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1. Peri-interventional outcome study in the elderly in Europe : A 30-day prospective cohort study

Author

Kowark, Ana, Rossaint, Rolf, Rückbeil, Marcia V., Hilgers, Ralf-Dieter, Bilotta, Federico, Bollheimer, Leo C., Buhre, Wolfgang, Guenther, Ulf, Hoeft, Andreas, Lee, Peter, Matot, Idit, Rex, Steffen, Steinmetz, Jacob, Tournoy, Jos, Alanoglu, Zekeriyya, Berger, Marc M., Falières, Xavier, Goettel, Nicolai, Kartalov, Andrijan, Katsanoulas, Konstantinos, Kenig, Jakub, Khoronenko, Victoria, Lundstrøm, Lars H., Macharadze, Tamar, Milenovic, Miodrag, Molliex, Serge, Órfão, Rosário, Soro, Marina, Stefan, Mihai, Sungur, Zerrin, Szakmany, Tamas, Baños, Victoria, Rodriguez, Mireia, Martinez, Selene, Saller, Thomas, Schäfer, Simon T., Clermond, Edouard, Martin, Charlotte, Le Moal, Charlene, Staikowsky, Frederik, Delannoy, Bertand, Desebbe, Olivier, Missant, Carlo, Desmet, Matthias, Gillmann, Hans-Joerg, Stueber, Thomas, Dalsø, Sille M., Vester-Andersen, Morten, Ranft, Andreas, Schneider, Gerhard, Huygens, Christel, Meeusen, Roselien, Cruz, Patricia, Fernández, Carmen, Otto, Mareike, Giltaire, Agathe, Hofmann, Pascal, Gurlit, Simone, Fernández, Alejandro Romero, Castelli, Federica, Ntouba, Alexandre, Lanoiselée, Julien, Schulz, Regina, Opperer, Mathias, Van Waesberghe, Julia, Ziemann, Sebastian, Refaeli-Awin, Einat, Bengisun, Zuleyha Kazak, Buchman, Immanuel, Yahav-Shafir, Dana, Dimakopoulou, Antonia, Le Guen, Morgan, Rodríguez-Pérez, Aurelio, Beran, Maud, Bonnal, Aurelien, Garot, Matthias, Maupain, Olivier, Michel, Denis, Fernandes, Sofia, Sanabra, Maria, Mangoubi, Eitan, Boselli, Emmanuel, Switzer, Timothy, García-Sánchez, Jose I., Boisson, Matthieu, Stamoulis, Konstantinos, García, María Merino, Wulf, Hinnerk, Gouraud, David, Lebrun, Christophe, Lasocki, Sigismond, Steiner, Luzius A., Bergmann, Lars, Baenziger, Bertram, Karpetas, Georgios, Meco, Basak C., Hızal, Ayşe, Hernández, Rosa Méndez, Smit-Fun, Valerie, Charco, Pedro, Nickel, Frank, Grau Torradeflot, Laura, Coburn, Mark, Berger, Marc, Farcher, Helmut, Adriaensens, Ine, Saldien, Vera, Berghmans, Johan, Van Hove, Sofie, Eerdekens, Gert-Jan, Mesotten, Dieter, Timmers, Maxim, Vandermeulen, Elly, De Bruyne, Ann, De Hert, Stefan, De Ruyter, Hendrik, Van Belleghem, Vincent, Boscart, Isabelle, De Corte, Wouter, Carlier, Stefaan, Castelain, Charlotte, Demeyer, Caroline, Vandenbossche, Carl, Detienne, Hans, Devroe, Sarah, Dewinter, Geertrui, Hoogma, Danny, Van de Velde, Marc, Poels, Stéphanie, Soetens, Filiep, Fenger-Eriksen, Christian, Draegert, Christina, Santos, Sofia Gaspar, Soelling, Christine, Andersen, Gertrud, Haderslev, Pernille, Rasmussen, Vibe M., Sommer, Tine G., Kirkegaard, Johan, Olesen, Christian M., Paramanathan, Sansu, Jensen, Lisbet Tokkesdal, Knudsen, Halfdan H., Schmidt, Jens C., Stehen, Nick P., Dupont, Hervé, Herbinet, Clément, Lorne, Emmanuel, Mahjoub, Yazine, Fritsch, Marine, Garcia, Manuela, Petit Phan, Jonathan, Lieutaud, Thomas, Bonneric, Laura, Gaillet, Maxime, des Déserts, Marc Danguy, Montelescaut, Etienne, Lamblin, Antoine, Muller, Violaine, Lagrange, Celine, Robert, Alain, Lebas, Benoit, Lebuffe, Gilles, Beuvelot, Johanne, Dejour, David, Deligne, Emmanuel, Gignoux, Benoit, Guillaud, Olivier, Nloga, Joseph, Prunier-Bossion, Florence, Sibellas, Franck, Abraham, Paul, Bidon, Cyril, Rimmele, Thomas, Bruge-Ansel, Marie-Hélène, Friggeri, Arnaud, Lukaszewicz, Anne-Claire, Dziadzko, Mikhail, Leone, Marc, Meresse, Zoe, Pastene, Bruno, Odin, Isabelle, Bouic, Nicolas, Trinh