Novel Advances and Innovation in Perioperative Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 5246

Special Issue Editor

Bicetre Hospital, Paris, France
Interests: anesthesiology; noninvasive cardiac output monitoring devices; fluid therapy; novel perioperative technologies; liver transplants; major abdominal surgery

Special Issue Information

Dear Colleagues,

The past 25 years brought remarkable advances in clinical anesthesia, critical care, pain and perioperative medicine and will continue to evolve. This means we will face novel challenges, and controversies and create innovations. The journal of personalized medicine is pleased to announce a planned thematic issue called: “Novel Advances and Innovation in Perioperative Medicine”.

Guest edited by Dr. Alexandre Joosten M.D. Ph.D., all authors of potential submissions should review the Journal’s “Instructions for Authors” before submitting an article. Interested authors can also contact Dr. Alexandre Joosten at joosten-alexandre@hotmail.com for additional information or to discuss specific topic proposals for this special thematic issue.

The aim and scope of this Special Issue will be to receive recent works on novel advances and innovations in perioperative medicine.  As all of us are aware, we work in one of the most data-rich clinical environments. From low resolution clinical data obtained from the electronic health record and administrative databases to high-fidelity physiologic waveforms and genomic data, the breadth of information accessible to clinicians seems almost unlimited. The recent boom of articificial intelligence, machine learning, decision support and closed-loop systems in perioperative medicine have been enormous advances in our pratice. Outside AI and data analytics, other recent advances and innovations have emerged (new perioperative technologies, new ways to optimize patient hemodynamic, patient level of sedation, analgesia etc.). We invite all anesthesia, critical care and perioperative medicine communities to submit your recent work, including the following manuscript types: 

  • Original Clinical Research Report
  • Original Laboratory Research Report
  • Narrative Review Article
  • Systematic Review Articles

Dr. Alexandre Joosten
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • closed-loop systems
  • artificial intelligence
  • big data
  • machine learning
  • perioperative technologies
  • NOVEL strategies for hemodynamic optimization
  • monitoring devices

Published Papers (4 papers)

