Anaesthesia Critical Care & Pain Medicine最新文献

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Barriers and options to implement improved oral care in the perioperative period. 围手术期实施改善口腔护理的障碍和选择。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-03 DOI: 10.1016/j.accpm.2026.101786

Dan Benhamou

引用次数: 0

The Effect of Excessive Noise Rejection, Noise Filtering and Twitch Threshold on Mechanomyograph Twitch Measurements. 过度噪声抑制、噪声滤波和抽动阈值对肌力图抽动测量的影响。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-03 DOI: 10.1016/j.accpm.2026.101780

Zain Wedemeyer, Andrew Bowdle, Srdjan Jelacic, Willis Silliman, Kelly E Michaelsen

Background: Severe respiratory failure is the leading cause of intensive care unit (ICU) admission and mortality in critically ill COVID-19 patients. However, whether active viral replication persists in the lower respiratory tract of these patients and contributes to lung injury remains unclear.

Methods: We conducted a prospective cohort study of 159 critically ill COVID-19 patients requiring invasive mechanical ventilation (IMV). A bronchoalveolar lavage (BAL) sample was collected within 24 hours of intubation. SARS-CoV-2 RNA load (N1, N2, E, and subgenomic E) and the expression of 18 host immune-related genes were assessed. A replication-competent virus was detected using a Vero cell culture assay by inoculating cells with BAL samples and monitoring cytopathic effects. SARS-CoV-2 replication was confirmed by RT-qPCR. Association of virological and immunological factors with time from symptom onset to IMV initiation was evaluated using multivariable linear regression.

Results: SARS-CoV-2 RNA was detected in 84.3% of BAL samples, and 71.7% were positive for subgenomic E RNA. Replication-competent virus was confirmed in 60% of the samples. High RNA levels and SARS-CoV-2 culture positivity were independently associated with shorter time from symptom onset to IMV initiation, with culture positivity showing the strongest association. Gene expression profiling revealed a marked suppression of innate immune effectors, despite robust expression of type I and type III interferons. CXCL10 and PDL1 were the only genes independently associated with shorter time from symptom onset to IMV initiation.

Conclusions: At the time of IMV initiation, patients with early respiratory failure showed high levels of SARS-CoV-2 RNA and evidence of active viral replication in the lower respiratory tract. This group represents a distinct virological phenotype that could benefit from therapeutic interventions targeting pulmonary viral replication.

Registration: sub-study of the CIBERESUCICOVID project (NCT04457505).

背景：严重呼吸衰竭是COVID-19危重症患者入住重症监护病房（ICU）和死亡的主要原因。然而，这些患者的下呼吸道是否持续存在活跃的病毒复制并导致肺损伤尚不清楚。方法：对159例需要有创机械通气（IMV）的COVID-19危重症患者进行前瞻性队列研究。在插管后24小时内收集支气管肺泡灌洗（BAL）样本。评估SARS-CoV-2 RNA载量（N1、N2、E和亚基因组E）和18个宿主免疫相关基因的表达。使用Vero细胞培养试验，通过将BAL样品接种细胞并监测细胞病变效应，检测到具有复制能力的病毒。RT-qPCR证实SARS-CoV-2复制。病毒学和免疫学因素与从症状出现到IMV开始时间的关系使用多变量线性回归进行评估。结果：84.3%的BAL标本检出SARS-CoV-2 RNA， 71.7%的标本检出亚基因组E RNA阳性。在60%的样本中确认有复制能力的病毒。高RNA水平和SARS-CoV-2培养阳性与从症状出现到IMV启动时间较短独立相关，其中培养阳性相关性最强。基因表达谱显示，尽管I型和III型干扰素表达强劲，但先天免疫效应物明显受到抑制。CXCL10和PDL1是唯一与症状发作到IMV起始时间较短独立相关的基因。结论：在IMV开始时，早期呼吸衰竭患者表现出高水平的SARS-CoV-2 RNA和下呼吸道病毒复制活跃的证据。这一组代表了一种独特的病毒学表型，可以从针对肺部病毒复制的治疗干预中受益。注册：CIBERESUCICOVID项目（NCT04457505）子研究。

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引用次数: 0

Author's Reply: "An interpretable Machine Learning Approach for Predicting Clinically Important Gastrointestinal Bleeding in Critically Ill Patients". 作者回复：“一种可解释的机器学习方法用于预测危重患者临床重要的胃肠道出血”。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-03 DOI: 10.1016/j.accpm.2026.101803

