Revista espanola de anestesiologia y reanimacion最新文献

{"title":"Paradoxical air embolism in patient with patent foramen ovale during liver transplant","authors":"E. Cabezuelo Markaide,&nbsp;P. Duque González,&nbsp;M. Zaballos García,&nbsp;J.A. Varela Cabo","doi":"10.1016/j.redare.2026.501984","DOIUrl":"10.1016/j.redare.2026.501984","url":null,"abstract":"<div><div>Patent foramen ovale (PFO) has an approximate prevalence of 25% in the adult population, being normally an asymptomatic condition. During liver transplant (LT), a PFO can enable the passing of embolic material to systemic circulation and cause ischemic events. Prophylactic closing of a PFO is not currently indicated in patients who are to undergo LT. Close haemodynamic monitoring is recommended in this type of cases in order to diagnose a paradoxical embolism and give an adequate treatment if necessary.</div><div>We present a case of a patient with a diagnosis of PFO who, during a LT, shows clinical findings compatible with a pulmonary and systemic embolism, requiring haemodynamic support and leaving a mild neurological sequelae at discharge.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 501984"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986142","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":"Reassessing anaemia in gastrectomy: Diagnostic definitions and predictive value in the POWER 4 cohort","authors":"J. Ripolles-Melchor ,&nbsp;A. Abad-Motos ,&nbsp;E. Nieto Moreno ,&nbsp;C. Jerico ,&nbsp;I. Otero-Martínez ,&nbsp;O. Abdel-lah Fernández ,&nbsp;R. García-Alvarez ,&nbsp;M.P. Tormos-Pérez ,&nbsp;A.V. Espinosa ,&nbsp;C. Aldecoa ,&nbsp;A. Abad-Gurumeta ,&nbsp;M.J. Colomina ,&nbsp;J.A. García-Erce ,&nbsp;POWER 4 Investigators Group","doi":"10.1016/j.redare.2026.502020","DOIUrl":"10.1016/j.redare.2026.502020","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative anaemia is a common finding in patients undergoing gastrectomy, and is frequently targeted in optimisation strategies. However, its independent association with postoperative complications remains unclear, and the prognostic value of redefining diagnostic thresholds has not been formally assessed.</div></div><div><h3>Methods</h3><div>This prospective substudy of the POWER 4 cohort included 742 patients undergoing elective gastrectomy for cancer. Anaemia was defined by WHO sex-specific thresholds (Hb &lt;13 g/dL in men, &lt;12 g/dL in women) and a universal threshold of &lt;13 g/dL. Four subcohorts were analysed: A1 (WHO, full cohort), A2 (universal, full), B1 (WHO, untreated), B2 (universal, untreated). Multivariable logistic regression was used to assess associations with postoperative complications. Discrimination was evaluated using AUC, AIC/BIC, and Net Reclassification Improvement (NRI). Generalised additive models (GAMs) were used to explore continuous relationships between haemoglobin and risk.</div></div><div><h3>Results</h3><div>Anaemia prevalence was 38.0% with WHO thresholds and 52.4% with the universal threshold. In full-cohort models, anaemia was not independently associated with complications (A1 OR 0.92 [95% CI 0.60–1.41]; A2 OR 0.89 [0.59–1.36]). Model performance was similar (AUC 0.686). In untreated patients (<em>n</em> = 584), discrimination improved (B1 AUC 0.750; B2 AUC 0.743), but anaemia remained non-significant. NRI modestly favoured the universal threshold (A1/A2: 0.048; B1/B2: 0.072), with most reclassification occuring in intermediate risk groups. GAMs showed a smooth monotonic relationship without a clear inflection point.</div></div><div><h3>Conclusion</h3><div>Anaemia was not independently associated with postoperative complications. Redefining thresholds altered prevalence but did not improve prediction. Haemoglobin may be better used as part of an integrated perioperative risk assessment rather than a binary stratifier.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 502020"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101216","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":"Variability in the application of patient blood management programs in the Iberian peninsula","authors":"J.A. García Erce ,&nbsp;F. Sabio ,&nbsp;C. Jericó ,&nbsp;S. Isabel Jorge ,&nbsp;M. Quintana Díaz ,&nbsp;D. Castro Paupério","doi":"10.1016/j.redare.2026.502017","DOIUrl":"10.1016/j.redare.2026.502017","url":null,"abstract":"<div><h3>Background</h3><div>In 2010, the World Health Organization (WHO) called for global implementation of Patient Blood Management (PBM) programs to optimize transfusion practices and reduce variability in blood utilization. This study examines the evolution of red cell, platelet, and plasma consumption in Iberia (Spain and Portugal), comparing trends within the region and with European benchmarks like the United Kingdom, Germany, and Italy.</div></div><div><h3>Methods</h3><div>National transfusion activity reports from Spain, Portugal, the United Kingdom (2011–2023) were analyzed. Key metrics included transfusion rates per 1,000 inhabitants for red cells, platelets, and fresh frozen plasma. Statistical analyses were performed using Kruskal–Wallis tests and ANOVA to identify differences between countries and over time.