Anaesthesia Critical Care & Pain Medicine最新文献

英文中文

Comment on "Association between arterial carbon dioxide tension and poor outcomes after cardiac arrest: A meta-analysis". 评论“动脉二氧化碳浓度与心脏骤停后不良预后之间的关系：一项荟萃分析”。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-06 DOI: 10.1016/j.accpm.2025.101737

Shubham Kumar, Ranjana Sah

引用次数: 0

Comment on "Comfort-Focused Assessment and Patient-Reported Experience After Regional versus General Anaesthesia: Post Hoc Analysis of a Cluster-Randomised Trial". 评论“局部麻醉与全身麻醉后的舒适度评估和患者报告的体验：一项聚类随机试验的事后分析”。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101735

S Dhanya Dedeepya, Vaishali Goel, Nivedita Nikhil Desai

引用次数: 0

Critical appraisal of "Nonsteroidal anti-inflammatory drug use and acute kidney injury in nephrectomies: A retrospective propensity score-matched cohort study." 对“非甾体抗炎药的使用和肾切除术中的急性肾损伤：一项回顾性倾向评分匹配的队列研究”的关键评价。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101728

Raihan Mohammed Mohiuddin, Mohammed Misbah Ul Haq

引用次数: 0

Optimal timing for initiating antibiotic therapy in suspected non-severe ventilator associated pneumonia in intensive care units: an ESICM endorsed international survey - OPTI-VAP Survey. 重症监护病房疑似非严重呼吸机相关性肺炎启动抗生素治疗的最佳时机：ESICM认可的国际调查- OPTI-VAP调查

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101726

Myriam Lamamri, Antoine Gallet, Marc Leone, Adrien Bouglé, Sheila Nainan Myatra, Emmanuel Weiss, Arnaud Foucrier

Background: Ventilator-associated pneumonia (VAP) is a major ICU concern. Current guidelines recommend immediate empirical antibiotic therapy, yet this approach carries substantial ecological risks. The OPTI-VAP study aimed to assess clinicians' decision-making strategies regarding the timing of antibiotic therapy initiation in suspected non-severe VAP.

Methods: The OPTI-VAP study was an international web-based survey endorsed by the European Society of Intensive Care Medicine.

Results: A total of 163 physicians from 142 centers in 27 countries responded, predominantly from France (47.8%) and India (20.9%). A substantial 62.6% of respondents systematically initiated immediate empirical antibiotic therapy for suspected non-severe VAP. Performing a bronchoalveolar lavage (OR 5.0; 95% CI [1.46-17.06]; p = 0.01) was associated with a strategy of systematically initiating immediate and empirical antibiotic therapy, while the systematic availability of direct examination (Gram stain) results (OR 0.3; 95% CI [0.08-0.98]; p = 0.04) was associated with a delayed strategy. The main justifications for immediate and empirical therapy were worsening gas exchange and pulmonary infiltrates on imaging.

Conclusions: The observed preference for immediate therapy aligns with current guidelines, likely driven by concerns about adverse clinical complications. However, significant practice disparities were evident, influenced by diagnostic resource availability and local workflows. Future randomized controlled trials are needed to optimize the timing of antibiotic initiation in suspected non-severe VAP.

背景：呼吸机相关性肺炎（VAP）是ICU关注的主要问题。目前的指南建议立即进行经验性抗生素治疗，但这种方法存在巨大的生态风险。OPTI-VAP研究旨在评估临床医生对疑似非严重VAP开始抗生素治疗时机的决策策略。方法：OPTI-VAP研究是由欧洲重症监护医学学会批准的一项基于网络的国际调查。结果：共有来自27个国家142个中心的163名医生参与了调查，主要来自法国（47.8%）和印度（20.9%）。62.6%的应答者系统地立即对疑似非严重VAP进行经验性抗生素治疗。进行支气管肺泡灌洗（OR 5.0; 95% CI [1.46-17.06]; p = 0.01）与系统地启动立即和经验抗生素治疗的策略相关，而系统地获得直接检查（革兰氏染色）结果（OR 0.3; 95% CI [0.08-0.98]; p = 0.04）与延迟策略相关。立即和经验治疗的主要理由是恶化的气体交换和肺部浸润影像学。结论：观察到的对立即治疗的偏好与当前指南一致，可能是由于对不良临床并发症的担忧。然而，受可用诊断资源和当地工作流程的影响，显著的实践差异是显而易见的。未来需要随机对照试验来优化疑似非严重VAP的抗生素起始时间。

