Anesthesia Journals Research Articles

Message by the Editor-in-Chief, Indian Journal of Anaesthesia; Way forward for Science - More opportunities for researchers to publish.

Message by the Editor-in-Chief, Indian Journal of Anaesthesia; Way forward for Science - More opportunities for researchers to publish.

Authorship by gender in anesthesiology journals: a retrospective cross-sectional study for Japan.

Although it is important to recognize gender disparities in publishing to achieve gender diversity, women's authorship in Japan remains unclear. Therefore, this study aimed to investigate the percentage and analyze the trends of articles authored and published in anesthesiology journals by Japanese female authors. The genders of the first and last authors affiliated with Japanese institutions were surveyed in the Journal of Anesthesia (JA) (1990, 1995, and 2000-2022) and 11 international anesthesiology journals (2010-2022). We included 845 and 819 original research articles from JA in the analyses of the first and last authors, respectively. The proportion of female first authors significantly increased from 41 (11.7%) out of 351 before 2009 to 119 (24.1%) out of 494 after 2010 (p < 0.001). The proportion of female last authors was 11 (3.3%) out of 335 before 2009 and 22 (4.5%) out of 484 after 2010, respectively, with no significant difference (p = 0.470). We included 624 and 572 original research articles from international anesthesiology journals in the analyses of first and last authors, respectively. Among these, there were 134 (21.5%) and 23 (4.0%) female first and last authors, respectively. These proportions in international anesthesiology journals did not significantly differ from those in JA (p = 0.334, p = 0.789, respectively). The percentage of female first authors has increased, commensurate with the percentage of female anesthesiologists. However, the percentage of female last authors has not increased and remains low in Japan.

Commentary on the article "Chronic obstruction of the stomach as a result of congenital malformation in a child of 1.10 months. Case report"

Commentary on the article Schneider IS, Tsap NA, Gaydysheva EV, Timoshinov MYu, Ekimov MN, Smirnova SE. Chronic obstruction of the stomach as a result of congenital malformation in a child of 1.10 months. Case report published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2022;12(4):513520. (In Russ.) DOI: https://doi.org/10.17816/psaic1283

Women Authorship Trends in the Highest-Impact Anesthesiology Journals from 2005 to 2021.

Background: Although women and men have matriculated into medical schools in similar proportions since the 1980s, recent data indicate that anesthesiology is lagging in gender equity, especially in academic leadership roles.1,2 As promotion in academic medicine is strongly influenced by publications, understanding whether a lack of women authorship is contributing to this gender gap is crucial.3,4 This article aims to assess how woman authorship trends have changed in the last 16 years, including during the COVID-19 pandemic. Materials and Methods: The five highest impact journals in anesthesia were identified as Journal of Clinical Anesthesia, British Journal of Anaesthesia, Anesthesiology, PAIN, and Regional Anesthesia & Pain Medicine. Number of total authors, including women, men, and unknown gender authors as well as incidence of woman first and/or last author, was documented from articles published in 2005, 2010, 2015, 2020, and 2021. Results: This analysis shows that women are gaining representation in anesthesia publications. Overall, there was a statistically significant increase in the total number of women authors and women first and last authorship. However, as of 2021, women still only represented ∼40% of total and first authors and ∼24% of last authors. In addition, increase in first/last woman authorship was not present in all journals when stratified. Conclusion: These journal differences may suggest the editorial evaluation process as a potential source of gender bias. There was a statistically significant relationship between women senior authors and articles with 50% or more women authors, indicating that woman mentorship is contributing to closing equity gap. These data present a starting point for further investigations into gender disparities within anesthesia to continue the forward progression for women in academic medicine.

Anesthesiology 2023: Ch-ch-ch-ch-changes.

Anesthesiology 2023: Ch-ch-ch-ch-changes.

