G. Madrid, E. Arango, L. Ferrer, R. Murillo, O. Amaya, Juan Cortés, M. Solórzano, L. Ramirez, C. Ariza, M. C. Montoya, Felipe Gómez, J. Caicedo, F. Raffán-Sanabria, J. Moyano
Introduction: Prostatectomy is the standard treatment for patients with clinically localized prostate cancer. Currently, robot-assisted radical prostatectomy (RARP) is widely used for its advantages, as it provides better visualization, precision, and reduced tissue manipulation. However, RARP requires a multidisciplinary approach in which anesthesia and analgesia management are especially important. Objective: This study aims to describe our experience delivering anesthesia for the first cases of patients undergoing RARP in a teaching hospital in Bogotá, Colombia. Methodology: An observational study was conducted. We included all patients undergoing RARP from September 2015 to December 2019 at Fundación Santa Fe de Bogotá. All patients with incomplete data were excluded. Patient demographics were recorded, and significant perioperative events were reviewed. Results: A total of 301 patients were included. At our institution, the mean age for patients undergoing RARP was 61.4 ± 6.7 years. The mean operative time was 205 ± 43 min and mean blood loss was 300 [200-400] mL. Only 6 (2%) patients required transfusion. Age and BMI were not associated with clinical outcomes. Conclusions: An adequate perioperative approach in RARP is important to minimize complications, which in this study and in this institution were infrequent.
{"title":"Characteristics of patients undergoing robotic-assisted prostatectomy. Observational study","authors":"G. Madrid, E. Arango, L. Ferrer, R. Murillo, O. Amaya, Juan Cortés, M. Solórzano, L. Ramirez, C. Ariza, M. C. Montoya, Felipe Gómez, J. Caicedo, F. Raffán-Sanabria, J. Moyano","doi":"10.5554/22562087.e984","DOIUrl":"https://doi.org/10.5554/22562087.e984","url":null,"abstract":"Introduction: Prostatectomy is the standard treatment for patients with clinically localized prostate cancer. Currently, robot-assisted radical prostatectomy (RARP) is widely used for its advantages, as it provides better visualization, precision, and reduced tissue manipulation. However, RARP requires a multidisciplinary approach in which anesthesia and analgesia management are especially important. \u0000Objective: This study aims to describe our experience delivering anesthesia for the first cases of patients undergoing RARP in a teaching hospital in Bogotá, Colombia. \u0000Methodology: An observational study was conducted. We included all patients undergoing RARP from September 2015 to December 2019 at Fundación Santa Fe de Bogotá. All patients with incomplete data were excluded. Patient demographics were recorded, and significant perioperative events were reviewed. \u0000Results: A total of 301 patients were included. At our institution, the mean age for patients undergoing RARP was 61.4 ± 6.7 years. The mean operative time was 205 ± 43 min and mean blood loss was 300 [200-400] mL. Only 6 (2%) patients required transfusion. Age and BMI were not associated with clinical outcomes. \u0000Conclusions: An adequate perioperative approach in RARP is important to minimize complications, which in this study and in this institution were infrequent.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45339519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subarachnoid opioids for cesarean section. Letter to the Editor","authors":"Carlos Wenceslao Sotelo Ciudad","doi":"10.5554/22562087.E982","DOIUrl":"https://doi.org/10.5554/22562087.E982","url":null,"abstract":" \u0000 ","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46089980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hugo Tolosa Pérez, Sebastián Gómez Santamaría, Laura Quintana Puerta, Miguel Andrés Bedoya López, Nicolás Echeverri Restrepo, Alejandra Gallo Parra, Leyla Margarita Redondo Morales, C. Urrego, José R. Jaramillo, Carolina Franco Roldán, José Hugo Arias, Nury Socha
Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.
{"title":"Incidence of post-anesthetic respiratory complications in pediatrics. Observational, single-center study in Medellin, Colombia","authors":"Hugo Tolosa Pérez, Sebastián Gómez Santamaría, Laura Quintana Puerta, Miguel Andrés Bedoya López, Nicolás Echeverri Restrepo, Alejandra Gallo Parra, Leyla Margarita Redondo Morales, C. Urrego, José R. Jaramillo, Carolina Franco Roldán, José Hugo Arias, Nury Socha","doi":"10.5554/22562087.E981","DOIUrl":"https://doi.org/10.5554/22562087.E981","url":null,"abstract":"Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics. \u0000Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications. \u0000Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit. \u0000Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications. \u0000Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43200232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Henry Jair Mayorga Anaya, M. T. Torres Ortiz, Daniel Hernando Flórez Valencia, Ómar Fernando Gomezese Ribero
Fibromyalgia is a chronic disease of unclear etiology, involving a neural oversensitization and impaired pain modulation, in addition to a clinical deficiency of the endocannabinoid system. Fibromyalgia is associated with a number of somatic and psychological disorders and hence multiple pharmacological approaches have been used, including opioids, antidepressants, antiepileptics, and more recently medical cannabis. This narrative review comprises a review of the current literature on the efficacy of cannabinoids in fibromyalgia. The studies describe a possible influence of cannabis on pain control in patients with fibromyalgia, with positive effects on quality of life and sleep. The use of cannabis seems to be beneficial in patients with fibromyalgia; however, more robust studies are still needed to establish is actual efficacy in pain management, quality of life and improvement of associated symptoms.
