5 research outputs found
Preoperative Anxiety Management Practices in Pediatric Anesthesia: Comparative Analysis of an Online Survey Presented to Experts and Social Media Users
No full textAbstract
BackgroundManaging preoperative anxiety in pediatric anesthesia is challenging, as it impacts patient cooperation and postoperative outcomes. Both pharmacological and nonpharmacological interventions are used to reduce children’s anxiety levels. However, the optimal approach remains debated, with evidence-based guidelines still lacking. Health care professionals using social media as a source of medical expertise may offer insights into their management approaches.
ObjectiveA public survey targeting health care professionals was disseminated via social media platforms to evaluate current practices in anxiety management in children. The same questions were posed during an annual meeting of pediatric anesthesiologists with their responses serving as reference. The primary objective was to compare pediatric anesthesia expertise between the groups, while secondary objectives focused on identifying similarities and differences in preoperative anxiety management strategies hypothesizing expertise differences between the groups.
MethodsTwo surveys were conducted. The first survey targeted 100 attendees of the German Scientific Working Group on Pediatric Anesthesia in June 2023 forming the “Expert Group” (EG). The second open survey was disseminated on social media using a snowball sampling approach, targeting followers of a pediatric anesthesia platform to form the “Social Media Group” (SG). The answers to the 24 questions were compared and statistically analyzed. Questions were grouped into 5 categories (pediatric anesthesia expertise, representativity, structural conditions, practices of pharmacological management, and practices in nonpharmacological management).
ResultsA total of 194 responses were analyzed (82 in EG and 112 in SG). The EG cohort exhibited significantly greater professional experience in pediatric anesthesia than the SG cohort (median 19 vs 10 y, PPP
ConclusionsDespite heterogeneous approaches, health care professionals using social media demonstrated less expertise in pediatric anesthesia but showed minimal differences in the daily management of preoperative anxiety compared with pediatric anesthesia experts. Our study highlights the potential for meaningful use of social media but future studies should explore the impact of social media health care professionals’ knowledge in other specific topics. Additionally, regarding preoperative anxiety, further recommendations are needed that could help to standardize and improve anxiety levels in children
Global evolution of female authorships in anesthesiology articles: an affiliation-based, longitudinal, scientometric analysis
No full textAbstract Background Although a gender gap in anesthesiology articles has been reported in certain subsets of anesthesiology literature, a comprehensive analysis is still lacking. Our objective was to conduct a scientometric analysis of the evolution of gender equity among anesthesiology authors worldwide, including all available affiliations. We hypothesized that gender inequity has diminished over time, with relevant differences among countries. Methods The MEDLINE/PubMed 2024 Baseline Repository was queried for all articles whose authors were affiliated with a department of anesthesiology. Author positions were sequenced into first, co-authors, and senior authors. Gender was inferred using online classification tools (genderize.io and gender-api.com). Geolocation was identified through text mining of the first author’s affiliation. The primary endpoint was the evolution of female authors from 1987 to 2023, calculated descriptively and by average annual growth rates. Secondary endpoints included the proportion of female authors in first or senior author position, the influence of senior authors’ gender on first authors’ gender, geographical differences, and future projections of parity (defined as 50% female authors). Results Among 374,301 anesthesiology articles and 7,574 journals, the proportion of female authors increased from 13.6% (1987) to 34.3% (2023) with an average annual growth of 0.57% (95%-confidence interval 0.38% − 0.77%). First authors were female in 30.0% and senior authors in 20.7%, with increases from 11.7% (1987) to 36.9% (2023), and from 11.0% (1987) to 25.9% (2023), respectively. Female authors were overall more likely to be first authors when the senior author was also female. In 2023, only Thailand and Portugal had a percentage of female authors over 50%. Tunisia achieved the highest average annual growth rate of female authors at 2.28% (95%-CI 1.51% − 3.06%). Based on the assumption that current trends continue unchanged, overall gender parity is estimated to be achieved by 2050, for first authors by 2043 and for senior authors by 2072. Conclusions Despite an increase in recent decades, women are still underrepresented as authors in academic anesthesiology, particularly in leading authorship positions. While relevant differences between countries exist, strategies addressing this gender gap at a country-specific level are needed to promote female authorship in academic anesthesiology
Untersuchung von Thrombozytenkonzentraten nach Pathogeninaktivierung mit Amotosalen/UVA und UVC mit Proteomanalyseverfahren
