1
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Sondekoppam RV, Dexter F, Vithani S, Wong CA. Survey of anesthesia department chairs about the environmental sustainability initiatives of their programs. J Clin Anesth 2024; 94:111378. [PMID: 38237442 DOI: 10.1016/j.jclinane.2024.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/05/2023] [Accepted: 01/04/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Anesthesia departments can reduce their environmental impact. Barriers exist to the promotion of individual anesthesiologists' roles in environmentally sustainable practices. We hypothesized that accountability of departmental leadership is associated with reports of practices that can encourage and sustain environmentally favorable practices. METHODS Invitations to complete a six-question survey were sent to academic anesthesia department chairs in the United States and Canada. Questions were presented in random sequence. We assessed the association between the sum of the answers to five questions about department- and hospital-related sustainability activities (e.g., more than one "educational session dedicated to environmental sustainability … for anesthesiology residents or other trainees?") and the sixth question ("In the past 12 months, did review of the anesthesia department chair or review of your department include" more than one "item related to promotion of environmental sustainability?"). RESULTS Of the 138 departments receiving invitation and reminder emails, 63 departments (46%) responded to our requests. The median (interquartile range) was 1 (0,3) sustainability activity for "No" items evaluating the department chair or department (N = 43) versus 4 (2, 4.5) activities for "Yes" evaluation of department chair or department (N = 20) (Wilcoxon-Mann-Whitney test, P = 0.0021; median regression, P = 0.0002). Results were similar for sensitivity analyses (excluding one question about hospital leadership, excluding the four responding Canadian departments, controlling for time to complete the survey, and controlling for the date of completion of the survey). CONCLUSIONS Anesthesia department chairs and departments with annual performance evaluations that included items related to environmental sustainability reported more activities to promote sustainability. The result suggests that leadership-sponsored initiatives directed toward environmental sustainability are associated with environmental sustainability activities in anesthesia departments.
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Affiliation(s)
| | - Franklin Dexter
- University of Iowa, Iowa City, IA, United States of America.
| | - Samira Vithani
- University of Iowa, Iowa City, IA, United States of America.
| | - Cynthia A Wong
- University of Iowa, Iowa City, IA, United States of America.
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2
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Martin SR, Kain ZN. The intersection of pediatric anesthesiology and social determinants of health. Curr Opin Anaesthesiol 2024; 37:271-276. [PMID: 38441068 DOI: 10.1097/aco.0000000000001367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
PURPOSE OF REVIEW There is increasing evidence of racial and ethnic disparities in pediatric perioperative care, which indicates a need to identify factors driving disparities. Social determinants of health (SDOH) play a fundamental role in pediatric health and are recognized as key underlying mechanisms of healthcare inequities. This article summarizes recent research exploring the influence of SDOH on pediatric perioperative outcomes. RECENT FINDINGS Despite the scarcity of research exploring SDOH and pediatric perioperative outcomes, recent work demonstrates an association between SDOH and multiple outcomes across the perioperative care continuum. Measures of social disadvantage were associated with preoperative symptom severity, longer hospital stays, and higher rates of postoperative complications and mortality. In some studies, these adverse effects of social disadvantage persisted even when controlling for medical comorbidities and clinical severity. SUMMARY The existing literature offers compelling evidence of the impact of SDOH on perioperative outcomes in children and reveals a critical area in pediatric anesthesia that necessitates further exploration and action. To improve outcomes and address care inequities, future efforts should prioritize the integration of SDOH assessment into pediatric perioperative research and practice.
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Affiliation(s)
- Sarah R Martin
- Department of Anesthesiology and Perioperative Care, University of California Irvine School of Medicine
- Center on Stress & Health, University of California Irvine, Irvine
- Emergency Medicine, Children's Hospital of Orange County, Orange, California
| | - Zeev N Kain
- Department of Anesthesiology and Perioperative Care, University of California Irvine School of Medicine
- Center on Stress & Health, University of California Irvine, Irvine
- Yale University Child Study Center, New Haven, Connecticut
- Children's Hospital of Orange County, Orange, California, USA
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3
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Li G, Freundlich RE, Rice MJ, Dunworth BA, Sandberg WS, Higgins MS, Wanderer JP. The impact of a medically directed student registered nurse anesthesia staffing model on Postprocedural patient outcomes. J Clin Anesth 2024; 94:111413. [PMID: 38359686 DOI: 10.1016/j.jclinane.2024.111413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/26/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
STUDY OBJECTIVE In 2018, the American Society of Anesthesiologists stated that student registered nurse anesthetists (SRNAs) "are not yet fully qualified anesthesia personnel." It remains unclear, however, whether postprocedural outcomes are affected by SRNAs providing anesthesia care under the medical direction of anesthesiologists, as compared with medically directed anesthesiology fellows or residents, or certified registered nurse anesthetists (CRNAs). We therefore aimed to examine whether medically directed SRNAs serving as in-room anesthesia providers impact surgical outcomes. DESIGN Retrospective, matched-cohort analysis. SETTING Adult patients (≥18 years old) undergoing inpatient surgery between 2000 and 2017 at a tertiary academic medical center. PATIENTS 15,365 patients exclusively cared for by medically directed SRNAs were matched to 15,365 cared for by medically directed CRNAs, anesthesiology residents, and/or fellows. INTERVENTIONS None. MEASUREMENTS The primary composite outcome was postoperative occurrence of in-hospital mortality and six categories of major morbidities (infectious, bleeding, serious cardiac, gastrointestinal, respiratory, and urinary complications). In-hospital mortality was analyzed as the secondary outcome. MAIN RESULTS In all, 30,730 cases were matched using propensity score matching to control for potential confounding. The primary outcome was identified in 2295 (7.5%) cases (7.5% with exclusive medically directed SRNAs vs 7.4% with medically directed CRNAs, residents and/or fellows; relative risk, 1.02; 95% CI, 0.94-1.11). Thus, our effort to determine noninferiority (10% difference in relative risk) with other providers was inconclusive (P = .07). However, the medically directed SRNA group (0.8% [118]) was found to be noninferior (P < .001) to the matched group (1.0% [156]) on in-hospital mortality (relative risk, 0.75; 95% CI, 0.59-0.96). CONCLUSIONS Among 30,730 patients undergoing inpatient surgery at a single hospital, findings were inconclusive regarding whether exclusive medically directed SRNAs as in-room providers were noninferior to other providers. The use of medically directed SRNAs under this staffing model should be subject to further review. Clinical Trial and Registry URL: Not applicable.
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Affiliation(s)
- Gen Li
- Department of Anesthesiology, Vanderbilt University Medical Center, United States
| | - Robert E Freundlich
- Department of Anesthesiology, Department of Biomedical Informatics, Vanderbilt University Medical Center, United States
| | - Mark J Rice
- Department of Anesthesiology, Vanderbilt University Medical Center, United States
| | - Brent A Dunworth
- Department of Anesthesiology, Vanderbilt University Medical Center, United States
| | - Warren S Sandberg
- Department of Anesthesiology, Department of Biomedical Informatics, Department of Surgery, Vanderbilt University Medical Center, United States
| | - Michael S Higgins
- Department of Anesthesiology, Department of Biomedical Informatics, Vanderbilt University Medical Center, United States
| | - Jonathan P Wanderer
- Department of Anesthesiology, Department of Biomedical Informatics, Vanderbilt University Medical Center, United States.
