Articles: monitoring.
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Curr Opin Anaesthesiol · Apr 2024
ReviewPatient-centered precision care in anaesthesia - the PC-square (PC)2 approach.
This review navigates the landscape of precision anaesthesia, emphasising tailored and individualized approaches to anaesthetic administration. The aim is to elucidate precision medicine principles, applications, and potential advancements in anaesthesia. The review focuses on the current state, challenges, and transformative opportunities in precision anaesthesia. ⋯ Precision anaesthesia tailors care to individual patients, incorporating genomic insights, personalised drug regimens, and advanced monitoring techniques. From EEG to cerebral/somatic oximetry, these methods enhance precision. Standardised reporting, patient-reported outcomes, and continuous quality improvement, alongside initiatives like SBI, contribute to improved patient outcomes. Precision anaesthesia, underpinned by collaborative programs, emerges as a promising avenue for enhancing perioperative care.
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Curr Opin Anaesthesiol · Apr 2024
ReviewIntraoperative lung protection: strategies and their impact on outcomes.
The present review summarizes the current knowledge and the barriers encountered when implementing tailoring lung-protective ventilation strategies to individual patients based on advanced monitoring systems. ⋯ Refining protective lung ventilation is crucial to provide patients with the best possible care during surgery, reduce the incidence of PPCs, and improve their overall surgical journey.
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We selectively review emerging noninvasive neuromonitoring techniques and the evidence that supports their use in the ICU setting. The focus is on neuromonitoring research in patients with acute brain injury. ⋯ The ability to detect brain dysfunction and injury in critically ill patients is being enriched thanks to remarkable advances in neuromonitoring data acquisition and analysis. Studies are needed to validate the accuracy and reliability of these new approaches, and their feasibility and implementation within existing intensive care workflows.
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Curr Opin Anaesthesiol · Apr 2024
ReviewIntraoperative EEG-based monitors: are we looking under the lamppost?
While electroencephalogram (EEG)-based depth of anesthesia monitors have been in use clinically for decades, there is still a major debate concerning their efficacy for detecting awareness under anesthesia (AUA). Further utilization of these monitors has also been discussed vividly, for example, reduction of postoperative delirium (POD).It seems that with regard to reducing AUA and POD, these monitors might be applicable, under specific anesthetic protocols. But in other settings, such monitoring might be less contributive and may have a 'built-it glass ceiling'.Recent advances in other venues of electrophysiological monitoring might have a strong theoretical rationale, and early supporting results, to offer a breakthrough out of this metaphorical glass ceiling. The purpose of this review is to present this possibility. ⋯ Attention-related monitoring might have a strong theoretical basis for the prevention of AUA, POD, and potentially other distressing postoperative outcomes, such as stroke and postoperative neurocognitive disorder. There seems to be already some initial supporting evidence in this regard.
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In the current review, we aim to highlight the evolving evidence on the diagnosis, prevention and treatment of critical illness weakness (CIW) and critical illness associated diaphragmatic weakness (CIDW). ⋯ This review aims to clarify some uncertain aspects and provide helpful information on developing monitoring techniques and therapeutic interventions for managing CIW and CIDW.