Duc, Pierre, Pillant, Thomas, Riboulet, Fabien, Degoul, Samuel, Saumier, Nicolas, Wasilewski, Marion, Asehnoune, Karim, Roquilly, Antoine, Glasman, Pauline, Puybasset, Louis, Garnier, Fanny, Verdonk, Franck, Samama, Charles M., Towa, Line, Blet, Alice, Barrau, Stéphanie, Debaene, Bertrand, Frasca, Denis, Imzi, Nadia, Delvaux, Bernard, Huynh, Davy, Mercadal, Luc, Zanoun, Nabil, de Baene, Armelle, Boulay-Maninovsky, Catherine, Fernandes, Olivier, Gomis, Philippe, Malinovsky, Jean-Marc, Romain, François-Xavier, Calmelet, Astrid, Dupont, Ségolène, Millet, Sophie, Simonneau, Frédéric, Charret, Francoise, Couturier, Charlène, Lornage, Estelle, Mallard, Jeremy, Milati, Ryan, Passot, Sylvie, Vallier, Sylvain, Agavriloaia, Mihaela L., Badoux, Quentin, Lewandowski, Mehdi, Mermet, Yanis, Kiskira, Olga, Adjavon, Sherifa, Dumans, Virginie, Josserand, Julien, Ma, Sabrina, Castanera, Jeremy, Massiera, Benjamin, Petua, Philippe, Bounes-Vardon, Fanny, Bosc, Gaëlle, Bosch, Laëtitia, Ferre, Fabrice, Labaste, François, Menut, Rémi, Minville, Vincent, Srairi, Mohamed, Tarasi, Maria, Varin, Florent, Grüßer, Linda, Nowak, Hartmuth, Oprea, Günther, Rump, Katharina, Unterberg, Matthias, Vogelsang, Heike, Klutzny, Mitja, Neumann, Claudia, Soehle, Martin, Wittmann, Maria, Scharffenberg, Martin, Wittenstein, Jakob, Hinterberg, Jonas, Kienbaum, Peter, Lurati-Buse, Giovanna, Schäfer, Maximilian, Lindau, Simone, Meybohm, Patrick, Piekarski, Florian, Kaufhold, Theresa A., Koppert, Wolfgang, Leffler, Andreas, Reiffen, Hans-Peter, Rudolph, Diana, Starke, Henning, Bischoff, Petra, Haberecht, Heinz, Plehn, Heiko, Bauer, Michael, Kortgen, Andreas, Sponholz, Christoph, Krüger, Uwe, Müller-Esch, Sabine, Rempf, Christian, Schmidt, Christian, Schumacher, Dunja, Blazek, Juliane, Büttner, Christin, Leibeling, Andrea, Rüsch, Dirk, Burow, Karsten, El-Hilali, Eugen A., Greke, Christian, Großmann, Paul, Kluth, Mario, Dridi, Sofiane, Popovska, Ivana, Brenes, Andrés, Feddersen, Pia, Gerstmeyer, Dominik, Fthenakis, Philippe, Miketta, Dirk, von Dossow, Vera, Groene, Philipp, Höchter, Dominik, Hofmann-Kiefer, Klaus, Kammerer, Tobias, Kamrath, Malte, Schaefer, Simon T., Tomasi, Roland, Wiedemann, Tobias, Zeuzem-Lampert, Catharina, Zwissler, Bernhard, Braune, Stephan, Brune, Mona, Hemping-Bovenkerk, André, Möllmann, Michael, Santamaria, Mario, Schirwitz, Leonie M., Meersch, Melanie, Zarbock, Alexander, Decker, Stefanie, Drexler, Berthold, Hipp, Silvia, Müller, Markus, Roth, Judith, Seiß, Miriam, Adam, Christian, Schwartges, Ingo, Kranke, Peter, Chloropoulou, Pelagia, Andreeva, Antonia, Douma, Amalia, Gregoriadou, Iphigeneia, Koutsouli, Evelina, Mendrinou, Konstantina, Mavrommati, Eirini, Stathopoulos, Anastasios, Batistaki, Chrysanthi, Matsota, Paraskevi, Kalopita, Konstantina, Skandalou, Vasiliki, Balanika, Marina, Papathanakos, Georgios, Tzimas, Petros, Ketikidou, Evgenia, Vachlioti, Anastasia, Kiamiloglou, Bioulent, Nikouli, Evangelia, Arnaoutoglou, Eleni, Kolonia, Konstantina, Laou, Eleni, Vlachakis, Epaminondas, Lianou, Ioanna, Spyraki, Maria, Tatani, Irini, Panagiotou, Eleni, Samara, Evangelia, Kolesnikova, Anna, Sifaki, Freideriki, Zarzava, Eirini, Bampzelis, Athanasios, Georgopoulou, Eleni, Christidou, Eleni, Tsaousi, Georgia, Nastou, Maria, Ioannidis, Orestis, Dolzenko, Eugene, Geleve, Georgia, Logotheti, Eleni, Yfantidis, Fotios, Rajamanickam, Senbagam, Ramaswamy, Shanmuga, Das