Anesthesiology
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Personalized Prehabilitation Before Major Surgery Modulates the Immune System and Lowers Complications: Translating Fitness Into an ‘Immunome’ Signal
A randomized trial found personalized, remotely coached prehabilitation improved preoperative physical and cognitive function, produced distinct immunologic dampening of inflammatory signaling, and reduced moderate-to-severe postoperative c
New Persistent Opioid Use Among ICU Survivors After Discharge: Incidence, Predictors, and Nationwide Cohort Insights
New persistent opioid use develops in 4.2% of opioid-naïve ICU survivors by six months post-discharge, with early opioid prescription as the strongest predictor. Risk varies by opioid potency and patient factors, highlighting tailored taper
Lacosamide Lowers Peripheral Nerve Excitability in Large Myelinated Fibers: Randomized Crossover Evidence and Biomarker Implications
A randomized, double‑blind crossover trial in healthy volunteers found lacosamide acutely reduced strength–duration time constant and other excitability metrics in large myelinated peripheral fibers; pregabalin and tapentadol produced no co
Preventing Post‑Induction Hypotension With Low‑Dose Norepinephrine Reduces Postoperative Complications After Major Abdominal Surgery
A single‑center RCT found that starting a titrated norepinephrine infusion at anesthesia induction reduced intraoperative hypotension and lowered 30‑day medico‑surgical complications compared with reactive ephedrine boluses in high‑risk abd
Continuous Intravenous Sedation Produces Novel EEG ‘Ups’ in Early Acute Hypoxemic Respiratory Failure — Implications for Monitoring and Outcomes
In mechanically ventilated patients with early acute hypoxemic respiratory failure, continuous IV sedation produces EEG patterns (EEG Ups) not seen in natural sleep; these patterns correlate with sedation dose, drug combinations, clinical s
Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches
A population PK–PD study in healthy volunteers found that a physiologic model incorporating CO2 kinetics and a ventilatory controller estimates fentanyl potency for ventilatory depression at ~2.3 ng/mL—substantially lower than estimates fro
Urine‑guided Intraoperative Hydration Halves AKI Risk After CRS‑HIPEC with Cisplatin: Randomized Trial Shows Promise
A randomized trial found that maintaining high intraoperative urine output (≥3 ml·kg−1·h−1 or ≥200 ml·h−1) during cytoreductive surgery and cisplatin‑based HIPEC reduced 7‑day postoperative AKI from 39.3% to 21.4% and lowered major 30‑day c
Pregabalin Restores Sleep and Circadian Rhythms in Neuropathic Pain—Unlike Morphine: Translational Insights from a Mouse SNI Model
In a mouse spared nerve injury model, pregabalin—but not morphine—restored REM sleep, normalized locomotor and temperature circadian rhythms, and reversed spinal circadian gene changes. Findings suggest analgesic choice can differentially a
Restrictive Red Blood Cell Transfusion Is Safe for Most Patients — Except in Neurocritical Care (and Some Bleeding Syndromes)
A Cochrane update (2025) of 69 randomized trials found restrictive RBC transfusion thresholds (typically Hb 7–8 g/dL) cut transfusion exposure ~42% without increasing 30‑day mortality overall, but liberal strategies improved long‑term neuro
Pathogen-Reduced Red Blood Cells Are Safe in Cardiac Surgery: ReCePI Phase 3 Shows Noninferior AKI Rates
The ReCePI randomized phase 3 trial found that amustaline/glutathione pathogen-reduced red blood cells produced similar rates of acute kidney injury compared with conventional transfusion after cardiac or thoracic-aorta surgery, with few tr
Darker Skin Tone Reduces Accuracy of Cerebral NIRS in Children: Implications from a Prospective Cohort
A prospective pediatric study shows forehead NIRS (INVOS 5100C) underestimates regional oxygenation in children with darker skin, producing clinically meaningful bias and raising concerns about equity in monitoring and device validation.
Postoperative Vasopressor Use After Noncardiac Surgery: Patterns, Outcomes, and Clinical Implications from a Global Observational Study
An international study reveals that postoperative vasopressor infusions after noncardiac surgery vary widely across hospitals and are linked to higher mortality and complications, highlighting the need for optimized management strategies.
Harnessing Digital Health: Efficacy of Virtual Reality and Interactive Tools in Reducing Pediatric Perioperative Anxiety and Pain
This network meta-analysis of 49 RCTs demonstrates that digital health interventions, notably virtual reality, 2D videos, and 2D games, significantly reduce perioperative anxiety and pain and improve induction compliance in pediatric surgic
Customized Protective Palatal Obturator Enhances Safe Intubation in Neonatal Cleft Lip Surgery: Evidence from a Randomized Controlled Trial
A customized protective palatal obturator significantly reduces oral tissue injury during intubation in newborns undergoing cleft lip surgery, improving safety without prolonging intubation.
Proactive Versus Reactive Intraoperative Blood Pressure Management: Insights from the PRETREAT Randomized Clinical Trial
The PRETREAT trial found that proactive blood pressure management tailored by risk of intraoperative hypotension does not reduce postoperative functional disability compared to standard care in noncardiac surgery.
Individualized Perioperative Blood Pressure Management in Major Abdominal Surgery: Insights from the IMPROVE-multi Trial
The IMPROVE-multi randomized clinical trial found that tailoring perioperative blood pressure targets to individual preoperative nighttime MAP levels did not reduce postoperative organ injury or mortality compared to routine management in h
Acute Normovolemic Hemodilution in Adult Cardiac Surgery: Efficacy, Safety, and Underutilization
This article reviews a large retrospective study evaluating acute normovolemic hemodilution (ANH) in adult cardiac surgery, demonstrating its association with reduced blood transfusions and cost savings, yet highlighting its underuse in cli
Dexmedetomidine for Analgesia in Nonintubated Patients With Traumatic Rib Fractures: A Randomized Clinical Trial Analysis
This trial found that adjunctive dexmedetomidine did not reduce opioid use, pain scores, or pulmonary complications in nonintubated ICU patients with traumatic rib fractures, challenging its routine analgesic use in this setting.
Clotting Factor Concentrates vs Frozen Plasma in Severe Trauma Resuscitation: Insights from the FiiRST-2 Randomized Trial
The FiiRST-2 trial found no superiority of clotting factor concentrates over frozen plasma for initial resuscitation in severely bleeding trauma patients, with similar transfusion needs and safety outcomes.
Intensive vs Conventional Intraoperative Blood Pressure Management: Insights from the BP-CARES Trial on Cardiovascular Outcomes After Major Abdominal Surgery
The BP-CARES randomized trial found no cardiovascular benefit of intensive intraoperative blood pressure management (MAP ≥80 mm Hg) over conventional targets in high-risk major abdominal surgery patients.
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