Shohei Ono

引用次数: 0

Toward a Science of Emotions and Cognitive Readiness in Healthcare Simulation: A New Priority for Anaesthesia and Critical Care. 迈向健康模拟中的情绪和认知准备科学：麻醉和重症监护的新优先事项。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-02 DOI: 10.1016/j.accpm.2026.101797

Marc Lilot, Vicki LeBlanc

引用次数: 0

Comment on: Sepsis is associated with radiological lesions in patients with primary brain injuries: the result of a bicentric retrospective cohort - The Role of Blood-Brain Barrier Permeability in Sepsis-Associated Brain Lesions: An Unexplored Dimension. 点评：脓毒症与原发性脑损伤患者的影像学病变相关：一项双中心回顾性队列研究的结果——血脑屏障通透性在脓毒症相关脑病变中的作用：一个未探索的维度。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-02 DOI: 10.1016/j.accpm.2026.101794

Hongfei Wang, Ning Luo, Yin Li

引用次数: 0

Gender Bias: reality or perception? - proposed solutions to create equitable and inclusive workplaces. 性别偏见：现实还是感知？-提出解决方案，以创造公平和包容的工作场所。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-02 DOI: 10.1016/j.accpm.2026.101796

Britta Sylvia von Ungern-Sternberg, Aine Sommerfield, Karin Becke-Jakob

This article reflects on deeply ingrained societal biases with regard to gender. Patriarchal structures and gender socialization have created a perceived incongruity between traditional leadership qualities and traits associated with women. This perception, explained by the role congruity theory, contributes to prejudice against female leaders and can lead to toxic male behavior being misidentified as "strong" leadership. We further examine cognitive shortcuts, specifically implicit bias and the affect heuristic, which perpetuate unconscious favoritism towards male leaders. Merely raising awareness about implicit bias is insufficient. We suggest a dual approach of individual and institutional actions-from personal reflection and allyship to mandatory bias training and transparent organizational processes-to create truly equitable and inclusive workplaces in which everyone, regardless of gender, can thrive.

这篇文章反映了关于性别的根深蒂固的社会偏见。父权结构和性别社会化在传统的领导素质和与妇女有关的特点之间造成了明显的不协调。角色一致性理论解释了这种看法，它助长了对女性领导者的偏见，并可能导致有害的男性行为被误认为是“强势”的领导。我们进一步研究了认知捷径，特别是内隐偏见和情感启发式，它们使对男性领导者的无意识偏袒永永化。仅仅提高对隐性偏见的认识是不够的。我们建议采取个人和机构行动的双重方法——从个人反思和盟友关系到强制性偏见培训和透明的组织流程——创造真正公平和包容的工作场所，使每个人，无论性别，都能茁壮成长。

引用次数: 0

Remimazolam And The Forgotten Window: A Hypnotic That Improves Ventilation. 雷马唑仑和被遗忘的窗户：一种改善通风的催眠药。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-03-02 DOI: 10.1016/j.accpm.2026.101799

Ahed Zeidan, Joana Berger-Estilita, Federico Bilotta

引用次数: 0

Comment on "Quantifying the Effective Cricoid Force to Occlude the Esophageal Entrance in Anesthetized and Muscle-Relaxed Children: A Videolaryngoscopy-Based Assessment". 对“麻醉和肌肉放松儿童环状软骨封堵食管入口的有效力量化：基于视频喉镜的评估”的评论。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-02-28 DOI: 10.1016/j.accpm.2026.101798

Wael Ghaly Elmasry, Ahmed Mohamed Abdelbaky, Ahmed Hossameldin Ahmed Awad

引用次数: 0

Letter to the Editor: "An interpretable machine learning approach for predicting clinically important gastrointestinal bleeding in critically ill patients". 致编辑的信：“一种可解释的机器学习方法，用于预测危重患者临床上重要的胃肠道出血”。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-02-28 DOI: 10.1016/j.accpm.2026.101805

Wing-Sum Chan, Yu-Chang Yeh

引用次数: 0

Critical Appraisal of "Effect of Intraoperative Remimazolam Infusion on Postoperative Sleep Disturbance in Elderly Patients After Gynecological Laparoscopy". “术中输液雷马唑仑对老年妇科腹腔镜术后睡眠障碍的影响”的批判性评价。

IF 4.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine

Pub Date : 2026-02-28 DOI: 10.1016/j.accpm.2026.101801

Parth Aphale, Himanshu Shekhar, Shashank Dokania

引用次数: 0

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