Comparison of intrathecal bupivacaine with different doses of clonidine for spinal anesthesia in adults: A systematic review

Background: Evaluating the optimal dose of intrathecal clonidine adjuvant has a great impact on day-to-day practice of anesthesia, as spinal anesthesia is one of the most commonly performed anesthetic procedure.Objectives: Evaluate for the minimal dose of intrathecal clonidine as an adjunct to bupivacaine heavy for spinal anesthesia that can produce optimal sensory and motor blockade with minimal hemodynamic effects.Methods: Randomized control trials carried out on adult patients, of both genders undergoing elective infraumbilical surgeries under spinal anesthesia with bupivacaine heavy and different doses of clonidine having ethical committee approval were included and articles published in non-English languages were excluded. Databases (PubMed and Google Scholar) and websites of the Indian Journal of Anaesthesia and anesthesia essays and researches journals were systematically searched and interpreted in accordance with the PRISMA guidelines. Quality assessment was done using the Risk of Bias assessment 2.O tool. The mean time taken for the onset of sensory and motor blockade, mean duration of sensory and motor blockade and significant adverse effects were the key outcome variables. Nonstatistical synthesis of quantitative data of the selected articles was done.Results: The efficacy in terms of sensory and motor blockade was comparatively more with 1 μg/kg of intrathecal clonidine than with lower doses, however, cardiovascular adverse effects were dose-dependent, with 15 μg intrathecal clonidine causing least cardiovascular disturbance.Conclusion: 15–30 μg intrathecal clonidine as an adjunct to bupivacaine heavy would produce optimal sensory and motor block with minimal hemodynamic disturbances.

Minimum false-positive risk of primary outcomes and impact of reducing nominal P-value threshold from 0.05 to 0.005 in anaesthesiology randomised clinical trials: a cross-sectional study

BackgroundReproducibility of research is poor; this may be because many articles report statistically significant findings that are false positives. Two potential solutions are to lower the P-value for statistical significance testing from 0.05 to 0.005 and to report the minimum false-positive risk (minFPR). This study determined these metrics for randomised controlled trials (RCTs) in general anaesthesiology journals. MethodsWe identified superiority RCTs published between January 1, 2019 and March 15, 2021 from seven leading anaesthesia journals. P-values for primary outcomes were collected, and minFPRs for these outcomes were calculated using a formula assuming a 50% prior probability of an intervention being effective (minFPR50). The primary outcomes were the percentage of RCTs maintaining statistical significance at P<0.005 and minFPR50. ResultsWe included 318 RCTs. P-values below 0.05 were reported in 205/318 (64%) of RCTs. Of these 205 RCTs, 119/205 (58%) maintained statistical significance at the P<0.005 threshold. The mean (standard deviation) minFPR50 was 22% (20). At P=0.005, the minFPR50 was approximately 5%. ConclusionsThese proposed metrics aimed at mitigating reproducibility concerns would call a significant portion of the anaesthesiology literature into question. We found a minFPR of 22% and determined that 42% of primary outcomes would not maintain statistical significance if the P-value threshold changed from 0.05 to 0.005. These findings could partially explain the lack of reproducibility of research findings.

