Revista espanola de anestesiologia y reanimacion最新文献

{"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 ,&nbsp;M. Vives ,&nbsp;P. Monedero ,&nbsp;A. Aldaz","doi":"10.1016/j.redare.2024.501657","DOIUrl":"10.1016/j.redare.2024.501657","url":null,"abstract":"<div><h3>Introduction</h3><div>The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial.</div><div>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).</div></div><div><h3>Material and methods</h3><div>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.</div><div>AKI was defined according to Kidney Disease Improving Global Outcomes criteria. Risk factors associated with AKI were determined by multivariable logistic regression analysis.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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 AUC_0-24/CMI ratio, the incidence of AKI was 26%.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501657"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inorganic phosphorus as a predictor of postoperative low cardiac output syndrome in congenital heart disease surgery.","authors":"M A Murillo-Pozo, A M Vázquez-Florido, A Ortiz-Alvarez, V Modesto I Alapont, A González-Calle, E Sánchez-Valderrábanos","doi":"10.1016/j.redare.2025.501654","DOIUrl":"10.1016/j.redare.2025.501654","url":null,"abstract":"<p><strong>Background and objective: </strong>Low cardiac output syndrome (LCOS) is the most common complication after cardiac surgery in children with congenital heart disease (CHD). The aim of this study was to assess the predictive value of serum inorganic phosphorus (SIPL) as an indicator of LCOS in the postoperative period.</p><p><strong>Materials and methods: </strong>From June 2018 to December 2019, a single-center prospective study was conducted in patients with CHD undergoing surgery who required extracorporeal circulation (ECC). In the postoperative period, patients were divided into group 1 with LCOS and group 2 without LCOS. Blood samples were extracted in pre and postoperative periods. Serial measurements of SIPL, NT-proBNP, troponin T and creatinine were collected and compared between both groups. Multivariate analyses were conducted to identify the risk factors of SBGC.</p><p><strong>Results: </strong>A total of 97 patients were included, with 31 in group 1 and 66 in group 2. There was an increment of SIPL which peaked at the 8-h postsurgery (5.3 mg/dL, 4.6-5.8). Postoperative median SIPL in the group 1 were significantly higher than in the group 2. All consecutive SIPL measurements also were significantly higher in group 1. Changes in SIPL over time approached statistical significance (p < 0.001). Logistic regression analyses indicated that ECC (OR: 1.01; 95% CI: 0,9-1.01), SIPL (OR: 1.02; 95% CI: 1-1.04), NT-ProBNP (OR: 1; 95% CI; 1-1.0) were the independent risk factors of LCOS.</p><p><strong>Conclusions: </strong>The increase in SIPL was more pronounced in LCOS group 1. SIPL emerged as a new predictive risk factors of LCOS.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501654"},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026230","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":"Incidence and risk factors of chronic post-thoracic surgery pain: A retrospective study","authors":"H. Rivera-Ramos,&nbsp;L. Larrañaga-Altuna,&nbsp;M. García-Olivera,&nbsp;M. Armengol-Gay,&nbsp;M. Soldevilla-García,&nbsp;S. Bermejo-Martínez","doi":"10.1016/j.redare.2024.101644","DOIUrl":"10.1016/j.redare.2024.101644","url":null,"abstract":"<div><h3>Background</h3><div>Chronic post-thoracic surgery pain (CPTSP) is a common complication that affects a patient’s quality of life. Thoracotomy is associated with a high risk of chronic pain. Video-assisted thoracoscopy surgery (VATS) is a less traumatic option, but its role in the development of CPTSP is unclear. Regardless of the approach, there is evidence that demographic, psychosocial, or clinical factors also contribute to pain. The primary objective of this study is to determine the incidence of CPTSP in our hospital. The secondary objective is to identify possible risk factors related to CPTSP.</div></div><div><h3>Method</h3><div>Retrospective, single-centre observational study. The medical records of patients that underwent thoracic surgery between January 2016 and January 2020 were reviewed. The diagnosis of CPTSP was made by reviewing the postoperative visits 6 months after surgery. We analysed the relationship between CPTSP and a series of variables, and then constructed a multivariate binary logistic regression model with a significance level of <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>A total of 259 patients were analysed, 46.7% underwent VATS and 53.3% underwent thoracotomy. The overall incidence of CPTSP was 12%; 4.1% in VATS and 18.8% in thoracotomies. The multivariate model revealed that moderate-to-severe acute postoperative pain and a greater number of chest tubes were risk factors for CPTSP.</div></div><div><h3>Conclusion</h3><div>The incidence of CPTSP was 12% in our hospital. Patients with higher acute postoperative pain severity and several chest tubes were more likely to develop CPTSP.