Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Impacto de los rellenos faciales en la valoración de la vía aérea","authors":"C. Juliá-Romero , B. Simón-Rivero , L. Ceresuela-Dionís , S. de Benito-Mendieta","doi":"10.1016/j.redar.2025.501802","DOIUrl":"10.1016/j.redar.2025.501802","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501802"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398364","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}

{"title":"Recomendaciones basadas en la opinión de expertos promovidas por GTIPO-SEDAR para optimizar el abordaje terapéutico de la candidiasis intraabdominal","authors":"E. Maseda ,&nbsp;T. Peláez ,&nbsp;G. Aguilar ,&nbsp;I. Martín Loeches ,&nbsp;A. Benítez-Cano ,&nbsp;A. Rodríguez ,&nbsp;R. Zaragoza ,&nbsp;J. Guinea ,&nbsp;C. Aldecoa ,&nbsp;A. Suárez de la Rica","doi":"10.1016/j.redar.2025.501916","DOIUrl":"10.1016/j.redar.2025.501916","url":null,"abstract":"<div><div>Intra-abdominal candidiasis (IAC) is a highly prevalent infectious syndrome and a significant cause of mortality in intensive care units. The Working Group on Perioperative Infections of the Spanish Society of Anesthesiology, Resuscitation, and Pain Management has promoted the development of recommendations based on the experience of a multidisciplinary panel of experts from various medical specialties, aiming to optimize the diagnosis and treatment of severe infectious processes such as IAC. These recommendations have been formulated through a rigorous critical appraisal of the currently available scientific evidence. This document provides guidance for optimizing the therapeutic approach to IAC, incorporating the latest findings in microbiology, recent therapeutic advances, pharmacokinetic and pharmacodynamic considerations in critically ill patients with IAC, special therapeutic considerations for patients undergoing extracorporeal membrane oxygenation and continuous renal replacement therapies, the appropriateness of empirical versus targeted therapy, and strategies for improving and reducing the duration of treatment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501916"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398365","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}

{"title":"Abordaje abierto frente a abordaje ecográfico para el bloqueo profundo del plano del músculo serrato anterior para analgesia postoperatoria tras mastectomía radical modificada: ensayo aleatorizado controlado","authors":"M. Mohammed Alseoudy ,&nbsp;M. Abd el-Ghaffar Saleh ,&nbsp;S. Saleh Elbalka ,&nbsp;T. Elmetwally Farahat ,&nbsp;D. Abdellatif Elebedy ,&nbsp;S. Elsayed Ahmed","doi":"10.1016/j.redar.2025.501902","DOIUrl":"10.1016/j.redar.2025.501902","url":null,"abstract":"<div><h3>Background and aims</h3><div>Ultrasound-guided deep serratus anterior plane (SAP) block has recently gained popularity as an analgesic technique in breast surgery. However, the effectiveness of ultrasound depends largely on the quality of the equipment used, and the technique can be complicated by patient-related factors such as obesity. We hypothesized that the simpler open approach to deep SAP block would be non-inferior to the ultrasound-guided approach in providing analgesia for modified radical mastectomy.</div></div><div><h3>Method</h3><div>A non-inferiority, randomized controlled study was performed in 100 patients aged 18-60 years who underwent modified radical mastectomy. In the open approach group (n<!--> <!-->=<!--> <!-->50), 30<!--> <!-->ml of 0.25% bupivacaine was injected deep to the serratus anterior muscle after breast resection and rib palpation. In the ultrasound-guided group (n<!--> <!-->=<!--> <!-->50), 30<!--> <!-->ml of 0.25% bupivacaine was injected deep to the serratus anterior muscle under ultrasound guidance before the skin incision. The primary outcome was total morphine consumption in the first 24 postoperative hours. Secondary outcome measures included time to first request for rescue analgesia (duration of SAP block), postoperative visual analogue scale score, and the incidence of adverse effects.</div></div><div><h3>Results</h3><div>Median (interquartile range) morphine requirement in the first 24<!--> <!-->h was similar in both groups (P<!--> <!-->=<!--> <!-->0.81), and the time to first request for analgesia was also similar (P<!--> <!-->=<!--> <!-->0.81). Evaluation of visual analogue scale scores during the initial 24<!--> <!-->h after surgery showed no statistically significant differences between groups (P<!--> <!-->&gt;<!--> <!-->0.05), except at 4 postoperative hours, when the score was significantly higher in the ultrasound group (P<!--> <!-->&lt;<!--> <!-->0.001). No complications were observed in either group.</div></div><div><h3>Conclusion</h3><div>The open approach to deep SAP block is comparable to the ultrasound-guided approach in providing postoperative analgesia in female patients undergoing modified radical mastectomy.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501902"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398369","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}