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4
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Khan AA, Yunus R, Sohail M, Rehman TA, Saeed S, Bu Y, Jackson CD, Sharkey A, Mahmood F, Matyal R. Artificial Intelligence for Anesthesiology Board-Style Examination Questions: Role of Large Language Models. J Cardiothorac Vasc Anesth 2024; 38:1251-1259. [PMID: 38423884 DOI: 10.1053/j.jvca.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
New artificial intelligence tools have been developed that have implications for medical usage. Large language models (LLMs), such as the widely used ChatGPT developed by OpenAI, have not been explored in the context of anesthesiology education. Understanding the reliability of various publicly available LLMs for medical specialties could offer insight into their understanding of the physiology, pharmacology, and practical applications of anesthesiology. An exploratory prospective review was conducted using 3 commercially available LLMs--OpenAI's ChatGPT GPT-3.5 version (GPT-3.5), OpenAI's ChatGPT GPT-4 (GPT-4), and Google's Bard--on questions from a widely used anesthesia board examination review book. Of the 884 eligible questions, the overall correct answer rates were 47.9% for GPT-3.5, 69.4% for GPT-4, and 45.2% for Bard. GPT-4 exhibited significantly higher performance than both GPT-3.5 and Bard (p = 0.001 and p < 0.001, respectively). None of the LLMs met the criteria required to secure American Board of Anesthesiology certification, according to the 70% passing score approximation. GPT-4 significantly outperformed GPT-3.5 and Bard in terms of overall performance, but lacked consistency in providing explanations that aligned with scientific and medical consensus. Although GPT-4 shows promise, current LLMs are not sufficiently advanced to answer anesthesiology board examination questions with passing success. Further iterations and domain-specific training may enhance their utility in medical education.
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Affiliation(s)
- Adnan A Khan
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Rayaan Yunus
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Mahad Sohail
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Taha A Rehman
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Shirin Saeed
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Yifan Bu
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Cullen D Jackson
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA
| | - Robina Matyal
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA.
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5
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Vetter TR. Anesthesiologist's Recollection of Transplant Surgeon's Dream: A Haibun. Anesth Analg 2024; 138:1148-1149. [PMID: 38381670 DOI: 10.1213/ane.0000000000006655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Affiliation(s)
- Thomas R Vetter
- From the Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, Texas
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6
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Dexter F, Scheib S, Xie W, Epstein RH. Bibliometric Analysis of Contributions of Anesthesiology Journals and Anesthesiologists to Operating Room Management Science. Anesth Analg 2024; 138:1120-1128. [PMID: 38091575 DOI: 10.1213/ane.0000000000006694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Anesthesiology journals appear to have been progressively publishing a smaller percentage of operating room (OR) management studies. Similarly, non-anesthesiologists have increasingly been authors of these publications. Five hypotheses were formulated to evaluate these impressions based on 2 of the authors' curation of an online, comprehensive bibliography of OR management articles and corresponding referenced course materials. METHODS We studied all 2938 publications having Scopus' SciVal topic T.6319 (OR management) more than 28 years from 1996 through May 2023, including 8608 distinct authors. RESULTS Half (50%) of the publications were absent from PubMed, and the percentage absent has been increasing progressively (Kendall's τ = 0.71; P < .0001). Fewer than half were published in journals including anesthesiology as the sole classification (20%) or as one of the classifications (27%). The anesthesiology journals have been publishing a progressively decreasing fraction (τ = -0.61; P < .0001). Among the 11 authors each contributing at least 1% of the OR management science publications, 9 were anesthesiologists and the other 2 had anesthesiologists as coauthors on all these publications. Only 3% of authors had at least 10 OR management publications from earlier years. There were 75% of authors with no such earlier publications and 85% with 0 or 1. There was a progressive increase in the number of authors publishing OR management annually and with at most 1 such earlier publication (τ = 0.90; P < .0001). Only 20% of publications had any author with at least 10 earlier OR management publications, 48% had every author with no such earlier publications, and 60% had all authors with 0 or 1. CONCLUSIONS Although most of the authors with the greatest production of OR management science were anesthesiologists, the percentage of publications in anesthesiology journals has been decreasing progressively. Anesthesiologists cannot rely solely on anesthesiology journals to keep up with the field. For most publications, every author had few or no earlier publications on the topic. Clinicians and managers relying on OR management science will continue to need to apply more information when judging whether published results can reliably be applied to their facilities.
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Affiliation(s)
- Franklin Dexter
- From the Department of Anesthesia, University of Iowa College of Medicine, Iowa City, Iowa
| | - Sara Scheib
- University of Iowa Libraries, Iowa City, Iowa
| | - Wei Xie
- University of Iowa Libraries, Iowa City, Iowa
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7
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Hewson DW, Ferry J, Macfarlane AJR. Celebrating the state of the art and innovations in regional anaesthesia in the British Journal of Anaesthesia. Br J Anaesth 2024; 132:1012-1015. [PMID: 38448273 DOI: 10.1016/j.bja.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024] Open
Abstract
To coincide with the annual scientific meeting of Regional Anaesthesia UK in London 2024, where there is a joint scientific session with the British Journal of Anaesthesia, a special regional anaesthesia edition of the journal has been produced. This editorial offers some highlights from the manuscripts contained within the special edition.
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Affiliation(s)
- David W Hewson
- Department of Anaesthesia and Critical Care Medicine, Academic Unit of Injury, Recovery and Inflammation Sciences, School of Medicine, University of Nottingham, Nottingham, UK; Department of Anaesthesia, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jenny Ferry
- Department of Anaesthesia, Aneurin Bevan University Health Board, Newport, UK
| | - Alan J R Macfarlane
- Department of Anaesthesia, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, Glasgow, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
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8
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Webster CS. Psychology in the operating theatre: the importance of colour and cognition in the redesign of clinical systems for medication safety. Br J Anaesth 2024; 132:837-839. [PMID: 38418333 DOI: 10.1016/j.bja.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/06/2024] [Indexed: 03/01/2024] Open
Abstract
Medication errors in anaesthesia remain a leading cause of patient harm. Compared with conventional methods, use of the international colour-code standard on syringes and medication trays allows significantly more errors to be detected, and does so under conditions of cognitive load. Testing methods from experimental psychology provide important new insights for human factors research in anaesthesia and health care.
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Affiliation(s)
- Craig S Webster
- Department of Anaesthesiology and Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand.
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9
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Mathis M, Steffner KR, Subramanian H, Gill GP, Girardi NI, Bansal S, Bartels K, Khanna AK, Huang J. Overview and Clinical Applications of Artificial Intelligence and Machine Learning in Cardiac Anesthesiology. J Cardiothorac Vasc Anesth 2024; 38:1211-1220. [PMID: 38453558 PMCID: PMC10999327 DOI: 10.1053/j.jvca.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 03/09/2024]
Abstract
Artificial intelligence- (AI) and machine learning (ML)-based applications are becoming increasingly pervasive in the healthcare setting. This has in turn challenged clinicians, hospital administrators, and health policymakers to understand such technologies and develop frameworks for safe and sustained clinical implementation. Within cardiac anesthesiology, challenges and opportunities for AI/ML to support patient care are presented by the vast amounts of electronic health data, which are collected rapidly, interpreted, and acted upon within the periprocedural area. To address such challenges and opportunities, in this article, the authors review 3 recent applications relevant to cardiac anesthesiology, including depth of anesthesia monitoring, operating room resource optimization, and transthoracic/transesophageal echocardiography, as conceptual examples to explore strengths and limitations of AI/ML within healthcare, and characterize this evolving landscape. Through reviewing such applications, the authors introduce basic AI/ML concepts and methodologies, as well as practical considerations and ethical concerns for initiating and maintaining safe clinical implementation of AI/ML-based algorithms for cardiac anesthesia patient care.