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101644"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632997","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":"Blood recirculation during continuous renal replacement therapy due to a thrombus in the inferior vena cava","authors":"J. Carballo Fernández,&nbsp;A. González Pereira,&nbsp;M.T. Rey Rilo,&nbsp;Ó. Pato López","doi":"10.1016/j.redare.2024.101626","DOIUrl":"10.1016/j.redare.2024.101626","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101626"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635435","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":"Quantitative analysis of genicular nerve block spread and variability: Anatomical correlations and clinical implications","authors":"T. Cuñat ,&nbsp;X. Sala-Blanch ,&nbsp;P. Pietrantoni ,&nbsp;J. Pomés ,&nbsp;S. Pregnolato ,&nbsp;A. Prats-Galino","doi":"10.1016/j.redare.2024.101640","DOIUrl":"10.1016/j.redare.2024.101640","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in anaesthesiology and regional anaesthesia, the three-dimensional spread of local anaesthetics is still poorly understood. This study investigates the pericapsular spread of radiopaque contrast after ultrasound-guided genicular nerve block in cadaveric knees using CT reconstruction. The aim is to assess the reproducibility, accuracy, and variability of this technique in order to improve safety and effectiveness.</div></div><div><h3>Methods</h3><div>We used a four-stage methodology that involved performing genicular nerve block on cadaveric knees, acquiring data using high-resolution ultrasound and helical CT imaging, performing segmentation and surface reconstruction of the CT images, and analysing the data quantitively to determine the spread of the infiltrate in each genicular nerve region. Coefficients of variation were calculated to estimate the spread and reproducibility of each genicular nerve block.</div></div><div><h3>Results</h3><div>Our results revealed significant variability in spread in all genicular nerve blocks, particularly around the recurrent genicular nerve. Despite this variability, the spread—particularly along the medial-lateral and anterior-posterior axes—showed moderate consistency. Furthermore, the regions covered by 80% of the spread closely matched the pericapsular distribution of the genicular nerves of the knee.</div></div><div><h3>Conclusions</h3><div>Notable variability in spread was observed in genicular nerve blocks, particularly around the recurrent genicular nerve. However, the spread showed moderate consistency and aligns closely with the pericapsular nerve distribution of the knee. Future studies should combine quantitative analysis with anatomical dissection to further investigate the involvement of the deep peroneal motor branch.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101640"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633226","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":"Simultaneous cardiac perforation and left pneumothorax as complications of temporary pacemaker probe","authors":"J.F. Muñoz Moreno,&nbsp;L. Segovia García de Marina,&nbsp;C.M. Marín Marín,&nbsp;L.J. Yuste Domínguez","doi":"10.1016/j.redare.2024.101596","DOIUrl":"10.1016/j.redare.2024.101596","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101596"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633419","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":"Continuous spinal anaesthesia for kidney transplantation in a lupus patient with severe mitral regurgitation: A case report","authors":"A.A. Pires ,&nbsp;M.J. Correia ,&nbsp;J. Sousa","doi":"10.1016/j.redare.2024.101617","DOIUrl":"10.1016/j.redare.2024.101617","url":null,"abstract":"<div><div>Anaesthesia for kidney transplant in a patient with severe mitral regurgitation is a real challenge given the need for judicious haemodynamic management to avoid pulmonary oedema and maximise reperfusion of the transplanted organ. This is the first experience described in the literature of continuous spinal anaesthesia in a patient with chronic severe mitral regurgitation undergoing cadaver donor kidney transplant. Transthoracic echocardiography monitoring was used during the procedure to avoid aggravating the patient’s mitral regurgitation. Intraoperatively, 17.5 ml/kg of crystalloids were administered and no vasopressors were required. Continuous spinal anaesthesia preserved haemodynamics and graft perfusion during the procedure.