RBC Transfusions in Early Sepsis Resuscitation: Common, Complex, and Potentially Harmful Above a 10 g/dL Threshold
Posted inAnesthesiology Critical Care Hematology-Oncology news

RBC Transfusions in Early Sepsis Resuscitation: Common, Complex, and Potentially Harmful Above a 10 g/dL Threshold

In a multicenter Korean sepsis cohort, early RBC transfusions were frequent and driven by illness severity. No overall 60‑day mortality difference was seen after propensity matching, but transfusion was associated with harm at hemoglobin ≥10 g/dL and a possible benefit below that threshold.
Phenylephrine Versus Norepinephrine in Acute Abdomen Surgery: Similar Clinical Outcomes but Different Early Renin Responses — Implications for Perioperative Hemodynamic Care
Posted inAnesthesiology Critical Care news

Phenylephrine Versus Norepinephrine in Acute Abdomen Surgery: Similar Clinical Outcomes but Different Early Renin Responses — Implications for Perioperative Hemodynamic Care

A randomized trial in 156 emergency acute-abdomen patients found phenylephrine and norepinephrine produced similar postoperative RAAS changes and complication rates; norepinephrine produced an early renin rise, while high preoperative renin predicted greater vasopressor needs and higher AKI incidence.
Home-Based Prehabilitation Did Not Reduce Disability or Complications in Older Adults with Frailty: Results of a Pragmatic Multicenter RCT
Posted inAnesthesiology General Surgery news Rehabilitation Medicine

Home-Based Prehabilitation Did Not Reduce Disability or Complications in Older Adults with Frailty: Results of a Pragmatic Multicenter RCT

A pragmatic multicenter randomized trial found that coach-supported, home-based multimodal prehabilitation before elective noncardiac surgery did not reduce 30-day postoperative disability or in-hospital complications in older adults with frailty; higher adherence signaled possible benefit for disability outcomes.
General vs Nongeneral Anesthesia in Endovascular Thrombectomy for Large Core Strokes: Insights from the SELECT2 Trial and Related Evidence
Posted inAnesthesiology Clinical Updates Neurology news

General vs Nongeneral Anesthesia in Endovascular Thrombectomy for Large Core Strokes: Insights from the SELECT2 Trial and Related Evidence

This review synthesizes evidence on anesthesia approaches during endovascular thrombectomy (EVT) for large core ischemic strokes, focusing on a prespecified secondary analysis of the SELECT2 trial that shows comparable 90-day outcomes between general anesthesia and non-general anesthesia.
General Anesthesia May Improve 90‑Day Outcomes and Reperfusion After EVT for Large‑Vessel Ischemic Stroke: Key Takeaways from the SEGA Randomized Trial
Posted inAnesthesiology Neurology news

General Anesthesia May Improve 90‑Day Outcomes and Reperfusion After EVT for Large‑Vessel Ischemic Stroke: Key Takeaways from the SEGA Randomized Trial

The SEGA randomized trial suggests general anesthesia (GA) during endovascular therapy for large‑vessel occlusion stroke may lead to better 90‑day functional outcomes and higher reperfusion rates than moderate sedation, though credible intervals overlap and uncertainties remain.
Personalized Prehabilitation Before Major Surgery Modulates the Immune System and Lowers Complications: Translating Fitness Into an ‘Immunome’ Signal
Posted inAnesthesiology General Surgery news

Personalized Prehabilitation Before Major Surgery Modulates the Immune System and Lowers Complications: Translating Fitness Into an ‘Immunome’ Signal

A randomized trial found personalized, remotely coached prehabilitation improved preoperative physical and cognitive function, produced distinct immunologic dampening of inflammatory signaling, and reduced moderate-to-severe postoperative complications compared with a paper-based standard program.
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.