{"title":"Efficacy of cannabinoids in fibromyalgia: a literature review","authors":"Henry Jair Mayorga Anaya, M. T. Torres Ortiz, Daniel Hernando Flórez Valencia, Ómar Fernando Gomezese Ribero","doi":"10.5554/22562087.E980","DOIUrl":"https://doi.org/10.5554/22562087.E980","url":null,"abstract":"Fibromyalgia is a chronic disease of unclear etiology, involving a neural oversensitization and impaired pain modulation, in addition to a clinical deficiency of the endocannabinoid system. Fibromyalgia is associated with a number of somatic and psychological disorders and hence multiple pharmacological approaches have been used, including opioids, antidepressants, antiepileptics, and more recently medical cannabis. This narrative review comprises a review of the current literature on the efficacy of cannabinoids in fibromyalgia. The studies describe a possible influence of cannabis on pain control in patients with fibromyalgia, with positive effects on quality of life and sleep. The use of cannabis seems to be beneficial in patients with fibromyalgia; however, more robust studies are still needed to establish is actual efficacy in pain management, quality of life and improvement of associated symptoms.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46389942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
W. F. Amaya-Zúñiga, Viviana Mojica-Manrique, Iván Santos-Gutiérrez, Julia Alfonso-Jaimes
The illegal use of liquid silicone products or biopolymers in gluteal augmentation procedures is giving rise to multiple complications, with a significant negative health impact, both in the short and long-term. The migration of polymers to the sacral and lumbar region represents a major limitation to conducting neuraxial anesthesia procedures. This silicon migration is unpredictable through the superficial tissue as is widely described in the literature. Caudal, spinal and epidural anesthesia may cross the silicone in the fascia and contaminate the neural axis with substances that are highly capable of causing inflammation, edema and tissue necrosis. In order to improve the safety of neuraxial anesthetic procedures and avoid the potential risk of dissemination and contamination of the neural axis, this complication must be ruled out, or be considered an emerging contraindication for these anesthetic procedures.
{"title":"Migration of liquid silicone, an emerging contraindication of neuraxial anesthesia","authors":"W. F. Amaya-Zúñiga, Viviana Mojica-Manrique, Iván Santos-Gutiérrez, Julia Alfonso-Jaimes","doi":"10.5554/22562087.E977","DOIUrl":"https://doi.org/10.5554/22562087.E977","url":null,"abstract":"The illegal use of liquid silicone products or biopolymers in gluteal augmentation procedures is giving rise to multiple complications, with a significant negative health impact, both in the short and long-term. The migration of polymers to the sacral and lumbar region represents a major limitation to conducting neuraxial anesthesia procedures. This silicon migration is unpredictable through the superficial tissue as is widely described in the literature. Caudal, spinal and epidural anesthesia may cross the silicone in the fascia and contaminate the neural axis with substances that are highly capable of causing inflammation, edema and tissue necrosis. In order to improve the safety of neuraxial anesthetic procedures and avoid the potential risk of dissemination and contamination of the neural axis, this complication must be ruled out, or be considered an emerging contraindication for these anesthetic procedures.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48501851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juan José Correa Barrera, Blanca Gómez del Pulgar Vázquez, Adriana Orozco Vinasco, Purificación Sánchez Zamora, Sonia Sánchez Solano, N. M. Gisbert, Ruben Saz Castro, D. M. O. Vinasco, Mónica San Juan Álvarez, Antonio García Rueda
The agent that causes the coronavirus disease (COVID-19), associated with the severe acute respiratory syndrome (SARS-CoV-2), produces a spectrum of symptoms that mainly affect the respiratory system, the central nervous system (CNS), the regulation of hemostasis and the immune system. Bilateral vocal fold paralysis (BVFP) is a condition of unknown incidence among infected patients, either because it is short-lived or because of the difficulty in establishing a direct cause to the virus. Viral infection has been described in the literature as a cause of BVFP and there is the suspicion that a proportion of the idiopathic cases are due to undiagnosed viral infections. Although the neurotropic mechanisms for SARS-CoV-2 remain unclear, there is strong evidence to ensure its neuroinvasive potential. The most frequent etiologies of BVFP are trauma, neoplasm, and neurological, but a viral origin should not be ruled out. Causality between COVID-19 and BVFP is plausible and will require further study in the short and long term.
