Abstract:
BACKGROUND:The respiratory exchange ratio (RER), defined as the ratio of CO2 production (VCO2) to O2 consumption (VO2), is reported to be a noninvasive marker of anaerobic metabolism. The intubated, ventilated patient's inspired and expired fractions of O2 and CO2 (FiO2, FeO2, FiCO2 and FeCO2) are monitored in the operating room and can be used to calculate RER. OBJECTIVE:To investigating the ability of the RER to predict postoperative complications. DESIGN:An observational, prospective study. SETTING:Two French university hospitals between March 2017 and September 2018. PATIENTS:A total of 110 patients undergoing noncardiac high-risk surgery. MAIN OUTCOME MEASURES:The RER was calculated as (FeCO2 - FiCO2)/(FiO2 - FeO2) at five time points during the operation. The primary endpoint was at the end of the surgery. The secondary endpoints were systemic oxygenation indices (pCO2 gap, pCO2 gap/arteriovenous difference in O2 ratio, central venous oxygen saturation) and the arterial lactate level at the end of the surgery. Complications were classified according to the European Peri-operative Clinical Outcome definitions. RESULTS:Postoperative complications occurred in 35 patients (34%). The median [interquartile range] RER at the end of surgery was significantly greater in the subgroup with complications, 1.06 [0.84 to 1.35] than in the subgroup without complications, 0.81 [0.75 to 0.91], and correlated significantly with the arterial lactate (r = 0.31, P < 0.001) and VO2 (r = -0.23, P = 0.001). Analysis of the area under the receiver operating characteristic curve for the predictive value of RER for postoperative complications revealed a value of 0.77 [95% confidence interval (CI) 0.69 to 0.88, P = 0.001]. The best cut-off for the RER was 0.94, with a sensitivity of 71% (95% CI 54 to 85) and a specificity of 79% (95% CI 68 to 88). CONCLUSION:As a putative noninvasive marker of tissue hypoperfusion and anaerobic metabolism, the RER can be used to predict complications following high-risk surgery. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT03471962.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Bar S,Grenez C,Nguyen M,de Broca B,Bernard E,Abou-Arab O,Bouhemad B,Lorne E,Guinot PGdoi
10.1097/EJA.0000000000001111subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1050-1057issue
11eissn
0265-0215issn
1365-2346journal_volume
37pub_type
杂志文章abstract::Etomidate is an imidazole-derived hypnotic agent preferentially used for rapid sequence induction of anaesthesia because of its favourable haemodynamic profile. However, 11β-hydroxylase inhibition causes adrenal insufficiency with potentially fatal consequences in specific populations. We review the arguments against ...
journal_title:European journal of anaesthesiology
pub_type: 评论,杂志文章
doi:10.1097/EJA.0b013e32835819ca
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The impact of blood pressure changes on tissue oxygenation differs between vital organs and with blood volume conditions. OBJECTIVE:To assess cerebral and renal autoregulation simultaneously and compare the impact of blood pressure, hypovolaemia and fluid resuscitation on tissue oxygenation using near-infra...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001021
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:According to international standards, autonomic function is assessed by heart rate variability (HRV) calculated from R-R intervals obtained with an electrocardiogram (ECG). However, intra-operative movement artefacts and electrical interference may complicate R-wave detection. Pulse rate variab...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e32834088c4
更新日期:2011-01-01 00:00:00
abstract::Regional anaesthesia for abdominal hysterectomy is commonly combined with heavy sedation or light general anaesthesia in order to avoid the occurrence of visceral pain. Our clinical experience has indicated that this pain can be controlled using regional anaesthesia techniques alone. In an effort to find the optimal t...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Measurement of inflammatory mediators in bronchoalveolar lavage (BAL) during lung resection surgery with periods of one-lung ventilation (OLV) has revealed an intense local pulmonary response. The role of each lung in the inflammation that occurs during this procedure has never been investigated. OBJECTIVE(...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000233
更新日期:2015-12-01 00:00:00
abstract::Morbidly obese patients present with excess fatty tissue externally on the breast, neck, thoracic wall and abdomen and internally in the mouth, pharynx and abdomen. This excess tissue tends to make access (intubation, tracheostomy) to and patency (during sedation or mask ventilation) of the upper airway and the functi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32833d91aa
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Propofol is an anaesthetic that resembles α-tocopherol and it has been suggested that it protects against ischaemia-reperfusion injury in liver transplantation. Living-donor liver transplantation (LDLT) presents an opportunity to test this hypothesis in both donors and recipients. OBJECTIVES:We compared cli...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000001018
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The kneeling prone position is often used for low back surgery in order to decrease intraoperative bleeding and increase the surgical exposure of the vertebral canal. The aim of this study was to assess effects of the kneeling prone position on respiratory gas exchange focusing on oxygen consum...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021504004053
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Postoperative shivering is one of the most common complications in patients recovering from general anaesthesia. Although a variety of pharmacological therapies have been used to control postoperative shivering, no ideal drug has been found to date. OBJECTIVES:The aim of this study was to compare the effica...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.EJA.0000436684.94403.1e
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Pectoral nerve blocks (PECS block) might be an interesting new regional anaesthetic technique in patients undergoing breast surgery. OBJECTIVE:The aim of this meta-analysis was to investigate postoperative pain outcomes and adverse events of a PECS block compared with no treatment, sham treatment or other r...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001403
更新日期:2020-11-24 00:00:00
abstract:BACKGROUND:Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE:We aimed to develop a new prediction score for PPCs t...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000845
