Current opinion in anaesthesiology
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Chronic obstructive pulmonary disease affects more than 65 million people worldwide. Lung transplantation is the only definitive treatment. However, donor availability is limited in meeting the demand. ⋯ The lung's ability to regenerate extensively after injury suggests that this capability could be promoted in diseases in which loss of lung tissue occurs. Lung bioengineering offers the potential to drastically extend life expectancy in patients with end-stage lung disease. If lung reengineering were successful, it would revolutionize the world of transplantation.
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During treatment in the ICU, patients, relatives, as well as staff members are exposed to a variety of potentially traumatic experiences. The study explores current concepts to prevent negative effects on mental health resulting from intensive care treatment. ⋯ Psychologists integrated in the ICU team can effectively target psychosocial needs of patients and relatives with varying complexity. They support the ICU team by taking on those tasks, and contribute to the overall resilience of the ICU team and its members.
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Curr Opin Anaesthesiol · Feb 2025
ReviewNonintubated video-assisted thoracic surgery: myth or reality?
This review discusses nonintubated video-assisted thoracic surgery (NIVATS) by presenting its physiological, technical aspects and recent clinical data from the literature. ⋯ Literature has demonstrated the feasibility of NIVATS and suggest that it can improve patient outcomes. High-quality international randomized multicenter studies comparing NIVATS and intubated video-assisted thoracic surgery are necessary for a strong comprehension to clarify whether it can be a technique that can guarantee safety and improve the perioperative course of patients.
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Curr Opin Anaesthesiol · Feb 2025
ReviewThe autonomous nervous system and the cholinergic anti-inflammatory reflex in postoperative neurocognitive disorders.
Postoperative delirium (POD) is a common and serious complication after surgery. It is associated with postoperative neurocognitive disorder (PNCD). The vagal cholinergic anti-inflammatory pathway (CAP) has been hypothesized to play a role in POD/PNCD and may be a target for interventions such as transcutaneous auricular stimulation (taVNS). We aim to review associations of heart rate variability (HRV) as an indicator of vagal function with POD and postoperative immune reaction as well as taVNS as a potential preventive intervention for POD. ⋯ Our review provides no evidence that CAP suppression is associated with POD/PNCD. Future studies should consider that high vagal tone may also mediate immunosuppression in surgical patients, yielding an increased risk for postoperative infections. Although taVNS is a promising approach to prevent POD/POCD, future studies should take these concerns into account.