Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Gastric POCUS, an emergent tool in the assessment of perioperative fasting: Narrative review","authors":"C. Juliá-Romero,&nbsp;C. Palau-Martí,&nbsp;A. Tejedor-Bosqued","doi":"10.1016/j.redare.2024.501655","DOIUrl":"10.1016/j.redare.2024.501655","url":null,"abstract":"<div><div>Pulmonary aspiration during anaesthesia induction is a serious adverse event that can lead to catastrophic consequences for the patient, including death. Preoperative fasting has so been assessed on the basis of the clinical history and fasting schedules recommended by clinical guidelines. This assessment is not objective, since the presence or absence of gastric contents cannot be guaranteed. Gastric point of care ultrasound (POCUS) is an objective, simple, and rapid method for assessing fasting prior to anaesthesia induction that stratifies risk and aids in decision-making. The aim of this review is to summarize the existing literature on gastric POCUS in the assessment of preoperative fasting. For this purpose, the Pubmed and Embase were searched for relevant studies published between 2014 and 2024.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501655"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866814","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":"Intraoperative goal-directed hemodynamic therapy targeting both arterial pressure and flow parameters using uncalibrated pulse contour techniques: A meta-analysis of randomized controlled trials","authors":"J. Ripollés-Melchor ,&nbsp;Á.V. Espinosa ,&nbsp;P. Fernández-Valdes-Bango ,&nbsp;R. Navarro-Pérez ,&nbsp;A. Abad-Motos ,&nbsp;J.V. Lorente ,&nbsp;M.J. Colomina ,&nbsp;A. Abad-Gurumeta ,&nbsp;M.I. Monge-García","doi":"10.1016/j.redare.2024.501653","DOIUrl":"10.1016/j.redare.2024.501653","url":null,"abstract":"<div><h3>Background</h3><div>Goal-directed haemodynamic therapy (GDHT) aims to optimize haemodynamic variables. However, its effectiveness in reducing postoperative complications in major abdominal surgery, particularly when targeting both arterial pressure and flow variables, remains unclear. This meta-analysis addresses this by evaluating GDHT using uncalibrated pulse contour (uPC) methods.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) in adult patients undergoing major abdominal surgery who received GDHT using uncalibrated pulse contour (uPC) methods for cardiac output monitoring, with predefined targets for both blood flow and blood pressure. The primary outcome was postoperative complications; secondary outcomes included postoperative acute kidney injury (AKI), hospital length of stay (EH), intraoperative fluid administration and mortality.</div></div><div><h3>Results</h3><div>Initial search retrieved 860 reports, with 12 RCTs (1367 patients) meeting the inclusion criteria. Our meta-analysis showed a significant reduction in postoperative complications (RR 0.78, 95% CI 0.68–0.90), AKI (RR 0.7, 95% CI 0.51–0.97), and hospital LOS (SMD −0.30, 95% CI −0.54 to −0.06) with uPC-guided GDHT. No significant differences were observed in intraoperative fluid volume and mortality.</div></div><div><h3>Conclusions</h3><div>Implementing GDHT in major abdominal surgery with predefined arterial pressure and blood flow targets significantly reduces postoperative morbidity and hospital EH without increasing intraoperative fluid administration.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501653"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873768","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":"Patient Blood Management: A conceptual and analytical vision from the leadership in Spain","authors":"E. Méndez-Arias ,&nbsp;A. Abad-Motos ,&nbsp;M. Barquero-López ,&nbsp;R. Delestal Aldaria ,&nbsp;Á.M. Muñoz de Solano Palacios ,&nbsp;A. Pajares ,&nbsp;S. Aguilar López ,&nbsp;I. Fornet ,&nbsp;M. Quintana-Díaz ,&nbsp;G. Yanes ,&nbsp;M.J. Colomina","doi":"10.1016/j.redare.2024.501650","DOIUrl":"10.1016/j.redare.2024.501650","url":null,"abstract":"<div><div>The evolution of blood saving programs to Patient Blood Management (PBM) represents a broader and more comprehensive approach to optimize the use of the patient's own blood, thus improving clinical outcomes and minimizing the risks associated with allogeneic blood transfusion with a holistic view of socio-economic sustainability.</div><div>Implementing the strategies of the three PBM pillars in any hospital center involves a transversal change throughout the organization in which it can be very useful to apply the strategy defined by Kotter at the business level for change management.</div><div>The support of renowned institutions such as the World Health Organization and the European Commission demonstrates the importance and urgency of implementing PBM programs, setting guidelines at an international level and supporting the adoption of effective strategies in the management of blood transfusion at a national and institutional level.</div><div>In Spain, we need to have health managers at both the Hospital Management level and the Regional Health Services and/or Ministry of Health that provide the necessary resources for its proper implementation in the health system from primary care to hospital care and also the resources for the timely evaluation of the results.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501650"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873770","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":"Perioperative anemia: Protocols and guidelines to facilitate the appropriate approach","authors":"S. Aragón Álvarez ,&nbsp;E. Bisbe Vives","doi":"10.1016/j.redare.2025.501725","DOIUrl":"10.1016/j.redare.2025.501725","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501725"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442973","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":"Patient blood management: it's now or never!","authors":"C. Jericó ,&nbsp;J.A. García Erce","doi":"10.1016/j.redare.2025.501752","DOIUrl":"10.1016/j.redare.2025.501752","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501752"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426885","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":"Pneumocephalus following a combined spinal-epidural technique: a case report","authors":"I. Martins de Carvalho,&nbsp;P. Costa Antunes,&nbsp;A. Nunes Miranda,&nbsp;J. Marques Vinagre","doi":"10.1016/j.redare.2024.101628","DOIUrl":"10.1016/j.redare.2024.101628","url":null,"abstract":"<div><div>Pneumocephalus refers to the presence of air within the intracranial cavity, and albeit its occurrence following neuraxial techniques is rare, it is commonly associated with a loss of resistance to air technique.