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  1. Article ; Online: Transfusion strategies in traumatic brain injury - A clinical debate.

    Filipovic, Mark G / Luedi, Markus M

    Journal of clinical anesthesia

    2023  Volume 90, Page(s) 111233

    MeSH term(s) Humans ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/therapy ; Blood Transfusion
    Language English
    Publishing date 2023-08-25
    Publishing country United States
    Document type Letter
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2023.111233
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  2. Article ; Online: Cardiovascular Biomarkers: Current Status and Future Directions.

    Filipovic, Mark G / Luedi, Markus M

    Cells

    2023  Volume 12, Issue 22

    Abstract: Cardiovascular disease (CVD) remains a global health concern of paramount significance, claiming millions of lives each year [ ... ]. ...

    Abstract Cardiovascular disease (CVD) remains a global health concern of paramount significance, claiming millions of lives each year [...].
    MeSH term(s) Humans ; Risk Factors ; Cardiovascular Diseases ; Biomarkers ; Global Health
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-11-17
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells12222647
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  3. Article: Beyond the Consulting Room and Telemedicine: Unveiling the Future of Anesthesiology with Virtual Preoperative Assessment.

    Romero, Carolina S / Filipovic, Mark G / Luedi, Markus M

    Anesthesiology clinics

    2023  Volume 42, Issue 1, Page(s) 27–32

    Abstract: Telemedicine has rapidly evolved, offering expanded applications including virtual consultations, remote patient education, and therapeutic options. It provides advantages such as increased accessibility, reduced travel time, and convenience. Challenges ... ...

    Abstract Telemedicine has rapidly evolved, offering expanded applications including virtual consultations, remote patient education, and therapeutic options. It provides advantages such as increased accessibility, reduced travel time, and convenience. Challenges include privacy concerns, the digital divide, and the need for regulatory frameworks. Virtual preoperative assessment shows promise in safely identifying patients who do not require in-person consultations. Legal considerations and liability issues need to be addressed. While the COVID-19 pandemic has accelerated the adoption of telemedicine, it has also highlighted the need for comprehensive policies and equitable access to maximize its potential in health care delivery.
    MeSH term(s) Humans ; SARS-CoV-2 ; Pandemics ; Anesthesiology ; Telemedicine ; Delivery of Health Care
    Language English
    Publishing date 2023-09-21
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2023.08.002
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  4. Article ; Online: Decision Curve Analysis of In-Hospital Mortality Prediction Models: The Relative Value of Pre- and Intraoperative Data For Decision-Making.

    Huber, Markus / Bello, Corina / Schober, Patrick / Filipovic, Mark G / Luedi, Markus M

    Anesthesia and analgesia

    2024  

    Abstract: Background: Clinical prediction modeling plays a pivotal part in modern clinical care, particularly in predicting the risk of in-hospital mortality. Recent modeling efforts have focused on leveraging intraoperative data sources to improve model ... ...

    Abstract Background: Clinical prediction modeling plays a pivotal part in modern clinical care, particularly in predicting the risk of in-hospital mortality. Recent modeling efforts have focused on leveraging intraoperative data sources to improve model performance. However, the individual and collective benefit of pre- and intraoperative data for clinical decision-making remains unknown. We hypothesized that pre- and intraoperative predictors contribute equally to the net benefit in a decision curve analysis (DCA) of in-hospital mortality prediction models that include pre- and intraoperative predictors.
    Methods: Data from the VitalDB database featuring a subcohort of 6043 patients were used. A total of 141 predictors for in-hospital mortality were grouped into preoperative (demographics, intervention characteristics, and laboratory measurements) and intraoperative (laboratory and monitor data, drugs, and fluids) data. Prediction models using either preoperative, intraoperative, or all data were developed with multiple methods (logistic regression, neural network, random forest, gradient boosting machine, and a stacked learner). Predictive performance was evaluated by the area under the receiver-operating characteristic curve (AUROC) and under the precision-recall curve (AUPRC). Clinical utility was examined with a DCA in the predefined risk preference range (denoted by so-called treatment threshold probabilities) between 0% and 20%.
    Results: AUROC performance of the prediction models ranged from 0.53 to 0.78. AUPRC values ranged from 0.02 to 0.25 (compared to the incidence of 0.09 in our dataset) and high AUPRC values resulted from prediction models based on preoperative laboratory values. A DCA of pre- and intraoperative prediction models highlighted that preoperative data provide the largest overall benefit for decision-making, whereas intraoperative values provide only limited benefit for decision-making compared to preoperative data. While preoperative demographics, comorbidities, and surgery-related data provide the largest benefit for low treatment thresholds up to 5% to 10%, preoperative laboratory measurements become the dominant source for decision support for higher thresholds.
    Conclusions: When it comes to predicting in-hospital mortality and subsequent decision-making, preoperative demographics, comorbidities, and surgery-related data provide the largest benefit for clinicians with risk-averse preferences, whereas preoperative laboratory values provide the largest benefit for decision-makers with more moderate risk preferences. Our decision-analytic investigation of different predictor categories moves beyond the question of whether certain predictors provide a benefit in traditional performance metrics (eg, AUROC). It offers a nuanced perspective on for whom these predictors might be beneficial in clinical decision-making. Follow-up studies requiring larger datasets and dedicated deep-learning models to handle continuous intraoperative data are essential to examine the robustness of our results.
    Language English
    Publishing date 2024-02-05
    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.0000000000006874
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  5. Article ; Online: Diabetes mellitus and the risk of aspiration - Safe and (ultra)sound?

