https://www.um.edu.mt/library/oar/handle/123456789/409 Tue, 18 Aug 2026 22:54:49 GMT 2026-08-18T22:54:49Z https://www.um.edu.mt/library/oar/handle/123456789/148530 Title: Fatigue among anaesthesiologists in Europe : findings from a joint EBA/NASC survey Authors: Camilleri Podestà, Anne Marie; Redfern, Nancy; Abramovich, Igor; Mellin-Olsen, Jannicke; Oremuš, Krešimir; Kouki, Pinelopi; Guasch, Emilia; Novak-Jankovic, Vesna; Sabelnikovs, Olegs; Bilotta, Federico; Grigoras, Ioana Abstract: BACKGROUND: Anaesthesiologists deliver an increasing amount of patient care and often work long hours in operating theatres and intensive care units, with frequent on-calls and insufficient rest in between. In the long term, this will negatively influence mental and physical health and well being. As fatigue becomes more prevalent, this has predictable implications for patient safety and clinical effectiveness.; OBJECTIVE: This study aimed to evaluate the prevalence, severity, causes and implications of work-related fatigue amongst specialist anaesthesiologists.; DESIGN: An online survey of specialist anaesthesiologists.; PARTICIPANTS: The survey was sent to anaesthesiologists in 42 European countries by electronic mail.; MAIN OUTCOME MEASURES: Responses from a 36-item online survey assessed work-related fatigue and its impact on anaesthesiologists in European countries.; RESULTS: Work-related fatigue was experienced in 91.6% of the 1508 respondents from 32 European countries. Fatigue was caused by their working patterns, clinical and nonclinical workloads, staffing issues and excessive work hours. Over 70% reported that work-related fatigue negatively impacted on their physical and mental health, emotional well being and safe commuting. Most respondents did not feel supported by their organisation to maintain good health and well being.; CONCLUSION: Work-related fatigue is a significant and widespread problem amongst anaesthesiologists. More education and increased awareness of fatigue and its adverse effects on patient safety, staff well being and physical and mental health are needed. Departments should ensure that their rotas and job plans comply with the European Working Time Directive (EWTD) and introduce a fatigue risk management system to mitigate the effects of fatigue. Mon, 01 Jan 2024 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148530 2024-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148528 Title: The Østergaard declaration : a European society of anaesthesiology and intensive care statement on advancing simulation-based education and training Authors: Berger-Estilita, Joana; Burlacu, Crina L.; Østergaard, Doris; Sinai, Yitzhak Brzezinski; Preckel, Benedikt; Crişan, Iulia; Diaz-Navarro, Cristina; Camilleri Podestà, Anne Marie; Langenecker, Sibylle; Guasch, Emilia; Sabelnikovs, Olegs; Ringvold, Else-Marie; Buhre, Wolfgang; Matot, Idit Abstract: Introduction: From Evidence to Action Simulation-based education and training (SBET) is now an essential component in anaesthesiology, intensive care, peri-operative medicine and team-based clinical practice. It enables clinicians to apply knowledge, refine procedural and social and cognitive skills, think critically, act decisively, communicate effectively and respond appropriately under pressure.1,2 Beyond individual competence, SBET strengthens team dynamics, exposes systems vulnerabilities and enhances patient safety in high-stakes environments.3-5 Despite compelling evidence, major policy reports and professional consensus,6,7 SBET remains inconsistently implemented, unevenly funded and frequently regarded as ancillary rather than integral to training. This contradiction lies at the centre of the current challenge. The question is no longer whether simulation is effective, but why healthcare and education systems have yet to integrate it systematically into routine training and clinical practice. The European Society of Anaesthesiology and Intensive Care (ESAIC) asserts that the time has come to move beyond advocacy and pilot initiatives. SBET must now be formally recognised, governed and funded as core education and healthcare infrastructure. