Revista espanola de anestesiologia y reanimacion最新文献

Detecting occult hemorrhage and retroperitoneal bleeding using a new protocol called the UFOH protocol: Ultrasound focused occult hemorrhage.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501660

D González-Delgado, A Hernández Martínez, J Mercadal Mercadal, G Romero-González, D N Wijeysundera, M Vives Santacana

引用次数: 0

History lessons for an uncertain future? Anaesthesiology and resuscitation during the Ifni-Sahara conflict (1957-1958).

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.101648

R N Suay, L E Togores Sánchez, R García Cañas, Fernando Gilsanz Rodríguez

引用次数: 0

Intrathecal catheter after accidental dural puncture in obstetric patients: safety and effectiveness reducing post-dural puncture headache.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501671

Gerard Moreno Giménez, Martha Cristina Melo Cruz, Marta Ferrándiz Mach, Sergi Sabaté Tenas

{"title":"Intrathecal catheter after accidental dural puncture in obstetric patients: safety and effectiveness reducing post-dural puncture headache.","authors":"Gerard Moreno Giménez, Martha Cristina Melo Cruz, Marta Ferrándiz Mach, Sergi Sabaté Tenas","doi":"10.1016/j.redare.2024.501671","DOIUrl":"https://doi.org/10.1016/j.redare.2024.501671","url":null,"abstract":"Background: Post-dural puncture headache (PDPH) after an accidental dural puncture (ADP) is a common complication in obstetric analgesia. It has been proposed that inserting an intrathecal catheter (ITC) after an ADP may reduce PDPH incidence and the need for therapeutic epidural blood patch (EBP). Our primary objective was to assess if the insertion of an ITC after an ADP reduces the incidence of PDPH in obstetric patients. Secondary objectives included evaluating EBP requirements and ITC-related complications.Methods: We conducted a retrospective study of all obstetric patients with a documented ADP during their labor analgesia between January 2018 to December 2022. Data from the patients in whom an ITC was inserted and those with a repeated epidural were compared.Results: Over our 5-year study period, 35 cases of ADP were documented. Of these, 16 patients (45.7%) received an ITC for 24 hours, while 19 (54.3%) underwent epidural re-siting. No significant difference was observed in PDPH incidence between ITC and re-sited epidural groups (62.5% vs 68.4%; RR 0.84; P = 0.713), nor in EBP requirement (18.8% vs 31.6%; RR 0.84; P = 0.387). Follow-up duration did not differ significantly between groups and no ITC-related complications were reported within 1 month.Conclusions: Our findings align with previously reported literature, indicating a trend favoring ITC utilization. In addition to the potential benefit of reducing CPPD incidence, their use is safe and provides quality analgesia with rapid onset.Irb number: IIBSP-CEF-2022-146.","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501671"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873769","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}

引用次数: 0

Clinical study on the predictive utility of high flow CPAP in weaning from prolonged mechanical ventilation in critical paediatric surgery patients.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501658

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":"https://doi.org/10.1016/j.redare.2024.501658","url":null,"abstract":"Introduction and objectives: Weaning paediatric patients from mechanical ventilation (MV) often results in extubation failure (EF) (14%-22%) and 2% of patients will require tracheostomy (2%).Methods: 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.Results: 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 (n = 4) or respiratory (n = 8) reasons, although the final rate of EF requiring tracheostomy was only 0.8%. After progressing from IPPV + TI to CPAP + TI, PO2/FiO2 values in successfully extubated patients immediately increased by 27% (p < 0.0003) vs only 13% (p > 0.3) in patients presenting EF. Switching to CPAP + TI increased the percentage of patients with pO2/FiO2 > 200, particularly in patients with heart disease, in whom >30% increase in pO2/FiO2 over baseline had a positive predictive value for successful extubation (AUC = 0.708; p = 0.056).Conclusions: 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.","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501658"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","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}

引用次数: 0

Pneumocephalus following a combined spinal-epidural technique: a case report.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.101628

Inês Martins de Carvalho, Pedro Costa Antunes, André Nunes Miranda, João Marques Vinagre

引用次数: 0

Environmental impact of volatile anesthetics at a high complexity teaching hospital from 2019 to 2022: A quantitative analysis.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501659

A M Obando Rondón, C A Triana-Schöonewolff, J D Guerra Toro, J F Parada-Márquez, N A Avila Ardila, A F Zuluaga Zuluaga

{"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":"https://doi.org/10.1016/j.redare.2024.501659","url":null,"abstract":"Background: The healthcare sector emits 5% of greenhouse gases worldwide, inhaled anesthetic 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.Methods: A retrospective exploration of inhaled anesthetic agents use was conducted using our hospital's pharmacy inventory between 2019 and 2022. ORACLE software tools were used, along with the amount of anesthetics dispensed by the pharmacy. The CO2 equivalent was calculated in kilograms using the global warming potential at 20 and 100 years.Results: A total of 743 kg of inhaled anesthetic 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 CO2 emissions from desflurane decreased from 190.7 to 131.9 tons over 20 years and from 711 to 492 tons over 100 years.Conclusions: The use of sevoflurane increased by 70%, whereas that of desflurane decreased by 31%. CO2 emissions were reduced by 557 tons in 20 years and 210 tons in 100 years. The environmental impact of sevoflurane is 97% lower than desflurane in our OR's.","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501659"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","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}