{"title":"Documento de consenso para la solicitud de pruebas de coagulación preoperatorias","authors":"J.L. Jover Pinillos ,&nbsp;R. Ferrandis Comes ,&nbsp;J.V. Llau Pitarch ,&nbsp;D. Zamudio Penko ,&nbsp;M. Basora Macaya ,&nbsp;M.J. Colomina Soler ,&nbsp;A. Abad Gurumeta ,&nbsp;J. García Fernández","doi":"10.1016/j.redar.2025.501931","DOIUrl":"10.1016/j.redar.2025.501931","url":null,"abstract":"<div><h3>Introduction</h3><div>Standard pre-operative coagulation tests have shown limited ability to detect haemostatic abnormalities, yet they continue to be ordered routinely. Clear guidance is lacking in our setting. We therefore sought to develop consensus recommendations on their indication using a Delphi methodology.</div></div><div><h3>Material and methods</h3><div>A three-round, online, multicentre Delphi study was conducted. Ten expert anaesthesiologists convened and recruited colleagues until the working group comprised 59 anaesthesiologists; 50 completed all rounds. The panel rated 46 statements on a 1-9 Likert scale. Consensus was defined in the third round as ≥<!--> <!-->70% of ratings ≥<!--> <!-->7. Accepted statements were classified as weak (70-79%), moderate (80-89%) or strong (90-100%) agreement.</div></div><div><h3>Results</h3><div>Twenty-nine statements were accepted, synthesised into 21 and grouped into 6 categories: general indication, patient risk factors, procedure characteristics, global assessment, paediatric patients, and special cases. Agreement was strong for 14 statements, moderate for 5, and weak for 2. Key recommendations were: (1)<!--> <!-->avoid universal testing; (2)<!--> <!-->base testing on medical history, standardised bleeding-risk questionnaires and specific risk factors (anticoagulation, liver disease, renal insufficiency, haematopoietic disorders); (3)<!--> <!-->order tests before high-complexity or high-bleeding-risk procedures; and (4)<!--> <!-->use specific assays in patients receiving direct oral anticoagulants.</div></div><div><h3>Conclusions</h3><div>Pre-operative coagulation testing should be individualised according to the patient's haemostatic risk profile and the haemorrhagic risk of the planned procedure.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501931"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398323","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}