The trends for the “trend toward significance” in the pediatric literature

PurposeThis study is to examine whether the term “trend toward statistical significance” is used to describe statistically nonsignificant results in biomedical literature. We examined articles published in five high-impact pediatric journals, including The Lancet Child & Adolescent Health, The Journal of Pediatrics, Early Human Development, Frontiers in Pediatrics, and BMC Pediatrics to identify manuscripts where a “trend” was used to describe a statistically nonsignificant result, from January 2020 to December 2021, and, furthermore, for The Journal of Pediatrics, Early Human Development, and BMC Pediatrics from January 2010 to December 2011. We detected that a “trend toward significance” was used to describe a statistically nonsignificant result at least once in 146 articles (2.7%) during the period between 2020 and 2021 and in 97 articles (4.0%) during the period between 2010 and 2011. We found no significant difference in the proportion of published articles with inappropriate use of “trend” across journals belonging to the first quartile of impact compared to the second quartile or across journals publishing under the subscription model or open access policy compared to journals publishing solely under the open access policy, in any period. The overall proportion of the inappropriate use of “trend” declined significantly between 2010 and 2011 to 2020 and 2021 (p = 0.002, RR 0.66 95% CI 0.51–0.86).Conclusion: “Trend” statements were sporadically used to describe statistically nonsignificant results across pediatric literature. The inappropriate use of “trend” to describe almost significant differences could be misleading, and “trend” should be reserved only when a specific statistical test for trend has been performed, or in relation to appropriate scientific definitions.What is Known:•Previously, researchers have reported inappropriate use of “trend” in articles across anaesthesia or major oncology journals.•In many cases, hypothesized results that are close but not lower than the statistical significance threshold are emphasized as “almost” significant.What is New:•“Trend” statements were sporadically used to describe statistically nonsignificant results across pediatric literature.•Inappropriate use of “trend” was similar in journals with a subscription model compared to those having an open access policy and decreased within a 10-year period.

Reviewing COVID-19 from an anesthesiologist's perspective in 2022: JA symposium.

The COVID-19 pandemic is ongoing as of September 2022. Since January 2020 when the first case was reported in Japan, the medical community faced a variety of problems both domestically and internationally. It is meaningful to review the impact of COVID-19 from an anesthesiologist's perspective to clarify our policy for future infectious disease outbreaks. In this year's Journal of Anesthesia (JA) symposium, five experts who were deeply involved in the COVID-19 response reviewed the past 2.5years and made recommendations for potential future pandemics. Anesthesiologists are specialists in airway management and their role in intubating patients with COVID-19 has received much attention. However, they have also played an important backup role in intensive care as critical care physicians and must be more involved in critical care in regular (non-pandemic) times to properly fulfill this role. It is especially important for the Japan Society of Anesthesiologists and JA to quickly disseminate accurate information on unknown infectious diseases to the medical community and wider society. Therefore, it is important to promptly publish papers that are quality-assured through peer review.

Innovation in simulation: reducing the cost

Simulation equipment is often prohibitively expensive. More so for smaller remote settings and developing countries. Reducing costs is essential to increase widespread uptake of high-fidelity simulation tools. We describe the evolution of a cooperative simulation model development team incorporating the local Emergency Medicine Department clinical staff and local Secondary school pupils. This was a symbiotic relationship that utilised the clinical expertise of the doctors while giving the students project management experience while using the significant resources of the schools for physical product development. Roughly 15,000 tracheostomies are performed each year in the UK. After looking further in depth at emergency tracheostomies, we recognised a gap in this area of healthcare training [1]. Consequently, developing a surgical airway trainer was selected as the model to produce over the course of an academic year. The partnership project required infrequent visit from the clinical team to inform on clinical particulars and review model progression. Ultimately 2 models were selected from various prototypes to take to completion. These represented 3 core areas we wished to develop. The first model was a high-fidelity model completed using latest technology available in the school’s workshops. The second was built with minimal technology and aimed to be reproducible following simple instructions with widely available materials and be completely biodegradable. This project resulted in successful development of two surgical airway models – both clinically and anatomically accurate, reusable, which deliver high quality simulation to a group of doctors and students at the local hospital. Both models are easily reproducible with minimal skills, but varied in both the detail and tools required to produce and degree of sustainability. Maximum cost of materials was £15. Partnership with local schools gives hospitals access to resources not otherwise available that can lead to the development of innovative simulation models that can significantly reduce the cost of simulation. Both parties gain significantly from this partnership. Going forwards we aim to continue the partnership with aims to develop a central line training model over the next academic year. 1. Taylor C. Training for tracheostomy. BJA: British Journal of Anaesthesia. 2013;111(5):842–843.