引用次数: 0

Difficult airway due to multiple sclerotic fibromas in a patient with Cowden's syndrome.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.101622

G Ballout, M López-Baamonde, L Gómez-López, R Berge, Raquel

引用次数: 0

Erector spinae plane block for obstetric analgesia in a patient with factor XI deficiency: a case report.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.101632

Patricia Martín Serrano, Aruma Ferraz Pérez, Cristina Medina Hernández, Vera Prieto Hidalgo

引用次数: 0

Perioperative transfusion management in craniotomies: a national survey, a starting point for the evaluation of improvements in health care.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501661

P Hurtado, M Garcia-Orellana, A Martinez-Simon, G Pujol-Fontrodona, E Méndez, P Doménech-Asensi, A Pajares, A López-Gómez, L Valencia, M J Colomina, J Fernández-Candil

{"title":"Perioperative transfusion management in craniotomies: a national survey, a starting point for the evaluation of improvements in health care.","authors":"P Hurtado, M Garcia-Orellana, A Martinez-Simon, G Pujol-Fontrodona, E Méndez, P Doménech-Asensi, A Pajares, A López-Gómez, L Valencia, M J Colomina, J Fernández-Candil","doi":"10.1016/j.redare.2024.501661","DOIUrl":"https://doi.org/10.1016/j.redare.2024.501661","url":null,"abstract":"Objective: To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.Method: Online questionnaire addressed to Spanish anaesthesiologists and promoted by the Neurosciences and Haemostasis, Transfusion Medicine and Fluid Therapy Sections of SEDAR. The questionnaire was sent by email and social media, and was active between June and October 2022.Results: We obtained 155 responses from 67 centres; 59.4% perform >100 craniotomies per year. 61.7% were regularly involved in neuroanaesthesiology. Only 21.9% of respondents had pre-anaesthesia assessment performed by a member of that section, and in most of them (83.0%) the assessment was performed ≤3 weeks in advance. Of the respondents with Patient Blood Management programmes, 58.2% had no specific protocols for craniotomies. 90.3% reported that haemoconcentrates are systematically reserved. A lower platelet limit of 100,000/mcL is considered acceptable by 76.8%. 99.4% of respondents discontinued antiplatelet medication based on half-life. Only 23.9% respondents routinely discontinued non-steroidal anti-inflammatory drugs. The transfusion threshold for haemoglobin during surgical bleeding was <10 g/dL in 18.7%, <9 g/dL in 38.1%, <8 g/dL in 38.7% and <7 g/dL in 4.5%.Conclusions: Preoperative anaemia screening and treatment programmes are not implemented and blood product reserves are systematised in patients scheduled for craniotomy. Anti-aggregation therapy is discontinued according to the half-life of the drug without checking platelet functionality.","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501661"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873771","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}

引用次数: 0

Use of vancomycin and acute kidney injury in critically ill patients with sepsis or septic shock: A retrospective observational cohort study.

Revista espanola de anestesiologia y reanimacion Pub Date : 2024-12-19 DOI: 10.1016/j.redare.2024.501657

D González-Delgado, M Vives, P Monedero, A Aldaz

{"title":"Use of vancomycin and acute kidney injury in critically ill patients with sepsis or septic shock: A retrospective observational cohort study.","authors":"D González-Delgado, M Vives, P Monedero, A Aldaz","doi":"10.1016/j.redare.2024.501657","DOIUrl":"https://doi.org/10.1016/j.redare.2024.501657","url":null,"abstract":"Introduction: The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial. The aim of this study was to evaluate the incidence of AKI in a cohort of patients with sepsis or septic Shock with an adequate and strict monitoring of vancomycin, guided by the area under the concentration-time curve in relation to the minimum inhibitory concentration (AUC/MIC ratio).Material and methods: Retrospective cohort study on 106 patients admitted to the ICU with a diagnosis of sepsis or septic shock with vancomycin treatment, consecutively from January 2017 to December 2019. AKI was defined according to Kidney Disease Improving Global Outcomes criteria. Risk factors associated with AKI were determined by multivariable logistic regression analysis.Results: In our cohort, 28 patients out of 106 (26%) developed AKI. ICU and 30-day mortality were 18% and 22%, respectively. After multivariable logistic regression adjusted analysis, chronic liver disease was associated with AKI.Conclusion: In our retrospective cohort study on critical patients with sepsis and septic shock, treated with vancomycin adjusting the dose guided by a pharmacokinetic/pharmacodynamic monitoring to achieve the target AUC0-24/CMI ratio, the incidence of AKI was 26%.","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501657"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873773","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}

引用次数: 0