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Affiliation(s)
- Michael Mathis
- Department of Anesthesiology, University of Michigan Medicine, Ann Arbor, MI
| | - Kirsten R Steffner
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Harikesh Subramanian
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh, Pittsburgh, PA
| | - George P Gill
- Department of Anesthesiology, Cedars Sinai, Los Angeles, CA
| | | | - Sagar Bansal
- Department of Anesthesiology and Perioperative Medicine, University of Missouri School of Medicine, Columbia, MO
| | - Karsten Bartels
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE
| | - Ashish K Khanna
- Department of Anesthesiology, Section on Critical Care Medicine, School of Medicine, Wake Forest University, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY.
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10
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Demailly Z, Brulard G, Tamion F, Veber B, Occhiali E, Clavier T. Gender differences in professional social networks use among critical care researchers. Aust Crit Care 2024; 37:483-489. [PMID: 37173167 DOI: 10.1016/j.aucc.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Recent studies highlight that female anaesthesiology researchers have lower visibility on professional social networks (PSNs) than male researchers. OBJECTIVE The objective of this work was to compare the use of PSNs between women and men in critical care research. METHODS We included the first/last authors (FAs/LAs) among the most frequently cited articles in 2018 and 2019 in three critical care journals (Intensive Care Medicine, Critical Care Medicine, and Critical Care). We compared the use of three PSNs-Twitter, ResearchGate, and LinkedIn-between women and men in the FA/LA positions. RESULTS We analysed 494 articles, which allowed us to include 426 FAs and 383 LAs. The use of a PSN was similar between women and men (Twitter: 35 vs. 31% FA p = 0.76, 38 vs. 31% LA p = 0.24; ResearchGate: 60 vs. 70% FA p = 0.06, 67 vs. 66% LA p = 0.95; LinkedIn: 54 vs. 56% FA p = 0.25, 68 vs. 64% LA p = 0.58; respectively). On ResearchGate, women had a lower reputation score (FA group 26.4 [19.5-31.5] vs. 34.8 [27.4-41.6], p < 0.01; LA group 38.5 [30.9-43.7] vs. 42.3 [37.6-46.4], p < 0.01) and fewer followers (FA group 28.5 [19-45] vs. 68.5 [72,5-657] p < 0.01; LA group 96.5 [43,8-258] vs. 178 [76.3-313.5] p = 0.02). Female researchers were FAs in 30% of the articles and LAs in 16%. CONCLUSION In the field of critical care, the visibility of female researchers on the social networks dedicated to scientific research is lower than that of male researchers.
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Affiliation(s)
- Zoé Demailly
- Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, Rouen, France; Medical ICU, Rouen University Hospital, Rouen, France; Normandy University, UNIROUEN, INSERM U1096, Rouen, France.
| | - Geoffroy Brulard
- Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, Rouen, France
| | - Fabienne Tamion
- Medical ICU, Rouen University Hospital, Rouen, France; Normandy University, UNIROUEN, INSERM U1096, Rouen, France
| | - Benoit Veber
- Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, Rouen, France
| | - Emilie Occhiali
- Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, Rouen, France
| | - Thomas Clavier
- Department of Anesthesiology, Critical Care and Perioperative Medicine, Rouen University Hospital, Rouen, France; Normandy University, UNIROUEN, INSERM U1096, Rouen, France
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11
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Gebhardt B, Jain A. Beyond the Beat: A Cardiac Anesthesiologist's Perspective on Cardiovascular-Kidney-Metabolic Health in Perioperative Care. J Cardiothorac Vasc Anesth 2024; 38:1078-1080. [PMID: 38467526 DOI: 10.1053/j.jvca.2024.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Brian Gebhardt
- Department of Anesthesiology and Perioperative Medicine University of Massachusetts Medical Center, Worcester, MA
| | - Ankit Jain
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, Augusta, GA
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12
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Dexter F, Walker KM, Brindeiro CT, Loftus CP, Banguid CCL, Loftus RW. A threshold of 100 or more colony-forming units on the anesthesia machine predicts bacterial pathogen detection: a retrospective laboratory-based analysis. Can J Anaesth 2024; 71:600-610. [PMID: 38413516 DOI: 10.1007/s12630-024-02707-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 02/29/2024] Open
Abstract
PURPOSE Preventing the spread of pathogens in the anesthesia work area reduces surgical site infections. Improved cleaning reduces the percentage of anesthesia machine samples with ≥ 100 colony-forming units (CFU) per surface area sampled. Targeting a threshold of < 100 CFU when cleaning anesthesia machines may be associated with a lower prevalence of bacterial pathogens. We hypothesized that anesthesia work area reservoir samples returning < 100 CFU would have a low (< 5%) prevalence of pathogens. METHODS In this retrospective cohort study of bacterial count data from nine hospitals, obtained between 2017 and 2022, anesthesia attending and assistants' hands, patient skin sites (nares, axilla, and groin), and anesthesia machine (adjustable pressure-limiting valve and agent dials) reservoirs were sampled at case start and at case end. The patient intravenous stopcock set was sampled at case end. The isolation of ≥ 1 CFU of Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Enterococcus, vancomycin-resistant Enterococcus, gram-negative (i.e., Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp.) or coagulase-negative Staphylococcus was compared for reservoir samples returning ≥ 100 CFU vs those returning < 100 CFU. RESULTS Bacterial pathogens were isolated from 24% (7,601/31,783) of reservoir samples, 93% (98/105) of operating rooms, and 83% (2,170/2,616) of cases. The ratio of total pathogen isolates to total CFU was < 0.0003%. Anesthesia machine reservoirs returned ≥ 100 CFU for 44% (2,262/5,150) of cases. Twenty-three percent of samples returning ≥ 100 CFU were positive for ≥ 1 bacterial pathogen (521/2,262; 99% lower confidence limit, 22%) vs 3% of samples returning < 100 CFU (96/2,888; 99% upper limit, 4%). CONCLUSIONS Anesthesia machine reservoir samples returning < 100 CFU were associated with negligible pathogen detection. This threshold can be used for assessment of terminal, routine, and between-case cleaning of the anesthesia machine and equipment. Such feedback may be useful because the 44% prevalence of ≥ 100 CFU was comparable to the 46% (25/54) reported earlier from an unrelated hospital.
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Affiliation(s)
- Franklin Dexter
- University of Iowa, Iowa City, IA, USA.
- Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA, 52242, USA.
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13
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Fisher AD, Fisher G. Evaluating performance of custom GPT in anesthesia practice. J Clin Anesth 2024; 93:111371. [PMID: 38154443 DOI: 10.1016/j.jclinane.2023.111371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Affiliation(s)
- Andrew D Fisher
- Medical University of South Carolina, Department of Anesthesia and Perioperative Medicine, 167 Ashley Avenue, Suite 301, Charleston, SC 29464, United States of America.
