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This Month in Anesthesiology
doi : 10.1097/ALN.0000000000003821
Anesthesiology June 2021, Vol. 134, A1–A2
Science, Medicine, and the Anesthesiologist
doi : 10.1097/ALN.0000000000003828
Anesthesiology June 2021, Vol. 134, A17–A20
Ultrasound Insights into Neonatal Fasting: Get in the NP-Know
Jonathan P. Wanderer; James P. Rathmell
doi : 10.1097/ALN.0000000000003825
Anesthesiology June 2021, Vol. 134, A21
Instructions for Obtaining Anesthesiology Continuing Medical Education (CME) Credit
doi : 10.1097/ALN.0000000000003823
Anesthesiology June 2021, Vol. 134, A15
Neonatal Preoperative Fasting: Time for a Change?
Laszlo Vutskits, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003755
Anesthesiology June 2021, Vol. 134, 823–825
Availability of Pediatric Surgery: Implications for Planning Pediatric Anesthesiology Education
Aditee P. Ambardekar, M.D., M.S.Ed.; Alan Jay Schwartz, M.D., M.S.Ed
doi : 10.1097/ALN.0000000000003771
Anesthesiology June 2021, Vol. 134, 826–827
The “True” Risk of Postoperative Pulmonary Complications and the Socratic Paradox: “I Know that I Know Nothing”
Sorin J. Brull, M.D., F.C.A.R.C.S.I. (Hon); Glenn S. Murphy, M.D.
doi : 10.1097/ALN.0000000000003767
Anesthesiology June 2021, Vol. 134, 828–831
Exploring New Risk Factors for Postpartum Hemorrhage: Time to Consider Gestational Age?
Sharon C. Reale, M.D.; Brian T. Bateman, M.D., M.Sc.; Michaela K. Farber, M.D., M.S.
doi : 10.1097/ALN.0000000000003775
Anesthesiology June 2021, Vol. 134, 832–834
A Crack at MAC
Misha Perouansky, M.D.; Jamie W. Sleigh, M.D.
doi : 10.1097/ALN.0000000000003761
Anesthesiology June 2021, Vol. 134, 835–837
Intraoperative Positive End-expiratory Pressure for Obese Patients: A Step Forward, a Long Road Still Ahead
Ana Fernandez-Bustamante, M.D., Ph.D.; Juraj Sprung, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003806
Anesthesiology June 2021, Vol. 134, 838–840
How Can Anesthesiologists Influence Policymaking? Reflections from a Year at the Council of Economic Advisers
Eric C. Sun, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003756
Anesthesiology June 2021, Vol. 134, 841–844
Ultrasound Evaluation of Gastric Emptying Time in Healthy Term Neonates after Formula Feeding
Jennifer J. Lee, M.D.; Jerri C. Price, M.D., Ph.D.; Andrew Duren, M.D.; Alon Shertzer, M.D.; Robert Hannum, III, M.D.; Francis A. Akita, M.D.; Shuang Wang, Ph.D.; Judy H. Squires, M.D.; Oliver Panzer, M.D.; Jacquelin Herrera, B.S.; Lena S. Sun, M.D.; Nicholas A. Davis, M.D.
doi : 10.1097/ALN.0000000000003773
Anesthesiology June 2021, Vol. 134, 845–851
The current American Society of Anesthesiologists fasting guideline for formula-fed infants in the periprocedural setting is 6 h. Prolonged fasting in very young infants is associated with an increased risk for hypoglycemia and dehydration as well as patient discomfort and patient/parental dissatisfaction. This study aimed to determine the time to gastric emptying in healthy neonates after formula feeding by serially evaluating the gastric antrum with ultrasound. The authors hypothesized that gastric emptying times in formula-fed neonates are significantly shorter than the current 6 h fasting recommendation.
Availability of Inpatient Pediatric Surgery in the United States
Michael L. McManus, M.D., M.P.H.; Urbano L. França, Ph.D.
doi : 10.1097/ALN.0000000000003766
Anesthesiology June 2021, Vol. 134, 852–861.
In 2015, the American College of Surgeons began its Children’s Surgery Verification Quality Improvement Program, promulgating standards intended to promote regionalization and improve pediatric surgical care. It was hypothesized that pediatric surgical care was already highly regionalized and concentrated before implementation of the program. This study aimed to demonstrate this by describing the sites and volume of nonambulatory pediatric surgery.
