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Anesthesiology
Editorial Board
Anesthesiology
This Month in Anesthesiology
This Month In: Anesthesiology
Anesthesiology CME Program
Instructions for Obtaining Anesthesiology Continuing Medical Education (CME) Credit
Editorial
The Study of Consciousness Comes of Age
Clinical Prediction of Postoperative Respiratory Failure
A Novel Approach to Preoperative Blood Orders
Multivariable Risk Prediction Models: It’s All about the Performance
Protect the Lungs during Abdominal Surgery: It May Change the Postoperative Outcome
Nitrous Oxide Genotoxicity
Primum Non Nocere or How to Resolve Drug-induced Respiratory Depression
Perioperative Medicine
Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane
This study demonstrates in human surgical patients that both GABAergic and non-GABAergic anesthetics disrupt frontal–parietal communication, despite distinct neurophysiologic profiles
Supplemental Digital Content is available in the text.
Development and Validation of a Score for Prediction of Postoperative Respiratory Complications
The authors developed a score for the prediction of postoperative respiratory complications based on five preoperative patients’ characteristics. It can be used preoperatively by anesthesiologists to identify patients at increased risk for severe postoperative respiratory complications.
Optimizing Preoperative Blood Ordering with Data Acquired from an Anesthesia Information Management System
The recommended maximum surgical blood order schedule (MSBOS) for common surgical procedures that was published over 30 yr ago may be obsolete because many new procedures have been introduced while others have been improved upon. Data on 53,526 surgical patients having 1,632 types of surgical procedures were acquired from an anesthesia information management system (AIMS). The type and crossmatch–to–transfusion ratios of all surgical services except cardiac and vascular/transplant greatly exceeded the proposed optimal ratio of 2. An updated, institution-specific MSBOS for each surgical specialty was created from a novel blood order algorithm and the AIMS data. Implementing the algorithm and an institution-specific MSBOS could improve operating room efficiency, enhance patient safety, and reduce costs.
Supplemental Digital Content is available in the text.
Impact of Present-on-admission Indicators on Risk-adjusted Hospital Mortality Measurement
The authors estimate a baseline risk index for in-hospital mortality using present-on-admission indicators and show that hospital performance measures appear to be dependent on whether or not the underlying model includes hospital-acquired conditions.
Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function
A protective mechanical ventilation strategy during open abdominal surgery may influence postoperative modified Clinical Pulmonary Infection Score, arterial blood gases, and pulmonary functional tests.
Leukocyte DNA Damage and Wound Infection after Nitrous Oxide Administration: A Randomized Controlled Trial
Nitrous oxide administration induces leukocyte DNA damage in patients undergoing major colorectal surgery. DNA damage was associated with postoperative wound infection.
Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score: The QoR-15
This study consisted of the development and psychometric evaluation of a short-form 15-item patient-rated postoperative quality of recovery score, the QoR-15. The QoR-15 is a valid, reliable, responsive, and clinically acceptable measure of postoperative quality of recovery.
Supplemental Digital Content is available in the text.
Using the Entropy of Tracheal Sounds to Detect Apnea during Sedation in Healthy Nonobese Volunteers
The entropy of the acoustic signal from a microphone placed over the trachea can detect apnea in sedated volunteers with satisfactory sensitivity and specificity, and provide an early warning of the onset of apnea.
Validity of the Lipid Sink as a Mechanism for the Reversal of Local Anesthetic Systemic Toxicity: A Physiologically Based Pharmacokinetic Model Study
The sink mechanism results in a redistribution of anesthetic from tissues to the blood stream. However, the extent to which this occurs and the associated timescale may not be adequate to explain the dramatic recoveries observed clinically.
Bone Fracture Exacerbates Murine Ischemic Cerebral Injury
Stroke is a risk factor for fracture and 1–1.5% of stroke patients suffer a fracture within 24 h of a stroke. The authors showed that fracture enhances stroke injury via HMGB1 release and macrophage/microglia brain infiltration.