    Filipovic, Mark G / Baettig, Sascha J / Ganter, Michael T / Asai, Takashi / Luedi, Markus M

    Journal of clinical anesthesia

    2024  , Page(s) 111396

    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2024.111396
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  6. Article ; Online: Electronic screening - of anesthesiologists and algorithms.

    Filipovic, Mark G / Huber, Markus / Luedi, Markus M

    Journal of clinical anesthesia

    2022  Volume 82, Page(s) 110951

    MeSH term(s) Algorithms ; Anesthesiologists ; Electronics ; Humans ; Perioperative Care
    Language English
    Publishing date 2022-08-18
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2022.110951
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  7. Article ; Online: Levels of Circulating Ketone Bodies in Patients Undergoing Cardiac Surgery on Cardiopulmonary Bypass.

    Levis, Anja / Huber, Markus / Mathis, Déborah / Filipovic, Mark G / Stieger, Andrea / Räber, Lorenz / Stueber, Frank / Luedi, Markus M

    Cells

    2024  Volume 13, Issue 4

    Abstract: Ketone bodies (KBs) are energy-efficient substrates utilized by the heart depending on its metabolic demand and substrate availability. Levels of circulating KBs have been shown to be elevated in acute and chronic cardiovascular disease and are ... ...

    Abstract Ketone bodies (KBs) are energy-efficient substrates utilized by the heart depending on its metabolic demand and substrate availability. Levels of circulating KBs have been shown to be elevated in acute and chronic cardiovascular disease and are associated with severity of disease in patients with heart failure and functional outcome after myocardial infarction. To investigate whether this pattern similarly applies to patients undergoing cardiac surgery involving cardiopulmonary bypass (CPB), we analysed prospectively collected pre- and postoperative blood samples from 192 cardiac surgery patients and compared levels and perioperative changes in total KBs with Troponin T as a marker of myocardial cell injury. We explored the association of patient characteristics and comorbidities for each of the two biomarkers separately and comparatively. Median levels of KBs decreased significantly over the perioperative period and inversely correlated with changes observed for Troponin T. Associations of patient characteristics with ketone body perioperative course showed notable differences compared to Troponin T, possibly highlighting factors acting as a "driver" for the change in the respective biomarker. We found an inverse correlation between perioperative change in ketone body levels and changes in troponin, indicating a marked decrease in ketone body concentrations in patients exhibiting greater myocardial cell injury. Further investigations aimed at better understanding the role of KBs on perioperative changes are warranted.
    MeSH term(s) Humans ; Cardiopulmonary Bypass/adverse effects ; Troponin T ; Ketone Bodies ; Cardiac Surgical Procedures ; Troponin ; Biomarkers ; Heart Injuries
    Chemical Substances Troponin T ; Ketone Bodies ; Troponin ; Biomarkers
    Language English
    Publishing date 2024-02-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells13040294
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  8. Article ; Online: Modern preoperative evaluation in ambulatory surgery - who, where and how?

    Filipovic, Mark G / Schwenter, Aline / Luedi, Markus M / Urman, Richard D

    Current opinion in anaesthesiology

    2022  Volume 35, Issue 6, Page(s) 661–666

    Abstract: Purpose of review: Ambulatory surgery is increasingly performed in medically complex patients. This dynamic environment requires new approaches to ensure cost-effective, efficient, and ultimately safe preoperative evaluation of the patient. This review ... ...