Postoperative Pulmonary Complications’ Association with Sugammadex versus Neostigmine: A Retrospective Registry Analysis
Gen Li, M.Stat., M.Chem.; Robert E. Freundlich, M.D., M.S., M.S.C.I.; Rajnish K. Gupta, M.D.; Christina J. Hayhurst, M.D.; Chi H. Le, B.S.; Barbara J. Martin, R.N., M.B.A.; Matthew S. Shotwell, Ph.D.; Jonathan P. Wanderer, M.D., M.Phil., F.A.S.A., F.A.M.I.A.
doi : 10.1097/ALN.0000000000003735
Anesthesiology June 2021, Vol. 134, 862–873
Postoperative residual neuromuscular blockade related to nondepolarizing neuromuscular blocking agents may be associated with pulmonary complications. In this study, the authors sought to determine whether sugammadex was associated with a lower risk of postoperative pulmonary complications in comparison with neostigmine.
Association of Gestational Age with Postpartum Hemorrhage: An International Cohort Study
Alexander J. Butwick, M.B.B.S., F.R.C.A., M.S.; Can Liu, Ph.D., M.Sc., M.B.; Nan Guo, Ph.D.; Jason Bentley, Ph.D.; Elliot K. Main, M.D.; Jonathan A. Mayo, M.P.H.; Gary M. Shaw, Ph.D.; Olof Stephansson, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003730
Anesthesiology June 2021, Vol. 134, 874–886
Risk factors for postpartum hemorrhage, such as chorioamnionitis and multiple gestation, have been identified in previous epidemiologic studies. However, existing data describing the association between gestational age at delivery and postpartum hemorrhage are conflicting. The aim of this study was to assess the association between gestational age at delivery and postpartum hemorrhage.
Individualized versus Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients: A Secondary Analysis
Philipp Simon, M.D., Ph.D.; Felix Girrbach, M.D.; David Petroff, M.Sc., Ph.D.; Nadja Schliewe, M.D.; Gunther Hempel, M.D.; Mirko Lange; Thomas Bluth, M.D.; Marcelo Gama de Abreu, M.D., Ph.D.; Alessandro Beda, M.D., Ph.D.; Marcus J. Schultz, M.D., Ph.D.; Paolo Pelosi, M.D., Ph.D.; Andreas W. Reske, M.D., Ph.D.; Hermann Wrigge, M.D., Ph.D.; for the PROBESE Investigators of the Protective Ventilation Network* and the Clinical Trial Network of the European Society of Anesthesiology
doi : 10.1097/ALN.0000000000003762
Anesthesiology June 2021, Vol. 134, 887–900
General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP.
Mitochondrial Function and Anesthetic Sensitivity in the Mouse Spinal Cord
Christian B. Woods, B.S.; Kira A. Spencer, Ph.D.; Sangwook Jung, Ph.D.; Hailey M. Worstman, B.A.; Jan-Marino Ramirez, Ph.D.; Philip G. Morgan, M.D.; Margaret M. Sedensky, M.D.
doi : 10.1097/ALN.0000000000003794
Anesthesiology June 2021, Vol. 134, 901–914
Ndufs4 knockout (KO) mice are defective in mitochondrial complex I function and hypersensitive to inhibition of spinal cord–mediated response to noxious stimuli by volatile anesthetics. It was hypothesized that, compared to wild-type, synaptic or intrinsic neuronal function is hypersensitive to isoflurane in spinal cord slices from knockout mice.
Factors Contributing to Lingering Pain after Surgery: The Role of Patient Expectations
Mark D. Willingham, M.D.; Molly R. Vila, M.D.; Arbi Ben Abdallah, D.E.S., Ph.D.; Michael S. Avidan, M.B.B.Ch.; Simon Haroutounian, M.Sc.Pharm., Ph.D.
doi : 10.1097/ALN.0000000000003754
Anesthesiology June 2021, Vol. 134, 915–924
Pain that lingers beyond the early weeks after the acute postoperative period is an important risk factor for chronic postsurgical pain. This study examined the hypothesis that patients’ expectations about their postsurgical pain would be independently associated with lingering postsurgical pain.
