Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Detección de hemorragia oculta utilizando un nuevo protocolo denominado UFOH: Ultrasound For Occult Hemorrhage-hemorragia oculta detectada por ecografía","authors":"D. González-Delgado ,&nbsp;A. Hernández Martínez ,&nbsp;J. Mercadal Mercadal ,&nbsp;G. Romero-González ,&nbsp;D.N. Wijeysundera ,&nbsp;M. Vives Santacana ,&nbsp;en nombre de The Spanish Critical Care Ultrasound Network Group","doi":"10.1016/j.redar.2024.501660","DOIUrl":"10.1016/j.redar.2024.501660","url":null,"abstract":"<div><div>Point-of-care abdominal ultrasound has emerged as a powerful tool for clinicians and is becoming a routine bedside tool to rapidly diagnose, manage hemodynamics, monitor fluid status, and guide procedures in emergency and critical care. Extended Focused Assessment with Sonography for Trauma is commonly used to detect free intraperitoneal blood in the trauma setting and may also be an option in non-trauma patients. However, it has significant limitations for detecting gastrointestinal or retroperitoneal bleeding. To date, there is no ultrasound protocol described for the diagnosis of occult bleeding in the retroperitoneal space. We describe a new ultrasound protocol called Ultrasound For Occult Hemorrhage for a fast diagnosis of occult hemorrhage. This protocol is a novel ultrasound-guided approach designed to detect occult bleeding in various clinical settings, including emergency department, intensive care and perioperative environment.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501660"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167736","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}

{"title":"Soporte circulatorio mecánico prolongado en shock cardiogénico secundario a acromegalia. Reporte de caso","authors":"L.A. Salazar-Rojas ,&nbsp;D.I. García-Gómez ,&nbsp;R.E. Gonzalez-Vesga ,&nbsp;C. Colmenares-Mejia","doi":"10.1016/j.redar.2024.05.002","DOIUrl":"10.1016/j.redar.2024.05.002","url":null,"abstract":"<div><div>Heart failure is a complication that may develop in patients diagnosed with acromegaly. This complication can progress to cardiogenic shock, which in cases like the one described, may be refractory to optimal medical management, necessitating the use of mechanical circulatory support as a bridge to decision. Given the specific morphology of this patient's heart, the likelihood of finding a suitable donor in our environment was very low. Therefore, the decision was made to utilize long-term ventricular assistance, which emerges as a viable option in our context.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 101638"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167732","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":"Trombectomía mecánica en el tromboembolismo pulmonar agudo: normalización de patrones de hipertensión pulmonar","authors":"A. Peral Santos ,&nbsp;J.F. Muñoz Moreno ,&nbsp;G. Hernández Gozalves ,&nbsp;A.M. Sobrino López","doi":"10.1016/j.redar.2024.04.005","DOIUrl":"10.1016/j.redar.2024.04.005","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 101635"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167726","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":"Técnica de Seldinger: si hay resistencia, más vale maña que fuerza","authors":"M. López-Baamonde,&nbsp;A. Capdevila,&nbsp;E. Lacoba,&nbsp;M. Magaldi","doi":"10.1016/j.redar.2024.04.002","DOIUrl":"10.1016/j.redar.2024.04.002","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 101631"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167731","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":"Prevalencia del síndrome de burnout en los anestesiólogos europeos y norteamericanos: una revisión sistemática y metaanálisis","authors":"E. Gili-Ortiz ,&nbsp;D. Franco-Fernández ,&nbsp;O. Loli-Aznarán ,&nbsp;M. Gili-Miner","doi":"10.1016/j.redar.2024.501665","DOIUrl":"10.1016/j.redar.2024.501665","url":null,"abstract":"<div><h3>Aims</h3><div>The prevalence of burnout syndrome dimensions in anesthesiologists show notable international differences. In this study, mean prevalences of European and North American anesthesiologists are compared.</div></div><div><h3>Methods</h3><div>Quantitative systematic review (meta-analysis) following the PRISMA and MOOSE criteria. Only studies made with the Maslach Burnout Inventory that includes a Human Services Survey (MBI-HSS) were included. The quality of the studies was evaluated with a modified Newcastle-Ottawa scale, which was used in the meta-regression analyzes together with the Healthcare Access and Quality Index (HAQI) and Gross National Income (GNI) indicators for each country. Publication bias due to small size studies was evaluated with the Egger test.