British journal of anaesthesia
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Minor adverse airway events play a pivotal role in the safety of airway management. Changes in airway management strategies can reduce such events, but the broader impact on airway management remains unclear. ⋯ NCT02743767.
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Observational Study
Endotypes of intraoperative hypotension during major abdominal surgery: a retrospective machine learning analysis of an observational cohort study.
Intraoperative hypotension is associated with myocardial injury, acute kidney injury, and death. In routine practice, specific causes of intraoperative hypotension are often unclear. A more detailed understanding of underlying haemodynamic alterations of intraoperative hypotension may identify specific treatments. We thus aimed to use machine learning - specifically, hierarchical clustering - to identify underlying haemodynamic alterations causing intraoperative hypotension in major abdominal surgery patients. Specifically, we tested the hypothesis that there are distinct endotypes of intraoperative hypotension, which may help refine therapeutic interventions. ⋯ Hierarchical clustering identified six endotypes of intraoperative hypotension. If validated, considering these intraoperative hypotension endotypes may enable causal treatment of intraoperative hypotension.
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Editorial Comment
Closing the gap: artificial intelligence applied to ultrasound-guided regional anaesthesia.
The role of artificial intelligence in ultrasound-guided regional anaesthesia is explored in a recent study by Bowness and colleagues, published in the British Journal of Anaesthesia. The investigators showed that non-expert ability to identify key sono-anatomical structures was improved with the assistance of proprietary artificial intelligence software. Whether such software could increase learning efficiency, and thereby patient access, to regional anaesthesia, will require further study.