Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Postoperative anaemia is associated with poor long term postoperative outcomes after elective colorectal oncologic surgery within an enhanced recovery after surgery pathway.","authors":"J Ripollés-Melchor, A Abad-Motos, M L Fuenmayor-Valera, A Ruiz-Escobar, A Abad-Gurumeta, G Paseiro-Crespo, P Fernández-Valdés-Bango, A León-Bretscher, P Soto-García, C Jericó-Alba, J A García-Erce","doi":"10.1016/j.redare.2025.501724","DOIUrl":"10.1016/j.redare.2025.501724","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is an independent risk factor for poor perioperative outcomes after major abdominal surgery, and is associated with an increased risk of 30-day postoperative mortality after noncardiac surgery.</p><p><strong>Objective: </strong>To investigate the frequency of postoperative anaemia and short- and long-term survival after colorectal oncologic surgery at a centre with a well-established Enhanced Recovery After Surgery (ERAS) program.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients undergoing elective colorectal oncologic surgery within an ERAS pathway at our institution between 2013 and 2017. Overall survival was calculated with the Kaplan-Meier log rank method and Cox proportional hazard regression based on anaemia at hospital discharge.</p><p><strong>Results: </strong>A total of 680 patients were included. Patients with anaemia at discharge showed a lower overall survival at 5 years (53.9% vs. 44%, p 0.05). Patients who were anaemic at discharge had a lower 5-year overall survival (hazard ratio [HR] 95% CI 2.663 [1.619-4.379], p < 0.001). Kaplan-Meier survival and Cox regression proportional hazard survival for overall survival in the combined preoperative, postoperative, and RBC transfusion model were 1.55 (1.038 2.318) p = 0.032.</p><p><strong>Conclusions: </strong>The combined prognostic value of preoperative anaemia, postoperative anaemia, and blood transfusion created a 40.7% higher risk of not surviving 5 years.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501724"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470398","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 haemoglobin as a predictor of in-hospital morbidity and 5-year mortality in colorectal cancer.","authors":"A Herrero García, S E Denis Filippini, A de la Fuente, E Choolani Bhojwani, J Sánchez González, M Bailón Cuadrado, S Veleda Belanche, V Simó Fernández, J A García Erce, C Aldecoa Álvarez-Santullano","doi":"10.1016/j.redare.2025.501723","DOIUrl":"10.1016/j.redare.2025.501723","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the third most diagnosed cancer worldwide. Preoperative anaemia is common in CRC patients undergoing surgery.</p><p><strong>Objective: </strong>This study assesses the prevalence of preoperative anaemia and its impact on postoperative outcomes, and aims to establish a cut-off point for increased morbidity and mortality in a large prospective single centre cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 1105 CRC patients (2014-2021). Anaemia was defined as per WHO criteria. Multivariate logistic regression and Kaplan-Meier survival analyses were used. The statistical significance level was set at <0.05.</p><p><strong>Results: </strong>Preoperative anaemia was present in 45.3% of patients, and was associated with a higher incidence of perioperative complications (OR 2.76, p = 0.011) and lower 5-year survival (73% vs 87%, p < 0.001.</p><p><strong>Discussion/conclusions: </strong>Preoperative anaemia, even when mild, is associated with a higher rate of complications, longer hospital stay, and a greater risk of 5-year mortality.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501723"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461101","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":"Underbody carbon-fiber contact warming versus underbody forced-air warming to prevent hypothermia during laparoscopic gynecologic surgery: A randomized trial.","authors":"M Chanzá, M Núñez, M C Velasco, C Rodríguez-Cosmen, A C Carpintero, L Gallart","doi":"10.1016/j.redare.2025.501689","DOIUrl":"10.1016/j.redare.2025.501689","url":null,"abstract":"<p><strong>Background: </strong>Studies comparing intraoperative warming devices report discordant or out-of-date results. This trial compared two underbody warming devices.</p><p><strong>Methods: </strong>Thirty patients undergoing elective prolonged laparoscopic gynecologic surgery were randomized to underbody warming by forced air (n = 15) or contact with a carbon fibre blanket (n = 15). The main outcome was esophageal temperature at the end of surgery. We also compared temperature throughout surgery and need for rescue warming, blood loss, fluids infused, urine output, and adverse events. Outcomes were compared with χ² or Fisher exact tests, t-tests, and mixed effects models as appropriate.