Punshi, Gurmukh, Srinivasan, Karthikeyan, Gilmartin, Michael, Morris, Osmond, Gozal, Yaacov, Merissat, Amar, Peled, Reut, Willner, Dafna, Chariski, Hila A., Eidelman, Leonid A., Livne, Michal Y., Berkenstadt, Haim, Orlcin, Dina, Aharonov, Rita, Cattan, Anat, Felman, Lior, Steinberg, Yohai, Zabeeda, Wisam, Kuzmanovska, Biljana, Naumovski, Filip, Toleska, Marija, Sivevski, Atanas, Andriessen, Anouk, Kortekaas, Minke, Van Gorp, Roos, de Korte-de Boer, Dianne, Theunissen, Maurice, Droger, Mirjam, van den Enden, Toine, Koopman, Seppe, Marsman, Marije, van Schaik, Eva, Azenha, Marta, Lanzaro, Camile, Borrego, Andreia, Branquinho, Pedro, Laires, Miguel, de Noronha, Denise, Ferraz, Inês, Pires, Ana, Silva, Joana, Corneci, Dan, Oprea, Oana, Zahiu, Stefan-Vladimir, Tomescu, Dana R., Grintescu, Ioana M., Filipescu, Daniela, Stefanescu, Elena, Vazenin, Andrey, Baskakov, Danil, Tipisev, Dmitry, Kozlova, Ksenia, Marinkovic, Olivera, Sekulic, Ana, Rajkovic, Marija, Djukanovic, Marija, Nikolic, Jovanka, Sreckovic, Svetlana, Stojanovic, Marina, Ladjevic, Nebojsa, Jovicic, Jelena, Unic-Stojanovic, Dragana, Stosic, Biljana, Bulasevic, Aleksandra, Espinosa-Moreno, Alma M., Martín-Vaquerizo, Beatriz, Morandeira-Rivas, Clara, Zamudio, Diana, Guadalupe, Nerea, Herranz, Gracia, Baute, Javier, Madrona, Vanesa, de Jose, Roser, Miralles, Jordi, Merten, Alfred, Muñoz, Rolando, Delgado, Anabel, Moral, Victoria, Blesa, Aleix Carmona, Espejo, Sara, Grau Torredeflot, Laura, Pujol, Pere Serra, Alvira Uribe, Maria J., Perez, Astrid Alvarez, Brunetto, Espedito, Aguirre, Jorge Gonzalez, Villar, Adriana Herivas, Rojas, Guido Munoz, Montero, Natalia, González, Víctor Baladrón, Becerra-Bolaños, Ángel, Santana-Ortega, Luis, Suárez-Romero, Vanessa, Torres-Machí, María L., Ferrero de Paz, Javier, Marcos-Vidal, Jose M., Garcia, Ana Martín, Diaz, Consuelo Rego, Santiago, Ana Crespo, Laso, Lourdes Ferreira, Solores, Felix Lobato, Burgos, Alba, Calvo, Alberto, Fernández, Ignacio, Garutti, Ignacio, Higuero, Fernando, Martinez, David, Piñeiro, Patricia, Carazo, Sonia Expósito, Rodríguez, Mar Orts, Rueda, Fernando Ramasco, Abad-Motos, Ane, Ripollés-Melchor, Javier, López, Carmen Pastor, Perez-Palao, Sara, Sancho-Iñigo, Laura, Segura, Nasara, Utrera, Esther, Albinarrate, Ania, Fondarella, Ana M., Gallego-Ligorit, Lucia, Torrijos, Luisa Lacosta, Bandschapp, Oliver, Blum, Andrea A., Seeberger, Esther, Thomann, Alessandra E., Frei, Seraina, Hoehn, Susan, Capaldo, Giuliana, Christ, Daniel, Doerig, Ramon, Hodel, Daniel, Weiss, Andreas, Witt, Lukas, Schumacher, Philippe, Siebing, Dirk A., Akbuz, Seyma Orcan, Kazbek, Baturay K., Koksoy, Ulku C., Terzi, Engin Z., Yilmaz, Hakan, Alkis, Neslihan, Turhan, Sanem Cakar, Hajiyeva, Konul, Guclu, Cigdem Yildirim, Ergil, Jülide, Ceran, Emine Unal, Ozcelik, Menekse, Bülent, Atik, Gökhan, Kilinc, Saracoglu, Kemal T., Kir, Bunyamin, Koltka, Kemalettin, Sivrikoz, Nükhet, Dincer, Pelin Corman, Canbolat, Nur, Kudsioglu, Turkan, Aydin, Gaye, Mucuoglu, Ceren Aygün, Inal, Duriye G., Kucukguclu, Semih, Egilmez, Ayse I., Kozanhan, Betul, Yildiz, Munise, Pinar, Hüseyin U., Erdivanlı, Başar, Karagöz, Emre, Kazdal, Hızır, Özdemir, Abdullah, Tas Tuna, Ayca, Gulgun, Gamze, and Oleg, Dolya

