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Anesthesiology Dec 2019Commercial applications of artificial intelligence and machine learning have made remarkable progress recently, particularly in areas such as image recognition, natural... (Review)
Review
Commercial applications of artificial intelligence and machine learning have made remarkable progress recently, particularly in areas such as image recognition, natural speech processing, language translation, textual analysis, and self-learning. Progress had historically languished in these areas, such that these skills had come to seem ineffably bound to intelligence. However, these commercial advances have performed best at single-task applications in which imperfect outputs and occasional frank errors can be tolerated.The practice of anesthesiology is different. It embodies a requirement for high reliability, and a pressured cycle of interpretation, physical action, and response rather than any single cognitive act. This review covers the basics of what is meant by artificial intelligence and machine learning for the practicing anesthesiologist, describing how decision-making behaviors can emerge from simple equations. Relevant clinical questions are introduced to illustrate how machine learning might help solve them-perhaps bringing anesthesiology into an era of machine-assisted discovery.
Topics: Algorithms; Anesthesiology; Artificial Intelligence; Humans; Machine Learning
PubMed: 30973516
DOI: 10.1097/ALN.0000000000002694 -
BMC Anesthesiology Mar 2019
Topics: Anesthesiology; Animals; Humans; Organ Transplantation; Specialization
PubMed: 30832567
DOI: 10.1186/s12871-019-0704-z -
Anesthesiology Jul 2008
Topics: American Heart Association; Anesthesiology; Humans; Science; United States
PubMed: 18580163
DOI: 10.1097/ALN.0b013e31817c1ad2 -
Anesthesiology Jan 2020
Topics: Anesthesiology; Biomedical Research; Humans; Research Subjects
PubMed: 31789636
DOI: 10.1097/ALN.0000000000003026 -
Anesthesia and Analgesia Feb 2022Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with... (Review)
Review
Ensuring a productive clinical and research workforce requires bringing together physicians and communities to improve health, by strategic targeting of initiatives with clear and significant public health relevance. Within anesthesiology, the traditional perspective of the field's health impact has focused on providing safe and effective intraoperative care, managing critical illness, and treating acute and chronic pain. However, there are limitations to such a framework for anesthesiology's public health impact, including the transient nature of acute care episodes such as the intraoperative period and critical illness, and a historical focus on analgesia alone-rather than the complex psychosocial milieu-for pain management. Due to the often episodic nature of anesthesiologists' interactions with patients, it remains challenging for anesthesiologists to achieve their full potential for broad impact and leadership within increasingly integrated health systems. To unlock this potential, anesthesiologists should cultivate new clinical, research, and administrative roles within the health system-transcending traditional missions, seeking interdepartmental collaborations, and taking measures to elevate anesthesiologists as dynamic and trusted leaders. This special article examines 3 core themes for how anesthesiologists can enhance their impact within the health care system and pursue new collaborative health missions with nonanesthesiologist clinicians, researchers, and administrative leaders. These themes include (1) reframing of traditional anesthesiologist missions toward a broader health system-wide context; (2) leveraging departmental and institutional support for professional career development; and (3) strategically prioritizing leadership attributes to enhance system-wide anesthesiologist contributions to improving overall patient health.
Topics: Anesthesiologists; Anesthesiology; Career Mobility; Humans; Leadership; Physician-Patient Relations
PubMed: 33684091
DOI: 10.1213/ANE.0000000000005428 -
British Journal of Anaesthesia Nov 2019
Topics: Anesthesiology; China; Health Policy; Humans; Societies, Medical
PubMed: 31543268
DOI: 10.1016/j.bja.2019.08.004 -
Critical Care (London, England) Aug 2021The respiratory system reacts instantaneously to intrinsic and extrinsic inputs. This adaptability results in significant fluctuations in breathing parameters, such as... (Review)
Review
The respiratory system reacts instantaneously to intrinsic and extrinsic inputs. This adaptability results in significant fluctuations in breathing parameters, such as respiratory rate, tidal volume, and inspiratory flow profiles. Breathing variability is influenced by several conditions, including sleep, various pulmonary diseases, hypoxia, and anxiety disorders. Recent studies have suggested that weaning failure during mechanical ventilation may be predicted by low respiratory variability. This review describes methods for quantifying breathing variability, summarises the conditions and comorbidities that affect breathing variability, and discusses the potential implications of breathing variability for anaesthesia and intensive care.
Topics: Airway Management; Anesthesiology; Critical Care; Humans; Respiration, Artificial; Respiratory Mechanics; Time and Motion Studies
PubMed: 34353348
DOI: 10.1186/s13054-021-03716-0 -
Anaesthesia Dec 2011In airway management, poor judgment, education and training are leading causes of patient morbidity and mortality. The traditional model of medical education, which... (Review)
Review
In airway management, poor judgment, education and training are leading causes of patient morbidity and mortality. The traditional model of medical education, which relies on experiential learning in the clinical environment, is inconsistent and often inadequate. Curriculum change is underway in many medical organisations in an effort to correct these problems, and airway management is likely to be explicitly addressed as a clinical fundamental within any new anaesthetic curriculum. Competency-based medical education with regular assessment of clinical ability is likely to be introduced for all anaesthetists engaged in airway management. Essential clinical competencies need to be defined and improvements in training techniques can be expected based on medical education research. Practitioners need to understand their equipment and diversify their airway skills to cope with a variety of clinical presentations. Expertise stems from deliberate practice and a desire constantly to improve performance with a career-long commitment to education.
Topics: Airway Management; Anesthesiology; Clinical Competence; Curriculum; Humans; Learning; Patient Care Team
PubMed: 22074084
DOI: 10.1111/j.1365-2044.2011.06939.x -
Anaesthesia Jul 1953
Topics: Anesthesiology; Trachea
PubMed: 13065726
DOI: 10.1111/j.1365-2044.1953.tb01908.x -
TheScientificWorldJournal Nov 2013Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine.... (Review)
Review
Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound-guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well-established field in point-of-care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum.
Topics: Anesthesiology; Education, Medical, Continuing; Humans; Physicians; Ultrasonography
PubMed: 24348179
DOI: 10.1155/2013/683685