COVID-19 pandemic and its impact on peer review speed of anesthesiology journals: An observational study.

BACKGROUND AND AIMS: Publication of a scientific article in a reputed journal is an uphill task that demands a significant amount of time and effort from the author and editorial team. It is a matter of great enthusiasm for all prospective researchers to know whether this daily evolving publication load of articles during this pandemic had changed the journal's inherent peer review or publication process. We aimed to compare the peer review speed of anesthesiology journal articles published during pandemic (2020) to the previous year and to analyze various factors affecting peer review speed. MATERIAL AND METHODS: Overall, 16 anesthesiology journals indexed in MEDLINE database were retrospectively analyzed. A set of 24 articles published in 2019 of the included journals were selected from each journal for control and a set of 12 articles published between January to September 2020 was selected for comparison. Time taken for acceptance and publication from the time of submission was noted. Peer review timing was calculated and its relationship with h-index, continent of journal origin and article processing charges were evaluated. RESULTS: The median peer review time in 2019 and 2020 were 116 (108-125) days and 79 (65-105.5) days, respectively. There was a 31.8% decrease (P = 0.0021) in peer review time of all articles in 2020 compared to 2019. The median peer review timings of COVID-19 articles were 35 (22-42.5) days. A 55.6% decrease was noted in peer review time of COVID-19 articles compared to non-COVID-19 articles in 2020. There was a significant correlation between peer review time and h-index (r = 0.558, P = 0.024). There was no significant difference in peer review timing of journals with or without article processing charge (P = 0.75) and between journals from different continents (P = 0.56). CONCLUSION: Anesthesiology journals managed to curtail their turnaround time for peer review during the pandemic compared to previous year. Journal with higher h-index had longer peer review time. The option for articles processing charge and continent of publishing journal had no impact on peer review speed.

Analysis of publication speed of anesthesiology journals: a cross-sectional study.

BACKGROUND: Publication speed is one of the critical factors affecting authors' preference to a journal for manuscript submission. The publication time of submitted manuscripts varies across journals and specialty. OBJECTIVES: Several bibliometric studies in various fields of medicine, except in anesthesiology, have addressed the issue of publication speed and factors that influence the publication speed. We aimed to identify factors affecting the publication speed of indexed anesthesiology journals. METHOD: Overall, 25 anesthesiology journals indexed in MEDLINE database were retrospectively analyzed for the time required during different stages of publication process. A total of 12 original articles published in the year 2018 were randomly selected from each journal based on the number of issues. Time periods from submission to acceptance and from submission to publication were noted, and their association with impact factor (IF), advanced online publication (AOP), and article processing charges (APCs) were evaluated. RESULTS: The median time from submission to acceptance and from submission to publication for the selected journals were 120 (IQR [83-167]) days and 186 (IQR [126-246]) days, respectively. Publication speed was not found to have any correlation with IF and APC. However, journals with AOP required significantly lesser time for publication than those without AOP 138.5 and 240 days, respectively, (p =  0.011). Moreover, the IF of journals with AOP was significantly higher than that of journals without AOP (p =  0.002). CONCLUSION: The study provides an overview of total time required for peer review, acceptance, and publication in indexed anesthesiology journals. Researchers should focus on journals with AOP for expediting the publication process and avoiding publication delays.

Myocardial Protection in Adult Cardiac Surgery With del Nido Versus Blood Cardioplegia: A Systematic Review and Meta-Analysis.

