The Physiologically Difficult Airway and Management Considerations
AbstractPurpose of ReviewThis paper evaluates the recent literature regarding the physiologically difficult airway.Recent FindingsAdverse events mainly desaturation, cardiovascular collapse, and cardiac arrest remain common complications. This risk is greatly increased in patients with altered physiology prior to intubation. Studies published over the last 5 years have explored many aspects surrounding the epidemiology, risks, and approach to managing the physiologically difficult airway.SummaryImportant work has been done to identify directly modifiable risks of complications related to the physiologically difficult air...
Source: Current Anesthesiology Reports - April 13, 2024 Category: Anesthesiology Source Type: research
Complications of Airway Management
AbstractPurpose of ReviewDespite notable advancements in technology and monitoring, coupled with the dissemination of guidelines, complications associated with airway management persist. This comprehensive review delves into the most prevalent complications, exploring their incidence rates, identifying associated risk factors, and proposing reduction strategies. Drawing insights from recent closed claims analyses, comprehensive reviews, and established guidelines, this review aims to provide a contemporary understanding of the challenges in airway management.Recent FindingsNotwithstanding the progress in technology and adh...
Source: Current Anesthesiology Reports - April 6, 2024 Category: Anesthesiology Source Type: research
Post-discharge Care and Monitoring: What ’s new, What’s Controversial
AbstractPurpose of ReviewTo summarize recent evidence that discusses the potential benefits and challenges of using new technology and virtual care models for post-operative patient monitoring after ambulatory surgery.Recent Findings• Artificial intelligence (AI) systems can be integrated into practice to play an important role in perioperative risk mitigation.• Remote monitoring and wearable technology can work synergistically to improve clinical outcomes after surgery.• Novel care models may result in a high level of care and patient satisfaction compared to inpatient stays.SummaryAI can be a useful tool to identif...
Source: Current Anesthesiology Reports - April 2, 2024 Category: Anesthesiology Source Type: research
Postoperative Acute Kidney Injury After Transcatheter Aortic Valve Replacement
AbstractPurpose of ReviewThe purpose of this review serves to briefly summarize the current literature surveying the incidence of posttranscatheter aortic valve replacement acute kidney injury (TAVR AKI). Furthermore, this review extends itself to evaluate and potentially address modifiable risk factors, while acknowledging non-modifiable risk factors in the perioperative setting. These modifiable risk factors include but are not limited to access method, perioperative hypotension events, and need for blood transfusion in the setting of preoperative anemia.Recent FindingsRecent retrospective studies have highlighted the in...
Source: Current Anesthesiology Reports - April 1, 2024 Category: Anesthesiology Source Type: research
Ultrasound-Guided Goal-Directed Therapy in the Critically Ill Patient
AbstractPurpose of ReviewThis review highlights the current clinical use of ultrasound-guided goal-directed therapy in critically ill patients with an attention to most up-to-date evidence.Recent FindingsCurrent ultrasound-guided therapy uses whole-body ultrasound to assess causes of shock as well as optimize management in an integrative manner. Echocardiography literature recognizes the limitations of left ventricular ejection fraction and focuses on cardiac output assessment to optimize forward flow in relation to systemic status. Lung ultrasound can determine the precise cause of acute respiratory failure and be used fo...
Source: Current Anesthesiology Reports - March 22, 2024 Category: Anesthesiology Source Type: research
Report and Interpretation of Randomized Controlled Trials with Statistically Nonsignificant Results for Primary Outcomes in the Anesthesia Domain: A Systematic Review
Conclusion section in 66 articles. The most common spin location was the Results section, and the type of spin was focused on statistically significant within-group comparisons. The most common spin strategy was language use that implied a benefit.SummarySpin reporting was highly prevalent in RCT reports in the anesthesia domain, and abstracts may effectively reflect the spin reporting status in articles. We scrutinized instances of spin within RCTs that failed to yield statistically significant results; however, the potential existence of spin in studies reporting statistically significant results may also exist. This war...
Source: Current Anesthesiology Reports - March 14, 2024 Category: Anesthesiology Source Type: research
Point-of-care Ultrasound (POCUS) for the Regional Anesthesiologist
AbstractPurpose of ReviewApplication of ultrasound in clinical anesthesia practice extends beyond regional anesthesia. In this review, we have discussed other point-of-care applications of ultrasound in perioperative care and anesthetic management with emphasis on regional anesthesia practice.Recent FindingsPoint-of-care ultrasound (POCUS) for anesthesiologists has gained widespread interest and popularity. Recent literature has highlighted multiple perioperative POCUS applications on various organ systems and their benefits. In this section, we have analyzed the recent available data and evidence for perioperative POCUS f...