{"title":"Bilateral vocal fold paralysis after COVID-19 infection. Another neuro-invasive manifestation? Case series","authors":"Juan José Correa Barrera, Blanca Gómez del Pulgar Vázquez, Adriana Orozco Vinasco, Purificación Sánchez Zamora, Sonia Sánchez Solano, N. M. Gisbert, Ruben Saz Castro, D. M. O. Vinasco, Mónica San Juan Álvarez, Antonio García Rueda","doi":"10.5554/22562087.E978","DOIUrl":"https://doi.org/10.5554/22562087.E978","url":null,"abstract":"The agent that causes the coronavirus disease (COVID-19), associated with the severe acute respiratory syndrome (SARS-CoV-2), produces a spectrum of symptoms that mainly affect the respiratory system, the central nervous system (CNS), the regulation of hemostasis and the immune system. Bilateral vocal fold paralysis (BVFP) is a condition of unknown incidence among infected patients, either because it is short-lived or because of the difficulty in establishing a direct cause to the virus. Viral infection has been described in the literature as a cause of BVFP and there is the suspicion that a proportion of the idiopathic cases are due to undiagnosed viral infections. Although the neurotropic mechanisms for SARS-CoV-2 remain unclear, there is strong evidence to ensure its neuroinvasive potential. The most frequent etiologies of BVFP are trauma, neoplasm, and neurological, but a viral origin should not be ruled out. Causality between COVID-19 and BVFP is plausible and will require further study in the short and long term.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44745203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio Alejandro Sepúlveda López, Luz María Jiménez Muñoz, J. Uribe, Jorge Alberto Castro Pérez
Patients with implantable electric stimulation devices are challenging to the anesthesiologist since these cases demand a comprehensive knowledge about how the device operates, the indications for the implant and the implications that must be addressed during the perioperative period . This article is intended to provide the reader with clear and structured information so that the anesthesiologist will be able to safely deal with the situation of a patient with an implantable cardiac stimulation device, who has been programmed for emergent surgery. A search for the scientific evidence available was conducted in Pubmed / Medline, ScienceDirect, OVID, SciELO), for a non-systematic review. The incidence of the use of cardiac electric stimulation devices has been growing. Their operation is increasingly complex, and demands being constantly updated on the knowledge in the area.
{"title":"Patient with an implantable cardiac electrical stimulation device. What should the anesthesiologist know?","authors":"Fabio Alejandro Sepúlveda López, Luz María Jiménez Muñoz, J. Uribe, Jorge Alberto Castro Pérez","doi":"10.5554/22562087.E976","DOIUrl":"https://doi.org/10.5554/22562087.E976","url":null,"abstract":"Patients with implantable electric stimulation devices are challenging to the anesthesiologist since these cases demand a comprehensive knowledge about how the device operates, the indications for the implant and the implications that must be addressed during the perioperative period . This article is intended to provide the reader with clear and structured information so that the anesthesiologist will be able to safely deal with the situation of a patient with an implantable cardiac stimulation device, who has been programmed for emergent surgery. A search for the scientific evidence available was conducted in Pubmed / Medline, ScienceDirect, OVID, SciELO), for a non-systematic review. The incidence of the use of cardiac electric stimulation devices has been growing. Their operation is increasingly complex, and demands being constantly updated on the knowledge in the area.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46123901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexander Trujillo Mejía, Juan Carlos Quintero Toro
The SARS-CoV-2 virus affects all age groups. According to the Colombian National Institute of Health, by November 5, 2020, nearly 83,698 children under 18 years of age had been infected by the virus in Colombia. The probability of viral transmission in this age group is similar to that found in adults, even in asymptomatic individuals (1,2). The World Health Organization has advocated social distancing, hand washing and the use of face masks as effective measures to mitigate contagion, and healthcare institutions have implemented measures for the protection of patients and healthcare workers in order to cope with this “new normal” at work (3-5). In accordance with national and international recommendations, our institution has implemented a new preoperative care protocol during the COVID-19 pandemic. Recommendations include the use of face mask in patients over 2 years of age during the process of admission to surgery. However, we would like to flag the risk associated with this practice. An 11-year-old male patient, assessed through telemedicine by the anesthetist and found to have no comorbidities, was premedicated in accordance with the institutional protocol based on the oral administration of 1 mg of lorazepam before surgery. After taking the medication, the patient used the face mask as a protective measure. Later, as he felt drowsy, he lay supine while he waited, in the company of his guardian, for his turn in surgery. A few minutes later, the plastic surgeon came to assess the patient before the surgery and finding him to be cyanotic, he activated the Code Blue. The patient responded immediately to physical stimulation and oxygen administration through a face mask, with no sequelae. The SARS-CoV-2 pandemic has affected pediatric surgical services. The biologic risk, plus overcrowding of inpatient services and shortages of medications and supplies, have required the implementation of preoperative screening and modifications in conventional pediatric anesthesia techniques (6,7). However, some reports have shown evidence