Atorvastatin-induced Cardioprotection of Human Myocardium Is Mediated by the Inhibition of Mitochondrial Permeability Transition Pore Opening via Tumor Necrosis Factor-α and Janus Kinase/Signal Transducers and Activators of Transcription Pathway
Atorvastatin-induced cardioprotection of human myocardium involves activation of tumor necrosis factor-α, Janus kinase-2, and signal transducers and activators of transcription-3, and inhibition of the mitochondrial Permeability Transition Pore opening in early reoxygenation.
Xenon and Isoflurane Reduce Left Ventricular Remodeling after Myocardial Infarction in the Rat
Compared to isoflurane and s-ketamine, xenon limited progressive adverse cardiac remodeling and contractile dysfunction 28 days after perioperative myocardial infarction.
Modeling the Influence of the A118G Polymorphism in the OPRM1 Gene and of Noxious Stimulation on the Synergistic Relation between Propofol and Remifentanil: Sedation and Analgesia in Endoscopic Procedures
Remifentanil has no effect on its synergistic relation with propofol with respect to the bispectral index in patients with the A118G genetic polymorphism. Noxious stimulation increases requirements of remifentanil by 4%.
Propofol and Thiopental Suppress Amyloid Fibril Formation and GM1 Ganglioside Expression through the γ-Aminobutyric Acid A Receptor
The effects of GM1 ganglioside on amyloid β-protein fibrillogenesis have not been reported. The results of the current study suggested that propofol and thiopental have direct and indirect inhibitory effects on amyloid β-protein fibrillogenesis.
The Benzodiazepine Diazepam Potentiates Responses of α1β2γ2L γ-Aminobutyric Acid Type A Receptors Activated by either γ-Aminobutyric Acid or Allosteric Agonists
Benzodiazepines act in the nervous system by potentiating the function of the γ-aminobutyric acid type A receptor. The authors present novel data that demonstrate that the benzodiazepine diazepam acts by increasing the channel gating efficacy.
Critical Care Medicine
Hypoxia-inducible Factor and Target Gene Expression Are Decreased in Patients with Sepsis: Prospective Observational Clinical and Cellular Studies
In sepsis, oxygen utilization can be impaired. Hypoxia-inducible factor-1α, the key player in adaptation to inflammation/hypoxia, was suppressed both in leukocytes from septic patients and in endotoxin-tolerant monocytic cells. This might contribute to disturbed adaptation to tissue hypoxia in sepsis.
Pain Medicine
Coadministration of the AMPAKINE CX717 with Propofol Reduces Respiratory Depression and Fatal Apneas
Propofol can induce respiratory depression including lethal apnea. Coadministration of AMPAKINE CX717 with propofol markedly reduced propofol-induced respiratory depression and thus increases the safety margin against profound apnea and death.
Education: Case Scenario
Case Scenario: Hemodynamic Management of Postoperative Acute Kidney Injury
Education: Images in Anesthesiology
Symmetric Peripheral Gangrene
Education: Anesthesia Literature Review
Anesthesia Literature Review
Education: Clinical Concepts and Commentary
Positive Inotropic Agents in Myocardial Ischemia–Reperfusion Injury: A Benefit/Risk Analysis
Positive inotropic agents should be used judiciously when managing surgical patients with acute myocardial ischemia–reperfusion injury, as use of these inotropes is not without potential adverse effects.
Education: Review Article
Managing New Oral Anticoagulants in the Perioperative and Intensive Care Unit Setting
Education: Mind to Mind
Count Backwards from 10
Endurance
Correspondence
Role of the Photoplethysmographic Waveform in the Care of High-risk Surgical Patients
In Reply:
In Reply:
Reviews of Educational Material
Regional Anesthesia for Ambulatory Surgery: Updates in Head-to-Toe Applications (International Anesthesiology Clinics 50, Number 1, Winter 2012).
Cardiology for Anesthesiologists (International Anesthesiology Clinics 50, Number 2, Spring 2012).
Acknowledgment
Acknowledgment
Anesthesiology Reflections from the Wood Library-Museum
From Giessen to Munich to the Readers of Anesthesiology: Justus von Liebig
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