Revista Espanola de Anestesiologia y Reanimacion最新文献

{"title":"Variabilidad en la aplicación de los programas de gestión de sangre del paciente en Iberia","authors":"J.A. García Erce ,&nbsp;F. Sabio ,&nbsp;C. Jericó ,&nbsp;S. Isabel Jorge ,&nbsp;M. Quintana Díaz ,&nbsp;D. Castro Paupério","doi":"10.1016/j.redar.2025.502017","DOIUrl":"10.1016/j.redar.2025.502017","url":null,"abstract":"<div><h3>Background</h3><div>In 2010, the World Health Organization (WHO) called for global implementation of Patient Blood Management (PBM) programs to optimize transfusion practices and reduce variability in blood utilization. This study examines the evolution of red cell, platelet, and plasma consumption in Iberia (Spain and Portugal), comparing trends within the region and with European benchmarks like the United Kingdom, Germany, and Italy.</div></div><div><h3>Methods</h3><div>National transfusion activity reports from Spain, Portugal, the United Kingdom (2011–2023) were analyzed. Key metrics included transfusion rates per 1,000 inhabitants for red cells, platelets, and fresh frozen plasma. Statistical analyses were performed using Kruskal-Wallis tests and ANOVA to identify differences between countries and over time.</div></div><div><h3>Results</h3><div>From 2011 to 2023, red cell transfusion rates decreased by 30% in the UK, 6% in Spain, and 15% in Portugal. Germany showed a modest decline, while Italy maintained stable rates exceeding 40 units per 1,000 inhabitants. Platelet and plasma consumption exhibited distinct patterns, with Portugal showing a steeper decline compared to Spain, and the UK maintaining the lowest overall rates. Platelet consume is clearly increasing.</div></div><div><h3>Conclusions</h3><div>The analysis reveals significant differences in blood component utilization across Iberia and Europe, reflecting varying levels of PBM adoption. Despite WHO and Council of Europe recommendations, Iberian countries lag behind the UK in reducing red cell transfusion rates. These findings underscore the need for uniform PBM implementation to harmonize practices and optimize resource use, not only Red Cell Concentrates. The creation of the Iberian task-force (section of the Ibero-American PBM Society (SIAPBM) could be an opportunity to create the necessary awareness in our countries and become a meeting point between America and Europe.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 502017"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135731","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":"Enfisema subcutáneo como emergencia de vía aérea tras cierre de traqueostomía","authors":"M. Linares,&nbsp;G. Álvarez Roca,&nbsp;R. Riera-Pérez,&nbsp;M. López-Baamonde","doi":"10.1016/j.redar.2025.502018","DOIUrl":"10.1016/j.redar.2025.502018","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 502018"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135617","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":"Hacia una implementación universal de la videolaringoscopia. Un nuevo hito en el manejo de la vía aérea impulsado por la SEDAR","authors":"M.Á. Gómez-Ríos ,&nbsp;A. Abad-Gurumeta","doi":"10.1016/j.redar.2025.501993","DOIUrl":"10.1016/j.redar.2025.501993","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 501993"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135618","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":"Bloqueo plano del erector en neonato: Revisión a propósito de un caso","authors":"J.A. Orozco Arango ,&nbsp;P.A. Cruces Muñoz","doi":"10.1016/j.redar.2025.502019","DOIUrl":"10.1016/j.redar.2025.502019","url":null,"abstract":"<div><div>Pain in neonates, if not adequately treated, can lead to long-term neurological and behavioral consequences. Among the most frequent causes are intrapartum fractures. Although rare, rib fractures represent a diagnostic and therapeutic challenge. This article presents the case of a 36-week neonate with a left rib fracture who exhibited symptoms such as inconsolable crying, feeding refusal, and oxygen desaturation. An ultrasound-guided erector spinae plane block (ESPB) was performed, resulting in significant clinical improvement without complications. Although ESPB has been widely used in adults and older children for the management of thoracic pain, its application in neonates is scarcely documented. This technique offers advantages over other regional analgesic methods, as it is associated with fewer adverse effects and provides direct analgesia to the thoracic nerves. Its use is suggested as a safe and effective alternative, particularly in non-surgical settings.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 502019"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135732","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":"Embolismo aéreo paradójico en paciente con foramen oval permeable durante cirugía de trasplante hepático","authors":"E. Cabezuelo Markaide,&nbsp;P. Duque González,&nbsp;M. Zaballos García,&nbsp;J.A. Varela Cabo","doi":"10.1016/j.redar.2025.501984","DOIUrl":"10.1016/j.redar.2025.501984","url":null,"abstract":"<div><div>Patent foramen ovale (PFO) has an approximate prevalence of 25% in the adult population, being normally an asymptomatic condition. During liver transplant (LT), a PFO can enable the passing of embolic material to systemic circulation and cause ischemic events. Prophylactic closing of a PFO is not currently indicated in patients who are to undergo LT. Close haemodynamic monitoring is recommended in this type of cases in order to diagnose a paradoxical embolism and give an adequate treatment if necessary.