Revista espanola de anestesiologia y reanimacion
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Rev Esp Anestesiol Reanim (Engl Ed) · Apr 2021
Ultrasound-guided brachiocephalic vein access in neonates and pediatric patients.
Central venous accesses in neonates and pediatric patients represent a common and important procedure for both, intraoperative and postoperative care. Point-of-care ultrasound-guided technique has been proposed to increased success rate and efficiency, as well as to decrease the number of complications. ⋯ Another central venous cannulation option in neonates and children has been supraclavicular ultrasound-guided cannulation of the brachiocephalic vein using the in-plane approach. This article gives a review of the current evidence, the basic knowledge of the technique and the structured approach to follow for supraclavicular ultrasound-guided brachiocephalic vein access in children and neonates.
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Rev Esp Anestesiol Reanim (Engl Ed) · Jan 2021
Case ReportsDisseminated intravascular coagulation as a form of presentation of coronavirus-19 disease. Clinical case.
The covid-19 disease (coronavirus disease 2019) is a novel disease causing a world pandemic. Its presentation varies from an asymptomatic infection to a pneumonia with acute respiratory distress syndrome. ⋯ On the contrary, a higher incidence of arterial thrombosis has not been described in these patients. The unusual case we present could be a manifestation of this altered tests.
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Rev Esp Anestesiol Reanim (Engl Ed) · Dec 2020
Case ReportsThe value of hypotensive prediction index and dP/dtmax to predict and treat hypotension in a patient with a dilated cardiomyopathy.
The Hypotension Prediction Index (HPi) is a new parameter, recently developed to predict the risk of a patient developing a hypotensive event, defined as a fall in mean arterial pressure below 65 mmHg. The calculated HPi value is displayed on a monitor as a number ranging from 1 to 100; where the first warning for the appearance of such event occurs when HPi values exceed 85. ⋯ We recommend the use of a HPi value >85 as a warning of intervention, and to use the secondary screen to determine the cause and the treatment. We consider that HPi technology may be a valid alternative for the anaesthetic management of patients with a dilated cardiomyopathy.
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Rev Esp Anestesiol Reanim (Engl Ed) · Nov 2020
Case ReportsPostpartum consciousness disturbance: can covid-19 cause posterior reversible encephalopathy syndrome?
We describe the case of a 24-year-old pregnant woman with no history of note who was admitted with a diagnosis of bilateral pneumonia caused by the new coronavirus. Due to clinical worsening, she required urgent cesarean section with general anaesthesia and intubation for decubitus intolerance. After extubation, she presented altered mental state that required a differential diagnosis of encephalitis/meningitis secondary to SARS-CoV-2. ⋯ Eleven days after the cesarean section the patient began to develop hypertension that required treatment. PRES is associated with certain clinical (headache, altered mental state, visual disturbances and convulsions) and radiological (reversible changes in white substance mainly affecting the parietal, temporal, and occipital lobes) characteristics suggestive of vasogenic oedema In pregnant SARS-CoV-2 patients, the differential diagnosis of hypertension and altered mental state is often extremely complicated because complementary tests can be normal and there is no immediate sign of peripartum hypertension. SARS-CoV-2 genome sequencing in spinal fluid could have provided a definitive diagnosis, but the treatment would not have differed.