Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Response to the Letter to the Editor: \"Delirium in the Postoperative Patient''.","authors":"","doi":"10.1016/j.redare.2026.502117","DOIUrl":"https://doi.org/10.1016/j.redare.2026.502117","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502117"},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248269","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":"PROtective ventilation with FLOW-controlled ventilation in ROBOT-assisted laparoscopic surgery (PROFLOW-ROBOTic pilot) -- study protocol for an international multicenter pilot randomized clinical trial.","authors":"Timur Yurttas, Denise Battaglini, Simon Becker, Galina Dorland, Marcelo Gama de Abreu, Lukas Gasteiger, Manuel Granell Gil, Sabrine N T Hemmes, John Laffey, Guido Mazzinari, David M van Meenen, Vanessa Moll, Ary Serpa Neto, Mareen Reiter, Patricia M Rocco, Carolina Romero Garcia, Silvia Gonzalez Santos, Martin Scharffenberg, Marcus J Schultz, Arthur S Slutsky, Jakob Wittenstein, Markus M Luedi","doi":"10.1016/j.redare.2026.502209","DOIUrl":"https://doi.org/10.1016/j.redare.2026.502209","url":null,"abstract":"<p><strong>Background: </strong>Optimizing intraoperative ventilation is crucial during robot-assisted laparoscopic surgery, where pneumoperitoneum and extreme body positioning impact respiratory system compliance and gas exchange. Flow-controlled ventilation (FCV) regulates both inspiratory and expiratory gas flow, and has shown benefits in both animal and human studies. However, its safe application and feasibility during robot-assisted laparoscopic surgery and its impact on reducing postoperative pulmonary complications (PPC) remain unclear.</p><p><strong>Aim: </strong>To test the safety and feasibility of a study protocol for a future randomized clinical trial of FCV with compliance-guided titration of positive end-expiratory pressure (PEEP) and driving pressure (ΔP) in patients scheduled for robot-assisted laparoscopic surgery.</p><p><strong>Methods: </strong>This pilot study assesses the safety and feasibility of a study protocol that includes a ventilation bundle consisting of FCV with dynamic compliance-guided titration of PEEP and ΔP. The control group will receive conventional pressure-controlled ventilation with PEEP set at 5-10 cmH₂O and a tidal volume of 7-9 ml/kg predicted bodyweight, in line with current best practices at the participating centres. The primary outcome focuses on the safety of using FCV, including gas exchange metrics, ventilator settings, ventilation parameters, and the incidence of intraoperative respiratory and haemodynamic complications. Secondary outcomes focus on the feasibility of FCV with individualized PEEP and driving pressure, the suitability of the study protocol, and safety endpoints such as the incidence of PPC during the first 7 postoperative days.</p><p><strong>Discussion: </strong>PROFLOW-ROBOTic will be the first international, multicentre study to investigate a protocol consisting of a ventilation bundle that includes FCV with dynamic compliance-guided titration of PEEP and ΔP and its effect on the incidence of PPC in patients undergoing robot-assisted laparoscopic surgery. This pilot study analyses the safety and feasibility of the FCV with individualized PEEP and ΔP ventilation protocol, and will inform the design of the future PROFLOW-ROBOTic trial that will test the efficacy of FCV with compliance-guided titration of PEEP and ΔP versus standard pressure-controlled ventilation (PCV) with respect to PPC in these patients.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502209"},"PeriodicalIF":0.0,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149248335","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":"Veno-arterial ECMO for the management of propofol infusion syndrome following cardiac surgery.","authors":"I Sanchis-Haba, B Rubio, I Morales-Rey, R Luna, D Pereda, E Sandoval","doi":"10.1016/j.redare.2026.502053","DOIUrl":"https://doi.org/10.1016/j.redare.2026.502053","url":null,"abstract":"<p><p>Propofol infusion syndrome (PRIS) has been described in patients requiring prolonged sedation with this drug, as may occur in some cases after cardiac surgery. Its treatment is based on discontinuation of the drug and supportive management of organ dysfunction until resolution. In the postoperative period of cardiac surgery, diagnosing PRIS poses a challenge, since it must be differentiated from other, more common complications such as postcardiotomy shock. In these patients, PRIS may fatally worsen the prognosis. Veno-arterial ECMO therapy may help maintain cardiac output. Both the diagnosis of PRIS after cardiac surgery and its treatment with ECMO have been scarcely reported. We present a case of PRIS after cardiac surgery successfully managed with ECMO.