Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Vía aérea difícil por fibromas esclerosantes múltiples en paciente con síndrome de Cowden","authors":"G. Ballout, R. Berge Ramos, L. Gómez-López, M. López-Baamonde","doi":"10.1016/j.redar.2024.03.002","DOIUrl":"10.1016/j.redar.2024.03.002","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 3","pages":"Article 101622"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055091","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":"Neumoencéfalo tras técnica espinal-epidural combinada: informe de caso","authors":"I. Martins de Carvalho,&nbsp;P. Costa Antunes,&nbsp;A. Nunes Miranda,&nbsp;J. Marques Vinagre","doi":"10.1016/j.redar.2024.03.008","DOIUrl":"10.1016/j.redar.2024.03.008","url":null,"abstract":"<div><div>Pneumocephalus refers to the presence of air within the intracranial cavity, and albeit its occurrence following neuraxial techniques is rare, it is commonly associated with a loss of resistance to air technique.</div><div>This case report describes a parturient who underwent neuraxial analgesia for pain management during labour. Epidural space identification with loss of resistance to saline technique was used and she went on to develop a symptomatic pneumocephalus.</div><div>The pneumocephalus had an atypical presentation without immediate headache but with a sudden change in consciousness, likely due to an increase in intracranial pressure following migration of air into the intracranial cavity through the ventricular system.</div><div>Although in most cases it is benign, asymptomatic, and self-limiting, early diagnosis is helpful as treatment with supplemental oxygen can speed recovery. In this case, due to its atypical and sudden presentation, supportive treatment was essential for the prognosis of both mother and baby.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 3","pages":"Article 101628"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394578","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":"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 ,&nbsp;A.V. Espinosa ,&nbsp;P. Fernández-Valdes-Bango ,&nbsp;R. Navarro-Pérez ,&nbsp;A. Abad-Motos ,&nbsp;J.V. Lorente ,&nbsp;M.J. Colomina ,&nbsp;A. Abad-Gurumeta ,&nbsp;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}

{"title":"Estudio prospectivo observacional multicéntrico de los pacientes en shock en tratamiento con vasopresina: protocolo de estudio del Registro VASOPRES","authors":"R. García Álvarez ,&nbsp;F. Ramasco ,&nbsp;J. Nieves Alonso ,&nbsp;L. Mouriz ,&nbsp;P. Rama ,&nbsp;I. Bilbao ,&nbsp;A. Pérez Carbonell ,&nbsp;M.A. Rodenas ,&nbsp;F. Ortega ,&nbsp;M. Vives ,&nbsp;C.A. Calvo ,&nbsp;M. Taboada ,&nbsp;A. Azzam ,&nbsp;M. Merino ,&nbsp;F. Martínez ,&nbsp;D. Domínguez ,&nbsp;C.T. de Llano ,&nbsp;R. Adalia ,&nbsp;G. Aguilar ,&nbsp;C. Aldecoa ,&nbsp;G. Hernández","doi":"10.1016/j.redar.2025.501768","DOIUrl":"10.1016/j.redar.2025.501768","url":null,"abstract":"<div><h3>Introduction</h3><div>In cases of arterial hypotension and/or hypoperfusion that do not respond to fluid therapy, the administration of intravenous catecholamines, especially norepinephrine, is usually the treatment of choice. However, prolonged exposure to high doses of norepinephrine increases mortality, as well as the possibility of arrhythmias, organ damage, and tissue ischemia. An early multimodal vasopressor strategy, which involves adding vasopressin (a drug with a mechanism of action different from catecholamines) to low-dose norepinephrine, could improve the safety profile.</div></div><div><h3>Objectives</h3><div>The main objective is to characterise the routine clinical practice of vasopressin (VASOPRES) use in the context of shock, collecting clinical, analytical and echocardiographic data.</div></div><div><h3>Materials and methods</h3><div>The VASOPRES Registry is a prospective multicentre observational study, in which critical care anaesthesia units from all over Spain will participate, collecting data on patients over 18 years of age in whom treatment with vasopressin is initiated, regardless of the type of shock they present. The duration of the study is estimated at 24 months, starting from its approval by the Clinical Research Ethics Committee (CEIm).</div></div><div><h3>Results</h3><div>Data collection started in July 2024 and is expected to end in July 2026.</div></div><div><h3>Ethics and publications</h3><div>The VASOPRES Registry has already been approved by the Clinical Research Ethics Committee of the Hospital Universitario de La Princesa, Madrid (registration number 5596) in May 2024. The study is registered in ClinicalTrials.gov under the number NCT06422975 and in the Spanish Clinical Trials Register (REec) through the GESTO platform (Observational studys with authorized medicines) under the identification number 0083-2024-OBS. The results will be published in specialised journals and presented at conferences and congresses.</div></div><div><h3>Conclusions</h3><div>The Vasopres Registry may provide insight into the uncertainties that still exist about the use of AVP as well as its use in routine clinical practice in various types of shock. Furthermore, it is also hoped that the results of this study will identify potential areas for improvement where more targeted research is needed.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501768"},"PeriodicalIF":0.