Abstract

European journal of anaesthesiology : EJA 39(3), 198-209 (2022). doi:10.1097/EJA.0000000000001639, Published by Lippincott Williams & Wilkins, Philadelphia, Pa.

Published
2022
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2. Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, de Abreu, Marcelo Gama, Pelosi, Paolo, Hemmes, Sabrine N. T., Aarts, Leon P. H. J., Akkerman, Ronald D. L., Albersen, Juliette J. E., Aurilio, Caterina, Battaglini, Denise, de Boer, Hans D., Boom, Annemieke, Boer, Christa, Brouwer, Tammo, Buhre, Wolfgang F. F. A., Bulte, Carolina S. E., Edward-Rutten, Gitara M., Godfried, Marc B., Helmerhorst, Hendrik J. F., Hofland, Jan, Hoogenboom, Hester, Ten Hoope, W., Houweling, Bernard M., Huhn, Ragnar, Konijn, Wanda, Koopman-van Gemert, Ankie W. M. M., De Korte-de Boer, Dianne J., Kortekaas, Minke C., Van Lier, Felix, Preckel, Benedikt, Rad, Mandana, Sansone, Pasquale, Stamkot, Andre, Stolker, Robert Jan, Thiel, Bram, Ubben, Johannes F. H., Struys, Michel, In 't Veld, Bastiaan A., Wrigge, Hermann, Zeillemaker-Hoekstra, Miriam, van der Zwan, Tim, Zwijsen, Johannes H. M. J., Hollmann, Markus W., Schultz, Marcus J., Anesthesiology, ACS - Diabetes & metabolism, Hol, L, Nijbroek, Sglh, Neto, A, de Abreu, Mg, Pelosi, P, Hemmes, Snt, Aarts, Lphj, Akkerman, Rdl, Albersen, Jje, Aurilio, C, Battaglini, D, de Boer, Hd, Boom, A, Boer, C, Brouwer, T, Buhre, Wffa, Bulte, Cse, Edward-Rutten, Gm, Godfried, Mb, Helmerhorst, Hjf, Hofland, J, Hoogenboom, H, Ten Hoope, W, Houweling, Bm, Huhn, R, Konijn, W, Koopman-van Gemert, Awmm, De Korte-de Boer, Dj, Kortekaas, Mc, van Lier, F, Preckel, B, Rad, M, Sansone, P, Stamkot, A, Stolker, Rj, Thiel, B, Ubben, Jfh, Struys, Mmrf, 't Veld, Bai, Wrigge, H, Zeillemaker-Hoekstra, M, van der Zwan, T, Zwijsen, Jhmj, Hollmann, Mw, Schultz, Mj, MUMC+: Centrum voor Acute en Kritieke Zorg (3), Anesthesiologie, MUMC+: MA Anesthesiologie (9), RS: MHeNs - R3 - Neuroscience, Graduate School, Intensive Care Medicine, APH - Quality of Care, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Radiotherapy, Intensive Care, and Cardiology

Subjects
Lung Diseases, Male, ATELECTASIS, medicine.medical_treatment, Medicine (miscellaneous), Atelectasis, Intraoperative ventilation, law.invention, Positive-Pressure Respiration, DEFINITIONS, Study Protocol, 0302 clinical medicine, Mechanical ventilation, Randomized controlled trial, 030202 anesthesiology, law, OBESE-PATIENTS, Clinical endpoint, Medicine and Health Sciences, Medicine, Pharmacology (medical), END-EXPIRATORY-PRESSURE, 030212 general & internal medicine, Tidal volume, Postoperative pulmonary, Randomized Controlled Trials as Topic, Aged, 80 and over, lcsh:R5-920, Postoperative pulmonary complications, Delta P, Positive end-expiratory pressure, Abdominal Cavity, Pulmonary, Middle Aged, respiratory system, Treatment Outcome, Recruitment maneuver, Anesthesia, Surgical Procedures, Operative, Breathing, Female, lcsh:Medicine (General), therapeutics, Compliance, circulatory and respiratory physiology, Adult, Pulmonary complication, ΔP, complications, Anesthesia, General, 03 medical and health sciences, Young Adult, Postoperative complications, Double-Blind Method, Tidal Volume, Humans, LOW-TIDAL-VOLUME, Aged, POSTOPERATIVE PULMONARY COMPLICATIONS, business.industry, CHEST-WALL MECHANICS, medicine.disease, PREVENTION, Postoperative complication, PROTECTIVE MECHANICAL VENTILATION, respiratory tract diseases, Pulmonary complications, business, Postoperative pulmonary complication, LUNG, Abdominal surgery
Abstract