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502053"},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229650","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":"The fallacy of global warming potential.","authors":"Julia Slingo","doi":"10.1016/j.redare.2026.502212","DOIUrl":"https://doi.org/10.1016/j.redare.2026.502212","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502212"},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229640","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":"Iatrogenic Withdrawal Syndrome in Adult Intensive Care Unit Patients: An Alternative Perspective to Design Sedation Protocols.","authors":"Emanuel Moisa, Federico Bilotta","doi":"10.1016/j.redare.2026.502135","DOIUrl":"https://doi.org/10.1016/j.redare.2026.502135","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502135"},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225643","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":"Videolaryngoscopy versus direct laryngoscopy for endotracheal intubation of obese patients: A prospective randomized trial.","authors":"P Maciejewski, T Składzień, Ł Tabin, M Cicio, T Klimczyk, T Lonc, A Kwinta, T Drygalski, P Major, M Terlecki","doi":"10.1016/j.redare.2026.502234","DOIUrl":"10.1016/j.redare.2026.502234","url":null,"abstract":"<p><strong>Background: </strong>Obese patients present challenging airway conditions, including reduced functional residual capacity and rapid desaturation during apnoea. Videolaryngoscopy improves glottic visualisation, but evidence comparing it with direct laryngoscopy in bariatric patients managed by experienced anaesthesiologists remains limited. We conducted a prospective randomised trial comparing these techniques.</p><p><strong>Methods: </strong>256 adult patients (BMI > 35 kg/m²) were randomised to intubation with a standard Macintosh laryngoscope or a hyperangulated videolaryngoscope (INSIGHT iS3-L), with a stylet routinely used in the videolaryngoscopy group. All received a standardised opioid-free anaesthesia protocol. The primary outcome was time to intubation (TOF = 0 to capnographic confirmation). Secondary outcomes included first-attempt success rate, number of intubation attempts, and bougie use.</p><p><strong>Results: </strong>Overall intubation success was achieved in all 256 patients; however, 4 patients (3.1%) in the Macintosh group required conversion to videolaryngoscopy as rescue. Median time to intubation was significantly shorter in the Macintosh group (35 [IQR 30-47.5] s vs 46 [IQR 35-62] s; P < .001), a difference partly attributable to operator familiarity and unlikely to be clinically relevant given comparable safety outcomes. No significant differences were observed in first-attempt success, intubation attempts, or bougie use. No airway injury or oxygen desaturation below 90% occurred; one prolonged Macintosh-group intubation was associated with peri-intubation bradycardia and hypotension. Neither Mallampati classification nor neck circumference > 43-44 cm reliably predicted intubation difficulty.</p><p><strong>Conclusions: </strong>In this single-centre study of selected obese patients managed by experienced anaesthesiologists, direct laryngoscopy achieved shorter intubation times than a hyperangulated videolaryngoscope with comparable safety outcomes; however, the 11-second difference in median times is unlikely to be clinically relevant. The 3.1% conversion rate underscores that videolaryngoscopy must always be immediately available. Videolaryngoscopy remains essential in anticipated difficult airway management.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502234"},"PeriodicalIF":0.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139776","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":"Non-operating room anaesthesia: An unresolved issue in our hospitals.","authors":"P A Vullo, J J Ariño Irujo","doi":"10.1016/j.redare.2026.502105","DOIUrl":"10.1016/j.redare.2026.502105","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502105"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883181","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":"Severe adverse events associated with general anesthesia with halogenated agents in patients of Venezuelan ancestry. Recommendations for clinical practice.","authors":"E Méndez Martínez, C García Cebrián, A M González González, P Sanabria Carretero, F Munar Bauzá, G Alcaraz García-Tejedor, P González Pizarro, D Méndez Marín, F Cassinello, J Encarnación Martínez, K Sifontes Romero, M Almena Marjalizo, C L Errando Oyonarte, F J Escribà Alepuz, J García Fernández","doi":"10.1016/j.redare.2026.502167","DOIUrl":"10.1016/j.redare.2026.502167","url":null,"abstract":"<p><p>The mtND4 Working Group of the Spanish Society of Anesthesiology and Resuscitation (SEDAR) has issued clinical practice recommendations. This article stems from reports of neurological injury and death following general in adult and patients of maternal Venezuelan ancestry, in whom a possible mitochondrial susceptibility associated with the mtND4 m.11232T>C variant of respiratory chain complex I has been identified. This document is for informational and guidance purposes only. The final clinical decision should be individualized for each patient, taking into account the urgency of the procedure, therapeutic alternatives, and the resources available at each center.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502167"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883171","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":"General anaesthesia or local anaesthesia with or without sedation for mechanical thrombectomy: from clinical evidence to organizational challenges.","authors":"M Taboada, J Fernández","doi":"10.1016/j.redare.2026.502070","DOIUrl":"10.1016/j.redare.2026.502070","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502070"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883197","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":"Spain's historical, innovative contribution to airway management.","authors":"M Á Gómez-Ríos, A Abad-Gurumeta, A A J Van Zundert","doi":"10.1016/j.redare.2026.502049","DOIUrl":"10.1016/j.redare.2026.502049","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502049"},"PeriodicalIF":0.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148883245","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}