| | - Gabrielle Fisher
- Medical University of South Carolina, Department of Anesthesia and Perioperative Medicine, 167 Ashley Avenue, Suite 301, Charleston, SC 29464, United States of America
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Rayaz H, Yedavalli V, Sair H, Sharma G, Rowan NR, Tackett S, Infosino A, Nabipour S, Kothari P, Levine R, Ishii M, Yousem D, Agrawal Y, Skarupski K, Faraday N, Lee JK, Brady M. Staying Virtual: A Survey Study of the Virtual Lecture Experience in Academic Medicine. Anesth Analg 2024; 138:1020-1030. [PMID: 37115722 DOI: 10.1213/ane.0000000000006490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Increasing clinical demands can adversely impact academic advancement, including the ability to deliver lectures and disseminate scholarly work. The virtual lecture platform became mainstream during the height of the coronavirus-19 pandemic. Lessons learned from this period may offer insight into supporting academic productivity among physicians who must balance multiple demands, including high clinical workloads and family care responsibilities. We evaluated perceptions on delivering virtual lectures to determine whether virtual venues merit continuation beyond the pandemic's initial phase and whether these perceptions differ by gender and rank. METHODS In a survey study, faculty who spoke in 1 of 3 virtual lecture programs in the Departments of Anesthesiology and Critical Care Medicine, Otolaryngology, and Radiology at a university hospital in 2020 to 2022 were queried about their experience. Speakers' motivations to lecture virtually and the perceived advantages and disadvantages of virtual and in-person lectures were analyzed using descriptive statistics and qualitative analyses. RESULTS Seventy-two of 95 (76%) faculty members responded (40% women, 38% men, and 22% gender undisclosed). Virtual lectures supported the speakers "a lot" to "extremely" with the following goals: enhancing one's reputation and credibility (76%), networking (70%), receiving feedback (63%), and advancing prospects for promotion (59%). Virtual programs also increased the speakers' sense of accomplishment (70%) and professional optimism (61%) by at least "a lot," including instructors and assistant professors who previously had difficulty obtaining invitations to speak outside their institution. Many respondents had declined prior invitations to speak in-person due to clinical workload (66%) and family care responsibilities (58%). Previous opportunities to lecture in-person were also refused due to finances (39%), teaching (26%), and research (19%) requirements, personal medical conditions or disabilities (9%), and religious obligations (5%). Promotion was a stronger motivating factor to lecture virtually for instructors and assistant professors than for associate and full professors. By contrast, disseminating work and ideas was a stronger motivator for associate and full professors. Associate and full professors also reported greater improvement in work-related well-being than earlier career faculty from the virtual lecture experience. Very few differences were found by gender. CONCLUSIONS Virtual lecture programs support faculty who might not otherwise have the opportunity to lecture in-person due to multiple constraints. To increase the dissemination of scholarly work and expand opportunities to all faculty, virtual lectures should continue even as in-person venues are reestablished.
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Affiliation(s)
- Hassan Rayaz
- From the Departments of Anesthesiology and Critical Care Medicine
| | - Vivek Yedavalli
- Radiology, Johns Hopkins University (JHU), Baltimore, Maryland
| | - Haris Sair
- Radiology, Johns Hopkins University (JHU), Baltimore, Maryland
| | - Garima Sharma
- Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, JHU, Baltimore, Maryland
| | - Nicholas R Rowan
- Departments of Otolaryngology, Head and Neck Surgery
- Neurological Surgery, JHU, Baltimore, Maryland
| | - Sean Tackett
- Department of Medicine, Division of General Internal Medicine, JHU, Baltimore, Maryland
| | - Andrew Infosino
- Department of Anesthesia and Perioperative Care, University of California San Francisco Medical Center, San Francisco, California
| | | | - Perin Kothari
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California
| | - Rachel Levine
- Department of Medicine, Division of General Internal Medicine, JHU, Baltimore, Maryland
| | - Masaru Ishii
- Departments of Otolaryngology, Head and Neck Surgery
| | - David Yousem
- Radiology, Johns Hopkins University (JHU), Baltimore, Maryland
| | - Yuri Agrawal
- Departments of Otolaryngology, Head and Neck Surgery
| | - Kimberly Skarupski
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California
| | - Nauder Faraday
- From the Departments of Anesthesiology and Critical Care Medicine
| | - Jennifer K Lee
- From the Departments of Anesthesiology and Critical Care Medicine
| | - MaryBeth Brady
- From the Departments of Anesthesiology and Critical Care Medicine
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15
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Dost B, De Cassai A. Self-Citation Patterns of Anesthesiology Journals Indexed in the Journal Citation Reports. Anesth Analg 2024; 138:e33-e34. [PMID: 38621289 DOI: 10.1213/ane.0000000000006961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
- Burhan Dost
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Türkiye,
| | - Alessandro De Cassai
- Sant'Antonio Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy
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16
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Evans B, Edwardson S. Modelling the economic constraints and consequences of Anaesthesia Associate expansion in the UK. Response from the Association of Anaesthetists Trainee Committee to Br J Anaesth 2024; 132: 867-76. Br J Anaesth 2024; 132:971-972. [PMID: 38503623 DOI: 10.1016/j.bja.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
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17
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Hansel J, Jones SJ. Anaesthetic rooms are no longer needed. Anaesthesia 2024; 79:465-468. [PMID: 38214405 DOI: 10.1111/anae.16224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Affiliation(s)
- J Hansel
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester, UK
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK
| | - S J Jones
- Department of Anaesthesia, Northumbria Healthcare NHS Foundation Trust, UK
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18
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Fleming RJ, Wain ECE. Modelling the economic constraints and consequences of Anaesthesia Associate expansion in the UK National Health Service. Response by the Association of Anaesthetists SAS Committee to Br J Anaesth 2024; 132: 867-76. Br J Anaesth 2024; 132:967-968. [PMID: 38508945 DOI: 10.1016/j.bja.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
- Robert J Fleming
- Department of Anaesthesia, Sherwood Forest Hospitals NHS Foundation Trust, Mansfield, UK.
| | - Emma C E Wain
- Department of Anaesthesia, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK
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19
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Lopez-Rincon RM, Plaza-Lloret M, Munoz-Monaco G, Mavarez AC. Fascinating Image of Pentalogy of Cantrell: Navigating Challenges for Optimal Anesthesia Care. Anesthesiology 2024; 140:1016-1017. [PMID: 38427825 DOI: 10.1097/aln.0000000000004877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Rosa Maria Lopez-Rincon
- Department of Anesthesiology and Perioperative Medicine, Wellstar MCG Health, Augusta, Georgia
| | - Miguel Plaza-Lloret
- Department of Anesthesiology and Perioperative Medicine, Wellstar MCG Health, Augusta, Georgia
| | - Gustavo Munoz-Monaco
- Department of Anesthesiology and Perioperative Medicine, Children's Hospital of Georgia, Augusta, Georgia
| | - Ana Corina Mavarez
- Department of Anesthesiology and Perioperative Medicine, Children's Hospital of Georgia, Augusta, Georgia
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20
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Krishnan A. A call for interprofessional education in the postgraduate anaesthesia curriculum. Br J Anaesth 2024; 132:973-975. [PMID: 38418331 DOI: 10.1016/j.bja.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/25/2023] [Accepted: 01/24/2024] [Indexed: 03/01/2024] Open
Affiliation(s)
- Aditya Krishnan
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.
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21
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Forget P, Van de Velde M, Pogatzki-Zahn E. Opioid-free or opioid-sparing anaesthesia: Let us be patient-centred first. Eur J Anaesthesiol 2024; 41:320-321. [PMID: 38426255 DOI: 10.1097/eja.0000000000001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Patrice Forget
- From the Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen (PF); Department of Anaesthesia, NHS Grampian, Aberdeen, UK (PF), Department of Cardiovascular Sciences, KULeuven and Department of Anaesthesiology, UZLeuven, Leuven, Belgium (VdV), University Hospital of Muenster, Muenster, Germany (EP-Z), and Pain AND Opioids After Surgery (PANDOS) European Society of Anaesthesiology and Intensive Care (ESAIC) Research Group, Brussels, Belgium (PF, VdV and EP-Z)
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22
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Buhre W, Maas L. Broadening the scope and rising to the occasion, an opportunity for anaesthesiologists to take the lead in healthcare quality & patient safety (again). Curr Opin Anaesthesiol 2024; 37:150-154. [PMID: 38390961 DOI: 10.1097/aco.0000000000001358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE OF REVIEW The landscape of healthcare is characterized by high demands and scarce human and financial resources. This calls for action in improving healthcare quality. This review shows how anaesthesiologists are the designated medical specialist to share their affinity and knowledge in quality and safety, throughout the hospital and across the care continuum. RECENT FINDINGS Recent studies show excellent frameworks and examples of anaesthesiologist leading the way in patient safety and quality of care. SUMMARY Anaesthesiologist are early adapters of patient safety. In the last decades anaesthesia has become linked with patient safety and the quality of care. With the recent transition from peroperative to perioperative care; new opportunities are emerging, expanding our professional scope. Unfortunately, the anaesthesiologist is not often positioned in a leading role in quality of care and patient safety. After a brief rise during the COVID-19 pandemic, in which anaesthesiologists were visible in the frontline in many countries, we have unfortunately disappeared from the spotlight. This review shows numerous ideas, examples, and a framework how a leading position can be realized.