BackgroundIntraoperative driving pressure (ΔP) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (VT) is kept constant, ΔP may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. ΔP may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery.MethodsThe “Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial” (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged ≥ 18 years and with a body mass index ≤ 40 kg/m2, scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) (“individualized high PEEP”) or one in which PEEP of 5 cm H2O without RM is used (“low PEEP”). In the “individualized high PEEP” group, PEEP is set at the level at which ΔP is lowest. In both groups of the trial, VTis kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events.DiscussionDESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery.Trial registrationClinicaltrials.gov,NCT03884543. Registered on 21 March 2019.

Published
2020
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5. Pulse transit time as a quick predictor of a successful axillary brachial plexus block

Author

Kortekaas, Minke, Niehof, Sjoerd, Velzen, Marit, Galvin, EM, Huygen, Frank, Stolker, Robert jan, and Anesthesiology

Abstract

Background It can take up to 30?min to determine whether or not axillary block has been successful. Pulse transit time (PTT) is the time between the R-wave on electrocardiography (ECG) and the arrival of the resulting pressure pulse wave in the fingertip measured with photoplethysmography. It provides information about arterial resistance. Axillary block affects vasomotor tone causing loss of sympathetic vasoconstriction resulting in an increased PTT. Early objective assessment of a block can improve efficacy of operating room time and minimize patient's fear of possible conversion to general anesthesia. This study explores whether PTT can objectively, reliably and quickly predict a successful axillary block. Methods Forty patients undergoing hand surgery under axillary block were included. A three-lead ECG and photoplethysmographic sensors were placed on both index fingers. Measurements were made from 2?min before until 30?min after induction of the block or less if the patient was transferred for operation. Afterwards, PTT was calculated as the time between the R-wave on ECG and a reference point on the photoplethysmogram. To assess the change in PTT caused by the block, the PTT difference between the control and blocked arm was calculated. Sensitivity and specificity of PTT difference were calculated using receiver operating characteristic analysis. Results In a successful block, the mean PTT difference significantly increased after 3?min by 12 (standard error of the mean 3.9) ms, sensitivity 87% and specificity 71% (area under the curve 0.87, P?=?0.004). Conclusions PTT is a reliable, quick and objective method to assess whether axillary block is going to be successful or not.

Published
2012

8. Pathophysiological Mechanisms Involved in Vasomotor Disturbances in Complex Regional Pain Syndrome and Implications for Therapy: A Review.

Author

Kortekaas, Minke C., Niehof, Sjoerd P., Stolker, Robert J., and Huygen, Frank J.P.M.

Abstract

Complex regional pain syndrome ( CRPS) is characterized by continuous pain, disproportional to the initial trauma. It usually spreads to the distal parts of the affected limb. Besides continuing pain, a mix of sensory, sudo- and vasomotor disturbances, motor dysfunction, and trophic changes is responsible for physical complaints. Vasomotor disturbance is characterized by changes in skin temperature and color. In CRPS patients with a cold extremity, a decrease in blood flow can cause decreased tissue saturation and tissue acidosis, resulting in ischemic pain. The pathophysiology of vasomotor disturbances is not completely understood. Temperature asymmetry is generally assumed as a result of disturbance in the sympathetic nervous system. Vasodilating drugs and sympathetic blockade have been cornerstones of therapy in cold CRPS for years. However, only a limited part of these patients improve on this kind of therapies. Research has shown a pivotal role for inflammation in the pathophysiology of CRPS. Inflammation can result in endothelial dysfunction. Endothelial function plays an important role in the local regulation of vascular tone. Endothelial dysfunction could be another mechanism responsible for the vasomotor disturbances in cold CRPS. An important goal in the treatment of cold-type CRPS is the restoration of a normal blood flow. Consequently it is important to distinguish the underlying pathophysiological mechanisms of vasomotor disturbances. A disturbance of the sympathetic nervous system may require another type of treatment than inflammation-induced endothelial dysfunction. Diagnostic tools to distinguish these underlying pathophysiological mechanisms of vasomotor disturbances would enable a mechanism-based treatment and improve clinical outcome. [ABSTRACT FROM AUTHOR]

