Evidence map›Paper›PMID 41808175›Full record

ArticleJournal of anesthesia, analgesia and critical care2026

Implementation and learning curve in AI-assisted fluid management during abdominal oncologic surgery: a retrospective observational study.

Gilda Pasta, Luciano Frassanito, Maria Maciariello, Carmine Iermano, Rosanna Accardo, Andrea Belli, Pasquale Sansone, Francesco Coppolino, Vincenzo Pota, Francesco Vassalli and 1 more

Abstract read
In one paragraph

Article in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Gilda PastaDepartment of Anesthesiology, Pain Therapy and Intensive Care, INT IRCCS Fondazione G. Pascale, Naples, Italy. g.pasta@istitutotumori.na.it.
Luciano FrassanitoDepartment of Scienza Dell'Emergenza, Anestesiologiche E Della Rianimazione, IRCCS Fondazione Policlinico A. Gemelli, Rome, Italy.
Maria MaciarielloDepartment of Anesthesiology, Pain Therapy and Intensive Care, INT IRCCS Fondazione G. Pascale, Naples, Italy.
Carmine IermanoDepartment of Anesthesiology, Pain Therapy and Intensive Care, INT IRCCS Fondazione G. Pascale, Naples, Italy.
Rosanna AccardoDepartment of Anesthesiology, Pain Therapy and Intensive Care, INT IRCCS Fondazione G. Pascale, Naples, Italy.
Andrea BelliDepartment of Abdominal Oncology, INT IRCCS Fondazione G. Pascale, Naples, Italy.
Pasquale SansoneDepartment of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Francesco CoppolinoDepartment of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Vincenzo PotaDepartment of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Francesco VassalliDepartment of Critical Care and Perinatal Medicine, IRCCS Ospedale G. Gaslini, Genoa, Italy.
Arturo CuomoDepartment of Anesthesiology, Pain Therapy and Intensive Care, INT IRCCS Fondazione G. Pascale, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative fluid management during major abdominal oncologic surgery is complex and highly operator-dependent. Assisted Fluid Management (AFM) is an artificial intelligence-based decision support system designed to guide fluid challenges based on real-time Stroke Volume (SV) analysis. However, limited data are available on how AFM is adopted in routine clinical practice and how clinician interaction with the system evolves over time.

methodsWe conducted a retrospective observational study based on a prospectively maintained institutional database at a high-volume tertiary referral center. Adult patients undergoing major abdominal oncologic surgery with intraoperative AFM monitoring were included. Two consecutive time periods following AFM implementation were compared. Analyses were performed at the fluid-challenge level and focused on patterns of fluid challenge initiation (clinician-initiated vs AFM-suggested), hemodynamic effectiveness (SV response), and bolus characteristics, as markers of system adoption and learning curve. Postoperative clinical outcomes were not assessed.

resultsFifty-nine patients were included, accounting for 404 fluid challenges. Over time, clinician-initiated boluses significantly decreased and AFM-suggested fluid challenges increased (p < 0.001). This shift was associated with higher overall effectiveness of fluid challenges and greater SV responses, particularly for AFM-suggested boluses, which showed a significant improvement in effectiveness and ΔSV over time (p < 0.05).

conclusionsProgressive integration of AFM into routine anesthetic practice was associated with measurable changes in clinician behavior and improved physiological effectiveness of intraoperative fluid challenges over time, consistent with a learning curve effect. These findings support the role of AI-based decision support systems in promoting more consistent and physiologically targeted fluid management and provide a foundation for future prospective studies evaluating their impact on clinical outcomes.

Indexed as

Artificial IntelligenceDecision Support SystemFluid TherapyLearning curveSurgical Oncology

Identifiers

PMID41808175
PMCPMC13003691

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.