D. González-Delgado , A. Hernández Martínez , J. Mercadal Mercadal , G. Romero-González , D.N. Wijeysundera , M. Vives Santacana , on behalf of the Spanish Critical Care Ultrasound Network Group
{"title":"Detecting occult hemorrhage bleeding using a new protocol called the UFOH protocol: Ultrasound Focused Occult Hemorrhage","authors":"D. González-Delgado , A. Hernández Martínez , J. Mercadal Mercadal , G. Romero-González , D.N. Wijeysundera , M. Vives Santacana , on behalf of the Spanish Critical Care Ultrasound Network Group","doi":"10.1016/j.redare.2024.501660","DOIUrl":"10.1016/j.redare.2024.501660","url":null,"abstract":"<div><div>Point-of-care abdominal ultrasound (US) 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 (eFAST), 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 US protocol described for the diagnosis of occult bleeding in the retroperitoneal space. We describe a new US protocol called “Ultrasound For Occult Hemorrhage” (UFOH) for a fast diagnosis of occult hemorrhage. The UFOH 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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501660"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873718","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":"Any news on the pharmacological treatment of trigeminal neuralgia?","authors":"A. Alcántara Montero , C. Álamo González","doi":"10.1016/j.redare.2025.501668","DOIUrl":"10.1016/j.redare.2025.501668","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501668"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043990","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}
M. López-Baamonde, A. Capdevila, E. Lacoba, M. Magaldi
{"title":"Seldinger’s technique: If resistance appears, brain over brawn","authors":"M. López-Baamonde, A. Capdevila, E. Lacoba, M. Magaldi","doi":"10.1016/j.redare.2025.101631","DOIUrl":"10.1016/j.redare.2025.101631","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 101631"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043996","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}
S. Cabezudo Ballesteros, P. Sanabria Carretero, L. Castro Parga, A. Martín Vega, L. López García, F. Reinoso Barbero
{"title":"Clinical study on the predictive utility of high flow CPAP in weaning from prolonged mechanical ventilation in critical paediatric surgery patients","authors":"S. Cabezudo Ballesteros, P. Sanabria Carretero, L. Castro Parga, A. Martín Vega, L. López García, F. Reinoso Barbero","doi":"10.1016/j.redare.2024.501658","DOIUrl":"10.1016/j.redare.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 (<em>n</em> = 4) or respiratory (<em>n</em>= 8) reasons, although the final rate of EF requiring tracheostomy was only 0.8%. After progressing from IPPV + TI to CPAP + TI, PO<sub>2</sub>/FiO<sub>2</sub> values in successfully extubated patients immediately increased by 27% (<em>p</em> < 0.0003) vs only 13% (<em>p</em> > 0.3) in patients presenting EF. Switching to CPAP + TI increased the percentage of patients with pO<sub>2</sub>/FiO<sub>2</sub> > 200, particularly in patients with heart disease, in whom >30% increase in pO<sub>2</sub>/FiO<sub>2</sub> over baseline had a positive predictive value for successful extubation (AUC = 0.708; <em>p</em> = 0.056).</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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501658"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873716","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}
R.C. Vela Pascual, J.M. Pérez Peña, A. Elvira Rodríguez, M. Power Esteban, C. Jimeno Fernández, J.A. Varela Cabo
{"title":"Cardiopulmonary arrest in liver transplantation surgery: Perioperative beta-blockade implication in the cirrhotic patient","authors":"R.C. Vela Pascual, J.M. Pérez Peña, A. Elvira Rodríguez, M. Power Esteban, C. Jimeno Fernández, J.A. Varela Cabo","doi":"10.1016/j.redare.2025.101645","DOIUrl":"10.1016/j.redare.2025.101645","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 CPAs 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 LT surgery, which was successfully resolved through advanced cardiopulmonary resuscitation (CPR) maneuvers and specific treatment for beta-blocker toxicity (calcium and glucagon).</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 101645"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043991","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}
E. Gili-Ortiz , D. Franco-Fernández , O. Loli-Aznarán , M. Gili-Miner
{"title":"Prevalence of burnout syndrome in European and North American anesthesiologists: A systematic review and meta-analysis","authors":"E. Gili-Ortiz , D. Franco-Fernández , O. Loli-Aznarán , M. Gili-Miner","doi":"10.1016/j.redare.2025.501665","DOIUrl":"10.1016/j.redare.2025.501665","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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501665"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043995","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":"Environmental impact of volatile anesthetics at a high complexity teaching hospital from 2019 to 2022: A quantitative analysis","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","doi":"10.1016/j.redare.2024.501659","DOIUrl":"10.1016/j.redare.2024.501659","url":null,"abstract":"<div><h3>Background</h3><div>The healthcare sector emits 5% of greenhouse gases worldwide, inhaled anaesthetic 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 anaesthetic agents use was conducted using our hospital's pharmacy inventory between 2019 and 2022. ORACLE software tools were used, along with the amount of anaesthetics 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 743 kg of inhaled anaesthetic agents was administered between 2019 and 2022. Sevoflurane accounted for 265.7 kg, Desflurane for 473.9 kg, while isoflurane was used in smaller quantities. There was a change in the trend between 2019/2020 and 2021/2022, with an increase of 69.3 kg in sevoflurane use and a decrease of 86.2 kg in desflurane use. The CO<sub>2</sub> emissions from desflurane decreased from 190.7 to 131.9 t over 20 years and from 711 to 492 t 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 557 t in 20 years and 210 t in 100 years. The environmental impact of sevoflurane is 97% lower than desflurane in our OR’s.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501659"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873720","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}
L. Velasco , A. Calle , J. Coronel , A. Gallo , A. Reyes , M. Portas , L. Bermejo , A. Giménez , A. Ribed , M. Zaballos
{"title":"Cohort study to evaluate the pattern of analgesic prescription in adult patients undergoing ambulatory surgery","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.redare.2025.501664","DOIUrl":"10.1016/j.redare.2025.501664","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 24 h and 7 days 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 24 h 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 24 h the median (IQR) of pain on the self-assessing verbal scale was 3 (2–5) and at one week 2 (0–4). The presence of moderate-severe pain was 46% at 24 h 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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501664"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043992","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":"Long-term mechanical circulatory support in cardiogenic shock secondary to acromegaly. Case report","authors":"L.A. Salazar-Rojas , D.I. García-Gómez , R.E. Gonzalez-Vesga , C. Colmenares-Mejia","doi":"10.1016/j.redare.2025.101638","DOIUrl":"10.1016/j.redare.2025.101638","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":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 101638"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043993","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}