Published
2016
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10. Peri-interventional outcome study in the elderly in Europe A 30-day prospective cohort study

Author

Ana Sekulic, Selene Martinez Perez, Danny Feike Hoogma, GÖKHAN KILINÇ, Marc Danguy des Déserts, Evangelia Samara, AYSE HIZAL, Nicolai Goettel, Martin Scharffenberg, Sofia Fernandes, Jose Ignacio García-Sánchez, Tobias Kammerer, Marc Moritz Berger, Florian Piekarski, CEREN AYGÜN MUÇUOĞLU, PATRICIA PIÑEIRO OTERO, Angel Becerra, Aurelio Rodriguez-Perez, Ülkü Ceren Köksoy, Jakob Wittenstein, Lars Lundstrøm, Diana Zamudio Penko, Hans-Joerg Gillmann, Dianne De Korte-de Boer, Jose miguel Marcos-vidal, Sebastian Ziemann, Tournoy, Jos, Kowark, Ana, Rossaint, Rolf, Matot, Idit, Nickel, Frank, Grau Torradeflot, Laura, Coburn, Mark, Berger, Marc, Farcher, Helmut, Opperer, Mathias, Adriaensens, Ine, Saldien, Vera, Berghmans, Johan, Van Hove, Sofie, Rex, Steffen, Beran, Maud, Eerdekens, Gert-Jan, Mesotten, Dieter, Timmers, Maxim, Vandermeulen, Elly, De Bruyne, Ann, De Hert, Stefan, De Ruyter, Hendrik, Van Belleghem, Vincent, Boscart, Isabelle, Steinmetz, Jacob, De Corte, Wouter, Desmet, Matthias, Missant, Carlo, Carlier, Stefaan, Castelain, Charlotte, Demeyer, Caroline, Vandenbossche, Carl, Detienne, Hans, Devroe, Sarah, Dewinter, Geertrui, Hoogma, Danny, Huygens, Christel, Meeusen, Roselien, Van de Velde, Marc, Lebrun, Christophe, Poels, Stéphanie, Soetens, Filiep, Fenger-Eriksen, Christian, Alanoglu, Zekeriyya, Draegert, Christina, Santos, Sofia Gaspar, Soelling, Christine, Andersen, Gertrud, Dalsø, Sille M., Haderslev, Pernille, Rasmussen, Vibe M., Vester-Andersen, Morten, Sommer, Tine G., Berger, Marc M., Kirkegaard, Johan, Lundstrøm, Lars H., Olesen, Christian M., Paramanathan, Sansu, Jensen, Lisbet Tokkesdal, Knudsen, Halfdan H., Schmidt, Jens C., Stehen, Nick P., Dupont, Hervé, Herbinet, Clément, Falières, Xavier, Lorne, Emmanuel, Mahjoub, Yazine, Ntouba, Alexandre, Fritsch, Marine, Garcia, Manuela, Lasocki, Sigismond, Petit Phan, Jonathan, Lieutaud, Thomas, Bonneric, Laura, Boselli, Emmanuel, Goettel, Nicolai, Gaillet, Maxime, des Déserts, Marc Danguy, Montelescaut, Etienne, Lamblin, Antoine, Muller, Violaine, Lagrange, Celine, Le Moal, Charlene, Robert, Alain, Staikowsky, Frederik, Lebas, Benoit, Kartalov, Andrijan, Lebuffe, Gilles, Garot, Matthias, Beuvelot, Johanne, Dejour, David, Deligne, Emmanuel, Desebbe, Olivier, Delannoy, Bertand, Gignoux, Benoit, Guillaud, Olivier, Nloga, Joseph, Katsanoulas, Konstantinos, Prunier-Bossion, Florence, Sibellas, Franck, Abraham, Paul, Bidon, Cyril, Rimmele, Thomas, Bruge-Ansel, Marie-Hélène, Friggeri, Arnaud, Lukaszewicz, Anne-Claire, Dziadzko, Mikhail, Leone, Marc, Rückbeil, Marcia V., Kenig, Jakub, Meresse, Zoe, Pastene, Bruno, Odin, Isabelle, Bonnal, Aurelien, Bouic, Nicolas, Trinh Duc, Pierre, Pillant, Thomas, Riboulet, Fabien, Degoul, Samuel, Saumier, Nicolas, Khoronenko, Victoria, Wasilewski, Marion, Asehnoune, Karim, Roquilly, Antoine, Glasman, Pauline, Puybasset, Louis, Garnier, Fanny, Verdonk, Franck, Samama, Charles M., Towa, Line, Blet, Alice, Barrau, Stéphanie, Boisson, Matthieu, Debaene, Bertrand, Frasca, Denis, Imzi, Nadia, Delvaux, Bernard, Huynh, Davy, Maupain, Olivier, Mercadal, Luc, Zanoun, Nabil, Macharadze, Tamar, de