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101617"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635439","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":"Impact of universal use of the McGrath videolaryngoscope as the first option for all intubations in the operating room: The multicentre prospective before-after VIDEOLAR-SURGERY study protocol","authors":"M. Taboada ,&nbsp;A. Estany-Gestal ,&nbsp;P. Rama-Maceiras ,&nbsp;M.A. Orallo ,&nbsp;M. Bermúdez ,&nbsp;C. Barreiro ,&nbsp;L. Gómez ,&nbsp;M. Amor ,&nbsp;F. Otero ,&nbsp;J. Fernández ,&nbsp;N. Molins ,&nbsp;J.J. Amate ,&nbsp;B. Bascuas ,&nbsp;R. Rey ,&nbsp;M.C. Alonso ,&nbsp;M.J. Castro ,&nbsp;A. Sarmiento ,&nbsp;L. dos Santos ,&nbsp;C. Nieto ,&nbsp;S. Paredes ,&nbsp;E. Paz","doi":"10.1016/j.redare.2024.101649","DOIUrl":"10.1016/j.redare.2024.101649","url":null,"abstract":"<div><h3>Introduction</h3><div>Standard tracheal intubation performed in the operating room is based on direct laryngoscopy using a standard Macintosh laryngoscope. Several authors recommend the universal use of a video laryngoscope as the first option for all intubations, regardless of whether the patient has predictors of a difficult airway or not. We hypothesize that using the McGrath video laryngoscope as the first intubation option increases the frequency of patients with <em>easy intubation</em>, and decreases intubation-related complications.</div></div><div><h3>Methods and analysis</h3><div>The VIDEOLAR-SURGERY trial is a prospective, multicentre, open-label, interventional, before-after study. In the pre-implementation period (non-interventional phase, 6–9 months [2600 intubations]), 35 anaesthesiologists from 8 hospitals perform all tracheal intubations for an elective or urgent surgical procedure using the standard Macintosh direct laryngoscope as the first intubation option. During the implementation period (2 months), each anaesthesiologist is given a McGrath Mac video laryngoscope and trained in its use. During the post-implementation period (interventional-phase, 6–9 months [2600 intubations]), the 35 anaesthesiologists perform all tracheal intubations using a McGrath Mac video laryngoscope as the first intubation option. The main objective of this study is to evaluate whether the use of a McGrath Mac video laryngoscope as the first intubation option increases the percentage of patients with <em>easy intubation</em> compared with the standard Macintosh laryngoscope.</div></div><div><h3>Ethics and dissemination</h3><div>The study protocol was approved on 2 May 2023 by the Ethics Committee of Galicia, Spain (CEI-SL, code No. 2023-177), and was registered on the Clinicaltrials.gov clinical trials registry under No. NCT <span><span>NCT05850260</span><svg><path></path></svg></span>. Informed consent is required. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences. If video laryngoscopy improves easy intubation compared with Macintosh direct laryngoscopy in all operating room intubations, its use may well become standard practice, thereby decreasing the risks of intubation-related complications.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101649"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635444","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":"Sonoanatomy of the difficult airway. A case-control study","authors":"P. Kot ,&nbsp;L. Rovira ,&nbsp;M. Granell ,&nbsp;P. Rodriguez ,&nbsp;B. Cano ,&nbsp;S. Pozo ,&nbsp;J. De Andrés","doi":"10.1016/j.redare.2024.101642","DOIUrl":"10.1016/j.redare.2024.101642","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The occurrence of a difficult airway during intubation is a critical event in anaesthesia. Despite the usefulness of clinical predictors, difficult intubation frequently arises unexpectedly. The aim of this study was to determine the utility of airway ultrasound in detecting these patients.</div></div><div><h3>Materials and methods</h3><div>This was a case-control study. The patients in the case group were identified from the registry of patients with reports of difficult laryngoscopy (Cormack III and IV). The controls were selected from among patients classed as Cormack I who underwent surgery under general anaesthesia. Fifty patients (25 cases and 25 controls) participated in the study. All patients underwent ultrasound to obtain 3 measurements: distance from the skin to the hyoid bone, distance from the skin to the epiglottis, and distance from the skin to the vocal cords.</div></div><div><h3>Results</h3><div>A skin-to-hyoid bone distance greater than 9.8 mm (50% of the sample) generated an odds ratio of 5.46 (<em>p</em> = 0.005); a skin-to-epiglottis distance greater than 21.3 mm (50% of the sample) generated an odds ratio of 6.62 (<em>p</em> = 0.002). There was no significant difference in the skin-to-vocal cords distance.</div></div><div><h3>Conclusions</h3><div>Ultrasound has proven to be a useful tool for predicting difficult laryngoscopy. Despite the low sensitivity of clinical predictors, they appear to improve the detection of patients with difficult laryngoscopy when integrated into predictive models alongside ultrasound values.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101642"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633925","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":"Comment on: “Single versus double injection costoclavicular block: non-inferiority trial”","authors":"R.M. Sethuraman,&nbsp;S. Krishnakumar,&nbsp;S. Rajendran","doi":"10.1016/j.redare.2024.101639","DOIUrl":"10.1016/j.redare.2024.101639","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 1","pages":"Article 101639"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635436","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}