Current Anesthesiology Reports

PURPOSE OF REVIEW: The purpose of this review is to summarize the current research and critically examine artificial intelligence (AI) technologies and their applicability to the daily practice of anesthesiologists. RECENT FINDINGS: Novel AI tools are developed using data from electronic health records, imaging, waveforms, clinical notes, and wearables. These tools can accurately predict the perioperative risk for adverse outcomes, the need for blood transfusion, and the risk of difficult intubation...

PURPOSE OF REVIEW: There is a great deal of interest in global health at all levels of educational attainment. Many residency programs wish to offer a global health opportunity (GHO) but lack the resources to create one de novo. This review will look at the prevalence of global health education in residency and consider the fellowships available. It will summarize the existing recommendations about a curriculum in global health and how best to prepare trainees for a GHO. RECENT FINDINGS: While approximately 45% of residency programs make GHOs available to their residents, there is a lack of standardization of curriculum...

PURPOSE OF REVIEW: Our goal in this review is to describe the current context and peculiarities of obstetric anaesthesia in low- and middle-income countries (LMIC) and the ongoing actions and perspectives in terms of teaching and learning, focusing on improving maternal outcomes. RECENT FINDINGS: Correct identification of barriers and lack of infrastructures and anaesthesia providers are still major problems despite efforts of different stakeholders. International consensus and commitment for 2030 goals are trying to be achieved...

PURPOSE OF REVIEW: Minority health disparities have received renewed attention in the USA following several highly publicized racial injustices in 2020. Though the focus has been largely on adults, children are not immune to these inequities. By reviewing racial disparities in pediatric perioperative care, we aim to engage the anesthesia community in the fight against systemic racism. RECENT FINDINGS: Minority children have higher rates of anesthetic and surgical morbidity compared to White children, including respiratory events, length of stay, hospital costs, and even death...

Purpose of Review: Multimodal prehabilitation aims to improve preoperative health in ways that reduce surgical complications and expedite post-operative recovery. However, the extent to which preoperative health has been affected by the COVID-19 pandemic is unclear and evidence for the mitigating effects of prehabilitation in this context has not been elucidated. The COVID-19 pandemic has forced a rapid reorganization of perioperative pathways. Delayed diagnosis and surgery have caused a backlog of cases awaiting surgery increasing the risk of more complex procedures due to disease progression...

PURPOSE OF REVIEW: This review highlights the importance of the anesthesia team in minimizing perioperative infection risks and prevention of surgical site infection. Due to the immense financial and patient care burden that results from perioperative infection, a foundational knowledge in preventive measures is essential. RECENT FINDINGS: Perioperative infection control, the role of the anesthesia team in reducing infection risk, and more specifically the outsized importance of hand hygiene in this space have become increasingly apparent...

PURPOSE OF THE REVIEW: This review summarizes the updated literature on airway management during cardiopulmonary resuscitation (CPR). It provides guidance for clinicians to carefully incorporate the most recent recommendations related to airway management, oxygenation, and ventilation both during CPR and after return of spontaneous circulation. RECENT FINDINGS: The American Heart Association and the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care provide updated recommendations related to airway management during CPR, which focus on advanced airway strategies in out-of-the hospital cardiac arrest and in-hospital cardiac arrest...

PURPOSE OF REVIEW: This review article summarizes the advantages and potential uses of focused transesophageal echocardiography (TEE) in the perioperative period for trauma patients. We suggest a locally developed TEE protocol for trauma and provide strategies to achieve widespread use of TEE in the anesthesia care of trauma patients. RECENT FINDINGS: In recent years, TEE has gained interest as an additional modality as point-of-care ultrasound (POCUS) for the resuscitation of acutely ill patients in whom transthoracic echocardiography is not feasible or non-diagnostic...

PURPOSE: This article focuses on the following:The importance of prehabilitation in people with cancer and the known and hypothesised benefits.Exploration of the principles that can be used when developing services in the absence of a single accepted model of how these services could be established or configured.Description of approaches and learning in the development and implementation of prehabilitation across three different countries: Canada, the Netherlands and the United Kingdom, based on the authors' experiences and perspectives...

Purpose of Review: Patients with cancer who have high levels of psychological distress have poor treatment compliance and worse outcomes. This "review of reviews" provides a narrative synthesis of the impact of psychological prehabilitation interventions on individuals awaiting cancer surgery. Recent Findings: Twenty reviews of prehabilitation with psychological interventions were identified. There is a trend towards improved psychological outcomes following intervention, particularly when psychologist-led...

