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Clinical Management for Anesthesia Critical Care
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Clinical Management for Anesthesia Critical Care

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 20 April 2026 | Viewed by 780

Special Issue Editor

Dr. Gianluca Zani

E-Mail Website
Guest Editor
Anesthesia and Intensive Care Unit, Umberto I Hospital, AUSL Romagna, 48022 Lugo, Italy
Interests: anesthesia; intensive care; mechanical ventilation; acute respiratory failure; sepsis; pain management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Clinical management in anesthesia critical care represents a multifaceted approach to the critically ill patient, with a comprehensive view of all aspects that can influence outcomes. This includes managing patients in the operating room, intensive care units, and other critical care settings. Anesthesia and critical care medicine represent two of the most rapidly evolving fields in clinical practice. The increasing complexity of patient profiles, the emergence of novel technologies, and the growing emphasis on personalized and multidisciplinary approaches demand a continuous reevaluation of current management protocols. The need for evidence-based, patient-centered care has never been more urgent. Specifically, the management of critically ill patients must increasingly be personalized based on the patient's characteristics using not only technical skills but also non-technical ones.

This Special Issue invites submissions that address key topics including but not limited to:

  • Advanced perioperative management and monitoring techniques;
  • Novel sedation and analgesia protocols;
  • Hemodynamic and respiratory support strategies;
  • Sepsis and infection control in critical care;
  • Management of organ dysfunction and failure;
  • Ethical and organizational challenges in ICU and anesthesia care;
  • Artificial intelligence and digital tools in clinical decision-making;
  • Postoperative outcomes and long-term follow-up of critically ill patients;
  • Technical and non-technical skills used to personalize treatments;
  • Organizational and management models of healthcare facilities and personnel.

We warmly welcome researchers to contribute their work to this issue and look forward to receiving innovative and impactful submissions.

Dr. Gianluca Zani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anesthesia
  • critical care medicine
  • clinical management
  • critically ill patients
  • organ failure
  • organ dysfunction
  • per-sonalized therapy
  • outcome
  • technical skills
  • non-technical skills

