Journal of Clinical Anesthesia and Intensive Care

The introduction of neuromuscular blocking agents by Griffith and Johnson 83 years ago revolutionized anesthesia and surgical practices. Muscle relaxants are vital for facilitating endotracheal intubation, minimizing upper airway trauma, and creating optimal surgical conditions.

Atrial fibrillation (AF) affects 4% of individuals over 60 years old, an incidence rising to 9% in those over 80. For patients with symptomatic AF unresponsive to medication, catheter ablation is a common treatment, though it carries risks including cardiac tamponade, thromboembolic events, and rarely, atrio-esophageal fistula (AEF). AEF, a severe complication (up to 0.1%) with a mortality rate of 67%-100%, arises from thermal injury to the esophagus. Cardiac, neurologic or infection related symptoms appear 2 days to 6 weeks post-procedure.

While opioids remain our most potent analgesics in the management of pain, the many potential harms of prescription opioids have become increasingly clear. Despite the analgesic benefits for people with acute and chronic pain [1], opioid therapy (especially long-term opioid treatment) can result in significant problems such as opioid misuse, the development of opioid use disorder, and overdose. Some authors report that up to 20-30% of patients in primary and tertiary care settings who are maintained on long-term opioid therapy misuse opioids (i.e., use them in a manner other than how the opioids are prescribed) [2,3]. Misuse of opioids can cause or exacerbate additional health problems in people with chronic pain [1,4], and in fact, roughly 10% of patients prescribed long-term opioid therapy may develop an opioid use disorder (OUD), although prevalence varies between studies depending on differences in methodology and operational definitions [3]. 

Background: Traumatic cardiac arrest during prolonged extrication presents significant physiologic challenges. While prehospital care traditionally relies on emergency medical services personnel, select systems deploy hospital-based teams capable of delivering advanced anesthetic and resuscitative interventions at the scene. 

Patients undergoing bariatric surgery have increased vulnerability to opioid-related adverse events, making multimodal and opioid-sparing strategies a clinical priority. Evidence for perioperative systemic lidocaine in bariatric surgery is controverse; pooled benefits in meta-analyses coexist with neutral findings in some contemporary randomized trials.

Intensive care unit (ICU) admissions have increased considerably in the last decade. A group of patients that remains poorly characterized are the ones who die within the first 24 hours following ICU admission.

Aim: Early identification of mortality risk remains a challenge in the Intensive Care Unit (ICU). The Prognostic Nutritional Index (PNI), a simple tool reflecting combined nutritional and immunological status (via serum albumin and lymphocyte count), has shown promise across various critically ill populations. This study aims to evaluate the prognostic value of PNI in predicting in-hospital mortality among a cohort of adult patients admitted to a medical ICU, and to assess its clinical utility as an accessible biomarker for risk stratification.

Background: Maternal hemorrhage represents the most prevalent complication and primary cause of mortality during childbirth. Extensive studies have elucidated noteworthy correlations between ABO blood type and cardiovascular disease risk in both genders. Notably, individuals with blood type O exhibit a substantial variation in the formation of the platelet plug on vascular lesions, accompanied by a reduction in von Willebrand factor.

While opioids remain our most potent analgesics in the management of pain, the many potential harms of prescription opioids have become increasingly clear. Despite the analgesic benefits for people with acute and chronic pain [1], opioid therapy (especially long-term opioid treatment) can result in significant problems such as opioid misuse, the development of opioid use disorder, and overdose. Some authors report that up to 20-30% of patients in primary and tertiary care settings who are maintained on long-term opioid therapy misuse opioids (i.e., use them in a manner other than how the opioids are prescribed) [2,3]. Misuse of opioids can cause or exacerbate additional health problems in people with chronic pain [1,4], and in fact, roughly 10% of patients prescribed long-term opioid therapy may develop an opioid use disorder (OUD), although prevalence varies between studies depending on differences in methodology and operational definitions [3].