</div></div><div><h3>Results</h3><div>The means of Emotional Exhaustion and Depersonalization were lower in anesthesiologists from Western Europe than in those from Eastern Europe and North America, but the differences were only statistically significant in the Emotional Exhaustion dimension. Meta-regression results were not statistically significant in any of the burnout dimensions for any of the three moderating variables. The test for publication bias was not statistically significant in any of the three dimensions.</div></div><div><h3>Conclusions</h3><div>Based on the results of the meta-analysis and the information from the included studies, social and organizational factors are the most important etiological factors that explain the differences in prevalence. Some of them are related specifically to Eastern Europe and other factors are more relevant in North America. These differences are discussed in this paper.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501665"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167735","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 clínico sobre la utilidad predictiva de CPAP de alto flujo en el destete de la ventilación mecánica en pacientes pediátricos críticos quirúrgicos","authors":"S. Cabezudo Ballesteros,&nbsp;P. Sanabria Carretero,&nbsp;L. Castro Parga,&nbsp;A. Martín Vega,&nbsp;L. López García,&nbsp;F. Reinoso Barbero","doi":"10.1016/j.redar.2024.501658","DOIUrl":"10.1016/j.redar.2024.501658","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Weaning paediatric patients from mechanical ventilation (MV) often results in extubation failure (EF) (14%-22%) and 2% of patients will require tracheostomy (2%).</div></div><div><h3>Methods</h3><div>We performed an observational study in 115 critically ill patients in whom a novel high-flow CPAP (CPAP-ANRI) system was connected to the tracheal tube during ventilation (CPAP+TI). After extubation, the same system was connected to various interfaces.</div></div><div><h3>Results</h3><div>Mean (±<!--> <!-->SD) age was 31<!--> <!-->±<!--> <!-->49 months, PRISM-III score was 2.9<!--> <!-->±<!--> <!-->2.4, and duration of intermittent positive pressure ventilation with tracheal intubation (IPPV+TI) was 6<!--> <!-->±<!--> <!-->5.6 days followed by CPAP+TI for 1.4±1.7 days. The initial rate of EF was 10.4% for either haemodynamic (n<!--> <!-->=<!--> <!-->4) or respiratory (n<!--> <!-->=<!--> <!-->8) reasons, although the final rate of EF requiring tracheostomy was only 0.8%. After progressing from IPPV+TI to CPAP+TI, PO₂/FiO₂ values in successfully extubated patients immediately increased by 27% (<em>P</em>&lt;.0003) vs only 13% (<em>P</em>&gt;.3) in patients presenting EF. Switching to CPAP+TI increased the percentage of patients with pO₂/FiO₂ &gt;200, particularly in patients with heart disease, in whom &gt;30% increase in pO₂/FiO₂ over baseline had a positive predictive value for successful extubation (AUC=0.708; <em>P</em>.056).</div></div><div><h3>Conclusions</h3><div>The CPAP-ANRI device is a simple respiratory aid that is highly effective in optimizing cardiopulmonary interaction to facilitate weaning from MV and identifying most cases in which extubation is likely to be successful.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501658"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167728","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":"Parada cardiorrespiratoria durante la cirugía de trasplante hepático: implicación del beta-bloqueo perioperatorio en el paciente cirrótico","authors":"R.C. Vela Pascual,&nbsp;J.M. Pérez Peña,&nbsp;A. Elvira Rodríguez,&nbsp;M. Power Esteban,&nbsp;C. Jimeno Fernández,&nbsp;J.A. Varela Cabo","doi":"10.1016/j.redar.2024.06.004","DOIUrl":"10.1016/j.redar.2024.06.004","url":null,"abstract":"<div><div>Liver transplantation (LT) has an incidence of intraoperative cardiopulmonary arrest (CPA) of around 5%. Patients who experience CPA during this procedure have a reduced survival rate of approximately 50%.</div><div>Most CPA occur during the neohepatic phase due to reperfusion syndrome, but this is not always the underlying cause, and a broad differential diagnosis must be performed.</div><div>We introduce the case of a cirrhotic patient who received beta-blocker therapy in the preoperative period and who experienced intraoperative CPA during liver transplantation surgery, which was successfully resolved through advanced cardiopulmonary resuscitation maneuvers and specific treatment for beta-blocker toxicity (calcium and glucagon).