{"title":"Efectos de la anestesia en la función cognitiva en ratones jóvenes y mayores: rol de la expresión de c-Fos en la excitabilidad neuronal del hipocampo","authors":"Y. Li ,&nbsp;Z. Jin ,&nbsp;L. Beiping ,&nbsp;A. Xiaolei","doi":"10.1016/j.redar.2025.501904","DOIUrl":"10.1016/j.redar.2025.501904","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the effects of anaesthesia and surgical procedures on the cognitive function of both young and aged mice. It will also explore the role and mechanisms of c-Fos expression in altering hippocampal neuron excitability and its relationship with perioperative neurocognitive disorders in mice.</div></div><div><h3>Methods</h3><div>In this study, we used a murine laparotomy model to assess cognitive behavioural changes in both young and aged mice at 1, 3, and 7<!--> <!-->days post-surgery. We used immunofluorescence techniques to evaluate c-Fos expression in the dorsal hippocampus of aged mice following laparotomy. We also used a chemical genetic approach, injecting a virus into the dorsal hippocampus to modulate neuronal excitability, and subsequently analysed changes in object location memory (OLM) and temporal order memory (TOM). Furthermore, we used Golgi staining to observe the density of dendritic spines in the dorsal hippocampal region of aged mice following anaesthesia and viral injection.</div></div><div><h3>Results</h3><div>No significant cognitive differences were observed between young mice and aged mice administered anaesthesia alone, compared to their respective control groups. However, only the aged mice that underwent surgery displayed significant deficits in OLM and T-maze (TOM) tasks one day post-surgery (one-way ANOVA: OLM: F<!--> <!-->=<!--> <!-->27.507, <em>P</em> <!-->&lt;<!--> <!-->.001; TOM: F<!--> <!-->=<!--> <!-->12.196, <em>P</em> <!-->&lt;<!--> <!-->.001), while the OLM recognition index showed no significant change (one-way ANOVA: F<!--> <!-->=<!--> <!-->.057, <em>P</em> <!-->=<!--> <!-->.982). Furthermore, c-Fos positive neurons in the dorsal hippocampus of aged mice decreased significantly one day after surgery (one-way ANOVA: F<!--> <!-->=<!--> <!-->.057, <em>P</em> <!-->=<!--> <!-->.0048). The application of a chemical-genetic method to enhance the excitability of neurons in the dorsal hippocampus effectively reversed surgery-induced cognitive impairment (one-way ANOVA: OLM: F<!--> <!-->=<!--> <!-->.032, <em>P</em> <!-->=<!--> <!-->.021; TOM: F<!--> <!-->=<!--> <!-->.024, <em>P</em> <!-->=<!--> <!-->.019) and depletion of dendritic spine density (<em>P</em> <!-->&lt;<!--> <!-->.01).</div></div><div><h3>Conclusion</h3><div>Temporal and spatial memory functions are impaired in aged mice following surgery, while object recognition memory remains unaffected. Surgical procedures result in a decrease in the number of c-Fos positive neurons and neuronal excitability in the dorsal hippocampus of aged mice. Furthermore, enhancing neuronal excitability in the dorsal hippocampus alleviates postoperative cognitive impairment in aged mice. Additionally, increasing neuronal excitability in the dorsal hippocampus can counteract the surgery-induced reduction in dendritic spine density.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 9","pages":"Article 501904"},"PeriodicalIF":0.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398372","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}

{"title":"Evaluación anestésica y estrategias perioperatorias en los pacientes con hepatopatía y síndrome cardiohepático","authors":"A. Espinosa ,&nbsp;J. Ripolles Melchor ,&nbsp;M. Jain ,&nbsp;R. Navarro-Perez ,&nbsp;Y.A. Shadad ,&nbsp;A. Malvido ,&nbsp;A. Abad Gurumeta ,&nbsp;R. Alharbi","doi":"10.1016/j.redar.2025.501735","DOIUrl":"10.1016/j.redar.2025.501735","url":null,"abstract":"<div><div>Cardiohepatic syndrome (CHS) presents a significant challenge in perioperative management due to the complex interaction between liver and heart dysfunction. CHS, analogous to cardiorenal syndrome, encompasses various conditions where hepatic and cardiovascular pathologies exacerbate one another. Patients with chronic liver disease, cirrhosis, or heart failure often exhibit increased perioperative morbidity and mortality, necessitating tailored anesthetic strategies. A comprehensive understanding of CHS pathophysiology is crucial, as it informs risk assessment and guides perioperative management. Risk stratification tools such as the Child-Pugh and MELD scores are commonly used, but they have limitations in fully capturing perioperative risks. The updated STS 2024 model includes liver-specific parameters, improving risk prediction in cardiac surgeries. Additionally, the VOCAL-Penn score addresses gaps in traditional risk models, providing a more accurate assessment for patients with advanced liver disease.</div><div>Perioperative management focuses on minimizing hemodynamic stress and avoiding drugs metabolized by the liver. Agents like Remifentanil, Atracurium, and Esmolol are preferred for their minimal hepatic metabolism. Vasopressors such as terlipressin and vasopressin, which target the splanchnic circulation, improve hemodynamics in these patients. Within the Enhanced Recovery After Surgery (ERAS) framework, optimizing nutrition and fluid management is essential for reducing perioperative complications. Effective management of patients with CHS requires a multidisciplinary approach that integrates comprehensive risk assessment and individualized anesthetic strategies. This approach improves outcomes by reducing perioperative complications and mortality in this high-risk population.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501735"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134784","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}