Deep Spinal Infection after Outpatient Epidural Injections for Pain: A Retrospective Sample Cohort Study Using a Claims Database in South Korea
Chang-Soon Lee, M.D.; Young Jae Park, M.D.; Jee Youn Moon, M.D., Ph.D.; Yong-Chul Kim, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003770
Anesthesiology June 2021, Vol. 134, 925–936
Deep spinal infection is a devastating complication after epidural injection. This study aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, this study assessed the national trends of the procedure and risk factors for said infection.
Airway Obstruction Attributable to Head and Neck Cancers: Awake Fiberoptic Intubation versus Awake Tracheostomy
Javier Lasala, M.D.; Carlos E. Guerra-Londono, M.D.; Dam-Thuy Truong, M.D.; Angela T. Truong, M.D.
doi : 10.1097/ALN.0000000000003744
Anesthesiology June 2021, Vol. 134, 937
Mid-Aortic Syndrome
Rakshika Rajakaruna, M.D.; Kalysa R. Porter, M.D., M.P.H.; Michale S. Ok, M.D.
doi : 10.1097/ALN.0000000000003760
Anesthesiology June 2021, Vol. 134, 938.
Perioperative Management of Patients for Whom Transfusion Is Not an Option
Nicole R. Guinn, M.D.; Linda M. S. Resar, M.D.; Steven M. Frank, M.D.
doi : 10.1097/ALN.0000000000003763
Anesthesiology June 2021, Vol. 134, 939–948
Quantitative Lung Ultrasound: Technical Aspects and Clinical Applications
Silvia Mongodi, M.D., M.Sc., Ph.D.; Daniele De Luca, M.D., Ph.D.; Andrea Colombo, M.D.; Andrea Stella, M.D.; Erminio Santangelo, M.D.; Francesco Corradi, M.D.; Luna Gargani, M.D., Ph.D.; Serena Rovida, M.D.; Giovanni Volpicelli, M.D.; Bélaid Bouhemad, M.D., Ph.D.; Francesco Mojoli, M.D.
doi : 10.1097/ALN.0000000000003757
Anesthesiology June 2021, Vol. 134, 949–965
The Similarities of My Profession and Motherhood
Parineeta Thapa, M.D.; Asish Subedi, M.D.
doi : 10.1097/ALN.0000000000003624
Anesthesiology June 2021, Vol. 134, 966–968
Anesthesia Delay
Benjamin M. Kristobak, M.D.
doi : 10.1097/ALN.0000000000003649
Anesthesiology June 2021, Vol. 134, 969
Paul Wood’s Grounding Plate: A Shockingly Down-to-Earth Strategy for OR Safety
doi : 10.1097/ALN.0000000000003826
Anesthesiology June 2021, Vol. 134, 844
Chevalier Jackson’s Laryngoscope: Seeing Light at the End of the Tunnel
doi : 10.1097/ALN.0000000000003827
Anesthesiology June 2021, Vol. 134, 936
Concordance of Upper and Lower Respiratory Tract Samples for SARS-CoV-2 in Pediatric Patients: Research Letter
Elaina E. Lin, M.D.; Elikplim H. Akaho, M.D., M.H.S.; Anna Sobilo, M.D.; Allison M. Blatz, M.D.; William R. Otto, M.D.; Audrey R. Odom John, M.D., Ph.D.
doi : 10.1097/ALN.0000000000003765
Anesthesiology June 2021, Vol. 134, 970–972
Hypotension Prediction Index Guidance: Comment
Elena Koepke, M.D., M.B.A.; Yafen Liang, M.D.; Omonele O. Nwokolo, M.D.
doi : 10.1097/ALN.0000000000003758
Anesthesiology June 2021, Vol. 134, 972–973
Hypotension Prediction Index Guidance: Reply
Kamal Maheshwari, M.D., M.P.H.; Zhongping Jian, Ph.D.; Daniel I. Sessler, M.D.
doi : 10.1097/ALN.0000000000003759
Anesthesiology June 2021, Vol. 134, 973
Leadership in Anesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility
George S. Bause, M.D., M.P.H.
doi : 10.1097/ALN.0000000000003617
Anesthesiology June 2021, Vol. 134, 974.
Complications as a Mediator of the Perioperative Frailty–Mortality Association: Mediation Analysis of a Retrospective Cohort: Erratum
doi : 10.1097/ALN.0000000000003768
Anesthesiology June 2021, Vol. 134, 975
