Revista Espanola de Anestesiologia y Reanimacion最新文献_第3页

Vía aérea difícil por fibromas esclerosantes múltiples en paciente con síndrome de Cowden 一名考登综合征患者因多发性硬化性纤维瘤导致呼吸道困难

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-03-01 DOI: 10.1016/j.redar.2024.03.002

G. Ballout, R. Berge Ramos, L. Gómez-López, M. López-Baamonde

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Neumoencéfalo tras técnica espinal-epidural combinada: informe de caso 脊髓-硬膜外联合技术后的气脑：病例报告

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-03-01 DOI: 10.1016/j.redar.2024.03.008

I. Martins de Carvalho, P. Costa Antunes, A. Nunes Miranda, J. Marques Vinagre

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Terapia hemodinámica guiada por objetivos intraoperatoria focalizada en parámetros de presión arterial y flujo mediante técnicas no calibradas de contorno del pulso: metaanálisis de ensayos controlados aleatorizados 以手术内目标为导向的血液动力学治疗，使用未校准的脉搏轮廓技术，以血压和流量参数为重点：随机对照试验的荟萃分析

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-03-01 DOI: 10.1016/j.redar.2024.501653

J. Ripollés-Melchor , A.V. Espinosa , P. Fernández-Valdes-Bango , R. Navarro-Pérez , A. Abad-Motos , J.V. Lorente , M.J. Colomina , A. Abad-Gurumeta , M.I. Monge-García

{"title":"Terapia hemodinámica guiada por objetivos intraoperatoria focalizada en parámetros de presión arterial y flujo mediante técnicas no calibradas de contorno del pulso: metaanálisis de ensayos controlados aleatorizados","authors":"J. Ripollés-Melchor , A.V. Espinosa , P. Fernández-Valdes-Bango , R. Navarro-Pérez , A. Abad-Motos , J.V. Lorente , M.J. Colomina , A. Abad-Gurumeta , M.I. Monge-García","doi":"10.1016/j.redar.2024.501653","DOIUrl":"10.1016/j.redar.2024.501653","url":null,"abstract":"<div><h3>Background</h3><div>Goal-directed haemodynamic therapy (GDHT) aims to optimize haemodynamic variables. However, its effectiveness in reducing postoperative complications in major abdominal surgery, particularly when targeting both arterial pressure and flow variables, remains unclear. This meta-analysis addresses this by evaluating GDHT using uncalibrated pulse contour (uPC) methods.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) in adult patients undergoing major abdominal surgery who received GDHT using uncalibrated pulse contour (uPC) methods for cardiac output monitoring, with predefined targets for both blood flow and blood pressure. The primary outcome was postoperative complications; secondary outcomes included postoperative acute kidney injury (AKI), hospital length of stay (EH), intraoperative fluid administration and mortality.</div></div><div><h3>Results</h3><div>Initial search retrieved 860 reports, with 12 RCTs (1367 patients) meeting the inclusion criteria. Our meta-analysis showed a significant reduction in postoperative complications (RR: 0.78; 95%CI: 0.68-0.90), AKI (RR: 0.7; 95%CI: 0.51-0.97), and hospital LOS (SMD: −0.30; 95%CI: −0.54 to −0.06) with uPC-guided GDHT. No significant differences were observed in intraoperative fluid volume and mortality.</div></div><div><h3>Conclusions</h3><div>Implementing GDHT in major abdominal surgery with predefined arterial pressure and blood flow targets significantly reduces postoperative morbidity and hospital EH without increasing intraoperative fluid administration.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 3","pages":"Article 501653"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511999","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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Hipoxemia refractaria durante la terapia de eliminación extracorpórea de CO2: informe de un caso y revisión de la literatura 体外CO2去除治疗期间的顽固性低氧血症：案例报告和文献综述

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-27 DOI: 10.1016/j.redar.2025.501769

S. Freitas Martín, J. Veganzones Ramos, S. Díaz Carrasco, L. Suárez Gonzalo

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Estudio de cohorte multicéntrico sobre la prevalencia del delirium postoperatorio a las 48 h de la cirugía: protocolo de «estudio DELPO» 关于术后48小时谵妄患病率的多中心队列研究：“DELPO研究”方案

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-24 DOI: 10.1016/j.redar.2025.501727

M. Varela Durán , R. Navarro Pérez , O. de la Varga Martínez , S. Montesinos Fadrique , E. Tamayo Gómez , R. Badenes Quiles

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Hemoglobina preoperatoria como factor predictivo de morbilidad intrahospitalaria y mortalidad a 5 años en el cáncer colorrectal 术前血红蛋白作为结肠直肠癌5年院内发病率和死亡率的预测因素

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-17 DOI: 10.1016/j.redar.2024.501723

