Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Creation and validation of a competency and error metrics for the orotracheal intubation technique using an angled blade video laryngoscope (GlideScope®)","authors":"M. Coll-Badell ,&nbsp;J.V. Serrano-Gonzalvo ,&nbsp;L. Carrillo-Luna ,&nbsp;J.M. Soto-Ejarque ,&nbsp;C. Ramírez-Miranda ,&nbsp;C. Añez-Simón","doi":"10.1016/j.redare.2026.502071","DOIUrl":"10.1016/j.redare.2026.502071","url":null,"abstract":"<div><h3>Objectives</h3><div>The main objective of this study was to create and validate a metric for the correct performance of orotracheal intubation with an angled blade video laryngoscope (GlideScope®). The secondary objectives were to break down the technique into correct phases and steps (competency metrics), define errors and critical errors.</div></div><div><h3>Method</h3><div>Prospective observational study divided into two phases. In phase I, the metric was created: a group of experts deconstructed the procedure, identifying phases and defining the competence metrics and errors with the help of three previous recordings. The metrics were stress-tested for objectivity and consensus was sought in a meeting of 24 experts using the modified Delphi methodology.</div><div>In phase II, the metric was validated by recording 9 experienced and 9 novice professionals performing the procedure on a mannequin. Subsequently, 2 external evaluators, previously trained in the use of the metric, evaluated the videos independently.</div></div><div><h3>Results</h3><div>A metric was created, defined by 4 phases, 22 competency metrics, and 31 errors, of which 16 were considered critical. Experienced professionals completed more competency metrics than novices (17.05 vs. 13.72 (p = 0.010), had fewer total errors (p = 0.0017) and fewer critical errors 0.55 vs. 2.61 (p &lt; 0.001). Inter-rater agreement for the total score of all videos was &gt;0.80.</div></div><div><h3>Conclusions</h3><div>The metric created is valid and reliably discriminates between operators who are competent and those who are not competent in performing the technique.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 4","pages":"Article 502071"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505891","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":"Use of extracorporeal membrane oxygenation with a cardiotomy reservoir for patient blood management in thoracoabdominal open surgery: A single centre experience.","authors":"J S Ruano, C Aparicio, A Gonzalez, L Carballo, L Enrique Muñoz, F Manzano","doi":"10.1016/j.redare.2026.502108","DOIUrl":"10.1016/j.redare.2026.502108","url":null,"abstract":"<p><p>Open thoracoabdominal aortic aneurysm repair (TAAAR) is associated with mortality rates of between 8% and 25%. One of the characteristics of TAAAR is massive bleeding that requires multiple units of blood, plasma and platelets. Following the development of endovascular techniques, open surgery is now reserved for more complex cases, such as collagenopathy diseases or failure of previous endovascular repair. These surgeries carry an even higher risk of bleeding. We present 4 cases in which veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and cardiotomy suction were used. In VA-ECMO, we used heparin 100 units/kg to achieve an activated clotting time of up to 250 s. At the end of the procedure, 1 mg of protamine was administered for every 100 units of heparin. This strategy has the advantage of preventing the loss of fibrinogen, coagulation factors and platelets in the blood processed from the cell saver. The use of a cardiotomy reservoir with VA-ECMO may help optimise intraoperative patient blood management and reduce the incidence of coagulopathy during TAAAR.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502108"},"PeriodicalIF":0.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583392","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":"Chylothorax after low-impact trauma: A rare complication unmasked in the surgical critical care unit.","authors":"J J Mateos, A Calvo, P Valero, P Piñeiro","doi":"10.1016/j.redare.2026.502039","DOIUrl":"10.1016/j.redare.2026.502039","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502039"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464644","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":"Preoperative and postoperative anaemia in colorectal cancer surgery: Are we there yet?","authors":"M A Warner, T Richards","doi":"10.1016/j.redare.2026.502041","DOIUrl":"10.1016/j.redare.2026.502041","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"502041"},"PeriodicalIF":0.0,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464609","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":"Comparative evaluation of intranasal dexmedetomidine and midazolam as premedication for children undergoing corrective surgery for congenital heart disease: A randomized clinical trial","authors":"R. Sharma ,&nbsp;S. Singh ,&nbsp;R. Nair ,&nbsp;M. Dhiman ,&nbsp;P. Taank","doi":"10.1016/j.redare.2026.502029","DOIUrl":"10.1016/j.redare.2026.502029","url":null,"abstract":"<div><h3>Background</h3><div>Premedication is essential in paediatric surgery for smooth induction and anxiety relief. Common agents—ketamine, midazolam, dexmedetomidine, and fentanyl—are administered via intramuscular injection, intravenous infusion, or oral routes, but efficacy varies and no consensus exists on an optimal protocol. Intranasal delivery offers a promising, more comfortable alternative with potential to improve outcomes.</div></div><div><h3>Methods</h3><div>This double-blind randomized trial evaluated intranasal dexmedetomidine (1 mcg/kg) (group D) versus midazolam (0.2 mg/kg) as premedication in 90 children (2–12 years) (group M) undergoing corrective surgery for acyanotic congenital heart disease (CHD). Sedation, parental separation anxiety, mask acceptance, and hemodynamic parameters were evaluated.