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

14 pages, 1164 KB  
Article
Albumin-Anchored Composite Ratios of Blood Urea Nitrogen, C-Reactive Protein, Lactate, and Creatinine for Predicting Mortality in Chronically Ill Intensive Care Unit Patients
by Nilgün Şahin, Semih Aydemir, Nazan Has Selmi, İbrahim Ertaş, Yavuz Kutay Gökçe, Cihan Döğer, Gökçen Terzi, Mesher Ensarioğlu and Recep Dokuyucu
J. Clin. Med. 2026, 15(7), 2470; https://doi.org/10.3390/jcm15072470 - 24 Mar 2026
Viewed by 239
Abstract
Background: This study aimed to evaluate the prognostic performance of four albumin-anchored ratios—blood urea nitrogen/albumin ratio (BAR), C-reactive protein/albumin ratio (CAR), lactate/albumin ratio (LAR), and albumin/creatinine ratio (ACR)—in predicting short-term mortality among intensive care unit (ICU) patients with pre-existing chronic comorbidities. Additionally, we [...] Read more.
Background: This study aimed to evaluate the prognostic performance of four albumin-anchored ratios—blood urea nitrogen/albumin ratio (BAR), C-reactive protein/albumin ratio (CAR), lactate/albumin ratio (LAR), and albumin/creatinine ratio (ACR)—in predicting short-term mortality among intensive care unit (ICU) patients with pre-existing chronic comorbidities. Additionally, we assessed their incremental prognostic value beyond established severity scores such as APACHE II and SOFA. Materials and Methods: This retrospective cohort study included 520 chronically ill adult ICU patients admitted between July 2022 and July 2025. Patients with missing laboratory data, ICU stay <24 h, or postoperative monitoring only were excluded. BAR, CAR, LAR, and ACR were calculated from admission laboratory values. The primary outcome was 28-day mortality. Receiver operating characteristic (ROC) analyses, multivariate logistic regression, and model improvement metrics (C-statistics, NRI, IDI) were used to assess predictive performance. Results: Non-survivors had significantly higher BAR (15.0 vs. 8.2), CAR (39.2 vs. 19.1), and LAR (0.86 vs. 0.44) values and lower ACR (2.0 vs. 3.4) (all p < 0.001). In multivariate analysis, all four ratios independently predicted 28-day mortality (p < 0.001 for each). CAR showed the highest AUC (0.80), followed by LAR (0.79), BAR (0.78), and ACR (0.76). Incorporating all four ratios improved model discrimination (C-statistic 0.872 vs. 0.823; Δ = +0.049, p < 0.001) and reclassification (NRI = 0.162; IDI = 0.052). Conclusions: BAR, CAR, LAR, and ACR are independent and complementary predictors of short-term mortality in ICU patients with chronic comorbidities. Among them, CAR exhibited the best discriminative power. The combined use of these ratios enhanced risk prediction beyond traditional severity scores, suggesting their utility as simple, cost-effective markers for early mortality assessment. Because these indices are calculated from routinely measured laboratory parameters, they may represent practical and widely accessible tools for mortality risk stratification in routine ICU practice. Full article
(This article belongs to the Special Issue Clinical Management for Anesthesia Critical Care)
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9 pages, 202 KB  
Article
Perioperative Factors and Radiographic Brixia Scores’ Effect on Early Extubation After Fallot Tetralogy Surgery
by İbrahim Akkoç, Selin Sağlam, Ezgi Direnç Yücel, Hatice Dilek Özcanoğlu, Erkut Öztürk, Ali Can Hatemi and Funda Gumus Ozcan
J. Clin. Med. 2026, 15(4), 1409; https://doi.org/10.3390/jcm15041409 - 11 Feb 2026
Viewed by 251
Abstract
Introduction and Objective: This study aims to evaluate the effect of perioperative factors and radiographic Brixia scores on early extubation following corrective surgery for Fallot tetralogy at a high-volume single cardiac center. Materials and Methods: A retrospective evaluation was conducted on 120 cases [...] Read more.
Introduction and Objective: This study aims to evaluate the effect of perioperative factors and radiographic Brixia scores on early extubation following corrective surgery for Fallot tetralogy at a high-volume single cardiac center. Materials and Methods: A retrospective evaluation was conducted on 120 cases who underwent complete correction due to Fallot tetralogy [Median age 6 months (IQR 5–7), Median weight 6.2 kg (IQR 5.2–8 kg)]. Patient demographics, preoperative characteristics, intraoperative variables, postoperative outcomes, surgical type, surgical duration, cardiopulmonary bypass (CPB) time, cross-clamp time, and blood product volumes were retrieved from electronic medical records. P/F ratio, PaO2/FiO2, and Oxygen Index (OI) were calculated. Early extubation was defined as extubation occurring within 6 h after the completion of surgery. The Brixia score (Interstitial opacities, 1 point; interstitial predominant alveolar, 2 points; and interstitial and alveolar opacities, 3 points) was graded for both lung lobes divided into three segments, with a total score ranging from 0 to 18. The results were analyzed statistically. Results: In 60% of the cases (n = 72), valve-preserving surgery was performed, and in 40% (n = 48), a transannular patch was used. The early extubation rate was 20% (n = 24). The median duration of mechanical ventilation was 10 h (IQR, 6–15). Older age (median 8 vs. 5 months), valve-preserving surgery, lower incidence of right-to-left shunt Patent Foramen Ovale (63% vs. 84%), higher P/F ratio on ICU admission (360 vs. 220), and lower Brixia scores on ICU admission (8 vs. 11) and on postoperative day 1 (7 vs. 12) were identified as significant factors for early extubation (p < 0.05). The mortality rate in the entire patient group was 3.3%. In multivariable logistic regression analysis, older age (OR: 1.2, 95% CI: 1.1–1.9 p = 0.03), valve-sparing repair (OR: 1.7, 95% CI: 1.2–2.5, p = 0.008), and lower postoperative Brixia scores (OR:1.4 95% CI: 1.2–2.1, p = 0.02) remained independently associated with early extubation. Conclusions: The Brixia score can be used as a reliable scoring system for evaluating postoperative lung status. Pulmonary valve-preserving repair shows a profile of earlier lung parenchyma recovery compared to transannular patch repair. Full article
(This article belongs to the Special Issue Clinical Management for Anesthesia Critical Care)
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