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Affiliation(s)
- Wolfgang Buhre
- Department of Anesthesiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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23
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Lambert DH, Mustafa W, Rendon LF, Hartman C, Xu L, Canelli R. Awareness During Anesthesia for Trauma: Has Anything Changed? Anesth Analg 2024; 138:e19-e20. [PMID: 38489804 DOI: 10.1213/ane.0000000000006927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Donald H Lambert
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts,
| | - Wissam Mustafa
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Luis F Rendon
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Ciana Hartman
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Lan Xu
- Department of Anesthesiology, Boston Medical Center, Boston, Massachusetts
| | - Robert Canelli
- Department of Anesthesiology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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24
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Bernstein W, Norris M, Chase A, Hayes R, Binda DD, Ortega R. Operating Room Fire Prevention: Video in Clinical Anesthesia. Anesth Analg 2024; 138:909-912. [PMID: 38489796 DOI: 10.1213/ane.0000000000006787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Wendy Bernstein
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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25
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Leonardsen ACL, Haugen AS, Raeder J, Finjarn TJ, Isern E, Aakre EK, Bruun AMG, Hennum K, Ramstad JP, Sand T, Monsen SA. The 2024 revision of the Norwegian standard for the safe practice of anaesthesia. Acta Anaesthesiol Scand 2024; 68:567-574. [PMID: 38317613 DOI: 10.1111/aas.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
The Norwegian standard for the safe practice of anaesthesia was first published in 1991, and revised in 1994, 1998, 2005, 2010 and 2016 respectively. The 1998 version was published in English for the first time in Acta Anaesthesiologica Scandinavica in 2002. It must be noted that this is a national standard, reflecting the specific opportunities and challenges in a Norwegian setting, which may be different from other countries in some respects. A feature of the Norwegian healthcare system is the availability, on a national basis, of specifically highly trained and qualified nurse anaesthetists. Another feature is the geography, with parts of the population living in remote areas. These may be served by small, local emergency hospitals. Emergency transport of patients to larger hospitals is not always achievable when weather conditions are rough. These features and challenges were considered important when designing a balanced and consensus-based national standard for the safe practice of anaesthesia, across Norwegian clinical settings. In this article, we present the 2024 revision of the document. This article presents a direct translation of the complete document from the Norwegian original.
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Affiliation(s)
- Ann-Chatrin Linqvist Leonardsen
- Department of Health, Care and Organisation, Ostfold University College, Østfold, Norway
- Department of Anaesthesia, Ostfold Hospital Trust, Moss, Norway
- Department of Health and Social Sciences, University of Southeastern Norway, Norway
| | - Arvid Steinar Haugen
- Institute of Health Sciences, Acute and Critical Care, Oslo Metropolitan University, Oslo, Norway
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Johan Raeder
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Erik Isern
- Department of Anaesthesiology, St. Olavs Hospital, Trondheim, Norway
| | - Elin K Aakre
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | | | | | | | - Tina Sand
- Department of Anaesthesiology, Nord University Hospital, Tromsø, Norway
| | - Svein Arne Monsen
- Department of Anaesthesiology, Helgelandssykehuset, Nordland, Norway
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26
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Likar R, Köstenberger M. [Developments in anesthesia : Thinking outside the box is worthwhile!]. Anaesthesiologie 2024; 73:221-222. [PMID: 38625540 DOI: 10.1007/s00101-024-01399-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Rudolf Likar
- Abteilung für Anästhesiologie, allgemeine Intensivmedizin, Notfallmedizin, interdisziplinäre Schmerztherapie und Palliativmedizin, Klinikum Klagenfurt am Wörthersee, Landeskrankenanstalten-Betriebsgesellschaft - KABEG, Klagenfurt am Wörthersee, Österreich
| | - Markus Köstenberger
- Abteilung für Anästhesiologie, allgemeine Intensivmedizin, Notfallmedizin, interdisziplinäre Schmerztherapie und Palliativmedizin, Klinikum Klagenfurt am Wörthersee, Landeskrankenanstalten-Betriebsgesellschaft - KABEG, Klagenfurt am Wörthersee, Österreich.
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27
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Daniel C, Feeney M, Gordon L. A New Distal Pharyngeal Airway Device Associated with a Reduced Need for Chin-Lift and Jaw-Thrust Maneuvers in Sedated Patients. AANA J 2024; 92:115-120. [PMID: 38564207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Oropharyngeal airways (OPA) or nasopharyngeal airways (NPA) sometimes require chin-lift or jaw-thrust (CLJT) maneuvers to relieve airway obstruction which creates the burden of continuous hands-on care by the anesthesia provider. A new distal pharyngeal airway device (DPA) was used on 63 successive ambulatory surgery patients to assess the frequency of patients requiring manual CLJT maneuvers to prevent airway obstruction. Results were then compared with a contemporaneous group of patients who had used OPA or NPA devices for similar procedures. Patients using the DPA had a 38.5% lower rate of CLJT maneuvers compared with the combined OPA/NPA groups (22.2% of 63 vs. 60.7% of 163, P ≤ .001). Moreover, the results for the DPA group were close to those of the natural airway group (22.2% of 62 vs. 24.8% of 233, P = .66) Results were similar for a sub-set of the above groups who required deep sedation or deep extubation. CLJT maneuvers were common in this ambulatory surgery setting. The new DPA device was associated with a reduced need for such manual maneuvers when compared with similar patients who received OPA or NPA devices and is comparable with the rate for natural airways.
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Affiliation(s)
- Carol Daniel
- is an Assistant Professor and the Academic Director at the Graduate Program in Nurse Anesthesiology, Saint Mary's University of Minnesota, Minneapolis, Minnesota.
| | - Monika Feeney
- is Director and an Associate Professor at the School of Anesthesia, Missouri State University, Springfield, Missouri.
| | - Leah Gordon
- is an Assistant Professor and the Nurse Anesthesia Doctoral Program Director, Saint Mary's University of Minnesota, Minneapolis, Minnesota.