{"title":"Variante paraparética del síndrome de Guillain-Barré tras anestesia epidural","authors":"F. Garvayo Fernández,&nbsp;A. López Olid,&nbsp;M. Pascual Salas,&nbsp;A. Sánchez López,&nbsp;L.M. Jiménez Rodriguez,&nbsp;F.J. Redondo Calvo","doi":"10.1016/j.redar.2025.501775","DOIUrl":"10.1016/j.redar.2025.501775","url":null,"abstract":"<div><div>Epidural procedures are widely used as an analgesic adjunct in various surgeries, allowing for a reduction in the use of opioids and the avoidance of their side effects. According to the third National Audit Project in the United Kingdom, the incidence of serious complications related to epidural puncture is very low. A case is presented of a 66-year-old woman who underwent surgery for ovarian oncological pathology and developed, as a complication of neuroaxial anaesthesia in the postoperative period, a sensory-motor disorder limited to the lower limbs, compatible with the paraparesis variant of Guillain-Barré syndrome.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501775"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134785","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}

{"title":"Suzetrigina como analgésico no opioide: entre la necesidad y la evidencia científica","authors":"A. Alcántara Montero","doi":"10.1016/j.redar.2025.501858","DOIUrl":"10.1016/j.redar.2025.501858","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501858"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134787","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}

{"title":"Estudio comparativo del diámetro de la vaina del nervio óptico y la puntuación Lung Ultrasound en parturientas sanas y con preeclampsia","authors":"A. Nagpal,&nbsp;M. Pandey,&nbsp;N. Kumar","doi":"10.1016/j.redar.2025.501773","DOIUrl":"10.1016/j.redar.2025.501773","url":null,"abstract":"<div><h3>Background</h3><div>Complications of preeclampsia include cerebral and pulmonary edema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.</div></div><div><h3>Methods</h3><div>In this prospective observational analytical study, 35 healthy pregnant women and preeclamptic women each underwent ultrasound assessment for ONSD and LUSS (12 region lung technique). Severity of preeclampsia was noted. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of &lt;<!--> <!-->.05 was considered significant.</div></div><div><h3>Results</h3><div>Mean ONSD and LUSS were higher in preeclamptic compared to healthy parturients (5.06<!--> <!-->±<!--> <!-->0.46 vs 4.24<!--> <!-->±<!--> <!-->0.38<!--> <!-->mm, <em>P</em> <!-->&lt;<!--> <!-->.0001), and (5 [1-12] vs 0 [0-1.5]; p value &lt;<!--> <!-->.0001, respectively). Mean ONSD in severe pre-eclampsia (5.36<!--> <!-->±<!--> <!-->0.32<!--> <!-->mm) was significantly higher as compared to mild pre-eclampsia (4.71<!--> <!-->±<!--> <!-->0.35<!--> <!-->mm; <em>P</em> <!-->&lt;<!--> <!-->.0001). Women with severe preeclampsia had a higher LUSS as compared to the mild preeclamptics and healthy parturients. However, no difference in ONSD and LUSS between mild preeclamptics and healthy parturients was observed. A mean ONSD of &gt;<!--> <!-->4.65<!--> <!-->mm and LUSS of &gt;<!--> <!-->2 could predict preeclampsia with a sensitivity of 77.14% and 68.57% and specificity of 91.43% and 85.71% with an AUC of 0.907 and 0.806 respectively.</div></div><div><h3>Conclusion</h3><div>Both ONSD and LUSS can be used to assess severity and complications of preeclampsia. Early detection can be used to treat, guide fluid therapy and monitor response to treatment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501773"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134781","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}

