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Article ; Online: Accuracy and clinical utility of heart rate variability derived from a wearable heart rate monitor in patients undergoing major abdominal surgery.

Yang, James / Ben-Menachem, Erez

Journal of clinical monitoring and computing

2023 Volume 38, Issue 2, Page(s) 433–443

Abstract: Low heart rate variability (HRV) can potentially identify patients at risk of intraoperative hypotension. However, it is unclear whether cheaper, readily accessible consumer heart rate (HR) monitors can provide similar utility to clinical Holter ... ...

Abstract	Low heart rate variability (HRV) can potentially identify patients at risk of intraoperative hypotension. However, it is unclear whether cheaper, readily accessible consumer heart rate (HR) monitors can provide similar utility to clinical Holter electrocardiograph (ECG) monitors. The objectives of this study were (1) to assess the validity of using the Polar H10 HR monitor as an alternative to a clinical Holter ECG and (2) to test total power (TP) as a predictor of intraoperative hypotension. The primary outcome was the level of agreement between Polar H10 and Holter ECG. Twenty-three patients undergoing major abdominal surgery with general anesthesia had 5-minute HR recordings taken concurrently with both devices during a pre-anesthetic consultation. Agreement between Polar H10 and Holter ECG was compared via Bland-Altman analysis and Lin's Concordance Correlation Coefficient. Patients were divided into groups based on TP <
MeSH term(s)	Humans ; Heart Rate/physiology ; Electrocardiography ; Electrocardiography, Ambulatory ; Hypotension ; Wearable Electronic Devices
Language	English
Publishing date	2023-10-13
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1418733-4
ISSN	1573-2614 ; 1387-1307 ; 0748-1977
ISSN (online)	1573-2614
ISSN	1387-1307 ; 0748-1977
DOI	10.1007/s10877-023-01080-8
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Article ; Online: Point-of-Care Ultrasound Frailty Assessments: Comment.

Ben-Menachem, Erez / Ashes, Catherine

Anesthesiology

2022 Volume 137, Issue 3, Page(s) 373–374

MeSH term(s)	Aged ; Frail Elderly ; Frailty/diagnostic imaging ; Geriatric Assessment/methods ; Humans ; Point-of-Care Systems ; Ultrasonography
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	269-0
ISSN	1528-1175 ; 0003-3022
ISSN (online)	1528-1175
ISSN	0003-3022
DOI	10.1097/ALN.0000000000004300
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Article ; Online: Kleine-Levin syndrome and general anesthesia: A case report.

Ben-Menachem, Erez / Winder, Mark J

Journal of clinical anesthesia

2021 Volume 75, Page(s) 110486

MeSH term(s)	Anesthesia, General/adverse effects ; Humans ; Kleine-Levin Syndrome
Language	English
Publishing date	2021-08-17
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	1011618-7
ISSN	1873-4529 ; 0952-8180
ISSN (online)	1873-4529
ISSN	0952-8180
DOI	10.1016/j.jclinane.2021.110486
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Article: Carbon Dioxide Elimination After Sodium Bicarbonate Administration as a Novel Method to Assess Cardiac Output: A Pilot Study.

Keidan, Ilan / Arzillo, Samantha / Vasilopoulos, Terrie / Ben-Menachem, Erez / Gravenstein, Nikolaus / McGough, Edward

Cureus

2021 Volume 13, Issue 10, Page(s) e18621

Abstract: Introduction Cardiac output/pulmonary blood flow measurement is an important way to assess patients during the perioperative period, as well as patients who are critically ill. Current methods of assessing cardiac output have limitations. One indicator ... ...

Abstract	Introduction Cardiac output/pulmonary blood flow measurement is an important way to assess patients during the perioperative period, as well as patients who are critically ill. Current methods of assessing cardiac output have limitations. One indicator of cardiac output may be the expired carbon dioxide (CO
Language	English
Publishing date	2021-10-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.18621
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Article ; Online: Smaller rectus femoris size measured by ultrasound is associated with poorer outcomes after cardiac surgery.

Ben-Menachem, Erez / Ashes, Catherine / Lepar, Gila / Deacon, James / Glavan, Nicole / Molan, Veronique / Watson, Alasdair

The Journal of thoracic and cardiovascular surgery

2022 Volume 167, Issue 3, Page(s) 1115–1122.e5

Abstract: Objective: We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery.: Methods: A single right-leg RFCSA was measured with ... ...