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28
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Coeckelenbergh S, Boelefahr S, Alexander B, Perrin L, Rinehart J, Joosten A, Barvais L. Closed-loop anesthesia: foundations and applications in contemporary perioperative medicine. J Clin Monit Comput 2024; 38:487-504. [PMID: 38184504 DOI: 10.1007/s10877-023-01111-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/21/2023] [Indexed: 01/08/2024]
Abstract
A closed-loop automatically controls a variable using the principle of feedback. Automation within anesthesia typically aims to improve the stability of a controlled variable and reduce workload associated with simple repetitive tasks. This approach attempts to limit errors due to distractions or fatigue while simultaneously increasing compliance to evidence based perioperative protocols. The ultimate goal is to use these advantages over manual care to improve patient outcome. For more than twenty years, clinical studies in anesthesia have demonstrated the superiority of closed-loop systems compared to manual control for stabilizing a single variable, reducing practitioner workload, and safely administering therapies. This research has focused on various closed-loops that coupled inputs and outputs such as the processed electroencephalogram with propofol, blood pressure with vasopressors, and dynamic predictors of fluid responsiveness with fluid therapy. Recently, multiple simultaneous independent closed-loop systems have been tested in practice and one study has demonstrated a clinical benefit on postoperative cognitive dysfunction. Despite their advantages, these tools still require that a well-trained practitioner maintains situation awareness, understands how closed-loop systems react to each variable, and is ready to retake control if the closed-loop systems fail. In the future, multiple input multiple output closed-loop systems will control anesthetic, fluid and vasopressor titration and may perhaps integrate other key systems, such as the anesthesia machine. Human supervision will nonetheless always be indispensable as situation awareness, communication, and prediction of events remain irreplaceable human factors.
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Affiliation(s)
- Sean Coeckelenbergh
- Department of Anesthesiology and Intensive Care, Hôpitaux Universitaires Paris-Saclay, Université Paris-Saclay, Hôpital Paul-Brousse, Assistance Publique Hôpitaux de Paris, Villejuif, France.
- Outcomes Research Consortium, Cleveland, OH, USA.
| | - Sebastian Boelefahr
- Department of Anesthesiology and Intensive Care, Klinikum Aschaffenburg-Alzenau, Frankfurt University and Wuerzburg University Affiliated Academic Training Hospital, Aschaffenburg, Germany
| | - Brenton Alexander
- Department of Anesthesiology & Perioperative Care, University of California San Diego, San Diego, CA, USA
| | - Laurent Perrin
- Department of Anaesthesia and Resuscitation, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Joseph Rinehart
- Outcomes Research Consortium, Cleveland, OH, USA
- Department of Anesthesiology & Perioperative Care, University of California Irvine, Irvine, CA, USA
| | - Alexandre Joosten
- Department of Anesthesiology & Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Luc Barvais
- Department of Anaesthesia and Resuscitation, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
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29
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Carter T, Wingo N, McMullan S, Childs G, Roche B, Merlo LJ, Heaton K. Challenges for Nurse Anesthetists Reentering Practice Following Substance Use Disorder Treatment. AANA J 2024; 92:131-138. [PMID: 38564209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Substance use disorder (SUD) is a persistent, relapsing condition that is present in approximately 10% of anesthesia providers, who, compared with other healthcare providers, face a greater risk of developing an SUD by virtue of constant access to medications. The ability of certified registered nurse anesthesiologists (CRNAs) to obtain or maintain employment after treatment for SUD treatment is not well documented. The purpose of this qualitative study was to explore challenges encountered by CRNAs in recovery as they attempt to reenter practice following SUD treatment. The phenomenon was explored through multiple-case study, using qualitative semistructured interviews with participants in four cases: CRNAs in recovery, CRNA colleagues, CRNA employers, and professional health program employees. Thirty-six participants conveyed their perspectives about challenges that CRNAs in recovery face upon reentry into practice following SUD treatment. The Worker Well-Being conceptual model was used to guide this study. The study revealed that more SUD education is a key facilitator for reentry, risk of relapse was a major concern, and stigma was the most significant barrier for CRNAs in recovery. Stigma persists as a considerable barrier in many facets of SUD, contributing to an increase in shame associated with having the disease.
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Affiliation(s)
| | - Nancy Wingo
- is an Associate Professor and Director of Instructional Innovation at the School of Nursing at the University of Alabama at Birmingham, Birmingham, Alabama.
| | - Susan McMullan
- is an Associate Professor and Director of the BS-DNP Nurse Anesthesia Pathway at the University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama.
| | - Gwen Childs
- is Associate Professor and Associate Dean, Undergraduate and Prelicensure Education, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Bernadette Roche
- is an independent nurse anesthesiology education consultant and a chair reviewer for the Council on Accreditation of Nurse Anesthesia Educational Programs, Chicago, Illinois.
| | - Lisa J Merlo
- is a Professor of Psychiatry and Director of Wellness Programs at the University of Florida, College of Medicine, Gainesville, Florida.
| | - Karen Heaton
- is an Associate Professor in the School of Nursing and the Director of Occupational Health Nursing, Deep South Center for Occupational Health and Safety, University of Alabama at Birmingham, Birmingham, Alabama.
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Tran BW, May KA, Pal N. Academic Anesthesiology: What Does It Mean for Most of Us? Anesth Analg 2024; 138:e15-e16. [PMID: 38489800 DOI: 10.1213/ane.0000000000006898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Bryant W Tran
- Department of Anesthesiology, Virginia Commonwealth University, Richmond, Virginia,
| | - Keith A May
- Department of Anesthesiology, University of Tennessee, Knoxville, Tennessee
| | - Nirvik Pal
- Department of Anesthesiology, Virginia Commonwealth University, Richmond, Virginia
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31
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Chalkias A. Lessons from aviation safety: unstabilised emergence from anaesthesia? Go-around! Br J Anaesth 2024; 132:796-797. [PMID: 38228420 DOI: 10.1016/j.bja.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Athanasios Chalkias
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Outcomes Research Consortium, Cleveland, OH, USA.
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32
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Ladha KS, Lavand'homme P. Unveiling the Uncertainties: Opioid-free Anesthesia and the Road Ahead. Anesthesiology 2024; 140:646-647. [PMID: 38470119 DOI: 10.1097/aln.0000000000004898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Affiliation(s)
- Karim S Ladha
- Department of Anesthesiology and Pain Medicine, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Patricia Lavand'homme
- Department of Anaesthesiology and Postoperative Pain Service, Saint-Luc University Hospital, Catholic University of Louvain, Brussels, Belgium
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Ma Y, Mi T, Sun M, Zhang C, Chang D, Liu S, Song H, Yang H, Liu Y, Cao J, Fu Q, Mi W. Public Knowledge and Awareness of Anesthesiology and Anesthesiologists in China: A Cross-Sectional National Survey of 1 Million Participants. Anesth Analg 2024; 138:829-838. [PMID: 37144921 DOI: 10.1213/ane.0000000000006478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND In the past 20 years, anesthesiology has become one of the most advanced specialties and has undergone rapid development. However, public awareness regarding anesthesiology and anesthesiologists is limited, especially in developing countries. It is important for anesthesiologists to make the public aware of their role during surgery. Therefore, a nationwide survey was set up to investigate public awareness of anesthesiology and anesthesiologists in China. METHOD A cross-sectional nationwide survey was performed from June 2018 to June 2019 in 34 provinces, municipalities, and autonomous regions across China and an overseas region. The questionnaires of the survey were divided into 2 main parts: general items and research items. General items included the demographic characteristics of the participants; research items consisted of 10 questions about the public's awareness of anesthesiologists and anesthesiology. Data quality control was undertaken by the investigation committee throughout the survey process. RESULTS The nationwide survey enrolled 1,001,279 participants (male, 40.7%). We found that most of the participants regarded anesthesiologists as doctors. However, public knowledge of anesthesiologists' work and duties during surgery was quite low, with correct response rate ranging from 16.5% to 52.9%, and anesthesiologist responsibilities were often mistakenly attributed to surgeons or nurses. It is disappointing that more than half of participants still thought that, once the patient fell asleep after receiving anesthetics, the anesthesiologist could leave the operating room. Finally, the correct response rate was positively correlated with the economic levels of the regions. CONCLUSIONS Public awareness regarding anesthesiology and anesthesiologists in China remains inadequate. Due to the biases and characteristics of the participants, the actual situation of the general Chinese public is likely even worse than reflected here. Therefore, extensive measures should be undertaken to improve public knowledge of anesthesiology and anesthesiologists.