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Research

7 pages, 3486 KiB  
Communication
Jet Ventilation Reduces Coronary Sinus Movement in Patients Undergoing Atrial Fibrillation Ablation: An Observational Crossover Study
by Cécile Maeyens, Pierre Nokerman, Ruben Casado-Arroyo, Juan-Pablo Abugattas De Torres, Brenton Alexander, Edgard Engelman, Denis Schmartz and Turgay Tuna
J. Pers. Med. 2023, 13(2), 186; https://doi.org/10.3390/jpm13020186 - 20 Jan 2023
Viewed by 1008
Abstract
Background: One of the reasons that high-frequency jet ventilation (HFJV) is used is due to the near immobility of thoracic structures. However, no study has quantified the movements of cardiac structures during HFJV compared with normal mechanical ventilation. Methods: After ethical approval and [...] Read more.
Background: One of the reasons that high-frequency jet ventilation (HFJV) is used is due to the near immobility of thoracic structures. However, no study has quantified the movements of cardiac structures during HFJV compared with normal mechanical ventilation. Methods: After ethical approval and written informed consent, we included 21 patients scheduled for atrial fibrillation ablation in this prospective crossover study. Each patient was ventilated with both normal mechanical ventilation and HFJV. During each ventilation mode, displacements of the cardiac structure were measured by the EnSite Precision mapping system using a catheter placed in the coronary sinus. Results: The median [Q1–Q4] displacement was 2.0 [0.6–2.8] mm during HFJV and 10.5 [9.3–13.0] mm during conventional ventilation (p < 0.000001). Conclusion: This study quantifies the minimal movement of cardiac structures during HFJV compared to standard mechanical ventilation. Full article
(This article belongs to the Special Issue Novel Advances and Innovation in Perioperative Medicine)
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11 pages, 1622 KiB  
Article
Photoplethysmography-Based Blood Pressure Monitoring Could Improve Patient Outcome during Anesthesia Induction
by Yan Degiorgis, Martin Proença, Yassine Ghamri, Gregory Hofmann, Mathieu Lemay and Patrick Schoettker
J. Pers. Med. 2022, 12(10), 1571; https://doi.org/10.3390/jpm12101571 - 23 Sep 2022
Cited by 1 | Viewed by 1178
Abstract
During anesthesia, noncritical patients are routinely monitored via noninvasive cuff-based blood pressure (BP) monitors. Due to the noncontinuous nature of the monitoring, the BP values of the patient remain unavailable between consecutive cuff measurements, carrying the risk of missing rapid and sudden variations [...] Read more.
During anesthesia, noncritical patients are routinely monitored via noninvasive cuff-based blood pressure (BP) monitors. Due to the noncontinuous nature of the monitoring, the BP values of the patient remain unavailable between consecutive cuff measurements, carrying the risk of missing rapid and sudden variations in BP. We evaluated the added value of using a photoplethysmography (PPG)-based continuous BP measurement device in addition to the standard cuff-based monitoring in a cohort of 40 patients in comparison with the current approach, in which only intermittent cuff-based measurements are available. When using a three-minute cuff measurement interval, using the PPG-based BP measurement in addition to the cuff-based monitor reduced the error (mean ± SD) of systolic (SBP) and mean (MBP) BP from 2.6 ± 19.6 mmHg and 1.2 ± 13.2 mmHg to 0.5 ± 11.2 mmHg and 0.0 ± 8.1 mmHg, respectively. Error grid analysis was also used to assess the improvement in patient safety. The additional use of the PPG-based BP measurement reduced the amount of data falling into higher risk categories. For SBP, points falling in the significant-, moderate-, and low-risk categories decreased from 1.1%, 8.7%, and 19.3% to 0.0%, 2.3%, and 9.6%, respectively. Similar results were obtained for MBP. These results suggest that using a PPG-based BP monitor—in addition to the standard cuff-based monitor—can improve patient safety during anesthesia induction, with no additional sensor needed. Full article
(This article belongs to the Special Issue Novel Advances and Innovation in Perioperative Medicine)
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8 pages, 550 KiB  
Article
Systolic Arterial Pressure Control Using an Automated Closed-Loop System for Vasopressor Infusion during Intermediate-to-High-Risk Surgery: A Feasibility Study
by Joseph Rinehart, Olivier Desebbe, Antoine Berna, Isaac Lam, Sean Coeckelenbergh, Maxime Cannesson and Alexandre Joosten
J. Pers. Med. 2022, 12(10), 1554; https://doi.org/10.3390/jpm12101554 - 21 Sep 2022
Cited by 2 | Viewed by 1354
Abstract
Introduction: Vasopressor infusions are essential in treating and preventing intraoperative hypotension. Closed-loop vasopressor therapy outperforms clinicians when the target is set at a mean arterial pressure (MAP) baseline, but little is known on the performance metrics of closed-loop vasopressor infusions when systolic [...] Read more.
Introduction: Vasopressor infusions are essential in treating and preventing intraoperative hypotension. Closed-loop vasopressor therapy outperforms clinicians when the target is set at a mean arterial pressure (MAP) baseline, but little is known on the performance metrics of closed-loop vasopressor infusions when systolic arterial pressure (SAP) is the controlled variable. Methods: Patients undergoing intermediate- to high-risk abdominal surgery were included in this prospective cohort feasibility study. All patients received norepinephrine infusion through a computer controlled closed-loop system that targeted SAP at 130 mmHg. The primary objective was to determine the percent of case time in hypotension or under target defined as SAP below 10% of the target (SAP < 117 mmHg). Secondary objectives were the percent of case time “above target” (SAP > 10% of the target or >143 mmHg) and “in target” (within 10% of the SAP target or SAP between 117 and 143 mmHg). Results: A total of 12 patients were included. The closed-loop system infused norepinephrine for a median of 94.6% (25–75th percentile: 90.0–98.0%) of case time. The percentage of case time in hypotension or under target was only 1.8% (0.9–3.6%). The percentages of case time “above target” and “in target” were 4.7% (3.2–7.5%) and 92.4% (90.1–96.3%), respectively. Conclusions: This closed-loop vasopressor system minimizes intraoperative hypotension and maintains SAP within 10% of the target range for >90% of the case time in patients undergoing intermediate- to high-risk abdominal surgery. Full article
(This article belongs to the Special Issue Novel Advances and Innovation in Perioperative Medicine)
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9 pages, 827 KiB  
Article
A Pilot Study Assessing a Closed-Loop System for Goal-Directed Fluid Therapy in Abdominal Surgery Patients
by Yann Gricourt, Camille Prin Derre, Christophe Demattei, Sébastien Bertran, Benjamin Louart, Laurent Muller, Natacha Simon, Jean-Yves Lefrant, Philippe Cuvillon, Samir Jaber and Claire Roger
J. Pers. Med. 2022, 12(9), 1409; https://doi.org/10.3390/jpm12091409 - 30 Aug 2022
Cited by 3 | Viewed by 1143
Abstract
Background: This prospective multicentre pilot study of patients scheduled for elective major abdominal surgery aimed to validate the fluid challenge (FC) proposed by the closed-loop (CL) system via anaesthesiologist assessment. Methods: This was a phase II trial consisting of two inclusion stages (SIMON [...] Read more.
Background: This prospective multicentre pilot study of patients scheduled for elective major abdominal surgery aimed to validate the fluid challenge (FC) proposed by the closed-loop (CL) system via anaesthesiologist assessment. Methods: This was a phase II trial consisting of two inclusion stages (SIMON method). Each FC (250 mL saline solution for 10 min) proposed by the CL was systematically validated by the anaesthesiologist who could either confirm or refuse the FC or give FC without the CL system. A ≥ 95% agreement between the CL and the anaesthesiologist was considered acceptable. Results: The study was interrupted after interim analysis of the first 19 patients (10 men, median age = 61 years, median body mass index = 26 kg/m2). The anaesthesiologists accepted 165/205 (80%) of fluid boluses proposed by the CL. Median cardiac index (CI) was 2.9 (interquartile: IQ (2.7; 3.4) L/min/m2) and the median coefficient of variation (CV) for CI was 13% (10; 17). Fifteen out of nineteen patients (79%) had a mean CI > 2.5 L/min/m2 or spent > 85% surgery time with pulse pressure variation < 13%. No adverse events related to the CL were reported. Conclusion: In this study of patients scheduled for elective major abdominal surgery, the agreement between CL and anaesthesiologist for giving fluid challenge was 80%, suggesting that CL cannot replace the physician but could help in decision making. Full article
(This article belongs to the Special Issue Novel Advances and Innovation in Perioperative Medicine)
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