{"title":"Optimal timing for initiating antibiotic therapy in suspected non-severe ventilator associated pneumonia in intensive care units: an ESICM endorsed international survey - OPTI-VAP Survey.","authors":"Myriam Lamamri, Antoine Gallet, Marc Leone, Adrien Bouglé, Sheila Nainan Myatra, Emmanuel Weiss, Arnaud Foucrier","doi":"10.1016/j.accpm.2025.101726","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101726","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is a major ICU concern. Current guidelines recommend immediate empirical antibiotic therapy, yet this approach carries substantial ecological risks. The OPTI-VAP study aimed to assess clinicians' decision-making strategies regarding the timing of antibiotic therapy initiation in suspected non-severe VAP.</p><p><strong>Methods: </strong>The OPTI-VAP study was an international web-based survey endorsed by the European Society of Intensive Care Medicine.</p><p><strong>Results: </strong>A total of 163 physicians from 142 centers in 27 countries responded, predominantly from France (47.8%) and India (20.9%). A substantial 62.6% of respondents systematically initiated immediate empirical antibiotic therapy for suspected non-severe VAP. Performing a bronchoalveolar lavage (OR 5.0; 95% CI [1.46-17.06]; p = 0.01) was associated with a strategy of systematically initiating immediate and empirical antibiotic therapy, while the systematic availability of direct examination (Gram stain) results (OR 0.3; 95% CI [0.08-0.98]; p = 0.04) was associated with a delayed strategy. The main justifications for immediate and empirical therapy were worsening gas exchange and pulmonary infiltrates on imaging.</p><p><strong>Conclusions: </strong>The observed preference for immediate therapy aligns with current guidelines, likely driven by concerns about adverse clinical complications. However, significant practice disparities were evident, influenced by diagnostic resource availability and local workflows. Future randomized controlled trials are needed to optimize the timing of antibiotic initiation in suspected non-severe VAP.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101726"},"PeriodicalIF":4.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696563","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}

引用次数: 0

Electrical Impedance Tomography- Based PEEP in Obese Patients Undergoing Laparoscopic Surgery: Comment LMA®Gastro™气道有助于放置经食管超声心动图探头。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101730

Brionna Sandridge Bulgarelli, Sophie Kupiec-Weglinski, Nancy M. Boulos

引用次数: 0

Response to Comment on "Comfort‑Focused Assessment and Patient‑Reported Experience After Regional versus General Anaesthesia". 对“以舒适为重点的评估和患者报告的区域麻醉与全身麻醉后体验”评论的回应。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101736

Axel Maurice-Szamburski, Romain Rozier

引用次数: 0

Comment on "Artificial intelligence in airway management: A systematic review and meta-analysis". “人工智能在气道管理中的应用：系统综述和荟萃分析”评论。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-04 DOI: 10.1016/j.accpm.2025.101727

Jaibir Singh, Suman Rani, Sulochana Devi

引用次数: 0

The LMA®Gastro™ airway facilitates the placement of the transesophageal echocardiography probe. LMA®Gastro™气道有助于放置经食管超声心动图探头。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-03 DOI: 10.1016/j.accpm.2025.101732

Dan Zhao, Yijuan Zhang, Chao Sun

引用次数: 0

Effect of head-elevated versus neutral position on tracheal intubation using a hyper-angulated video laryngoscope under cervical spine immobilization: a randomised crossover trial. 颈椎固定下使用超角度视频喉镜进行气管插管时头部抬高与中性体位的影响：一项随机交叉试验。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-03 DOI: 10.1016/j.accpm.2025.101720

Sung Hyun Lee, Kyung Mi Kim, Eun Mi Choi, Jung Mo Son, Jiho Park, Joo Hyun Jun

Background: Videolaryngoscopes with hyper-angulated blades improve glottic visualisation in patients with cervical spine immobilisation but may complicate blade insertion and tracheal tube (TT) advancement. We compared the head-elevated (HE) and head-neutral (HN) position during GlideScope®-guided intubation under manual in-line stabilisation (MILS).

Methods: In this randomised crossover trial, 180 adult patients undergoing elective surgery were allocated to HN or HE groups. Under MILS, videolaryngoscopy was performed in both positions, but intubation was attempted only in the second designed position. The HE position was achieved by elevating the back section of the table to align the external auditory meatus and sternal notch.