In-situ obstetric simulation – ticking all the boxes

Simulation is increasingly valued as a versatile and effective tool for medical education [1]. This is even timelier with the recent release of the Ockenden Report which recommends in-situ simulation in obstetric units to promote safety [2]. With the recent change of speciality training curricula, especially in anaesthetics, there has been an increased requirement for simulation-based training. However, the COVID-19 pandemic has had a significant negative impact on medical training, both in terms of clinical breadth and opportunities for educational activities [3]. In order to tackle all these requirements, we developed an in-situ multidisciplinary obstetric simulation programme. This was supported by the anaesthetic simulation fellow, obstetric anaesthetic lead and fellow and obstetric safety fellow, together with senior midwifery input. This allowed simulation development, running and debriefing to benefit from the skill and experience of a multidisciplinary team. The local simulation centre provided technical support which allowed us to take the simulation to multiple locations on the labour ward. Learners were from anaesthetic, midwifery, theatre, and operating department practitioner backgrounds and we conducted this simulation programme as three-monthly sessions corresponding with trainees’ rotations. The scenarios were based around previous critical incidents while ensuring the psychological safety of the candidates. This demonstrates an open learning culture where lessons learnt can be shared and patient safety prioritised. It was also be useful in applying a systems approach to understanding how errors occurred. Feedback confirmed the in-situ aspect of this session provided experiential learning and improved familiarity of the environment. This was especially pertinent as the sessions were conducted with trainees new to the department. It also allowed midwifery and theatre staff to take part in the session who otherwise may not have. A multidisciplinary approach allowed flattening of team hierarchy as shown by feedback. We ensured challenges associated with in-situ simulation were met with the team ready to respond to clinical needs in the department. No simulated equipment or medication was used and all documentation was labelled appropriately. Obstetric emergencies can be life changing and can significantly affect those involved. This simulation session addressed several learning needs while rising to the challenges of in-situ simulations. We hope to continue developing this programme with more specialities represented and integrating learning from critical incidents while ensuring psychological safety. 1. Higham H, Baxendale B. To err is human: use of simulation to enhance training and patient safety in anaesthesia. BJA: British Journal of Anaesthesia. 2017;119(suppl_1):i106–14. 2. Ockenden D. Emerging findings and recommendations from the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust. House of Commons. 2020 Dec 10. 3. Seifman MA, Fuzzard SK, To H, Nestel D. COVID-19 impact on junior doctor education and training: a scoping review. Postgraduate medical journal. 2022;98(1160):466–76.

Creating an easy to construct, low-cost aspiration simulator for airway training

Aspiration of gastric contents remains the commonest cause of death during anaesthesia, accounting for 50% of deaths and occurring more frequently than cannot intubate, cannot oxygenate (CICO) events [1]. Despite this, training for CICO is ubiquitous while rehearsal of aspiration management is rare. Soiled airway simulation has been shown to reduce the time to intubation with less volume entering the lungs, a factor known to correlate with the severity of aspiration [2]. Initially developed by Dr DuCanto, high-fidelity vomit simulators have existed since 2014 however cost (£1,595) precludes their widespread use. Low-cost models have since been described, however, the materials are sourced from hardware stores, relatively expensive, require skills to construct, utilise noisy pumps, and some even require electrical safety considerations [3]. We aimed to improve access to aspiration training by designing an aspiration simulator that is easy to construct and low-cost. Employing an iterative design process we created an aspiration simulator using materials readily available in the operating theatre. The final model requires an intubatable manikin with an oesophagus, such as the Laerdal Airway Management Trainer The setup silently produces a titratable flow of up to 250 ml per minute, sufficient to flood the oropharynx within 30 seconds. The simulation itself can be set up in under 10 minutes, used several times before requiring refilling, and is easily transported between theatres as a part-task trainer or concealed for a multi-disciplinary simulation (Figure 1, bottom left). All parts are reusable and the total cost equals £9.90 (excluding the manikin, which is undamaged). Our simulator was tested on a cohort of 16 middle-grade anaesthetic trainees and its performance was evaluated using pre and post-course questionnaires (scale 0–10). All successfully intubated the simulator. Average user-rating scores for realism were 8.4/10 while confidence in managing soiled airways improved from 6.2/10 to 8.9/10 after exposure to the simulation. Soiled airway simulation can be simple and affordable, creating a realistic environment to practise the unique skills necessary to manage this important yet under-rehearsed cause of death during anaesthesia. 1. Cook T, Woodall N, Frerk C. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: Anaesthesia †. British Journal of Anaesthesia. 2011;106(5):617–631 2. Jensen M, Louka A, Barmaan B. Effect of Suction Assisted Laryngoscopy Airway Decontamination (SALAD) Training on Intubation Quality Metrics. Air Medical Journal. 2019;38(5):325. 3. Sampson C, Pauly J, Horner J. Low-cost Portable Suction-Assisted Laryngoscopy Airway Decontamination (SALAD) Simulator for Dynamic Emesis. Journal of Education and Teaching in Emergency Medicine. 2019;4(2).