BACKGROUND: Myocardial protection in adult cardiac surgery is commonly achieved with either multidose blood cardioplegia or single-dose del Nido crystalloid cardioplegia. AIM: The aim of this systematic review and meta-analysis was to compare the outcomes of del Nido cardioplegia versus blood cardioplegia in adult cardiac surgery. METHOD: All English-language articles were searched in MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar up to March 2020, to identify randomised control trials, prospective observational studies, and retrospective analyses (with or without propensity matching) reporting any or all of the primary and secondary endpoints. The primary endpoint was all-cause mortality. Secondary endpoints included cardiopulmonary bypass (CPB) and aortic cross-clamp (AoX) time; cardioplegia volume; need for defibrillation after AoX release; intraoperative glucose; postoperative myocardial enzyme release; postoperative left ventricular ejection fraction (LVEF); incidence of postoperative acute kidney injury (AKI), atrial fibrillation (AF), stroke, and low cardiac output syndrome (LCOS); postoperative blood transfusion; duration of mechanical ventilation; and length of intensive care unit (ICU) and hospital stay. RESULTS: Twenty-nine (29) studies were included. There was no difference in the primary outcome of mortality between the two groups (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.82-1.72 [p=0.37]). del Nido cardioplegia was associated with significantly shorter CPB (mean difference [MD], -7.42 minutes; 95% CI, -12.53 to -2.31 [p=0.004]) and AoX times (MD, -6.39 minutes; 95% CI, -10.30 to -2.48 [p=0.001]), and lower cardioplegia volumes. Significantly fewer patients required defibrillation after AoX release in the del Nido group. Intraoperative glucose homeostasis was better preserved in the del Nido group. Postoperative cardiac troponin T release and the number of patients needing transfusions were less in the del Nido group. No differences were seen in postoperative LVEF, or in the incidence of AKI, stroke, AF, and LCOS. Duration of mechanical ventilation, and length of ICU and hospital stay were similar. CONCLUSIONS: Although this meta-analysis failed to find any mortality benefits with del Nido cardioplegia, significant benefits were seen in a number of intraoperative and postoperative variables. del Nido cardioplegia is a safe and favourable alternative to blood cardioplegia in adult cardiac surgery.

Impact of visually guided versus blind techniques of insertion on the incidence of malposition of Ambu® AuraGain™ in paediatric patients undergoing day care surgeries: A prospective, randomised trial.

BACKGROUND AND AIMS: In adults, video laryngoscopy is recommended for supraglottic airway device (SGAD) placement as it results in better device position and higher oropharyngeal leak pressures. In children, there is a paucity of studies evaluating the impact of visually guided techniques on SGAD placement. Aim of the study was to evaluate the usefulness of visual-guided techniques of SGAD placement in children. METHODS: Totally, 75 children, scheduled for elective surgery, were randomly allocated into three groups, that is, standard (S), direct laryngoscopy (DL), and video laryngoscopy (VL). Ambu AuraGain was placed blindly in group S, and under visual guidance with video laryngoscopy and direct laryngoscopy in groups VL and DL, respectively. Ambu AuraGain position was determined by flexible videoendoscope. First attempt success rate, time for successful insertion, oropharyngeal leak and any complications were studied. RESULTS: Incidence of malposition was not significantly different in group S (44%), DL (48%), and VL (64%); P = 0.32. The first attempt success rate was 100% in DL and 92% each in S and VL. Time to insert (seconds) was significantly higher in VL (37.9 ± 21.6), compared to S (18.4 ± 7.9) and DL (27.4 ± 14.5); P <0.001. Incidence of oropharyngeal leak, impact on ventilation, and complications were similar in all three groups. CONCLUSION: In this study, there was no advantage of visually guided techniques for Ambu AuraGain placement in children.

Management of a parturient with uncorrected tetralogy of Fallot in shock: an anesthetic challenge.

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. The survival of patients with uncorrected TOF till the fourth decade of life is rare (around 3%). Pregnancy in a patient with uncorrected TOF requires a multidisciplinary approach. A confluence of pregnancy, uncorrected TOF and shock is infrequent. The state of hypovolaemia and a decrease in systemic vascular resistance due to anaesthetic agents increase the right to left shunt. The decrease in pulmonary blood flow provokes a 'hypercyanotic spell'. We report the successful management of 30-year-old pregnant (G3P2A2L0) with uncorrected TOF, presenting to the emergency department with incomplete abortion in shock.

Diencephalic syndrome: an anaesthetic challenge.

Diencephalic syndrome is one of the rare causes of failure to thrive in infants and young children. It is caused by a tumour in diencephalon (thalamus and hypothalamus), characterised by profound emaciation with uniform loss of body weight despite normal or slightly decreased appetite, locomotor hyperactivity, euphoria and visual symptoms. Anaesthetic considerations due to decreased body fat include positioning to avoid pressure necrosis, measures to avoid hypothermia, proper drug dosing, treating electrolyte imbalances and delayed recovery. We report successful anaesthetic management of a child with diencephalic syndrome scheduled for an endoscopic biopsy of suprasellar space occupying lesion under general anaesthesia.