Abstract	Objective: We sought to evaluate the association of low rectus femoris cross-sectional area (RFCSA) with hospital length of stay and poorer outcomes in patients undergoing cardiac surgery. Methods: A single right-leg RFCSA was measured with ultrasound preoperatively and baseline characteristics, clinical data, and outcomes recorded. Patients were categorized as low rectus femoris muscle size (lowRF) or normal rectus femoris muscle size (normalRF), if they were in the lowest quartile or not, respectively. All analyses were performed on both body surface area (BSA)- and sex-adjusted RFCSA. Results: One hundred eight-four patients had a RFCSA measured with a mean of 5.01 cm Conclusions: Low RFCSA has a significant association with increased hospital length of stay, morbidity, and nonhome discharge in patients undergoing cardiac procedures. Trial registry number: ACTRN12620000678998.
MeSH term(s)	Humans ; Quadriceps Muscle/diagnostic imaging ; Length of Stay ; Cardiac Surgical Procedures/adverse effects ; Ultrasonography ; Hospitals
Language	English
Publishing date	2022-07-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	3104-5
ISSN	1097-685X ; 0022-5223
ISSN (online)	1097-685X
ISSN	0022-5223
DOI	10.1016/j.jtcvs.2022.07.005
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Article ; Online: Anesthetic Management of Staged Bilateral Adrenalectomy for Neuroendocrine Tumors in a Heart-Lung Transplant Patient: A Case Report.

Liu, Amy C / Andrews, Gareth / Ben-Menachem, Erez

A&A practice

2018 Volume 11, Issue 9, Page(s) 253–257

Abstract: Neuroendocrine tumors may rarely present after organ transplantation, including cardiac transplant. Treatment is surgical resection with careful perioperative management to optimize blood pressure and intravascular volume. We present the anesthetic ... ...

Abstract	Neuroendocrine tumors may rarely present after organ transplantation, including cardiac transplant. Treatment is surgical resection with careful perioperative management to optimize blood pressure and intravascular volume. We present the anesthetic management of a patient who was diagnosed with bilateral neuroendocrine tumors soon after heart-lung transplantation and underwent successful staged bilateral adrenalectomy.
MeSH term(s)	Adrenal Gland Neoplasms/surgery ; Adrenalectomy ; Anesthetics ; Female ; Heart-Lung Transplantation ; Humans ; Middle Aged ; Neuroendocrine Tumors/surgery
Chemical Substances	Anesthetics
Language	English
Publishing date	2018-05-30
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2575-3126
ISSN (online)	2575-3126
DOI	10.1213/XAA.0000000000000800
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Article ; Online: Devil in the detail: citation accuracy.

Zalcberg, Dave / Ben-Menachem, Erez

European journal of anaesthesiology

2013 Volume 30, Issue 3, Page(s) 129

MeSH term(s)	Anesthesiology/methods ; Humans ; Job Satisfaction ; Physicians/psychology ; Stress, Psychological
Language	English
Publishing date	2013-03
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0b013e32835aa527
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Article ; Online: High-flow Nasal Oxygen Versus Standard Oxygen During Flexible Bronchoscopy in Lung Transplant Patients: A Randomized Controlled Trial.

Ben-Menachem, Erez / McKenzie, Jane / O'Sullivan, Chris / Havryk, Adrian P

Journal of bronchology & interventional pulmonology

2020 Volume 27, Issue 4, Page(s) 259–265

Abstract: Background: Diagnostic and interventional flexible bronchoscopy (FB) is increasingly utilized in complex and high-risk patients. Patients are often sedated for comfort and procedure facilitation and hypoxia is commonly observed in this setting. We ... ...

Abstract	Background: Diagnostic and interventional flexible bronchoscopy (FB) is increasingly utilized in complex and high-risk patients. Patients are often sedated for comfort and procedure facilitation and hypoxia is commonly observed in this setting. We hypothesized that high-flow nasal oxygen (HFNO) would reduce the incidence of patients experiencing oxygen desaturation. Methods: In this randomized controlled trial, postlung transplant patients booked for FB with transbronchial lung biopsy were assigned to either HFNO or low-flow nasal oxygen (LFNO). The patient and bronchoscopist were blinded to group allocation. The primary endpoint was the proportion of patients experiencing mild desaturation [peripheral oxygen saturation (SpO2)<94%]. Secondary endpoints included desaturation (SpO2<90%), the number of airway interventions required and procedure interruptions, the duration of oxygen desaturation and patient, bronchoscopist and anesthesiologist satisfaction scores. Results: The trial analyzed data from 76 patients (LFNO, n=39; HFNO, n=37). HFNO reduced the proportion of patients experiencing SpO2<94% (43.2% vs. 89.7%, P<0.001) and SpO2<90% (16.2% vs. 69.2%, P<0.001). The FB was interrupted 11 times in 9 patients in the LFNO group, whereas there were no interruptions in the HFNO group. There were no differences in patient and bronchoscopist satisfaction scores between groups, anesthesiologists had higher satisfaction scores when using HFNO (P<0.001). Conclusion: Hypoxia occurred less commonly in postlung transplant patients receiving HFNO during FB. Further studies are warranted in other high-risk populations undergoing longer duration FB.
MeSH term(s)	Adult ; Aged ; Anesthesiologists/statistics & numerical data ; Biopsy/adverse effects ; Biopsy/methods ; Bronchoscopy/methods ; Bronchoscopy/statistics & numerical data ; Cannula/adverse effects ; Case-Control Studies ; Female ; Humans ; Hypoxia/epidemiology ; Hypoxia/etiology ; Hypoxia/prevention & control ; Incidence ; Lung/pathology ; Lung Transplantation/adverse effects ; Male ; Middle Aged ; Oxygen/administration & dosage ; Oxygen/blood ; Personal Satisfaction ; Prospective Studies ; Pulmonologists/statistics & numerical data
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2020-04-23
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2478320-1
ISSN	1948-8270 ; 1944-6586
ISSN (online)	1948-8270
ISSN	1944-6586
DOI	10.1097/LBR.0000000000000670
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Article ; Online: Low pre-operative heart rate variability and complexity are associated with hypotension after anesthesia induction in major abdominal surgery.