</div><div>We present a case of a patient with a diagnosis of PFO who, during a LT, shows clinical findings compatible with a pulmonary and systemic embolism, requiring haemodynamic support and leaving a mild neurological sequelae at discharge.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 501984"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135738","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":"Delirium en el paciente posquirúrgico","authors":"C. Chamorro-Falero ,&nbsp;J. García-García ,&nbsp;J.J. Morales-Domene","doi":"10.1016/j.redar.2025.501987","DOIUrl":"10.1016/j.redar.2025.501987","url":null,"abstract":"","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 501987"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135733","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":"Consejos y recomendaciones prácticas para el manejo seguro de la vía aérea en anestesia pediátrica","authors":"D. Pérez-Ajami ,&nbsp;F. Escribá Alepuz ,&nbsp;J.D. Jiménez Santana ,&nbsp;B. Aguado Rodríguez ,&nbsp;E. Estupiñán Valido","doi":"10.1016/j.redar.2025.501998","DOIUrl":"10.1016/j.redar.2025.501998","url":null,"abstract":"<div><div>Advanced airway management in pediatric anesthesia has undergone substantial development with the incorporation of emerging technologies and strategies tailored to the unique anatomy and physiology of children. This review provides a critical appraisal of the clinical utility of tools such as videolaryngoscopy, high-flow nasal cannula oxygen therapy, and supraglottic devices, as well as specific techniques including the Bailey maneuver, fiberoptic-assisted intubation, and one-lung ventilation. Relevant studies published up to March 2025 were identified through searches in PubMed, Embase, Scopus, and Web of Science. Current evidence supports the use of these resources to enhance safety and effectiveness in complex scenarios, underscoring the importance of individualized device selection and specialized training. The integration of these strategies into tailored protocols represents a key step toward optimizing airway management in pediatric patients.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 501998"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135737","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 consulta preanestésica en la ansiedad prequirúrgica valorada mediante la Amsterdam Preoperative Anxiety and Information Scale","authors":"M.M. Ureña Consuegra,&nbsp;Y.V. Llaverías Guzmán,&nbsp;L.R. Peralta Henson,&nbsp;S.E. Tejada Estrella,&nbsp;V.M. Cepeda Santos","doi":"10.1016/j.redar.2025.502005","DOIUrl":"10.1016/j.redar.2025.502005","url":null,"abstract":"<div><h3>Background</h3><div>Preanesthesia consultation can be an effective tool for reducing anxiety scores in patients scheduled for elective surgery. Anxiety can cause perioperative complications.</div></div><div><h3>Objective</h3><div>Determine the impact of preanesthesia consultation on anxiety scores.</div></div><div><h3>Patients and methods</h3><div>A single-center, observational study was carried out, with a descriptive, cross-sectional design and primary source. The anxiety score assessed using the APAIS scale (Amsterdam Preoperative Anxiety and Information Scale) was evaluated in adult participants before and after the pre-anesthetic consultation during the period December 2024 to April 2025. Statistical analysis was performed using the Wilcoxon, McNemar and chi-square tests. A P value &lt;<!--> <!-->0.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 190 participants were interviewed, of whom 180 were ultimately analyzed; 76.7% were women, and the mean age was 41.6 years. The most frequent procedures were general surgery and gynecological procedures. 86.7% had previously received anesthesia. The prevalence of pre-consultation anxiety was 68.3%, decreasing to 47.2% after the consultation (p<!--> <!-->=<!--> <!-->0.001). All interviewees between the ages of 18 and 25 reported anxiety before the pre-anesthesia consultation (p<!--> <!-->=<!--> <!-->0.031). The anesthetic technique that generated the greatest fear was general anesthesia (42.8%), with the most frequently reported cause being fear of death (15.6%).</div></div><div><h3>Conclusion</h3><div>Preoperative anxiety is highly prevalent, and preanesthetic consultation could be an effective intervention to significantly reduce it.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 2","pages":"Article 502005"},"PeriodicalIF":0.