Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Factores asociados a la mortalidad, estancia hospitalaria y limitación del esfuerzo terapéutico en ancianos mayores de 80 años en una UCI quirúrgica: estudio observacional retrospectivo","authors":"F. Guitart de la Lastra,&nbsp;F. Ramasco Rueda,&nbsp;C. Martín,&nbsp;A. Figuerola,&nbsp;A. Calderón,&nbsp;A. García-Jorge","doi":"10.1016/j.redar.2025.502027","DOIUrl":"10.1016/j.redar.2025.502027","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the clinical characteristics of patients over 80 years admitted to the Surgical Intensive Care Unit (SICU) of Hospital de La Princesa, and to identify admission variables associated with mortality and prolonged hospital stay. As a secondary objective, we explored decisions regarding limitation of therapeutic effort (LTE), their predictors, and their impact on survival and length of stay.</div></div><div><h3>Material and methods</h3><div>Retrospective observational study including 100 patients over 80 years admitted to the SICU. Clinical, demographic, and prognostic variables were collected, including age, gender, type of surgery, SOFA and Charlson scores, nutritional status (CONUT), and frailty. Multivariate analysis was performed to identify factors associated with mortality, length of stay, and LTE.</div></div><div><h3>Results</h3><div>Mean age was 85.8 years (SD<!--> <!-->±<!--> <!-->4.2). Thirty-day mortality was 16%, and mean ICU length of stay was 5.36 days (SD<!--> <!-->±<!--> <!-->8.2). Mechanical ventilation was the only factor independently associated with mortality (OR 16.6; 95% CI: 1.5-180.6). Development of sepsis and use of vasoactive drugs were associated with longer hospital stays (<em>P</em> <!-->&lt;<!--> <!-->0.05). LTE decisions were made in 68% of deceased patients, with no significant differences in survival or length of stay between patients with and without LTE.</div></div><div><h3>Conclusions</h3><div>Mechanical ventilation is the main predictor of mortality in patients over 80 years admitted to SICU. Sepsis and vasoactive support prolonged hospital stay. LTE decisions are frequent in this population, although no clear predictors for their application were identified.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502027"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427241","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":"Más allá del algoritmo: defendiendo la integridad científica en la era de la inteligencia artificial","authors":"R. Casans-Francés ,&nbsp;A. Abad-Gurumeta","doi":"10.1016/j.redar.2025.502002","DOIUrl":"10.1016/j.redar.2025.502002","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502002"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427246","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":"Patrón radiológico de inyección intradural de contraste radiopaco","authors":"F. Galván-Román,&nbsp;Á. Alonso Chico,&nbsp;L. Gómez Suárez,&nbsp;M.V. López-Chuecos","doi":"10.1016/j.redar.2025.502004","DOIUrl":"10.1016/j.redar.2025.502004","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502004"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427247","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":"Intubación submentoniana como alternativa a la traqueostomía en fractura panfacial compleja: reporte de un caso clínico","authors":"M. Arias Salazar ,&nbsp;F. Javier Cuesta ,&nbsp;M. López-Baamonde ,&nbsp;R. Bergé ,&nbsp;I. Martínez ,&nbsp;L. Garavito","doi":"10.1016/j.redar.2025.502023","DOIUrl":"10.1016/j.redar.2025.502023","url":null,"abstract":"<div><div>Submental intubation, first described in 1986, is an effective alternative to tracheostomy in patients with complex facial fractures in whom nasotracheal intubation is contraindicated and orotracheal intubation would interfere with the surgical field. We report the case of a 38-year-old man with a history of morbid obesity who suffered a panfacial fracture with involvement of the frontal sinuses and intracranial communication after falling from a second floor. Nasotracheal intubation was contraindicated, and orotracheal intubation would have interfered with the planned intermaxillary fixation. We first performed fibreoptic orotracheal intubation, which was then surgically converted to submental intubation. No intraoperative or postoperative complications occurred, and the patient's evolution was favourable, with only minimal scarring in the submental region. Recent literature has confirmed that this technique is safe and is associated with less morbidity and better aesthetic outcomes than tracheostomy. This case highlights the need to consider submental intubation as a priority airway management option in complex panfacial fractures.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502023"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147426027","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 comparativa del efecto de la aplicación de maniobras externas vs. ausencia de maniobras en la visión glótica durante la videolaringoscopia en pacientes sometidos a cirugía electiva con la cabeza en posición neutra","authors":"S. Panda ,&nbsp;N. Agrawal ,&nbsp;K. Jain V ,&nbsp;A. Gupta","doi":"10.1016/j.redar.2025.502016","DOIUrl":"10.1016/j.redar.2025.502016","url":null,"abstract":"<div><h3>Objectives</h3><div>In patients with cervical spine injury, glottic visualization is difficult in the head-neutral position. The role of external laryngeal manoeuvres, such as backward-upward-rightward pressure (BURP) and jaw thrust in intubation outcomes remains unclear. We compared the effects of jaw thrust and BURP on the quality of glottic view with the head in a neutral position during C-MAC videolaryngoscopy.