European journal of anaesthesiology
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Previous studies have explored tools for evaluating the effects of positive fluid balance, with recent emphasis, and controversies, on venous ultrasound parameters and composite scores. The portal vein pulsatility index and the renal venous pattern have emerged as the most promising indicators of volume-induced venous congestion. But in the general intensive care unit (ICU), numerous factors influence cardiovascular homeostasis, affecting venous function. ⋯ The study findings emphasise the unique sensitivity of portal vein pulsatility index in assessing fluid balance in general ICU patients. The lack of correlation between portal vein pulsatility index and other parameters of venous congestion underscores its potential to provide distinctive insights into venous congestion.
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Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries. ⋯ The survey provides data on the current anaesthesia practice in Europe. The availability, composition and organisation of anaesthesia team members differ among European countries. The study highlights areas for further focus in operating room organisation and anaesthesia team composition, particularly regarding safety, efficacy and cost-effectiveness.
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With the growing use of glucagon-like-peptide-1 (GLP-1) receptor (GLP-1R) agonists as anti-obesity medication it is becoming increasingly important to examine its consequences in the peri-operative period. GLP-1R agonists are known for their glucose-lowering and gastroparetic effects of which the latter causes some safety concerns regarding induction of anaesthesia, more specifically the risk of pulmonary aspiration. ⋯ Current evidence makes us assume there is indeed an increased level of gastroparesis, but there are no studies to date with evidence of a presumed elevated risk of pulmonary aspiration. Future perspectives should focus on the actual risk of pulmonary aspiration and the possible implementation of ultrasound in the preoperative assessment.
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Randomized Controlled Trial Comparative Study
Bacterial contamination and greenhouse gas emissions: A randomised study of reuse versus single-use of infusion-set components for intravenous anaesthesia.
Reusing anaesthesia infusion-set components may reduce the climate impact from plastic waste and discarded medications. Infusion-set contents can be shielded from patient contact by single use of an infusion line fitted with dual antireflux valves, preventing retrograde entry of microorganisms, and eliminating the risk for patient-to-patient cross-contamination. However, infusion-set contamination from compromised aseptic handling could affect quality of care. ⋯ We conclude that the prevalence of bacterial contamination was low for both methods. A much larger study would be needed to detect an inter-method difference. Reuse of infusion-set components allowed significantly reduced intravenous anaesthesia climate emissions.