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The current opioid epidemic highlights the urgent need for effective adjuvant therapies to complement postoperative opioid analgesia. Intra-operative ketamine infusion has been shown to reduce postoperative opioid consumption and improve pain control in opioid-tolerant patients after spinal fusion surgery. I...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000877
更新日期:2019-01-01 00:00:00
abstract::In anaesthetized dogs, stellate ganglion blockade led to a moderate disturbance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echocardiographic variables of ventricular function in eight otherwise healthy patients with sympat...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00606.x
更新日期:2000-02-01 00:00:00
abstract:CONTEXT:Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). OBJECTIVE:We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. DESIGN:Prospective, placebo-controlled...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32834c580b
更新日期:2011-12-01 00:00:00
abstract::In a prospective randomized study in children, we compared caudal bupivacaine-clonidine with bupivacaine-morphine to evaluate whether clonidine can be used as an alternative to morphine in caudal anaesthesia. Caudal anaesthesia was administered in 36 children undergoing orchidopexy, hernia repair or circumcision, usin...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00430.x
更新日期:1999-01-01 00:00:00
abstract::A 36-year-old female presented with seizures and transient dysphasia in her 31 week of pregnancy. Neuroradiological investigations revealed a large falx meningioma. A decision was taken to deliver the infant and excise the tumor before term because of the risk of an increase in the size of the tumour and the risk of s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00225.x
更新日期:1998-01-01 00:00:00
abstract::The rate of failed spinal anaesthesia, defined as the need for unplanned general anaesthesia, was evaluated in a prospective study involving 137 patients undergoing transurethral resection of the prostate (TURP). The incidence of sensations at the operative site which did not require general anaesthesia was also evalu...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1992-01-01 00:00:00
abstract::The time-course of the neuromuscular effects of vecuronium (n = 25) and atracurium (n = 25) has been compared at three different levels of maintenance dose in anaesthetized patients. Following intubation with vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1, surgical muscle relaxation was maintained by using increment...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Alpha-2 agonists offer useful effects that make these drugs an interesting alternative for pharmacological premedication. METHODS:In a randomized, double-blind study, effects of clonidine (150 microg orally), midazolam (7.5 mg orally) and placebo administered 60-90 min prior to estimated anae...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32832a0c7c
更新日期:2009-07-01 00:00:00
abstract::The relative potencies of the intravenous anaesthetics propofol and thiopentone have been investigated by finding the dose necessary to produce unconsciousness in approximately 30%, 50% and 80% of patients. The estimated potency of propofol to thiopentone was 1:1.604 as obtained by the probit method of analysis which ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The efficiency of bilateral paravertebral blockade combined with general anaesthesia (active) vs. general anaesthesia alone (control) in reducing postoperative pain following laparoscopic cholecystectomy was evaluated using a prospective randomized study design. METHODS:Patients were randomly ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s026502150400612x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Arterial pressure monitoring using the a continuous noninvasive arterial pressure (CNAP) device during general anaesthesia is known to be interchangeable with continuous invasive arterial pressure (CIAP) monitoring. Agreement with invasive measurements in cardiovascular postsurgical intensive care patients h...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000136
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Pulse pressure variation (PPV) is a well known dynamic preload indicator of fluid responsiveness. However, its usefulness in open-chest conditions remains controversial. OBJECTIVE:We evaluated whether augmented PPV during a Valsalva manoeuvre can predict fluid responsiveness after sternotomy. DESIGN:A pros...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0000000000000613
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Several video and optical laryngoscopes have been developed but few have been compared in terms of their learning curves and efficacy. Using a manikin with normal airways we compared the Glidescope, the McGrath, the Airtraq and the Macintosh laryngoscopes. METHODS:Sixty anaesthetists (20 staff...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/eja.0b013e3283269ff4
更新日期:2009-07-01 00:00:00
abstract::Although there is a continual improvement in the understanding of the pathophysiology of brain ischaemia and reperfusion, the pharmacological approach of treating or preventing brain ischaemic injury has had limited clinical impact so far. The great majority of clinical trials testing neuroprotectants for the treatmen...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32832fa606
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Stress in anaesthesiologists is a common and multifactorial problem related to patients, colleagues and organisations. The consequences of stress include depression, work-home conflicts and burnout. Reduction in stress can be achieved by reducing the number and magnitude of stressors or by increasing resilie...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000518
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000627
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In most studies of cardiac output changes after spinal anaesthesia, the time-resolution is limited. The aim of this study was to demonstrate cardiac output changes with high time-resolution during onset of spinal anaesthesia in elderly patients. METHODS:We investigated 32 patients aged 60 yr s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507000427
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To investigate whether the administration of ketamine before induction with propofol produces a smaller decrease in arterial pressure. METHODS:Twenty-two patients were assigned to one of two groups to receive either propofol with ketamine (n = 11) or propofol alone (n = 11, control). Anaesthes...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00784.x
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000785
更新日期:2005-06-01 00:00:00