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Article ; Online: General anaesthesia with desflurane or propofol in lung volume reduction surgery: Results of an unpublished randomised clinical trial.

Kachulis, Bessie / Mitrev, Ludmil / Easthausen, Imaani / Mets, Berend

2021 Volume 38, Issue 5, Page(s) 552–554

MeSH term(s)	Anesthesia, General/adverse effects ; Anesthetics, Inhalation/adverse effects ; Anesthetics, Intravenous/adverse effects ; Desflurane ; Humans ; Isoflurane/adverse effects ; Pneumonectomy ; Propofol
Chemical Substances	Anesthetics, Inhalation ; Anesthetics, Intravenous ; Desflurane (CRS35BZ94Q) ; Isoflurane (CYS9AKD70P) ; Propofol (YI7VU623SF)
Language	English
Publishing date	2021-04-06
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0000000000001328
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Article ; Online: Preface.

Mitrev, Ludmil / Kachulis, Bessie

Best practice & research. Clinical anaesthesiology

2017 Volume 31, Issue 2, Page(s) 139–140

Language	English
Publishing date	2017-06
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	2028818-9
ISSN	1878-1608 ; 1521-6896 ; 1753-3740
ISSN (online)	1878-1608 ; 1521-6896
ISSN	1753-3740
DOI	10.1016/j.bpa.2017.07.008
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Article ; Online: Gender Differences in Authorship and Quality of Anesthesia Clinical Practice Guidelines From 2016 to 2020 Using the Appraisal of Guidelines for Research and Evaluation II Instrument.

Rong, Lisa Q / Martinez, Andrew P / Rahouma, Mohamed / Lopes, Alexandra J / Lee, Jerry Y / Wright, Drew N / Demetres, Michelle / Kachulis, Bessie / O'Shaughnessy, Sinead M

Anesthesia and analgesia

2024

Abstract: Introduction: Women continue to be underrepresented in academic anesthesiology. This study assessed guidelines in anesthesia journals over the past 5 years, evaluating differences in woman-led versus man-led guidelines in terms of author gender, quality, ...

Abstract	Introduction: Women continue to be underrepresented in academic anesthesiology. This study assessed guidelines in anesthesia journals over the past 5 years, evaluating differences in woman-led versus man-led guidelines in terms of author gender, quality, and changes over time. We hypothesized that anesthesia guidelines would be predominately man-led, and that there would be differences in quality between woman-led versus man-led guidelines. Methods: All clinical practice guidelines published in the top 10 anesthesia journals were identified as per Clarivate Analytics Impact Factor between 2016 and 2020. Fifty-one guidelines were included for author, gender, and quality analysis using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Each guideline was assessed across 6 domains and 23 items and given an overall score, overall quality score, and overall rating/recommendation. Stratified and trend analyses were performed for woman-led versus man-led guidelines. Results: Fifty out of 51 guidelines were included: 1 was excluded due to unidentifiable first-author gender. In total, 255 of 1052 (24%) authors were women, and woman-led guidelines (woman-first author) represented 12 of 50 (24%) overall guidelines. Eighteen percent (9 of 50) of guidelines had all-male authors, and a majority (26 of 50, 52%) had less than one-third of female authors. The overall number and percentage of woman-led guidelines did not change over time. There was a significantly higher percentage of female authors in woman-led versus man-led guidelines, median 39% vs 20% (P = .012), as well as a significantly higher number of female coauthors in guidelines that were woman-led median 3.5 vs 1.0, P = .049. For quality, there was no significant difference in the overall rating or objective quality of woman- versus man-led guidelines. However, there was a significant increase in the overall rating of all the guidelines over time (P = .010), driven by the increase in overall rating among man-led guidelines, P = .002. The overall score of guidelines did not increase over time; however, they increased in man-led but not woman-led guidelines. There was no significant correlation between the percentage of female authors per guideline and either overall score or overall rating. Conclusions: There is a substantial disparity in the number of women leading and contributing to guidelines which has not improved over time. Woman-led guidelines included more women and a higher percentage of women. There was no difference in quality of guidelines by first-author gender or percentage of female authors. Further systematic and quota-driven sponsorship is needed to promote gender equity, diversity, and inclusion in anesthesia guidelines.
Language	English
Publishing date	2024-05-20
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.0000000000006803
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Article ; Online: Evaluation of the quality of COVID-19 guidance documents in anaesthesia using the Appraisal of Guidelines for Research and Evaluation II instrument.

O'Shaughnessy, Sinead M / Dimagli, Arnaldo / Kachulis, Bessie / Rahouma, Mohamed / Demetres, Michelle / Govea, Nicolas / Rong, Lisa Q

British journal of anaesthesia

2022 Volume 129, Issue 6, Page(s) 851–860

Abstract: Background: Guidance documents are a valuable resource to clinicians to guide evidenced-based decision making. The quality of guidelines in anaesthesia and across other specialties has been demonstrated to be poor. COVID-19 presented an urgent need for ... ...