PURPOSE OF REVIEW: With advances in technology and availability of handheld ultrasound probes, studies are focusing on the perioperative care of patients, but a limited number specifically on trauma patients. This review highlights recent findings from studies using point of care ultrasound (POCUS) to improve the care of trauma patients. RECENT FINDINGS: Major findings include the use of POCUS to assess volume status of trauma patients upon arrival to measure the major vasculature...

Purpose of Review: Preoperative anemia is independently associated with worse postoperative outcomes following cardiac and noncardiac surgery. This article explores the current understanding of perioperative anemia and iron deficiency with reference to definition, diagnosis, and treatment. Recent Findings: Iron deficiency is the most common cause of anemia. It can arise from reduced iron intake, poor absorption, or excess iron loss. Inflammation throughout the preoperative period can drive iron sequestration, leading to a functional deficiency of iron and the development of what was referred to until recently as the "anemia of chronic disease...

PURPOSE OF REVIEW: This review illustrates the current benefits, limitations, ongoing research, and future paths for Low Titer O Whole Blood compared to Component Therapy in massive transfusion for trauma patients. RECENT FINDINGS: Many studies show that compared to Component Therapy, Low Titer O Whole Blood transfusion is associated with better patient outcomes and simplified transfusion logistics among others. There are, however, issues with cost, supply/demand and handling of Whole Blood that limit its use, but experience in the military setting has shown that these limitations can be easily overcome...

PURPOSE OF REVIEW: Assessment of functional capacity is a cornerstone of preoperative risk assessment. While subjective clinician assessment of functional capacity is poorly predictive of postoperative outcomes, other objective functional assessment measures may provide more useful information. RECENT FINDINGS: Cardiopulmonary exercise testing (CPET) is generally accepted as the gold standard for functional capacity assessment. However, CPET is resource-intensive and not universally available...

Purpose of Review: Population-based increases in ageing and medical co-morbidities are expected to substantially increase the incidence of expensive postoperative complications. This threatens the sustainability of essential surgical care, with negative impacts on patients' health and wellbeing. Recent Findings: Identification of key high-risk areas, and implementation of proven cost-effective strategies to manage both outcome and cost across the end-to-end journey of the surgical episode of care, is clearly feasible...

Purpose of Review: A review of American history is presented to understand how public policy has contributed to a disproportionate burden of disease in members of underrepresented groups. A review of research conducted in the Stroke Belt provides an opportunity to examine more closely traditional and non-traditional risk factors in an effort to consider strategies for change. Recent Findings: A diverse physician workforce has been offered as a way of improving care for our increasingly diverse populace...

Purpose of Review: For many children, the SARS-CoV-2 pandemic has impacted the experience and treatment of their pain. This narrative review draws from the pain literature and emerging findings from COVID-19 research to highlight potentially meaningful directions for clinical consideration and empirical inquiry in the months and years to come. Recent Findings: COVID-19 has been linked to diffuse acute pains as well as chronic pain sequelae. Contextual factors known to increase vulnerability for pain and associated functional disability have been exacerbated during the pandemic...

Purpose of Review: This review summarizes and provides a comprehensive narrative synthesis of the current evidence on pediatric airway management during the COVID-19 pandemic. Recent Findings: The safe care of children undergoing airway management is a primary concern for pediatric anesthesiologists. The COVID-19 pandemic has brought challenges related to airway management and the use of personal protective equipment, aerosol barriers, and the need for simulation and intubation teams...

Purpose of Review: This review explores recent international guidance on the anesthetic management of patients undergoing thoracic surgery during the COVID-19 pandemic: those with suspected or confirmed COVID-19 requiring urgent thoracic surgery and those presenting for elective procedures. Recent Findings: A significant mortality risk is associated with patients with COVID-19 undergoing thoracic surgery; therefore, where possible, it should be avoided. Thoracic surgery also carries a significant risk of viral transmission to healthcare workers due to the necessarily high frequency of intraoperative aerosol-generating procedures involved, such as lung isolation, one-lung ventilation, and flexible bronchoscopy...

Purpose of Review: "Distance-learning" encompasses a variety of didactics, from self-directed online learning to focused courses and programs. Despite increasing internet availability, focused distance-learning courses are rarely practiced in low- or middle-income countries, particularly among non-physician anesthetists. This review aims to discuss the availability, significance, and challenges of distance-learning programs for non-physician anesthesia providers in low-resource settings...