</p><p><strong>Results: </strong>No median (interquartile range) differences between forced-air and contact warming were found in initial or final temperatures (36.2 °C [36.0, 36.2] vs 36.3 °C [35.9, 36.6] and 36.6 °C [36.2, 36.8] vs 36.3 °C [35.6, 36.5]). Temperature slightly increased over time in the forced-air group and slightly decreased in contact group (0.11 °C/h (0.02, 0.19) vs -0.05 °C/h (-0.13, 0.03), p = 0.008). A single patient required rescue warming (in contact group after 4.75 h). Surgery took longer in the contact group (3.2 h [2.5, 3.8] vs 4.0 h [2.9, 5.6] h, p = 0.042). Two surgeons complained of dizziness related to ambient heat in the forced-air group. No differences were found in the remaining variables.</p><p><strong>Conclusions: </strong>During use of the underbody forced-air and carbon-fibre warming devices tested, we recorded only very slight differences in temperature changes over the course of surgery. The variations can be considered clinically unimportant as no significant difference was evident at the end of surgery.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501689"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442975","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":"Potentially modifiable ventilation factors associated with outcome in neurocritical care vs. non-neurocritical care patients: Rational and protocol for a patient-level analysis of PRoVENT, PRoVENT-iMiC and ENIO (PRIME).","authors":"S C Serafini, R Cinotti, K Asehnoune, D Battaglini, C Robba, A S Neto, L Pisani, G Mazzinari, E M Tschernko, M J Schultz","doi":"10.1016/j.redare.2025.501690","DOIUrl":"10.1016/j.redare.2025.501690","url":null,"abstract":"<p><strong>Introduction: </strong>Ventilator settings and ventilation variables and parameters vary between neurocritical care and non-neurocritical care patients. We aim to compare ventilation management in neurocritical care patients versus non-neurocritical care patients under invasive mechanical ventilation support, and to determine which factors related to ventilatory management have an independent association with outcome in neurocritical patients.</p><p><strong>Methods and analysis: </strong>We meta-analyze harmonized individual patient data from three observational studies ('PRactice of VENTilation in critically ill patients without ARDS' [PRoVENT], 'PRactice of VENTilation in critically ill patients in Middle-income Countries' [PRoVENT-iMiC] and 'Extubation strategies and in neuro-intensive care unit patients and associations with outcomes' [ENIO]), pooled into a database named 'PRIME'. The primary endpoint is all cause ICU mortality. Secondary endpoints are key ventilator settings and ventilation variables and parameters. To identify potentially modifiable and non-modifiable factors contributing to ICU mortality, a multivariable model will be built using demographic factors, comorbidities, illness severities, and respiratory and laboratorial variables. In analyses examining the impact of ventilatory variables on outcome, we will estimate the relative risk of ICU mortality for neurocritical and non-neurocritical care patients by dividing the study population based on key ventilator variables and parameters.</p><p><strong>Ethics and dissemination: </strong>This meta-analysis will address a clinically significant research question by comparing neurocritical care with non-neurocritical care patients. As this is a meta-analysis, additional ethical committee approval is not required. Findings will be disseminated to the scientific community through abstracts and original articles in peer-reviewed journals. Furthermore, the PRIME database will be made accessible for further post-hoc analyses.</p><p><strong>Registration: </strong>PROVENT, PROVENT-iMiC and ENIO, and the pooled database PRIME are registered at clinicaltrials.gov (NCT01868321 for PRoVENT, NCT03188770 for PRoVENT-iMiC, and NCT03400904 for ENIO, and for PRIME is pending).</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501690"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442974","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":"External cephalic version and neuroaxial analgesia. A secondary analysis.","authors":"H J Lacassie, L Basso, L Marfán, M Astete","doi":"10.1016/j.redare.2025.501663","DOIUrl":"10.1016/j.redare.2025.501663","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501663"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434741","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":"Neuroanesthesiological management of carotid rupture in the endoscopic endonasal approach to the skull base.","authors":"F Iturri Clavero, I Ingelmo Ingelmo, K de Orte Sancho, M P Valcarcel Fernández, G Catalán Uribarrena, F Valcarcel Martín, O Prieto Calderón, E M González Díaz, A Uresandi Iruin","doi":"10.1016/j.redare.2025.501691","DOIUrl":"10.1016/j.redare.2025.501691","url":null,"abstract":"<p><p>The medical literature on perioperative anesthesiological care of carotid artery rupture in endoscopic endonasal skull base surgery is practically non-existent. This type of neurovascular injury combines a relatively low incidence with a non-negligible morbidity and mortality. It also requires coordinated multidisciplinary treatment to minimize brain injury induced by inadequate therapeutic management. This article presents a series of clinical recommendations and an algorithm for perioperative neuroanesthesiological care of this serious complication. To prepare them, a group consisting of five neuroanesthesiologists, a neurosurgeon, an otorhinolaryngologist, a neuroradiologist, and a haematologist reviewed the limited literature on anesthesiological care of this complication. In addition, they adapted anesthesiological care in neurosurgical scenarios similar to the treatment of carotid artery rupture during endoscopic skull base surgery.