Revista Espanola de Anestesiologia y Reanimacion最新文献

Ácido úrico y daño renal agudo en pacientes con alto riesgo de desarrollar daño renal agudo sometidos a cirugía cardiaca: cohorte prospectiva multicéntrica 接受心脏手术的急性肾损伤高危患者的尿酸和急性肾损伤：前瞻性多中心队列。

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.09.005

{"title":"Ácido úrico y daño renal agudo en pacientes con alto riesgo de desarrollar daño renal agudo sometidos a cirugía cardiaca: cohorte prospectiva multicéntrica","authors":"","doi":"10.1016/j.redar.2023.09.005","DOIUrl":"10.1016/j.redar.2023.09.005","url":null,"abstract":"<div><h3>Purpose</h3><p>It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI.</p></div><div><h3>Design</h3><p>Multicenter prospective international cohort study.</p></div><div><h3>Setting</h3><p>Fourteen university hospitals in Spain and the United Kingdom.</p></div><div><h3>Participants</h3><p>We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥4 points, from July to December 2017.</p></div><div><h3>Interventions</h3><p>None.</p></div><div><h3>Measurements and Main Results</h3><p>AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (> = 7 mg/dL) and AKI. Elevated preoperative AUS (> = 7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; p = 0.17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95% CI 0.93-1.19, p = 0.37).</p></div><div><h3>Conclusions</h3><p>Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003493562400015X/pdfft?md5=166e065b850d42f573a927e270fa6e1b&pid=1-s2.0-S003493562400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Hernia diafragmática congénita tipo Morgagni-Larrey 莫加尼-拉雷型先天性膈疝

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.05.006

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Monitorización sonográfica de la vena cava inferior para la valoración de fenómenos embólicos durante la artroplastia de cadera 超声监测下腔静脉以评估髋关节置换术中的栓塞现象

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.06.003

{"title":"Monitorización sonográfica de la vena cava inferior para la valoración de fenómenos embólicos durante la artroplastia de cadera","authors":"","doi":"10.1016/j.redar.2023.06.003","DOIUrl":"10.1016/j.redar.2023.06.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Embolic phenomena frequently occur during hip joint replacement surgery, and may lead to haemodynamic instability in frail patients. Transoesophageal ultrasound monitoring is rarely available in non-cardiac operating theatres, and cannot be performed in awake patients under spinal anaesthesia. The main objectives of this prospective exploratory study were to determine the feasibility of using an alternative ultrasound approach to monitor the inferior vena cava during hip replacement surgery, and to determine the intra- and interobserver reliability of the ultrasound findings.</p></div><div><h3>Method</h3><p>We conducted a prospective exploratory study in 20 patients undergoing cemented hip arthroplasty in the supine position under spinal anaesthesia and sedation. The inferior vena cava was assessed through a subcostal window at 10 intraoperative time points, and the findings were rated on a qualitative embolism severity scale. The ultrasound images were evaluated by 2 independent observers.</p></div><div><h3>Results</h3><p>An adequate subcostal window was obtained in 90% of cases. Intra- and inter-observer reliability was high (kappa index>0.80, p<0.001). Nearly all (95%) patients presented some degree of embolism, which was severe in 50% of cases.</p></div><div><h3>Conclusions</h3><p>Our study suggests that ultrasound assessment of embolic phenomena in the inferior vena cava through a subcostal window is reliable in 90% of cases. The qualitative embolic severity rating scale is highly reproducible and has high intra- and inter-observer reliability.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Hiperlactacidemia en pacientes con estatus asmático. Análisis mediante el modelo de Stewart 哮喘状态患者的高乳酸血症。使用斯图尔特模型进行分析

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.10.004

{"title":"Hiperlactacidemia en pacientes con estatus asmático. Análisis mediante el modelo de Stewart","authors":"","doi":"10.1016/j.redar.2023.10.004","DOIUrl":"10.1016/j.redar.2023.10.004","url":null,"abstract":"<div><h3>Background</h3><p>Patients with status asthmaticus (SA) frequently present with lactic acidosis (LA). Our goal is to identify the nature of LA using the Stewart physicochemical model and to identify the independent factors associated with LA in children with SA.</p></div><div><h3>Methods</h3><p>Analytical study of a retrospective cohort using a nested case-control design. Twenty-eight episodes of SA in 24 children were included. Patients admitted to a paediatric intensive care unit (PICU) for SA over a 9-year period were recruited consecutively. LA was analysed using the Stewart model and the Strong Ion Calculator. Data and were analysed using descriptive statistics and regression models were fitted in the general linear model.</p></div><div><h3>Results</h3><p>Hyperlacticaemia (Lact[mM/L]=3.905 [95% <span>C</span>I=3.018-4.792]) and acidosis (pH=7.294 [95% CI=7.241-7.339]) were observed in 18 episodes (15 patients; 62.5%). According to the Stewart model, acidosis was caused by a decrease in strong ion difference. Initially, pCO2 was high (pCO2[mmHg]=45.806 [95% CI=37.314-54.298]) but the net unmeasured ion (NUI) component was normal (NUI=-4,461 [95% CI=-3.51 - -5.412]), and neither changed significantly over the clinical course. There was no need to determine pyruvate, as the NUI was normal and the LA was type B (non-hypoxic, lactate / pyruvate <25). We observed a correlation (p=0.023) between LA and intramuscular epinephrine administered on arrival at hospital, but not between LA and the cumulative dose of nebulized salbutamol.</p></div><div><h3>Conclusions</h3><p>Most patients with SA presented LA. The Stewart model confirmed that LA is not hypoxic, probably due to sympathomimetic-related glycolysis.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Conexiones NRFit en anestesia regional: evitando errores de medicación 区域麻醉中的 NRFit 连接：避免用药错误

