Posted inAnesthesiology Diabetes & Endocrinology news

European Perioperative Diabetes Care: Significant Practice Variation Impacts 30-Day Recovery Outcomes

The MOPED study of over 6,000 European patients reveals significant international variations in perioperative diabetes management. Findings demonstrate that higher preoperative HbA1c levels and practice inconsistencies are linked to fewer days at home within 30 days of surgery, highlighting an urgent need for clinical harmonization.
Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?
Posted inAnesthesiology Critical Care news

Ketamine vs. Etomidate: Does Your Choice of Induction Agent Influence Mortality in the Critically Ill?

This article explores recent evidence comparing ketamine and etomidate for rapid sequence intubation. While new cohort data suggests a mortality benefit for ketamine, meta-analyses of randomized trials show clinical equipoise, highlighting the complex trade-offs between adrenal suppression and hemodynamic stability.
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.