of unforeseen complications with some techniques and devices, such as the use of breathing filters and aerosol boxes in the pediatric population (8,9). The coronavirus disease has highlighted the importance of preoperative anxiolysis in children to avoid respiratory aerosol development due to agitation or crying when they are separated from their parents and during anesthesia induction. However, what happened to our patient shows how clinical surveillance is compromised by the face mask during the preoperative period, in particular after the administration of sedatives and anxiolytics. This requires the implementation of improved surveillance techniques, especially in preparation for surgery, as well as regular reviews of the efficacy and safety of the new care protocols. For this reason, we suggest continuous pulse-oximetry surveillance in all patients premedicated with anxiolytics from the time of admission to the operatin
{"title":"Associated risks with the use of surgical face mask in children during the COVID-19 pandemic","authors":"Alexander Trujillo Mejía, Juan Carlos Quintero Toro","doi":"10.5554/22562087.E974","DOIUrl":"https://doi.org/10.5554/22562087.E974","url":null,"abstract":"The SARS-CoV-2 virus affects all age groups. According to the Colombian National Institute of Health, by November 5, 2020, nearly 83,698 children under 18 years of age had been infected by the virus in Colombia. The probability of viral transmission in this age group is similar to that found in adults, even in asymptomatic individuals (1,2). The World Health Organization has advocated social distancing, hand washing and the use of face masks as effective measures to mitigate contagion, and healthcare institutions have implemented measures for the protection of patients and healthcare workers in order to cope with this “new normal” at work (3-5). In accordance with national and international recommendations, our institution has implemented a new preoperative care protocol during the COVID-19 pandemic. Recommendations include the use of face mask in patients over 2 years of age during the process of admission to surgery. However, we would like to flag the risk associated with this practice. An 11-year-old male patient, assessed through telemedicine by the anesthetist and found to have no comorbidities, was premedicated in accordance with the institutional protocol based on the oral administration of 1 mg of lorazepam before surgery. After taking the medication, the patient used the face mask as a protective measure. Later, as he felt drowsy, he lay supine while he waited, in the company of his guardian, for his turn in surgery. A few minutes later, the plastic surgeon came to assess the patient before the surgery and finding him to be cyanotic, he activated the Code Blue. The patient responded immediately to physical stimulation and oxygen administration through a face mask, with no sequelae. The SARS-CoV-2 pandemic has affected pediatric surgical services. The biologic risk, plus overcrowding of inpatient services and shortages of medications and supplies, have required the implementation of preoperative screening and modifications in conventional pediatric anesthesia techniques (6,7). However, some reports have shown evidence of unforeseen complications with some techniques and devices, such as the use of breathing filters and aerosol boxes in the pediatric population (8,9). The coronavirus disease has highlighted the importance of preoperative anxiolysis in children to avoid respiratory aerosol development due to agitation or crying when they are separated from their parents and during anesthesia induction. However, what happened to our patient shows how clinical surveillance is compromised by the face mask during the preoperative period, in particular after the administration of sedatives and anxiolytics. This requires the implementation of improved surveillance techniques, especially in preparation for surgery, as well as regular reviews of the efficacy and safety of the new care protocols. For this reason, we suggest continuous pulse-oximetry surveillance in all patients premedicated with anxiolytics from the time of admission to the operatin","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45212765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Manzano-Nuñez, Julián Chica-Yanten, M. P. Naranjo, Isabella Caicedo-Holguín, J. Ordoñez, D. McGreevy, J. Puyana, T. Hörer, Ernest E. Moore, A. García
While reading the novella “Chronicle of a Death Foretold” by the Colombian Nobel Laureate Gabriel Garcia-Marquez, we were surprised to realize that the injuries sustained by the main character could have been successfully treated had he received modern trauma care in which REBOA may have been considered. This is a discussion of Mr. Nasar's murder to explore whether he could have been saved by deploying REBOA as a surgical adjunct to bleeding control and resuscitation. In reading Garcia-Marquez's novel we noted the events that unfolded at the time of Santiago Nasar's murder. To contextualize the claim that Mr. Nasar could have survived, had his injuries been treated with REBOA, we explored and illustrated what could have done differently and why. On the day of his death, Mr. Nasar sustained multiple penetrating stab wounds. Although he received multiple stab wounds to his torso, the book describes seven potentially fatal injuries, resulting in hollow viscus, solid viscus, and major vascular injuries. We provided a practical description of the clinical and surgical management algorithm we would have followed in Mr. Nasar's case. This algorithm included the REBOA deployment for hemorrhage control and resuscitation. The use of REBOA as part of the surgical procedures performed could have saved Mr. Nasar's life. Based on our current knowledge about REBOA in trauma surgery, we claim that its use, coupled with appropriate surgical care for hemorrhage control, could have saved Santiago Nasar's life, and thus prevent a death foretold.
