Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Mar 2007
Review[Epidural fat in various diseases: contribution of magnetic resonance imaging and potential implications for neuro axial anesthesia].
Epidural fat is a reservoir of lipophilic substances that cushions the pulsatile movements of the dural sac, protects nerve structures, and facilitates the movement of the dural sac over the periosteum of the spinal canal during flexion and extension. Excessive epidural fat can compress the underlying structures, however, and affect the placement of catheters and the distribution of injected solutions. ⋯ The relevance of epidural fat in spinal surgery is considered. Finally, we discuss the possible anesthetic implications of the abnormal deposition of epidural fat, to explain the unexpected complications that can arise during performance of epidural anesthesia.
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Rev Esp Anestesiol Reanim · Mar 2007
Clinical Trial[Effect of tranexamic acid on postoperative bleeding in pediatric heart surgery].
To assess the effects of a single dose of tranexamic acid on bleeding and requirement for blood product transfusion in children undergoing cardiac surgery with cardiopulmonary bypass. ⋯ A single preoperative dose of tranexamic acid to inhibit fibrinolysis reduces bleeding 24.8% in pediatric patients undergoing heart surgery with cardiopulmonary bypass. The effect is greater in reoperated patients, leading to a reduction in their requirement for transfusion. The use of this therapy in these patients is therefore highly justified.
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Risk of morbidity and mortality increases for critically ill patients during transfers within the hospital. Such patients often require sedation, and suboptimal sedation is associated with hypertension, tachycardia, and ventilator dyssynchrony. The aim of this study was to assess level of sedation as indicated by monitoring of the bispectral (BIS) index during intrahospital transport of critical patients. ⋯ Monitoring the BIS index during intrahospital transport of sedated, mechanically ventilated patients may be useful for detecting inadequate sedation.