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2022

This special article is the 15th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief Dr. Kaplan and the editorial board for the opportunity to continue this series, namely the research highlights of the past year in the specialties of cardiothoracic and vascular anesthesiology. The major themes selected for 2022 are outlined in this introduction, and each highlight is reviewed in detail in the main body of the article. The literature highlights, in the specialties for 2022, begin with an update on COVID-19 therapies, with a focus on the temporal updates in a wide range of therapies, progressing from medical to the use of extracorporeal membrane oxygenation and, ultimately, with lung transplantation in this high-risk group. The second major theme is focused on medical cardiology, with the authors discussing new insights into the life cycle of coronary disease, heart failure treatments, and outcomes related to novel statin therapy. The third theme is focused on mechanical circulatory support, with discussions focusing on both right-sided and left-sided temporary support outcomes and the optimal timing of deployment. The fourth and final theme is an update on cardiac surgery, with a discussion of the diverse aspects of concomitant valvular surgery and the optimal approach to procedural treatment for coronary artery disease. The themes selected for this 15th special article are only a few of the diverse advances in the specialties during 2022. These highlights will inform the reader of key updates on a variety of topics, leading to the improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.

To the 75th anniversary of Vladimir I. Petlakh

The paper describes the professional activities and merits of the pediatric surgeon, science editor of Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, Vladimir I. Petlakh in celebration of his anniversary.

Overview of statistical methods usage in Indian anaesthesia publications.

Despite the importance of statistics being well established for medical research, it remains a neglected area of understanding and learning. The present survey aimed to examine the use of various statistical methods in a two-year sample (2019-2020) of representative Indian anaesthesia journals and compare it with an international top-ranked journal. The literature survey included analysis of 748 original articles from 'Indian Journal of Anaesthesia' (179), 'Journal of Anaesthesiology Clinical Pharmacology' (125) and 'Anesthesia & Analgesia' (444) published over the period. Original research articles were identified from the table of contents of each issue. Articles were assessed for statistical methods, categorised as being descriptive, elementary, multivariable, advanced multivariate or diagnostic/classification. Compared to Anesthesia & Analgesia, the Indian journals (considered together) had a significantly greater use of mean (standard deviation) (91.2% versus 70%) and percentages (79.5% versus 67.6%) (P = 0.000 each); and lesser for Wilcoxon (5.4% versus 14.6%) and Pearson/Spearman (5.1% versus 13.5%) correlation tests (P = 0.000 each), multivariable tests including various regression methods (P < 0.001), classification/diagnostic tests [Receiver operating characteristic (ROC) curve analysis, P = 0.022; sensitivity/specificity, P = 0.000; precision, P = 0.006; and relative risk/risk ratio, P = 0.010] and a virtual absence of complex multivariate tests. The findings show limited use of advanced complex statistical methods in Indian anaesthesia journals, usually being restricted to descriptive or elementary. There was a strong bias towards using randomised controlled designs. The findings suggest an urgent and focussed need on training in research methodology, including statistical methods, during postgraduation and continued medical training.