</div></div><div><h3>Results</h3><div>From 2011 to 2023, red cell transfusion rates decreased by 30% in the UK, 6% in Spain, and 15% in Portugal. Germany showed a modest decline, while Italy maintained stable rates exceeding 40 units per 1,000 inhabitants. Platelet and plasma consumption exhibited distinct patterns, with Portugal showing a steeper decline compared to Spain, and the UK maintaining the lowest overall rates. Platelet consume is clearly increasing.</div></div><div><h3>Conclusions</h3><div>The analysis reveals significant differences in blood component utilization across Iberia and Europe, reflecting varying levels of PBM adoption. Despite WHO and Council of Europe recommendations, Iberian countries lag behind the UK in reducing red cell transfusion rates. These findings underscore the need for uniform PBM implementation to harmonize practices and optimize resource use, not only Red Cell Concentrates. The creation of the Iberian task-force (section of the Ibero-American PBM Society (SIAPBM) could be an opportunity to create the necessary awareness in our countries and become a meeting point between America and Europe.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 502017"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992390","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":"Videolaryngoscopy versus direct laryngoscopy for tracheal intubation by anesthesia residents in the operating room: The randomized multicenter VILARE trial protocol","authors":"M. Taboada ,&nbsp;M. Bermúdez ,&nbsp;J. Fernández ,&nbsp;A. Estany-Gestal ,&nbsp;J.J. Amate ,&nbsp;R. Ruido ,&nbsp;M. Amor ,&nbsp;R. Mato ,&nbsp;C. Barreiro ,&nbsp;P. Martínez ,&nbsp;F. Ramasco ,&nbsp;O. Vázquez ,&nbsp;T. Seoane-Pillado","doi":"10.1016/j.redare.2026.501988","DOIUrl":"10.1016/j.redare.2026.501988","url":null,"abstract":"<div><h3>Introduction</h3><div>Tracheal intubation using direct laryngoscopy with a Macintosh blade remains the standard technique in the operating room. However, this method requires precise anatomical alignment and direct visualization of the glottis, which can be challenging for anesthesia residents with limited experience. Multiple intubation attempts are associated with an increased risk of complications. Videolaryngoscopy allows indirect visualization of the glottis and enables real-time supervision and feedback during the procedure, potentially improving safety and facilitating learning. Although videolaryngoscopy has shown benefits in difficult airway scenarios and in experienced hands, evidence is limited on whether it improves first-pass success and reduces complications when used by anesthesia residents in patients without predicted airway difficulty. The aim of this study is to compare first-pass intubation success with videolaryngoscopy versus direct laryngoscopy when performed by anesthesia residents in the operating room.</div></div><div><h3>Methods and analysis</h3><div>The VILARE trial is a prospective, multicenter, randomized, open-label study. A total of 1008 adult patients undergoing elective or urgent surgery under general anesthesia, without predictors of difficult airway, will be randomized to undergo tracheal intubation using either a standard Macintosh direct laryngoscope or a Macintosh videolaryngoscope on the first attempt. All tracheal intubations will be performed by anesthesia residents. The primary endpoint is successful intubation on the first attempt. Secondary outcomes time for successful tracheal intubation, attempts for successful intubation, laryngoscopic vision with the modified Cormack-Lehane scale, need of adjuvant airway devices for intubation, subjective difficulty of intubation, and complications during tracheal intubation (e.g., desaturation, dental trauma).</div></div><div><h3>Ethics and dissemination</h3><div>The study protocol was approved November 28, 2024, by the Ethics Committee of Galicia, Spain (CEI-SL, code No. 2024/394).and was registered into the Clinicaltrials.gov clinical trials registry with No. <span><span>NCT06842082</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 videolaryngoscopy improves first-attempt intubation success and reduces complications in anesthesia residents, its use may be recommended as the first-line device in anesthesia training programs.</div></div><div><h3>Trial registration number</h3><div>ClinicalTrials.gov Registry: <span><span>NCT06842082</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 501988"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986137","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":"Delirium in the postoperative patient","authors":"C. Chamorro-Falero ,&nbsp;J. García-García ,&nbsp;J.J. Morales-Domene","doi":"10.1016/j.redare.2025.501987","DOIUrl":"10.1016/j.redare.2025.501987","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 501987"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812315","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":"Practical guidance and recommendations for the safe management of the pediatric airway in anesthesia","authors":"D. Pérez-Ajami ,&nbsp;F. Escribá Alepuz ,&nbsp;J.D. Jiménez Santana ,&nbsp;B. Aguado Rodríguez ,&nbsp;E. Estupiñán Valido","doi":"10.1016/j.redare.2026.501998","DOIUrl":"10.1016/j.redare.2026.501998","url":null,"abstract":"<div><div>Advanced airway management in pediatric anesthesia has undergone substantial development with the incorporation of emerging technologies and strategies tailored to the unique anatomy and physiology of children. This review provides a critical appraisal of the clinical utility of tools such as videolaryngoscopy, high-flow nasal cannula oxygen therapy, and supraglottic devices, as well as specific techniques including the Bailey maneuver, fiberoptic-assisted intubation, and one-lung ventilation. Relevant studies published up to March 2025 were identified through searches in PubMed, Embase, Scopus, and Web of Science. Current evidence supports the use of these resources to enhance safety and effectiveness in complex scenarios, underscoring the importance of individualized device selection and specialized training. The integration of these strategies into tailored protocols represents a key step toward optimizing airway management in pediatric patients.