    Abstract Purpose of review: Ambulatory surgery is increasingly performed in medically complex patients. This dynamic environment requires new approaches to ensure cost-effective, efficient, and ultimately safe preoperative evaluation of the patient. This review investigates recent advances in the assessment of ambulatory patients, with a special focus on patient screening, digital communication, and multidisciplinary team evaluation.
    Recent findings: Identifying suitable candidates for ambulatory surgery relies on a variety of medical, surgical, and institutional factors. Identification of high-risk patients and optimization of their treatment can be achieved through multidisciplinary protocols specific to the local institution and in line with current guidelines. Virtual assessment may be sufficient for most patients and provide an efficient evaluation strategy and high patient satisfaction. Prescreening can be supported by preoperative nursing teams.
    Summary: The increasing complexity of treatment provided in day surgery offers a unique opportunity to highlight the importance of anesthesiology staff as perioperative caregivers. Preoperative evaluation serves as a central junction to integrate a variety of surgical, medical, and institutional factors to provide safe, satisfactory, and efficient care for patients. Implementing technological innovation to streamline and facilitate this process is paramount.
    MeSH term(s) Humans ; Ambulatory Surgical Procedures ; Preoperative Care ; Anesthesiology ; Patient Satisfaction
    Language English
    Publishing date 2022-10-04
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 645203-6
    ISSN 1473-6500 ; 0952-7907
    ISSN (online) 1473-6500
    ISSN 0952-7907
    DOI 10.1097/ACO.0000000000001192
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  9. Article: Systems Anesthesiology: Systems of Care Delivery and Optimization in the Operating Room.

    Cochand, Laure / Filipovic, Mark G / Huber, Markus / Luedi, Markus M / Urman, Richard D / Bello, Corina

    Anesthesiology clinics

    2023  Volume 41, Issue 4, Page(s) 847–861

    Abstract: Anesthesiology presents a challenge to a traditional simplifying approach given the ever-increasing amount of medical data and a more demanding environment. Systems anesthesiology is a modern approach to perioperative care, integrating the complexity of ... ...

    Abstract Anesthesiology presents a challenge to a traditional simplifying approach given the ever-increasing amount of medical data and a more demanding environment. Systems anesthesiology is a modern approach to perioperative care, integrating the complexity of multifactorial knowledge and data to achieve a more adequate representation of reality, while including both patient-related medical aspects as well as economic and organizational challenges. We discuss the value of some innovative technologies such as the emergence of anesthesia information systems, the use of tele-medicine, predictive monitoring, or closed-loop systems as it pertains to the changes in the current standards of care in anesthesiology. Furthermore, we highlight the importance of systems anesthesiology in operating room planning, anesthesia research, and education.
    MeSH term(s) Humans ; Anesthesiology/education ; Operating Rooms ; Anesthesia
    Language English
    Publishing date 2023-07-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2228899-5
    ISSN 2210-3538 ; 1932-2275 ; 0889-8537
    ISSN (online) 2210-3538
    ISSN 1932-2275 ; 0889-8537
    DOI 10.1016/j.anclin.2023.05.006
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  10. Article ; Online: Cultural Framing and the Impact On Acute Pain and Pain Services.

    Rogger, Rahel / Bello, Corina / Romero, Carolina S / Urman, Richard D / Luedi, Markus M / Filipovic, Mark G

    Current pain and headache reports

    2023  Volume 27, Issue 9, Page(s) 429–436

    Abstract: Purpose of review: Optimal treatment requires a thorough understanding of all factors contributing to pain in the individual patient. In this review, we investigate the influence of cultural frameworks on pain experience and management.: Recent ... ...

    Abstract Purpose of review: Optimal treatment requires a thorough understanding of all factors contributing to pain in the individual patient. In this review, we investigate the influence of cultural frameworks on pain experience and management.
    Recent findings: The loosely defined concept of culture in pain management integrates a predisposing set of diverse biological, psychological and social characteristics shared within a group. Cultural and ethnic background strongly influence the perception, manifestation, and management of pain. In addition, cultural, racial and ethnic differences continue to play a major role in the disparate treatment of acute pain. A holistic and culturally sensitive approach is likely to improve pain management outcomes, will better cover the needs of diverse patient populations and help reduce stigma and health disparities. Mainstays include awareness, self-awareness, appropriate communication, and training.
    MeSH term(s) Humans ; Acute Pain/therapy ; Ethnicity/psychology ; Pain Management ; Social Stigma
    Language English
    Publishing date 2023-07-05
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055062-5
    ISSN 1534-3081 ; 1531-3433
    ISSN (online) 1534-3081
    ISSN 1531-3433
    DOI 10.1007/s11916-023-01125-2
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