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146135735","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 cumplimiento: riesgo del paciente, adherencia a ERAS y resultados postoperatorios mediante aprendizaje automatizado explicable","authors":"J. Ripollés-Melchor ,&nbsp;Á.V. Espinosa ,&nbsp;A. Abad-Motos ,&nbsp;A. Abad-Gurumeta ,&nbsp;P. Galán-Menéndez ,&nbsp;A. Zorrilla-Vaca ,&nbsp;R. Navarro-Pérez ,&nbsp;A. Ruiz-Escobar ,&nbsp;J. Fernanz-Antón ,&nbsp;A. Suárez-de-la-Rica ,&nbsp;C. Aldecoa ,&nbsp;el Grupo de investigadores de EuroPOWER","doi":"10.1016/j.redar.2025.501990","DOIUrl":"10.1016/j.redar.2025.501990","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) protocols improve outcomes after colorectal surgery, but adherence remains variable and may interact with patient risk. Traditional compliance scores lack granularity to explore these dynamics. We aimed to use interpretable machine learning to quantify the contribution of individual ERAS items and clinical features to postoperative complications, and to identify data-driven ERAS phenotypes.</div></div><div><h3>Methods</h3><div>This was a secondary analysis of the EuroPOWER cohort (NCT04889798), a prospective European study including 2,841 adults undergoing elective colorectal surgery. Two Extreme Gradient Boosting models were trained to predict in-hospital complications: a complete model (clinical variables + 23 ERAS items) and an ERAS-only model. Both were interpreted using Shapley Additive Explanations (SHAP). In the complete model, SHAP matrices were clustered to derive phenotypes. Feature importance, adherence, and complication rates were compared descriptively.</div></div><div><h3>Results</h3><div>The complete model achieved an AUC of 0.627. SHAP analysis identified frailty, ASA class, BMI, and age as leading predictors, followed by early mobilisation, nutritional care, and thromboprophylaxis. Three phenotypes were identified, with complication rates of 17.7%, 27.1%, and 41.1%, corresponding to robust, intermediate, and frail profiles. The ERAS-only model showed similar discrimination (area under the curve 0.642), but reduced interpretability. SHAP redundancy analysis supported inclusion of all ERAS items.</div></div><div><h3>Conclusions</h3><div>The clinical effect of ERAS adherence appears to be modulated by baseline vulnerability and implementation patterns. SHAP-based models enable transparent risk attribution and phenotype identification, supporting more targeted ERAS strategies and future development of automated quality monitoring tools.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501990"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915379","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":"¿Perdido en la presentación? Investigación del sesgo de publicación en anestesia regional: estudio de un caso piloto de bloqueo en el plano del músculo erector de la columna","authors":"A. De Cassai ,&nbsp;B. Dost ,&nbsp;Y.E. Karapinar ,&nbsp;M.A. Yilmaz ,&nbsp;E.I. Turan ,&nbsp;E. Sarikaya Ozel","doi":"10.1016/j.redar.2025.501995","DOIUrl":"10.1016/j.redar.2025.501995","url":null,"abstract":"<div><h3>Background</h3><div>The Erector Spinae Plane (ESP) block is a regional anaesthesia technique with a growing range of clinical applications due to its short learning curve, low complication rate, and effectiveness. However, publication bias can distort the perceived efficacy of interventions, especially when studies with negative or inconclusive results remain unpublished. The real extent of publication bias in ESP-related clinical research currently remains unclear.</div></div><div><h3>Methods</h3><div>We searched ClinicalTrials.gov on 2 February 2025 using the terms «Erector Spinae Plane Block» and «ESP block», and obtained 671 records. After excluding duplicates, irrelevant, and ongoing studies, 500 records were eventually included. Study characteristics and publication status were determined using a multi-step search strategy that included PubMed®, Scopus®, Embase®, and Central®. Data were analysed using appropriate statistical tests on R (v3.4.0).</div></div><div><h3>Results</h3><div>Of the 500 studies included, 361 (72.2%) were complete, 102 (20.4%) had unknown status, and 37 (7.4%) had been suspended, terminated, or withdrawn. Only 211 studies (42.2%) were published, and included data from 14374 of 32,600 intended patients. Published studies were registered significantly earlier than unpublished ones (median year 2020 vs 2021; <em>P</em>=.004). No significant differences were found between published and unpublished studies in terms of main outcome, continent, surgical setting, study design, or sample size.</div></div><div><h3>Conclusions</h3><div>A substantial proportion of ESP block studies remain unpublished, indicating potential publication bias. Although earlier registration was associated with publication, other study characteristics were not. These findings highlight the need for increased transparency and for clinical trial results to be published regardless of outcome in order to ensure that the evidence base is unbiased.</div></div>","PeriodicalId":46479,"journal":{"name":"Revista Espanola de Anestesiologia y Reanimacion","volume":"73 1","pages":"Article 501995"},"PeriodicalIF":0.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915359","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}