翻译：史晨阳 徐州医科大学2024级麻醉学研究生
审校：赵林林 徐州医科大学附属医院麻醉科
《Minerva Anestesiologica》 2024年7-8月刊
《Minerva Anestesiologica》 2024年9月刊
《Minerva Anestesiologica》 2024年10月刊
EDITORIAL
1.The role of interleukin-6 in septic patients: why biomarkers cannot substitute our brain
白细胞介素-6 在败血症患者中的作用：为什么生物标志物不能替代我们的大脑？
POSITION PAPER
1.Recommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement
关于成人心脏手术患者快通道拔管的建议：共识声明
ORIGINAL ARTICLE
1.Individualized positive end-expiratory pressure in laparoscopic surgery: a randomized controlled trial
腹腔镜手术中的个性化呼气末正压：随机对照试验
BACKGROUND: The reduction in functional residual capacity (FRC) is a significant pathological factor in the development of postoperative pulmonary complications. Appropriate positive end-expiratory pressure (PEEP) is critical to preserve FRC during mechanical ventilation. Our previous study suggests that using driving pressure-guided PEEP can reduce postoperative pulmonary complications. In this study, we hypothesize that individualized PEEP can increase immediate postoperative FRC and improve lung ventilation.
背景：功能残气量（FRC）的降低是导致术后肺部并发症的一个重要病理因素。在机械通气过程中，适当的呼气末正压（PEEP）对保持功能残气量至关重要。我们之前的研究表明，使用驱动压力引导的PEEP可以减少术后肺部并发症。在本研究中，我们假设个体化PEEP可以提高术后即刻FRC并改善肺通气。
METHODS: This single-centered, randomized controlled trial included a total of 91 patients scheduled for laparoscopic surgery for colorectal carcinoma. Patients were randomly assigned to receive individualized PEEP guided by minimum driving pressure or a fixed PEEP of six cmH2O. The primary outcome was postoperative FRC. Secondary outcomes included the incidence of postoperative pulmonary complications, postoperative Oxygenation Index, alveolar-arterial oxygen tension difference (PA-aO2), intrapulmonary shunt (QS/QT), and Respiratory Index, as well as lung ventilation measured by electrical impedance tomography.
方法：这项单中心随机对照试验共纳入 91 名计划接受腹腔镜结直肠癌手术的患者。患者被随机分配接受以最低驱动压力引导的个性化 PEEP 或 6 cmH2O 的固定PEEP。主要结果是术后FRC。次要结果包括术后肺部并发症的发生率、术后氧合指数、肺泡-动脉氧分压差（PA-aO2）、肺内分流（QS/QT）、呼吸指数以及电阻抗断层扫描测量的肺通气量。
RESULTS: The median value of PEEP in the individualized group was 14 cmH2O, with an interquartile range of 12-14 cmH2O. The postoperative FRC was significantly higher in the individualized PEEP group than that in the PEEP six cmH2O group (32.8 [12.8] vs. 25.0 [12.6] mL/kg, P=0.004). Patients receiving driving pressure-guided PEEP also had significantly higher Oxygenation Index, better ventilation distribution, and lower PA-aO2, QS/QT, and Respiratory Index.
结果：个体化组的PEEP中位数为14 cmH2O，四分位距为12-14 cmH2O。个体化PEEP组的术后FRC明显高于PEEP 6 cmH2O组（32.8 [12.8] vs 25.0 [12.6] mL/kg，P=0.004）。接受驱动压引导的PEEP的患者的氧合指数也明显更高，通气分布更好，PA-aO2、QS/QT 和呼吸指数更低。
CONCLUSIONS: Driving pressure-guided PEEP can preserve postoperative FRC and provide better ventilation and oxygenation for patients undergoing laparoscopic colorectal surgery.
结论：驱动压引导的 PEEP 可以保护术后FRC，为腹腔镜结直肠手术患者提供更好的通气和氧合。
2.Maximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy
在接受腹腔镜胆囊切除术的患者中，通过腹外斜肌肋间肌阻滞或改良经肋软骨膜入路胸腹神经阻滞获得的皮肤感觉阻滞的最大延伸范围和消退速度
3.Effect of non-invasive bilateral sphenopalatine ganglion block on postoperative pain in patients undergoing septorhinoplasty surgery: a randomized controlled study
无创双侧蝶腭神经节阻滞对鼻中隔成形术患者术后疼痛的影响：随机对照研究
4.Sex related differences in applied tidal volume with flow-controlled ventilation: a subgroup analysis
使用流量控制通气时潮气量的性别差异：亚组分析
BACKGROUND: Flow-controlled ventilation (FCV) ensures a constant gas flow whereby precise determination of dynamic compliance is feasible. Accordingly, ventilator pressure settings can be adjusted to achieve the highest compliance. This setting will automatically adapt tidal volume to the functionally available lung volume as a personalized approach. This is in contrast to current ventilation settings, where fixed tidal volumes according to predicted body weight (PBW) are recommended. Aim of this subgroup-analysis was to determine whether applied tidal volume differs in male and female patients after compliance guided individualization of ventilation parameters.