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721964","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":"Hipoxemia refractaria durante la terapia de eliminación extracorpórea de CO2: informe de un caso y revisión de la literatura","authors":"S. Freitas Martín,&nbsp;J. Veganzones Ramos,&nbsp;S. Díaz Carrasco,&nbsp;L. Suárez Gonzalo","doi":"10.1016/j.redar.2025.501769","DOIUrl":"10.1016/j.redar.2025.501769","url":null,"abstract":"<div><div>Extracorporeal carbon dioxide removal is increasingly used in clinical practice as a means of facilitating protective mechanical ventilation and reducing the risk of ventilator-induced lung injury in patients with acute respiratory distress syndrome. In some cases, however, extracorporeal carbon dioxide removal can worsen hypoxaemia due to various pathophysiological mechanisms that need to be taken into consideration. We report a case of refractory hypoxaemia that required interruption of extracorporeal carbon dioxide removal therapy.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501769"},"PeriodicalIF":0.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882056","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 anestésico en la cirugía de estenosis traqueal crítica con Tritube® y ventilación controlada por flujo: a propósito de 2 casos","authors":"P. Cruz,&nbsp;A. Puig,&nbsp;E. de la Fuente,&nbsp;S. González,&nbsp;M. Rueda,&nbsp;M. Portas","doi":"10.1016/j.redar.2025.501772","DOIUrl":"10.1016/j.redar.2025.501772","url":null,"abstract":"<div><div>Tracheal resection surgery for critical stenosis requires a highly specialized and multidisciplinary team, with the primary objectives being adequate airway management, safe ventilation, and optimal exposure of the surgical field. This necessitates effective communication and coordination between the anaesthetic and surgical teams.</div><div>We present two clinical cases of critical tracheal stenosis surgery in which intubation was performed with the patient awake. A small-gauge tube with pneumotaponation (Tritube®, Ventinova Medical B.V.; Eindhoven, The Netherlands) was placed, along with a flow-controlled ventilation system (Evone®, Ventinova Medical B.V.; Eindhoven, The Netherlands), as a strategy to be considered for this type of surgery.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501772"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722155","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 de la vía aérea en un paciente con bronquio traqueal derecho supernumerario propuesto para esofagectomía","authors":"S. Moreno-Jurico ,&nbsp;M. Roger ,&nbsp;M. Ubré ,&nbsp;G. Martínez-Pallí","doi":"10.1016/j.redar.2025.501771","DOIUrl":"10.1016/j.redar.2025.501771","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501771"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134789","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 de cohorte multicéntrico sobre la prevalencia del delirium postoperatorio a las 48 h de la cirugía: protocolo de «estudio DELPO»","authors":"M. Varela Durán ,&nbsp;R. Navarro Pérez ,&nbsp;O. de la Varga Martínez ,&nbsp;S. Montesinos Fadrique ,&nbsp;E. Tamayo Gómez ,&nbsp;R. Badenes Quiles","doi":"10.1016/j.redar.2025.501727","DOIUrl":"10.1016/j.redar.2025.501727","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 5","pages":"Article 501727"},"PeriodicalIF":0.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882053","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":"Aportación al artículo «Un dolor de bolsillo: prevalencia de dolor en los pacientes con implantación de sistemas de neuromodulación: estudio retrospectivo»","authors":"L. Valero Verche ,&nbsp;P. Alfaro de la Torre","doi":"10.1016/j.redar.2025.501770","DOIUrl":"10.1016/j.redar.2025.501770","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 7","pages":"Article 501770"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722119","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 preliminar: cambios en el índice de volumen sistólico durante la cirugía de Nuss","authors":"B. Cabeza Martín,&nbsp;M. García-Navlet,&nbsp;A. Melone,&nbsp;M. Arellano Pulido,&nbsp;E. Sanjuan,&nbsp;M. Hervías","doi":"10.1016/j.redar.2025.501726","DOIUrl":"10.1016/j.redar.2025.501726","url":null,"abstract":"<div><h3>Introduction</h3><div>The surgical correction of the pectus excavatum (PE) is justified by the progressive cardiopulmonary involvement. There are few studies that analyze the hemodynamic changes during the intraoperative period.</div></div><div><h3>Objectives</h3><div>To describe the stroke volume index (SVI) changes during the intraoperative with the Nuss technique, through the monitoring of the invasive blood pressure curve (IAP).</div></div><div><h3>Material and methods</h3><div>A prospective observational study of pediatric patients undergoing Nuss surgery by right video-assisted thoracoscopy (VATS). By analyzing the IAP curve using the FloTrac monitor (Edwars®), the following dynamic parameters were evaluated: stroke volume index (SVI), cardiac index (CI), stroke volume variation (SVV). The dates were collected on 3 occasions: baseline, before bar placement (after preload optimization in search of the target IVS) and after bar placement.</div></div><div><h3>Results</h3><div>Were included 6 patients aged 14-16 years, 5/6 males. Five of six had cardiac MRI with decreased FEVD (33-44%), 1/6 with FEVD 53%. At baseline, IVS and CI were decreased, 19-29 ml/lat/m² and 1.1-1.9 L/min/m². Two-Three overloads of volume were performed to reach target IVS (25-35 ml/lat/m²), with an increase of 0-75%. After the placement of the bar, the IVS was increased by 8%-42% (35-40 ml/lat/m²) with respect to the target IVS, with normalization of the CI (2.5-3.5 L/min/m²).</div></div><div><h3>Conclusions</h3><div>PE produces compression of the VD, with descent of the IVS. After the placement of the Nuss bar, through the analysis of the IAP, we can objectifield an increase in the IVS and normalization of the CI.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"72 8","pages":"Article 501726"},"PeriodicalIF":0.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134822","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}