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501691"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442972","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":"Multicentre cohort study on the prevalence of postoperative delirium 48 h after surgery: \"DELPO study\" protocol.","authors":"M V Durán, R N Pérez, O de laVarga Martínez, S M Fadrique, E T Gómez, R B Quiles","doi":"10.1016/j.redare.2025.501727","DOIUrl":"10.1016/j.redare.2025.501727","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative delirium (POD) is characterized by an acute, fluctuating change in the patient's cognitive capacity, including altered perceptions and inappropriate behavioural changes. Incidence ranges from 4% to 62%, depending on the population and the study. POD has been linked to an increase in morbidity and mortality and a decrease in quality of life.</p><p><strong>Methods: </strong>We will perform a multicentre, observational, cross-sectional nationwide study in various Anaesthesiology, Resuscitation, and Pain Therapy units in Spain. Patients undergoing non-ambulatory surgery will be tested for the presence of delirium 48 h after surgery using the 4AT scale in the case of discharged patients, the CAM scale in hospitalised patients, and the CAM-ICU scale for patients in an Intensive Care Unit. We will also collect several variables associated with the risk of postoperative delirium. The relationship between preoperative nutritional status and POD will be assessed in the DELPO-NUT sub-study. The quality of life and survival of surgical patients one year after surgery will be evaluated in the DELPO-LIFE sub-study.</p><p><strong>Results: </strong>Data collection will take place on two consecutive Tuesdays (14 and 21 November 2023), and results are expected during the first or second quarter of 2024.</p><p><strong>Conclusions: </strong>Our objective is to determine the overall prevalence of POD in Spanish hospitals and the different risk factors that contribute to its appearance.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501727"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442878","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":"Importance of training in anesthesia systems technology.","authors":"J J Ariño Irujo","doi":"10.1016/j.redare.2025.501662","DOIUrl":"10.1016/j.redare.2025.501662","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501662"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442893","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":"Anaesthesetic considerations in the perioperative management of patients with hereditary angioedema-FXII.","authors":"P García Robledo, J C García Ortiz","doi":"10.1016/j.redare.2025.501732","DOIUrl":"10.1016/j.redare.2025.501732","url":null,"abstract":"<p><p>Hereditary angioedema (HAE) is of interest to anaesthesiologists due to its impact on perioperative management. HAE manifests as episodic, self-limiting oedema in the deep subcutaneous or submucosal tissue that can be fatal if it involves the airway. It is usually caused by C1 esterase inhibitor deficiency. HAE episodes can be triggered by trauma, including surgical and medical procedures associated with mechanical trauma. Our understanding of HAE has evolved in recent years following the development of new genetic sequencing technologies that have made it possible to differentiate variants with normal C1 esterase inhibitor levels. In Spain, the most frequent of these is HAE due to a mutation in FXII, previously known as HAE type III. There are as yet no good quality studies on perioperative management and treatment of these patients. The admission of a patient with FXII-HAE for labour induction has given us the opportunity to review the perioperative management of these cases.</p>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"501732"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442805","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":"Hemidiaphragmatic elevation and cardiovascular collapse.","authors":"E Soto Garrucho, F Federero Martínez, F Polonio Enríquez","doi":"10.1016/j.redare.2025.101637","DOIUrl":"10.1016/j.redare.2025.101637","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":" ","pages":"101637"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434747","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}