Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2015
[Treatment of preoperative anemia in major orthopedic surgery].
The prevalence of preoperative anemia in major orthopedic surgery is high and is the main predictive factor for allogeneic blood transfusion. The scheduling of a preoperative visit with sufficient notice (at least 3 weeks before surgery), with a blood count test and a basic iron metabolism study, enables us to treat the anemia and/or improve preoperative hemoglobin levels, thereby reducing the need for transfusion and the risks associated with transfusions. Intravenous iron and/or erythropoietin are treatments for optimizing preoperative anemia, with good levels of scientific evidence.
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Rev Esp Anestesiol Reanim · Jun 2015
[Treatment of anemia in Patient Blood Management from an economic perspective].
The liberal use of transfusions is not only a risk for patients but also represents a significant healthcare expenditure. The rational use of allogeneic blood transfusions and the use of transfusion alternatives, such as the optimization of preoperative hemoglobin levels, can offer substantial savings to health departments by reducing the cost of transfusions and the morbidity related to the transfusions.
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Rev Esp Anestesiol Reanim · Jun 2015
Comparative Study Observational StudyComparison between transthoracic lung ultrasound and a clinical method in confirming the position of double-lumen tube in thoracic anaesthesia. A pilot study.
To compare the ability of lung ultrasound and a clinical method in the confirmation of a selective bronchial intubation by left double-lumen tube in elective thoracic surgery. ⋯ Lung ultrasound was superior to the clinical method in confirming the adequate position of the left double-lumen tube. On the other hand, in confirming the misplacement of the tube, differences between both methods could not be ensured.
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Rev Esp Anestesiol Reanim · Jun 2015
Multicenter Study[Implementation of blood sparing programs in Spain: results of a survey of departments of anesthesiology and resuscitation].
The objective of this article is to determine the availability of a perioperative transfusion management program (Patient Blood Management [PBM]) in various hospitals through a survey that included a description of the preanesthesia visit, the availability and use of the various blood-sparing techniques and the factors limiting their implementation in elective surgery. The survey included 42 questions, directed at the representative departments of anesthesiology of hospitals in Spain (n=91). The survey was conducted from September to November 2012. ⋯ The absence of a well-established circuit and the lack of involvement and collaboration with the surgical team were the main limiting factors in implementing PBM. Currently, the implementation of PBM in Spain could be considered acceptable, but it could also be improved, especially in the treatment of preoperative anemia. The implementation of PBM requires multidisciplinary collaboration among all personnel responsible for perioperative care, including the health authorities.
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Rev Esp Anestesiol Reanim · Jun 2015
Case Reports[Inadequate management of a difficult airway. Case SENSAR of the trimester].
A clinical case reported to SENSAR is presented (www.sensar.org). A patient came to the operating room for surgery for parathyroidectomy. She had several predictors of difficult airway management, including a story of difficulties in previous intubations in other hospitals, as the patient reported. ⋯ Finally, tracheal intubation was achieved after several attempts. Analysis of the incident revealed the active error due to lack of experience of the professional who performed intubation maneuvers, favored by latent factors or contributors as were the complex pathology of the patient and the absence of protocols to difficult airway management in the hospital. Communication and analysis of this incident served to highlight the importance of the security protocols in Anesthesia, and as a result a working group that conducted the current algorithm approach to a difficult airway management was formed, established guidelines for further information patient and deals since clinical training and professional practice for the management of airway devices availables in the hospital.