Abstract	Background: Guidance documents are a valuable resource to clinicians to guide evidenced-based decision making. The quality of guidelines in anaesthesia and across other specialties has been demonstrated to be poor. COVID-19 presented an urgent need for immediate guidance for anaesthetists as frontline clinicians. The aim of this study was to evaluate the quality of COVID-19 guidance documents using the internationally validated Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Methods: A search was conducted in Ovid EMBASE and Ovid MEDLINE to identify all COVID-19 anaesthesia guidance documents from 2020-2021. Thirty-eight guidance documents were selected for analysis by 4 independent appraisers using the AGREE II instrument, across its 6 domains and 23 items. A scoring threshold for high quality was agreed by the working group via consensus. Results: Overall, the body of COVID-19 guidance documents achieved poor scores using AGREE II. Only 5% of documents met the high-quality criteria. Markers of quality included international and multi-institutional collaboration. Document title ('guideline' vs 'consensus statement'/ 'recommendations') did not yield any differences in domain scores and overall quality ratings. Compared with recent general anaesthesia guidelines, COVID-19 guidelines performed significantly worse. Conclusions: COVID-19 guidance documents published during the first two years of the pandemic lacked rigour and appropriate quality. This raises concern about their trustworthiness for use in clinical practice. Enhanced systems are required to ensure the integrity of rapidly formulated guidance.
MeSH term(s)	Humans ; COVID-19 ; Consensus ; Anesthesia
Language	English
Publishing date	2022-09-20
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2022.09.008
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Article ; Online: Quality of recent clinical practice guidelines in anaesthesia publications using the Appraisal of Guidelines for Research and Evaluation II instrument.

O'Shaughnessy, Sinead M / Lee, Jerry Y / Rong, Lisa Q / Rahouma, Mohamed / Wright, Drew N / Demetres, Michelle / Kachulis, Bessie

British journal of anaesthesia

2022 Volume 128, Issue 4, Page(s) 655–663

Abstract: Clinical practice guidelines are a valuable resource aiding medical decision-making based on scientific evidence. In anaesthesia, guidelines are increasing in both number and scope, influencing individual practice and shaping local departmental policy. ... ...

Abstract	Clinical practice guidelines are a valuable resource aiding medical decision-making based on scientific evidence. In anaesthesia, guidelines are increasing in both number and scope, influencing individual practice and shaping local departmental policy. The aim of this review is to assess the quality of clinical practice guidelines published in high impact anaesthesia journals over the past 5 yr using the internationally validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A literature search was conducted in Scopus to identify all guidelines published in the top 10 anaesthesia journals as per Clarivate Analytics Impact Factor from 2016 and 2020. Fifty-one guidelines were included for analysis by five independent appraisers using AGREE II. Each guideline was assessed across six domains and 23 items. Individual domain scores were calculated with a threshold agreed via consensus to represent high-quality guidelines. There was a significant increase in overall score over time (P=0.041), driven by Domain 3 (Rigour of Development, P=0.046). The raw overall score for Domain 3, however, was low. The other domains performed as expected based on previous studies, with Domains 1, 4, and 6 achieving high scores and Domains 2 and 5 incurring poor ratings. Most guidelines studied involved international collaboration but emerged from a single professional society. Use of an appraisal tool was stated as high but poorly detailed. The improvement in the overall score of guidelines and rigour of development is promising; however, only seven guidelines met high-quality criteria, suggesting room for improvement for the overall integrity of guidelines in anaesthesia.
MeSH term(s)	Anesthesia ; Consensus ; Humans
Language	English
Publishing date	2022-01-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2021.11.037
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Article ; Online: Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1.

Makkad, Benu / Heinke, Timothy Lee / Sheriffdeen, Raiyah / Khatib, Diana / Brodt, Jessica Louise / Meng, Marie-Louise / Grant, Michael Conrad / Kachulis, Bessie / Popescu, Wanda Maria / Wu, Christopher L / Bollen, Bruce Allen

Anesthesia and analgesia

2023 Volume 137, Issue 1, Page(s) 2–25

Abstract: Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal ... ...

Abstract	Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure, thus preventing the risk of developing persistent postoperative pain. This practice advisory is part of a series developed by the Society of Cardiovascular Anesthesiologists (SCA) Quality, Safety, and Leadership (QSL) Committee's Opioid Working Group. It is a systematic review of existing literature for various interventions related to the preoperative and intraoperative pain management of thoracic surgical patients and provides recommendations for providers caring for patients undergoing thoracic surgery. This entails developing customized pain management strategies for patients, which include preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various thoracic surgical procedures. The literature related to this field is emerging and will hopefully provide more information on ways to improve clinically relevant patient outcomes and promote recovery in the future.
MeSH term(s)	Humans ; Pain Management/methods ; Analgesics, Opioid/therapeutic use ; Pain, Postoperative/diagnosis ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Opioid-Related Disorders/prevention & control ; Thoracic Surgical Procedures/adverse effects ; Analgesics
Chemical Substances	Analgesics, Opioid ; Analgesics
Language	English
Publishing date	2023-04-20
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006441
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Practice Advisory for Preoperative and Intraoperative Pain Management of Cardiac Surgical Patients: Part 2.