No full textThrombozytenkonzentrate (TKs) sind wichtige Blutprodukte für die Therapie von Blutungen unter Thrombozytopenie oder bei Thrombozytenfunktionsstörungen. Trotz moderner Sicherheitsmaßnahmen können Infektionsübertragungen und immunologische Nebenwirkungen durch die Transfusion von Thrombozyten nicht gänzlich ausgeschlossen werden. Pathogeninaktivierungsverfahren (PIV) wurden entwickelt, um Bakterien und Viren in TKs zu inaktivieren und die Sicherheit von TKs weiter zu erhöhen. Zu diesen Verfahren zählen u.a. das Intercept-Verfahren (Amotosalen und UVA-Bestrahlung) und das Theraflex-Verfahren (ausschließlich UVC-Bestrahlung). In dieser Arbeit wurde der Einfluss der PIV durch Amotosalen/UVA und durch UVC auf das Thrombozytenproteom untersucht, welches mit Massenspektrometrie (LC-ESI MS/MS) untersucht wurde.Pathogen reduction in platelet concentrates (PC) using Amotosalen/UVA-light (Intercept-Blood-System) or UVC-light (Theraflex-System) reduces the risk of transfusion transmitted infections. Little is known about potential platelet lesions caused by Amotosalen/UVA and/or UVC-light, which may reduce therapeutic efficacy of PCs. This study investigates the impact of the pathogen reduction techniques using mass spectrometry (LC-ESI MS/MS) on the platelet proteom
Automated control of inspired oxygen fraction in mechanically ventilated patients: A study protocol for a single-centre randomised controlled trial
No full textBackground A novel automated system for the control of the inspired fraction of oxygen, named LeoClac, has been implemented on a mechanical ventilator. The system uses a separate sensor for the measurement of peripheral oxygen saturation which is connected directly to the ventilator. We hypothesise that LeoClac will be superior to manual control in keeping critically ill and mechanically ventilated patients in a SpO2-target range (93–96%).Methods This is a randomised controlled, single-centre superiority study with two parallel groups including 40 patients. Mechanically ventilated patients treated on the intensive care unit (ICU) will be screened for eligibility and included in the study after written informed consent. Patients in the intervention group will be treated with LeoClac. In the control group, FiO2 will be controlled manually by the intensive care team. The primary endpoint of the study is the proportion of time in the target zone for peripheral oxygen saturation within the first 24 hours following randomisation. Secondary endpoints include the analysis of hyperoxia and hypoxia, number of changes in FiO2, number and reasons for self-aborts and manual overrides of the automated system, proportion of time in target zone for peripheral oxygen saturation in the subgroups of patients with hypoxemic respiratory failure and acute hypercapnic respiratory failure. Furthermore, ventilator-free days and ICU mortality at day 28 will be analysed.Analysis The precise control of FiO2 with the aim of avoiding both hyperoxia and hypoxia is a fundamental challenge in the highly technical field of mechanical ventilation. Incorporation of patient heterogeneity, the benefits of reduced manual intervention and the potential to optimise treatment outcomes underscore the importance of this research. By addressing the complexities of precise oxygen control in adults, this study contributes to the advancement of critical care practices and may improve patient outcomes.Ethics The study protocol was approved by the ethics committee of the Christian-Albrechts-University Kiel, Germany, on 17 May 2023.Trial registration number DRKS00032113
Patient-specific prediction of regional lung mechanics in ARDS patients with physics-based models: A validation study
No full textThe choice of lung protective ventilation settings for mechanical ventilation has a considerable impact on patient outcome, yet identifying optimal ventilatory settings for individual patients remains highly challenging due to the inherent inter- and intra-patient pathophysiological variability. In this validation study, we demonstrate that physics-based computational lung models tailored to individual patients can resolve this variability, allowing us to predict the otherwise unknown local state of the pathologically affected lung during mechanical ventilation. For seven ARDS patients undergoing invasive mechanical ventilation, physics-based, patient-specific lung models were created using chest CT scans and ventilatory data. By numerically resolving the interaction of the pathological lung with the airway pressure and flow imparted by the ventilator, we predict the time-dependent and heterogeneous local state of the lung for each patient and compare it against the regional ventilation obtained from bedside monitoring using Electrical Impedance Tomography. Excellent agreement between numerical simulations and experimental data was obtained, with the model-predicted anteroposterior ventilation profile achieving a Pearson correlation of 96% with the clinical reference data. Even when considering the regional ventilation within the entire transverse chest cross-section and across the entire dynamic ventilation range, an average correlation of more than 81% and an average root mean square error of less than 15% were achieved. The results of this first systematic validation study demonstrate the ability of computational models to provide clinically relevant information and thereby open the door for a truly patient-specific choice of ventilator settings on the basis of both individual anatomy and pathophysiology.11 pages, 9 figure