Results: Intubation was attempted in 177 patients with 100% success. Median intubation time was shorter in HE group than HN group (27.2 [23.4-34.3] vs. 31.5 [27.0-40.5] s; difference -4.5 s, 95% CI -7.5 to -1.8; P = 0.001). The modified intubation difficulty scale was lower in HE group (1 [0-1]) than HN group (2 [1-3]; P < 0.001). The need for optimisation manoeuvres was less frequent in the HE position for GlideScope® blade insertion (5.6% vs. 13.9%; P = 0.0001) and for TT advancement (31.8% vs. 58.4%; P < 0.001). Laryngeal view was superior in the HE position, with a higher mean percentage of glottic opening score (42.9 ± 35.6% vs. 26.8 ± 32.3%; P < 0.0001) and a greater proportion of easy modified Cormack-Lehane grades (83.8% vs. 64.8%; P < 0.0001).

Conclusion: The HE position significantly improved intubation efficiency and technical ease using a hyper-angulated videolaryngoscope under MILS.

Trial registration: ClinicalTrials.gov identifier: NCT05671978.

背景：带超角度叶片的视频喉镜可改善颈椎固定患者的声门显像，但可能使叶片插入和气管管（TT）推进复杂化。我们比较了GlideScope®引导下手动在线稳定（MILS）插管时头部升高（HE）和头部中立（HN）的位置。方法：在这项随机交叉试验中，180名接受择期手术的成年患者被分配到HN组或HE组。在MILS下，两种体位都进行了视频喉镜检查，但仅在第二个设计体位尝试插管。通过抬高手术台后部，使外耳道和胸骨切迹对齐，达到HE位置。结果：177例患者插管成功率100%。HE组中位插管时间短于HN组（27.2 [23.4-34.3]vs. 31.5 [27.0-40.5] s，差异为-4.5 s， 95% CI为-7.5 ~ -1.8;P = 0.001）。改良后的HE组插管难度评分（1[0-1]）低于HN组(2 [1-3]；P结论：HE体位明显提高了MILS下超角度视频镜插管效率和技术难度。试验注册：ClinicalTrials.gov标识符：NCT05671978。

{"title":"Effect of head-elevated versus neutral position on tracheal intubation using a hyper-angulated video laryngoscope under cervical spine immobilization: a randomised crossover trial.","authors":"Sung Hyun Lee, Kyung Mi Kim, Eun Mi Choi, Jung Mo Son, Jiho Park, Joo Hyun Jun","doi":"10.1016/j.accpm.2025.101720","DOIUrl":"https://doi.org/10.1016/j.accpm.2025.101720","url":null,"abstract":"<p><strong>Background: </strong>Videolaryngoscopes with hyper-angulated blades improve glottic visualisation in patients with cervical spine immobilisation but may complicate blade insertion and tracheal tube (TT) advancement. We compared the head-elevated (HE) and head-neutral (HN) position during GlideScope®-guided intubation under manual in-line stabilisation (MILS).</p><p><strong>Methods: </strong>In this randomised crossover trial, 180 adult patients undergoing elective surgery were allocated to HN or HE groups. Under MILS, videolaryngoscopy was performed in both positions, but intubation was attempted only in the second designed position. The HE position was achieved by elevating the back section of the table to align the external auditory meatus and sternal notch.</p><p><strong>Results: </strong>Intubation was attempted in 177 patients with 100% success. Median intubation time was shorter in HE group than HN group (27.2 [23.4-34.3] vs. 31.5 [27.0-40.5] s; difference -4.5 s, 95% CI -7.5 to -1.8; P = 0.001). The modified intubation difficulty scale was lower in HE group (1 [0-1]) than HN group (2 [1-3]; P < 0.001). The need for optimisation manoeuvres was less frequent in the HE position for GlideScope® blade insertion (5.6% vs. 13.9%; P = 0.0001) and for TT advancement (31.8% vs. 58.4%; P < 0.001). Laryngeal view was superior in the HE position, with a higher mean percentage of glottic opening score (42.9 ± 35.6% vs. 26.8 ± 32.3%; P < 0.0001) and a greater proportion of easy modified Cormack-Lehane grades (83.8% vs. 64.8%; P < 0.0001).</p><p><strong>Conclusion: </strong>The HE position significantly improved intubation efficiency and technical ease using a hyper-angulated videolaryngoscope under MILS.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05671978.</p>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":" ","pages":"101720"},"PeriodicalIF":4.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688567","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}

引用次数: 0

Evaluation of disparities in neuro-sedation treatment for intracranial hypertension in traumatic brain injury in France: A national survey 评价法国外伤性脑损伤颅内高压患者神经镇静治疗的差异：一项全国性调查。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2025-12-03 DOI: 10.1016/j.accpm.2025.101722

Hugues Ravaux , Jean-Denis Moyer , Benjamin Cohen , Päer-Sélim Abback

Importance

Sedation is a cornerstone therapeutic option for the control of intracranial hypertension in patients with traumatic brain injury. However, the absence of specific recommendations regarding the choice of agents, their combinations, or dosing strategies contributes to the heterogeneity of sedation practices, which may be applied at varying levels of therapeutic intensity (Tier 0, 1, 2, 3).