Baene, Armelle, Boulay-Maninovsky, Catherine, Fernandes, Olivier, Giltaire, Agathe, Gomis, Philippe, Malinovsky, Jean-Marc, Romain, François-Xavier, Calmelet, Astrid, Dupont, Ségolène, Gouraud, David, Milenovic, Miodrag, Millet, Sophie, Simonneau, Frédéric, Charret, Francoise, Couturier, Charlène, Lanoiselée, Julien, Lornage, Estelle, Mallard, Jeremy, Milati, Ryan, Passot, Sylvie, Vallier, Sylvain, Molliex, Serge, Agavriloaia, Mihaela L., Badoux, Quentin, Lewandowski, Mehdi, Mermet, Yanis, Michel, Denis, Kiskira, Olga, Adjavon, Sherifa, Dumans, Virginie, Le Guen, Morgan, Josserand, Julien, Órfão, Rosário, Ma, Sabrina, Castanera, Jeremy, Massiera, Benjamin, Petua, Philippe, Bounes-Vardon, Fanny, Bosc, Gaëlle, Bosch, Laëtitia, Clermond, Edouard, Ferre, Fabrice, Labaste, François, Soro, Marina, Martin, Charlotte, Menut, Rémi, Minville, Vincent, Srairi, 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Willner, Dafna, Chariski, Hila A., Eidelman, Leonid A., Livne, Michal Y., Mangoubi, Eitan, Berkenstadt, Haim, Orlcin, Dina, Yahav-Shafir, Dana, Aharonov, Rita, Cattan, Anat, Felman, Lior, Refaeli-Awin, Einat, Steinberg, Yohai, Zabeeda, Wisam, Kuzmanovska, Biljana, Naumovski, Filip, Toleska, Marija, Sivevski, Atanas, Andriessen, Anouk, Kortekaas, Minke, Buhre, Wolfgang, Van Gorp, Roos, de Korte-de Boer, Dianne, Smit-Fun, Valerie, Theunissen, Maurice, Droger, Mirjam, van den Enden, Toine, Koopman, Seppe, Marsman, Marije, van Schaik, Eva, Azenha, Marta, Lanzaro, Camile, Borrego, Andreia, Branquinho, Pedro, Fernandes, Sofia, Laires, Miguel, de Noronha, Denise, Ferraz, Inês, Pires, Ana, Silva, Joana, Corneci, Dan, Oprea, Oana, Zahiu, Stefan-Vladimir, Tomescu, Dana R., Grintescu, Ioana M., Filipescu, Daniela, Stefanescu, Elena, Vazenin, Andrey, Baskakov, Danil, Tipisev, Dmitry, Kozlova, Ksenia, Marinkovic, Olivera, Sekulic, Ana, Rajkovic, Marija, Djukanovic, Marija, Nikolic, Jovanka, 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García, María Merino, Diaz, Consuelo Rego, Santiago, Ana Crespo, Laso, Lourdes Ferreira, Solores, Felix Lobato, Burgos, Alba, Calvo, Alberto, Fernández, Ignacio, Garutti, Ignacio, Higuero, Fernando, Martinez, David, Piñeiro, Patricia, Carazo, Sonia Expósito, Hernández, Rosa Méndez, Rodríguez, Mar Orts, Rueda, Fernando Ramasco, Abad-Motos, Ane, Ripollés-Melchor, Javier, López, Carmen Pastor, Charco, Pedro, Perez-Palao, Sara, Sancho-Iñigo, Laura, Segura, Nasara, Utrera, Esther, Albinarrate, Ania, Fondarella, Ana M., Gallego-Ligorit, Lucia, Torrijos, Luisa Lacosta, Bandschapp, Oliver, Blum, Andrea A., Seeberger, Esther, Steiner, Luzius A., Thomann, Alessandra E., Frei, Seraina, Hoehn, Susan, Baenziger, Bertram, Capaldo, Giuliana, Christ, Daniel, Doerig, Ramon, Hodel, Daniel, Weiss, Andreas, Witt, Lukas, Schumacher, Philippe, Siebing, Dirk A., Akbuz, Seyma Orcan, Bengisun, Zuleyha Kazak, Kazbek, Baturay K., Koksoy, Ulku C., Terzi, Engin Z., Yilmaz, Hakan, Alkis, Neslihan, Turhan, Sanem Cakar, Meco, Basak C., Hajiyeva, Konul, Guclu, Cigdem Yildirim, Ergil, Jülide, Ceran, Emine Unal, Ozcelik, Menekse, Bülent, Atik, Gökhan, Kilinc, Saracoglu, Kemal T., Kir, Bunyamin, Koltka, Kemalettin, Sivrikoz, Nükhet, Dincer, Pelin Corman, Canbolat, Nur, Kudsioglu, Turkan, Aydin, Gaye, Mucuoglu, Ceren Aygün, Inal, Duriye G., Kucukguclu, Semih, Egilmez, Ayse I., Kozanhan, Betul, Yildiz, Munise, Pinar, Hüseyin U., Erdivanlı, Başar, Hızal, Ayşe, Karagöz, Emre, Kazdal, Hızır, Özdemir, Abdullah, Tas Tuna, Ayca, Gulgun, Gamze, Oleg, Dolya, Hoeft, Andreas, MUMC+: MA Anesthesiologie (3), RS: MHeNs - R3 - Neuroscience, and MUMC+: MA Anesthesiologie (9)

