Anesth. Res., Volume 1, Issue 1 (June 2024) – 5 articles

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10 pages, 655 KiB  
Review
Transformative Landscape of Anesthesia Education: Simulation, AI Integration, and Learner-Centric Reforms: A Narrative Review
by Nobuyasu Komasawa
Anesth. Res. 2024, 1(1), 34-43; https://doi.org/10.3390/anesthres1010005 - 6 May 2024
Viewed by 412
Abstract
This article examines the intersection of simulation-based education and the AI revolution in anesthesia medicine. With AI technologies reshaping perioperative management, simulation education faces both challenges and opportunities. The integration of AI into anesthesia practice offers personalized management possibilities, particularly in preoperative assessment [...] Read more.
This article examines the intersection of simulation-based education and the AI revolution in anesthesia medicine. With AI technologies reshaping perioperative management, simulation education faces both challenges and opportunities. The integration of AI into anesthesia practice offers personalized management possibilities, particularly in preoperative assessment and monitoring. However, the ethical, legal, and social implications necessitate careful navigation, emphasizing patient data privacy and accountability. Anesthesiologists must develop non-technical skills, including ethical decision-making and effective AI management, to adapt to the AI era. The experience-based medical education (EXPBME) framework underscores reflective learning and AI literacy acquisition, fostering lifelong learning and adaptation. Learner-centered approaches are pivotal in anesthesia education, promoting active engagement and self-regulated learning. Simulation-based learning, augmented by AI technologies, provides a dynamic platform for technical and non-technical skills development. Ultimately, by prioritizing non-technical skills, embracing learner-centered education, and responsibly leveraging AI technologies, anesthesiologists can contribute to enhanced patient care and safety in the evolving perioperative landscape. Full article
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10 pages, 2776 KiB  
Case Report
Near-Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2): Methodological Issues and Dilemmas
by Marceli Lukaszewski and Kamil Nelke
Anesth. Res. 2024, 1(1), 24-33; https://doi.org/10.3390/anesthres1010004 - 29 Apr 2024
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Abstract
Introduction: Monitoring cerebral perfusion in patients with brain injury is a major clinical challenge. Monitoring cerebral oxygenation (rSO2) via NIRS was introduced in the early 1980s, and many clinicians believed it to be a valuable method for assessing cerebral perfusion and subsequent measures [...] Read more.
Introduction: Monitoring cerebral perfusion in patients with brain injury is a major clinical challenge. Monitoring cerebral oxygenation (rSO2) via NIRS was introduced in the early 1980s, and many clinicians believed it to be a valuable method for assessing cerebral perfusion and subsequent measures to optimize cerebral flow. The main problem with the use of NIRS is the presence of intermediate structures—the skin, skull, meninges, cerebrospinal fluid—and their influence on the test result. Therefore, it seems that NIRS assessment performed on a patient during brain death can give an idea of the magnitude of the influence of these intermediate structures on the monitoring result. Case presentation: We present a case study of cerebral oxygenation measurements in a patient undergoing a brain death diagnostic procedure. A clinical situation in which cerebral blood flow is stopped can give an idea of the specificity of this method, in particular of the influence of intermediate structures on the monitoring result. In this case, the result obtained using NIRS is increased by the patient’s oxygenation before the apnea test. The influence of chromophores in the tissues surrounding the CNS and reflections and scattering of the light wave spectrum have a very significant effect on the final result of cerebral saturation measurement. Discussion: The majority of observations in existing research describing changes in cerebral perfusion or its optimization may be burdened by the problem described here, i.e., by the significant influence of measured intermediate structure oxygenation. The specificity of NIRS in assessing cerebral perfusion requires careful analysis. The therapeutic implications of monitoring cerebral oxygenation with NIRS are of great importance, and based on the example presented and the literature provided, this method should be used with caution. It has been shown that in a patient with brain death, the result of NIRS oxygenation measurements depends on the structures surrounding the brain. Full article
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16 pages, 3661 KiB  
Case Report
Combined Styletubation with Videolaryngoscopy for Tracheal Intubation in Patients Undergoing Thyroidectomy with Intraoperative Neuromonitoring
by Hui-Shan Pan, Tiffany Corey, Hsiang-Ning Luk, Jason Zhensheng Qu and Alan Shikani
Anesth. Res. 2024, 1(1), 8-23; https://doi.org/10.3390/anesthres1010003 - 22 Sep 2023
Cited by 1 | Viewed by 1160
Abstract
The purpose of this case series report is to demonstrate the current state of the art regarding tracheal intubation of an evoked electromyography-endotracheal tube (EMG-ET tube) for continuous intraoperative recurrent laryngeal nerve monitoring (IONM) in patients undergoing thyroid surgery. Both direct laryngoscopy (DL) [...] Read more.
The purpose of this case series report is to demonstrate the current state of the art regarding tracheal intubation of an evoked electromyography-endotracheal tube (EMG-ET tube) for continuous intraoperative recurrent laryngeal nerve monitoring (IONM) in patients undergoing thyroid surgery. Both direct laryngoscopy (DL) and videolaryngoscopy (VL) are popular for routine tracheal intubation of an EMG-ET tube. A new intubating technique (styletubation), using a video-assisted intubating stylet (VS), provides less traumatic and swift intubation. Styletubation combined with VL ensures the precise placement of the EMG-ET tube. This novel intubation technique improves the outcome of intubating an EMG-ET tube for IONM. Full article
(This article belongs to the Special Issue Anesthesia, Pain, and Monitoring: Past and Future)
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5 pages, 1226 KiB  
Case Report
Electrical Impedance Tomography (EIT) to Optimize Ventilatory Management in Critically Ill Patients: A Report of Two Cases
by Iacopo Cappellini, Laura Campiglia, Lucia Zamidei and Guglielmo Consales
Anesth. Res. 2024, 1(1), 3-7; https://doi.org/10.3390/anesthres1010002 - 24 Jul 2023
Cited by 1 | Viewed by 1574
Abstract
Background: Electrical impedance tomography (EIT) is a non-invasive, radiation-free imaging method that enables the continuous bedside monitoring of regional ventilation and lung volume changes. The technique is based on the estimation of the resistivity changes that occur across the lungs with breathing. Methods: [...] Read more.
Background: Electrical impedance tomography (EIT) is a non-invasive, radiation-free imaging method that enables the continuous bedside monitoring of regional ventilation and lung volume changes. The technique is based on the estimation of the resistivity changes that occur across the lungs with breathing. Methods: We present two case reports of patients affected by acute respiratory distress syndrome successfully managed with prone-positioning-based regional ventilation shown on EIT. Results: Both patients were submitted to cycles of prone-positioning-guided EIT and were successfully extubated and discharged from intensive care unit. Conclusions: EIT is a functional imaging method that has the potential to improve respiratory care by providing real-time, continuous monitoring of regional ventilation and lung volume changes at the bedside. Further research is needed to evaluate its efficacy in different clinical scenarios and to optimize its use in respiratory care. Full article
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2 pages, 357 KiB  
Editorial
Why a New Anesthesia Journal?
by Marco Ranucci
Anesth. Res. 2024, 1(1), 1-2; https://doi.org/10.3390/anesthres1010001 - 11 Apr 2023
Viewed by 1838
Abstract
Anesthesia Research (ISSN 2813-5806) is the new open-access journal published by MDPI [...] Full article
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