Pushing Propofol and Gender Equity-Female Authorship in Anesthesia Publications.

Purpose: While women and men have graduated from medical school in similar proportions since 2009, some specialties, such as anesthesia, have lagged behind in equal gender representation. This difference is especially evident when it comes to academic leadership roles. 1,2 As promotion in academic medicine is influenced by scholarly activities including research and publication, it is important to understand if a lack of women’s authorship in anesthesia publications is contributing to this gender gap. 3,4 This paper aims to assess how women’s authorship trends have changed in the last 15 years. Method: The 3 highest-impact journals in anesthesia were identified using InCites Journal Citation Reports. These were the Journal of Clinical Anesthesia, British Journal of Anesthesia, and Anesthesiology. Data was collected from articles published in 2005, 2010, 2015, and 2020. For each article, number of total authors, women authors, male authors, authors of unknown gender, and the presence or absence of a woman first and/or last author were recorded. A total of 750 articles were included in the study. Results: There was a statistically significant increase in the total number of women authors listed over the 15-year period with 21.9% women authors in 2005 and 32.5% in 2020. This was true in all 3 journals when stratified. Women’s first authorship increased from 18.8% of articles in 2005 to 29.2% in 2020. When stratified by journal, increase in women first authors was only significant for Anesthesiology. Women’s last authorship rose from 9.2% in 2005 to 20.1% in 2020. Increase in women last authors was only significant in The British Journal of Anaesthesiology. There was a statistically significant relationship between women senior authors and articles with 50% or more women authors. Only 14.7% of articles with male senior authors had 50% or more women authors compared with 53.2% of publications with women senior authors. This trend remained significant when stratified by year. Discussion: This analysis shows that women are slowly gaining representation in academic publications in the top journals in anesthesia. In the last 15 years, there has been an upward trend not only in the number and proportion of women authors but also in women last and first authors. While this is encouraging news for the progress of gender equity in academic medicine and anesthesia, a closer look at the numbers shows there is more work to be done. As of 2020, women still only represented ~30% of total and first authors and ~20% of last authors in the journals surveyed. This disparity remains important as senior authorship in particular can be important in advancing in academic leadership. 3,4 As recently as 2016, just 7.4% of women in anesthesiology were full professors compared with 17.3% of their male counterparts and only 14% of anesthesiology department chairs were women. 1 Significance: These data present a starting point for further investigation into contributing issues to the gender disparities seen within anesthesia. For example, the difference in number of articles with 50% or more women authors with men versus women senior authors should be considered. This may point to a lack of mentorship from women playing a role in the gender gap. Additionally, not all journals showed a significant increase in women’s first and last authorship when stratified. Although this may be due to lower statistical power from a decreased sample size, the editorial evaluation process for article acceptance presents as a potential source of gender bias. These among other issues must be identified and addressed to continue the forward progress in gender equity in anesthesia.

Editorial introductions.