</div><div>This case report describes a parturient who underwent neuraxial analgesia for pain management during labour. Epidural space identification with loss of resistance to saline technique was used and she went on to develop a symptomatic pneumocephalus.</div><div>The pneumocephalus had an atypical presentation without immediate headache but with a sudden change in consciousness, likely due to an increase in intracranial pressure following migration of air into the intracranial cavity through the ventricular system.</div><div>Although in most cases it is benign, asymptomatic, and self-limiting, early diagnosis is helpful as treatment with supplemental oxygen can speed recovery. In this case, due to its atypical and sudden presentation, supportive treatment was essential for the prognosis of both mother and baby.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 101628"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873772","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":"Difficult airway due to multiple sclerotic fibromas in a patient with Cowden’s syndrome","authors":"G. Ballout,&nbsp;R. Berge Ramos,&nbsp;L. Gómez-López,&nbsp;M. López-Baamonde","doi":"10.1016/j.redare.2024.101622","DOIUrl":"10.1016/j.redare.2024.101622","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 101622"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873719","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":"Perioperative transfusion management in craniotomies: A national survey, a starting point for the evaluation of improvements in health care","authors":"P. Hurtado ,&nbsp;M. Garcia-Orellana ,&nbsp;A. Martinez-Simon ,&nbsp;G. Pujol-Fontrodona ,&nbsp;E. Méndez ,&nbsp;P. Doménech-Asensi ,&nbsp;A. Pajares ,&nbsp;A. López-Gómez ,&nbsp;L. Valencia ,&nbsp;M.J. Colomina ,&nbsp;J. Fernández-Candil ,&nbsp;Grupo de trabajo de Neurociencias y Hemostasia, Medicina Transfusional y Fluidoterapia de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR)","doi":"10.1016/j.redare.2024.501661","DOIUrl":"10.1016/j.redare.2024.501661","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the perioperative management of haemostasis and transfusion practices in adult patients undergoing craniotomies.</div></div><div><h3>Method</h3><div>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.</div></div><div><h3>Results</h3><div>We obtained 155 responses from 67 centres; 59.4% perform &gt;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/µL 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 &lt;10 g/dL in 18.7%, &lt;9 g/dL in 38.1%, &lt;8 g/dL in 38.7% and &lt;7 g/dL in 4.5%.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 501661"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management of pregnant women with skeletal dysplasia and short stature: a case report","authors":"Á. Barranco de Santiago,&nbsp;Á. Alandes-Gallego,&nbsp;I. García-Rojas,&nbsp;B. Tena,&nbsp;M. Magaldi","doi":"10.1016/j.redare.2024.101625","DOIUrl":"10.1016/j.redare.2024.101625","url":null,"abstract":"<div><div>Skeletal dysplasias and short stature are a heterogeneous group of pathologies in which achondroplasia is the most common presentation. The presence of bone deformities leads to thoracic and airway changes that can complicate ventilation and airway management. Most individuals with skeletal dysplasia present spinal abnormalities that increase the difficulty of administering neuraxial anaesthesia. In pregnant patients, physiological and anatomical changes further complicate obstetric and anaesthesia management.</div><div>We report the case of a patient with skeletal dysplasia and short stature who was admitted to our hospital in week 34.3 of her pregnancy due to labour and respiratory difficulties. It was decided to perform an emergency caesarean section due to the disproportionate size of the foetal head with respect to the pelvis. We also review the different anaesthesia techniques described in the literature, and discuss their potential advantages and difficulties.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 3","pages":"Article 101625"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857487","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":"Detecting occult hemorrhage bleeding using a new protocol called the UFOH protocol: Ultrasound Focused Occult Hemorrhage","authors":"D. González-Delgado ,&nbsp;A. Hernández Martínez ,&nbsp;J. Mercadal Mercadal ,&nbsp;G. Romero-González ,&nbsp;D.N. Wijeysundera ,&nbsp;M. Vives Santacana ,&nbsp;on behalf of the Spanish Critical Care Ultrasound Network Group","doi":"10.1016/j.redare.2024.501660","DOIUrl":"10.1016/j.redare.2024.501660","url":null,"abstract":"<div><div>Point-of-care abdominal ultrasound (US) has emerged as a powerful tool for clinicians and is becoming a routine bedside tool to rapidly diagnose, manage hemodynamics, monitor fluid status, and guide procedures in emergency and critical care. Extended focused assessment with sonography for trauma (eFAST), is commonly used to detect free intraperitoneal blood in the trauma setting and may also be an option in non-trauma patients. However, it has significant limitations for detecting gastrointestinal or retroperitoneal bleeding. To date, there is no US protocol described for the diagnosis of occult bleeding in the retroperitoneal space. We describe a new US protocol called “Ultrasound For Occult Hemorrhage” (UFOH) for a fast diagnosis of occult hemorrhage. The UFOH protocol is a novel ultrasound-guided approach designed to detect occult bleeding in various clinical settings, including emergency department, intensive care and perioperative environment.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"72 2","pages":"Article 501660"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873718","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}