背景：流量控制通气（FCV）可确保气体流量恒定，从而精确地确定动态顺应性。因此，可以调整呼吸机压力设置以实现最佳肺顺应性。作为一种个性化方法，这种设置会根据肺功能可用容量自动调整潮气量。这与当前的通气设置不同，当前的通气设置建议根据预测体重（PBW）使用固定的潮气量。本亚组分析旨在确定在肺顺应性指导的通气参数个体化后，男性和女性患者的潮气量是否存在差异。
METHODS: A sub-group analysis of 24 patients randomized to receive flow-controlled ventilation in cardiac surgery was performed. Linear mixed-effects model was used in order to investigate sex related differences in respiratory parameters.
方法：对心脏手术中接受流量控制通气的随机24名患者进行了分组分析。采用线性混合效应模型研究呼吸参数的性别差异。
RESULTS: Compliance guided pressure titration led to comparable pressure settings in male (N.=18) and female (N.=6) patients. In contrast, the applied tidal volume was significantly lower in female patients (8.6 vs. 9.9, 95% CI: -2.3 to -0.2 mL/kg PBW; P=0.029) compared to male individuals, due to a significantly lower compliance (49.3 vs. 70.3, 95% CI: -33.1 to -8.8 mL/cmH2O; P=0.003). Gas exchange parameters were comparable in either sex.
结果：经肺顺应性指导的压力滴定，男性患者（18 人）和女性患者（6 人）的压力设置相当。相比之下，女性患者的潮气量明显低于男性（8.6 vs. 9.9，95% CI：-2.3 to -0.2 mL/kg PBW；P=0.029），原因是顺应性明显降低（49.3 vs. 70.3，95% CI：-33.1 to -8.8 mL/cmH2O；P=0.003）。男女的气体交换参数相当。
CONCLUSIONS: Female patients were found to receive lower tidal volumes after compliance guided individualization compared to men during cardiac surgery. This finding may indicate that the functionally available lung volume in women is lower and thus using PBW may not adequately comply with sex related differences, which supports the use of a personalized ventilation strategy.
结论：与男性相比，女性患者在心脏手术中接受顺应性引导的个体化通气后潮气量较低。这一发现可能表明，女性的肺功能可用容积较低，因此使用PBW可能无法充分满足与性别相关的差异，这支持了个性化通气策略的使用。
5.Beliefs and attitudes of PICU doctors and nurses on parental presence and open visiting policies: an Italian nationwide survey
PICU医生和护士对父母陪伴和开放探视政策的看法和态度：意大利全国调查
REVIEW
1.Ciprofol versus propofol for adult sedation in gastrointestinal endoscopic procedures: a systematic review and meta-analysis
胃肠镜手术中成人镇静的环泊酚与丙泊酚的比较：系统综述和荟萃分析
2.The anesthetic implications of lumbar tattoos
腰部纹身的麻醉影响
3.Multimodal analgesic strategies in polytraumatized patients
多发创伤患者的多模式镇痛策略
4.Diagnostic value of circulating IL-6 in adult sepsis: a meta-analysis
循环 IL-6 在成人败血症中的诊断价值：一项荟萃分析
LETTERS TO THE EDITOR
1.Alternatives for erector spinae plane block: retrolaminar block and thoracolumbar interfascial plane block
竖脊肌平面阻滞的替代方法：椎板后阻滞和胸腰筋膜间平面阻滞
2.Hip replacement using pericapsular nerve blocks in a high-risk patient
在高风险患者中使用囊周神经阻滞进行髋关节置换术
3.Which place for hyperbaric oxygen therapy in Intensive Care Unit and operating room?
在ICU和手术室的哪个地方进行高压氧治疗？
4.Combined awake intubation technique for predicted difficult airways in a patient with thyroid goiter
预计困难气道的甲状腺肿大患者的联合清醒插管技术
5.A novel technique to exchange tracheal tubes using an Aintree Intubation CatheterTM over an airway exchange catheter
在气道交换导管上使用 Aintree 插管导管的交换气管导管的新技术
6.Serratus posterior superior intercostal plane block for postoperative analgesia in clavicle surgeries: new indications for a novel block
用于锁骨手术术后镇痛的后上锯肌肋间平面阻滞：新型阻滞的新适应症
7.The need for consistent epidemiological data on chronic pain in Italy and beyond
意大利及其他国家需要一致的慢性疼痛流行病学数据