</div></div><div><h3>Methods</h3><div>In this self-controlled study, glottic view was assessed in 120 adult patients using a C-MAC videolaryngoscope with no manoeuvre, BURP, or jaw thrust. After induction, endotracheal intubation was performed according to Grupo allocation. Screenshots of the best glottic view were taken each time to assess the percentage of glottic opening (POGO) score, modified Cormack-Lehane (MCL) grade, and glottic opening area en píxeles cuadrados. Intubation times, ease of intubation, haemodynamics, and complications were also recorded.</div></div><div><h3>Results</h3><div>POGO scores (mean [DE]) were significantly higher with BURP (72.7 [19.9]) and jaw thrust (60[26.3]) manoeuvres compared to no manoeuvre (25 [26.9]; p<!--> <!-->&lt;<!--> <!-->0.0001). Glottic opening area in square pixels (p<!--> <!-->&lt;<!--> <!-->0.001) and MCL grades (p<!--> <!-->=<!--> <!-->0.043) were considerably higher after the application of laryngeal manoeuvres. There were no significant differences in the duration of laryngoscopy and intubation times between Grupos; however, intubation was significantly easier with BURP (p<!--> <!-->=<!--> <!-->0.021) and jaw thrust (p<!--> <!-->=<!--> <!-->0.032).</div></div><div><h3>Conclusion</h3><div>External manoeuvres, such as BURP and jaw thrust, should improve glottic view during C-MAC videolaryngoscopy in patients with the head in a neutral position.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502016"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427242","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":"Predicción clínica en el tratamiento con parche de capsaicina al 8% en dolor neuropático postraumático: una mirada crítica desde la evidencia acumulada","authors":"A. Alcántara Montero ,&nbsp;P.J. Ibor Vidal","doi":"10.1016/j.redar.2025.501992","DOIUrl":"10.1016/j.redar.2025.501992","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 501992"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147426028","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 comparativa de dexmedetomidina y midazolam por vía intranasal como premedicación para niños sometidos a cirugía correctiva de cardiopatía congénita: ensayo clínico aleatorizado","authors":"R. Sharma ,&nbsp;S. Singh ,&nbsp;R. Nair ,&nbsp;M. Dhiman ,&nbsp;P. Taank","doi":"10.1016/j.redar.2025.502029","DOIUrl":"10.1016/j.redar.2025.502029","url":null,"abstract":"<div><h3>Background</h3><div>Premedication is essential in paediatric surgery for smooth induction and anxiety relief. Common agents —ketamine, midazolam, dexmedetomidine, and fentanyl— are administered via intramuscular injection, intravenous infusion, or oral routes, but efficacy varies and no consensus exists on an optimal protocol. Intranasal delivery offers a promising, more comfortable alternative with potential to improve outcomes.</div></div><div><h3>Methods</h3><div>This double-blind randomized trial evaluated intranasal dexmedetomidine (1<!--> <!-->μg/kg) (group<!--> <!-->D) versus midazolam (0.2<!--> <!-->mg/kg) as premedication in 90 children (2-12<!--> <!-->years) (group<!--> <!-->M) undergoing corrective surgery for acyanotic congenital heart disease (CHD). Sedation, parental separation anxiety, mask acceptance, and hemodynamic parameters were evaluated.</div></div><div><h3>Results</h3><div>Acceptable sedation was achieved in 62.2% of children in group<!--> <!-->D and 53.3% in group<!--> <!-->M. Group<!--> <!-->D showed superior anxiolysis during separation from parents (93.3% vs. 73.3%) and better mask acceptance during induction (93.3% vs. 53.3%). A statistically significant but clinically mild decrease in diastolic BP occurred in the dexmedetomidine group without adverse effects.</div></div><div><h3>Conclusion</h3><div>Both drugs were effective as intranasal premedication. However, dexmedetomidine showed better results in sedation, less anxiety upon separation from parents, and greater acceptance of the mask, without significant side effects.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 502029"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427249","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":"Maniobra de reclutamiento: hechos y cifras","authors":"Z. Salihoglu ,&nbsp;E. Salihoglu","doi":"10.1016/j.redar.2025.501999","DOIUrl":"10.1016/j.redar.2025.501999","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 3","pages":"Article 501999"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147427251","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":"Videolaringoscopia versus laringoscopia directa en la intubación traqueal de pacientes quirúrgicos realizada por residentes: protocolo del ensayo aleatorizado y multicéntrico VILARE","authors":"M. Taboada ,&nbsp;M. Bermúdez ,&nbsp;J. Fernández ,&nbsp;A. Estany-Gestal ,&nbsp;J. José Amate ,&nbsp;R. Ruido ,&nbsp;M. Amor ,&nbsp;R. Mato ,&nbsp;C. Barreiro ,&nbsp;P. Martínez ,&nbsp;F. Ramasco ,&nbsp;O. Vázquez ,&nbsp;T. Seoane-Pillado","doi":"10.1016/j.redar.2025.501988","DOIUrl":"10.1016/j.redar.2025.501988","url":null,"abstract":"<div><h3>Introduction</h3><div>Tracheal intubation using direct laryngoscopy with a Macintosh blade remains the standard technique in