Subjects
Aged, 80 and over, Male, Patient, Frailty, Preoperative assessment, Surgical outcomes, Europe, Hospitalization, Older, Anesthesiology and Pain Medicine, Outcome Assessment, Health Care, Humans, Female, Surgery, Prospective Studies, Derivation, Mortality, Aged
Abstract

OBJECTIVES The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality. DESIGN A prospective cohort study. SETTING European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period. PATIENTS Nine thousand four hundred and ninety-seven consecutively recruited patients aged 80 years and older undergoing any kind of surgical or nonsurgical procedures under anaesthesia. MAIN OUTCOME MEASURES The primary outcome was all-cause mortality within 30 days after procedure described by Kaplan–Meier curves with 95% CI. Risk factors for 30-day mortality were analysed using a Cox regression model with 14 fixed effects and a random centre effect. RESULTS Data for 9497 patients (median age, 83.0 years; 52.8% women) from 177 academic and nonacademic hospitals in 20 countries were analysed. Patients presented with multimorbidity (77%), frailty (14%) and at least partial functional dependence (38%). The estimated 30-day mortality rate was 4.2% (95% CI 3.8 to 4.7). Among others, independent risk factors for 30-day mortality were multimorbidity, hazard ratio 1.87 (95% CI 1.26 to 2.78), frailty, hazard ratio 2.63 (95% CI 2.10 to 3.30), and limited mobility, hazard ratio 2.19 (95% CI 1.24 to 3.86). The majority of deaths (76%) occurred in hospital. Mortality risk for unplanned ICU admission was higher, hazard ratio 3.57 (95% CI 2.38 to 5.26) than for planned ICU admission, hazard ratio 1.92 (95% CI 1.47 to 2.50). Compared with other studies, the in-hospital complication rates of 17.4 and 3.9% after discharge were low. Admission to a unit with geriatric care within 30 days after the intervention was associated with a better survival within the first 10 days. CONCLUSIONS The estimated 30-day mortality rate of 4.2% was lower than expected in this vulnerable population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03152734, https://clinicaltrials.gov. ispartof: European Journal Of Anaesthesiology vol:39 issue:3 pages:198-209 ispartof: location:England status: published

Published
2022
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11. Effect of heat-induced pain stimuli on pulse transit time and pulse wave amplitude in healthy volunteers.

Author

van Velzen MH, Loeve AJ, Kortekaas MC, Niehof SP, Mik EG, and Stolker RJ

Subjects
Adolescent, Adult, Female, Humans, Male, Pain Measurement, Young Adult, Healthy Volunteers, Hot Temperature adverse effects, Pain etiology, Pain physiopathology, Pulse Wave Analysis
Abstract

Pain is commonly assessed subjectively by interpretations of patient behaviour and/or reports from patients. When this is impossible the availability of a quantitative objective pain assessment tool based on objective physiological parameters would greatly benefit clinical practice and research beside the standard self-report tests. Vasoconstriction is one of the physiological responses to pain. The aim of this study was to investigate whether pulse transit time (PTT) and pulse wave amplitude (PWA) decrease in response to this vasoconstriction when caused by heat-induced pain. The PTT and PWA were measured in healthy volunteers, on both index fingers using photoplethysmography and electrocardiography. Each subject received 3 heat-induced pain stimuli using a Temperature-Sensory Analyzer thermode block to apply a controlled, increasing temperature from 32.0 °C to 50.0 °C to the skin. After reaching 50.0 °C, the thermode was immediately cooled down to 32.0 °C. The study population was divided into 2 groups with a time-interval between the stimuli 20s or 60s. The results showed a significant (p  <  0.05) decrease of both PTT and PWA on the stimulated and contralateral side. Moreover, there was no significant difference between the stimulated and contralateral side. The time-interval of 20s was too short to allow PTT and PWA to return to baseline values and should exceed 40s in future studies. Heat-induced pain causes a decrease of PTT and PWA. Consequently, it is expected that, in the future, PTT and PWA may be applied as objective indicators of pain, either beside the standard self-report test, or when self-report testing is impossible.

Published
2016
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