A. Herrero García , S.E. Denis Filippini , A. de la Fuente , E. Choolani Bhojwani , J. Sánchez González , M. Bailón Cuadrado , S. Veleda Belanche , V. Simó Fernández , J.A. García Erce , C. Aldecoa Álvarez-Santullano

{"title":"Hemoglobina preoperatoria como factor predictivo de morbilidad intrahospitalaria y mortalidad a 5 años en el cáncer colorrectal","authors":"A. Herrero García , S.E. Denis Filippini , A. de la Fuente , E. Choolani Bhojwani , J. Sánchez González , M. Bailón Cuadrado , S. Veleda Belanche , V. Simó Fernández , J.A. García Erce , C. Aldecoa Álvarez-Santullano","doi":"10.1016/j.redar.2024.501723","DOIUrl":"10.1016/j.redar.2024.501723","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) is the third most diagnosed cancer worldwide. Preoperative anaemia is common in CRC patients undergoing surgery.</div></div><div><h3>Objective</h3><div>This study assesses the prevalence of preoperative anaemia and its impact on postoperative outcomes, and aims to establish a cut-off point for increased morbidity and mortality in a large prospective single centre cohort.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 1105 CRC patients (2014-2021). Anaemia was defined as per WHO criteria. Multivariate logistic regression and Kaplan-Meier survival analyses were used. The statistical significance level was set at <.05.</div></div><div><h3>Results</h3><div>Preoperative anaemia was present in 45.3% of patients, and was associated with a higher incidence of perioperative complications (OR: 2.76; <em>P</em>    <!-->.001.</div></div><div><h3>Discussion/conclusions</h3><div>Preoperative anaemia, even when mild, is associated with a higher rate of complications, longer hospital stay, and a greater risk of 5-year mortality.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501723"},"PeriodicalIF":0.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882049","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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Consideraciones anestésicas en el manejo perioperatorio del paciente con angioedema hereditario FXII FXII遗传性血管水肿患者术后管理中的麻醉考虑因素

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-10 DOI: 10.1016/j.redar.2025.501732

P. García Robledo , J.C. García Ortiz

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Impacto medioambiental de los anestésicos volátiles en un hospital docente de alta complejidad de 2019 a 2022: análisis cuantitativo 2019 - 2022年高复杂性教学医院挥发性麻醉剂对环境的影响：定量分析

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-01 DOI: 10.1016/j.redar.2024.501659

A.M. Obando Rondón , C.A. Triana-Schöonewolff , J.D. Guerra Toro , J.F. Parada-Márquez , N.A. Avila Ardila , A.F. Zuluaga Zuluaga , M.C. Cardona-Lozano

{"title":"Impacto medioambiental de los anestésicos volátiles en un hospital docente de alta complejidad de 2019 a 2022: análisis cuantitativo","authors":"A.M. Obando Rondón , C.A. Triana-Schöonewolff , J.D. Guerra Toro , J.F. Parada-Márquez , N.A. Avila Ardila , A.F. Zuluaga Zuluaga , M.C. Cardona-Lozano","doi":"10.1016/j.redar.2024.501659","DOIUrl":"10.1016/j.redar.2024.501659","url":null,"abstract":"<div><h3>Background</h3><div>The healthcare sector emits 5% of greenhouse gases worldwide, inhaled anesthetic agents have contributed to this effect for years. Other countries measured and limited their use, leading to positive environmental changes. There is a lack of data on Colombia. This project aims to evaluate the environmental impact of desflurane, isoflurane, and sevoflurane between 2019 and 2022 in a hospital in Bogota.</div></div><div><h3>Methods</h3><div>A retrospective exploration of inhaled anesthetic agents use was conducted using our hospital's pharmacy inventory between 2019 and 2022. Oracle software tools were used, along with the amount of anesthetics dispensed by the pharmacy. The CO<sub>2</sub> equivalent was calculated in kilograms using the global warming potential at 20 and 100 years.</div></div><div><h3>Results</h3><div>A total of 743kg of inhaled anesthetic agents was administered between 2019 and 2022. Sevoflurane accounted for 265.7kg, desflurane for 473.9kg, while isoflurane was used in smaller quantities. There was a change in the trend between 2019/2020 and 2021/2022, with an increase of 69.3kg in sevoflurane use and a decrease of 86.2kg in desflurane use. The CO<sub>2</sub> emissions from desflurane decreased from 190.7 to 131.9t over 20 years and from 711 to 492t over 100 years.</div></div><div><h3>Conclusions</h3><div>The use of sevoflurane increased by 70%, whereas that of desflurane decreased by 31%. CO<sub>2</sub> emissions were reduced by 557t in 20 years and 210t in 100 years. The environmental impact of sevoflurane is 97% lower than desflurane in our OR's.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501659"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167727","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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Uso de vancomicina y lesión renal aguda en pacientes críticos con sepsis o shock séptico: cohorte observacional retrospectiva 在严重败血症或脓毒症休克患者中使用万古霉素和急性肾损伤：回顾性观察队列

