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Anesthesia and Intensive Care: Clinical Practices and Prospects
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Anesthesia and Intensive Care: Clinical Practices and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: 20 August 2026 | Viewed by 2156

Special Issue Editor

Dr. Jungchan Park

E-Mail Website
Guest Editor
1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2. Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
Interests: artificial intelligence in clinical practice; perioperative patient safety & risk stratification; optimization of anesthetic management in non-cardiac surgery; clinical informatics & data-driven quality improvement; geriatric anesthesia & vulnerable populations
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue explores emerging clinical practices and future directions in anesthesia and intensive care, with a particular emphasis on integrating advanced technologies and strategies into perioperative medicine. Key themes include the application of artificial intelligence in real-world clinical settings, innovations in perioperative risk stratification and patient safety, the optimization of anesthetic management for high-risk populations, and the use of clinical informatics to enhance quality of care. By bringing together interdisciplinary research and clinical insights, this issue aims to illuminate transformative approaches that will shape the next generation of anesthesia and critical care practice.

Dr. Jungchan Park
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • artificial intelligence
  • clinical decision support
  • perioperative risk stratification
  • perioperative patient safety
  • hemodynamic optimization

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Published Papers (2 papers)

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Research

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16 pages, 695 KB  
Article
Risk Factors for the Development of Pressure Injury in the Heel Area in Critically Ill Patients
by Anna Surmacz, Izabela Sałacińska, Maria Kózka, Maria Teresa Szewczyk, Robert Ślusarz and Dariusz Bazaliński
J. Clin. Med. 2026, 15(5), 1969; https://doi.org/10.3390/jcm15051969 - 4 Mar 2026
Viewed by 1248
Abstract
Background/Objectives: Pressure injuries on the heels of critically ill patients occurring during hospitalization are a global problem. Risk factors include comorbidities, distal perfusion disorders, multiple organ failure, pharmacotherapy, and immobilization associated with mechanical ventilation. These factors affect microperfusion quality in the heels. The [...] Read more.
Background/Objectives: Pressure injuries on the heels of critically ill patients occurring during hospitalization are a global problem. Risk factors include comorbidities, distal perfusion disorders, multiple organ failure, pharmacotherapy, and immobilization associated with mechanical ventilation. These factors affect microperfusion quality in the heels. The presence of friction, shear, and compressive forces contributes directly to local tissue hypoxia and secondary tissue destruction in the heels. This study aimed to assess the impact of risk factors on the development of pressure injuries on the heels of patients in intensive care. Methods: A prospective observational study using controlled observation and assessment was conducted on 120 patients treated in the Department of Anesthesiology and Intensive Care. The initial risk assessment for pressure injuries was conducted within 24 h of admission to the ward, with a follow-up assessment conducted between five and ten days after admission. Data were collected using a scientific research protocol consisting of three parts (A, B, and C). Part A contained sociodemographic data, selected biochemical results, an ankle-brachial index assessment, and a pressure injury risk assessment using the Braden scale within the first 24 h of admission. Parts B and C involved re-evaluating selected biochemical parameters and assessing areas particularly vulnerable to pressure injury development. Statistical analysis was performed using IBM SPSS Statistics v. 21. Results: It was shown that the high risk of pressure injuries in the heel area in critically ill patients is dependent on catecholamine infusion (p < 0.001, r = 0.45) and distal perfusion dysfunction, which is assessed using the ankle-brachial index (ABI-PAD) (p = 0.026, r = 0.23). The ABI (PAD) index is an important factor in the development of pressure ulcers associated with peripheral artery disease, which is associated with an approximately fivefold increase in the likelihood of heel pressure injuries compared to patients with normal ABI values (OR = 5.10, 95% CI: 1.56–16.65, p = 0.007). A correlation was demonstrated between CRP values (chi-square = 5.795, df = 1, p = 0.016) and creatinine levels (chi-square = 7.512, degrees of freedom = 2, p = 0.023, r = 0.25) and the occurrence of pressure ulcers in the heels of critically ill patients. It was shown that the strongest prognostic factor for the occurrence of heel pressure injury was a below-normal creatinine level (OR = 8.75, 95% CI: 1.20–64.13, p = 0.033). Conclusions: Distal perfusion disorders resulting from circulatory failure and low peripheral perfusion increase the risk of pressure ulcer development in critically ill patients. The use of catecholamines to stabilize the circulatory system increases the risk of pressure ulcers on the heels of critically ill patients. Specific pharmacotherapy and invasive medical procedures may contribute to the development of pressure ulcers regardless of the level of pressure ulcer prevention. Full article
(This article belongs to the Special Issue Anesthesia and Intensive Care: Clinical Practices and Prospects)
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Review

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17 pages, 1438 KB  
Review
Mapping High-Level Evidence in Neuroanesthesia: A Scoping Review of Multicenter Randomized Controlled Trials in Anesthesia for Neurosurgery
by Mouad Elganga, Abramo Aziz Rizk and Tumul Chowdhury
J. Clin. Med. 2026, 15(5), 2012; https://doi.org/10.3390/jcm15052012 - 6 Mar 2026
Viewed by 573
Abstract
Background/Objectives: Anesthesia for intracranial neurosurgery presents unique challenges because of the sensitivity of the brain to perioperative physiological disturbances, yet neuroanesthetic practice remains highly variable and supported by a limited high-level evidence base. We conducted a scoping review to map and characterize [...] Read more.
Background/Objectives: Anesthesia for intracranial neurosurgery presents unique challenges because of the sensitivity of the brain to perioperative physiological disturbances, yet neuroanesthetic practice remains highly variable and supported by a limited high-level evidence base. We conducted a scoping review to map and characterize multicenter randomized controlled trials (RCTs) evaluating perioperative management strategies in adults undergoing intracranial neurosurgery. Methods: This scoping review was reported in accordance with the PRISMA extension for Scoping Reviews. MEDLINE, PubMed, EMBASE, Cochrane Central, and Web of Science were searched from inception to 25 June 2025. Multicenter RCTs enrolling adults undergoing intracranial neurosurgery and evaluating anesthetic, hemodynamic, ventilatory, or perioperative interventions were included. We prioritized mapping multicenter designs for their greater external validity and implementation potential. Data were extracted in duplicate and summarized descriptively. Results: Of 417 records identified, 13 multicenter trials (≥2 recruiting sites) involving 2765 participants across nine countries from 1997–2025 were included. Most trials evaluated anesthetic maintenance or opioid regimens (7/13), followed by post-craniotomy pain control (3/13), ventilation/brain relaxation strategies (1/13), antiemetic prophylaxis (1/13), and temperature management (1/13). Outcomes were predominantly short-term and process-based (hemodynamics 7/13, opioid use 7/13, emergence metrics 5/13). Patient-centered outcomes were rarely measured (mortality 1/13, functional neurological outcome 1/13, cognitive outcome 1/13; quality of life 0/13). Only one trial assessed outcomes at ≥72 h postoperatively. Over half of the included trials were judged at high risk of bias. Conclusions: Multicenter RCT activity in neuroanesthesia remains sparse and narrowly focused, highlighting the need for larger, methodologically robust trials targeting patient-centered and long-term outcomes. Full article
(This article belongs to the Special Issue Anesthesia and Intensive Care: Clinical Practices and Prospects)
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