Current Opinion in Anesthesiology was launched in 1988. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of anesthesiology is divided into 16 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Anthony AbsalomAnthony AbsalomProf. Anthony Absalom studied medicine at the University of Cape Town, South Africa, and underwent specialist training in East Anglia and Scotland in the UK. He is currently Professor of Anaesthesiology at the University Medical Center Groningen, Netherlands. His clinical interests are procedural sedation, anaesthesia for neurosurgery, and intravenous anaesthesia techniques. His research interests are mostly in the domains of pharmacology and neuroscience. He is an editor of the British Journal of Anaesthesia, past President of the Society for Intravenous Anaesthesia, and a former vice-president of the World Society for Intravenous Anaesthesia. He is currently Chairman of the Neuroanaesthesia Section of the Dutch Association of Anaesthetists and past-Chair of the General Anaesthesia Scientific Sub-committee of the European Society of Anesthesiology. Ellen SoffinEllen SoffinEllen M. Soffin, MD, PhD is an Associate Professor of Anesthesiology, Weill Cornell Medical College, New York, USA and an anesthesiologist at Hospital for Special Surgery, New York, USA. She is the Director of the Anesthesia-Spine Service, and Co-Director of the Hospital for Special Surgery's interdisciplinary spine research program. Dr Soffin earned her medical degree at King's College Medical School, London, UK and PhD in neuroscience at Edinburgh University, Edinburgh, UK, before moving to the United States. She completed residency training in anesthesiology at The Johns Hopkins Hospital, Baltimore, Maryland, USA and a fellowship in regional anesthesia and acute pain medicine at Hospital for Special Surgery. Dr Soffin's research interests include evaluating the role and value of field and fascial plane blocks for the spine surgery patient; optimizing surgical outcomes using enhanced recovery pathways for total joint arthroplasty and spine surgery; and implementation of regulatory, institutional, and clinical strategies for opioid stewardship programs. She has published extensively on outcomes related to pathway-based care, regional analgesia techniques, and opioid-minimizing approaches to the perioperative care of the orthopedic surgery patient. Dr Soffin serves on the editorial board of Regional Anesthesia & Pain Medicine and is the Section Editor, Acute Pain and Perioperative Care, for Journal of Pain Research. She is an active faculty member of American Society of Regional Anesthesia & Pain Medicine, the American Academy of Pain Medicine, and the Society of Anesthesia & Sleep Medicine, where she is the co-chair of the research committee.

A POTENTIALLY UNDER-RECOGNIZED COMPLICATION OF POSITIVE PRESSURE VENTILATION: ACUTE HYPOCALCEMIA

A POTENTIALLY UNDER-RECOGNIZED COMPLICATION OF POSITIVE PRESSURE VENTILATION: ACUTE HYPOCALCEMIA

The hotspots and publication trends in postoperative delirium: A bibliometric analysis from 2000 to 2020.

BackgroundPostoperative delirium (POD) is a common aging-associated postoperative complication that has received increasing attention in the context of the aging global population and the number of articles published on POD is gradually increasing. This study aimed to quantify the basic information of scholarly publications on POD and identify the most impactful literature, trends, and hotspots in POD research.Materials and methodsWe searched articles on POD through the Science Citation Index Expanded databases published from 2000 to 2020. Bibliographic information, including year, country, authorship, type, journal, funding, affiliations, subject areas, and hotspots, was collected for further analysis.ResultsA total of 2,114 articles on POD from 2000 to 2020 were identified. The highest number of studies (n = 748) were published in the United States, comprising the most total citations (13,928), followed by China (n = 278), and Germany (n = 209). Inouye, Sharon K. was the most productive author, with 66 publications on POD. The Journal of the American Geriatrics Society published the highest number of articles (n = 80), with the most total citations (4,561) and average (57.01), followed by Anesthesia and Analgesia (n = 52), and the British Journal of Anaesthesia (n = 43). Harvard University was the most productive institute, with the highest H-index (n = 46) and highest degree centrality (n = 191). The top hotspots in the field of POD during this period were “elderly,” “cardiac surgery,” “cognitive impairment,” “hip fracture,” and “intensive care unit.”ConclusionThis study provides an overview of developments in the field of POD over the past 20 years using bibliometric analysis. Overall, research on POD has flourished worldwide. The United States (US) has a relatively high academic impact owing to its productive expertise and institutions in this field. Despite much research illustrating the diagnosis and management of POD in clinical practice, more basic research is needed.

Kristin Schreiber, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

Kristin Schreiber, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award