impact of visual <em>versus</em> ML-driven phenotyping are now needed to guide further development and implementation.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101647"},"PeriodicalIF":4.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号