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Affiliation(s)
- Yulong Ma
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tianyue Mi
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Miao Sun
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Changsheng Zhang
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dandan Chang
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Siyuan Liu
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Han Song
- Department of Health Service, PLA General Hospital, Beijing, China
| | - Huikai Yang
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yanhong Liu
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiangbei Cao
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiang Fu
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Weidong Mi
- From the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Koontz DB. Anesthesia Medication Safety in Relation to Pharmacopeia Medication Use Best Practice Initiatives. AANA J 2024; 92:93-103. [PMID: 38564205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Improvement to anesthesia medication safety is a useful and worthwhile area of research. Anesthesia is one of the few healthcare professions to have immediate access to compounding and label high-hazard medications at the bedside. There is a need to assess the perceptions of anesthesia medication safety and this relationship with pharmacopeia's updated recommendations for anesthesia to improve medication safety and prevent adverse drug events. Certified registered nurse anesthetist (CRNA) perceptions of medication safety climate in Florida were measured utilizing a validated Likert-scale that merged the Attitudes Questionnaire themes of teamwork, climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture themes utilized were organizational learning, error communication, and support for patient safety. The overall email invitations delivered 5,890, 524 participants voluntarily started, and 401 completed the questionnaire resulting in a 77% completion rate. The overall response rate was 8.896% and 6.8% overall completion rate. The findings demonstrate a correlation between themes related to supportive organizational learning, stress reduction, positive changes, and creating anesthesia medication quality improvements. CRNAs' openness in adopting new pharmacopeia best practice recommendations can improve anesthesia medication safety delivery. The survey indicated clinical noteworthiness that supports the importance of additional examination of frontline providers' perceptions regarding anesthesia medication safety, buy-in, and adoption of updated pharmacopeia recommendations.
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Affiliation(s)
- David B Koontz
- is a Certified Registered Nurse Anesthetist at the University of South Florida College of Nursing as Adjunct Faculty for the Doctor of Nursing Practice in the Nurse Anesthesiology Program, Tampa, Florida. ; ordid ID https://orcid.org/0000-0001-8026-6797
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Beloeil H, Joshi GP. Opioid-free anaesthesia: should we all adopt it? An overview of current evidence: a reply. Eur J Anaesthesiol 2024; 41:319-320. [PMID: 38426254 DOI: 10.1097/eja.0000000000001906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
- Helene Beloeil
- From the Anaesthesia and Intensive Care Department, Univ Rennes, CHU Rennes, Inserm, COSS 1242, CIC 1414, F-35000 Rennes, France (HB) and Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ)
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36
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Rehn M, Chew M, Kalliomäki ML, Olkkola KT, Sigurðsson MI, Møller MH. Awake proning in patients with COVID-19-related hypoxemic acute respiratory failure: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine. Acta Anaesthesiol Scand 2024; 68:444-446. [PMID: 38131369 DOI: 10.1111/aas.14367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Awake proning in spontaneously breathing patients with hypoxemic acute respiratory failure was applied during the coronavirus disease 2019 (COVID-19) pandemic to improve oxygenation while avoiding tracheal intubation. An updated systematic review and meta-analysis on the topic was published. METHODS The Clinical practice committee (CPC) of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) assessed the clinical practice guideline "Awake proning in patients with COVID-19-related hypoxemic acute respiratory failure: A rapid practice guideline" for possible endorsement. The Appraisal of Guidelines for REsearch and Evaluation (AGREE) II tool was used. RESULTS Four out of six SSAI CPC members completed the appraisal. The individual domain totals were: Scope and Purpose 90%; Stakeholder Involvement 89%; Rigour of Development 74%; Clarity of Presentation 85%; Applicability 75%; Editorial Independence 98%; Overall Assessment 79%. CONCLUSION The SSAI CPC endorses the clinical practice guideline "Awake proning in patients with COVID-19-related hypoxemic acute respiratory failure: A rapid practice guideline". This guideline serves as a useful decision aid for clinicians caring for critically ill patients with COVID-19-related acute hypoxemic respiratory failure and can be used to provide guidance on use of prone positioning in this group of patients.
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Affiliation(s)
- Marius Rehn
- Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway
- The Norwegian Air Ambulance Foundation, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Michelle Chew
- Department of Anaesthesia and Intensive Care, Medicine and Health, Linköping University, Linköping, Sweden
| | - Maija-Liisa Kalliomäki
- Department of Anaesthesia, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Klaus T Olkkola
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Martin Ingi Sigurðsson
- Department of Anaesthesia and Intensive Care Medicine, Landspitali University Hospital, Reykjavík, Iceland
| | - Morten Hylander Møller
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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37
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Fuller D, Ruskin KJ. Human system integration: Managing risk in anesthesia. Int Anesthesiol Clin 2024; 62:62-65. [PMID: 38374695 DOI: 10.1097/aia.0000000000000434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Affiliation(s)
- David Fuller
- Flight Systems Engineer, Research and Engineering Directorate, NASA Glenn Research Center, Cleveland, Ohio
| | - Keith J Ruskin
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois
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38
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Kovacheva VP, Nagle B. Opportunities of AI-powered applications in anesthesiology to enhance patient safety. Int Anesthesiol Clin 2024; 62:26-33. [PMID: 38348838 DOI: 10.1097/aia.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Affiliation(s)
- Vesela P Kovacheva
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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39
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Fitzgerald MM, Hoyler MM, Srivastava A. Con: Implementation Science Is Not Relevant to Cardiothoracic Surgery and Anesthesiology. J Cardiothorac Vasc Anesth 2024; 38:1052-1053. [PMID: 38383274 DOI: 10.1053/j.jvca.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 02/23/2024]
Affiliation(s)
- Meghann M Fitzgerald
- Department of Anesthesiology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.
| | - Marguerite M Hoyler
- Department of Anesthesiology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
| | - Ankur Srivastava
- Department of Anesthesiology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
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40
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Lopes S, Rocha G, Guimarães-Pereira L. Artificial intelligence and its clinical application in Anesthesiology: a systematic review. J Clin Monit Comput 2024; 38:247-259. [PMID: 37864754 PMCID: PMC10995017 DOI: 10.1007/s10877-023-01088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/04/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE Application of artificial intelligence (AI) in medicine is quickly expanding. Despite the amount of evidence and promising results, a thorough overview of the current state of AI in clinical practice of anesthesiology is needed. Therefore, our study aims to systematically review the application of AI in this context. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched Medline and Web of Science for articles published up to November 2022 using terms related with AI and clinical practice of anesthesiology. Articles that involved animals, editorials, reviews and sample size lower than 10 patients were excluded. Characteristics and accuracy measures from each study were extracted. RESULTS A total of 46 articles were included in this review. We have grouped them into 4 categories with regard to their clinical applicability: (1) Depth of Anesthesia Monitoring; (2) Image-guided techniques related to Anesthesia; (3) Prediction of events/risks related to Anesthesia; (4) Drug administration control. Each group was analyzed, and the main findings were summarized. Across all fields, the majority of AI methods tested showed superior performance results compared to traditional methods. CONCLUSION AI systems are being integrated into anesthesiology clinical practice, enhancing medical professionals' skills of decision-making, diagnostic accuracy, and therapeutic response.
