British journal of anaesthesia
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Observational Study
Pulmonary artery wave reflection and right ventricular function after lung resection.
Lung resection has been shown to impair right ventricular function. Although conventional measures of afterload do not change, surgical ligation of a pulmonary artery branch, as occurs during lobectomy, can create a unilateral proximal reflection site, increasing wave reflection (pulsatile component of afterload) and diverting blood flow through the contralateral pulmonary artery. We present a cardiovascular magnetic resonance imaging (MRI) observational cohort study of changes in wave reflection and right ventricular function after lung resection. ⋯ NCT01892800.
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Editorial Comment
Do we have the 'power' to 'drive' down the incidence of pulmonary complications after thoracic surgery.
The concept, mechanisms, and physical and physiological determinants of ventilator-induced lung injury, as well as the influence of lung-protective ventilation strategies, are novel paradigms of modern intensive care and perioperative medicine. Driving pressure and mechanical power have emerged as meaningful and modifiable targets with specific relevance to thoracic anaesthesia and one-lung ventilation. The relationship between these factors and postoperative pulmonary complications remains complex because of the methodological design and outcome selection. Larger observational studies are required to better understand the characteristics of driving pressure and power in current practice of thoracic anaesthesia in order to design future trials in high-risk thoracic populations at risk of acute lung injury.
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Editorial Historical Article
Celebrating the first centenary of the British Journal of Anaesthesia: a century of discovery and dissemination.
In 2023, the British Journal of Anaesthesia commemorates its first century of publishing innovations in anaesthesia, pain, critical care and perioperative medicine. In honour of this special anniversary we outline a number of exciting initiatives to occur over the course of the year to commemorate this important milestone, and to highlight the many contributions that the British Journal of Anaesthesia has made to patient care, medical research, and medical education in our first 100 years.