Registers and biobanks in ICU and anesthesia

Abstract

Anesthesia, perioperative and critical care medicine are specific areas where registries, biobanks and big data are gaining a leading role in increasing knowledge and improving patients' care. The adoption of these robust data infrastructures - aimed at bridling, manipulating, aggregating, and linking patients' multiparametric data - supports anesthesiologists and intensive care physicians in several aspects of bedside practice and clinical research. Indeed, registries-integrated calculators may promote the concept of personalized medicine acting as "sniffers," electronic alarm systems, or decision support systems. Artificial intelligence applied to large databases or meta-registries may further increase dramatically this functionality, identify associations among thousands of different and only apparently uncorrelated variables. From a research perspective, large datasets are increasingly mined to create observations about medical care beyond prospective randomized clinical trials enrolling thousands of patients, often only presumably homogeneous ore well-balanced. Registries in this context may effectively explore the association between patients' management and patients' outcomes with a negligible impact on ethical issues, limited costs, and easy management. Finally, registries may promote self-evaluation and continuous quality improvement in the field of perioperative and critical care medicine. In a different way, the role of biobanks primarily relies on translational medical research. These allow rapidly creating pools of biological samples available for epidemiological description, pathophysiological definition, and treatment effectiveness verification, basically acting as an accelerator of knowledge production in critical care and perioperative medicine. Nowadays, registries and biobanks are thus routine tools for anesthesiologists and critical care physicians.