Objective

To describe the sedative molecules and their combinations used in the treatment of ICH in TBI in France.

Methods

From May 1^st to August 31^st, 2024, a questionnaire was sent to French senior physicians working in intensive care units of level 1 trauma centers.

Results

A total of 115 responses were obtained. At the initial tier of therapeutic intensity, the most frequently reported sedations were midazolam (n = 52, 45%) and propofol (n = 43, 37%). For analgesia, sufentanil was the predominant agent (96%). The most common combination at the first tier was midazolam/propofol/sufentanil (n = 78, 69%). Forty-eight respondents (42%) reported escalating to a higher level of sedation at Tier Two, most often with midazolam/propofol/ketamine/sufentanil (n = 35, 73%). Sixty-four respondents (56%) reported using barbiturate coma for intracranial hypertension refractory to Tier Two therapy.

Conclusion

This study describes a high level of heterogeneity in the use of sedation agents, their maximum doses, and their monitoring in the treatment of traumatic ICH among neurointensivists in France.

重要性：镇静是控制外伤性脑损伤患者颅内高压的基础治疗选择。然而，由于缺乏关于药物选择、药物组合或给药策略的具体建议，镇静实践存在异质性，可能适用于不同水平的治疗强度（第0、1、2、3级）。目的：介绍法国创伤性脑损伤后脑出血的镇静分子及其复方。方法：于2024年5月1日至8月31日，对在法国一级创伤中心重症监护病房工作的高级医师进行问卷调查。结果：共获得115份问卷。在治疗强度的初始阶段，最常报道的镇静是咪达唑仑（n = 52, 45%）和异丙酚（n = 43, 37%）。镇痛以舒芬太尼为主（96%）。第一层最常见的组合是咪达唑仑/异丙酚/舒芬太尼（n = 78, 69%）。48名应答者（42%）报告在二级镇静时升级至更高水平，最常使用咪达唑仑/异丙酚/氯胺酮/舒芬太尼（n = 35, 73%）。64名应答者（56%）报告使用巴比妥昏迷治疗颅内高压，二级治疗难治性。结论：该研究描述了法国神经强化医生在治疗外伤性脑出血时镇静药物的使用、最大剂量和监测方面的高度异质性。

{"title":"Evaluation of disparities in neuro-sedation treatment for intracranial hypertension in traumatic brain injury in France: A national survey","authors":"Hugues Ravaux , Jean-Denis Moyer , Benjamin Cohen , Päer-Sélim Abback","doi":"10.1016/j.accpm.2025.101722","DOIUrl":"10.1016/j.accpm.2025.101722","url":null,"abstract":"<div><h3>Importance</h3><div>Sedation is a cornerstone therapeutic option for the control of intracranial hypertension in patients with traumatic brain injury. However, the absence of specific recommendations regarding the choice of agents, their combinations, or dosing strategies contributes to the heterogeneity of sedation practices, which may be applied at varying levels of therapeutic intensity (Tier 0, 1, 2, 3).</div></div><div><h3>Objective</h3><div>To describe the sedative molecules and their combinations used in the treatment of ICH in TBI in France.</div></div><div><h3>Methods</h3><div>From May 1<sup>st</sup> to August 31<sup>st</sup>, 2024, a questionnaire was sent to French senior physicians working in intensive care units of level 1 trauma centers.</div></div><div><h3>Results</h3><div>A total of 115 responses were obtained. At the initial tier of therapeutic intensity, the most frequently reported sedations were midazolam (<em>n</em> = 52, 45%) and propofol (<em>n</em> = 43, 37%). For analgesia, sufentanil was the predominant agent (96%). The most common combination at the first tier was midazolam/propofol/sufentanil (<em>n</em> = 78, 69%). Forty-eight respondents (42%) reported escalating to a higher level of sedation at Tier Two, most often with midazolam/propofol/ketamine/sufentanil (<em>n</em> = 35, 73%). Sixty-four respondents (56%) reported using barbiturate coma for intracranial hypertension refractory to Tier Two therapy.</div></div><div><h3>Conclusion</h3><div>This study describes a high level of heterogeneity in the use of sedation agents, their maximum doses, and their monitoring in the treatment of traumatic ICH among neurointensivists in France.</div></div>","PeriodicalId":48762,"journal":{"name":"Anaesthesia Critical Care & Pain Medicine","volume":"45 2","pages":"Article 101722"},"PeriodicalIF":4.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688509","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Anaesthesia Critical Care & Pain Medicine

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