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Affiliation(s)
- Sara Lopes
- Department of Anesthesiology, Centro Hospitalar Universitário São João, Porto, Portugal.
| | - Gonçalo Rocha
- Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luís Guimarães-Pereira
- Department of Anesthesiology, Centro Hospitalar Universitário São João, Porto, Portugal
- Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
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41
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Behringer W, Böttiger BW, Biasucci DG, Chalkias A, Connolly J, Dodt C, Khoury A, Laribi S, Leach R, Ristagno G. Temperature control after successful resuscitation from cardiac arrest in adults: a joint statement from the European Society for Emergency Medicine (EUSEM) and the European Society of Anaesthesiology and Intensive Care (ESAIC). Eur J Emerg Med 2024; 31:86-89. [PMID: 38126247 PMCID: PMC10901227 DOI: 10.1097/mej.0000000000001106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Wilhelm Behringer
- Department of Emergency Medicine, Medical University Vienna, Vienna General Hospital, Vienna, Austria
| | - Bernd W. Böttiger
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Cologne, Germany
| | - Daniele G. Biasucci
- Department of Clinical Science and Translational Medicine, ‘Tor Vergata’ University of Rome, Rome, Italy
| | - Athanasios Chalkias
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
- Outcomes Research Consortium, Cleveland, Ohio, USA
| | - Jim Connolly
- Accident and Emergency, Great North Trauma and Emergency Care, Newcastle-upon-Tyne, UK
| | - Christoph Dodt
- Department of Emergency Medicine, München Klinik, Munich, Germany
| | - Abdo Khoury
- Department of Emergency Medicine and Critical Care, Besançon University Hospital, Besançon
| | - Said Laribi
- Department of Emergency Medicine, Tours University Hospital, Tours, France
| | - Robert Leach
- Department of Emergency Medicine, Centre Hospitalier de Wallonie Picarde, Tournai, Belgium
| | - Giuseppe Ristagno
- Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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42
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D'Andria Ursoleo J, Losiggio R, Monaco F. The first 100 years of the British Journal of Anaesthesia: a bibliometric analysis of the top-cited articles. Br J Anaesth 2024; 132:789-792. [PMID: 38336514 DOI: 10.1016/j.bja.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 02/12/2024] Open
Affiliation(s)
- Jacopo D'Andria Ursoleo
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rosario Losiggio
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabrizio Monaco
- Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Cavaliere F. Highlights of the April 2024 issue. Minerva Anestesiol 2024; 90:235-236. [PMID: 38652446 DOI: 10.23736/s0375-9393.24.18168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Franco Cavaliere
- IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy -
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Chen W, Zheng Z, Liu Y. Evaluating the potential of GPT-4 in assisting communication in clinical anaesthesia: A quantitative assessment. Eur J Anaesthesiol 2024; 41:321-323. [PMID: 38293731 DOI: 10.1097/eja.0000000000001955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Wanpei Chen
- From the Department of Anesthesiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (WC, YL) and Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (ZZ)
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45
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Warwick E, Mckechnie A. Society for Obesity and Bariatric Anaesthesia UK (SOBA UK) response to the 7th National Audit Project report. Anaesthesia 2024; 79:441-442. [PMID: 38345231 DOI: 10.1111/anae.16254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 03/07/2024]
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46
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Remmers CA, Conroy MM, Korom BM, Malloy ME, Sieracki R, Fairbanks SL, Nelson DA. Anesthesiologists and Community Engagement: A Scoping Review of the Literature. Anesth Analg 2024; 138:794-803. [PMID: 38009932 DOI: 10.1213/ane.0000000000006740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Millions of individuals require anesthesia services each year. Although anesthesia-associated mortality rates have declined, anesthetic-related morbidity remains high, particularly among vulnerable populations. Disparities in perioperative screening, optimization, surveillance, and follow-up contribute to worse outcomes in these populations. Community-engaged collaborations may be the essential ingredient needed for anesthesiologists to improve disparities in anesthetic outcomes and prioritize the needs of patients and communities. This scoping review seeks to examine the available literature on community engagement among anesthesiologists to identify gaps and seek opportunities for future work. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). OVID MEDLINE, Scopus, and Web of Science Core Collection were searched to identify sources that used or recognized community-engaged strategies and involved the work of anesthesiologists. Sources were selected based on inclusion criteria and consistent data were extracted from each paper for compilation in a data chart. The initial search generated 1230 articles of which 16 met criteria for inclusion in the review. An updated search of the literature and reference scan of included sources resulted in 7 additional articles being included. The sources were grouped according to overarching themes and methods used and ultimately categorized according to the spectrum of public participation developed by the International Association for Public Participation (IAP2). This spectrum includes 5 levels: inform, consult, involve, collaborate, and empower. This review identified 5 sources at the inform level, 8 studies in consult, 0 in involve, 7 in collaborate, and 3 in empower. Results indicate that most initiatives representing deeper levels of community engagement, at the collaborate or empower level, occur internationally. Efforts that occur in the United States tend to emphasize engagement of individual patients rather than communities. There is a need to pursue deeper, more meaningful community-engaged efforts within the field of anesthesiology at a local and national level.
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Affiliation(s)
| | | | | | | | - Rita Sieracki
- From the Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Stacy L Fairbanks
- Department of Obstetric Anesthesia, Advocate Aurora Sinai Hospital, Milwaukee, Wisconsin
| | - David A Nelson
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
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Navare S, Rozental O, Girardi N. PRO: Implementation Science Has Value in Anesthesiology and Cardiothoracic Surgery. J Cardiothorac Vasc Anesth 2024; 38:1049-1051. [PMID: 38057168 DOI: 10.1053/j.jvca.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 11/01/2023] [Indexed: 12/08/2023]
Abstract
Implementation science is a nascent field that aims to study the factors that influence the effectiveness of a given clinical intervention, such as the characteristics of the individuals involved, the internal and external settings, the process of implementation, and other factors. Overall, implementation science aims to increase the extent to which an intervention is practiced, and the quality of its delivery to a patient. Although still in its infancy, the applications of implementation science in anesthesiology and cardiothoracic surgery abound. Whether used to adopt novel innovations, avoid the use of obsolete practices, or redeploy existing interventions to improve quality, implementation science holds promise in optimizing how we bring the latest in clinical science to produce tangible benefits to patients and create sustainable change.
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Affiliation(s)
- Sagar Navare
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY.
| | - Olga Rozental
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY
| | - Natalia Girardi
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY
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48
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Bernstorff M, Vistisen ST, Enevoldsen KC. Natural language processing for electronic health records in anaesthesiology: an introduction to clinicians with recommendations and pitfalls. J Clin Monit Comput 2024; 38:241-245. [PMID: 38310589 PMCID: PMC10995065 DOI: 10.1007/s10877-024-01128-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/18/2024] [Indexed: 02/06/2024]
Affiliation(s)
- Martin Bernstorff
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Center for Humanities Computing, Aarhus University, Jens Chr. Skous Vej 4, Aarhus N, 8200, Denmark
| | - Simon Tilma Vistisen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark.
| | - Kenneth C Enevoldsen
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Center for Humanities Computing, Aarhus University, Jens Chr. Skous Vej 4, Aarhus N, 8200, Denmark
- Quantitative Genomics Group, Aarhus University, Aarhus N, Denmark
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49
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Smith M. Geographic Authorship Trends in the Journal of Neurosurgical Anesthesiology. J Neurosurg Anesthesiol 2024; 36:93-94. [PMID: 38619918 DOI: 10.1097/ana.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
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50
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Behringer W, Böttiger BW, Biasucci DG, Chalkias A, Connolly J, Dodt C, Khoury A, Laribi S, Leach R, Ristagno G. Temperature control after successful resuscitation from cardiac arrest in adults: A joint statement from the European Society for Emergency Medicine and the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol 2024; 41:278-281. [PMID: 38126249 PMCID: PMC10906202 DOI: 10.1097/eja.0000000000001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
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