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148528 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148511 Title: 2026 ESAIC consensus document on mitigation strategies in intensive care medicine : consensus document of the European Society of Anaesthesiology and Intensive Care Authors: Koch, Susanne; Bilotta, Federico; Brazzi, Luca; Camilleri Podestà, Anne Marie; Canle, Mois es; De Robertis, Edoardo; Gibb, Sebastian; Gonzalez-Pizarro, Patricio; Henderson, Philip; H.Y. Ip, Vivian; Jöbges, Susanne; Kranke, Peter; Kreutziger, Janett; McConnell, Paul; Metaxa, Victoria; Montrucchio, Giorgia; Muret, Jane; Pecher, Sabine; Romero, Caroline S.; Weiland, Nicolaas H. Sperna; Tomassi, Andrea; Trinks, Alexandra; Buhre, Wolfgang Abstract: Due to the continued use of fossil fuels and other chemical pollutants, atmospheric greenhouse gas concentrations and environmental pollution continue to rise. The health sector is both a driver and a victim of these developments, and intensive care medicine (ICM), with its high energy demands, extensive use of disposable products, and large variety of pharmaceuticals, contributes substantially to the climate crisis and environmental degradation. The European Society of Anaesthesiology and Intensive Care (ESAIC) therefore aimed to develop consensus recommendations to reduce the environmental footprint of ICM across Europe. A total of 37 recommendations were initially drafted by four topic groups (1) energy, (2) waste management, (3) medication, and (4) ethics—each composed of three to five experts. To facilitate implementation in both middle- and high-income European countries, the agreement threshold was set at 80%. The recommendations were validated by 37 experts from 20 countries using a two-step Delphi procedure. In the first round, all recommendations reached at least 75% agreement. After amendments to four recommendations based on expert feedback, all achieved over 80% approval in the second round, with 32 receiving more than 90% agreement. The final recommendations address: (1) a complete transition to renewable energy and implementation of energy-saving strategies; (2) optimisation of procurement in clinical processes (10Rs) and waste management solutions for single-use plastics; (3) reduction of greenhouse gas emissions (mainly fluorinated gases) and water toxicity caused by medications, as well as prevention of a further increase in antimicrobial resistance (AMR); and (4) implementation of an environment-related, ethically guided precautionary principle. This ESAIC consensus provides a practical framework for sustainable ICM. Stakeholders at all levels should now introduce these recommendations through institutional policies, procurement criteria, guidelines and quality improvement programmes to align intensive care practice with planetary health goals. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148511 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148510 Title: Perioperative anemia and patient blood management in neurosurgery and neurocritical care : a narrative review Authors: Domi, Rudin; Saxena, Sarah; Berger‑Estilita, Joana; Guerino Biasucci, Daniele; Meco, Basak Ceyda; Lilaj, Krenar; Huti, Gentian; Matot, Idit; Rubulotta, Francesca; Camilleri Podestà, Anne Marie Abstract: Correction of anemia in the perioperative period is essential to reduce complications, optimise tissue oxygen delivery and improve overall patient outcomes. However, in neurosurgical and neurocritical care settings, the management of preoperative anemia presents unique challenges. The brain is highly sensitive to reductions in oxygen delivery, whereas interventions commonly used to correct anemia, most notably blood transfusions, carry inherent risks that may adversely affect neurological outcomes. Therefore, clinicians must carefully balance the prevention of cerebral hypoxia to avoid treatment-related complications. The prevalence of perioperative anemia in neurosurgical and neurocritical patients is influenced by multiple factors, including advanced age, comorbidities, frailty, malnutrition, chronic anticoagulant or antiplatelet therapy and the type and extent of planned intervention. Patient blood management provides a structured, multimodal approach for optimising oxygen delivery, while reducing exposure to allogeneic blood transfusion. Within this framework, anemia correction represents only one pillar, alongside strategies to minimise perioperative blood loss and enhance physiological tolerance to anemia. In neurosurgical and neurocritical care, patient blood management may include targeted anemia treatment (e.g. iron supplementation, erythropoiesis-stimulating agents or carefully restricted transfusion), management of coagulation disturbances using specific “antidotes” such as tranexamic acid and close monitoring of cerebral oxygenation to individualize transfusion and hemodynamic decisions. Despite the limited standardization of patient blood management pathways in neurosurgery, current evidence suggests that it represents a coherent and physiologically grounded approach that may contribute to improved outcomes in this high-risk patient population. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148510 2026-01-01T00:00:00Z