Source: Current Anesthesiology Reports - March 14, 2024 Category: Anesthesiology Source Type: research
The Effect of Unimodal, Non-pharmacological, Preoperative Psychological Prehabilitation Interventions on Preoperative Anxiety and Stress: A Systematic Review
ConclusionsThere is contradictory evidence whether unimodal, non-pharmacological psychological prehabilitation can reduce preoperative anxiety. There is little evidence that non-pharmacological prehabilitation can reduce preoperative stress. Suggestions to improve the research in this field are discussed. (Source: Current Anesthesiology Reports)
Source: Current Anesthesiology Reports - March 4, 2024 Category: Anesthesiology Source Type: research
Pediatric Ambulatory Surgery: What ’s New, What’s Controversial
This article aims to review recent innovations and trends in ambulatory anesthesia through the lens of the pediatric ambulatory population and strategizes the feasibility of implementation for individual ambulatory sites.Recent FindingsReducing greenhouse gasses via total intravenous anesthesia (TIVA) and/or low fresh gas flows (FGF), the expansion of 23-h stays, and increasing prescriptions for GLP-1 agonists are all contemporary issues with relevance to pediatric ambulatory surgery.SummaryPediatric patients present unique challenges for environmental stewardship. It is likely eliminating nitrous oxide and using low flows...
Source: Current Anesthesiology Reports - March 4, 2024 Category: Anesthesiology Source Type: research
Providing Safe Anesthetic Care and Sedation for GI Endoscopy
This article provides a comprehensive summary of the latest developments in anesthetic care for gastrointestinal (GI) endoscopy. It assesses how traditional anesthesia delivery methods fare against emerging trends, particularly in regard to patient safety and overall treatment outcomes.Recent FindingsModerate sedation is sufficient and safe for most gastrointestinal (GI) endoscopies in low-risk patients. Currently, propofol is the sedative of choice owing to its versatility, favorable pharmacological profile, and safety across various patient demographics. There is increasing data supporting that non-anesthesiologists ca...
Source: Current Anesthesiology Reports - February 26, 2024 Category: Anesthesiology Source Type: research
The Path to Safety in Dental Anesthesia
AbstractPurpose of ReviewSedation and anesthesia in dental office –based settings are specialty practices that have unfortunately been riddled with bad outcomes and near misses. Both healthcare professionals and the public usually receive information about these events from media reports and seldom from any other comprehensive sources. This review will identify potential sources of reliable data in which to guide practice and training.Recent FindingsRecent investigations into the training of practitioners and auxiliaries, the dental office –based setting, and regulations governing dental sedation and dental anesthesia ...
Source: Current Anesthesiology Reports - February 26, 2024 Category: Anesthesiology Source Type: research
Intraoperative Colloid Use on Post-operative Renal Function
AbstractPurpose of ReviewThis review summarizes the most recent literature on the association between intraoperative colloid administration and its effect on post-operative renal function.Recent FindingsIt appears albumin decreases the incidence of acute kidney injury (AKI); however, meta-analysis studies show an increased need for post-operative renal replacement therapy. There was moderate certainty that early starches increased the need for renal replacement therapy; however, it appears newer starches have a better safety profile. Gelatins do not appear to contribute to renal dysfunction, despite a study showing a stati...
Source: Current Anesthesiology Reports - February 23, 2024 Category: Anesthesiology Source Type: research
Goal-Directed Therapy in Liver Surgery
AbstractPurpose of ReviewThis review summarizes the updated literature on goal-directed therapy during liver surgery. It provides guidance for clinicians regarding physiologic concepts and clinical evidence related to fluid and hemodynamic management strategies during and after liver resection.Recent FindingsOpen liver resection presents unique anatomic and physiologic challenges for the anesthesiologist. Care must be taken to reduce hemorrhage via control of inflow and outflow of hepatic blood. Resuscitation should be individualized to the patient and primarily utilize balanced crystalloids, blood products, and possibly a...
Source: Current Anesthesiology Reports - February 23, 2024 Category: Anesthesiology Source Type: research
Preoperative Considerations for Ambulatory Surgery: What Is New, What Is Controversial
AbstractPurpose of ReviewAmbulatory anesthesia has experienced a rapid expansion in procedural breadth and patient complexity. Proper patient selection via preoperative evaluation and testing is imperative to ensure the safety of patients with major comorbidities and advanced age who undergo procedures in ambulatory surgical settings.Recent FindingsNew developments and controversies have arisen in the preoperative considerations for ambulatory surgical patients with class III obesity, obstructive sleep apnea, pulmonary hypertension, cardiomyopathy, heart failure, and other severe diseases. The value of preoperative laborat...
Source: Current Anesthesiology Reports - February 22, 2024 Category: Anesthesiology Source Type: research
Introducing a New Service Line at Your ASC: You Want to Do What?
This article will outline, in a stepwise manner, some of the considerations before undertaking new procedures at the ASC.Recent FindingsSeveral market research reports predict continued growth in the ASC sector for both revenue and procedural volumes. The key drivers of this growth are improved surgical capabilities, advanced anesthetic techniques, cost savings, update in payment policies from CMS increasing payment rates under the Outpatient Prospective Payment System, and changes to the Medicare inpatient only list over the last 3 years. It is expected that ASCs will see higher volumes of surgical procedures with an esti...
Source: Current Anesthesiology Reports - February 15, 2024 Category: Anesthesiology Source Type: research