</div></div><div><h3>Results</h3><div>Acceptable sedation was achieved in 62.2% of children in group D and 53.3% in group M. Group D showed superior anxiolysis during separation from parents (93.3% vs. 73.3%) and better mask acceptance during induction (93.3% vs. 53.3%). A statistically significant but clinically mild decrease in diastolic BP occurred in the dexmedetomidine group without adverse effects.</div></div><div><h3>Conclusion</h3><div>Both drugs were effective as intranasal premedication. However, dexmedetomidine showed better results in sedation, less anxiety upon separation from parents, and greater acceptance of the mask, without significant side effects.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502029"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151615","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":"Efficacy of using intrathecal mu-receptor antagonist in preventing pruritus and PONV after spinal anesthesia – A systematic review and meta-analysis","authors":"A.U. Huda ,&nbsp;R. Fernando ,&nbsp;H.B. Ghafoor ,&nbsp;R. Minhas","doi":"10.1016/j.redare.2026.502034","DOIUrl":"10.1016/j.redare.2026.502034","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and objective&lt;/h3&gt;&lt;div&gt;Different adjuvants are used in combination with intrathecal local anesthesia to improve the quality of spinal anesthesia. Opioids are most used for this purpose, but these are associated with side effects such as pruritus and postoperative nausea and vomiting. Various medications have been utilized for prophylaxis or treatment of these side effects especially pruritus. Although mu-receptor antagonists are generally used intravenously or subcutaneously for the treatment of pruritus, few studies have investigated the role of intrathecal mu-receptor antagonists. So, this systematic review aimed to evaluate the effect of using intrathecal mu-receptor antagonists when used with local anesthetics like bupivacaine, and opioids for the prevention of opioid-related side effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;This meta-analysis was conducted while following PRISMA guidelines. We registered this review with the PROSPERO database in February 2025. Two authors performed the literature searches in February 2025 and then repeated after one month to ensure accuracy. Two authors independently appraised the individual studies according to the Consolidated Standards of Reporting Trials checklist. Literature search was done using online databases including PubMed, Google Scholar, Science Direct and Cochrane library. Potential bias was evaluated using the risk of bias-2 (RoB-2) tool. We included randomized controlled trials that compared intrathecal mu-receptor antagonists with control for patients undergoing surgery under spinal anesthesia. The primary outcome of the study was the incidence of pruritus. We utilized the Review manager software, RevMan for MAC 5.4, to conduct the meta-analysis. Mean difference (MD), standard mean difference (SMD) and odds ratios (OR) were calculated for different outcomes. Using random effect models, Peto odd ratios were used for weighing models. Funnel plots and Egger’s test were utilized to assess the risks for publication bias across studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 9 randomised controlled trials (n = 653) were included in this systematic review and meta-analysis. The incidence of pruritus in mu-receptor antagonist group was 19.3 vs 58.8 in the control group with an OR of 0.15 [&lt;em&gt;P&lt;/em&gt; &lt; .00001, (CI 0.11−0.21)]. Mu-receptor antagonists significantly reduced the incidence of PONV with an OR of 0.26 [&lt;em&gt;P&lt;/em&gt; &lt; .00001, (CI 0.18−0.36)]. I&lt;sup&gt;2&lt;/sup&gt; value for pruritus was 32% while it was 72% for PONV. There was no significant difference in VAS pain scores between two groups during the first 24 h except at 2 h postoperatively. Furthermore, the use of intrathecal mu-receptor antagonists did not significantly affect the time to first analgesic request.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The use of intrathecal mu-receptor antagonists significantly reduces the occurrence of opioid-related side effects such as pruritus and PONV.&lt;/div","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502034"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168650","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":"Submental intubation as an alternative to tracheostomy in complex panfacial fracture: a case report","authors":"M.A. Salazar ,&nbsp;F.J. Cuesta ,&nbsp;M. López ,&nbsp;R. Bergue ,&nbsp;I. Martínez ,&nbsp;L. Garavito","doi":"10.1016/j.redare.2026.502023","DOIUrl":"10.1016/j.redare.2026.502023","url":null,"abstract":"<div><div>Submental intubation, first described in 1986, is an effective alternative to tracheostomy in patients with complex facial fractures in whom nasotracheal intubation is contraindicated and orotracheal intubation would interfere with the surgical field. We report the case of a 38-year-old man with a history of morbid obesity who suffered a panfacial fracture with involvement of the frontal sinuses and intracranial communication after falling from a second floor. Nasotracheal intubation was contraindicated, and orotracheal intubation would have interfered with the planned intermaxillary fixation. We first performed fibreoptic orotracheal intubation, which was then surgically converted to submental intubation. No intraoperative or postoperative complications occurred, and the patient’s evolution was favourable, with only minimal scarring in the submental region. Recent literature has confirmed that this technique is safe and is associated with less morbidity and better aesthetic outcomes than tracheostomy. This case highlights the need to consider submental intubation as a priority airway management option in complex panfacial fractures.