Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Jun 2016
Case ReportsRespiratory monitoring with electrical impedance tomography for lung protective ventilation and alveolar recruitment maneuver in a patient with a single lung transplant and early graft dysfunction.
A case is presented on a patient who underwent left single lung transplantation for emphysema type COPD. There was early graft dysfunction gradeiii during the immediate postoperative period, which required the implantation of an extracorporeal membrane oxygenator (ECMO). ⋯ On monitoring the pulmonary tidal volume distribution by bedside electrical impedance tomography (EIT), it was noted that most of the tidal volume was distributed in the native lung emphysema. An alveolar recruitment manoeuvre was performed, under control of the EIT, that enabled the current volume and distribution and the pressures required to ventilate the transplanted lung to be observed.
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Rev Esp Anestesiol Reanim · Jun 2016
Reliability and validity of the Spanish version of the modified Yale Preoperative Anxiety Scale.
To minimise preoperative stress and increase child cooperation during induction of anaesthesia is one of the most important perioperative objectives. The modified Yale Preoperative Anxiety Scale was developed to evaluate anxiety. The aim of this study was to translate into Spanish, and validate the psychometric properties of the Spanish version of this scale. ⋯ Validated assessment tools are needed to evaluate interventions to reduce child preoperative anxiety. The Spanish version of the modified Yale Preoperative Anxiety Scale evaluated in this study has shown good psychometric properties of reliability and validity.
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Rev Esp Anestesiol Reanim · Jun 2016
Hospital mortality in postoperative critically ill patients older than 80 years. Can we predict it at an early stage?
To determine the incidence of in-hospital mortality throughout the post-surgical period of patients aged 80 or over who were admitted to the post-surgical critical care unit, as well as to assess the predictive capacity of those variables existing in the first 48hours on the in-hospital mortality. ⋯ The incidence of hospital mortality in very old patients found in our study is comparable to that reported by other authors. Patients who need mechanical ventilation over 48h, and with higher scores in the APACHE II scale could be at a higher risk of in-hospital mortality.
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Rev Esp Anestesiol Reanim · Jun 2016
Characteristics of particulate and non-particulate corticosteroids. Indications for their use in chronic pain treatments.
Corticosteroids been used frequently in pain treatments since the middle of last century (1952). Due to a review of the complications as a result of their application in epidural injections, the United States of America Food and Drug Administration (FDA) issued an «alert controversy» requesting that a warning label should be added to injectable corticosteroids, where risks must be described (loss of sight, brain damage, paralysis and death) when administering by this route. It must be mentioned that there are different types of corticosteroids with diverse characteristics, which as a result, may produce different side-effects. Due to the aforementioned developments, the controversies that have arisen, and the lack of well-conducted studies on the use of steroids in epidural injections, we must begin by reviewing their indications in different pain conditions.
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Rev Esp Anestesiol Reanim · May 2016
ReviewManagement of bleeding and coagulopathy following major trauma.
Bleeding is the most common preventable cause of death in trauma patients. Acute traumatic coagulopathy is a specific condition with a different pathophysiology from other causes of the massive bleeding. ⋯ There have been many changes in the management of massive hemorrhage, for example, the administration of the tranexamic acid and the use of balanced transfusion ratio. This review presents these practical points, some of them with scientific evidence, in order to achieve a beneficial effect for patient outcomes.