the operating room. However, this method requires precise anatomical alignment and direct visualization of the glottis, which can be challenging for anesthesia residents with limited experience. Multiple intubation attempts are associated with an increased risk of complications. Videolaryngoscopy allows indirect visualization of the glottis and enables real-time supervision and feedback during the procedure, potentially improving safety and facilitating learning. Although videolaryngoscopy has shown benefits in difficult airway scenarios and in experienced hands, evidence is limited on whether it improves first-pass success and reduces complications when used by anesthesia residents in patients without predicted airway difficulty. The aim of this study is to compare first-pass intubation success with videolaryngoscopy versus direct laryngoscopy when performed by anesthesia residents in the operating room.</div></div><div><h3>Methods and analysis</h3><div>The VILARE trial is a prospective, multicenter, randomized, open-label study. A total of 1008 adult patients undergoing elective or urgent surgery under general anesthesia, without predictors of difficult airway, will be randomized to undergo tracheal intubation using either a standard Macintosh direct laryngoscope or a Macintosh videolaryngoscope on the first attempt. All tracheal intubations will be performed by anesthesia residents. The primary endpoint is successful intubation on the first attempt. Secondary outcomes time for successful tracheal intubation, attempts for successful intubation, laryngoscopic vision with the modified Cormack-Lehane scale, need of adjuvant airway devices for intubation, subjective difficulty of intubation, and complications during tracheal intubation (e.g., desaturation, dental trauma).</div></div><div><h3>Ethics and dissemination</h3><div>The study protocol was approved November 28, 2024, by the Ethics Committee of Galicia, Spain (CEI-SL, code No. 2024/394).and was registered into the Clinicaltrials.gov clinical trials registry with No. NCT06842082. Informed consent is required. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences. If videolaryngoscopy improves first-attempt intubation success and reduces complications in anesthesia residents, its use may be recommended as the first-line device in anesthesia training programs.</div><div>Trial registration number ClinicalTrials.gov Registry: NCT06842082.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 501988"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135734","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":"Reevaluar la anemia en gastrectomía: definiciones diagnósticas y valor predictivo en la cohorte POWER 4","authors":"J. Ripolles-Melchor ,&nbsp;A. Abad-Motos ,&nbsp;E. Nieto Moreno ,&nbsp;C. Jerico ,&nbsp;I. Otero-Martínez ,&nbsp;O. Abdel-lah Fernández ,&nbsp;R. García-Alvarez ,&nbsp;M.P. Tormos-Pérez ,&nbsp;A.V. Espinosa ,&nbsp;C. Aldecoa ,&nbsp;A. Abad-Gurumeta ,&nbsp;M.J. Colomina ,&nbsp;J.A. García-Erce ,&nbsp;Grupo de Investigadores POWER 4","doi":"10.1016/j.redar.2025.502020","DOIUrl":"10.1016/j.redar.2025.502020","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative anaemia is a common finding in patients undergoing gastrectomy, and is frequently targeted in optimisation strategies. However, its independent association with postoperative complications remains unclear, and the prognostic value of redefining diagnostic thresholds has not been formally assessed.</div></div><div><h3>Methods</h3><div>This prospective substudy of the POWER<!--> <!-->4 cohort included 742 patients undergoing elective gastrectomy for cancer. Anaemia was defined by WHO sex-specific thresholds (Hb<!--> <!-->&lt;<!--> <!-->13<!--> <!-->g/dL in men, &lt;<!--> <!-->12<!--> <!-->g/dL in women) and a universal threshold of &lt;<!--> <!-->13<!--> <!-->g/dL. Four subcohorts were analysed: A1 (WHO, full cohort), A2 (universal, full), B1 (WHO, untreated), B2 (universal, untreated). Multivariable logistic regression was used to assess associations with postoperative complications. Discrimination was evaluated using AUC, AIC/BIC, and Net Reclassification Improvement (NRI). Generalised additive models (GAMs) were used to explore continuous relationships between haemoglobin and risk.</div></div><div><h3>Results</h3><div>Anaemia prevalence was 38.0% with WHO thresholds and 52.4% with the universal threshold. In full-cohort models, anaemia was not independently associated with complications (A1, OR: 0.92 [95%<!--> <!-->CI: 0.60-1.41]; A2, OR: 0.89 [0.59-1.36]). Model performance was similar (AUC: 0.686). In untreated patients (n<!--> <!-->=<!--> <!-->584), discrimination improved (B1, AUC: 0.750; B2, AUC: 0.743), but anaemia remained non-significant. NRI modestly favoured the universal threshold (A1/A2: 0.048; B1/B2: 0.072), with most reclassification occurring in intermediate risk groups. GAMs showed a smooth monotonic relationship without a clear inflection point.</div></div><div><h3>Conclusion</h3><div>Anaemia was not independently associated with postoperative complications. Redefining thresholds altered prevalence but did not improve prediction. Haemoglobin may be better used as part of an integrated perioperative risk assessment rather than a binary stratifier.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 502020"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135736","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}