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502023"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986156","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":"Recuritment maneuvre: Facts and figures","authors":"Z. Salihoglu ,&nbsp;E. Salihoglu","doi":"10.1016/j.redare.2026.501999","DOIUrl":"10.1016/j.redare.2026.501999","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 501999"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095409","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":"Systemic inflammatory response syndrome after cardiopulmonary bypass: prevalence, predictors, and outcomes","authors":"J.J. Nuño-Pulido ,&nbsp;R. Gopar-Nieto ,&nbsp;G. Rojas-Velasco ,&nbsp;D. Manzur-Sandoval","doi":"10.1016/j.redare.2026.502021","DOIUrl":"10.1016/j.redare.2026.502021","url":null,"abstract":"<div><h3>Background</h3><div>Systemic Inflammatory Response Syndrome (SIRS) is a frequent and critical complication following cardiac surgery, particularly in patients undergoing cardiopulmonary bypass (CPB). Although SIRS is associated with increased morbidity and mortality, its impact on hemodynamic stability and postoperative outcomes remains unclear. This study aimed to determine the prevalence of SIRS in patients undergoing cardiac surgery with CPB at the Instituto Nacional de Cardiología “Ignacio Chávez” and to explore its association with preoperative comorbidities, intraoperative factors, hemodynamic alterations, vasoactive drug requirements, and adverse outcomes.</div></div><div><h3>Methods</h3><div>A retrospective, observational study was conducted on 546 adult patients who underwent cardiac surgery with CPB. Patients were classified into SIRS and no SIRS groups based on standard clinical criteria. Statistical analysis included normality testing (Shapiro-Wilk), comparisons of continuous and categorical variables (Mann–Whitney U test, chi-square test, and Fisher’s exact test), and logistic regression to identify predictors of outcomes.</div></div><div><h3>Results</h3><div>SIRS was present in 31.86% of patients upon ICU admission. The most frequent criterion was leukocytosis (69.05%), followed by tachycardia (33.88%). Patients with SIRS exhibited elevated inflammatory markers and increased requirements for vasoactive drugs. SIRS significantly increased the odds of several postoperative complications: mediastinal bleeding (OR 2.08, CI 1.24–3.48), vasoplegic syndrome (OR 1.79, CI 0.92–3.49), low cardiac output syndrome (OR 1.71, CI 1.02–2.85), acute kidney injury (OR 1.69, CI 1.15–2.48), and in-hospital mortality (OR 1.83, CI 0.90–3.72).</div></div><div><h3>Conclusion</h3><div>SIRS is a prevalent and clinically significant condition in postoperative cardiac surgery patients. The SIRS score is as a valuable risk stratification tool. Early identification and targeted interventions may improve patient outcomes. Further prospective studies are needed to refine predictive models and optimize management strategies.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502021"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151665","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":"Comparative evaluation of the effect of application of external manoeuvres with no manoeuvre on glottis view during videolaryngoscopy in patients undergoing elective surgery with the head in neutral position","authors":"S. Panda ,&nbsp;N. Agrawal ,&nbsp;K. Jain V ,&nbsp;A. Gupta","doi":"10.1016/j.redare.2026.502016","DOIUrl":"10.1016/j.redare.2026.502016","url":null,"abstract":"<div><h3>Objectives</h3><div>In patients with cervical spine injury, glottic visualization is difficult in the head-neutral position. The role of external laryngeal manoeuvres, such as backward-upward-rightward pressure (BURP) and jaw thrust in intubation outcomes remains unclear. We compared the effects of jaw thrust and BURP on the quality of glottic view with the head in a neutral position during C-MAC videolaryngoscopy.</div></div><div><h3>Methods</h3><div>In this self-controlled study, glottic view was assessed in 120 adult patients using a C-MAC videolaryngoscope with no manoeuvre, BURP, or jaw thrust. After induction, endotracheal intubation was performed according to Grupo allocation. Screenshots of the best glottic view were taken each time to assess the percentage of glottic opening (POGO) score, modified Cormack-Lehane (MCL) grade, and glottic opening area en píxeles cuadrados. Intubation times, ease of intubation, haemodynamics, and complications were also recorded.</div></div><div><h3>Results</h3><div>POGO scores (mean[DE]) were significantly higher with BURP (72.7[19.9]) and jaw thrust (60[26.3]) manoeuvres compared to no manoeuvre (25[26.9];<em>P</em> &lt; 0.0001). Glottic opening area en píxeles cuadrados (<em>P</em> &lt; 0.001) and MCL grades (<em>P</em> = 0.043) were considerably higher after the application of laryngeal manoeuvres. There were no significant differences in the duration of laryngoscopy and intubation times between Grupos; however, intubation was significantly easier with BURP (<em>P</em> = 0.021) and jaw thrust (<em>P</em> = 0.032).</div></div><div><h3>Conclusion</h3><div>External manoeuvres, such as BURP and jaw thrust, should improve glottic view during C-MAC videolaryngoscopy in patients with the head in a neutral position.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 3","pages":"Article 502016"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032205","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}