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-01 DOI: 10.1016/j.redar.2024.501657

D. González-Delgado , M. Vives , P. Monedero , A. Aldaz

{"title":"Uso de vancomicina y lesión renal aguda en pacientes críticos con sepsis o shock séptico: cohorte observacional retrospectiva","authors":"D. González-Delgado , M. Vives , P. Monedero , A. Aldaz","doi":"10.1016/j.redar.2024.501657","DOIUrl":"10.1016/j.redar.2024.501657","url":null,"abstract":"<div><h3>Introduction</h3><div>The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial.</div><div>The aim of this study was to evaluate the incidence of AKI in a cohort of patients with sepsis or septic Shock with an adequate and strict monitoring of vancomycin, guided by the area under the concentration-time curve in relation to the minimum inhibitory concentration (AUC/MIC ratio).</div></div><div><h3>Material and methods</h3><div>Retrospective cohort study on 106 patients admitted to the ICU with a diagnosis of sepsis or septic shock with vancomycin treatment, consecutively from January 2017 to December 2019.</div><div>AKI was defined according to Kidney Disease Improving Global Outcomes criteria. Risk factors associated with AKI were determined by multivariable logistic regression analysis.</div></div><div><h3>Results</h3><div>In our cohort, 28 patients out of 106 (26%) developed AKI. ICU and 30-day mortality were 18% and 22%, respectively. After multivariable logistic regression adjusted analysis, chronic liver disease was associated with AKI.</div></div><div><h3>Conclusion</h3><div>In our retrospective cohort study on critical patients with sepsis and septic shock, treated with vancomycin adjusting the dose guided by a pharmacokinetic/pharmacodynamic monitoring to achieve the target AUC<sub>0-24</sub>/CMI ratio, the incidence of AKI was 26%.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501657"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167729","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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Estudio de cohortes para evaluar el patrón de prescripción analgésica en pacientes adultos intervenidos en cirugía mayor ambulatoria 评估成人门诊大手术患者止痛处方模式的队列研究

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Revista Espanola de Anestesiologia y Reanimacion Pub Date : 2025-02-01 DOI: 10.1016/j.redar.2024.501664

L. Velasco , A. Calle , J. Coronel , A. Gallo , A. Reyes , M. Portas , L. Bermejo , A. Giménez , A. Ribed , M. Zaballos

{"title":"Estudio de cohortes para evaluar el patrón de prescripción analgésica en pacientes adultos intervenidos en cirugía mayor ambulatoria","authors":"L. Velasco , A. Calle , J. Coronel , A. Gallo , A. Reyes , M. Portas , L. Bermejo , A. Giménez , A. Ribed , M. Zaballos","doi":"10.1016/j.redar.2024.501664","DOIUrl":"10.1016/j.redar.2024.501664","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative pain in ambulatory surgery (AS) continues to be a recurrent problem despite anesthetic and surgical advances. Analgesic prescription and follow-up by patients at home may be a determining factor. Our objective was to evaluate analgesic prescription and its impact on the intensity of postoperative pain at 24h and 7days in an AS unit.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients undergoing AS. Anthropometric data, ASA classification, surgery, anesthesia, analgesic prescription and postoperative pain. A telephone call was made by nurses to evaluate the DAP at 24h and one week after surgery.</div></div><div><h3>Results</h3><div>A total of 875 patients, 62% women, aged 50±17 years, were studied. Orthopedic (45.4%); head and neck (19.5%); general (10.6%); vascular (11.9%); plastic (2.4%) and gynecological (10.2%) surgery was performed. Multimodal analgesia was prescribed: 83.7%, combination of nonsteroidal anti-inflammatory drug (NSAID) +paracetamol +metamizole: 70.79%; opioid +paracetamol or NSAID or in monotherapy: 13.1%; monotherapy with paracetamol (15%) or NSAID (1.15%). Some 62.45% were prescribed «if pain» and 61.87% had rescue analgesia. At 24h the median (IQR) of pain on the self-assessing verbal scale was 3 (2 to 5) and at one week 2 (0 to 4). The presence of moderate-severe pain was 46% at 24h and 31% at one week after surgery.</div></div><div><h3>Conclusions</h3><div>Our results show great variability in analgesic prescription with insufficient control of postoperative pain in ambulatory surgery. Although the multimodal analgesic strategy has been widely used, opioid prescription has been insufficient in surgeries associated with moderate to severe pain.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501664"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167734","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