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 501998"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095401","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":"Subcutaneous emphysema as an airway emergency following tracheostomy closure","authors":"M. Linares,&nbsp;G. Álvarez Roca,&nbsp;R. Riera-Pérez,&nbsp;M. López-Baamonde","doi":"10.1016/j.redare.2026.502018","DOIUrl":"10.1016/j.redare.2026.502018","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 502018"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046940","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 preanesthetic consultation on presurgical anxiety assessed using the Amsterdam Preoperative Anxiety and Information Scale","authors":"M.M. Ureña Consuegra,&nbsp;Y.V. Llaverías Guzmán,&nbsp;L.R. Peralta Henson,&nbsp;S.E. Tejada Estrella,&nbsp;V.M. Cepeda Santos","doi":"10.1016/j.redare.2026.502005","DOIUrl":"10.1016/j.redare.2026.502005","url":null,"abstract":"<div><h3>Background</h3><div>Preanesthesia consultation can be an effective tool for reducing anxiety scores in patients scheduled for elective surgery. Anxiety can cause perioperative complications.</div></div><div><h3>Objective</h3><div>was to determine the impact of preanesthesia consultation on anxiety scores.</div></div><div><h3>Patients and methods</h3><div>A single-center, observational study was carried out, with a descriptive, cross-sectional design and primary source. The anxiety score assessed using the APAIS scale (Amsterdam Preoperative Anxiety and Information Scale) was evaluated in adult participants before and after the pre-anesthetic consultation during the period December 2024 to April 2025. Statistical analysis was performed using the Wilcoxon, McNemar and chi-square tests. A P value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 190 participants were interviewed, of whom 180 were ultimately analyzed; 76.7% were women, and the mean age was 41.6 years. The most frequent procedures were general surgery and gynecological procedures. 86.7% had previously received anaesthesia. The prevalence of pre-consultation anxiety was 68.3%, decreasing to 47.2% after the consultation (<em>p</em> = 0.001). All interviewees between the ages of 18 and 25 reported anxiety before the pre-anaesthesia consultation (<em>p</em> = 0.031). The anesthetic technique that generated the greatest fear was general anaesthesia (42.8%), with the most frequently reported cause being fear of death (15.6%).</div></div><div><h3>Conclusion</h3><div>Preoperative anxiety is highly prevalent, and preanesthetic consultation could be an effective intervention to significantly reduce it.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 502005"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101246","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":"Erector spinae plane block in neonates: Case study","authors":"J.A. Orozco Arango ,&nbsp;P.A. Cruces Muñoz","doi":"10.1016/j.redare.2026.502019","DOIUrl":"10.1016/j.redare.2026.502019","url":null,"abstract":"<div><div>Pain in neonates, if not adequately treated, can lead to long-term neurological and behavioural consequences. Among the most frequent causes are intrapartum fractures. Although rare, rib fractures represent a diagnostic and therapeutic challenge. This article presents the case of a 36-week neonate with a left rib fracture who exhibited symptoms such as inconsolable crying, feeding refusal, and oxygen desaturation. An ultrasound-guided erector spinae plane block (ESPB) was performed, resulting in significant clinical improvement without complications. Although ESPB has been widely used in adults and older children for the management of thoracic pain, its application in neonates is scarcely documented. This technique offers advantages over other regional analgesic methods, as it is associated with fewer adverse effects and provides direct analgesia to the thoracic nerves. Its use is suggested as a safe and effective alternative, particularly in non-surgical settings.</div></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 2","pages":"Article 502019"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101270","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":"Response to the letter to the editor regarding: ‘New-onset neuropathic and chronic pain in survivors of severe COVID-19: secondary analysis of the PAIN-COVID trial’","authors":"A. Ojeda,&nbsp;T. Cuñat,&nbsp;Ó. Comino-Trinidad,&nbsp;J. Aliaga,&nbsp;M. Arias,&nbsp;A. Calvo","doi":"10.1016/j.redare.2025.501997","DOIUrl":"10.1016/j.redare.2025.501997","url":null,"abstract":"","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":"73 1","pages":"Article 501997"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759052","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}