</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 101645"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167733","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":"¿Alguna novedad en el tratamiento farmacológico de la neuralgia del trigémino?","authors":"A. Alcántara Montero ,&nbsp;C. Álamo González","doi":"10.1016/j.redar.2024.501668","DOIUrl":"10.1016/j.redar.2024.501668","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 2","pages":"Article 501668"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167730","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":"Factores de ventilación potencialmente modificables asociados a los resultados de los pacientes neurocríticos frente a los no neurocríticos: fundamento y protocolo para el análisis desde el nivel del paciente de PRoVENT, PRoVENT-iMiC y ENIO (PRIME)","authors":"S.C. Serafini ,&nbsp;R. Cinotti ,&nbsp;K. Asehnoune ,&nbsp;D. Battaglini ,&nbsp;C. Robba ,&nbsp;A.S. Neto ,&nbsp;L. Pisani ,&nbsp;G. Mazzinari ,&nbsp;E.M. Tschernko ,&nbsp;M.J. Schultz ,&nbsp;para el PRoVENT, el PRoVENT–iMiC y ENIO, los investigadores","doi":"10.1016/j.redar.2024.501690","DOIUrl":"10.1016/j.redar.2024.501690","url":null,"abstract":"<div><h3>Introduction</h3><div>Ventilator settings and ventilation variables and parameters vary between neurocritical care and non-neurocritical care patients. We aim to compare ventilation management in neurocritical care patients versus non-neurocritical care patients under invasive mechanical ventilation support, and to determine which factors related to ventilatory management have an independent association with outcome in neurocritical patients.</div></div><div><h3>Methods and analysis</h3><div>We meta-analyze harmonized individual patient data from 3 observational studies (PRactice of VENTilation in critically ill patients without ARDS [PRoVENT], PRactice of VENTilation in critically ill patients in Middle-income Countries [PRoVENT-iMiC] and Extubation strategies and in neuro-intensive care unit patients and associations with outcomes [ENIO]), pooled into a database named PRIME. The primary endpoint is all cause ICU mortality. Secondary endpoints are key ventilator settings and ventilation variables and parameters. To identify potentially modifiable and non-modifiable factors contributing to ICU mortality, a multivariable model will be built using demographic factors, comorbidities, illness severities, and respiratory and laboratorial variables. In analyses examining the impact of ventilatory variables on outcome, we will estimate the relative risk of ICU mortality for neurocritical and non-neurocritical care patients by dividing the study population based on key ventilator variables and parameters.</div></div><div><h3>Ethics and dissemination</h3><div>This meta-analysis will address a clinically significant research question by comparing neurocritical care with non-neurocritical care patients. As this is a meta-analysis, additional ethical committee approval is not required. Findings will be disseminated to the scientific community through abstracts and original articles in peer-reviewed journals. Furthermore, the PRIME database will be made accessible for further post-hoc analyses.</div></div><div><h3>Registration</h3><div>PRoVENT, PRoVENT-iMiC and ENIO, and the pooled database PRIME are registered at clinicaltrials.gov (NCT01868321 for PRoVENT, NCT03188770 for PRoVENT-iMiC, and NCT03400904 for ENIO, and for PRIME is pending).</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501690"},"PeriodicalIF":0.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881940","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":"Manejo neuroanestesiológico de la rotura carotídea en el abordaje endoscópico endonasal a la base del cráneo","authors":"F. Iturri Clavero ,&nbsp;I. Ingelmo Ingelmo ,&nbsp;K. de Orte Sancho ,&nbsp;M.P. Valcarcel Fernández ,&nbsp;G. Catalán Uribarrena ,&nbsp;F. Valcarcel Martín ,&nbsp;O. Prieto Calderón ,&nbsp;E.M. González Díaz ,&nbsp;A. Uresandi Iruin","doi":"10.1016/j.redar.2024.501691","DOIUrl":"10.1016/j.redar.2024.501691","url":null,"abstract":"<div><div>The medical literature on perioperative anesthesiological care of carotid artery rupture in endoscopic endonasal skull base surgery is practically non-existent. This type of neurovascular injury combines a relatively low incidence with a non-negligible morbidity and mortality. It also requires coordinated multidisciplinary treatment to minimize brain injury induced by inadequate therapeutic management.</div><div>This article presents a series of clinical recommendations and an algorithm for perioperative neuroanesthesiological care of this serious complication.</div><div>To prepare them, a group consisting of 5<!--> <!-->neuroanesthesiologists, a neurosurgeon, an otorhinolaryngologist, a neuroradiologist, and a hematologist reviewed the limited literature on anesthesiological care of this complication. In addition, they adapted anesthesiological care in neurosurgical scenarios similar to the treatment of carotid artery rupture during endoscopic skull base surgery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501691"},"PeriodicalIF":0.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882054","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}