{"title":"Impacto de la supervisión y la gestión guiada por el índice de predicción de la hipotensión frente a la hemodinámica estándar en la reducción de la hipotensión intraoperatoria","authors":"J. Ripollés-Melchor ,&nbsp;P. Fernández-Valdés-Bango ,&nbsp;D. García-López ,&nbsp;M. Olvera-García ,&nbsp;J.L. Tomé-Roca ,&nbsp;C.A. Vargas-Berenjeno ,&nbsp;A. Ruiz-Escobar ,&nbsp;A.B. Adell-Pérez ,&nbsp;L. Carrasco-Sánchez ,&nbsp;A. Abad-Gurumeta ,&nbsp;J.V. Lorente ,&nbsp;A.V. Espinosa ,&nbsp;I. Jiménez-López ,&nbsp;M.A. Valbuena-Bueno ,&nbsp;M.I. Monge-García","doi":"10.1016/j.redar.2025.501803","DOIUrl":"10.1016/j.redar.2025.501803","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraoperative hypotension (IOH) is a commonly observed phenomenon during major abdominal surgery. The severity and duration of IOH have been identified as crucial factors in the development of these complications.</div></div><div><h3>Methods</h3><div>The study compares two groups of adult patients undergoing major abdominal surgery: one group received standard hemodynamic management using the Edwards Flotrac device, while the second group received hypotension prediction index duration, and severity of intraoperative hypotension in high-risk patients (HPI)-guided hemodynamic management, with anesthesiologists trained via a structured proctoring program. We retrospective analized prospectively gathered anonymized data from 6 Spanish centers during 2021-2022. The primary outcome measure was the time-weighted average of mean arterial pressure &lt;<!--> <!-->65<!--> <!-->mmHg (MAP) during surgery (TWA MAP 65<!--> <!-->mmHg). The secondary outcome measures included incidence of hypotensive episodes, total time with hypotension, and percentage of time spent in hypotension during surgery.</div></div><div><h3>Results</h3><div>A total of 607 patients were analyzed, 270 in the pre-proctoring group vs 337 in the post-proctoring group. The median TWA MAP 65<!--> <!-->mmHg was 0.09<!--> <!-->mmHg (interquartile range [IQR]: 0.00-0.31<!--> <!-->mm Hg) post-proctoring group vs 0.37<!--> <!-->mmHg (IQR: 0.08-1.01<!--> <!-->mm Hg) in the pre-proctoring group, for a median difference of 0.19<!--> <!-->mmHg (95%<!--> <!-->CI: 0.13-0.27<!--> <!-->mmHg; <em>P</em> <!-->&lt;.001), whereas the median TWA MAP &lt;<!--> <!-->55<!--> <!-->mmHg was 0.00<!--> <!-->mmHg (IQR: 0.00-0.01<!--> <!-->mmHg) post-proctoring group vs 0.00<!--> <!-->mmHg (IQR: 0.00-0.07<!--> <!-->mm Hg) in the pre-proctoring group, 0<!--> <!-->mmHg (95%<!--> <!-->CI: 0.0-0.02<!--> <!-->mm Hg; <em>P</em> <!-->&lt;.001).</div></div><div><h3>Conclusions</h3><div>A structured program in hemodynamic training based on the intraoperative use of the hemodynamic prediction index decreases the incidence.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501803"},"PeriodicalIF":0.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134782","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}