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.11.007

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Compresiones torácicas como maniobra de rescate para mantener la apertura de la válvula aórtica durante el síndrome de distensión ventricular izquierdo en la oxigenación por membrana extracorpórea venoarterial 在静脉体外膜氧合治疗左心室扩张综合征期间，将胸外按压作为维持主动脉瓣开放的一种救援手段

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.09.004

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Papel de la oxigenación por membrana extracorpórea veno-venosa en cirugía traqueal y de carina: a propósito de 2 casos clínicos 静脉体外膜肺氧合在气管和气管手术中的作用：2 例报告回顾

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.03.008

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Cómo un único caso de delirio perioperatorio marca la diferencia 一例围手术期谵妄病例如何带来改变

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2024.01.003

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Sarcopenia medida por tomografía como predictor de morbimortalidad en cirugía torácica, una cohorte retrospectiva 通过断层扫描测量的 "肌肉疏松症 "可预测胸外科手术的发病率和死亡率，这是一项回顾性队列研究。

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2023.08.006

{"title":"Sarcopenia medida por tomografía como predictor de morbimortalidad en cirugía torácica, una cohorte retrospectiva","authors":"","doi":"10.1016/j.redar.2023.08.006","DOIUrl":"10.1016/j.redar.2023.08.006","url":null,"abstract":"<div><h3>Background</h3><p>Sarcopenia has been identified as a risk factor for perioperative adverse events. Several studies have shown that tomographic assessment of muscle mass can be an appropriate indicator of sarcopenia associated with morbidity and mortality. The aim of the study was to determine the association between height-adjusted area of the pectoral and erector spinae muscles (haPMA and haESA) and perioperative morbidity and mortality in thoracic surgery.</p></div><div><h3>Methods</h3><p>Retrospective cohort study. Measurement of muscle areas was performed by tomography. The outcomes were 30-day mortality and postoperative morbidity. The discriminative capacity of the muscle areas was evaluated with an analysis of ROC curves and the Youden index was used to establish a cut-off point. The raw morbidity and mortality risk was determined and adjusted for potential confounders.</p></div><div><h3>Results</h3><p>A total of 509 patients taken to thoracic surgery were included. The incidence of 30-day mortality was 7.3%. An association was found between muscle areas and 30-day mortality and pneumonia, with adequate discriminative power for mortality (AUC 0.68 for haPMA and 0.67 for haESA). An haPMA less than 10 and haESA less than 8.5cm2/m2 were identified as a risk factor for 30-day mortality with an adjusted OR of 2.34 (95%<span>C</span>I 1.03 – 5.15) and 2.22 (95%CI 1.10 – 6.04) respectively.</p></div><div><h3>Conclusions</h3><p>Sarcopenia, defined as low muscle area in the pectoral and erector spinae muscles, is associated with increased morbidity and mortality in patients undergoing thoracic surgery.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Estimulación del ganglio de Gasser para dolor neuropático del trigémino refractario 刺激加瑟神经节治疗难治性三叉神经痛

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2024-08-01 DOI: 10.1016/j.redar.2024.01.007

{"title":"Estimulación del ganglio de Gasser para dolor neuropático del trigémino refractario","authors":"","doi":"10.1016/j.redar.2024.01.007","DOIUrl":"10.1016/j.redar.2024.01.007","url":null,"abstract":"<div><h3>Background and objective</h3><p>Painful trigeminal neuropathy is a complex clinical entity due to its severity and refractoriness to pharmacological and interventional management. We describe our experience in treating refractory painful trigeminal neuropathy (RPTN) with Gasserian ganglion stimulation (GGS).</p></div><div><h3>Materials and methods</h3><p>Six patients with RPTN were treated with GGS in our unit between 2019 and 2022. The following data were collected: socio-demographic characteristics, triggering event, duration of the disease and treatment received prior to surgery, pre- and post-intervention visual analogue scale score, follow-up time, and pre- and post-intervention functionality and quality of life.</p></div><div><h3>Results</h3><p>All patients were women who had received aggressive first-, second-, and third-line pharmacological, non-pharmacological, and interventional management before being referred for GGS. Patients reported a 50-72% decrease in pain on visual analogue scale and improved functionality during follow-up.</p></div><div><h3>Conclusions</h3><p>GGS is a promising therapeutic alternative for patients with RPTN. Although the initial outcomes and experience are encouraging, RPTN is recommended on the basis of safety, reproducibility, and trends observed in clinical practice.</p></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0