Continuous Intravenous Sedation Produces Novel EEG ‘Ups’ in Early Acute Hypoxemic Respiratory Failure — Implications for Monitoring and Outcomes
Posted inAnesthesiology Critical Care news

Continuous Intravenous Sedation Produces Novel EEG ‘Ups’ in Early Acute Hypoxemic Respiratory Failure — Implications for Monitoring and Outcomes

In mechanically ventilated patients with early acute hypoxemic respiratory failure, continuous IV sedation produces EEG patterns (EEG Ups) not seen in natural sleep; these patterns correlate with sedation dose, drug combinations, clinical sedation depth, and ICU mortality.
Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches
Posted inAnesthesiology Critical Care news

Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches

A population PK–PD study in healthy volunteers found that a physiologic model incorporating CO2 kinetics and a ventilatory controller estimates fentanyl potency for ventilatory depression at ~2.3 ng/mL—substantially lower than estimates from simpler models, with implications for perioperative opioid safety and modeling methodology.
Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise
Posted inAnesthesiology Nephrology news

Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise

A randomized trial found that maintaining high intraoperative urine output (≥3 ml·kg−1·h−1 or ≥200 ml·h−1) during cytoreductive surgery and cisplatin‑based HIPEC reduced 7‑day postoperative AKI from 39.3% to 21.4% and lowered major 30‑day complications without increasing adverse events.
Pregabalin Restores Sleep and Circadian Rhythms in Neuropathic Pain—Unlike Morphine: Translational Insights from a Mouse SNI Model
Posted inAnesthesiology Neurology news

Pregabalin Restores Sleep and Circadian Rhythms in Neuropathic Pain—Unlike Morphine: Translational Insights from a Mouse SNI Model

In a mouse spared nerve injury model, pregabalin—but not morphine—restored REM sleep, normalized locomotor and temperature circadian rhythms, and reversed spinal circadian gene changes. Findings suggest analgesic choice can differentially affect sleep and circadian biology in neuropathic pain.
Restrictive Red Blood Cell Transfusion Is Safe for Most Patients — Except in Neurocritical Care (and Some Bleeding Syndromes)
Posted inAnesthesiology Critical Care Hematology-Oncology news

Restrictive Red Blood Cell Transfusion Is Safe for Most Patients — Except in Neurocritical Care (and Some Bleeding Syndromes)

A Cochrane update (2025) of 69 randomized trials found restrictive RBC transfusion thresholds (typically Hb 7–8 g/dL) cut transfusion exposure ~42% without increasing 30‑day mortality overall, but liberal strategies improved long‑term neurological outcomes after brain injury and restrictive thresholds reduced mortality in GI bleeding.
Pathogen-Reduced Red Blood Cells Are Safe in Cardiac Surgery: ReCePI Phase 3 Shows Noninferior AKI Rates
Posted inAnesthesiology Cardiology General Surgery news

Pathogen-Reduced Red Blood Cells Are Safe in Cardiac Surgery: ReCePI Phase 3 Shows Noninferior AKI Rates

The ReCePI randomized phase 3 trial found that amustaline/glutathione pathogen-reduced red blood cells produced similar rates of acute kidney injury compared with conventional transfusion after cardiac or thoracic-aorta surgery, with few treatment-emergent antibodies and no clinically significant hemolysis.
Lower-Intensity Anticoagulation During Venovenous ECMO: A Pilot RCT Shows Feasibility and a Signal Toward Less Bleeding
Posted inCardiology Critical Care news

Lower-Intensity Anticoagulation During Venovenous ECMO: A Pilot RCT Shows Feasibility and a Signal Toward Less Bleeding

A 3-center randomized pilot trial found that randomized allocation to low- versus moderate-intensity anticoagulation during venovenous ECMO is feasible, with lower major bleeding rates in the low-intensity arm and no clear excess of thromboembolic events—but the study was underpowered for definitive safety or efficacy conclusions.
Combining α and β Radiopharmaceuticals in mCRPC: Interim AlphaBet Results Show Feasible Safety and Promising PSA Activity for 177Lu‑PSMA‑I&T plus 223Ra
Posted innews Oncology Urology

Combining α and β Radiopharmaceuticals in mCRPC: Interim AlphaBet Results Show Feasible Safety and Promising PSA Activity for 177Lu‑PSMA‑I&T plus 223Ra

Interim data from the AlphaBet phase 1/2 trial show that combined 177Lu‑PSMA‑I&T and radium‑223 is feasible, with no dose‑limiting toxicities, a recommended radium‑223 dose of 55.0 kBq/kg, and a PSA50 rate of 55% (95% CI 36–72). Hematologic grade ≥3 adverse events were uncommon.
Predicting Early Acute Kidney Injury After Liver Transplantation: A Clinically Useful 48‑Hour Risk Model
Posted inGastroenterology Nephrology news Transplantation

Predicting Early Acute Kidney Injury After Liver Transplantation: A Clinically Useful 48‑Hour Risk Model

A single-center study developed and internally validated a 48‑hour post‑liver transplant AKI risk model using five readily available preoperative and intraoperative variables (HE, alcohol cirrhosis, ALBI ≥ −1.78, operation time ≥560 min, and FFP transfusion). The model showed good discrimination (AUC ≈0.76).
肝移植後の早期急性腎障害の予測：48時間リスクモデル
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肝移植後の早期急性腎障害の予測：48時間リスクモデル

単施設研究で、術前および術中における5つの容易に入手可能な変数（HE、アルコール性肝硬変、ALBI ≥ −1.78、手術時間 ≥560分、FFP輸血）を使用して、肝移植後の48時間以内の急性腎障害（AKI）リスクモデルを開発し、内部検証を行った。このモデルは優れた識別力（AUC 約0.76）を示した。