Padley, James R / Ben-Menachem, Erez

Journal of clinical monitoring and computing

2017 Volume 32, Issue 2, Page(s) 245–252

Abstract: Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in ... ...

Abstract	Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease. Ten minutes of electrocardiogram at 1024 Hz were recorded a median of 3 days pre-operatively. Pre-operative HRV parameters were compared in patients who experienced significant hypotension (fall in systolic and mean arterial pressure (MAP) >30% baseline and MAP ≤60 mmHg) versus those who remained haemodynamically stable after induction of general anesthesia with propofol and fentanyl. Patients who experienced hypotension after general anesthesia induction had significantly lower pre-operative HRV (SDNN 16 vs. 37 ms, p < 0.001), reduced spectral power (total power 262 vs. 1236 ms
MeSH term(s)	Abdomen/surgery ; Aged ; Algorithms ; Anesthesia/methods ; Anesthesia, General ; Autonomic Nervous System/drug effects ; Cohort Studies ; Electrocardiography ; Female ; Fentanyl/therapeutic use ; Heart Rate ; Hemodynamics ; Humans ; Hypotension/physiopathology ; Male ; Middle Aged ; Preoperative Period ; Propofol/therapeutic use ; Signal Processing, Computer-Assisted ; Surgical Procedures, Operative/methods
Chemical Substances	Fentanyl (UF599785JZ) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2017-03-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1418733-4
ISSN	1573-2614 ; 1387-1307 ; 0748-1977
ISSN (online)	1573-2614
ISSN	1387-1307 ; 0748-1977
DOI	10.1007/s10877-017-0012-4
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Article ; Online: Depth of anesthesia monitoring: a survey of attitudes and usage patterns among Australian anesthesiologists.

Ben-Menachem, Erez / Zalcberg, Dave

Anesthesia and analgesia

2014 Volume 119, Issue 5, Page(s) 1180–1185

Abstract: Background: Utility of depth of anesthesia (DoA) monitors is contentious as evidence appears ambiguous regarding their clinical effectiveness and exact role. We conducted a survey of Australian anesthesiologists to determine their attitudes toward, and ... ...

Abstract	Background: Utility of depth of anesthesia (DoA) monitors is contentious as evidence appears ambiguous regarding their clinical effectiveness and exact role. We conducted a survey of Australian anesthesiologists to determine their attitudes toward, and how and why they use, DoA monitors. Methods: A random sample of 963 anesthesiologists was invited to participate in an anonymous online survey. Results: The overall response rate was 30% (289 respondents). Twenty-nine percent (95% confidence interval, 24%-34%) of respondents thought DoA monitoring was indicated in all cases under relaxant general anesthesia. During total IV anesthesia with muscle relaxants, 74% of respondents (69%-79%) opined that DoA monitoring should be mandatory. DoA usage was never used by 5% of respondents (3%-8%), used in less than one-third of cases by 66% (61%-72%), and in more than one-third of cases by 29% (24%-35%). Belief in the usefulness of DoA monitoring for prevention of awareness was strongly associated with higher usage (P < 0.0001, Pearson correlation 0.32). Anesthesiologists were more influenced by higher DoA numbers than lower ones. In comparison with end-tidal anesthetic concentration monitoring, 30% (25%-35%) of respondents felt that DoA monitoring was more effective for prevention of intraoperative awareness. Thirty percent (25%-36%) of respondents reported having a previous case of awareness. Conclusions: The relatively frequent use of DoA monitoring contrasts with patterns in the UK, suggesting greater acceptance by Australian anesthesiologists. "Awareness prevention" rather than "recovery enhancement" appears to be the primary driver in DoA monitoring use in Australia. Highly variable usage patterns of DoA monitoring in the context of the current body of evidence suggest the need for greater education on the appropriate use of these monitors.
MeSH term(s)	Adult ; Anesthesia/methods ; Attitude of Health Personnel ; Australia ; Consciousness Monitors/utilization ; Electroencephalography ; Female ; Health Care Surveys ; Humans ; Intraoperative Awareness/prevention & control ; Male ; Middle Aged ; Prospective Studies
Keywords	covid19
Language	English
Publishing date	2014-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000000344
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