Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jan 2010
[Survey of perioperative hemostasis and transfusion management in cardiac surgery: how do anesthesiologists practice?].
To determine practices related to control of perioperative hemostasis and transfusion in patients undergoing cardiac surgery in Spain, including the extent to which protocols are being used. ⋯ Hemostasis, perioperative coagulation, and criteria for transfusion vary widely among the hospitals surveyed. Few guidelines are available and they are not often being followed. A high percentage of patients receive transfusions, although not all hospitals can cite a figure. New technology has not been widely applied.
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Rev Esp Anestesiol Reanim · Jan 2010
Review[Applications of noninvasive mechanical ventilation in anesthesiology and postanesthesia recovery care].
Noninvasive ventilation (NIV) can be useful to anesthesiologists working in critical care units, postanesthesia recovery units, operating theaters, or other settings. NIV can help in situations of acute respiratory failure or serve as a preventive measure in patients undergoing interventions under local-regional anesthesia or diagnostic or therapeutic procedures requiring sedation. Successful NIV depends on adequately trained health personnel and the proper choice of material (interfaces, respirators, etc.) for each setting where this modality is used.
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Rev Esp Anestesiol Reanim · Jan 2010
Case Reports[McGrath video laryngoscope used with a Frova intubating introducer for management of the difficult airway].
The McGrath video laryngoscope is a new airway management device. It is similar to the Macintosh laryngoscope but incorporates a blade at a 60 degrees angle and a camera that sends an image to a color display screen connected to the handle. The device, which requires use of an anti-fog substance and an introducer to guide the angled blade, has been reported to aid in the management of difficult airways. ⋯ Advantages of this introducer are that it offers the possibility of administering oxygen or changing the size of the endotracheal tube if the first choice proves inappropriate. We discuss whether or not tests to predict difficult airways are applicable when the McGrath video laryngoscope is being used, given that it is not necessary to align the axes of the 3 airways. We conclude it may be useful to combine the McGrath video laryngoscope and the Frova introducer to manage difficult airways.
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Rev Esp Anestesiol Reanim · Jan 2010
[Monitoring skill acquisition in obstetric epidural puncture at a university hospital using the cumulative sum method].
Skill acquisition in anesthesiology is subject to a great deal of interindividual variability. Our aim was to develop and test an individualized tool for monitoring acquisition of technical skills based on the cumulative sum (CUSUM) approach. This system objectively assesses whether an individual has acquired a minimum skill level and identifies the moment when the skill has been learned. ⋯ Although some third-year residents reach the targeted rate of success quickly, we believe that close supervision is useful to control progress along the learning curve for individuals who need more help.