Anesthesia and analgesia

2023 Volume 137, Issue 1, Page(s) 26–47

Abstract: Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of ... ...

Abstract	Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure. This Practice Advisory is part of a series developed by the Society of Cardiovascular Anesthesiologists (SCA) Quality, Safety, and Leadership (QSL) Committee's Opioid Working Group. It is a systematic review of existing literature for various interventions related to the preoperative and intraoperative pain management of cardiac surgical patients. This Practice Advisory provides recommendations for providers caring for patients undergoing cardiac surgery. This entails developing customized pain management strategies for patients, including preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various cardiac surgical procedures. The literature related to this field is emerging, and future studies will provide additional guidance on ways to improve clinically meaningful patient outcomes.
MeSH term(s)	Humans ; Pain Management/methods ; Analgesics, Opioid/adverse effects ; Pain, Postoperative/diagnosis ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Cardiac Surgical Procedures/adverse effects ; Opioid-Related Disorders ; Analgesics/therapeutic use
Chemical Substances	Analgesics, Opioid ; Analgesics
Language	English
Publishing date	2023-06-16
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006506
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: In Response.

Anesthesia and analgesia

2023 Volume 137, Issue 6, Page(s) e52–e53

Language	English
Publishing date	2023-11-16
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006708
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Intraoperative anesthetic management of lung transplantation patients.

Kachulis, Bessie / Mitrev, Ludmil / Jordan, Desmond

Best practice & research. Clinical anaesthesiology

2017 Volume 31, Issue 2, Page(s) 261–272

Abstract: Lung transplantation is a high-risk procedure that requires a highly trained cardiothoracic anesthesiologist and a considerable degree of vigilance. In the 50 years since the first lung transplantation, improvements in immunosuppression, preservation ... ...

Abstract	Lung transplantation is a high-risk procedure that requires a highly trained cardiothoracic anesthesiologist and a considerable degree of vigilance. In the 50 years since the first lung transplantation, improvements in immunosuppression, preservation solutions, and surgical techniques and technologies have led to increased survival rates. The development of the extracorporeal circulatory membrane oxygenation allowed for bridge to transplantation and for donor organ recovery from primary graft dysfunction post transplantation [1]. In addition, changes in the criteria for lung allocation will cause the anesthesiologist to encounter older recipients with comorbidities that would have been disqualifying for transplantation a decade ago [2].
MeSH term(s)	Anesthesia/methods ; Anesthesia/trends ; Anesthetics/administration & dosage ; Extracorporeal Membrane Oxygenation/methods ; Extracorporeal Membrane Oxygenation/trends ; Humans ; Immunosuppressive Agents/administration & dosage ; Lung Transplantation/methods ; Lung Transplantation/trends ; Monitoring, Intraoperative/methods ; Monitoring, Intraoperative/trends
Chemical Substances	Anesthetics ; Immunosuppressive Agents
Language	English
Publishing date	2017-06
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2028818-9
ISSN	1878-1608 ; 1521-6896 ; 1753-3740
ISSN (online)	1878-1608 ; 1521-6896
ISSN	1753-3740
DOI	10.1016/j.bpa.2017.04.004
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Article ; Online: Acute postoperative management after lung transplantation.

Potestio, Christopher / Jordan, Desmond / Kachulis, Bessie

Best practice & research. Clinical anaesthesiology

2017 Volume 31, Issue 2, Page(s) 273–284

Abstract: Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic ... ...

Abstract	Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure. Maintaining fluid balance, pain control, and preserving renal function also decrease postoperative complications. Advancements in immunotherapy with the use of calcineurin inhibitors and monoclonal antibodies have been shown to decrease the incidence of acute rejection. However, when unexpected complications occur, appropriately timed rescue therapies such as the initiation of extra-corporeal membrane oxygenation, retransplantation, and plasmapheresis are important considerations geared toward a positive transplant outcome.
MeSH term(s)	Graft Rejection/etiology ; Graft Rejection/therapy ; Humans ; Immunosuppressive Agents/administration & dosage ; Lung Transplantation/adverse effects ; Postoperative Care/methods ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Time Factors
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2017-06
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2028818-9
ISSN	1878-1608 ; 1521-6896 ; 1753-3740
ISSN (online)	1878-1608 ; 1521-6896
ISSN	1753-3740
DOI	10.1016/j.bpa.2017.07.004
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