{"title":"Use of REBOA in the universe of magical realism: a real-world review","authors":"R. Manzano-Nuñez, Julián Chica-Yanten, M. P. Naranjo, Isabella Caicedo-Holguín, J. Ordoñez, D. McGreevy, J. Puyana, T. Hörer, Ernest E. Moore, A. García","doi":"10.5554/22562087.E973","DOIUrl":"https://doi.org/10.5554/22562087.E973","url":null,"abstract":"While reading the novella “Chronicle of a Death Foretold” by the Colombian Nobel Laureate Gabriel Garcia-Marquez, we were surprised to realize that the injuries sustained by the main character could have been successfully treated had he received modern trauma care in which REBOA may have been considered. This is a discussion of Mr. Nasar's murder to explore whether he could have been saved by deploying REBOA as a surgical adjunct to bleeding control and resuscitation. In reading Garcia-Marquez's novel we noted the events that unfolded at the time of Santiago Nasar's murder. To contextualize the claim that Mr. Nasar could have survived, had his injuries been treated with REBOA, we explored and illustrated what could have done differently and why. On the day of his death, Mr. Nasar sustained multiple penetrating stab wounds. Although he received multiple stab wounds to his torso, the book describes seven potentially fatal injuries, resulting in hollow viscus, solid viscus, and major vascular injuries. We provided a practical description of the clinical and surgical management algorithm we would have followed in Mr. Nasar's case. This algorithm included the REBOA deployment for hemorrhage control and resuscitation. The use of REBOA as part of the surgical procedures performed could have saved Mr. Nasar's life. Based on our current knowledge about REBOA in trauma surgery, we claim that its use, coupled with appropriate surgical care for hemorrhage control, could have saved Santiago Nasar's life, and thus prevent a death foretold.","PeriodicalId":36529,"journal":{"name":"Colombian Journal of Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46678019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Estivalis Acosta-Gutiérrez, Andrés M. Alba-Amaya, Santiago Roncancio-Rodríguez, José Ricardo Navarro-Vargas
Adult In-hospital Cardiac Arrest (IHCA) is defined as the loss of circulation of an in-patient. Following high-quality cardiopulmonary resuscitation (CPR), if the return of spontaneous circulation (ROSC) is achieved, the post-cardiac arrest syndrome develops (PCAS). This review is intended to discuss the current diagnosis and treatment of PCAS. To approach this topic, a bibliography search was conducted through direct digital access to the scientific literature published in English and Spanish between 2014 and 2020, in MedLine, SciELO, Embase and Cochrane. This search resulted in 248 articles from which original articles, systematic reviews, meta-analyses and clinical practice guidelines were selected for a total of 56 documents. The etiologies may be divided into 56% of in-hospital cardiac, and 44% of non-cardiac arrests. The incidence of this physiological collapse is up to 1.6 cases/1,000 patients admitted, and its frequency is higher in the intensive care units (ICU), with an overall survival rate of 13% at one year. The primary components of PCAS are brain injury, myocardial dysfunction and the persistence of the precipitating pathology. The mainstays for managing PCAS are the prevention of cardiac arrest, ventilation support, control of peri-cardiac arrest arrythmias, and interventions to optimize neurologic recovery. A knowledgeable healthcare staff in PCAS results in improved patient survival and future quality of life. Finally, there is clear need to do further research in the Latin American Population.
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